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Home My WebLink About2541 SANTA CATALINA DR - Building Permits City of Coins Mesa OeOelonment Servides Department CERTIFICATE OP OCCUPANCY No. r- 't f 3 Building Safety Division U _ _ k P:O.eo( 1200 Crista Mesa,C4lifornie the Building located at ^r T,__,_z-a.___.—_" .... - has been inspected and found to cornply with tfie provisions of all City of Co to Mesa Ordinances applicable thereto to? a Group Occupancy: Use of Building_ - _ Legal Description_!-^ <. (See reverse"side for Metes end Bounds) Building Paten it No-an=tnc—ni.•>r,2Eleetrioal Permit No...- .,r_.___ -.Plumbing Permit No. - - Meehanidal Permit No: - NUniber of apartments - and/or guest rooms ISSUED fen Building Official - -.: 1-1 : _._m.. _ ._ Rai rvi Ala Manr__nc±mnrlr .. ..._-- -._•--._.. • 2400 [Main Street,, Ste,, 210 by -i r r?rvinc . CA 92716 -_ Date nannmb.nr 0 1 Orr This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015=46.rev:1/83 White-Owner;Canary-Numerical File;Pink-Bldg:Permit File U1 MF CITY OF COSTA MESA 4/, 9@ BUILDING DIVISION t:i ce al g DEVELOPMENT SERVICES DEPARTMENT RMIT NUMBER I w.a.,.� Ili. :� �a� PERMIT B03-01917 (714)757`°54p•527c3D• Fax(714)754-4856 • www.ci.costa-mesas uILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2541 SANTA CATALINA DR Status: ISSUED Suite: 101 Applied: 11/04/2003 Vicinity: Issued: 11/04/2003 Parcel Number: 42005103 Zoning: Applicant: LESLIE MARLER ISSUED BY: ,% g Address: 2500 MERRIMAC WY Phone: 714-545-0442 COSTA MESA,CA Zip: 92626 Owner: STATE OF CALIFORNIA%CONTINENTAL WINGATE Address ASSOCINC 63 KENDRICK STREET Phone: ONE CHARLES RIVER PLACE Zip: 02494 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 000000 • Arch : Eng: Address: • Address: • Phone: Phone: Zip: License: License: SCOPE OF PERMIT REMOVE EXISTING KITCHEN AREA TO CREATE A NEW LAUNDRY FACILITY.WORK TO INCLUDE:RELOCATE WINDOWS,ADD EXTERIOR DOORS,DEMOLISH INTERIOR WALLS AND RECONFIGURAGE.SUITE 101. FEE SUMMARY Plan Check: $287.46 Calc Valuation: $29,700.00 Permit: $442.25 Claim Valuation: $29,700.00 SMIP Res: $2.97 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 • Total: $732.68 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 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or If work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 244646(WOO) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm undebenalty of perjury one of the following declarations: ❑ I have end will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. ❑ I have and will maintain workers'compensation in rance -required by section 3700 of the Labor Code,for the performance of the wwork for this permit is issued. My workers'comp: sati.1 In- race carrier a.- •. number ere: II Carrier: S._ .PAL`-1M Policy Number: is '' ion need not be competed if the permit i vat-ed at one hundred dollars($100)or less.) Ll I certify that in the performance of the work to which this permit Is Issued,I shall not employ any person in any manner so as to become subject to the workers' 414- compensation laws of Ca'tomer,and agree that if I should become subject to the workers'compensation provisions of Section 37 of the bor Code,I shall forthwith comply with these ; �Q� Applicant Signature: ) n X (f)G NNT� Date: • r�L � WARNING:FAILURE T" ORKERS COMPENSATION COVERAGEAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL E T S ONE HUNDRED THOUSAND DOLLARE( ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and effect.Llc.a Class A Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 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 sl ed 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 Busin 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 su ' cts the applicant to civil penalty of not more than five hundred dollars(5500).): I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exam.;t u her se — �� Busi.:as and Profess'. s Code for this reason: ' 1 Signature: r .. 7 7I 7 t -.dd ("tires: 07.2 7—.04 Verificatlo • • •ne hip by(type of docum: t,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,fatsework,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 Safely Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has et any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? DI Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). m.........._..."'" __. _..__ .— _ 7 Ifa a permitn athe South Coast s Qualityci ed Management Californiaal or other et pollution control district03 or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califoia Health and Safety Cade Section 42303 been made? 0 Yes 0 No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penally of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given Is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy; any building authorized b this er ' u final inspection. ,I. re Of'nyrei.Ti/'r(.,/ �1 a Date ant •nd/Or Authorized Applicant Date VON I INS' •••.• gdI€ =GS QOPFt INSPECTION TYPE PATE MEMO 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval /) 203 Final Sign _ 222 Final Site 204 Final Demolition 250 Final Building/Occupancy din ,STp F CITY OF COSTA MESA a BUILDING DIVISION >: i.i.ror nit..s/ DEVELOPMENT SERVICES DEPARTMENT PERMI MBER �. IPIKAPERMIT -"1sroenw° • P03-00725 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2541 SANTA CATALINA DR Status: ISSUED Suite No 101 Applied: 11/04/2003 Issued: 11/04/2003 Vicinity: Parcel Nunmber: 42005103 ISSUED BY: Applicant: LESLIE MARLER Address: 2500 MERRIMAC WY Phone: 714-545-0442 COSTA MESA,CA Zip: 92626 Owner: STATE OF CALIFORNIA%CONTINENTAL WINGATE Address ASSOCINC 63 KENDRICK STREET Phone: ONE CHARLES RIVER PLACE Zip: 02494 Contractor; OWNER-BUILDER Address; ' Phone: Zip: License: 000000 Arch/ Eng Address; Phone: Zip: License: SCOPE OF PERMIT REMOVE EXISTING KITCHEN AREA TO CREATE A NEW LAUNDRY FACILITY.WORK TO INCLUDE: RELOCATE WINDOWS,ADD EXTERIOR DOORS,DEMOLISH INTERIOR WALLS AND RECONFIGURAGE. SUITE 101.REF.:B03-01917 PLUMBING TO INCLUDE: 1 RECEPTOR AND 1 WATER PIPING. FEE SUMMARY •• AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 . Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $9.80 1 Vacuum Brkr Bktow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 ' Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(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 work for which this permit is Issued. ❑ I have and will maintain workers'compen tion insurance,as required by section 3700 of the Labor Code,for the performance of the work for whi this permit Is issued. My workers'compen at n nsurance nd policy number are: �I1 Carrier: Policy Number: (J 717 (This s on need not be co Mete ii th permit Is valued at one hundred dollars(3100)or less.) I certify that in the performance of the work for which this permit Is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation la s of•,:Ilfomia,'and ag t If I should becomepubject to the workers'compensation provisions of Section 3 00 oft e Labor Code,I shall forthwith comply with the ..