The URL can be used to link to this page

Home My WebLink About3432 SANTA CLARA CIR - Building PermitsCITY OF COSTA MESA �,O'�pMF,p BI/ILDING DIVISION >�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax 1714) 754-4856 • www.ci.costa-mesa.ca.us % L �� FOR INSPECTIONS CALL: (714) 754-5626 ""'fi PERMIT NUMBER: M09-00127 PERMIT TYP� MECH APN: 41206151 STATUS: ISSUED DATE ISSUED: 12/2412009 ISSUED BY: BE JOB ADDRESS: 3432 SANTA CLARA CI CM Suite/Unit: Vicinity: SQ. FT: 0 SCOPE OF WORK: REPLACE FURNACE EXISTING LOCATION.90000 BTU OWNER: GILBERT, JOHN J PHONE: 714-338-910'I APPLICANT: ERIC JACOBY PHONE: 7y4-777-7777 CONTRACTOR; SERVICE CHAMPIONS Address: 22917 SAVI RANCH PKWYUnit City/State: YORBA LINDA, CA ZipCode: 92887 MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: $38.30 PLAN CHECK FEE: $0.00 INVESTIGATION FEE: $0.00 REINSPECTION FEE: $0.00 TOTAL FEES: $38.30 Address: 3432 SANTA CLARA CIR Unit: City/State/Zip: COSTA MESA, CA Address: 22911 SAVI RANCH PKWY Unit: City/State/zZip: YORBA LINDA, CA License No. 799170 PHONE: 714-777-7777 CELL: 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: P�RMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF �AST INSPECTION. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must wmply with all applicable codes, and all required inspections and £nal approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit. COOEp. INSPECTIONTYpE OATE INTITIALS W�EN MSPEGTONTYPE OATE 'I{N,TIT/IA�L.,S� 1616 Fixed System Final Fire Prevention 206 Final Mechani�yl —�5- _[�•If �w�,� 126fi Pool Spa Fiqal 208 Final Plumbing 200 Final Re-RObf 210 Final ElecMcal 201 Final BIocWRetaining Wall 272 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign , 222 Final Site 204 Final Demolition 250 Final Building/Occupancy n WORKERS' COMPENSATION DECLARATION:' I here6y affrm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certifcate of consent lo sel4lnsure for workers' compensation, as provided for by section 3700 of Ihe Labor Code, !or the �pertormance of ihe work for which this permit is issued. ( K1 I have and will maintain v.orkere' compensation insurance, as requiretl by section 3700 ot the Labor Code, tor the pertormance of the vrork for which this pertnit is issuetl. My workers' compensation Insurance carrier and policy ///num6er are: � ,/ �Carrier. N'�"�is T / e� (i�a SMion naetl rrol 0e mmplefetl Al��e /p[eim�rt is valued a! one nuntlietl da9ars (S i00J o� less.) Policy NumDer: � �� 01 7 �� L ❑ I certify lhal in the performance o( the work lor which lhis permit is issued, I shall not employ any person in any manner so as to become subjecl to Ihe workers' compensation laws of Califomia, and agree Nat if I should become subjecl to Ihe vrorkers' compensation provisions of Seclion 3700 ot the Labor Code, I shall IoAhwi comply with these pr �is��v ��D � pWvanl's Sigvt Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm Ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 0( Ihe Business and Professions Code, and my license is in full force anC effect. � Lic. # U Class tt �i� x 7� ]i O Cory a tor's Sgnalure Da�e 1/ CONSTRUCTION IENDING AGENCY: ❑ I hereby affirtn that there is a constructbn lending agency !w the perfortnance ol the v.ork fa which this permii is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: SignaWre Oate OWNER•BUILDER DECLARATIONS: I hereby aHirm that under penalty of perjury thal I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for [he following reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires a permit to construct, alter, improve, demolish, or repair any sWcture. pnor lo its issuance, also requires the applicant tor such permit to file a signed statement thal he or she is licensed pursuant to the provisions o/ the Contractors License Law (Chapter 9(commencing wilh Section 7000) of Division 3 of Ihe Business antl Professions Code) or that he or she is exempt therefrom and Ihe basis for t�e allegetl exemption. Any violation ot Section 7031.5 by any applicant (or a permit subjec[s the applicant to a civil penalty of not more than fve hundred dollars ($500).