Loading...
HomeMy WebLinkAbout2551 SANTA BARBARA LN - Building Permits 5111 CITY OF COSTA MESA BUILDING DIVISION F .Er rgrrrIA , DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER � PERMIT � 11 � 802-00449 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2551 SANTA BARBARA LN Status: ISSUED Suite: Applied: 04/02/2002 Vicinity: HARBOR VILLAGE APARTMENTS Issued: 04/02/2002 Parcel Number: 42005103 Zoning: Applicant: POWDERLY, PAUL ISSUED BY: Address: 135 W SANTA FE AV Phone: 714449-7750 FULLERTON,CA - ' Zip: 92832 - Owner: STATE OF CALIFORNIA%CONTINENTAL WINGATE Address ASSOCINC 63 KENDRICK STREET Phone: ONE CHARLES RIVER PLACE Zip: 2494 Contractor: ROYAL ROOFING CO Address: 135 W SANTA FE AVE Phone: (714)449-7750 FULLERTON,CA Zip: 92832 License: 678705 Arch : - Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF 20 YEAR COMP SHINGLES.INSTALL FELT AND APPLY 3 0 YEAR COMP SHINGLES.REPLACE SHEATHING AS REQUIRED IF NECESSARY. FEE SUMMARY Plan Check: $0.00 Calc Valuation: • $15,000.00 Permit: $251.25 Claim Valuation: $15,000.00 SMIP Res: $1.50 SMIP Com: $0.00 Other: $0.00 - Inspection: $0.00 • • Total: $252.75 . , PLANNING&ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: • • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2448-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: . ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the wr which this permit Is issued. I have and will maintain workers'compensation insurance,as required by section 3700 cite 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 at one hundred dollars($100)or less) O I certify th In the pe ormance of the wo or w ' h this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensa n laws California,a agr:.that' should t> ome sub act to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith complywithprovisio , t—a Applicant Signature: 4-+ > 0-..L/C Date: WARNING:FAILURE TO SECURE WORKS 'CO PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND COLLARE($1X,000),IN ADDITION T 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 n der provision of a apter r (comm,ncing 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: r . D->-I' 7 Date: Ce' a—6' . CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business 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.). O I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business end Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-properly 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? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 II an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the Califomia 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? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 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 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 inss.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 9•nature rr :gal 3-A-C er(s) �/rid dap„,...„. ?-Q And/ar Authonzed Applicant T _UDatee CODE I INSPECTIONTYPE QAIE INTTAI5 CODE II INSPECTION TYPE UTE INTIT1AL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final208 Final Plumbing 200 Final Re-Roof ®6 Wl- 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 - ; . . 4c.•5 o CITY OF COSTA MESA A.` CALIFORNIA 92628-1200 P.0.BOX 1200 J `.Iir,.;�IC+�.A DEVELOPMENT SERVICES DEPARTMENT ..:._:- e" October 20, 1986 To: Building Safety Division '� Pacific Bell (2) Business License Division Police Department - Ping. & Research Communication Santa Ana Heights Water Canpany County Administration Office Sanitary District Engineer County Clerk/Board of Supervisors Southern California Edison Co. County Registrar of Voters Southern California Gas Co. County Tax Assessor State Board of Equalization Engineering Division (2) Street Division Finance, Revenue Division United States Post Office, Adams Avenue Fire Prevention United States Post Office, Santa Ana Manager, MID Zip 4 - Santa Ana Mesa Consolidated Water District File (2) Newport-Mesa Unified School District (2) The City of Costa Mesa wishes to advise you that in revising street addresses, the following addresses have been added: OLD ADDRESS NEW ADDRESS A.P. NO. None Lxaellirlgs: 2565 San Clemente Dr. , 101-108, 201-208 420-212-10 2566 San Clemente Dr. , 101-108, 201-208 2569 San Clemente Dr. , 101-108, 201-208 2575 San Clemente Dr. , 101-108, 201-208 2579 San Clemente Dr. , 101-108, 201-208 2551 Santa Barbara Ln. , 101-110, 201-210 2556 Santa Barbara Ln. , 101-110, 201-210 Carports: San Clemente Dr. , A-I Santa Barbara In. , A-D For your convenience we are listing the agencies above that we have notified of the change. In addition to those listed, you are advised to notify your correspondents of the change in order to avoid any possible interruption of mail service. Your cooperation in this matter is appreciated. Sincerely,ok(y MEL E. LEE - Planning Intern ML:alm (F-1-56) cc: Sharon F. Mills Village Investments 1176 Main St. Irvine, CA 92714 Code Enforcement/Business License (714) 754-5234 Building Division (714) 754-5626 Planning Division (714) 754-5245 77 FAIR DRIVE I= j. LiEJ'. \ •rr ' . _ - — _ re s� \ r.:ITS. , `�- ram i t� MUM` Mita= 911111a' BU i I:©J'1,'- .r,�, IIherr. a4 :b." f . EV&Fa j.e.4'. _ 7�Xf� uno ! 'tot ' foil . Kie , " -SI \ aiglita - " -- ALIc,„, iiiw . '...1iegbi -1 . . • - - . • ��ot� �09 1a, tog iA WAY m�� `° `. sm_ it '—N►ERRIM • I Cl CSM / I ,' ei HARBOR * VILLAGE ' .M 4e..W•rolmt. Y•.. uu.r mil • :000, .. FAIRVIEW DEVELOPMENT COMPANY IN ...a.. w.�� I•� x "'X' y' / ;� BURKE• LESTER do ASSOCIATES J // AHCNRECi S ANO PANNING .IDM it MM..MR. UMW iota•4.i.0 MU ON rw..M. . • _* • TYPIcf.L :\.:\t, t 1 25x$ h Bl4REJ•RA LN• .111 . !at= •. 1. g'; 107 •. -0: I� R4 LT{. �_Y-77i F �� ., . • _ • f 04). o •, . .kie pr �C� x • 1 .a to iv.` . `"Ps*, l .� . . I µ' 4.* / . • $ K^ � HARBOR * • VILLAGE ' rig 406 MUMnal MITI IIIII 74iij • FAJAVIEW DE OPMENT COMPANY . ' w COM A h r �_� /� ISJINO: • ' I fid ��•�.i�\' . ■ ' BURKE• LESTER & ASSOCIATES \. \�\ ,� ARCHITECTURE AND PLANNING ,`,02 MOLL•a CALL MR Car MV.tA•OMC OM IIN1 A•MY SPECIAL INSPECTOR REGISTRATION • Job Address Vis"/ (.5fA/7,/J,S,P.e10,,9 S7 cAs ei1F�i0 Name \Ti - Tit/la A 'LA/ 7771# Residence Address //R14-'3 L/,c�o,re,An tP7 Number&Street C/ry aff. pozs-v City nState Zip Laboratory \T. /3' / 46-err--e7/C,it-/c�7,Ps/az �A Address a -38 ttzz �A z 2StreetCity 40145- ate. 9Zhi7 p All licenses listed below must be currently valid and legible copy(s) and must be attached to this registration. DISCIPLINE L.A. COUNTY L.A. CITY ORANGE COUNTY OTHER CONCRETE DUCTILE MOMENT RESISTING FRAME REINFORCING STEEL PRESTRESSING STEEL WELDING HIGH STRENGTH BOLTING STRUCTURAL MASONRY REINFORCED GYPSUM CONCRETE {� INSULATING CONCRETE FILL SPRAYED ON FIRE PROOFING PILINGS, DRILLED PIERS, CAISSONS SPECIAL GRADING, EXCAVATION OR PILLING SPECIAL CASES UNUSUAL HAZARDS I hereby certify that I am qualified by training and experience to perform the inspections for which I hold the above listed Special Inspectors licenses, and will provide all certifications required by the City of Costa Mesa. I will inspect and certify the following procedures: 721 ,22/1c51-/s-A7 4/r 2,Rrct'U• v✓75 TC-6'. ix/ 6,t/g- FclY& 71 z( >9C/'7-75r/A' I will