��' s ` C�/ /� \ l s Applicant Sipnetu :y :�� - � /! [ I/ �rJ Date: �� WARNING:FAILUR: TO SF `r WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE TIES D CML FINES UP TOONE HUNDRED THOUSAND DOLLA-. . •,•..),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I an licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and effect.Uc.# Class e Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). 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�s5igned 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 Busine iland 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 ub s the applicant to a civil penalty of not more than five hundred dollars(5500).): I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursu.nt to the Contractors License Laws.). ❑ I am exam. ,•.,r e . a a Bu' •ess and Prof. .ns Code for this reason: Signature: `I, . ._ /Etat*j 1:t EN /`WL�.f� Owner ID ye inrr• 'vers license. es ❑No Drivers License No. // spires: SIP Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 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 materialsr ❑Yes ❑No (Section 25534 of Ire California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication 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? U Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits). 8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code), ._ _._...hich i._...._..._ect of_ 7 Ifa a permit from a l South Coast res Qualityced Management Di Heal or other airpollution ooncontrol district3 agency is required for 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 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given Is correct. I agree to comply with all state laws end city ordinances relating to building construction,and authorize representatives of a City fCosta Mesa to enter upon the above-described property for Inspection purposes.I agree not to occupy or allow occupancy of:ny building authorized by this per It I � ' on. .0, I•n: ur art ••I 1.raf 1/ / Date r raft I- And/Or Authorized Applicant Date DODE I INSPECTIONTYPE PATE INRTIAL6 cODFE INSPECTION TYPE PAIL KEELS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 7r, �J, 1268 Pool Spa Final 208 Final Plumbing /A-1AS'O✓ //x" 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retalning 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 _ - ST$i f CITY OF COSTA MESA 4 � @@ BUILDING DIVISION -,- :� DEVELOPMENT SERVICES DEPARTMENT PERMIT NU R 1. 1 his PERMIT Deet , •• . PO4-00025 (714)754-5273 • Fax(714)754-4856 • www.ci,costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2541 SANTA CATALINA DR Status: ISSUED Suite No 101 Applied: 01/13/2004 Issued: 01/13/2004 11//113/2004 Vicinity: 101 Parcel Nunmber: 42005103 ISSUED BY: Applicant: LESLIE MARLNER Address: 2500 MERIMAC Phone: 714-545-0442 CM Zip: 92626 Owner: STATE OF CALIFORNIA%CONTINENTAL WINGATE Address ASSOCINC 63 KENDRICK STREET Phone: ONE CHARLES RIVER PLACE Zip: 02494 r f‘ t % �� . +r.7).¢ rAtor: OMIER-BU. Et CI 1', �• Address: Phone: Zip: • License: 000000 Arch / Eng: Address: Phone: Zip: License: SCOPE OF PERMIT 2 WATER HEATERS FOR UNIT 101. FEE SUMMARY • AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 - Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow inigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $24.60 2 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 I••C,1€ei11 ...MINI), +`...'sVAil; 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 end 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 2446-46(9/00) 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 work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compensation Insurance carrier and policy number are: x • Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit Is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($1%,000),IN ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37080F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in lull force and effect.Lic.N Class• Contractor's Signature: _ Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation at Section 7031.5 by any applicant for a permit Ablects 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 and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). • exempt ..,10 ec. . a • Business and Professions Code for this reason: ••• : D verified A' ars license. :• Yes 0 No o. ' Ex.re : EF4Ovil . Vellication of Ownership by(type of docume t,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: O 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,The 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 hes a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous materiel? 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 en RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If en RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application a,permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the Califomia Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia 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 slate 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 end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this p mit until final inspection. Signatur- • Legal Own.qpiiiffI it OP' Date And/Or Authorized Applicant Date CODE L INSPECTION TYPE PATE IKRTIAI8 CODE I INSPECTION TYPE GATE INI11AL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical u 1266 Pool Spa Final 208 Final Plumbing 1- i M"Q 1E1V 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy CITY OF COSTA MESA i,"4) BUILDING DIVISION > tan14.0 1,11.1 DEVELOPMENT SERVICES DEPARTMENT ERMIT NUMBER 00041 . PERMIT /I B03-01918 Steponansol (714)754-5273 • Fax(714)754-4856 • wvAv.ci.costa-mesa.ca,uUIsLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2541 SANTA CATALINA DR Status: ISSUED Suite: 104 Applied: 11/04/2003 Vicinity: • Issued: 11/04/2003 Parcel Number: 42005103 Zoning: Applicant: LESLIE MARLER ISSUED BY: Address: 2500 MERRIMAC WY Phone: 714-545-0442 COSTA MESA,CA Zip: 92626 Owner: STATE OF CALIFORNIA%CONTINENTAL WINGATE Address ASSOCINC 63 KENDRICK STREET Phone: ONE CHARLES RIVER PLACE Zip: 02494 Contractor OWNER-BUILDER Address: Phone: Zip: License: 000000 Arch : Eng: Address: Address: Phone: ' Phone: Zip: License: License: SCOPE OF PERMIT REMOVE EXISTING KITCHEN AREA TO CREATE A NEW LAUNDRY FACILITY.WORK TO INCLUDE:RELOCATE WINDOWS,ADD EXTERIOR DOORS,DEMOLISH INTERIOR WALLS AND RECONFIGURAGE.SUITE 104. FEE SUMMARY Plan Check: $287.46 Calc Valuation: $29,700.00 Permit: $442.25 Claim Valuation: $29,700.00 SMIP Res: $2.97 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $732.68 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 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 expiratlon.ofthis permit. FOR INSPECTIONS CALL: (714)7544626 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a cenificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. ❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for whhrylllch this permit Is Issued. My workers'compensation� rinnsu,rrIa��nn1cee��ta-trier and policy number are: / Cartier: , :'XE I r / Policy Number: /`K/ (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit is Issued,I shall not employ any person In any manner so as to become subject to the workers' compensation laws of Califo• la,and agree th t 1 I should become subject to the wo rs'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pr. %411.;1 /€ r 0 r ,/ Applicant Signature: .t.0 (.0//YlC ( C r Date: /!