HomeMy WebLinkAbout2522 SANTA CATALINA DR - Building Permits/�o
Applicant to fill in all spaces except those within heavy border lines and sign all apprppriat¢declarations. 3030 ��
•t PERMIT NO. TRACT NO. LOT NO. UNIT�y o. - • 0365 5/12/2 ;r7,,
CITY OF COSTA MESA CONSTRUCTION PERMITS I I ( Q icy UNI T N
ProiJct Address '2522- 5'9'vr4 C4r4GidA 0•4/vC V 334 �Oo /ZSS$ 3 260-2.06
' Applicant's Mailing Address25�-d AftRQ/A4 A4
LE C.H• Q26.%b TYPE OF CONSTRUCTION QrvEW Li ADD LI ALTERATION LI REPAIR -
•
❑ CONVERSION ❑ DEMOLISH 0 OTHER
(2wner's Name fA/4u/CW M6HT CO Phone S4-S-1-727 A.P.# C'� /2-0--r /0 'I ZonenvE_bO
!! D SCR I PT ION OF ORK/USE OF BLDG. R//
Address, 2"S�� wA.[_, t..d.t� ApAlzTKe-/t uNl'tS �uy2i n / y S Main Building: I/ ` Accessory Building:
Z
Arch/Eng.q&4LF /e7 A.9 AS'OG License No. TYPE OF PERMIT 0 GRADING I�'FOUNDATION LJ STRUCTURAL E Front /"4' 40 t\'5 _ D
• Address Z Zs .of/LC. C4P_.ix UR LA6(ANH 14&LS 9.2653 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear /_'I^ p N
❑ OTHER 1 N
Contractor's Name pw.(�E./�Ruu�S2 Phone 3,4A-re-
.
A'zjE PROJECT DESCRIPTION SO. FT- 7 h I OCCUPANCY g-) C Right ( - \2_ t A.CSV-
Address(mailing) CONST RUCTION TYPE VALUATION$ &i'1. r1 c'- S Left ' r not l A.K G
City License No. 2]�fp ZONE - GRADING CU.YDS. ACRES r R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# pi 83--/830 Parking Req./Provided U
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Pc 4 $r,4_ fin Planning Notes: PHASE .. a M
with section 7000) of Division 3 of the Business and Professions Code,and 4
my license is in full force and effect. T
License Class / License No. — -- t)IREIi'IENT$ $
.Li/
Date Signature A PLUMBING FEES_ v O CPF('1AL REQ
WORKERS'COMPENSATION DECLA ATION Bar Sink - Showers ,10 1�
ELECTRICAL
`�
1 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 0 15-50 KW
Policy No. Company ./J A Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW
�. Certified copy is hereby furnished.
— Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100) or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issued, I
shall not e pl y any person in any�manner so as to becomesubject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1%-8
Workers'.Ofq�8)8ens on Laws of Cal'�T%�ia,ti •`�
Date f%1Ir1'y�j Signature '^' 1• /R }� Floor Drains - Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 0i6-15+
NOTICE: II anter making this decla(lllon,you should become su ect to the
—
' Workers' Compensation provisions of the Labor Code, you mus forthwith Floor Sinks Urinal Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked. ,
CONSTRUCTION LENDING AGENCY Gas Service . . Outlets Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance • - Pole Light
of the work for which this permit Is issued (Section 3097 Civ. C.) -
Lender's Name C.LEAr .s+CO,/GQ.x1 5YL Interceptors . _ , Watei Heater Outlets Range
Lender's Address(..CO$ST Sa,/TC- 904 S4.tJ D/C`rFo 92/53 Kitchen SinkWater Service Switches
Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - Auto-Wash Garbage Disposal 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 ❑0-5 KW ❑$-1$KW •
any structure, prior to its issuance, also requires the applicant for such permit - - Trash Compactor
• to file a signed statement that he/she Is licensed pursuant to the provisions of ROOF Drains - - •
the Contractor's License Law (Chapter 9 (commencing with Section 7000)of '
Division 3 of the Business and Professions Code) or that he/she is exempt
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil
penalty of not more than five hundred dollars ($500).
❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered - Reinspection Fee $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves DEVELOPMENT SERVICES REQUIREMENTS: �S
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 1 9
employees, provided that such improvements are not intended or offered for at -/y� D
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By 1 ,fit/1 Date Lt
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By `d II S� s, Date _T�� (�
prove for the purpose of sale). 5�Iz.�K
❑ 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). •
_am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ I SMIP $ 41.19
proof of their Worker's Compensation insurance should be provided to me. - PLAN CHECK $ I PERMIT
I am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# 'Fire Dampers PLUMBINGN CHECK
$ "L' ISSUANCE $ --
Date !//'�.-'>� Owner �+k-t"�"�°�/ ✓.fL� ...IHeating System& Ducting —
Registers - PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have rea' his application and state that he above 0o-100,000 BTU 0100,000 Elf GRADING $
information is correct. I agree to comply with all city and county .rdinances ELECTRICAL $
and state laws relating to building construction,and hereby authorize repre-
sentatives of t city to enter upon the above-mentioned pr p rty for p�
inspection Pur es. /�s- Cif_J i� • MECHANICAL $ TOTAL FEE $ 3°3°45
Signature -4i'-./`moi-!�\
Reinspection Fee $15 ` Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor I
1
CONSTRUCTION AND PLANNING POOL&SPA
APPROVALS . Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' '
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement'
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
' 5. Steel Reinforcement ,;-t 56. Rough Plumbing & Pressure Test •
6. Electrical UFER Grnd. ...��5,,,(//////f�f/ge 57. APPROVAL TO COVER-GUNITE -
7. Footings c. /f(G/ p� 58. Electrical Conduit-Undrgrnd. '
• 8. Foundation-. � 59. Gas Pipe, ❑ Undrgrnd.,Test . '
9. Water Pipe-Undr-grnd. - 60. Backwash Lines, P-Trap, ❑ Undrgrnd.
-. 10. Structural Floor System f' � 171 00- 61. APPROVAL TO DECK ' ,„.4)/ H.