�: ❑ I, as owner of the property, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, and lhe strucWre is not intentle0 or offered for sale (Sec. 7044, Business and Pmfessions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who tloes such work himself or herself or through his or her own employees, provided that such improvements are not intended or oftered for sale. If, however, the building or impmvement is sold within one year of completion, the ovmeo-builder will have [he burtlen of proving that he or she ditl not build or improve tor purpose of sale.). ❑ I, as ovmer ol the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct the pmject (Sec. 7044, Business and Professions Code: The contractors License Law dces not apply to an ovmer of property who builtls or improves thereon, and who cont2cls for such projecl with a cont2ctw(s) license pursuant tothe Contractars License Laws.�. ❑ I am exempl under sec. Business and Professions Code (or this reason: Sgnawre Oa�e ]OS]dfi (]I01) Owner ID venfed by driver s license. ❑ Yes ❑ No Driver's License No. Expires: Veri(ication o( Ownership by (rype of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certify that no excavation (rve (5) or more (eet in tlepth into which a person is requiretl to descend, will be made in connection with v.ork au[horized by this pertnit, antl that no builtling stmclure, scaffdding, falsework, or tlemolition or dismantling Ihereol, will be more than thitly-six (36) feet high. (Chap. 32, Grp 2. Arl 2, Sec. 341, Ttle 8, Calitomia Administ2tive Code�. ❑ As owner-builder, I will not employ anyone to do v+ork which would require a permit from Ihe Division of Intlustrial Safery, as noted above, unless such person has a permit to do such work from the division. Appliwnl'S Signature Date Division of Industrial Safety Permit Number. _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applican[ or present or future building occupant need [o file and certify a Business Plan for emeigency response to release or threatened release o( a hazardous ma�erial? ❑ Yes ❑ No (Section 25505 of Ihe California Health and Safe[y Code requires, with some exceptions, that a Business Plan be fled with the Costa Mesa Fi�e Department 6y every bu5ine55 whiCh has al any one lime during a feported year a quantiry o( hazartlous matenals equal ro or greater than a weight ot 500 pountls, or a volume of 55 gallons, or 200 cubic feet ot compressetl gas at standard temperaNre and pressure). 2. Does or will the applicant or present or fuNre building occupant need to fle a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Safety Code, with some exceptions, requires registretion wilh 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 leet of compressed gas at slandard temperemre and pressure). 3. Does or vrill the apPlicant or present or fuNre building occupant need ro prepare an RMPP (Risk Management and Prevention Progrem for awtety hazardous materials)? O 1'es ❑ No (Section 25534 of Ihe California Healih and Safety Code provides tha[ the Costa Mesa Fire Department may require the prepara[ion, certifcation and (iling with the Fire Department of an RMPP by businesses which are required to register acWety hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health antl Safety Code been (ully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or fulure builtling occupant require for the woB which is Ihe Subjecl Of lhis applicalion a pertnit (or SUch Gon5lfuCliOn or modifcation from lhe Soulh Coast Air Quality Management District or (mm any other air polNtion control diSMct or agency? ❑ Yes ❑ No (Section 658502 of Ihe Califomia Govemment Code requires that the requestetl intortnation he fumishetl on applications !a rao-residential builtling pertni[s�. 6. Will any part of the facility to be constructed under ihis permit be vnthin 7000 (eet from Ihe outer boundanes o( a school? ❑ Yes ❑ No (I('yes", the facility must meel Ihe requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7. If a permit from the SouN Coast Air �vality Management Distnct or other air polNtion conirol tlisMcl or agency is required for the work which is the suDject of this application, have all of the tlisclosures prescribed by Califomia Health and Sa/ety CoOe Section 42303 been made? ❑ Yes ❑ No 8. Qt "yes", attach certi(icale ot compliance lrom Ihe appropriate air polWtion control oKcer). CERTIPICATE OF COMPLIANCE: I certify that under penalty ot perjury Ihe information given above is correcL I agree lo comply with all state laws and city ordinances regartling Hazardous Materials and Emissions. SignaWre Dale CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application antl state thal the infortnation given is correcL I agree to comply with all state laws and city ortlinances relating to building construction, and authonze representatives of the Ciry ot Costa Mesa to enter upon the above-descnbed property for inspection purposes. I aqree not to occupy or allow occupancy ot any building authorize y this per t until final ins ection. � S�gnawreol alOvmer�s) aie � Andlor Aut eE Npplicant Daie O .