-1T -Da WARNING:FAILURE TOS •• ERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND COLLARE($100,.:•••ILII •DN10N TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and effect.Lic.# Class ft Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its Issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit su leets the applicant to a civil penalty of not more than five hundred dollars(5500).): I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exe . u)•er s, . B tress and Pro:- skins Code for this reason: Signature: al' . .-air ier& A G _ Expires: , 2 Verification of• nership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Dale: 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? ❑Yes ❑No (Section 25533 of the California Health end 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 Mit-tad-its)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ..........._....___...._..i_. __i _ _.__._ ___ ..._ _. 4 If an RMPP is presently required,has Section 25534 of the Celifomia Health and Sefery Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aggermit TOTsuch construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 101 Yes U No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 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 Distrix 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 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. a& SI• =lure • al Own: (s) ® 4— Det ark_ 1!— And/Or •ulharized Applicant Date ;ODE I INSPEC110N TYPE QAIE EMU PPE INSPECTION TYPE 683 al 1616 Fixed System Final Fire Prevention 208 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing - 200 Final Re-Roof 210 Final Electrical 201 Final BIock/Retalning Wall 212 Final Fire Prevention _ 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign222 Final Be 204 Final Demolition 250 Final Building/Occupancy Ell ,p_ F CITY OF COSTA MESA i4.01/4:) 9 BUILDING DIVISION >k r,,,,., 1..,1 DEVELOPMENT SERVICES DEPARTMENT PER NUMBER :t "Ca PERMIT *tbePonsno e4* P03-00726 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2541 SANTA CATALINA DR Status: ISSUED Suite No 104 Applied: 11/04/2003 Issued: 11/04/2003 Vicinity: Parcel Nunmber: 42005103 ISSUED BY: Applicant: LESLIE MARLER Address: 2500 MERRIMAC WY Phone: 714-545-0442 COSTA MESA,CA Zip: 92626 Owner: STATE OF CALIFORNIA%CONTINENTAL WINGATE Address ASSOCINC 63 KENDRICK STREET Phone: ONE CHARLES RIVER PLACE Zip: 02494 Contractor: OWNER-BUILDER Address: ' Phone: Zip: License: 000000 Arch / Eng: Address: Phone: Zip: License: SCOPE OF PERMIT REMOVE EXISTING KITCHEN AREA TO CREATE A NEW LAUNDRY FACILITY.WORK TO INCLUDE: RELOCATE WINDOWS,ADD EXTERIOR DOORS,DEMOLISH INTERIOR WALLS AND RECONFIGURAGE. SUITE 104.REF.: B03-01918 PLUMBING TO INCLUDE: 1 RECEPTOR AND 1 WATER PIPING. FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap'Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $9.80 1 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.-N9.92;28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 244646(600) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of tho work for which this permit is issued. My workers'comperAsati �//anion Insurance t- Pcarrier and policy number are: O /� Carder: Fr---Y T Policy Number: I gis section need not be completed it the permit is valued at one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Call 'rnia,and agree I should become subject to the workers'compensation provisions of Section 37pppppp of the Labor Code,I shall forthwith comply with(hese pro 'si.fs. L� (Ik�� //_ _D 2 Applicant Signature: Date: J WARNING:FAILURE TO- . -ORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED THOUSAND DOLLARE(St:•,••: IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION STe5OF THE LABOR030E,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full I force and effect.Lie.N Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). 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 su facts the applicant to a cMl penalty of not more than five hundred dollars(5500).): g 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 appy to an owner of property who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). - ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt nd,I sec. r a a Busin: -and Professions'''e for this reason: �/ Signature: a /• . . _ - I17� y! n / _ Expires: 5–.27-104 Verification o rship by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth Into which a person Is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,lalsework,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--0No (Section 25533 of the California Health and Safely Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes IJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 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 aermit 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 8 (If'yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy /orr allow occupancy of any building authorized by this permit until final inspection. 7%, Nr //— Date CODE f INSPECTION TYPE PATE I/ ALS CODE! INSPECTIONTYPE QAIE MALA 1816 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing Th1 a5 c3 CSN 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval – 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy Citbibmffib - CITY OF COSTA MESA BUILDING DIVISION J I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT PO4-00024 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2541 SANTA CATALINA DR Status: ISSUED Suite No 104 Applied: 01/13/2004 Issued: 01/13/2004 Vicinity: 104 Parcel Nunmber: 42005103 ISSUED BY: Applicant: LESLIE MARLER Address: 2500 MERIMAC WAY Phone: 714-545-0442 CM,CA Zip: 92626 Owner: STATE OF CALIFORNIA%CONTINENTAL WINGATE Address ASSOCINC - 63 KENDRICK STREET Phone: ONE CHARLES RIVER PLACE Zip: 02494 tl ,&.1, grgactor: OWNER-BUI5 isp�s • 4 • Address: Phone: Zip: License: 000000 Arch / Eng: Address: . Phone: Zip: License: SCOPE OF PERMIT 2 WATER HEATERS FOR UNIT 104. FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 - Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $24.60 2 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 244648(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm undelsenalty of perjury one of the following declarations: ►' • ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carder and policy number are: Cartier: / Policy Number: (This section need not be completed if the permit Is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit Is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(51040001,IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Lic.