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HomeMy WebLinkAbout771 SCHENLEY BAY - Building Permits ;OE 9 CITY OF COSTA MESA oq �. BUILDING DIVISION f i ' � I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER m..4 Oka PERMIT 'bRroRmso se P01-00007 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 771 SCHENLEY BAY Status: ISSUED Suite No Applied: 01/08/2001 Issued: 01/11/2001 Vicinity: Parcel Nunmber: 93768137 ISSUED BY: Applicant: BAILEY, RONALD Address: Phone: 714-319-5180 Zip: Owner: SABER, SABRA S & PAYTON J Address 771 SCHENLEY BAY �/Y�- Phone: ,(� Ky �j COSTA MESA,CA Zip: 92626 %.* Y�YYY��_ j Contractor: Dis" Address: • Phone: Zip: License: Arch / Eng: • Address: Phone: Zip: License: SCOPE OF PERMIT REF: BD1-00020. KITCHEN AND BATH REMODEL. 1 BATHTUB, 1 DISHWASHER, 1 SHOWER, 1 KITCHEN SINK,2 WASH BASINS,2 WATER CLOSETS. 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 $9.80 1 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 $19.60 2 Dishwasher $9.80 1 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) $19.60 2 Drain,Roof $0.00 0 Shower $9.80 1 Water Heater/vent $0.00 0 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 Gas(1-4 outlets) $0.00 0 Sink,kitchen $9.80 1 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink, service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $101.90 COMMENTS/SPECIAL CONDITIONS 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 2416.46(6/00) • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the followi g declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: 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($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and effect.Lic.# Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 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 end Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself,or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is =sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). c ❑ I,as owrner of the,property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors,Llcense 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.). v�L ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: ,:r_ Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No, Expires: Verification of Ownership by(type of document,I.e.-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,Title 8,California Administrative Code). O As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? Dyes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 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 appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (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 Ouality 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 Safely 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 certity that under penalty of perjury the information given above is correct. I agree to comply with at state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given Is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 411.11nr aleignatur:�r... s.