� AOP��unt to fill In all ipaus eYnpt those wlthin �eavY �or0ar Ilnes anE sign all approDrlata Geclao�ions CITY OF CQSTA MESA �, . _ . ----.._ ..-- _^. ..^ . ^— •.^ ^. CONSTRUCTION PERMIT � ApplicanYs Meiling Addr � , � Project Addren �� '� �= Q n Owner's Name �' � � hone ' n ! Atldrass � Arch/Eng. License No. Address Contractor i Nam ^ r� � h�e 5 Addresslmeiling) � � ) . Licenm No. Q / LICENSED CONTRACTOR DECLARATION 4 �� 1 heraby affirm tllat 1 am Ilcensetl untlsr Orovislons oT C�artef 9(t mmencing wit� section 7000) 01 Division 3 oT tha Businass antl ROTessl �Cotla, antl my IlCanse Is In f 11 res anE effect. 1 Ucense C a — ense No —LLB�� Date ^ Si9nature �ORKER ' C MPENSATION DEC RATION � _��ireby aTllrm that I Ilave a cartlTl Wte ot consent to Self-Iniure or a cerUfiWte -� �s�.�^Norkers' CompanSaUon Insurance, or a cerqile0 copY tneroof (Sectlon JJbo, Lab. C. /� /j Pony�llcy No, r,�� %� � Company - DL7 Cartl'le �ePY Is111etlbwAPPlltantY.B �WIf��IFA� ' _ � h A{ EXEMPT,ION FROM WORKERS' COM ENSATION DECLARATION (Thii ction neetl not be comD�eteC Ii tne permit Is for one huntlrea ($300) or . less). I certify th In the performance of the work for which t�ls perm�t is issuetl I s�all not em any penon in any manner SO d5 t0 DBCOm¢ Subject.t0 t�a Work9r5' COTO tlOn Ldw3 Of Cdll}Olnla. � Date Slqna[ure . NOTICE: If, after ma this tleclaratlon, you should become subject to tha Workers' Compansatlon ovlsions o/ the labor COCe, you must Tort�with comDly wit� such provi s or this permlt shall be deemetl revokeU. CONSTRUCTION IENDING�eGENCV � 1 hereby affirm t�at t�ere Is a conStr,uctlon lentling agenty Tor the'performance of the work }or which this Dermit I5 •Issuetl (Sectlon �3097 Civ. C.) lentler's Name lentler's AtlCress � � �- � � OWNEH BUILOEit OECLARATION • 1 haleby dL111m that 1 dT !%BTpt fIOT tt18 COntIaGtOf'S LICen58 Ldw fOr th8 ' o/ tne BusinecF an0 P/ofeulons Cotle) oYNaFhe/she is�es antl the ba515 fOr.[he allagetl axemptlOn. AnY vlolation�of Se any appllwnt ldna permit SUE�ectS the aDVliwnt to a not mora than fiva huddratl tlotlars (E500). the.nrooerb or mv amolovees with emp�oy ees, proviGea tnat sucn Improv¢mants ara no[ Intenaea or otlerea tor sale. I/, �owevar, t�a bulltling or ImD�ovement is soltl�v+jt�in one year ot com- pletlon, the owner will nave the burtlen of proving he/sh4,Qitl not builtl or Im- �love for tha purpose af sale). � I, as owner of the property, am exclusively contracting�with.11censea con- tractorsto construct the'projec[.15ectlon 7044, Buslness antl ProteSslons Cotle: The Contractor's Llcansa Law does no[ apply to an owner of pPoperty who builtls or improves t�ereon, antl w�o contracts (or such projects wlth a con- � tra<tor(s)Ilcense pursuant to the Con[ractorS License Law). ❑ I aM Bzempt untlar Settlon B. 6 P. C. for thi5 r ason Date Owner � � I-hereby certlfy that�l have reatl chis applicatlon antl state�that the above - Intormation is correct. I agree to comply wlth all clty.antl county ortlinances ' antl state laws relating to builtling constructlon, antl heraby au[horize repre- sentatives o('t�Is,cJty,to enJpr upon lhe above-menllonetl prop,erty for l��,C�a.r,c�n.o� �,� ,�(�,/'h.� � hc.�d a�t v�� TVPE OFCONSTRUCTION � U'NEW LJ A�D .IJ ALTERATION IJ REPAIR I 56� JII� I IIjJ � FoU�- TL ❑ CONVERSION ❑ DEMOLISH ❑ OTHER . . ' DESCRIPTION OF WORK TVPE OP PERMIT GRADING FOUNDATION .STRVCTURAL A. P. M� � ❑ TENANT ❑ ELECTRICAL �LUMBINO ❑ MECHANICAL PLNG. HEF, qY� ❑ UTMER TO BUILOING PR0.IECT DESCRIPTION S�. FT. OCCUVANCV � Y � CON STRUCTION TVPF VALUATION $ LEFT SIDE VARD ZON$ ORADING CU. VDS. 