certify not only to the job conditions but that they are in conformance with the approved plans. If at any time, progress occurs on the above mentioned job relating to my area(s) of responsibility, without my knowl- edge or approval, I will stop the jobs progress immediately with notification in writing to the job superintendent and notify the Building Division of the situation. A record of my tests and/or inspections as agreed to above will be available upon request by the Building Division. Upon request I will submit a complete package of testing and inspection results, A letter certifying satisfactory completion will be provided by me upon completion. t—la, 2i a Signature 4— Date This registration is accepted and approved by: a 4-/0 •gc (Plan Check Engineer) (Building 0 ficial) (Date) CMF 1068-46 White• Building Division; Canary•Special inspector; Pink• Developer City of Costa Mesa INSULATION CERTIFICATION . Building Safety Division 2551 Santa Barbara.Lane Costa Mesa Orange Number and Street City County Tract 12594 Subdivision Lot Number DESCRIPTION OF INSTALLATION ROOF Material N/A Brand Name Thickness (inches) Thermal Resistance (R Value) EXTERIOR WALL Material Fiber Glass Batt Brand Name Manville Gold Fiber Glass Thickness (inches) 3} Thermal Resistance (R Value) R-11 CEILING Ban or Blanket Type Fiber Glass Batt Brand Name Manville Gold Fiber Glass Thickness (inches) 6 Thermal Resistance (R Value) R-19 Loose Fill Type N/A Brand Name Minimum Thickness (inches) N/A Number of bags Weight per bag lb. Area Covered (ft2) N/A Thermal Resistance (R Value) FLOOR, ELEVATED Material Fiber Glass Batt Brand Name Manville Gold Fiber Glass Thickness (inches) 3} Thermal Resistance (R Value) R-11 FLOOR,SLAB Material N/A Brand Name Thickness (inches) Thermal Resistance (R Value) Width (inches) FOUNDATION WALL Material N/A Brand Name Thickness (inches) Thermal Resistance (R Value) DECLARATION I hereby certify that the above insulation was installed in the building at the above location in conformance with the current regulations setting Energy Conservation Standards for new residential buildings (located in Title 24 of the California Administrative Code). Fairview Development Company B 496001 General Contractor(Builder) License Number .kz Ga'lr �. /SLG rC{Ca� !�P May 8, 1987 Signature and Title Date Red's Insulation 381933 Sub Contractor(Insulation Applicator) License Number ` May 8, 1987 Signature and Title — Date CMF 1106-46 Don Greek DC++ and flssooiotes CONSULTING CIVIL ENGINEERS ENVIRONMENTAL ENGINEERS SURVEYORS May 18, 1987 CITY OF COSTA MESA Department of Public Works 77 Fair Drive Costa Mesa, CA 92626 Attention: Mr. Gary Conlon SUBJECT: TRACT 12594, GRADING CERTIFICATION (FILE 1250) Dear Mr. Conlon: This is to certify that the final grading for Buildings 1 through 5 for the above-referenced tract has been completed in substantial conformance with the grades shown on the approved grading plan. Very truly yours, DON GREEK AND ASSOCIATES eithiLPThi-laCki SURENDER DEWAN, P.E. R.C.E. 34559 rtk cc: Fairview Development, Attn: Mr. Frank Kindstrand QQpf ESS/ (44 NOER q / �`��e\ rn in NO. 34559 *; "4 p.Iv 4�<Q: E OF CAtf 2438 N.GRAND AVE., • SUITE L • SANTA ANA,CA 92701 • (7141543-0990 r DC19Don Greek and fRssooiates CONSULTING CIVIL ENGINEERS ' { ENVIRONMENTAL ENGINEERS SURVEYORS July 22, 1987 CITY OF COSTA MESA Department of Public Works 77 Fair Drive Costa Mesa, CA 92626 Attention: Mr. Gary Conlon SUBJECT: TRACT 12594 - GRADING CERTIFICATION (FILE 1250) Dear Mr. Conlon: This is to certify that the final grading for Buildings 6 and 7 for the above-referenced tract has been completed in substantial conformance with the grades shown on the approved grading plan. Very truly yours, DON �GREEK AND ASSOCIATES 77 N. S. KABBARA, P.E. R.C.E. 40812 • rtk • cc: Fairview Development, Attention: Mr. Frank Kindstrand QPOf ESSio1 .04P %‘1. S. KABp99 c h~ 9 Z V m cc No. C•40812 * L)ce'&a m-Cs `1›.4 CIVIL aNt 3- 3 9 E OF CAU 2428 N.GRAND AVE., • SUITE L • SANTA ANA,CA 92701 • (714)543.0990 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. ProjectAiidress2SSl Santa Barbara Ln./Trash Encl. 13a7o90 �. • a l I I 13 TL 9a62 TYPE OF CONSTRUCTION NEW H ADD H ALTERATION H REPAIR 1 2 inn,o+ 54e' Applicant's Mailing Address2510 N.Shelley Cr. ,Costa Mesa,C TI Comp ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,P.# - O/ 2—/I Zana Owners Name Fairview Management �fiYne714/863-15 0 O l�,Q-f-F(� DESCRIPTION OF WORK/USE OF BLDG. Trash Enclosure Address 2400 Main sSLt. • Irvine, Ca. 92714 H • s Main Building: Accessory Building: Arch/Engj3S]Lke-Lester & Assoc. License No. C-6925 TYPE OF PERMIT GRADING LJ FOUNDATION L�YSTRUCTURAL T Front. /D/ ' — a,• �y(Z„ LA.... a Address 71025 Mill Creek Dr. ,Laguna Hills,Ca.92653 ❑ TENANT ❑ ELECTRICAL LI PLUMBING ❑ MECHANICAL B Rear 1f %/ N CO an ❑ OTHER A p t,' 17 • I Contractor's Nem rView Development Phone l4/979-50 7 c Right p� ya - - N PROJECT DESCRIPTION SQ. FT. OCCUPANCY M?• ( /teal,.,,., ... Address(mailing)_2510N.Shelby Cr. ,Costa Mesa,Ca.92626 �� K f G CONSTRUCTION TYPE X/A../ VALUATION$2/DUO S Left �Ip vhD - �� City License No. 39582 NRef. R ZONE GRADING CU.YDS. ACRES ping. dh Parking Req./Provided l E LICESED CONTRACTOR DECLARATION •� L� O 1s I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: D 6 L 8O`ss3/ PlanningNotes: ,,II ,�. 1��qp� �,.�s�� I` with section 7000) of Division 3 of the Business and Professions Code, and ,`�• � �' 6'T GN � M �\ my license is in full force and effect. T Licensg Class B 'cense No. 496001 • S \ Dale SI natu - ` .4r PLUMBING FEES 9 \� WORKERS'COMPmthat I aceATION DE dARAT10N Bar Sink Showers I hereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES f Workers' Compensation Insurance, or a certified copy thereof (Section ' Backflow Preventer Service Sink —' -vl 300, Lab. C.) Automatic Washer Transformer 0 15-50 KW Policy rvo[7$ .3.OF944-9-86 Company ThP. Travelers Ins.Co Backflow Irrigation Sewer Cap ❑ 50+KW Construction Pole Sub. !/ ❑ Certified copy Is hereby furnished. _ LXCertifi•d •.y is fll-d .it, he cit Building DI isi• Bathtubs ,Sewer Connection Cooking Unit Meter 0 u to 100 amps Date i. i • .. - _ EXEMPTI• FROM WORKERS' •MPENSATION •ECLARATION Clarifiers - Solar Collect 5 Dishwasher Meter Dover 100 ampsZ . - (This section need not be completed if the permit Is for one hundred($100) or less). Dishwasher . ' Solar P. ng - i Dryers ❑Gas ❑Electric Sub Panel / I certify that in the performance Of the work for which this permit is issued, I -. shall not employ any person in any manners so as to become subject to the ' Drinking Fountains So r Tank Fan Motors❑0-1�kfP❑1'h-8 Workers' Compensation Laws of California. - Date Signature • Floor Drains wimming Pool w/Spa F.A.U. - Inc.Sola 9-15 HP ❑16-15+ - NOTICE:If,after making this declaration,you should become subject to the - - - - - • Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Mi Wave comply with such provisions or this permit shall be deemed revoked. , CONSTRUCTION LENDING AGENCY - Gas Service Outlets Water Closet Device Boxes I hereby affirm that there��ea is a constructionl lending agency for the performance Pole Light. of the work f'.rreath American First (LS5eection 3047 Civ. C.) Interceptors Water Heater Outlets Range of Lender's Name 1',1ru d Savings Bank g , Lender's Address1017_� Slater Ave. ,Fountain Valley,Ca. _ Kitchen Sink Water Service Switches Sign - OWNER BUILDER DECLARATION 92728 I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city.or - • county which requires a permit to construct,alter,improve,demolish or repair - P-Trap Laundry Trays Generator ❑ W❑5-15 KW any structure, prior-to its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of • ROOF rains 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 _ l alty of not more than five hundred dollars($500). _ CenI, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee • $ 3 • compensation, will do the work, and the structure is not intended or offered - - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's - MECHANICAL FEES License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own _ DEVELOPMENT SERVICES REQUIREMENTS: ' employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 ^^ /-2-?