--: / / 0 fate l•..for1... zed-A:Ern: jel/tAIO Date ;ODE 0 ':hi.. .' gATE JNTrIALS5 . INSPECTION TYPE MIE )fig 1616 Fixed stem Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy CITY OF COSTA MESA BUILDING DIVISION CH,1i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT E01-00016 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 771 SCHENLEY BAY Status: ISSUED Suite No Applied: 01/08/2001 Vicinity: Issued: 01/11/2001 Parcel Nunmber: 93768137 � �{ Applicant: UNKNOWN ISSUED BY: Address: Phone: Zip: Owner: SABER, SABRA S & PAYTON J Address 771 SCHENLEY BAY Phone: COSTA MESA, CA Zip: 92626 P / Si Contractor: ewe / 5c�i II Address: Phone: Zip: License: SCOPE OF PERMIT REF: 601-00020. ELECTRICAL FOR REMODEL OF KITCHEN AND BATH. 12 LIIGHT FIXTURES, 23 OUTTLETS, 17 SWITCHES,4 LOW VOLTAGE LIGHTING TRACKS. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res. a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $13.20 12 up to 50 kva/kw $0.00 0 Recept Outlets $24.19 23 up to 100 kva/kw $0.00 0 Switches $18.70 17 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $25.00 1 Service to 200a $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $104.59 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. , INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. . FOR INSPECTIONS CALL: (714)754-5626 2448-49(8/00) ' DECLARATIONS 1-Th (T1 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: Cartier: Policy Number: (This section need not be completed i/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(S100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lie.N Class it Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). "CP0..M r—,S 1,k 0 )Las owner o contractors operly,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The cntractLicense Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes ❑No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 6,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 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 ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U No (Section 65850.2 of the California 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 Califomia 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 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. ,4111109, '1017474,iist CODE, 111SPON TYPE DATE flhilALa CODE! INSPECTION TYPE gag =NJ 1616 Fix-• tem 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 CITY OF COSTA MESA 4 BUILDING DIVISION r ). • DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER t � " l PERMIT o.� ' --6' B01-00020 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 771 SCHENLEY BAY Status: ISSUED Suite: Applied: 01/05/2001 Vicinity: Issued: 01/11/2001 Parcel Number: 93768137 Zoning: Applicant: UNKOWN ISSUED BY: Address: Phone: Zip: Owner: SABER,SABRA S & PAYTON J Address 771 SCHENLEY BAY .r0 '�i Phone: yyrr � ` y • COSTA MESA,CA Zip: 92626 L.- -Contractor • Address: �4 Phone: Zip: License: Arch : Eng: Address: • Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT INSTALL NEW JAQUZZI TUB, NEW SHOWER, RELOCATE TOILET AND INSTALL NEW WASH BASIN. NEW COOKTOP, NEW COUNTER TOP OVEN. • FEE SUMMARY Plan Check: $227.01 Calc Valuation: $22,000.00 Permit: $349.25 Claim Valuation: $22,000.00 SMIP Res: $2.20 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $578.46 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28,§1,12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with.all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) 1\ DECLARATIONS —� a. ' 'J /-1 • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penally of perjury one of the following declarations: ❑ I have and this ea iscertificate 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: • Carder: 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 CML AMES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full force and effect.Lic.# Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 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'dr,county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property;or,my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec, 341,Title B,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 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 akermit 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 No (Section 65850.2 of the California 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 Califomia Health and Safety Code). 7 If a permit from the South Coast Air duality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 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. Af tet, I�� /�iL t wir Wim „ rte ;ODE I I•. I-.' PATE INTRIALS §ODER INSPECTION TYPF PATE RITIDSLS 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 DECLARATION OF AUTHORITY Bldg. Permit# BO�� OcOQC FOR AGENTS OF PROPERTY OWNER L J - coo 1 co TO APPLY FOR PERMI{S• This Permit# -17-00-017-1 Street Address: .71 ( hen 4y v "•k3a tox, AP Number: 1. I (we),y\ Jotl01^a SaVier , declare that I am the Owner of Title of the above referenced real property,and that I (we)hereby authorize: Name&\c,1. At- \N CZR.t 1.'t n Telephone Number: H Street Address: ( 2 �f (9� ��p1 tJ N a et. City: LI, 14, State: Ldldt t t't Zip: 91(p A-/- • to obtain permits in my behalf,as owner/builder,for \ 'Ll -{j'4.I�IfcL'j '..may , a*A- (In&S A at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I (we)shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. 3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or corporation. 4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the penalty of perjury that the foregoing is true and correct. Executed this day of 20 , at , California. Print Name: X JAptG r Signature: 5bI`a r Date: h O 200 1 Note: This authorization does not grant authorization to perform the work as owner, it solely provides for limited power of attorney to secure this permit in any behalf. 0779-46(rev.11/00) 7< ,ry_.,_.062 _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • 2- CITY OF COSTA MESA' T s PERMIT NO. TR••C‘Na LOT NO.`, , BLDG.NO. j r ; 1 + 1 I CONSTRUCTIONPgERMIT' I " i '�` ilSo'�O ,S ', lc) , I ., . • Applicant's Mailing AddreJ�ALI a it ' 1 ' IIIc I •j� ',TYPE OF CONSTRUCTION . I'i:NEW ADD i ] ALTERATION REPAIR I " y - I � "I I - , +„ • '1 5, 1' , I Project AddrJssi ��I - _❑CONVERSION ;❑ DEMOLISH THER - _. y n �- i, - J�.-2e5J1 , TI. • / , DESCRIPTION OF WORK . OwnersNa .e 1 AB. .srp ' L _•hone a - 7 I. �t, i . 1 . . .. � t l ,, , - : k - JZONING REGULATIONS - Address I i i ' alai UMW 1 - !: . -..: - . 1 _ • y �Zi =TYPE OF.PERMIT U,GRADING L_I FOUNDATION STRUCTURAL 4 P. Pb4pI . �-�'.�— lorl :1-TZONE • _IC�a 6- t. I 1 Arch/Eng.' �ilL tl/� 'r�� �p �rA'I - 1 ❑ITENANT ❑I•EL•ECTRICALI ❑IPCUM• •GING•• ❑:MECHANICAL' I C j I sl ` i76 q 1 LQ .`BUILDING '^' I - ' 11 '• ' 1 fyl / r 1/ �v a, I - .PLNG.REF. t ' ITcj-f Ui TaterB rir, cr-, ,.. I' .•s . Address! • Ii:a t Ua11 h7��.