'ACRFc PKG.SPACE REQ. Remarks: ' . ' STREET WIDTH - SPECIAL CONDITI Sink kflow Preventer kflow Irriqation Clarifiers �, DishNraSher � Drinking Fountains Floor Drains � Floor Sinks ' Gas Service 'Outlets Interceptors � - Kitchen Sink ' Lavatories, P—Trap � Showers Service $ink Under Ground , Exheust System ❑ Multiple Firepl/Fact.Blt.IC805W � � Heating��System & Ducting O ai oo,000 eru O i oo,000 ' Hood or Typel � ' DriverY Licenie or 55 # � � I ' I Re9isters CMF 0865-46 rav. 12/82 - Appllcan[; Pink - Accounting; Goltlenrotl - Assetsor Sevuer Cap Savuer CqnnMion - Solar Coilectors Solar Piping � Sofar Tank Swimming Pool wlSpa Water Closei ' Water eater �' te rv • " ' Reinspection'Fee $15 laue Fee , �S 3 MECHANICAL Refrigera[ion System � ' ❑o-ioopooeru ❑�oo,000aru - System Pepair/Alteration � �. .... �' ' ' ' . Heinspection Fee §15 Issue Fee ' � $' 3 Washer. �oking Unit , IShWdS�lEf F.A.U. Fixtures Device Boxes 'REAR VApD (TO P/U RIGHTSIDE VARD • PROVIDED PARK FEE $ Meter IJover 100 emps Sub Panel � Sub Pole Motors �0-1 HP ❑1K$ lectric Inc.Solar 09-15HP �16-15+ Microwave � Pole Light ' Range ' Sign Standing Sections Trazh Compactor - Generator LJO-5 KW LJ5-15 KW Transformer �15-SOKW , ❑5U+ KW Meter ❑up to 100ampa Zoning Approved By � ApPliqtion Approved By Appliration Issued By � Reinspeccion Fee ' SUMMA�RY OP FEES . BUILDINGPERMIT $ � . SMIP ' $ ' ' 'PLAN CHECK $ � • PERMIT � � � , PLUMBING � $ �_ ISSUANCE �, $ PLAN CHECK . $ ' � � GRADING ' $ ! 'EIECTRICAL $ � $ �,;�P�ANCHECK $ ' MICROFiLM $ , . MECHANICAL $ TOTAL FEE' $ ; PLAN CHECK y LESS • � � , ADVANCED PC � $ � � /�J� FINAL FEE � $ �!' �" ' ,, , . . '? '�OONSSRUCTION,AND�PLANNING ° � � P � �'� ':'�' `'? �' ?OOL ?A � , , _ � . , ;^ �� - ' � - ° � - � a�Date � �Inspector : �� " � - � Date'� �In'specto� '=APPROVALS Permir# � • , rAPPROVAtS Permit#' � - >" 1 : . '. _ ' � � , � � _ ., .- � � r � '� . � r > , ; . . LL : . . ry 1.� Temporary�Electrica7 Servic�or`Pole ' � �n � r� `F � '[52 Pool &�Equipmenf Location � ��'� - _ .�2)�SoilPipe-Undr,gmd`; ` �.o_ , �r:: "� �%- . �,53,SteelReinforcement • ;' � , � ��+ . - c 3t Eiectrical Conduii Utiliiv-Undrgrnd: y� : ` "-� �> :�54r Forms a '. - � - � , � � . ; � . 1 .� .' . �r, Jr ca • ::. . . _ - , �, 4: ElGctr,ical Conduit-Undr,grrid. : ` � � ^ r_ � ' � ' ; �, � 55,- Electrical�Bonding . � " , � . `�,". Steel �Reinforcemeni � � '' ; �` ` ; � j � � j � � ° � � �56. Rough Plumbing & Preesure Test �� ' � i I I I � 1 + 4�� . �6: tElectrical UFER Grnd.� �, q'�� i � y; �^ �'." r- ='�57'.' APPROVP,L�TO COVER-GUNITEII� . .� � 7. Footin � � ' - � � � ^ �: � o t , >. : . , � . . . - . � 9 I I { . � � i ' n � �` ! ' , i9 .�58. Electrical Coniluit-Undrarnrl. . _ _ i ' 8. Foundation � � � - = ,� � ° � ; � �_ �,;: ��59. Gas Pipe; O-Undrgrnd:, Test" ' - � ' � . ;, , � 9. N/ate� Pipe-Undrgmd. ' ; _ � " ' • ��60. Backwash Lines,�P-Tra'p, � Undrgrnd.. � ' . 10. Structural Floor System ' �� % S ' ; � � � 61. APPROVAL TO DECK '�-- � ' � . 11. Property Sewer Line.&`Hous a�Connection, � ' �,� � - �'62. BackwasFi,&_Receptor-Final - , � . 0 12. Sewer Cap � I, �.� ', i F'� � u�% "- �63. Heater & Vent-Final . � • � I �' . � � ` " ; I n, - ' - • �_ � . _ 13. Roof�Drains , . ' �� g4. Plumbing,Systerti,=Final•,. ' � � ' - � � r.- 74. Rough Plumbing I � � ' .�� ' ° ' - � `�65. Electrical-Final� - � - � � � u � � u'15C�Rough EIecL�ical=Conduit'�'--�----�� - i I � f ' ' �66�Sola��SYstem-Final . . .- � '-- - - �.:16.'Rou h�EleeicicW,irin '` '`. _ � ` .�_:- - •. - - - - - ' � g gi ��, �;, 'i �G� i u j- ;c „ n 67.� Fencin & Access A roval o-' . � r i m� :�. n r. I� 1� i� �, i �� .- I� 9 PP . - " ��'17. �Rough.Winng;Si`gnF ,� n � �� '� ,'r. � � � =� ;'•: � ' � _' � � , '68. APPROV,ED FOR PLASTERING ' '� - � �' - � tl 18. ,�Rou'gh`Electricaf':T�Ba� Ceiling� �� i � �, � _ � � . " I C I -, + ' �69.i POOUSPA SYSTEMS�FINAL � ` � ' ' ' - rt . . , . ., I� 19. `Rougli-Heating &�Air Conditioning , I '-' ' � � � _. ' � ' FIRE DEPT..REQUIREMENT ' � �., ,I�= � _ ` � � i �i � E� � I j . . . - �- . a �, 20. �Rou h:Factor Fireplace � � �� ". � f � � ' � I � � ' , g y r � , � APPROVALS� , Permit # . . i . 21.,iDucts; in Structure� '' � � , � � � � � I i ' � 70. Unde�ground Hydro �� - '��22. �Ducts, Ventilaiing ;;�{ i i, I: I.� � � . �;71.' Product Piping � Gas ❑ Oil -�� + --- - -�- - - - . . *� �+23. �Gas.Pipe-Rough & Test n I I �;� f' _} � I. � � � � J2.i Undergroun8 Flush� . '� ' :; � 24. Roof fi aming� � �� jR � �, �., j� � I^j ��; �. ��: . 73.� Undergrnd. Storage Tank; � Gas O Oil � , � ' 25. '�Roof Sheat6ing i , � � � � �iw !j ; ' i - � ; � � � _ I . � _ r74 � Overfiead Hydro � � � -26. �T-Bar Ceiling �Structurall. & Monocoat ' � i - � `_, i ' _' � 25.; Dry Chemical -� , - ' � - � . � i u � ' i � �. t - S . r �.- � �. i 27. Frame and �Flashing� � � � i �� ' � > � � , � . ;76. Dry Standpipe � � . � � . ' ' 28. � �athing &'Siding� ;� o i ! � �� ! � � � � - � � � 77.' FIXED SYSTEMcFINAL , . � ��_29,:.Insulation ^ _ � ; " n � ! �� ;I � ' � i' I �� i78� FIRE PREV. F�INAL _ .