# Class# Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). 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 sub is the applicant to a civil penalty of not more than five hundred dollars($500).): as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Co •tors License Laws.). ❑ I am exempt •=r , P : .iness and Professions Code for this reason: Si ��_—A��►,'�� !�r .."L ask � ner ID verifie.b :war's license. =s 0 No F�- No. • . E E •. es: WA/4 2f Verification of Ownership by(type of document,I.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 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 ❑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 Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Ll Yes IP No (Section 65850.2 Of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 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 ❑No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. .4118 iga ff eget Owner"'r . i/' I> , - ate /3— Y AndJcVuthotized-AppllcaDi Date ;ODE I INSPECTION TYPE PAIS ATRIAL$ cODFE INSPECTION TYPE Ply INTIRAL$ • 1618 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing )-IL) -CA {SW 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy p! r9,/1 Applicant to fill in all spaces except those within heavy border lines and sign all apprepria a declarations. 4 $F COSTA MESA CONSTRUCTION PERMIT q PERMIT NO. / TRACT NO. LOTSNO. /o"IJ.�1O' � ject Address 254/ BQZ T4 C'AT.1L/.t/A paE/t t; 13l.LYj 1 zone's.0 6920 N. 4/I ( / • 1Applicant'CMading Address 252-0 Alca'HA e.. w' CH, 4,26'26 TYPE OF CONSTRUCTION IA'NEW LI ADD ❑ ALTERATION LI REPAIR ' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � Owner's Name P/Iwer//Edo/ M6Kl Co Phone x'5-7327 DESCRIPTION OF WORK/USE OF BLDG. A.P.# }(-. "� 2'11 J 10 I Zone POR-HO Addlfess /5�a�r-4E S /Main Building: 4Accessory Building Z Arch/Eng. 4—4'2�. 4.e-Sieg icense No. TYPE OF PERMIT ❑ GRADING S FOUNDATION TRUCTURAL T Front V•5 °± ..i.r. k o Address 2 ?n2-S— /-/ICC/4FfK.. l2 L4•,rrtd4 ni#CCY 92, S ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BA Rear Z®' ` N Contractor's Name c7r^'�� 6.•f a.-OF/2- Phone SA^^e- ❑ OTHER 11 ' Address(mailing) 3iksfve PROJECT DESCRIPTION SQ. FT. t '.4`T OCCUPANCY �'--1 C Right 4/ / N I CONSTRUCTION TYPE V14 VALUATION$ (iriz931"` S Left */S- R City License No. -3A9 ZONE GRADING CU.YDS. - ACRES LICENSED CONTRACTOR DECLARATION " Ping. Ref.# pf( 8s-/83/' Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing,! , Remarks: Liu, 'r 1 'h . .. 1 egg- g f I— El pc Planning Notes: P,y qse ]r 0 M with section 7000) of Division 3 of the Business and Professions Code, and . IN L.�I//TiV -I`•( my license Is in full force and effect. T ense Class License No. " • HOLO ruR SPECIAL R;.:eCIRR"rlaO.r�T s S .te Signature // A PLUMBING FEES WORKERS'COMPENSATION DECLARATION / Showers I hereby affirm that I have a certificate of consent to self-in ure or a certificate ELECTRICAL FEES Bar Sink of Workers' Compensation Insurance, or a certified c y thereof (Section 3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW -, Policy No. Company /J , 0 50+ KW Construction Pole Sub. BCertified copy Is hereby thehed. Certified copy Is filed withAp the city Building Division. z ' • '[ J.SLU1U• _Date APPeted i � ' • .�EXEMPTION FROM WORKERS'COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred($100)or less). ishwasher Solar Piping Dryers OGas DElectric Sub Panel I certify that in the performance of the work for which this permit is issuetltl shall not pe�m toy any person in any mann so as to become subject to- the ,Drinking , I. • I:10-1 , ■ Workers'/ ran Laws a Califor i � /'�,.��-- Dale %)✓ v Signature - �'r" ��/ • �. NOTICE:Compensation mooing this ions n, y r eyosubject to th . ■ Mil Walkers' provisions o the o! Code, you must forthwith oor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. Fl Microwave CONSTRUCTION LENDING AGENCY Gas Service • Device I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for��s+�'hJ� [hi pe it s issued/ Section 3097 Civ. C.) Lender's Name L7ff ,�,y�f' Iadv �}s� utlets Range Lender's Address('..[yarr Sy:re QLd SA.f/OiEfaO 402/IJP Kitchen Sink • Water Service I :witches OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the e Disposal Standing Sections .following reason (Section 7031.5 Business and Professional Code: Any city or ":ounty which requires a permit to construct,alter,improve,demolish or repair • • Generator •-5 KVV . ",'my structure, prior to its issuance, also requires the applicant for such permit III Co file a signed statement that he/sheel e Is licensed pursuant tan Me provisions of the Contractor's License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). U I, as owner of the property Or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered Reinspection Fee $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 REQUIREMENTS: employees, provided that such Improvements are not Intended or offered for Boiler Hood or Type I ❑ �/ 1 sale. If, however, the building or improvement Is sold within one year of com- Canopy Type!! 0 Zoning Approved By a' pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Date prove for the purpose of sale). Building Approved By i �I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System a: • 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 ❑0100,000 BTU ❑100,000 BTUSUMMARY OF FEES Lf 7--f i builds or improves thereon,and who contracts for such projects with a con- tractor(s) on- tract Or(5 license pursuant to the Contractor's License Law). I am aware thata Zai proof of) their Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration12 0 I am exempt under Section B.& P.C.for this reason . Firepl/Fact.Blt. ICBG# ■ Fire Dampers PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ ;Y Date '4/1"y Owner '� v / 4 - • RegistersPLAN CHECK 25% $ ELECTRICAL $ ENERGY P.C. $ 1 hereby ctrl fy that I have read is ap tion an state that the above 00-100,000 11,111 : GRADING $ r I Information is correct. I agree to comply t all city and county ordinances and state laws relating to building construction,and hereby authorize repre- a. MICROFILM $ •sentatives o/ [his sty to e r upon the above-mentioned pro•er for' y inspection ur # TOTAL •_'�_ - ,>F • Si nature _ Date .a �-�"" Drivers'riLip se o # Reinspection Fee $15 Issue Fee $ 3 J CMF 0865-46,rev. 1 /84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor 302-1 i 2 - .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. s 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement4', 56. Rough Plumbing & Pressure Test t 6. Electrical UFER Grnd. �/3/8EZ) .Dtf 57. APPROVAL TO COVER-GUNITE 7. Footings 7 93188 (D#4' 58. Electrical Conduit-Undrgrnd. 