%, /� e 1 a' "❑I OTHER i 1 , v i SO BUILDING- /. / (• j 1 I • OM ,r'� I ! c ay i /[T�1"y/ �� - ' ' PROPERTY LINE oc O ; REAR VARD (T0 P/L) I t i Contractors Name • -Phone lai�1/ .1PROJECT DSC. RIPTION i SG I r TION$ N Y _ c rl k; I i '•C CONSTRUC ION TYPE _+/ ! VALUATION$ 7i �t .LEFT SIDE YARD [ I " RIGHT GIDE YARD ' Qj 'r Address(marling) `� _ _ ��1' r• .'' -, & i I I r ' I ZO•IE GRADING CU.YOS" 'ACREc ]., `1...1-X! PKG.SPACE'REO. r� + PROV'DE,D �^1�� 0vC j �,s� _t__ ,) • License No ! i ! i , - './ , } ' , . a ,5 o[-• J�tQ 1 1P-r'{f LICENSED CONTRACTOR DECLARATION { r ' 1 Remarks: .4 I I 1 1, I , 1 " 1 j I `- j STREET WIDTH . Cxw , • I IPARK FEE!$ I`'J� I rJ' I ', I.herebytaffIrm that 1 am licensed under provisions of Charter:9 (commencing i - - - . - . , with section 7000) of Division 31of the Business anti Professions Code,and 1 + r 1 , _ ' ' I � SPECIAL CONDITIONS: ri '-,� i ' : I t • . ' , my licenseis In full force and effect. 1 r- I s�a}�p�s�s� I . License Class '`- ' ' License No ' _ ' I I I I PLUMBING : I I , j izl{idi{7 RIR�E ' 1 QAL REnrrrprvair' i .. _ Date ' Signature - , ORKERS'COMPENSATION DECLARATION I 1 I f: I l I i ! Bar Sink ! SewerCep - .j I i ELECTRICAL reby;affirm.that.I have a Certificate of consentlto self-Insula or a certificate.... rAutomatic Washer 'Meter Dover 100 amps t G• 1 Workers' Compensation Insurance,'or a certified.copy thereof (Section , BackfloW.Preventer . .i " - Se Wer Connettiom--}- ,.•-!'•- •�" i - - - •.--• -+- - -' 1 ,. .. -I- -•�•�- 1 - I . Construction Pole , ,• I Sub Panel 1 . ; , t4- 1- I 0, Lab. C-) 1 , 1 Backflow Irrigation I Solar_Collectors,.1 ' • 1 . - . Icy No. Company ' - t - - - I Cooking Unit Sub Pole ' +'- y�w.sLl Certified copy is hereby furnished. , ( • ' I ' Bathtubs I I I Solar.Piping 1 • -!1 I 1I - g , I I ! I + I i ,T j ..'LJ Certified copy is filed with the city Building Division. I I ! , - - ! Dishwasher j i j -Motors D0-1 HP ❑1'h$•'s I Date I + I Applicant ' + 1 , Clarifiers , I l I ; Solar_Tank j j I. - ' 'r-EXEMPTION';FROM WORKERS COMPENSATION DECLARATION i - . - - Drye•rs"ri ...- Electric-•"1-' • 1 . (Ttrls section road not be completed if the permit Is for one hundred($100)or I' Dishwasher 1 , I 1 Swimming Pool w/Spa.1 .a t I ';Inc.Solar,09415 HP 016 15f ' - 1 _ : lass): i I 5 1 . ' I i 1' - I + - - Fan I ! 'Microwave ' 1 'I 1 , I I certify'that In the performance of the work for which this permit Is issued I I' Drinking Fountains 1 j Urinal L-'..t 1 .�.i' 1 i 1 v, I f . shall.not employ any person In any manner so'as to become subject to the I 1 f I I F.A.U. , I j Pole'.Light . t • I I t Workers',Compensation'Laws of Callfornia.r • i • I ! I j Floor Drains I r Water Closet t ,'1 f I _ 1 I ✓• • DateO1 his decia + I. Floor- L_ i__ ._ __Water-Heater :.y..N' _ -_ ,r_ Fixtures I 1__- ' • I 1 !Range a._._I I GI• -Nor ars Compensation ,-mper maoingproirdons ofi th; Labor Code ,you, sutforto forthwith, . , Sinks- 5- 1-- .z; ! ._. • _ I- • Workers' Compens provi ionsloor of the Labor byou.,m ust forthwith _ - I •I I r 1 I -1 comply with( such .provisions=or.this),permit shall( be 'deemetl' revoked:. I Gas Service j ;Outlets; "_. I miter.Service ;- I . I ^t ! Device BO%¢s 1 I 1$19gI , { I i I : CONSTRUCTION LENDING AGENCY i I .1 - I - '• _I 1 I hereby affirm that there is alconstructian lending agency for the performance 1 Interceptors i , ... .-.. 1 ,-- , C... 1 .