� � i� � n i, � , i � � I� li ' � I I � I , , l�°30. �Drywall Nai�irtg i > . `. � � � � , ,' � tNotes:� i ' � - � _ , ; ' • � . � . .,. . . . 4 - � - -- - - -- - -- - - - - -� - � - -- .. , _ .. -�31. �Plaster Brown Co�t � i � �� -� 1 � � ' � � � 8 i y � 32. Electrical IPower Meter.Finsl � ',� i ' � ; � ',� � i � - � f�l �. � �� ' - . 33. �Final Electric :��- i ' 1 ! . s. � ! ! - _ i� � J 34. Final �ieating &�Ai � Conditioni�rtg� �� ' � � ' � 'i i .. i � � � � a i - r� - � �� a C •� 35. FinalGas�Pipe=?_e"si. ylti �mI ril � :c I' I' I �I,,� � ;`; .. � , ' . 36.Hoodor�Cano"pY?i,r'm _Iol ', � �^I� � � �`-i �.' �' ' ' Y"��P�-s�4lb� i ioi'..� �� , i . � . . � i. 37. Final Faaor �Pire lace�. i _ i� ; � , � � ' � � _ � � � _, 38. Final Plumbing � ' � ' .^� �! - ' V i � ' I � � � 39. Water Seivice-Final� � i ,"� r j 1 � � �� . i i � � - i 40. Gas Sgrvice-Finil � � . I � '� ' j t I , , � 41. Solar pomesticFinal I � I 4�__ j__�__ I__ '. _' ; '' � n � � - - --- - - ' 42. Backflow�P,^,eventeh �_ � � � � �.,1_ � �. � -r� �_ � . ; � , , . ' � _ ; 43. Backflow Irii atio�� ' � � '�'� � . " �" c �' ' � � � ' - <,.. �9,m �ir�: i � � �ti.. �°� �i ..i: 44. Landsc2Pe Itcigat�on SYstem � 1 ' � I � -; ! �'' �, � � ' � ! - ' ; : � i .- _ • . �. t _. �. � ' 1 .4. I " 45. Sound� �Attenuation i h i a � I � ( % � 1 �' ' i � � . _ � , , ' � ` ' � ' �I ..i • . �e:l � � �1 i - �ti�� i r.- �� i , , i • � ' 46. Handicap Regulations � � �; � � � � � ' � �. -i t �:.� 47. FINA�LSTRUCTURE&BUILDING'� IM1 � � ' - � � I ' . � ! , � u<< i � i t' 6 � �'. , � �. 48. Special Requiremerits Conipleted P � � ! � I ; i ' � �� '� j i , � , • . . . �i i � � � i P I � � i { � 49. Elec[ric �ielease�to Edison� ' � ';i ..� ' � � '_J._. � ! _j._ _.� � ' . ' . � ' ' � ,i � � i 1 f - � i - - ^" f � i � � n � � � �i � � i i ' I � ' � � � 50. Gas ReleBse to Southe�n Califorriia Gas Co � � � �, ' 51. CERTIFICATE OF OCCUPANCY ; ' _ ' ' ' � . ' _ ._ � � � '� _�.�_. ! �-r-- No. [f � { � Date i i �� ; -` - � - � - ' � � � u._• �-�--- �,,.-•`__�. _ ,--r�r-•- - --1- ' - - - - - - , APpliwnt to fill in all spates ezcept thasa wit�in heavy EorEer Ilnas an0 si9� all a0��ooriate tleelarations. �-. CIT i'��COSTA MESA ' � � P' iT.NO. - TRACT NO. . LOT NO. BlD . .� , CON�STRUCTION PERMIT. - — 72 �� j� ' � AppliCent'S Msiling Add�855 n TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAI R PrOjectAdd�¢55- � � /'�- - ' � CONVERSION ❑ DEMOLISH ❑ OTHER e� Pha�e�`' DESCRIPTION OF WORK 5��'�G �'� � u T �� Owner's Name � � Addreu� �2�l2 S � Cf../�1C�} - ' . � � � TVPEOFPERMIT ,GRADING FOVNDATION TRUCTURAL A}Ch/Eng. �� LICCnse NO. ❑ TENANT O ELECTRICAL ❑ PLUM8ING ❑ MECHANICAL. .. Addfeu' - e��e�,��'�' '�,�OTHER. - ' ' Contractor's Nam�L . �`1�-� �a �'� -�phone�z..s� PROJECT DESCRIPTION 5q. F7. � ' �OCCUPANCV . I � 9128, 5%23/d3. , ' " -7 20NING.HEGULATIO� A.P.3Y' ��L��6Lol—�•j• zoNE. - ). PLNG.REF.�k � � .BUILDING cTenrv TOBUILDING'._ ' ' . „�,,,,.,.,,,,,.�. Addreulmailingl�� ' ��'pS�PR�+� � '- �� CONSTRUGTIONTVPE � VALUATION$ �rd O ' LEFTSIDEVARD ��, D�/SS �ON� GRADINGCV.V�S. 'ACRE� ' PKG.SPACEREO. , �� License No. � - LICENSED CONTRACTOR DECLARATION ' ' � Remarks: � . � ' • ' � � - STREET WIDTH I hereby atilrm Ihat I' am Iicensetl untler provislonz ot�Charter 9(commencing , . , witti iactlon 7000) of Dlvision 3 of the Business antl Protesslons Cotle, antl � _ - , • . � SPECIAL CONDITIDNS: � my�licenie'i5 in tyL torc antl affact. � �O/�� i L1�ense Class' "' ' <ue e � PLUMBING � � � ' . � , . I ' ' �I Dat `�• - 99nature � '' . ; � � gar Sink � � SeW2r Cap ' ' - ' 1 WORKERS'COMPENSATION DECLARATION' , .. � � � - ' - - � \�-:.� reby afflrm that I have a certlficate of.consent to se ns re oi.a certitifate � ' _. . _ _ _- __ _ -�. ;� . Backflow Preventer - - � Sewer Conpection'• -- � ' Workars' Compansatlon Insurance, or a certlfietl copy [he�eot (Section � � 1 s�'�a, Lab. C ' '� Q l � �� n ' � Backflo�v Irrigation Solar Collectors � � �� Policy No. �� Company �� C� ^� BOthtubi � Sola� Pi m Cer I¢tl topy I5 h¢Ieby fUrnlshed. � ' , � ' � � P 9' ertHiea cop�¢ fI� wltb the�tlty ir� sio Date �` -��S�6s Applicant �U��L�V' 1 • Clerifiers � SolarTank _ . EXEMPTION'FROM WORKERS' COMPENSATION D LARATION DiihWeshef � SWimming POoI W/Spa .(Thissectlon ueetl not be completetl if the permlt I5 for ona huntlretl (E100j or . ' -- lessl. � � � . � i : , . • I certify �that in the perto�Tance of th¢ wo�k /o/ whlth IhiS pa�m�t is ISSuetl I Drinking �Fountains � Urinal . snall' no[ employ any person in any manner so as to become subject. to t�e , -�� Workers' Compensatlonl laws of Calitornla.