-89.. sale. If, however, the building or improvement is sold within one year of com- Zoning Approved By l'-a Date pletion, the owner will have the burden of proving he/she did notbuildor im- Duct-Under Ground Canopy Type II ❑ rBuilding Approved By fDate --,, H--2317--,, H--2317ove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural 2 Refrigeration S em Application Issued By '' �r ••t Date /',9/- "� tractors to construct the project (Section 7044,Business and Professions Code: • �f/ � The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0.100 BTU ❑100,000 BTU _ SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- ' tractor(s) license pursuant to the Contractor's License Law). ram aware that ' Exhaust System 0 Multiple 0 em Repair/Alteration BUILDING PERMIT $ 72 •Sd SMIP $ ' SO proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ '1/ ' /3 PERMIT ❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG 4 Fire Dampers PLUMBING $ ISSUANCE $ - Date Owner - Heating System& Du ' Registers - PLAN CHECK : 25% $ ENERGV P.C. $ I hereby certify that I have read this application and state that the above ❑o-100,000 B 100,000BT • ELECTRICAL $ GRADING $ . • information is correct. I agree to comply with all city and county ordinances' i and state laws relating to building construction, and hereby authorize repre- • MICROFILM $ sentatives of this y to enter u n the above-mentioned property-for PLAN CHECK . 50% $ inspection pur s}yyt r �7(j MECHANICAL $ /fit:/ Signature Daty�o<Q J TOTAL FEE $ / 3 Drivers' Licens r SS - CMF 0865:46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 1AVe 11,el.It 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System • 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final • 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe,Test - 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final • 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING A616.1 48. 48. Special Requirements Completed //JFi 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date qk - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - re- 6630 I I /04/86 CITY OF COSTA MESA ONST• r- UC ION PERMIT s/��y PERM fO./,9 TRACT NO. LOT O. 7T N0. 490.50�'L I. •Project Address - 57 •`+•�1t1Q• lei •r•/ a L 11, V! r 1 �L 4S , / 8 S,� TYPE OF CONSTRUCTIONVEW U ADD U ALTERATION U REPAIR Applicant's Mailing Address 134fD ' .�/h,P(/t"la� r ,r ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# • Zone Owner's Name r�tOVt1 ' Vc('t,�• (t ryPhone DESCRIPTION OF WORK/USE OF BLDG. Address a S 1 C N•S1,-ti met.rC064 .'1' resc-- • S Main Building: Accessory Building: • Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING U FOUNDATION ❑ STRUCTURAL T Front // - ZO ❑ TENANT ❑ ELECTRICAL g PLUMBING ❑ MECHANICAL @ ( N Address - Rear C Right N Contractor's Nam ' ■ a `k we Phone g-1-44-14%3 ❑ OTHER • PROJECT DESCRIPTION S(]. FT, OCCUPANCY Address lmailing)13�^d�8a^E. me. - , tJy sou , ons,1 K G 11`tl ` 11 CONSTRUCTION TYPE VALUATION$ S Left • City License No. 31 1"7 ' ZONE _ GRADING CU.YDS. ACRES - R LICENSED CONTRACTOR DECLARATION • �,s / Ping. Ref.# b '�s.` Parking Req./Provided E • Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: al a5 pj7,f„s,.`7A4' ) t553 4. Planning Notes: I-71 f? fr, VED ACT 2 M with section 7000 of Division 3 of the Business and Professions Code,and [A ,•s. my license is in full rc 79tl.effect: I 1^•-�s '1 - )){��� NOVT Lice is in .rc : Licens: N„. �y d5I '1 � ritrd r s Date v -w o - Signature I;.'.:- __r_ a- aPLUMBING FEES - WORKRS' COMPENSATION DECLARATION - E - 1 I Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure ora certificate of Workers' Compensation Insurance, or a cerrrj�fled copy the eof (Section Backflow Preventer Service Sink - ' 1800, Lab. ¢' 48,�e�k ��pub�• 6 x. Automatic Washer Transformer 0 75-50 KW ” Policy No. CLrYO Companyn 7L..1-Vtz� Backflow Irrigation Sewer Cap — 050+KW • Construction Pole Sub. Certified copy is hereby furnished. /n� C�jyfiegcerz pled with the cit �I.,'•g•Diyisiorl 6 . l..QBathtubs Sewer Connection '�O - Cooking Unit Meter ❑up to 100 amps Date f/ e1Ll�at7 Applicant 'J '. EXEMPTION FROM WORKERS'COMPENSATION DECLARATIO Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps I (This section need not be completed if the permit is for one hundred ($100)or - less):i. asc x Dishwasher Solar Piping t0 - Dryers ❑Gas ❑Electric Sub Panel I certifydpat in the:performance ofrthee work for vfvhich this permit is issued,I O snall not=employ any'person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan - Motors 00-1 HP 01%-8 Workers' Compensation Laws of California. Date Signature t. —Floor Drains Swimming Pool w/Spa F.A.U. III Inc.Solar 0$-15 HP 016-15+ NOTICE:Jf,after making this declaration,yd,Pihould become subject to the Workers' Compensation provisions of therlZabor Code, you must forthwith Floor Sinks Urinal • Fixtures Microwave comply with such provisions or• this permit shall be deemed revoked. . CONSTRUCTION LENDING. AGENCY 1 Gas Service Outlets tip Water Closet \\Q - Device Boxes POI¢ I hereby affirm that there is a construction lending agency for the performance Light '- • of the work for •which this permit is Issued (Section ,3097,Civ. C.) Interceptors • 1'O Water Heater -C• Outlets. • Range Lender's Name - - - _ - Or ' Lender's Address - - Kitchen Sink Water Service - . Flo DD Switches - Sign OWNER BUILDER DECLARATION ��,�v I hereby affirm that I am exempt from the Contractor's License Law for the "ilJ Lavatories Auto-Wash Eb- Garbage Disposal r - following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections county which requires a permit to construct,alter,improve,demolish or repair , r•• r P-Trap ' Laundry Trays Generator ❑0-5 KW ❑5.15 KW Trash Com actor any structure, prior to Its issuance, also requires the applicant for such permit P - . • to file a signed statement that he/she is licensed pursuant to the prbvisions of • Roof Drains - • -^_, the Contractor's License Law(Chapter 9(commencing with section-7000) of ` ' I ' Division 3 of the Business and Professions Code) or that he/she is exempt I - - - therefrom and the basis for the alleged exemption. Any violation of Section . 