11. Property Sewer Line &'House Connection 62. Backwash & Receptor-Final. ,f . ,
12. Sewer Cap • 63. Heater & Vent-Final. Y ^ 34 '" .4-
13. Roof Drains 64. Plumbing System - Final T cy l.,1 l.,7 0 ,
•
14. Rough Plumbing 65. Electrical-Final ' t' r. trr. .
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 't'
20. !Rough Factory Fireplace APPROVALS Permit# - •,
21. Ducts, in Structure 70. Underground Hydro •
22.. Ducts, Ventilating • 71. Product Piping El 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
r r nv ' 74. Overhead Hydro -
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ,
27. Frame and Flashing It 3Ar Or . Dry Standpipe -_
28. Lathing & Siding // 16/4 0 ,,,,tr 77. FIXED SYSTEM FINAL ,•
29. Insulation /0,At 6W , 78. FIRE PREV. FINAL .
30. Drywall Nailing Ort8 A HEALTH DEPT. REQUIREMENT
/,l z7
31. Plaste Brown Coat 7 ! - 79. FINAL INSPECTION .
r 3
•
32. Electrical Power Meter-Final 80. FORD CERTIFICATE ISSUED
33. Final Electric Notes: .
34. Final Heating & Air Conditioning SLC.Q ei4 nO// 4278/7 t
W n 1 1,
35. Final Gas Pipe-Test t'!O1101104011111018hrn.
1 36. Hood or Canopy "••��Z.'d`ia�l1'iig l� •
-
37. Final Factory Fireplace
38. Final'Plumbing • - , '
39. Water Service-Final •
'
40. Gas Service-Final , I
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation i •
44. Landscape Irrigation System ' -
45. Sound Attenuation
46. Handicap Regulations • i .
47. FINAL STRUCTURE & BUILDING spieler F _
Vl'
48. Special Requirements Completed a 2/� tt- '
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
/
51. CERTIFICATE OF OCCUPANCY i �,
-. .
No. Date ''
.. :t .eG ,r. ru..,.�al+r^ .. Aaa+T/a��:...
J •
0 PACIFIC.SOILS`ENGINtEERING. 1NC. .
17909 FITCH, IRVINE, CA 92714 '
:TELEPHONE: (714)863-9118 .
.. ., . . f I .
•
NOTICE . OF FOOTING .EXCAVATION `INSPECTION •
300 LOCATION: . G..r v s Q`'J - O
v5-n-c t.. t-;s'0. ' : . r H
WORK ORDER NO.: � Uo9IJ F
, OWNER.OR CONTRACTOR:, ' ••'\I'I`c'c- (r' • .
OWNER'S ADDRESS: - . .
i • :-%
DATE FOOTINGS INSPECTED ' Stl8(6?) '
DESCRI TION•OF FOOTINGSOR CAISSONS COVERED BY THIS NOTICE: • - , -
x711(c(c '.2cc . f 4, k"'s'c-Ft 'e,cccy-c-ks'-J ' ik..'t. \a -' ,�.:
. • i:t,<<iswCc Std'. :(-dc( `f-c,-cil - s '6v.,: is e(---.4: .t a' . •
L. S 4C.-=•()C ' o-•s--`._ociLL- - P^c'L V-..._ ( V , t-c-t,'1-1..'e r .
.'M'L. L.C.. IX l 1 (1-2t, SZ .S 'A„..c v. <•
v t
• _-The undersigned has inspected the footing and%oi caisson excavations listed above on•the-referenced 'property and • •
•
' • ' same were excavated in accordance-with our recommendations in the preliminary foundation report and the Building Code "
• of the
I. : ' - ,
4 ' <.S ._ n ''• •t SIGNATURE‘44.) -
CITY OF COSTA MESA
CAL, .1NIA 92628-1200 P.0.BOX 1200
Insulation Certificate
7572 Santa Catalina Drive Costa Mesa .
Numbs and Street - City
orange
County Subdivision Lot Number
Description of Installation
ROOF
Material Brand Name
Thickness(inches) Thermal Resistance(R-Value) - -
EXTERIOR WALL
Material Fiberglass Batts Brand Name Manville
Thickness(inches) 3 1 /2" Thermal Resistance(R-Value) R-11
CEILING
Batt or Blanket Type Batt Brand Name Manville
Thickness(inches) 6 3/4" Thermal Resistance(R-Value) R-19
Loose Fill Type Brand Name
Contractor's minimum installed weight/ft2 lb Minimum thickness inches '
Manufacturer's installed weight per square foot to acheive Thermal Resistance(R-Value)
RAISED FLOOR
Material Brand Name
Thickness(inches) Thermal Resistance(R-Value)
SLAB FLOOR
Material Brand Name
Thickness(inches) Thermal Resistance(R-Value)
Width(inches)
FOUNDATION WALL
Material 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 Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the
California Administrative Code.