8. Foundation?... / 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. r 10. Structural Floor System ablgeg 404-- 61. APPROVAL TO DECK ;: .t, 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final - ) r . •,,, , 14. Rough Plumbing 65. Electrical-Final .l 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 A 43 20. Rough Factory Fireplace APPROVALS Permit# • 21. Ducts, in Structure 70. Underground Hydro t \- 22. Ducts, Ventilating 71. Product Piping O Gas ❑Oil• 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil „ , 25. Roof Sheathing 7/09 -& 74. Overhead Hydro • "'_ 26. T-Bar Ceiling (Structural) & Monocoat /1 �fY 75. Dry Chemical • 27. Frame and Flashing y ,y !Y 76. Dry Standpipe _ • 28. Lathing & Siding / ,�O- 77. FIXED SYSTEM FINAL 29. Insulation !tel �� 78. FIRE PREV. FINAL 30. Drywall Nailing 2 /� fie HEALTH DEPT. REQUIREMENT ' • ' 31. Plaster Brown Coat /6Q 79. FINAL INSPECTION 32. Electrical Power Meter-Final C 80. FOOD CERTIFICATE ISSUED 33. Final Electric Note : 34. Final Heating & Air Conditioning 7 OcElsit. Y � OFA 35. Final Gas Pipe-Test yr 4e �i �/ ��Qc" ?./'/ - 36. Hood or Canopy BIlAs � J ?JIG-Pit 37. Final Factory Fireplace 38. Final Plumbing 4%-L( f /tfj lIa;, rr e,tc2 39. Water Service-Final at, � , (nn 40. Gas Service-Final - . • 41. Solar Domestic-Final , - ) 42. Backflbw Preventer • 43. Backflow Irrigation n 44. Landscape Irrigation System • ;, • 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING -2pfg t 48. Special Requirements Completed u : b� 2,6 r 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 4 • 51. CERTIFICATE OF OCCUPANCY , No. Date I 'jL • Applicant to fill in all spades except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. • Project Address' 25-f/ 3•4f/r-,4 c47.-A4_,,44 oQ_ 331ZS /2558 Applicant;Mailing Address 2D ZO e(--1-C-012-1,,,,,i, GHf G� TYPE OF CONSTRUCTION NEW H ADD LJ ALTERATION LJ REPAIR Y ❑ CONVERSION ❑ DEMOLISH CI OTHER Owner's Name fA444-11te 'c46417- cet Phone -732'7 DESCRIPTION OF WORK/USE OF BLDG. A.P.# #20-2/,'' jb Zone �'Q/1- NO '200 .4/C°/-Q../MAC u-'-4/ C i 57-zeasS Main Building: Accessory Building: Arch/Eng.6/LiCF core.,-c. ?LASSO e License No. A'/'i TYPE OE PERMIT ElGRADING ElFOUNDATION ❑ STRUCTURAL T Front s /5 / o Address 230 2 M/r-C C.eC&C D4. 44 Cr .-f / CGS 9.26$3 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear y N Contractor's Name ULu.uFG Burr oF�C Phone N'uF ❑ OTHER A �T �� h� I S A.�zc PROJECT DESCRIPTION SQ. FT. OCCUPANCY aG C Right ✓L �O t -� 4�.wfi G Address(mailing) ��sn� L..3 i T/ CONSTRUCTION TYPE VALUATION$ �7W S Left C'C'�� 30±-�p Cry 7a City License No. 4-4-'S8$' ZONE GRADING CU.YDS. ACRES r R LICENSED CONTRACTOR DECLARATION r Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: T2��-N EN CLO,$Ja�.L Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and my license is in full force and effect. T License Class / License No. S ' ate Signature zt/ A t PLUMBING FEES JORKERS' COMPENSATION DECLARATION 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 3800, Lab. C.) ��/qI Automatic Washer Transformer 0 15-50 KW Policy No. Company / 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 em loy any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP 01%.B Workers',e p Laws of Calif erru� /� Date // /flan Signature 7��^^�-. /tet �� Floor Drains _ Swimming Pool w/Spa �— Inc.Solar ❑9-15 HP 016-15+ NOTIC .If, iter making this decla/±f on, you should becomes jest to the Workers' Compensation provision of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. Fixtures Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes POI Light I hereby affirm that there is a construction lending agency for the performance ¢S 9 of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name Q' e'T A*+EAr4A-v SCL Range Lender's Address 40,d ST See ire Soo S44.nvflo 9 2/A? Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION -I hereby affirm that 1.'im 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 o file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains L.- :he 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). 0 I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 • - compensation, will do the work,and the structure is not intended or offered - Reinspection Fee - I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves ir thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: `; �� b� employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 's\V./x 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 prove for the purpose of sale). G� n I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By CJf-'t Date ecr--7 tra ors 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 SUMMA_ OF FEES builds or improves thereon, and who contracts for such projects with a con- ��vvSV tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ [J proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ 22.-- PERMIT Lel am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers PLUMBING $ ISSUANCE $ Date r/?4Owner t. -•"'----- v -....if Heating System& Ducting Registers ENERGY P.C. $ PLAN CHECK 25% $ I hereby certify that I have rto co is application and state at the above ❑0.100,000 BTU ❑100,000 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- - PLAN CHECK 50% $ MICROFILM $ inspection of this city to enter upon the above-mentioned prop rty for inspection purpo s. Signature ---iin "y"'—Date // MECHANICAL-- • ,. MECHANICAL $ TOTAL FEE $ Drivers' ense or SS yfr Reinspection Fee I $15 Issue Fee - $ 3 PLAN CHECK 25% $ . rev. 10 84 White - Building; Canary -Applicant; Goldenrod - Assessor ai 'ry"+uOUr 1 uuU00PbL 1 rJ I Q0.13 CMF 0865-46, / Pink -Accounting; CONSTRUCTION AND PLANNING POOL& SPA - Date Inspector Date Inspector APPROVALS Permit#/' APPROVALS Permit# 1- Temporary Electrical Service or Pole 52. Pool & Equipment Location t 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 7. Footings 8/(//f �� 58. Electrical Conduit-Undrgrnd. 8. Foundation ^ / / 59. Gas Pipe, D Undrgrnd.,Test '- 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, D Undrgrnd 10. Structural Floor System 61. APPROVAL TO DECK I- 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final • 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground:Hydro 22. Ducts, Ventilating 71. Product Piping D Gas D Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas D 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: 8fir(&} 06e. To C Q ..` 34. Final Heating & Air Conditioning cJ 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 )21/2r et 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date _,y_ • - CONSULTANTS'INC. December 14, 1988 CITY OF COSTA MESA 77 Fair Drive Costa Mesa, CA 92626 ATTN: Building Department SUBJ: CIVIL ENGINEER'S FINAL GRADE CERTIFICATION FOR A PORTION OF TRACT NO. 12558, IN THE CITY OF COSTA MESA (FILE 1250) This is to certify that the final grade for building No. 9 also known as 2541 Santa Catalina was field checked on Dec 14, 1988 and found to be in conformance with the intent of the grading plan. Very truly yours, DGA CONSULTANTS -A Surender Dewan, R.C.E. 34559 Engineering Manager of ESSI040. ,,,4, c.SER M. pFF41sn C1\L-COSTA.M � J� a 152 r7 2 rn NO. 34550 Ir.