7031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). • I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 i compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee . $ 3 for sale (Section 7044, Business and 'Professional Code: The Contractor's MECHANICAL ii.. FEES License Law does not apply to an owner of a:property who builds or improves thereon, and who does such work himself/herself or through his or her own __ - - - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I 0 -sale. If, however, the building or improvement is sold within one year of com- ' Canopy Type II 0 Zoning Approved By Date .pletlon, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By • Date rove for the purpose of sale). �Q/wG1/� • I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural • ' Refrigeration System Application Issued By Date tractorsto construct the project (Section 7044,Business and Professions Code: • The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU r SUMMARY OF FEES builds or,improves thereon, and who contracts for such projects with a con- tractor(s)'license pursuant to'the Contractor's License Law). I am aware that Exhaust System 0 'Multiple ❑ System Repair/Alteration BUILDING PERMIT $ QO SMIP $ • proof o their Worker's Compensation insurance should be provided to me. PLAN CHECK $ : PE R,MIT • ❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers • 3 OV Date Owner Heating System& Ducting Registers PLUMBING $g - ISSUANCE $ I hereby certify that I have read this application and state that the above ' ❑o-100,000 BTU ❑100,000 BT PLAN CHECK 25% $ - 97.50 'ENERGY P.C. $ information is correct. I agree to comply with all city and county ordinances - ELECTRICAL $ - GRADING: $ and state laws.relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of his city to enter upon.the abve- mentioned -property for inspection p4? - • , / CO Signature (%III .. _ Date 10- oT o Reins emion Fee $15 • • Issue Fee MECHANICAL $ TOTAL FEE $ 490, Drivers' License or SS* P $ 3 PLAN CHECK 25% $ • CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor • CONSTRUCTION AND PLANNING POOL &SPA APPROVA,I,$ .' Permit# Date Inspector APPROVALS Permit# .. Date Inspector 1.'Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 11-6-V(. LED 53. Steel Reinforcement 4.0o 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding %'., 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER'-GUNITE 7. Footings • 58. Electrical Conduit-Undrgrnd 8. Foundation • . 59. Gas Pipe, 0 Undrgrnd.;Test.11 9. Water Pipe-Undrgrnd. gj,671(r LBD 60. Backwash Lines, P-Trap;,0 Ubdrgrnd. • 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 7.-G-117 e_gab65. 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 1:" 20. Rough Factory Fireplace APPROVALS Permit# - 21. Ducts, in Structure - 70. Underground Hydro 22. Ducts, Ventilating• 71. Product Piping 0 Gas 0 Oil • 23. Gas Pipe-Rough & Test 72. Underground Flush ' 24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil ' 25. Roof Sheathing 74. Overhead Hydro • 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding77. 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 6/6/g7 £217 . 36. Hood or Canopy - ' . 37. Final Factory Fireplace - . 38. Final Plumbing 7f pj' t40 . 39. Water Service-Final .i2.3f_e4 Le) 40. Gas Service-Final • • - - t 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- . • ' 1 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. • • CIOF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. n TRACT NO. LOT NO. UNIT NO. • I — TY Project Address 2551 Santa Barbara Lane _ ,.• 'i a4 Z-�5 • _ - + 0792 I•/23/87' I17E1.130 TL Applicant's Mailing Address 5380' E. Hunter Ave, Anaheim TYPE OF CONSTRU ION NEW ADD ALTERATION REPAIR - - Owner's Name Fairview- Management Co phone Zone CI CONVERSION CI DEMOLISH 117 OTHER - A.P.# - - DESCRIPTION OF WORK/USE OF BLDG. Housing Address 2400 Main St. . Irvine. CA 92714 r � S Main Building: Accessory Building: • Arch/Eng. RnrkP,J,P¢ter & Assoc License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION IJ STRUCTURAL E Front ZO Address ❑,TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL B Rear - N •Contractor's Name Migcinn RhePt MPtA1 Phone 970-5734 • ❑ 'OTHER A I PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Right N Address(mailing) 380 E Hnnter Ave, Anahein, CA 92807 K Left G CONSTRUCTION TYPE VALUATION$ S R City License No. 026&67 ZONE _ GRADING CU.YDS. •' ACRES- LICENSED CONTRACTOR DECLARATION ! Ping. Ref. # Parking Req./Provided E ,� I hereby affirm that I am licensed under provisions of Charter 9 (commencing' Remark g553)..7 Planning Notes: -• M with •section 7000) of Division 3 of the Business and Professions Code, and my license is in f rc andeffect. T License Class C43License�No. r , /� Date 1-23-87 Signature" • -Q'�'fll3G7`- /.!f I PLUMBING I FEES . 1 WORKERS'COMPENSATION F LARATION gar Sink Showers I hereby affirm that I have a certificate of consent to self-insure or a certificate • ELECTRICAL FEES of Workers' Compensation Insurance, or.a certified copy thereof (Section Backflow Preventer Service Sink - 3800, Lab. C , _ Automatic Washer Transformer D 15-50 KW PolicyNo. 470893 company %a State Fund B • ackflow Irrigation P g Sewer Cap _ . Construction Pole Sub., • D 50+ KW , Certified copy is hereby furnished. • _),Certified copy is filed with the city uil ig Division. /,, �', / Bathtubs Sewer Connection . - Cooking Unit Meter ❑up t0 100 amps Date _ Applicant �y.G(:MsA - EXEMP I M WORKERS'C ENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps •" (This section need not be completed if the permit is for one hundred ($100)or -- - - less). Dishwasher . Solar Piping Dryers ❑Gas ❑Electric ' Sub Panel I certify that in the performance of the work for which this permit is issued, I • shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar TankFan Motors El 0-1 HP 01%-8 Workers' Compensation Laws of California. • Date Signature Floor Drains i Swimming Pool w/Spa F.A.U. • NOTICE:If,after making this declaration, you should become subject to the - - - Inc.Solar ❑9-15 HP ❑16-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - - - - Fixtures - . - comply with such provisions or this permit shall be deemed revoked. - Microwave CONSTRUCTION LENDING AGENCYGas Service Outlets Water Closet I hereby affirm that there is a construction lendingFssuuagency( for the performance Device Boxes Pole Light of the work for.GwreatthAmperlCan IJavilk soon 3097 Civ. CJ Interceptors Water Heater . - Outlets Range Lender's Name b SS _ 9 Lender's Address g - - Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for the Lavatories • . ' following reason (Section 7031.5 Business and Professional Code: Any city or Auto-Wash Garbage Disposal ;Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap ' Laundry Trays Generator ❑O-5 KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permitTrash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000) of , Division 3 of the Business and Professions Code) or that he/she is exempt . i - therefrom and the basis for the alleged exemption. Any violation of Section - 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). D I, as owner of the property or my employees with wages as their sole Reinspection Fee 1 I ' $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered Reinspection Fee ' f $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's - MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves _ _ thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By - Date plebe for the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date prove the purpsale). • ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who, Duct-Ventilating - 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES 'builds or improves thereon,and who contracts for such projects with a con- - tractor(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ SMIP $ proof oftheir Worker's Compensation Insurance should be provided to me. Exhaust System ❑ Multiple❑ System Repair/Alteration PLAN CHECK $ - PERMIT ❑ 1 am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that.I have read this application and state that the above ' ❑O-100,000BTU ❑1OQ000BT - I GRADING $ ril information,is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relating to building construction, and hereby authorize repre- $ MICROFILM $ . ' sentatives of thiscity to enter .on t above-mentioned property for PLAN CHECK 50% /,(/,J�^� p �y� inspection . rp;7s. r/ 9e/ Kit'-hen hood en `x' MECHANICAL $ //f�a Signetur;�if. .t flA. Reinspection Fee $15 - Issue Fee $ 3 ,i/ PLAN CHECK 25% $ V4/ -��� . /\ C_'^465-46,rev. 10/84 white - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor ' CONSTRUCTION AND PLANNING POOL APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1.-Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9: Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17.'Rough Wiring Sign 68. APPROVED FOR PLASTERING 18.:Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning L/.447 14Q FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 2t)Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating L1447 (ALO 71. Product Piping O Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush . 24. Roof Framing 73. Undergrnd.Storage Tank O Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - 79. FINAL INSPECTION • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning 7/tom/Y7 GS) 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 Ul 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 A _ Ap- - plicant to fill in all spaces except those within heavy border lines and sign all.appropriate declarations. CITY OF COSTA MESA C NST U/CZTI TION PERMIT PERMIT NO. / TRACT NO. LOT NO. •UNIT NO. 9'IB�I "�Dc/22/86 "}" 268s(]0 T ' Project AAdress agar 4 /.`6•c�Y_s•�-a.�C4ac.. G�e�y ((t[��tP p _ Ap)flicant's Mailing Address 231 W . BLUE"RIDGE AVE . O; 7, TYPE OF CONSTRUCTION KNEW H ADD LJ ALTERATION LJ REPAIR #2308 _ , FAIRVIEW DEV . CO. Phone ❑ CONVERSION ❑-DEMOLISH ❑ OTHERESIDENTIAL AP zone_ Owner's Name DESCRIPTION OF WORK/USE OF BLDG. Address 2510 N. SHEL LEY CIRCLE ' S Main Building: Accessory Building: • Arch/Eng. • License No. TYPE OF PERMIT D GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front - O Address • ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL BA Rear I N ❑ OTHEftC//--C- - Contractor'sName ,SANTIAGO A/C Phone 998-1600 - .c Right I RECEIVED ;t r'n" N PROJECT DESCRIPTION SQ. T. OCCUPANCYK R Address(mailing) '231 W. Ri,TiERIDGE AVE . CONSTRUCTION TYPE VALUATION-$ S Left ' • +may O" " 1�$S G City License No. .015264 ZONE 'GRADING CU.YDS. ACRES' -• R LICENSED CONTRACTOR DECLARATION - _ Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: BLDG. PERMIT Br2 •tJ 52E, thru B 25534 Planning Notes: • , - 0 with section 7000) of Division 3 of the Business and Professions Code, and # my license is in ful4or e .nd effect. j REctIVED DEC -} T Licen e la "— License No._ 2 9496 _ s }�$6 $ Date � � /• k....---i PLUMBING FEES - WORKERS'COMP CLARATION • Bar Sink Showers " I hereby affirm that I have a certificate of consent to self-insure or a certificate - - • . ELECTRICAL - FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - Service Sink • - - Automatic Washer Transformer 0 15-50 KW 1800, Lab. k&878-5227 IND. INDEMNITY - - - 0 Bo+KW Policy No. Company Backflow Irrigation Sewer Cap Construction Pole Sub. Certified copy is hereby furnished. �S'Ceet: eQ�jopy`is.filed with the city�uildin9-Qlvis�'on. Bathtubs • Sewer Connection - Cooking Unit Meter ❑up to 100 amps Date PTI N FROM ' Applicant—_,I, DEC}.+ ION • ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION i Clarifiers Solar Collectors , _ Dishwasher Meter Dover 100 amps ' (This section need not be completed if the permit is for one hundred ($100) or - less). Dishwasher, - Solar Piping Dryers ❑Gas ❑Electric .. Sub Panel , I certify that in the performance of the work for which,this permit is issued, I - .. shall not employ any person in any manner so as to become subject to the , Drinking'FountainsSolar-Tank `_ Fan• Motors ❑0-1. HP ❑1'/:-8 Workers' Compensation Laws of California. , Date Signature : Floor Drains - Swimming Pool w/Spa F.A.U. NOTICE: If,after making.this declaration,you should become subject to the Inc.Solar 09-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal i Fixtures -• comply with such provisions or this permit shall .be deemed revoked. - Microwave CONSTRUCTION LENDING AGENCY • Gas Service Outlets Water Closet Device Boxes r I hereby affirm that there is a construction lending agency for the performance - •- Pole Light- • of the work -for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater • Outlets Range ' Lender's Name - Lender's-Address ' - - - Kitchen Sink -. . • . . . - Water Service - - Switches -, - Sign • - OWNER BUILDER DECLARATION • - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - Auto-Wash - following reason (Section 7031.5 Business and Professional Code: Any city or • Garbage •Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW • any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions ofR Roof Drains the Contractor's License Law (Chapter 9 (commencing with Section 7000) of ' • • Division 3 of the Business and Professions Code) or that'he/she is exempt • - - - - therefrom and the'basis for the alleged exemption. Any violation of Section _ 7031.5 by any applicant for a permit subjects the applicant to a civil - penalty of not more than five hundred dollars($500). II • - D I, as owner of the' property or my employees with wages as their sole4 Reinspection Fee $15 Issu¢ Fee $ 3 • compensation, will do the work,and the structure is not intended or offered ! - Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES - License Law does not apply to an owner of a property who builds or improves • • 'DEVELOPMENT SERVICES REQUIREMENTS: ' thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I ❑ employees, provided that such improvements are not intended or offered forypI sale. If,,however;the building or improvement is sold within one year of com- Canopy Type II 0 Zoning. Approved By Date • pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground 'Building Approved By • Date rove for the purpose of sale). U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By '- Date tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU • SUMMARY OF FEES • - ' builds or improves thereon,and who contracts for such projects with a.con- '" • . tractor(s) license pursuant to the Contractor's License•Law). I am aware that - ' Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ - SMIP ' _ $ proof of their Worker's Compensation insurance should be provided to me: _ PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason, J Firepl/Fact Blt. ICBG# Fire Dampers ISSUANCE $ PLUMBING $ Date Oviner - O Heating System& Ducting '39. Registers r - AM p D't� PLAN'CHECK 25% $ ENERGY P.C. $ I hereby certify'that I have-read this application and state that the above (a.. ❑o-100,000 BTU 0100,000 BT OD GRAD• ING $ information is correct. I agree to comply with all city and county ordinances O ELECTRICAL ' $ • and state laws relating to building construction, and hereby authorize repre- - PLAN CHECK 50% $ MICROFILM $ _. - sentatives of this city to enter upon the above-mentioned property for z+ // �j l inspection p.p.2res. — MECHANICAL $ �J . TOTAL FEE $ �S�r7. at Signature " I/�t�I�.