General Contractor(Builder) License Number
SignanueardT,i TERN INSULATIOW Date
(kntau %c21 W aeon?F AVF .t
Contractor
InSta%lef ,CA 92704 ''5./. License Number
Signatureide Date
7941: _oE 7 _,?0 n
•
COSTA MESA SANITARY DISTRICT -,:t ✓ (1
MONEY RECEIPTS ADVICE
Datil
Amount $ �' \
Name '1,n1(ZVI i L),) l l((vll�'(\Cl �� 1`I4 ,
Payer Address �Pk-) . �� L— k - (n I l l �-V k n` cf�� c)k 3 I l L1
For . Il f.' ._�.� � \Av
•• 1 : I `"S 5
signed �t1131� �1i�1Cil �\ —
CMF 0944-68 White-Customer;Canary-Department;Pink-Finance;Goldenrod-File
791;7 .7/. ! /:!' :.7;;J•
COSTA MESA SANITARY DISTRICT ,-,, ; 51
MONEY RECEIPTS ADVICE
Date ° sII \ — � ) �
Amount $ P-)947
Name 1.MS! 1.1 0 NO,(Y l_Is.c n - it
Payer � --
y Address Y!� , 1"_) Sc (t — 1 (� < < . _k_\- :'1c?. I IL1
For tc- 1 ,(L'; D 3J\ U E12_
\-)..c-sc.-
5._-;
CMF 0944-68 White-Customer;Canary-Department;Pink•Finance;Goldenrod-File
i
CONSULTANTS'INC. -
•
. February 14, 1989
•
•
CITY OF COSTA MESA
77 Fair Drive . '
Costa Mesa, CA 92626 • . .
Attn: Building Department
Subi: CIVIL ENGINEER'S FINAL GRADE CERTIFICATION FOR. •
TRACT NO. 12558, IN THE CITY OF COSTA MESA (FILE 1250)
•
This is to certify that the final grade for building No.11 also -
known as 2522 Santa Catalina was field checked on February 10, 1989 '•
and found• to be in conformance with the intent o the grading plan.
Very truly yours,
•
DGA CONSULTANTS •
•
' Surender Dewan, R.C.E. 34559
Engineering Manager
•
•
/rw
s;h2•" ti
vF ESS/(?,S?
NO..34559 ( • •
\29,.
�l0,1
Or/CALji°
•
•
1182 North ltstin Ave •
otange.CA92667 C2/1250
' (714)744-0802
• Fax(714)538-2152 ,
9035 Haven Ave.,Suite 105
Rand°Cucamonga,CA 91730
1714)944-5400•
• Fax(714)944-2790
Applicant to fill in all spaces except those within heavy border lines and sign all appropilate declarations.
P RMIT NO. TRACT NO. LOT NO. UNIT NO. p
CITY Project OF COSTA MESA' CONS RUC�.TiON PERMIT i.r / � — A.P.# ^s �+ Jo I zonvoO.0 ...#/)
�C�i �� 31 Z �"] / S ^5JI ��O-mt�- -
Addy esr� 7Ta� a 5 GSA P° - + S Main Building: - Accessory Building:
Applicant's Mailin Address- .5 6 4)11; -~r�1" ..• t1/4,14TYPE OF CONSTRUCTION NEW ADD U ALTERATION U REPAIR E Z
Owner's Name I2�f EVV ?nil �4�'S 1 ❑ CONVERSION ❑ DE OLISH El OTHER i T Front O 0
//j7 Phone Jn+IC DESCRIPTION OF WORK/USE OF BLDG. B Rear �+ N
Address .� kl/++the N '/f/I . - A 7/ / 1
Arch/Eng. / = %n.• a./.)-�. � TYPE OF PERMIT ❑ GRADING U FOUNDATION ❑ STRUCTURAL C Right AO N
Address 'r a r'67 / I(JlIJ•�lF•',! ❑ PLUMBING ❑ MECHANICAL S Left . 7 xe G
' + • C CI TENANT ❑ ELECTRICAL R
Contractor's Nam- OJdn9• i ' + -* •ho 4154 73 .7 ❑ OTHER I Ping. Ref.# Parking Req./Provided E
�.�w �,�1 PROJECT DESCRIPTION SQ. FT. OCCUPANCY Q
CityAddress
License(mailing) 4443 ��t 0��/r Q'L 6�✓7 / / Planning Notes: ,/d�/ ) M
a7 v
CONSTRUCTION TYPE VALUATION 5 5O c' T
City License No. ZONE GRADING CU.YDS. ACRES $.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 1 .
•
with section 7000) of Division 3 of the Business and Professions Code, and T-"a� ,4C�aIV Y{,'
my license is in full force and effect. . ELECTRICAL 'FEES
I icense lass /y� License No. -
e �s� Signature • - PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
ARK RS'COMPENSATION DELLA ATION Construction Pole Sub.