-7., , ,,- 1! I ' v i , Outlets I Standing Sections I . i i , of the .work for which-this;permit :is issued (Section 3097. Civ C) • + r i I - 1 :. r T. i Switches I I •I ;Trash Compactor i ' Lender si Name : Krtcheri Sinkj �. j 7 - 1 - , 1 - , 1 I 1 COFlea: ttir�xs � - FNt �, �'Lantler's Adtlress •� 1 Lavat`aries' .rt I + I • l{ t i Garbage Disposal ; I j i j ', 4 1 I OWNERIBUILOER DECLARATION 1 I n i y • 4 . .4 c I C. ; : i .. .. i r - - t • I following reason:(Seddon:7031:5 Business and Professional Code: Any city or P-TraP I r, i f - I r -t I 1 t 1 Y I i I 1 _ I ' county which.requires a permitto construct,alter,improve',dem olish'opermiir I r in - - - s - - Transformer ❑75-50 KW. . ; ' 1 S. I ;,any structure;prior to its'issuane/shesis requires purse plicae thor such permit' .} 1 Root Drains 11' S j , I c�I ,1 , I „ , - . , l ( ' ' ' 1 I -to file a signed statement that he/she is licensed pursuant to the'provisinns of . _ - - s - `_ j, 050+KW. .Reinspection Fee I 1 the Contractor's License Law,(Chaptfess(commencing withjSection,7000)axe of S 1 1 r Cr I 1. - - 1 : . its', (Sion j3'of the Business and'Professions Code),or;that.he//she',rs!exempt i `- 1 Showers rn , ! I . 1 $ Reinspection�Fee I $15 -, I efrom and the.basis for the alleged ekemptlonAnyylolafiod of,Section _ w I Meter Cup to 100 amps • 1 Issue Fee! I ' • '$ 3 1:5 by:any applicant fora.permit subjects the'Rappllca nt to a civil I I " i ' am penalty of not more than fivehundred dollars($500)' I -. I -- i `t - I i . 1 Service Sink( 1 ._ I !• Issue Fee Y + I $ 3 Zoning Approved By ' J HA 1 ' ' 'Date • i �R 1 • LJ I,°.as owner of the'property 'or-my employees•with wagestas their •sole I •• i 1 i I ' 1 C , compensation' wi11!do the work,and;the.structure.is not intended or offered . - I ,, ! _ I I t .: MECHANICAL I j I i ' Application Approved By '- I 'Data - r 1'13 i for sale:(Section 7044, Business' and;Professional Code::The/Contractor's ' • ' • rI • License Law does not apply to:an owner of a property'who builds or improves I . Boiler, I 1 1 1 - Refrigeration System I ' ' • ! I .Date thereon,jand who does:such work-himself/herself or through his or her own • ' c , 1 Application Issued ByProtease. ' employees, provided that such.improvements are'not Intended or offered for , 1 �o-„100,000 BTU 0100000BTU: I - ! sale. If, however,the building or Improvement Is sold within one year.of com- • Ductll UnderjG round 1 i i , 1 I• I 1 I I SUMMARY OF FEES 1 I I ple�Ion,the owneriwill have the burden of proving he/she did not build or Im- , • 1 I - - ' aryve forthe purpdze of sale). ; i a j I i 1 Duct-Structural, 6 I I • System Repair%Alteration I BUILDING PERMIT $ �� + SMIP ' $ . • • (USI I,is 'owner of the roper[ am exel uslvel contractin (with lice n'setl can- I t ' I ' ;, ,actors to.construct the project' Section 7o44Y.Business and Professions Code._I -. putt-Ventilating I I I : : I '_ w-_-; iPLAN CHECK! $, t �• , PERMIT ? , I The Contractor's License Law does not apply to suchan.owner of property who '1 1 r ISSUANCE . $ 1 1 . builds or improves thereon,and who contracts for such projects with a con- 1 I Exhaust'System ❑ Multiple 0' I I I PLUMBING , $ • I ( 1 • tractor(s) license pursuant to the Contractor's License Law): I . - ' GRADING $ r 1 l , i PLAN CHECK $, - j t i . ❑ 5- exempt untie,Section i B.& i C.for this reason I I Firepl/Pott.BIt. ICBG# I r , ' Date ` -• ewnerj ' ' I Heating System1 + ! I ELECTRICAL; I $ ' $ ' I I I r &Ducting I I I I I { I MICROFILM I $ , PLAN CHECK. $ • I • -Thereby-certify ' at• - av:ereatl thislapplication-ty,and - - 00-loosmO-BTU 0900,000 BTU-- - I - - , , II Information Is c• act a rte to comply Ith all city county ordinancesI ' I I w- _ , j 13 TOTAL-FEE.