* LA cf2/wfrt y:' r‘-e7) poi 1182 North Tustin Ave. f or C�tl . Orange.CA 92667 17141744-0802 Fax(7141538-2152 9035 Haven Ave.Surte105 Rancho Cucamonga,CA 91730 1714)944-5400 Fax 17141944-2790 • CITY OF COSTA MESA • CALIFORNIA 02628.1200 P.O.BOX 1200 Insulation Certificate 2541 Santa Catalina Drive Costa Mesa Number end Street City Orange County Subdivision Lot Number Description of Installation ROOF Material Brand Name Thickness(inches) Thermal Resistance(R-Value) EXTERIOR WALL Material Fibergalss Batts Brand Name Manville Thickness(inches) 3 1/11' Thermal Resistance(R-Value) R-11 CEILING Batt or Blanket Type Rarrc Brand Name Manville Thickness(inches) 6 3/4" Thermal Resistance(R-Value) R-19 • Loose Fill Type Brand Name Contractor's minimum installed weight/ft! 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 Connecta(Builder) License Number Signsmre dW$366T2E1 iRWN.„PAI,ONO�SRAUE9LA2ATON - Due 7/ l c7942 7n 1 174 b-Conncta � oSignatu Signature License Number er Date • 7940 I /': 2767' , °Q ;I COSTA MESA SANITARY DISTRICT r 5 1 i MONEY RECEIPTS ADVICE • Date .3 -31 - Amount Name '--c\ 'Q.A I'l Lk) 1 1 (\ClCs\CAI\C_ f. ' Payer Address Y) ) . l� C-• (\ \ 1 For L�. .a.k kir, ..b1— -15-1)\ 11R1 I ):X • r • .u � `l i CMF 0944-68 white-Customer;Canary-Department:Pink-Finance;Goldenrod-File 79&47 a/ ! /1: . COSTA MESA SANITARY DISTRICT n,, r71 J . r MONEY RECEIPTS ADVICE • Date 3:)A _ Amount $ - 9k..(7 r Name \--i\W k1 UU Y d.�,Q 111 = RT Payer Ads . , � H _ . L- C-Y k 17 \,' I(-\Q r r • n For �)l< I ( 39i'.I'-A) L 05.a\ k-',PQ��.�� • �� . �,�-fir • • • CMF 0944-68 White-Customer;Canary-Department;Pink-Finance;Goldenrod-File • • . 4114 • • PACIFIC SOILS ENGINEERING, INC. 17909 FITCH, IRVINE, CA 92714 TELEPHONE: (714)863-9118 NOTICE OF FOOTING EXCAVATION INSPECTION JOB LOCATION: {"c. ,f Vke vJ WORK ORDER NO.: lo ( 3 F OWNER OR CONTRACTOR: ' ( ( o `+ �' \'' s`" 4`' `"{ OWNER'S ADDRESS: DATE FOOTINGS INSPECTED S( Sf 57� t'-; DESCRIPTION OF FOOTINGS OR CAISSONS COVERED BY THIS NOTICE:VS r�•, '{ ( Jv '(- rte PKCc rt. c-s ...&tci tL. 5f r_ � L_. £ . . � Yc (!J L.. 4 (., s1ca(-o4c t-- t •••• Z (wee c•-im (ins v v • The undersigned has inspected the looting and/or caisson excovations listed above on the referenced property and some were excavated in accordance with our recommendations in the preliminary foundation report and the Building Code of the SIGNATURE `/ Lin OF COSTA MESA CALIFORNIA 92828.1200 P.O.BOX 1200 Insulation Certificate 2541 Santa Catalina Drive Costa Mesa Numba and Street City Orange County Subdivision Lot Number Description of Installation ROOF Material Brand Name Thickness(inches) Thermal Resistance(R-Value) EXTERIOR WALL Material Fibergalss Batts Brand Name Manville • Thickness(inches) 3 1/f Thermal Resistance(R-Value) R-11 CEILING Batt or Blanket Type Ratts Brand Name Manville Thickness(inches) 6 3/4" Thermal Resistance(R-Value) R-19 Loose Fill Type Brand Name Contractor's minimum installed weight/ft' 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 Signature adVIli36TERN INSULATION 7 Date ,1 3621 W. PAOORE AVE. � / 1g/aV 7A1 i S 0-COntra01.0Tfinguiat4 l }l CA 92704 Licata Number Signature and Ti Date I j _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • PERMIT NO. TRACT NO. LOT N0. UNIT NO. ,,r CITY OF A TA MESA CONSTRUCTION PERMIT r �Q'73 Project Address . 2541 SANTA rATAT,TNA "Lit• 33 Z� laJ� r1 "� /�� ' �f�. t.�/ './ "/ Appl team's Mailing Address N1 PArIFIC AVE, STANTON TYPE OF CONSTRUCTION ID NEW LJ.ADD U ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER . A•P,# Zone Owner's NameIRVI_EW___MD1.1 Ejy1$js]r�' phone. 4S-7 3 27 DESCRIPTION OF WORK/USE OF BLDG. Address 240U MAIN ST . ST 210 , IRVINE, 92714 I' S Main Building: Accessory Building: Z. Arch/Eng. License No. TYPE OF PERMIT Li GRADING L I FOUNDATION U STRUCTURAL T Front 0 Address ❑ TENANT ❑ ELECTRICAL ® PLUMBING ❑ MECHANICAL B Rear • N Contractor's Name PAULEY & SONS PLMB Phone 827-7403 ❑ OTHER A I PROJECT DESCRIPTION SQ. FT. OCCUPANCY CK Right N CityAddLicensess e in . 043450X 967 • CON ST RUCTION TYPE VALUATION$ S Left G City License No. 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: go;1/. 1117 / j_ fl i'j ' 3 33,0/_ Planning Notes: M with section 7000) of:Division 3 of the Business and Professions Code, and V' LLYY 'j� (/ IPJ my license is in full force and effect. T- LlcenseClass C 36 plumb. License No. 498533 • $ ?ate Signature __ PLUMBING FEES WORKERS'COMPENSATION DECLARATION 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 ' 3800, Lab. C. 1 / Automatic Washer' • Transformer 0 15-50 KW Policy No.o73- 11 2-,-51 Company 's3k4I Z^t.4 W fl Backflow Irrigation Sewer Cap0 50+ KW Construction Pole Sub. Certified copy is hereby furnished. n — edified copy is filed with the city Bui n^ Nag'// s_ 2n Bathtubs Sewer Connection gD ,Q Cooking Unit Meter ❑up to 100 amps Date Applicant r w G-�i 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). 16 Dishwasher Solar Piping - 39a,0 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 01%-8 Workers' Compensation Laws of California. - (�(� Date Signature Floor Drains' Swimming Pool w/Spa `2, D'Yd F.A.U. Inc.Solar ❑9-15 HP 016-15+ 'SIJ NOTICE:If,after making this declaration, you should become subject to the 1.___ _ (� Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal it Fixtures Microwave W comply with such provisions or this permit shall be deemed revoked. 7 CONSTRUCTION LENDING AGENCY Gas Service Outlet " Water Closet 42 l 17 51 2 C �0 S._ .::A Device Boxes Pole Li ht hereby affirm that there is a construction lending agency for the performance 9 1 of the work for which this permit is Issued (Section 3097 Civ. C.) 34 COutlets Ran e Interceptors 1: Water Heater — — • Lender's Name 9 Lender's Address 16 Kitchen Sink \� Water Service 32.co Switches 0 OWNER BUILDER DECLARATION 1 fti L.f • Sign V I hereby affirm that I am exempt from the Contractor's License Law for the 7n Lavatories L.kD - 3 Auto-Wash Goo 4(o Iro Garbe eDis oral following reason (Section 7031.5 Business and Professional Code: Any city or / 1 9 ,- P Standing Sections county,which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays • 2 to Generator ❑0-5 KW ❑5.15 KW ,y structure, prior to Its issuance, also requires the applicant for such permit - 1 - Trash Compactor 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 Sectiom7000) 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). LI I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 -Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offered — s - Reinspection Fee I $15 Issue Fee • S 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 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 Dale ' prove for the purpose of sale). .q • LJ I, as owner of the property, am exclusively contracting with licensed Con- Duct-Structural Refrigeration System Application Issued By Dater-1�- V6 tractors là 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 Firepl/Fact.Blt. ICBG 7k Fire Dampers PLUMBING $ 5' ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ (55C_ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0100,000 BT GRADING $ Information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws rel ng to building nstructlon,and hereby authorize repre- sentatives of Ihi to enter on the above-mentioned property for S-L.) pure s rte/�� q Signature .e.r Date MECHANICAL $ - TOTAL FEE $ 3 ` Dri veil' License or SS ) Reinspection Fee $15 Issue Fee PLAN CHECK -25% $ CMF 0865-46,rev. 10/84 White - Building; Canary . Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. Laj9( (.6417 • 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. ti127/i1( tes9 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection ittpyge LE,D 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing '7-2(eir(( bED 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 (1101-41/ z Q 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 1l,21-ci- Leap 39. Water Service-Final ;j. '-)'t Lea 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 - ', 40.1 "s i/ - t w T l/ y JP to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CI Y OF COSTA MES; SCO R� TIS NvPE-'IMIT PMERMITT NO. �� TRACT NO. LOT NO. UNIT NO. Sri, 1L / �•� Project Address, r✓` 14' ��'i i, - 1 7 U — '` g �" Applicapt's Mailing Address a- • ., a TYPE OF CONSTRUCTION NEW U ADD L I ALTERATION Li REPAIR �'1��^ Q 1 / i' ✓ . : . /r, ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone Owner's Name/// g- [ •I DES IPTI OF WORT' USE OF LDC. S Main Building: cc sso/ Buil in Address ?S/[2 , S / ♦ -+ �— „Amu; € . Y. 9'OC-r-Zeta-.t 1. Arch/Eng. Lic'nse No. TYPE OF PERMIT ID GRADING ❑ FOUNDAT 0 El STRUCTURAL E Front 01 00011424-00011425 Tot 3t .Ot Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING /�' MECHANICAL B Rear Mit; LS/U iWCI I lilt: 14:UU N Contractor's Nam•e. L_'✓'`irlf Ph. e,� • - �� ❑ OTHER A — I I1r�/ PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right G Address cens(Mailing) — ►- _ ♦ _ _ - S Left �2� a CONSTRUCTION TYPE VALUATION S City License No. ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E Q I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: Planning Notes: TVI with sectionis 7000) •ivis'on 3 of the Business and Professions Lod¢..antl _, T my license is In full br< fect. Q/y(/(J /4/[75'(5,5(/I p %✓jam/ S Licens;Vi a 'cons t.- Date f -Ma Signature IIIIV�M., __T� PLUMBING FEES WORKS'S'COMPENSATION DECLA-ATI• ✓ Bar Sink ■ ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self= re or a certificate aShowers of Workers' Compensation Insurance, Or a certi d c.• f-- .•f (Se ion `"10 rvice Sink Automatic Washer Transformer 15-50 KW 3800, Lab..CJ ✓L3�SI ' , Policy No. / f'r Compy'� / • 7S �� Construction Pole Sub. 0 50+ KW % ® Corti ' cop is hereby furnished. Cert e p e with the city a•• .J h ■ a• . �`� Date Applicant �� l EXEMPTI RKERS'COMPENSATION D4 ARATION , ••• ■. • 11 . (This section need not be completed if the permit is for hundred ($100) or 'Bathtubs • ■ ■Electric less).I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature ,NOTICE: If,after making this declaration, you should become subject to the , ■Workers' Compensation provisions of the labor Code, you must forthwith Floor Sinks Urinal FixturescomplT with such Erovisions or this permit Shall be deemetl revoked. ■ ■CONSTRUCTION LENOI a AGEcCV interceptors VVater Heater •- vice Boxes , t hereby affirm Shat there is a construttian lentling agency for the performance ■ ®■ Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) , Outlets Lender's Name Range Lender's AddressKitchen Sink , Water ServiceS, Switches Sign BUILD OWNER BUILDER DECLARATION • I hereby affirm that I am exempt from the Contractor's License Law for the - 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.1-Trap Laundry Trays • I' Generator ■• 05-15 KVV Trash Compactor 'y structure, prior to its su he/,also requires the applicant for such permit fiie a signed statementthat he/she is licensed pursuant tothe provisions of ;Roof Drains . . ' .e 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 . $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 thereon, and who does such work himself/herself or through his or her own ■ • •' MENT 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 cam- CanOpy Type II ■ Zoning Approved ByDate pletion, the owner will have the burden of proving he/she did not build or imCluct-Under Ground Building Approved By ii, .41111- prove for the purpose of sale). • - o I, as owner of the property, am exclusively contracting with licensed conDuct-Structural- 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 • ■a ,al000BTU O100,000 builds or improves thereon, and who contracts for such projects with a con- tractors) 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. ❑ 1 am exempt under Section - B. & P.C.for this reason ■ :• # ■ Fire Dampers PLUMBING $ ISSUANCE $ Date Owner I hereby certify that I h y•• read this application and state that the above v/0-100,000 : 0100,000• : GRADING information is correct.j e o comply with all city and county ordinances and state laws relating ding construction, and hereby auth•ri e re. e- l•, MICROFILM sentatives of thi city - ter upon the above-mentioned n4 inspection purpose . - gY a'I Signature L -Accounting; Goldenrod - Assessor OATE: 00/05/$8 TINE: 14:00 CONSTRUCTION AND,PLANNING POOL &SPA APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector i•.,Temporary ElectricalService 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.' A. 57. APPROVAL TO COVER-GUNITE A7i Footings :r�1 58 Electrical Conduit-Undrgrnd. 8.' Foundation r•''` ,X59. Gas Pipe, D Undrgrnd.,Test . •n 9.'.Water Pipe-Undrgrnd .,,/ 60. Backwash Lines, P-Trap, 0 Undrgrnd. i 10. Structural Floor System / 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final . . n: 12. Sewer Cap S-" 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 1.7. Rough4Wiring Sign 68. APPROVED FOR PLASTERING `k8,)Rough`Electrical-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL 19:Rough"Heating & Air Conditioning 912-0 LEO FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# . 21. Ducts, in Structure • 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0.0i1 23. Gas Pipe-Rough &Test 72. Underground Flush • 24. Roof Framing 73. Uridergrnd.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 //i 77. FIXED SYSTEM FINAL - 29. Insulation • 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION (,r 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ' . .i 33. Final Electric Notes: • /1.1 34. Final•Heating & Air Conditioning 10•3/-98 LE p 35. Final Gas Pipe-Test -., ' 36: Hood or Canopy - _ `, 37. Final Factory Fireplace - f '. 38. Final Plumbing - : 39. Water Service-Final .:40. Gas Service-Final , - • • - . 41. Solar Domestic-Final . r - -42. Backflow Preventer - I r - ' 43.(Backflow Irrigation - - . :44. Landscape Irrigation System r . , i 451: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 - ' I -' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMI O. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA MESA (�,+O�NSTRU(CTIION PERMIT }� A.P.