• ❑ 50+KW
Ei Bar Sink Showers
I h Workers'
C that I atio a nsre of consent toi self4 py or a certificate
of Workers' Compensation Insurance, or a certified py thereof (Section Cooking Unit Meter Duo to 100 amps
3800, Lab. C.) �) Backf low Preventer Service Sink
Policy No. Company /y , Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps
8 Certified copy is hereby furnished. Dryers DGas DElectric — Sub Panel
—
Certified copy Is filed with the city Building Division. Bathtubs Sewer Connection
Date Applicant Fan Motors 00-1 HP ❑1'fi-8
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors
(This section need not be completed If the permit is for one hundred($100) or Dishwasher Solar Piping F.A.U.
less). I Inc.Solar 09-75 HP ❑16-15+
I certify that in the performance of the wprk for which this permit is issued, I Fixtures
shall not mplgy any person in any/napier so as to ecome s bject to the Drinking Fountains Solar Tank Microwave
Workers' 7 .pa n Laws of Cali la. /��b,,,
Date / %r Signature / � a"`- Floor Drains Swimming Pool w/Spa Device Boxes Pole Light
NOTI If,a ter making this declar on,you should become sub ct to the
Workers' Compensation provisions of the Labor Code, you mu forthwith Floor Sinks Urinal • Outlets Range 1
comply with such provisions or this permit shall be deemed revoked. —
CONSTRUCTION LENDING AGENCY Gas$ervlge Outlets Water Closet Switches Sign
I hereby affirm that there is a construction lending agency for the performance
of the work for ]41J ILIS pliqf,;,mi[ is issued (Sectjpn 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lender's Name 1.0q&M., A -7f, f i7 (�
Lender's Address 4d/1 e!/' CO( 11,:,01 fl ql Kitchen Sink Water Service Generator ❑0.5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION�/ —
I hereby affirm that I am exempt from the Contractor's Lice se Law for the Lavatories Auto-Wash
following reason (Section 7031.5 Business and Professional Code: Any city or
-ounty which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays t
y structure, prior to Its issuance, also requires the applicant for such permit \
file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains \
.e 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 Reinspection Fee $15 Issue Fee $ 3
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)• $ 3 DEVELOPMENT SERVICES REQUIREMENTS: '/ Qo
I, •as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee Zoning Approved By Date/-2T'rO/
compensation, will do the work,and the structure Is not intended or offered _ a,
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date
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. ❑ Application Issued By Datel ZL —L1�
employees, provided that such Improvements are not intended or offered for
sale. If, the owner
building dof pro i sold she one year of com- Canopy Type II 0 SUMMARY O�_FEES
elation, the owner will have the burden of proving he/she did not build or Int- Duct-Under Ground SUMMARY
r e for the purpose of sale). - BUILDING PERMIT $ $MIP $ �`l-
1 as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ �.�._S PERMIT
ractors 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 PLUMBING $ ISSUANCE $
builds or improves thereon. and who contracts for such oroiects with a con- _
tractor(s) license pursuant to sne Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $ ENERGY P.C. $
proof of their Worker's Compensation insurance should be provided to me. GRADING $
0 I am ex pt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers ELECTRICAL $
i PLAN CHECK 50% $ MICROFILM $
Date Owner - .----..._ al Heating System& Ducting Registers MECHANICAL $ Q Zr
I hereby certify that I have re.•this application and state th the above DO-100,000 BTU 0100,000 BTL TOTAL FEE $ S_,-
Information is correct. I agree to comply with all city and coun ordinances . PLAN CHECK 25% $
and state laws relating to building construction,and hereby authorize r pre-
sentatives of t s city to enter upon t> prY
above-mentioned ert for
Inspection p ses. iiqP••
Signature i •ate / 2T //�. Reinspection Fee $15 Issue Fee $ 3 �1 0002-0962-r5024964 TOT '8 e2
Drivers' L se or SS# al�._ ._ 1
UMTS' .21/24/87 TTtIE: 15:200865-46,rev.5/88 white - Building; Canary - Applicant; Pink -Accounting: Goldenrod - Assessor
,
CONSTRUCTION AND PLANNIN )L &SPA
APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole . •' 52. Pool& Equipment Location ;j
2. 'Soil Pipe-Undrgrnd. •' ,, 53. Steel Reinforcement ';, ` '
3. Electrical Conduit Utility-Undrgrnd. 2.
54. Forms
4.•Electrical Cgnr�uit-Undrgrnd. 55. Electrical Bonding `
.1
5. (Steel Reinforcement , 56."Rough Plumbing & Pressure Test ,.. 4I
6;'. ElectricalUFERrarnd.• ,_ 57. 'APP3 VALTOCOVER-G UNITE l
7. •Footings ; 4_,,r Si - '_-I (/L,/� 2 if 58. Electrical Conduit-Undrgrnd. ,1 1 )
l %`
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 .•
. 1 .
11. Property'Sewer Line& House Connection 62. Backwash & Receptor-Final -
12;Sewer Cap.. ..; - 63. Heater & Vent-Final 9
•13. Roof Drains. • - 64. Plumbing System - Final
14. Rough Plumbing'' 65. Electrical-Final •
15: Rough Electrical-Conduit ‘• 66. Solar System-Final
1'6. 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 r APPROVALS Permit#
21. Ducts, in Structure ' 70. Underground Hydro
22:�Dut:tsN j• , Ventilating • 71. Product Piping 0 Gas 0 Oil
23)Gas Pipe-Rough & Test 72. Underground Flush
t
24.E Roof Framing • ' 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 1 r 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 r . 79. FINAL INSPECTION .