- $ g py 'MECHANICAL I $, 1 r 1 1 zndstate laws .IatI .. to •until a cons tiondand hereby authorize repro- , • Hood or Type I- ' ' t ! • t 1 t . ' ' sentatives of isi/•1�Y, en j upo. he ab•ve-mentioned property ,for YPDI Reinspection Fee. 1 $15 i l t ' ' Inspection p os��� / I I Canopy Type II ❑' I j ;PLAN CHECK t $ • I , 1 gDVANCED,PC i $ I_ ! Signature Al - /. I .G[� `• S •-te 6'/Q'a' 3 ' r. , . j j 1 I 1 'I j 1 i I I Accounting;Goldenrod-Assessor - - "'•”- - - -r - - i- t1CONSTRUTIONAND,PLANn - .trr- , ^ 5o ' -L '9 oPool !A "- -- 'E �-� _ ' : : r .` i- 0 ' •-t- a n" - c - a ; Date c . ;Inspecto „ O` '''''•''' , -P ' t a Date - •Ins ector APPROVALS Perimit#_ :- , • ; o c r»APPRVAL$, erm1t# - - (5 ! � , 7 .: S .o >r. Im: :- ._ ' p , amu. tic ; . : rc r - 'a .. _ 7.z.; iI .. -a •:, r; j Temporary,Electncal Servce or�Pole I �d c'• '3 -6S °[`^ '524 Poo &:EquipmentLocation t r I • k 1 c (I= �C� V <` l o:- ✓fnp ,n ,)- ' � 'n. _ is 'c i �^ 1 2_. Soil Piortindrg;nd _ a ,•r :o , 1 1 ,; ^ i ,..>, gg 1;5_3:: Steel Reinfoicementc= ,_ ;. .. •••ft. c 'c: 1 I 3? Electrical Conduit Utility Undrgrnd d 1 , r ' :; = ^ '-l01.541.-Forms c... �t 2 ''-• �' 4 2 tri::`" ' n c.i C : 7 i ft - -; ` - - 4" . “ tic• ... --'duit-Undrgrnd.__ r I Y_ ``•0 81<,, • 55.::A_ g ic_aGBondirg:- 4 .-77 • _ `I _ 5 Steel ltReinforcement "'.�ss, i o ^`i, ; so= - '`+1 ° 1z^ ;==rf56_ Ro(igli_Plumbing-&Pressure Test -!' ii JT I .4 ; :,:,:::::i-t• ; 'I! •6: lElectricalUFERGrnd1 'et. ' 7APPROVALTOCOVERGUNITE44 ' . 1 .1eG - I lit % 1 t=:. t. - ! 5 , . l 6 ,-;:-= r , K. t • • _ f :I .r 7. Footings •i f 'Wit I I f ;' 1 c ° ' ^' , I !i58.'E lectrica1,65' duit Undr-"'Wt•_' �: ' ''': '1 `' 8. Foundation _ -] 1 ! I-I . e 1 s 12 v ' 1-E i '4159. GaslPipe =fl On'drrnd' Test '_ 1.- r. • 9.'Water Pipe-Undrgrnd. I I i p `_ ; ; S I " 1 -.15,:.,-.15,:., '';69 kw Bacashm Les P_Trap Q Undrgrnd `j :,,b' 2,{ a 10. StIructurhl-FloorrSystem 1 ;IA c 1 I -4. n2. ?°; ; ,'61. APPROVALTODECKt ' • t ,,,,,•.;- ' i! 11. •Property Sewer Line&iHoluse Connection( - 1 4 r. E62. Backwash&:Recept'_or-Final ` _ _ , _ N 12. Sewer,Ca 7",l ' I I - , . . i1 , . �� ^ .. .. P . 1 H.HI "n ! , . o_ •� 1' 63. Heater4&Vett Final >° n r .� .� 13• . .- ,J.1 1. l' I. ' ,f I i I -, 64. Plurntiing`>System_Final- _ 4; - %1 • e 14. Rough'-Plumbing4.-,4 1 ! sn I t 2 1 65. Electrical-Final -Q 'c> - r• - - 1 - 1 -- r15-�Rough Electrical -Conduit II ( �" 17"{"'" '-'�T"' 166.�Solai�Sysiem-Final-i-•'3i j--_ '____ _- 7-1. r. x16.tRoughEle mire Wicih9t n 1 :41 IIy r' 9 j T c i,";1171:17, 167 Fencing&AccessrAPP�ovaf='t T: 1" -7,-- 1 :±----,,,L.,[1;t h;17.rRiiugh'Wir n.ng`Signr `; r I 'j ! (; '1 1 1 I _ ' I71 o c I APPROVED FC R.PLASTERING ' ;j r ' f 18:-LRougS Electri al,T,Bac Ceiling V !I � ! : I I "I , -- x' '691 POOL/SPA SYSTEMS;FINAL ' I : ' .' •_1 ' , a :, i 19:YRough'Heating&IAirrConditioning 1: I { 1, I I I ' I 1 1 (FIRE DEPT.tREQUIREMENT i_ ` . I ' • -, i ! I_ 'j , • >, 120.}•Rough:Factory Fireplace 1 1, 1 1 j I I 1 I APP.ROVALSI ! Permit# 4 - L 1 , +: T - S. _ I I ,. ! I ! • ! 1 - , 1 I , - I n 21. 'Ducts;in Stiruature, ' ' I i '' II 1 I I I I i I 701ergrun Underground Hydro d 4 ; ' ! ! -I ! ` j ' 2 ;__-a I - 1 1 I _1 .1 Ii ! i I r - t n. , ! 