# Zone Project Address tx 54I -X\NTT-A, C.A7 AL7N A De • e- 17 " C 1 • - S Main Building: Accessory Building: Applicantk AQeilin Address TYPE OF CONSTRUCTION NEW ❑ ADD ❑ ALTERATION U REPAIR E ❑ CONVERSION ❑ DEMOLISH ❑ OTIAER . T Front O Owner's Name \ev itW MAn7AgEMoIT Phone DESCRIPTION OF WORK/USE OF BLDG. /'1p A Rear N Address Arch/Eng. License No. TYPE OF PERMIT GRADING ❑ FOUNDATION ❑ STRUCT RAL C Right • G Address ❑ TENANT ELECTRICAL ❑ PLUMBING 0 MECHANICAL $- Left R ❑ OTHER PIng. Ref.# Parkin Re /Provided E Contractor's Name > n F ec. phone_I�J-ns --�� Q9 Req ./Provided (mailing) 1028 Nn Wr.Ks FN. PROJECT DESCRIPTION SQ. FT. I i i'14-"r OCCUPANCY I_ '� Planning Notes: M 43S ' CONSTRUCTION TYPE 'ff• VALUATION$ T City License No. C ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION 1^�r S' I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: `J 331 O i y with section 7000) of Division 3 of the Business and Professions Code,and J my license is in f force and effect. , ELECTRICAL FEES Licen • las • icense 'o. %_ Automatic Washer Transformer pate 1 Me- Signature .ft�''-- - --� PLUMBING FEES 0 15.50 KW (YORKERS'COMPENSATION DECLAR• ION Construction Pole Sub. ❑ 50+KW L I hereby affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink Showers by of Workers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit l7 Meterup to 100 amps 3800, Lab. C Backflow Preventer Service Sink - = ` Policy No. 13(0 3(e' Company 4r `1J&D Backflow Irrigation Sewer Cap - Dishwasher Meter Dover 100 amps `a rtified copy is hereby furnished. -� - Dryers ❑Gas ❑Electric Sub Panel ^ Certp{gp jY J,s,filed with the city yiltling Mt/slay_ Bathtubs Sewer Connection 1 ` Date TION' RO KERSAppl'antMVUUT c)C-Eo 11 RATION . Fan Motors 00-1 HP ❑1X-8 EXEMPTion FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors /• (This section need not be completed If the permit Is for one hundred ($100)orF,A.U. Inc.Solar 09-15 HP ❑76.15+ less). Dishwasher Solar Piping I certify that in the performance of the work for which this permit IS Issued, I shall not employ any person in any manner so as to become subject to te Drinking Fountains Solar Tank Fixtures Microwave Workers' Compensation Laws of California. Date Signature F-lour Drains Swimming Pool w/Spa A Device Boxes 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 Switches Sign Gas Service Outlets Water Closet 9 I hereby affirmk that there is a permit ssue agency for the performancev. of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater - Garbage Disposal Standing Sections Lender's Name Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05.15 KW Trash Compactor OWNER BUILDER DECLARATION - .( / �// // s � I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash 14'114..., arob . ( / IL S/ -v.S following reason (Section 7031.5 Business and Professional Code: Any city or — i county 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 $Ajr-s"file a signed statement that he/she is licensed pursuant to the provisions of :;+s„2 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 te therefrom and the basis for the alleged exemption. Any violation of Section Reinspection Fee $15 Issue Fee $,� 7031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: U I I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 compensation, will do the work,and the structure Is not Intended or offered Zoning Approved By Date - for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By __�. License Law does not apply to an owner of a property who builds or Improves , Date g---5 thereon, and who does such work himself/herself or through his or her own Application Issued By ��,/ia-,. as ete employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ . _ el sale. If, however, the building or Improvement is sold within one year of corn- 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 prove for the purpose of sale). BUILDING PERMIT $ SMIP $ ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Re geration System PLAN CHECK tractors to construct the project (Section 7044,Business and Professions Code: $ PERMIT 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- 51:19etractor(s) license pursuant to the contractor's License Law). am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration PLAN CHECK 25% $ ENE RGV P.C. $ proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers ELECTRICAL $ GRADING $ PLAN CHECK $ MICROFILM $ Date Owner Heating System& Ducting Registers MECHANICAL / 51-13 � /•y I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000 BT $ TOTAL PEE $ s•-� ' TO information is correct agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relati g;to building c struction, and hereby authorize repre- sentatives of thl it to enter u the above-mentioned property for • Inspection purpo e . Fish Signature Date O s U Reinspection Fee $15 Issue Fee $ 3 01 ��01140 Drivers' Lice se or s5 DAT 6'0�{I114Q] 1- e 0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor (]8/oU�$g DIE 13:18 43.48 - 1,. �.. CONSTRUCTION AND PLANNING .7 /L& SPA APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector -1. Temporary Electrical Service or Pale 52. Pool & Equipment Location j . 1i 1 2. not Pipe-Undrgrnd. a t,1 53. Steel Reinforcement n5 Electrical Conduit-Utility-Undrgrnd. LAI 54. Forms 1 I 4 :1 Electrical Conduit-Undrgrnd. ,, 55. Electrical Bonding • .1, I., i5! SteeiiReinforce merit R' 56. Rough Plumbing & Pressure Test . 6_ Elea ical UFER;1Grnd. J 57. APPROVAL TO COVER-GUNITE . , , 7'f• Footings , 2 `(•1 58. Electrical Conduit-Undrgrnd. 8. Foundation • -t . '• 59. Gas Pipe, 0 Undrgrnd.,Test 9r Watei Pipe-Undrgrnd. - r 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10.E 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 8-15-ee /eLd 67. Fencing & Access Approval ,`7' Rough Wiring Sign t•` / vt 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 4a9r Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 201 Rough Factory Fireplace •'t APPROVALS Permit# 21.• Ducts, in Structure -• 70. Underground Hydro 22. Ducts, Ventilating .` - .. 71'. Product Piping 0 Gas 0 Oil s 23/Gas Pipe-Rough & Test 52. Underground Flush . 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0Oi1 25. Roof,Sheathing l•. 74. Overhead Hydro - 26. T-Ba*Ceiling (Structural) & Monocoat 75. Dry Chemical 27'. Frame and Flashing 76. Dry Standpipe 28. La)hing\& Siding A 77. FIXED SYSTEM FINAL 29. Insulation ) ! 78. FIRE PREY. FINAL 30. Drywall Nailing - ' HEALTH DEPT. REQUIREMENT 31. PlasteFBrown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final /012le -' 80. FOOD CERTIFICATE ISSUED 33. Final Electric /10 2/99 A J Notes: 34. Final Heating& Air Conditioning j�' 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing ' . • 39. Water Service-Final - •--I 40. Gas Service-Final 1 i 41. Solar Domestic-Final 1 I - 42. Backflow Preventer Imo• . i, . t ' _ 43. Backflow Irrigation �; .• - r 44. Landscape Irrigation System t• • ��'�' 45. Sound Attenuation - 46. Handicap Regulations 7.. 47. FINAL STRUCTURE & BUILDING • 48. Special Requirements Completed ! 49. Electric Release to Edison I 50. Gas Release to Southern California Gas Co •_ " ,' 51. CERTIFICATE OF OCCUPANCY • No. Date . '`