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:-2/10A ct 0-c .7-6 G'/i_45,}7---
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory fireplace
38. Final�PlpMb* ing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
4 1
42. Backflow Preventer - I
43. Backflow Irrigation -)
44. Landscape,Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUI LDING 3ira/81 B'4--
48. Special Requirements Completed
.
(49. Electric Release to Edison -
'50. Gas Release to Southern California Gas Co • t-, '
51. CERTIFICATE OF OCCUPANCY -
No! Date
II3 I--. .r Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. `
CITY OF COSTA MESA CONSTRUCTIONt� �+ a/P``E.RM/IT� PERMIT NO. TRACT NO. LOT NO. UNIT NO.
a4f23 Y�> ie Q�i9 v0 act J r 33-5 6.s--fes .3 of-im1 r aol
Applicant's
IicaAdd Mailingress ❑ ADD U ALTERATION U REPAIR
e�� q�� ���1� TYPE OF CONSTRUCTION ❑ NEW A'UPlicant's Address � / ! CI ❑ OTHER
Owner's Namet e-144read .�.0.rtl*SV,tPh0 nd
El CONVERSION A.P.# I Zone
DESCRIPTION OF WORK/USE OF BLDG.
Address 241.00 /Wes 3t sfA ele /49,9fie 7217, S Main Building: Accessory Building: •
Z
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING DI FOUNDATION El STRUCTURAL T Front CITY OF COSTA PESAt CA Q
Address ❑ TENANT ❑ ELECTRICAL *PLUMBING ❑ MECHANICAL B Rear 1-UK Ut!'USII IJNLI N
yy ❑ OTHER 'e' CEr,�,;.".:TY l��.e,.tf ln. �'Ai:l�iifl 1i11�'t
Contractor's Namell�L�/ *�� Phone ►' C Right RANK ACf.ONNT :: ?$fi-i+;�:t(�',
Q� L PROJECT DESCRIPTION SQ. FT. OCCUPANCY
Address lmailing) f10
w �AC
CONSTRUCTION TYPE OCCUPANCY
VALUATION s Left ACCOUNT ��_D 1307_200c05 _
City License No. � ZONE GRADING CU.YDS. ACRES 1 U !i Gd G-GVJS TO'GVVW} {
LICENSED CONTRACTOR DECLARATION rrr111 Ping. Ref.# Pa �slld TClI{15 311. '
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ; e 4o ige4r/�`. Ain
Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and "�/7 We T
my license is in full foreg�and effect. .ite
PLUMBING FEES ) •
WORKERS'COMPENSATION DECLARATION Bar Sink Showers EL r ai!3f0DOD3997 TOT FC .00
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 Backflow Preventer Service Sink
3800, Lab. C.) 1 L 1L� Automatic Washer Transformer D 15-50 KW •
\ P_olic No. -t �� � Company �jj�ry Alai' Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW
ertifietl copy is hereby furnished. /]
%SS Cert" " d copy Is filed with the city Bu' iwsioy (/ " 620 Bathtubs Sewer Connection q4:100 Cooking Unit Meter pup to 100 amps
C\\ Dat Applicant L�
EXE TI N FROM WORKERS'COMP NSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100) or
less). 14, Dishwasher Solar Piping —7).00 Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for:which this permit is issued, I
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP El'A-8
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa —^ F.A.U. Inc • ar 1:19-15 HP ❑76-15+
NOTICE:If,after making this declaration,you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. Icrowave
•
CONSTRUCTION LENDING AGENCY //_ Gas Service Outlets Water Closet nee Device Boxes Pole Light
I hereby affirm that there is a construction lending agency for the performance AA
of the work for which this permit is issued (Section -3097 jCiv. C.) - Interceptors a Water HeaterSal-. OQ Outlets Range
Lender's Name _
Lender's Address /0 Kitchen Sink Water Service 32_OO Switches Sign
OWNER BUILDER DECLARATION .�11
I hereby affirm that I am exempt from the Contractor's License Law for the NJA Lavatories Auto-Wash i Doe Garbage Disposal Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or ff
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator 00-5 KW 05-15 KW ..
•ny structure, prior to its issuance, also requires the applicant for such permit Trash Compactor
.o 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
❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee
compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves •
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type ❑ DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not Intended or offered foryp Zoning Approved By • Date
sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II El ^,
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By '/�,>� Date
s
prove for the purpose of sale). �•�
❑ I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By I Date f7'�"'l�
tractors to construct the project (Section 7044, Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 0o-100,000 BTU 0100,000 BTU SUMMARY OF F S .
builds or improves thereon, and who contracts for such projects with a con-
trector(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact,Blt. ICBG# / Fire Dampers
$ 00 - ISSUANCE $
Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ 00 ENERGY P.C. $
I hereby certify that I have read this application and state that the above ❑o-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 cit enter up gqpp the above-mentioned property for Q
inspection purposes.