� , � Flaor Oreins. � � ' Water Clout' � � Date Signature • � � ' ' , NOTICE:�If, after makin9 thi5 tlaUaration, you�shoultl betoma'sub7ett to the �� Floor SinkS �- -- � Wate� H2ate� � - - Workers' Compenzatlon provisions of the Labor Cotle, you mus[ for[hwltn . ' " comply 'witn, such provisions �or Ihis, permit'shall be tleemetl revokatl. � GasService: � •Outlet5� •� W2te�Service � � ' - �CONSTRUCTION;LENDING AGENCY " . t hereby atTlrm that lhere Is a.<onstructlon Ientlin9 agency for tha, ertorman<e, � , In(ercCpto�s � � '" � - � -� of the work tor w�ich Mis, oermit is Issuetl (Section .30�7 Civ. C;�_ '. - ' Lentler's Name � ' � Kitchen Sink ' ' � � � � Lentler's Atltlress' . � : .� • . � - � � � " . . � . ,.. ' OWNER'BUILDER OEC—�A�ON, - ' ' ' ' LavatOriES� . - . . ' " �'�� Z . I heraby atfirm t�at I a'm exempt from tFie,Contiactor'S litense Law for tha- � � • .. . � �roverortne purpose LJ 1. a5 owner of the 0 a wo*essions coae) or mai ne/sne is examp[ ie allegeA exemption. Any'violaUon of SecHon { � a�permiC5ub7ects the applicant to a�ivil � iunOretl dollars (E500). � � �- � � �ty or my employees with wages�as their sole 1 h, antl tha st�u<ture I5 not 7ptentletl Ot ofte�etl ' �¢55' antl� Professional. Cotle: The Contractor's � an owner oT a property who builtls or improves � x0/k hlrtfsClf/he�self o� Ihrough his O/ h¢r own � 9mprovements ara not intentletl or oiferetl for . or improvement is soltl within one year of com- ie burtlen ot proving he/she tlitl not builtl or Im- , �, am excluslvely tontracting�with�llcensetl con- P-Trap ' - • . Roof DrainS � ' � � . Showers �^ � ' �. .' i .. Service Sink , � Boil¢r. : � �. Duct - Under Ground Duct-Strucmral � � tra<torsto mnstruct the project (Section Z044, Buslness antl Profesvons.CoOe: .• Duct - Venblating ._ _,,. The Contractor's Llcense Law'does not apply fo an owner of Oroperry who builez or improves thereon, antl who mntracts for sucb proJec[s wrth a con- � Exhaust System ❑ Multiple � i tractor�s) Ilcensa vursuant to the ContractorY Lironse Law). ' � � ❑ I am exempt untle� Section B. & V. C. to� th6 rea5on ! Firepl/Fact. BIt ICBO # . ; � Date � " ' � owner' ' � � � • Heating,System & Ducting ; � Phereby certify that I�have reatl�this applicatiomantl state�that ttie abova-, -� ❑6700,OOO,BTU �700,OOOBTI inTormation is correct. I agree to comply with all city and <ounty ortlinances • antl 5tate laws relating to builtlin onstructlon, antl heraby authorize repre- HOod o� Type I ❑' sentatives ot�t � . o ent r i n above-mentloned property for - , ' ins0ectlon purpo s. ' �� C �Z; CanO � T e II ❑ Slgnature ' Dats �� ' , • � Orivers' License or.55 � ' Registe�5 ' '.MF 0865-46 rev. 12/82 White - BUIICin9; Canary - ApDlicant; Pink - Accounting; Goltlenrotl - Assessor � - � ' _ , i ReinspectioniFee � � � i Isue Fee �� I','�� Refrigeration Sysrem . ❑0-100,OOOBTU ❑100 . I System Repair/Alteretion - '.� v y fU ,'r� • � . _ . _ _ , � � .i . _ - �f� ' Reinspection Fee'� -•,$15 . �� Iswe Fee � ' � � '-^$ 3 Auromatic Washer _� .. . Conitruction Pole , Cooking Unit � ' � i Dishwasher � ; . Dryers �OGas' DElectric Fan F.A.U. Fixtures ' Device Boxes OuUets , Switches � . GarbageDisposal • ' Generator �0-5 KW �5-15 KW Transformer �15-50KW • RI � IDE VARD .1 PROVIDED � PARK FEE $ � . � 1 7.00 � TL �: . i I �Meter. LJover 100,emps; _ _ ' Sub Panel , j � 5ub Pole � ' � �.Motors OO-1 HP ❑7X-8 � � '�InaSolar0945HP 016-15+ 'Microwave . � � ;Pole Light , � _. . . _ ._ ._.. I., ,_ �StandingSection's; � Trash Compactor � _ ( •�`•y rr �,� , �� 3 � � ❑5U+ KW , '1 �,'•.Reinspection fee � $15' Meter ❑up to 100 amps � ' :' ;{ttue�Fee' � ' $ 3 2onin9 APProved BY •• '�: aate -% f: i 1 � � Applimtion Approved By �-` ate �r � Application Issued By ' 'Date � � ' � SUMMARV OF FEES } � � ' 'BUILDING PE�FiM1T $ O �0 . � SMIP 1� � ;$ I D• SO ;P �aAN CHECK� ' $ � Sfi�,,. , a pERMIT � ' ' 'P6 MBING $ � ISSUANCE . � '$ ; P�N CHECK, ' $ ' ' ' GRADING � � $ ; .ELECTRICAL � $ - . ' � $ � � . -PLAN CHECK� $ MICROFILM �� $ � ' � TOTAL'FEE ' $' � d:MECHANICAL $ � � � . , LESS � �PLAN CHECK - $ : 1 qDVANCED PC � $ c ' � t � . 1 . . , . . � ' FINAL FEE: � $ �' I •Ofl _�'u . ., ._ .._ ' q- �-:, y -� � � POOL?.._`�;7q a� � - •«... �� `�CONSTRUCTION,AND,PLA NING� � � '� J -. r „ , . �, ' ' t + ' t. ' � 'r � c s � ' 1 '.