✓�LJ �.�._P ' Date 12/3/86 • - ,�tt Drivers' License or 55# Reinspection Fee $15- Issue Fee $ 3 PLAN CHECK 25% $ V s. CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor ' CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms '"' -'•' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding , sv 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 7 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 is 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 414-17 Q FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro .22: Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 01/87 GAO 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. Backflbw 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 T M.: Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERM T it PERMITN'O. ry/ TRACT NO. LOT NO. UNIT NO. Project'Address 2551 5,wiva• . vs 7 • 5982 10/27/86 772e50 TL Applicants Mailing Ad'tress % C` Oan CAC) 6Q % -. TYPE OF CONSTRUCTION LI NEW U ADD ❑ ALTERATION 1111 REPAIR ❑ CONVERSION CI DEMOLISH ❑ OTHER ^ A.P.# Zone Owner's Nam- - •hon DESCRIPTION OF WORK/USE OF BLDG. Addresses Ma t'� y K� � . ' S Main Building: Accessory Building: Z Arch/En `Q-g- Licen • No. I TYPE OF PERMIT U GRADING ❑ FOUNDATION Li STRUCTURAL T • Front 0 Address Ara 1I v �-i\ aa S CI TENANT El ELECTRICAL ❑ PLUMBING CI MECHANICAL BA Rear • _ N L• f." Contractor's Nam-, •L c • eg Z tom_ • on: eir_ CI _ - Z� en r.CJ Sr �� also, h t .c jy PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Right G Address lmailing Ctu�• I fit' CON ST RUCTION TYPE - -- VALUATIONS S Left City License No. 'S ZONE - - GRADING CU.YDS. ACRES - R LICENSED CONTRACTOR DECLARATION (1 �1� �+/// Ping. Ref.# Parking Req./Provided E 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: U..1 dr A� 1! )Z95i5 Planning Notes: M 0 with section 7000) of Division 3 of the Business and Professions Code, and 1 O��J e✓ T f� my license is in full rc a (tett. •��.[� S .. _ Lice ass _� est se • o.47 psLJ6 LITDate �L — Signa raw— LIT 40 le/ r PLUMBING FEES WORKERS' COMPENSATI•N DECLARATION Bar Sink • _ Showers •' hereby affirm that have a certificate of consent to self-insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW r Polic00, Lab. C]__. - 0 50+KW ' Policy No. CA J t(,J�Q �� Compan eco S-i�- R Backflow Irrigation Sewer Cap Construction •Pole Sub. Certified copy is hereby furnisAppliched.r\ B Ce 1U}ie cop(v .i"led ere with the cit B p Bathtubs Sewer Connection Cooking Unit ,f Meter•�'rp to 100 amps /oS LID . Date thean Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps X, CID EXEMP ON FROM WORKERS' PENSATIO D C hundred �ZC less). eclion need not be completed if the permit Is for one hundred ($100)or less). Dishwasher Solar Piping - Dryers DGas DElectric /11 Sub Panel • 7pr DD I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank _ j• Fan Motors 00-1 HP,011/2-8' 1/0Workers' Compensation Laws of California. _ Cell Date Signature Floor Drains Swimming Pool w/Spa F.A.U. ❑9.15 HP 016-15+ .2-0 m NOTICE:If,after making this declaration,you should become subject to theInc .Solar _ .Solar Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal pD Fixtures comply with such provisions or this permit shall be deemed revoked. //a17LL Microwave SS` CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm(�taf�t� there is . construction lending a ncy for t"perfo ance d) Pole Light of the work/fdeidti. .1';,•Jyt i iss;d n 1�7.- C.) Interceptors/ Water Heater d•i:0 utters Range81 ) • Lender's Nam ` �` - ^'^4 �^ Lender's Addres\O11 ��a• /l*. In Kitchen Sink Water Service 0D OSwitches - Sign W 0.� OWNER BUILDER D LARATION - I hereby affirm that I am exempt from the Contractor's License L. or the Lavatories Auto-Washa Garbage Disposal �l O di following reason (Section 7031.5 Business and Professional Code: • ny city or C Standing Sections O" county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator 00-5 KW 05.15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for such permit to file a Signed statement that he/she Is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9.(commencing with Section 7000)of _ Division 3 of the Business and Professions Code) or that he/she is exempt - therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil ' penalty of not more than five hundred dollars ($500). $ 3 LI I, as owner' of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee compensation, will do the work,and the structure is not intended or offered - Reinspection Fee . $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES ' License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTS: . employees, provided that such improvements are not intended or,offered forZoning Approved By • sale. If, however, the building or improvement is sold within one year of con- Canopy Type II ❑ • Date ' pletion, the owner will have the burden of proving,he/she did not build or Im- Duct-Under Ground _ Building Approved By Date rove for the purpose of.sale). D I, as owner of the property, am exclusively contracting with licensed-con- Duct-Structural Refrigeration System Application Issued By Dat: 1.27W • - tractorsto construct the project (Section 7044,Business and Professions Code: • The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00100,000 BTU 0100,000 BTUSUMMARY OF FEES builds or Improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ _ SMIP $ proof oftheir Worker's Compensation insurance should be provided to me. I` PLAN CHECK $ PERMIT 0 I am exempt under Section B.&P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers . PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I ave read this application and state that the above 00100,000 BTU 0100,000 BT ELECTRICAL $ S�/O' CO GRADING $ information is correct. -agree to comply wi all city and county ordinances and state laws relati•• to building o'.tr �yFV•n, and hereby authgrize epre- PLAN CHECK 50% $ 2S'/a rSfl MICROFI LM $ sentatives of 'thi ty to enter above-mentionet:`p[7/o pert ' inspection p,n• / �,- !\?j(.� MECHANICAL $ TOTAL FEE $ }�S� Signatu /i• CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor I CONSTRUCTION AND PLANNING - POOL&SPA. APPROVALS Permit Date Inspector APPROVALS Permit# Date - Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation . (1 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. I;r 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 ,jlr/.s1 67. Fencing & Access Approval . •17. Rough Wiring Sign �( 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# - 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank O Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro . 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe • 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT..REQUIREMENT 31. Plaster Brown Coat 9. FINAL INSPECTION .. . 32. Electrical Power Meter-Final /7�/� 80. FOOD CERTIFICATE ISSUED, 33. Final Electric `F , Notes: 34. Final Heating & Air Conditioning . 35. Final Gas Pipe-Test 36. Hood or Canopy i '• 37: Final Factory Fireplace ' 1. 38. Final Plumbing •m 39. Water Service-Final f - - • a - 40. Gas Service-Final • ' . _a 41. Solar Domestic-Final - .. 42. Backflow Preventer - I 43. Backflow Irrigation - ,' • r - t44. Landscape Irrigation System -- . 4: Sound Attenuation - • - 45. Handicap Regulations " ,„ 47. FINAL STRUCTURE & BUILDING _ '- _ . ��; 48. Special Requirements Completed a " . -. I.„ (` ,49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co - . 51. CERTIFICATE OF OCCUPANCY • r • No. Date i'` �/!J'' = Applicant to fill in all spaces except those within Iieavyborden..in. _.;;Ian'all appropriate declarations. • CITY OF ROSTA�J MESA CONSTRUCTION PERMITBi.o 7 PERMIT NO. TRACTR7NNO.' LOT'NO. UNIT NO./'� • $ Proj• ect'AddressprrSi 34AJTA 544-ed.e4 44A:E,.. r3 is-6-34- jr•2L5 /LI / SLDU Q '�•S�/GN. 5:41411-e1( i - e/' TYPE OF CONST�7�5CTION y�l NEW H ADD H ALTERATION LI REPAIR ) ^ ' n' ^ -' Iii^ '-, /t C/7 jj Aptant'S Mailing Address ❑ CONYERS r5N ❑ DEMOLISH ❑ OTHER A.P.# r+'G� -• Q - , I Zone pDQ'.'N L Owrrer's Name FAbL'✓/B�y44thil Erlfvre-G Phone sic 3'�-S�G DESCRIP ION'rOF WORK/USE OF BLDG. Address //76 /y'47A/S/ /2-i'/AJs 4'44 927J S Main Building: Accessory Building: a / 'f- -L.itl/'T APfla�/"//F�f 7T 1q Arch/Eng. /1'F/' LES%c License No. C-d9& TYPE OF PERMIT L I GRADING ylf FOUNDATION XSTRUCTURAL • T £aewtN C�A/ 4 1t o Address 73b.as• - /�J<4 tce-tc De 24 y("Am I/pi_S ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B e 5 . /,5-/ � /]S N ' Contractor's Nam fit - •0 ✓ 7_ Phone 979<4C ❑ OTHER C Y / /p���4�q7� D N Address(mailing) . /a 4 • J'41 >< GP. S7-' ,_ PROJECT DESCRIPTION SQ. FT.2/qca OCCUPANCY 3re/ f C -Wert£• 70/ „y'�`,"" G CON ST RUCTION TYPEt44ne -5y.GA-C V ALUATION S 9,?�9/ C S 1 " L✓ 18 Vo A. R City License No. .eL'�4iii!• ...IL. ZONE GRADING CU.YDS. ACRES 2 ,Mil Ping. Ref.# Parking Req./Provided 'f�1 E LICENSED CONTRACTOR DECLARATION ,.• / r d' - IIS fY ^" / � O I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: PGfy �� — L Planning Notes: y�AAQ a A /I/1CR,R u��,d� M with section 7000) of Division 3 of the Business and Professions Code,and VW pp /-t+'.- /a iT�� my license is in full forte . d effect. er �n61y FOR p i�.jil. 3sG Ui- C1:�E11'1 S S License Class I - / ie Lice a No ' - 4 SP Q r`;•'- Date - - 7 Signatur- _ �. PLUMBING FEES WORKERS'COMPENSATION DECLARATION --Baf Sink Showers • ELECTRICAL FEES 'hereby affirm that 1 have a certificate of consent to self-insure or a Certificate Workers' Compensation Insurance, or a certified copy thereof (Section .00, Lab. c.) Backflow Preventer • Service Sink Automatic Washer - Transformer 0 15-50 KW Policy No.J/45?3rl9J 156 Company feriel&F.Cti Backflow Irrigation ' Sewer Cap0 50+ KW- Construction Pole Sub. ❑ Certified copy is hereby furnished.thcit - - ❑ Certified copy is filed with the city Building Division / Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date G-9-s4 Applicant z" . EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers . Solar Collectors • - Dishwasher Meter Dover 100 amps ' - (This section need not be completed it the permit I5 for one hundred ($100)or less). Dishwasher - Solar PipingDryers ❑Gas ❑Electric Sub Panel I certify that In the performance of the work for which this permit Is Issued I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1'h-8 Workers' Compensation Laws of California. __ _ • Date signature Floor Drains Swimming Pool w/Spa F.A.U.' NOTICE: If,after making this declaration, you should become subject to the Inc.Solar 09-15 HP 016-15+ • Workers' Compensation provisions of the Labor Code, you must forthwith Floor SinksUrinal - Fixtures • comply with such provisions or this permit shall be deemed revoked. , Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work fo which t` permit is Issued (Section 3097 Civ. C.) Interceptors Water_Heater Outlets Range Lender's Name . - s9 SJ /ZF /! - Lender's Address /A/7S S�Tit 4✓- �GOwtfn.q/�AKt.a 9270y Kitchen Sink .. Water Service Switches - Sign - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License LaW for the r Lavatories • - Auto-Wash Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or - 9Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW - any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/She is licensed pursuant to the provisions of Roof Drains • the Contractor's License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt - - -- - - ' herefrom and the basis for the alleged exemption. Any violation of Section '031.5 by any applicant for a 'permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). U I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 • Issue Fee $.3 compensation, will do the.work,and the structure is not intended or offered - �, for.sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL• FEES Reinspection Fee $15 Issue Fee $ 3 License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own • DEVELOPMENT SE VICES REe UI' MENTS: V employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 ,, �.-. sale, if, however, the building or Improvement is sold within one year of com- - Canopy Type II 0 Zoning Approved By IP- 'i- Date "A� pletiony the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By ,�/,ate /�/ _ Date ,�, 71. rove for the purpose of sale). Z � U I, as owner of the property, am exclusively contracting With licensed con- Duct-Structural Refrigeration System - -Application Issued By �' - Dat' �d "If tractorsto construct the protect (Section 7044,Business and Professions Code: The Contractor's'License Law does'not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU S M RY F FEES builds or improves thereon, and who contracts for such projects with a con- 11,Y6 • FEES license pursuant to the Contractor's License Law). I am aware that —Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ �c/s -SMIP $ (QRS/79 proof of ,their Worker's Compensation insurance should be provided to me: • PLAN CHECK $ r Or, PERMIT 0 1 am exempt under Section B.