Signature Dat:,:# TOTAL FEE— MECHANICAL $ $3I 3. D 0
Drivers' License or SS# + _ Reinspection Fee $15 Issue Fee
PE
PLAN CHECK 25% $
CMF oe65-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
,CONSTRUCTION ANDIPLANNING POOL'&SPA
� Date Inspector Date Inspector
APPROVALS Permit•# APPROVALS Permit# I:
1,_Temporary Electrical:Service or Pole 52. Pool & Equipment Location !,
2r.Soil Pipe-Undrgrnd. (" J!'//fr o614 53. Steel Reinforcement4 ,"
3. Electrical Conduit Utility-Undrgrnd. 54. Forms • • E
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding -
5. Steel Reinforcement t 56. Rough Plumbing & Pressure Test 1
6. Electrical UFER Gr d-. - 57. APPROVAL TO COVER-GUNITE .
7. Footings 0 %%j r' 58. Electrical Conduit-Undrgrnd. -
8. Foundation • / 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe'-Undrgrnd f# / 60. Backwash Lines, P-Trap, 0 Undrgrnd.
i
..110. Structural Floor System 61.. APPROVAL TO DECK
11. Property Sewer Line &House Connection 62. Backwash & Receptor-Final "
P •
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing b,//ilrtC [rP 65. Electrical-Final -.I
l
15. Rough Electrical-Conduit 66. Solar System-Final .. •
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 42 ,• �' s 68. APPROVEDFOR PLASTERING
18. Rough Electrical-T Bar Ceiling (1 'I )1 69. POOL/S_PA SYSTEMS FINAL
19. Rough Heating & Air Conditioning ` ;I i I I .// 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 ii',' -
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 -I. 76. Dry Standpipe . ,
28. Lathing &-Siding 77. FIXED SYSTEM FINAL • - .
29. Insulation 78. FIRE PREV. FINAL 4
30. Drywall Nailing HEALTH DEPT. REQUIREMENT 4
31. Plaster Brown Coat , 79. FINAL INSPECTION U/
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED !V
33. Final Electric Notes: I'(
r .
34. Final Heating & Air Conditioning I '1
n
35. Final Gas Pipe-Test
111-VY rA?'
36. Hood or Canopy
37. Final Factory Fireplace
38: Final Plumbing • 3-14q L40 .r ; r.
39. Water Service-Final • 3-1-11k 140 1 ! . I" '
40. Gas Service-Final I I
1.41. Solar Domestic-Final I r - I r l
r 42. Backf low Preventer ../ . �
43. Backflow Irrigation >"
I,'44. Landscape Irrigation System - '
'OB. Sound Attenuation - 1' ' - '
•
' 46. Handicap Regulations 11
h
4 .-FINAL STRUCTURE & BUILDING r "•
'"�. 1 1
48. Special Requirements Completed C r
49. Electric Release to Edison '. r
50. Gas Release to Southern California Gas Co '' -
•
51. CERTIFICATE OF OCCUPANCY r• ?
No. Date .
%
6/ may ' // Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MES CO 4 RUCTION •• R IT PERMIT Q3 4/8 93 TRACT NO. LOT NO. UNIT NN.
/,
Project Andress ZZ' -t -i i .� ♦ 1
�j�`er�`7/ /I •I . TYPE OF CONSTRUCTION NEW DD ALTERATION REPAIR
-
Applicant's Maili Address e� -
�� / Y / / ! CONVERSION ❑ DEMOLISH OTHER A.P.
Zone
Owner's Na e tis' se. �� ����� �—� "' a
/ / 0 CR•y1eN r—
OF R /USE QF BLD .
Address -- D 07,.. - —' .,irS Main Building: Accessory Building:
Arch/Eng. License No. - - TYPE OF PE'MIT U GRADING FOUNDATION U STRUCTURAL T Z
Front
O
Address ,'-- •���i• %r. • ❑ED TENANT ELECTRICAL ❑ PLUMBING MECHANICAL BOTHER A Rear N
Con tractor's N.01tr i qILtF/./ ���rJ� rk neiart��� C Right N
Address(mailing) -5� • ;-f / re. PROJECT DESCRIPTION 50. FT. OCCUPANCY K Left G
SR CONSTRUCTION TYPE VALUATION$ $ R
City License No. /` Z v"CC!//!V' ZONE GRADING CU.YDS. ACRES E
r J
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
twith section 700 of Division 3 of the Business and Prof sion ode,a
my license is in f}fll Too • effect. �, , T
iclte 411,3 s L1r I._
Signature •.
et.*
N PLUMBING I FEES S
SORK' ' ' • i ATION DECLARAT • 0• (Bar Sink I I Showers I ELECTRICAL FEES
I hereby affirm that I have a certificate of consent t elerins • or a certificate
1 ` of Workers' o ensation Insur n e, or a cerci 1 cop I -r-of ion Backflow Preventer Service Sink 1111
3800, La Automatic Washer Transformer 0 15-50 KW
P
y
Policy No. ��C� Compan / BY-_. -LA Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
- Certified copy is hereby furnished.