� �Date � Inspector� - � -� � ' Date `� Inspectoc ' �~ �,PJPP,ROVALS „ Permit.#�1___ .,�� .�,, 4 -APP,ROVALS Permit # r' n. - � in n � t - " .r - jt �� TemporaryeElectrical Service or�Pole,� _' `• � �: o' (� �52:. �Pool &yEguipmeot Location . , ' : , � � ,:. _ S' _ _ `� 27 �Soil Pipe-Undrgrnd� _ � ` - � � � , o ,- � m ' � � • - . -� �' - . � r��_r , Y,`�' � �53� Steel Reinforcement � � � �3' Electrical�Condurt Utilit'v Undrgrnd: � N •- t :.,,.' y'' �� z ` �:54i Forms; �� ' �� _� � - ' _'' ' : 4. Electrical Conduit-Undrgrnd' -- � . • �55 � Electrical. Bondin - ' ` � , � - ' .� - i" n..n I�n' 4^. c?+ � 9 n�' . L'�� O } 5' Sfeel'Reinforcemenf ,`: � , �� ,`y � ^ � ' �' � ° : x- , _ ';56.� Rough. Rlumbing:&�Piessure Test' � �� _'- '.��" -•� � s, - i 6� �Electrical UFER G�nd:� ! � r« ,�-`' q; �'> � �� Y' �57: APP.ROVAL�TO�COVER-GUNITE� �r` - -�.' .; . .� . : ' .r-r� _ -r:;�-. _ .... � - -.-. ' "�� 7.Foofings I� �, � �=-" '.. �, _ �_ ' .'58'. Electricai'ConHuit-Undrar��f: + _ _ , ,;-_ �".'i r "� _. .0 , � � . ' .. '. ^ .' ' : .� +. .: � ' . ' ' ' �-: _ � � � � �� : ��' ,' i.:` . ._r '•59. �;Gas�Pi ep�'Undr r�d'.,Tes`t'�>�, �'�'�' - 8. Foundatiop. _ s_ p g, , ' , - =� ! -.�'i � _ . . .��. . �., i • I � � _ ii. J,` - , r�' _ -, . ... •`,._ . . 9. WatervPipe,Undrgmd." � �J � �.F _._ t' � 60. Backwash Lines',.P-Trap,� Undrgmd � �;:..,," ,, 10. Structural Floor Sy,stem ' '�a ,�u"� � � V ! ��. � , , 61. APPROVALTO�DEC,K = �.'�� ` 3( � 11. Property Sewer Line &IHouse�Connection �� ,ri� =� "` -,62. Backwasti�&��Receptor Final� ��- ' • � ,' - 12. Sewec.CaP � ' � _ ,.��i � � ,�,' "° " ' 63. Heater & Vent �Final � �;`�� ' • . ' 13. .Roof.Drains � � � � ° '�`� � - � - , ;64. Plumbing.SYstem - Fival'; '' - � - ' _ _ ' � ` . . , . i .. . . _ Y �_ . _ - � 14. RougH.Plumbing � � ' ' b� . � - - 65. Electrical-Final �- �� ` � � .� fi 75.•�Rough�Electrical-Conduir: = T'-'T^��"r �� " �-�' �""T- --T "B6.�Sola��Sy`stem-Final � - ,� !� � "- " ; ' ' ~ '�'- a ��1�6.'Rough,Elect�ic Wiring� � � E � �i �� ;� j ' .-_' i,: �-= '_ �. _ �� 67.f F cing`& Acce �App�o'val `' � � ; � ' . ' 17. -Rough,Wiring'SignF'. � ,`r � ' I � ��° � � � �=: � ( '; - � , j �68.� APPROVED FOR�P.LASTERING - ' � - - ' _ �� T8: �Rough�Elect�icaGT`Bar Ceiling� ,i '� j - •-� I i ` ' T � �' �69., P,OOL/SPA SYSTEMS=FINAL - . � � ' �� :� j 19.�';Rough;Heating &IAir'Gonditioning ; � _ � ; � ! � � ; " � IFIRE DEPT.,REQUIREMENT` r , _ ,. � _: _, I '� z0. iRough,Factory Fireplace; I � j1 ° � � � i � � APPROVALSr , Permit�# �, � i'' j ' ' � r - ' 21.'.D'ucts; in StructureJ '" � � � �i i; � � � � �� i70. Underground Hydro �� . . �� ' , �'�,22r_�Ducts, Ventilaiing a , n i ' �� ;� y ! � � � � � � �7�„ Product Piping �Gas ❑Oil � � � � ! • _ , .. , , ' i-' - 72.� , , . . �. T. = .;` 23. Gas PiPe-Rough & Tesf ,: j I �� ;i --T--� -t Unde�ground Flush � ;��,� �-. ;- ^. - - - , -..- . . -- ��. i .I i � i . =24. Roof F�aming I I ' ' � � ��: �4. f � ' �� ` ., � �, � �• I ; � . 73. Undergrrid. Storage Tank�O.Gas� � Oil � , i , � I .�c, i� i�-1'�-� .i - � 25. ,Roof SheatFiin � J ' ' - ?� ' � � � ' � _ . _ . � � � ' . 9 ;i . ,i ^ � . : , ; . _ - � � 74.; Oderhead Hydro .. '°"`' a -___ . _._ - � . . � ' ' ' ,. - ' -' _' -. . � . . .. "�26.�T-8ar Ceiling (Structuralj,,& Monocoat' � � � 4 � ° , �- ` I ' � � ' J5. Dry Chemical � � . . -� � • , I� ' �2�Frame and �Flashing � - � � � +� �; ' ; � ' { � � � � � ' � �76.` Dry Standpipe � ,r � -� = I � "' _ r �: 28. ��Lathing &'Siding � , � � 1� �I � � k � � � � �77.� F�IXED SYSTEM"FINAL � � � ` � r � r ,, �l I i �` I � 1 I i � ` � 29. lnsulaiion-�.i.� , F ? ; � !� �I � 1 I I I � . ' �78! FIRE PREV. F�INAL � i . - . .. ' � '30. �D� wall Nailin ' �' �' � � Il I' . t t � - ; � f ' � . (.? . ' . :" �.� e � . � �Notes.' < < - - i:_ Y 9 �`�� y I � ii �.j I � ( � ( � I � iJa� i"}c �1 _ . ! I �l �I i._.'_�'I._ __� '� _� �� %,'c_"`�'- J/� � 'i :is '. . . �;'31. Plaste'r._Brown Coat' �"" � o' 32.��Electrical Power Meter-Final ( i� y � ' � � ( ' � � � ! � � � � ' ' � ' '�� . �� - � �, r t _ � 33. �Final Electric i ,. � "i._L, ��_.ai_ � � � � I J _� � � , . � ,. .. , , 5, � �� ._ .., __�.;_ __,_..:._ . y �.,.� .. . _ = 34. Final Heatmg &,Air Condi'[ionmg t� � i � � . ,y i � � ,' , ' � �;�,i.:��;�-� n � i i 35.FinalGasPipe-�Test -i�.iy�"i � !��` -!'I� � � '�" ' �- i t". � '-= �.�. - . .1 : I ' 1 N N t.l �. R. L ' f 1 1• I` �T '��YM". i 36. Hood or �CanoPY. � n i n �- i r, � �'? �?� I �, j � I i � I�' "r . ' � ''.