&P.C.for this reason Firepl/Fact.Blt.ICBG# Fire Dampers PLUMBING $ ISSUANCE $ Date owner Heating System& Ducting Registers - t ENERGY P.C. $ • ❑0-100,000 BTU ❑100,000BT PLAN CHECK 25% $ I hereby certify correct. I have read this application all and state that the above GRADING $ _ information is c aagreeui toicomply cost with all city and uth repress- ELECTRICAL $ sen state laws relating to building p construction,and- herebyiauthorize repre- - - $ MICROFILM $ inspection of this city to enter up• the above-mentioned property for _ PLAN CHECK 50% inspection purposes. - ‘--9-151.' J � Signature - MECHANICAL $ TOTAL FEE $ 1,13€0 ,29 / _ Reinspection Fee $x\7{5 Issue Fee $ 3 PLAN CHECK 25% $ _/ CMF 0865-46,rev. 10/84 White - Building; Canary`- Applicant: Pink -Accounting; Goldenrod - Assessor \ / .CONSTRUCTION"AND PLANNING POOL &SPA I APPROVALS .Permits Date Inspector APPROVALS Permit _ Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement, , 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 6I/7/86 0a 57. APPROVAL TO COVER-GUNITE 7. Footings "', it illQb D 14 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 (/'�/g(, 0 µ 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection / 62. Backwash & Receptor-Final ' 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final , 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • ` 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT' ' ' 20. Rough Factory Fireplace APPROVALS Permit# _ - 1121. Ducts, in Structure 70. Underground Hydro • 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 2191 Oi�4' 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat /• 75. Dry Chemical ' 27. Frame and Flashing 411614 /// 76. Dry Standpipe 28. Lathing & Siding . _ /11 491 ' 77. FIXED SYSTEM FINAL 29. Insulation __` // 78. FIRE PREV. FINAL 30. Drywall Nailing SPIT) HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat / r 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED • 33. Final Electric Notes: 34. Final Heating & Air Conditioning ,3/87 OK WQ� , 35. Final Gas Pipe-Test '�`I� 36. Hood or Canopy •. , • 37. Final Factory Fireplace rS� _ Q 'J , 38. Final Plumbing , /C1 2," - 39. Water Service-Final - ~ .i 40. Gas Service-Final , 41. Solar Domestic-Final ' • 42. Backflow Preventer • 43. Backflow Irrigation V 44. Landscape Irrigation System 45. Sound Attenuation . 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING is ^$A 04 . 48. Special Requirements Completed 7/82 nI • 49. Electric Release to Edison / �-' • ..50. Gas Release to Southern California Gas Co ,• • 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT _ffMIT NO. TRACT NO. LOT NO. UNIT NO. asst snWr-� a 4 P a A V A 7p`l� . Project Address ✓Ir I Applicant's Mailing Address /p 61 40X 967 5rg/U7-ONJ TYPE OF CONSTRUCTION Li NEW LJ ADD ALTERATION U REPAIR Owner's Name '48 / ' //:i.' ..e 54/6-7$17 U CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone X79'07' At41/,J' ST rI�'D'//O� DESCR TION OF WORK/USE OF BLDG Address (y�y ex-u, j a.L 4.u/ Q. S Main Building: Accessory Building: Arch/Eng. License No. r' -- - TYPE OF PERMIT . GRADING . FOUNDATION N STRUCTURAL T Front O Address rrJJ��`` ''// ❑ TENANT ❑ ELECTRICAL te PLUMBING ❑ MECHANICAL B Rear N Contractor's Name 7�.9/✓]GCyp�� 15 44.Phone 7.2d-7 YQ� U OTHER A p C Ri ht N Address(mailing) /2.0••,dO-I' 767 .574/f/70,J PROJECT DESCRIPTION SQ. FT. OCCUPANCY R-/ g K G 4K. 9 � CONSTRUCTION TYPE S� VALUATION$ S Left R City License No. T Yb� ZONE GRADING CU.YDS. ACRESE LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and T my license is in full force a d effect. ��_ /2 45 S License Class - �_4`Licens: Nom h'r - Date - Signature / —��� PLUMBING FEES - WORKERS' COMPENSATION DECLARATION llif Bar Sink Showers ELECTRICAL • FEES 1" I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section ' Backflow Preventer Service Sink \, 3800, Lab. C.) '/Z. yAutomatic Washer Transformer 15-50 KW Policy No. 0742 '-e'?ComPany • Sr-n 7S UF /f//) 050+KW Backflow Irrigation Sewer Cap Construction Pole Sub. N` ❑ Certified copy is hereby the ed. edified copy filed with the city Bul ng Division. / //// Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps A Date s�2� Applicant f1L`f ) \ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher - Meter Cover 100 amps (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher 'bderrgq Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is issued, I - ' shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 01'A-8 Workers' Compensation Laws of California. - Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar Q9-15 HP ❑16-15+ • NOTICE: If,after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Micro ye comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY • Gas Service Outlets Water Closet • I hereby affirm that there is a construction lending agency for the performance Z Devic¢BO%¢s le Light ' of the work for which this permit is issued (Section 3097.'Civ. C.) Interceptors Water Heater Outlets / Ran e Lender's Name - ' g Lender's Address Kitchen Sink Water Service Switches OWNER BUILDER DECLARATION ' Sign •, I hereby affirm that I am exempt from the Contractor's License Law,for the '_" Lavatories Auto-Wash Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair 1, P—Trap LaundryTrays s any structure, prior to its issuance, also requires the applicant for such permit _ Generator 00-5 KW ❑5-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of • I the Contractor's License Law(Chapter 9(commencing with Section-7000) of - • Roof Drains 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 Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offered Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The-Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves el thereon, and who does such work himself/herself or through his'or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date pn, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date . prove for the purpose of sale). g ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100.000 BTU 0100,000 BTU SUMMARY OF FEE builds or improves thereon,and who contracts for such projects with a con- �, tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System El Multiple 0 S tem Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# f Fire Dampers PLUMBING $ 00 PERMIT ISSUANCE $ Date Owner Heating System stem& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this ty to enter upon tpe� abo e-mentioned property for inspectionpurpo ' 2p�c+> MECHANICAL $ TOTAL FEE $ 6' 6)0 Drivers' Signature - _ /. Date Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ SIIISIIIIIIISDrivers' License or SS# ��-- '��,?� p n CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor ill COO 294s?-i SL29453 T Ci T ...,,, CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical:Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. r' 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test • 6. Electrical UF ER Grnd.�"- 57. APPROVAL TO COVER-GUNITE i 7. Footings , i • 58. Electrical Conduit-Undrgrnd. 8. Foundation . " 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe:Undrgrnd;,�/ 7 60. Backwash Lines, P-Trap, ❑ Undrgrnd. .10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. 'Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush / � t 24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro • .. 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe • 28. Lathing& Siding 77. FIXED SYSTEM FINAL •" 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION •. 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: - •') 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test UPLO_P • _ ,•.r 36. Hood or Canopy 37. Final Factory Fireplace • 38. Final Plumbing (1(/1(fi 1 (N2 . 39. Water Service-Final 1 r 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 -t .