- Certified copy is filed with the city = � irt Bathtubs $ewer Connection Cooking Unit Meter Duo to 100 amps
Date Applicant Clarifiers Solar Collectors Dishwasher Meter
EXEMPTION FROM WORKERS'COMPENSATION DECL• •ATION Dover 100 amps
(This section need not be completed if the permit Is for one hi dred ($100)or
less). Dishwasher Solar Piping Dryers OGas ❑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-B
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa — F.A.U. Inc.Solar ❑9-15 HP 016-15+
NOTICE:If,after making this declaration, you should become subject to the —
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet
I hereby affirm that there is a construction lending agency for the performance - Device Boxes Pole Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater
Outlets Range
Lender's Name - -
Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION - -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal •
following reason (Section 7031.5 Business and Professional Code: Any city or 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
my structure, prior to Its issuance, also requires the applicant for such permit - Trash Compactor
.0 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 —
LIpenalty of not more than five hundred dollars($500). $ 3
I, as owner of the properly or my employees with wages as their sole Reinspection Fee $15 Issue Fee
compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL .FEES
-
License Law dues not apply to an owner of a property who builds or Improves s _ _ _. _ .— _
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such Improvements are not intended or offered foryp Zoning Approved By Date -
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0
n, the owner will have the burden Of proving he/she did not build or im- Duct- Under Ground
doveBuilding Approved By —�\ Date
LI trove for the purpose of sale). iLly/1
I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By fi 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
I builds or improves thereon, and who contracts for such projects with a con- -- -
lractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I BUI LDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. If PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers
�� PLUMBING $ Di 00512633-0e* .5ET $ 37,50
$
Date Owner ) J Heating„, System& Ducting Registers PLAN CHECK 25% $ n /• ' o
I hereby certify that I -ad this application and state that the above/ •yv100,000 BTU 0100,000 BTL DaTE: Ds. ♦Gl83. 12
information is correct. ee t• with all city and county ordinance / ELECTRICAL $
and state laws rel ting '•• co r ab and herebyentior1 ap(horiz repre- •
PLAN CHECK 50% $ MICROFILM $
inspection of this •o r go, aDOve-mentiorRd/p[4�e r 'j
inspection purposes. ' MECHANICAL $ 37. 'O
Signature •�
ns' ”-C- n V_---- •
CMF 0665-46,rev.10/84 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor FOR DEPOSIT ONLY
FriIDTTv nwn rrrn .,..-....... -.....
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 1 (,
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 'I
t
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test r
•
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
-84. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
.'n9;'Mater 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
Z8. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning 10Lo--EJ' tCO FIRE DEPT. REQUIREMENT ✓
20. Rough Factory Fireplace APPROVALS Permit#
1,21. 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 OSI
25. Roof Sheathing 74. Overhead Hydro
26:T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical r
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 - rn
31. Plaster Brown Coat 79. FINAL INSPECTION - 1
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED r•:'
33. Final Electric Notes:
34. Finat Heating & Air Conditioning 77274Y1 %
35. Finial Gas Pipe-Test (
36. Hood or Canopy •
37. Final Factory Fireplace •
38. Final Plumbing t fY'
39. Water Service-Final • .
'#
r
t 40. Gas Service-Final
41. Solar Domestic-Final ,
42. Backflow Preventer -
43. Backflow Irrigation • • •
t •7
44. Laridscape Irrigation System ",r"1
45. Sound Attenuation r . 'IM
46. Handicap Regulations •' . fi
47. FINAL STRUCTURE & BUILDING - Y
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY
No. Date
J,ZI, /-/4 lin Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PERMIT NO. TRACT NO. LOT NO. UNIT NO.
e OF COSTA MESA{ C STRU TION/ PERMIT j E 3 Cg, A.P.# Zone
Project Arress aJ�� � !J/l�fJ �.Q. - �� I� S Main Building: Accessory Building:
TYPE OF CONSTRUCTION [ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR
A plicant s Mailin Address E - - 0
re ❑ CONVERSION ❑ DEMOLISH ❑ OTHEJI _ T Front Q
Z
Owner's Name FI(LV i�a� ' /A�9F.MFT- Phone DESCRIPTION OF WORK/USE OF BLDG. �"t B Rear N
Address
Arch/Eng. License No. -- TYPE OF PERMIT��, .0 GRADING ❑ FOUNDATION ❑ STRUCTURAL K Right N
Address r-' •
❑ TENANT IJ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL 1 $ - Left R
Contractor's erne-WaltNGECM C� Phone/75-WDI ❑ BOTHER ,�pp I Ping. Ref.# Parking Req./Provided E
'1 PROJECT DESCRIPTION SQ. FT. II 744 OCCUPANCY h'' • Q
IN Address(mailing) �'1T-' Hicks, F V r r Planning Notes: M
4�� I CO N STRUCTION TYPE VALUATION$
City License No. ZONE GRADING CU.YDS. ACRES T
LICENSED CONTRACTOR DECLARATION S.
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: •
nn
with section 7000) of Division 3 of the Business and Professions Code, and {[ G.t
es
my license is in full once and effect. �� ELECTRICAL - FEES
ILicense C ass IcenseQg o.