�, ' . 37. Final Factory Fi ePlace� -� '� � '-� ir I �. f '' � ' � , . - . , .. .� " � . '. � � I ( I 38. Final Plumbing i t �l n� !j � � � � � '; � I I ' i . � � - � ' � 39. Water�Se�vice-Final! j ; � �V� '� I i I � ' ` I i � � � � ' 40. Gas Service-Finsl i + � i � y I i i � I, I I � � � � "� � -� � 41. Solar pomesticFinal � ' ' � �� { � ' � � ' � i : � � � ' �`' + � i i ' r _t_"r _1'_.' _ t..' "' ' "'. . . 42. Backflo�i' P,reventer. � � � �y r � � � � � ' � ; ' w ; � . ' . : � ' � . � . �' � .1= ' .� ` __i -r -r...r- - � t{i 43. Backflow I i�igatiion =.; � , � �;�� n` -' -� ,''. �> i 4, -- . i I . ' • , . � _r.il i �� _�' - � i " � � �i - -- � 1 ' ��- � � : i -� � ; , = � ; E; X P , 44. Landsc�pe Irrigation-System � �z �-- �; j � �_ � -,; � � , ; � ' . . _ � , ..i;, , . ,..� � i l iJ�11". � - �m' i I' � �:. "� .' _ 45. Sound AttenuaLon ;. } - � 1 � � � � � � , ,. , „� i , _ . • � . �' : _ � - � ; � .} : � �� ' i � �i� I - - .r1j8. u;. `' • ' 46. Handicap; Regulations 1 ; ,« j � � i- , � � � � � , � � pafe � ` . - - � 47.�FINAL'STRUCTURE&BUILDWGd �cl � �� i i ' � ��cl� ,. I 1 I � �^ I i � i �' � I-., � i { � . 48. Special Requirements Completed 1 � � �, "� ; i s";' j � � I ' � � - � . . ,. . . o� . i � �.i .a I � 49. Electr � Release�to �Edisom � � � :_ I - 7 ,_! ` � + 1_ ' ' I I-y- !. i _�- _,, � •� , ' � . � 50. Gas Release to Southern California Gas Go i � { ( � � 1 i � I � t� �. � t�, , � � ✓� 51. CERTIFICATE'OF'OCCUPANCY �� ! ' ' ! � ' ' ; " i � � ' ' � � . p , I I � r � t--� ._,.-+ ._.{__i_. �._ r_ . , - , , {�_ - � No. I� �� i Date_ ;I_ � f� � � � � � :, j . -"-- -�-- - - --- - - OWNER HELTZER ENTERPRISES-GOSTA MESA DATE q_26-69 JOB ADDRE55 3432 Santa Clar ^.ircle B' DING PERMIT N0. 30905 GENERAL CONTRACTOR CamP DESCRIPTION of WORK - gneid n e W/A a had .argg AP No. _ LOTsn TRACT ��qn FIRE ZONE VAWE $ �� nz� nn GAS SUBCONTRACTOR ��r►�r��.�v��-i�iri;ii�i��i_�s��i�s��r�cc� MISCELLANEOUS ROIIGH HEATING ANO AIR TEMPORARY SERVICE OR UNOERGROUND � PO ROIIGH WIRING ir.xr„c-��3E-»aa�:i�m�:Ll�'�'J•l.� ��•:��•�IIiYd:///1/J/�/Alt✓i%LAR:��/d�arryl7O HING �.ANO FLASHI STRUCTURAL, FINq� ' ' { NEATING, VENT., REFRIG. ANO A.C., FINAL � - � PLUMBING FINAL AN� GAS TEST n . i S �(% "/ �ZO ELECTRIC. FINAL �� //-/� o Z . av H Z Z � O �n am J � J V1 m J J m Q U N za w� yW WZ J Q m Z J � W w � _ ZH w� N � �O 30�05 COSTA MESA BUILDING•SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA.CALIFORNIA 92626 �;av � z-6�-`"f000 q��2� **TM 1 Z4.50 CN50 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIV D�T E, C IV DATE I S BUILDING 3432 Santa Clara Circle %�a�—� SEP 2�� ADORESS PERMIT�NOi� OWNER Heltzer Enterprises-Costa Mesa A.P.NO. -� .tvJV MAIL 740 N. La BTflB AVE'.. ADDRIEss ✓a ��2, ADDRESS CITV L.A. Cal. No'-937-2171 TRACT 66'3H LOT 50 BLOCK CONSfRUC710N United California Bank A � A IENDER BRANCH Main Office AODRESS 6th and Spring� L.A. OWNER VALUE ^� O� ARCHITECT F. Gonzales TE�� 532-687 5 � �� OR ENGINEER , / /� 1336 E. Chapman Ave. Orange,Cal. ZoNE TVPE v GROVP c�'� ADDRESS APPROVED CONTRACTOR George Heltzer � l�SSOC. BY DATE ADDFESS Sd171e aS above TEL. ZONE NO.OF USE OF NEWS�IIg C F8m FLANS BUILDING CITV NO. r STATE 201098 CITY �'ARDSAPPROVED VARDSAPPROVED �IC. NO. LIC. NO. 1707 MAIN BUI�DING ACCESSORY BVILDING S12E NO.OF BLIX3S. (FROM C/L STREET) OF LOT NOW ON LOT R NT OFT. FT. VSE OF / EXISTING BLDG. FT SIZE OF NO. OF NEWBLDG. ROOMS STORIES L SID FT. FT. EMERIOR WALL ROOF COVERING COVERING REAR OFT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLOGS. ACCE�. BLDGS. Residence with attached garage VAR.qW DATE C.U.P.qW APPROVED Plan 402 APPROVED �D / t7 I hereby acknowladBe thet I hevo reatl this opplication anC ztete ffint the ebove in/ormeUon is correct en0 aprea 2o comply with ell laws re9ulatinp builtling construction, antl I sholl noi emplay any parson In vlolation of tha wo�kmen's compenantlon lews of tha Stero ot Califomia. � �� j/� m I he�eby ce�tity that 1 em p�opa�ly Ilcensetl es a contrec[or untler � S�. FT O the State af Celitornia Business entl Protezsions Cotle, Dlvisicn 3, THE AMOUNT OWN UNDEfl VALUATION IS FOR � Chapter 9, antl that such licenses ere in full force entl effoct, or I THE PVFPOSE OF ESTABLISHING A PERMIT FEE ONLV: � em ezempt from the proviflons of tha State of Callfornie Buslness yALUATION �/ entl �rotessions Cotle, ivis n 3, Che er 9. PERMff FEE $ O � �� Petmittee�t ' aa o,�y� PLANCHECK $ �r� � a Authorizatl ABant � � LL TOTAL FEE 5 /� ��