c•-:
^ •te� .�' 6 Signature yOdJL � PLUMBING I FEES Automatic Washer Transformer 0 15-50 KW
JR ERS' COMPENSATION DECLARA ION Construction Pole Sub. 0 50+ KW
i hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers
of Workers' compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit 11
Meter INfip to 100 amps
3800, Lab. C.) CITE Dishwasher Meterp
Policy No. ��� Company ^•/ backflow Irrigation Sewer Cap Dover 100 amps
—
II�ylf�rt itietl copy is hereby furnished. • Dryers ❑Gas ❑Electric Sub Panel
Date
e Dco7 is d with the city 'Itling Islon. / Bathtubs Sewer Connection -
Date 7 Qui KERS'ant.c Tr t�RATION ' Fan
EXEMP ION ROM WORKERS'COMPENS TION DECLARATION Clarifiers Solar Collectors >•- Motors 00.1 HP I:11%-6
essis section need not be completed if the permit is for one hundred ($100) or lDishwasher Solar Piping F.A.U. Inc.Solar 09-15 HP 016.15+
I certify that in the performance of the work for which this permit is issued, I -
• Fixtures
shall not employ any person in any manner so as to become subject to the . D'rinking Fountains Solar Tank _ - Microwave
Workers' Compensation Laws of California. /� Device Boxes
Date Signature - Floor Drains Swimming Pool w/Spa Pole Light
NOTICE:If,after making this declaration, you should become subject to the - Outlets
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Range
comply with such provisions or this permit shall be deemed revoked. •
CONSTRUCTION LENDING AGENCY • f Gas Service Outlets Water Closet ' Switches Sign
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.) Garbage Disposal Standing Sections
Interceptors Water Heater
Lender's Name
Lender's Address Kitchen Sink Water Service f Generator 00.5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash *O3 X 1/,wet }
35172-
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 /7 i73
ny structure, prior to its issuance, also requires the applicant for such permit •
: file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains
re Contractor's License Law(Chapter 9(commencing with Section 7000) of - n J
Division 3 of the Business and Professions Code) or that he/she is exempt Reins action Fee $
therefrom and the basis for the alleged exemption. Any violation of Section P $15 Issue Fee
7031.5 by any applicant for a permit subjects the applicant to a civil -
penalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS:
LI I, as owner of the property or my employees with wages as their sole Reinspection Fee I
$15 Issue Fee $ 3 -
compensation, will do the work, and the structure is not intended or-offered Zoning Approved By Date
for sale (Section 7044, Business and Professional Code: The Contractor'sMECHANICAL FEES Building Approved By
License Law does not apply to an owner of a property who builds or improves r Date rry
thereon, and who does such work himself/herself or through his or her own a Application Issued By I�1 Date tot�l3
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 • SUMMARY OF FEES
pletion, the owner will have the burden of proving he/she did not build or Im- Duct- Under Ground I
prove for the purpose of sale). BUILDING PERMIT $ SMIP $
LJ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT
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 PLUMBING $ ISSUANCE $
builds or improves thereon. and who contracts for such oroiects with a con-
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ �s - ENERGY P.C. $
proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ �� /•�Z GRADING $
❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers ......-a• MICROFILM $
Date Owner Heating System&Ducting Registers PLAN CHECK 50% $
I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BTU - MECHANICAL $ TOTAL FEE $ 30.3 Y
Information is correct, agree to comply with all city and county ordinances PLAN CHECK 25% $
and state laws relatim •o building co truction, and hereby authorize repre- , -
•
sentatives of this to a ter up n the above-mentioned property for
.Inspection purpos-•
Signature t42 Date/001C
Drivers' License or SS • Reinspection Fee $15 Issue Fee $ 3 • •
01 00017963-00017963 T0T367.32
0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor DATE: 10/26/88 TIME: 16:25
. I , `. c + '
,+1 ' - > JL & SPA
COWSTRUCTION AND PLANNINt. ; -
Date ,. Inspector - Date Inspector
APPROVALS Permit .APPROVALS Permit#
1.S!emporary Electrical Service or Pole �,. 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ftp �� 53. Steel Reinforcement ;
3`, Electrical Conduit-Utility-Undrgrnd. 54. Forms
-4-,Electrical Conduit'Uridigrnd. 55. Electrical Bonding
5. Steel Reinforcement` 56. Rough Plumbing & Pressure Test ��",
`6•.'- Electrical UFER'Ernd. :L r 57. APPROVAL TO COVER-GUNITE • `tj
II:Footings L-• R r `r1 58. Electrical Conduit-Undrgrnd. <,ti
'8.../Foundation ^',. - t'" 59. Gas Pipe, 0 Undrgrnd.,Test , '''
a
9� Water Pipe-Undrgnrid. - -� 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10f Structural Floor System -4 'In )- 61. APPROVAL TO DECK
11.;;Property Sewer Line & House Connection T '1
v' 1 _ 62. Backwash & Receptor-Final
12%Sewer Cap t.. (.'1 ,� C: 63. Heater & Vent-Final '"
13. Roof Drains � G. • r0 64. Plumbing System - Final
14. Rough Plumbing- 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
1116. Rough Electric Wiring /j_3.gg V`, 67. Fencing & Access Approval
i1.7. 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 1, APPROVALS Permit#
21. Ducts, in Structure /;' 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping ❑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 L' i,
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 2..' j,�J'7/�,d 80. FOOD CERTIFICATE ISSUED
33. Final Electric Z-22-8? J Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace L".,,--
38.
/38. Final Plumbing .
39. Water Service-Final •
40. Gas Service-FinalI
41. Solar Domestic-Final V
42. Backflow Preventer -I
43. Backflow Irrigation • '
44. Landscape Irrigation System ,
45. Sound Attenuation -
46. Handicap Regulations •�• - 1
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
Development Services Department CERTIFICATE OF OCCUPANCY No.
Building Safety Division O
P.0.Box 1200
Costa Mesa,California
The Building located at 2522 Srnti C taina Drive, Building 11
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 Arorhmcnt•a
Legal Description 4170-217-10
(See reverse side for Metes and Bounds)
Building Permit No 1113460.B37267 Electrical Permit No. E 35899 Plumbing Permit No. P 33555
Mechanical Permit No. f1 34893 Number of apartments Cc and/or guest rooms
ISSUED TO: Building Official William T. Howard
R- irvi nw Manaaatrt_tnt Comoanv - 1-
2920 t brriaac Way by . 1 —• —77 4
rnahr CA 92526
Date March 27, 1965
lrhis 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