1 , 1 • ,t:22.,Du'cts,•Ventilatmg('�`'}fr, 1 1 11 1l 1 I 1 1 l I I 177; Product Piping r Gas •©Oil 1 ! 1 .- I I • , 1• j 23.,'Gas'Pipe-Rough & 'Et i I l';IL_ I T j I i i 172.! d UndergrounFlush 1 i i I ic24.{ROof'Framing ;;,...-4! !J 1 1 H r('7: I,•i. n 'i -p i- 1 - 1 , I I 1 ; 1 I • 1 s lI !/ I '-1. 73: Undergrnd.Storage Tank�O Gas;-❑Oil i i ' 25.1!RoofSh_eathing. s.:f- I - 1 I I'ra!I o-' 1••i.ISM I• - I_ 17T4. Overhead Hydro I!�' _ I ` I i . 1 -.f P. - n �. n Int ,r 2 1-26.t :Bar Ceiling (Structurall<•& Mont . I ` h 1 a 1 I : r r75! Dry Chemical I ' h . _ " 'r-27.!Frani eanii'Flashmg = cc I II I ! 1 1 ,76 Dry Stan•dpipe ' , 1 1, i I 1 128./Lathing & mgn I Sld , ! ! il I ' ' [ ! 77 FIXED SYTEM`FINAL. '• 1 ! i 1 ; 1 129_ill;sulation S1 5 ', I II 1 I e-Y.t.� ,lhc/ 178E FIRE PREV. FINAL ; I �'30..Dr waall Nailin I >, 1 ,i ;I 1 17 CI. i Q '\I ''Notes: i ! I i . , �� I 1 �31..'iPlasterl8rown Coat i _ :1 Il d. , ' I 1 i I 1 ! i t _ r L , ci 1.. • �, . , , I I 1' I I i !. 1 i i I , I • 1 32.'rElectncal'Power Meter-Finall; !� 1 I I i I_ _!- 1. 1 ! I `- . ' ' I ::•• e ' •-s::,.- -: .-...1....4,..--1--L- ...- ..L_L.l . - 1 I I ! - t 1 t ! . 33 !Final Eletric, . i.L_ ' 1 t - �....__' I ' __ _'!- ._ . _ _. .1 - .- I --' -I ! r 34. Final Heating'&'Air Conditioning 4 1 1 - 1 ! 1 ! i 1 ' I I ' I 1 ' ! . g a a'I , 1 4-144f- 1,. 1 r I 11 .� i.. d ,r- n- O I O -:I : ' - • 1. r!" - - c - " 35. Final Gas RipeTest '1 - ! n ' _ .r 1 • 't ., -i ' `- - n u '- roi'- Ir.11 r_• 1g1 = 1K 1�� I-; �.i , `k :e 1` -1.. 1_ . . : ? �kr - .. 36. Hood'orllparipor;"I -r i� ir{ K1 nI U }` ,L ( ` 14. 1 i 1 °' ' - ice 1 :s I,-i . i- c tel: .' . - 1 1_ ' 37. Final .1 „ .-ly tFiraplacen 1x ! G� ti I l - 1- 1 - 1 %i I . 1 1 "I 1 1 . , -'1 - 1 p i' -- - - r' 'I a u t r. - n c i , n ,r. .. - p 38. Final ,, ,, ngl _I 1 i 01 S1 !I Imo !- i ! i' ; 1 I I ! t i• I �i � 1f- -' 1- T. > - , : r 1 - l; I .,.1 n ' , 1 ..1 I I 1 i t., i _' 39. Water Selrvi_1 . i�n,1='T't • I -, I X11 l I. 1. I ' i i l , I I I t itl i T i 'E..i. !:. 40. Gas Service:Tina! 4 44 I' I I. I .. •' II 1 I I 1 I 1 I 1 1 I 1 I I .. 1 ! , i I t I ' I 7 1 I I_. } I 1 41. Solar Domestic-Final 1 " .. 1 I I [ I ! - 4. .,; v l 42. Backflow Preventer ,,I I I i a 1-- t-I I 1 -:---r'-r- ! ' P-;- -t ---- , 1°', •1 `i 'r i , ., a. •1. t.lf )!1 1 I I lid"^ I\11 ''. I'o1 ^i : `n cYI '- '- ) ! • 1. 1 p i' ' C ' 1 43. Backflow Inn anon 1- I ,1 z, 1 _ 9: !P 1 4=1� " Irl". I Ii' 1 I . • I , �1 , , .1 ..I m w - I O 7; 1 91 ' .-1 I ' I 1 .`1 n , , ' ` 1,1 G • 44. Lands'caoe lrrigationTSYstem1 1 • . � � 1 1 ^ 1-, 1 g! ' 1 c i ! I ° "1 l ' 1 1 a. .. : , -A.` } Ir ( i •7, c-, I 1 I It _ r 45. SoundcZag t41ation�fr._:, IEC 1 i^ 1 I 1_ l vi I I I 1 = .:I : i 1 1 •' X11 ' -"? c _ c 1 1 !PI ! _I r1 J 1. ..r 1. .. . 46. HandicapRegulatisni1 ' IM1: I I I 1 1.. 1 ri- I i l I "1 ( 1 1. I `I .,• .7 ±; ' -o c ;- r', 47.•FINAiLSTRUCTUREI&BUILDIN9; 1c {D5' t c1aoiky. :I •I l 1 , i,: i I , _ I 48. S ecial Re uirements Com feted I 1 I - Special '. a� I, L? 1 � 4(I�JB`Pr 1�[c�kD : I I I , 1 1 (�� 1_:. t 49. Electric Release to Edison:: ' ! k [_ !' .i. r 1 1 i i i . l _:-4 -'(1 ' i 'r i l't' 1 -i I r -1 4- i t---1 �, .. 50. Gas Rel Soithein'Califo : Gast I - ( 1 t I ! 11 I i t I , i t 1 '' r t •i ! I, ! r •N I I _ N51. CERTo LIFIICATEI 09 O DatePANCY 1 i i__,-� -!. -I i i` I i l . j _t_.42.:4:2,,I _! , l.v- I I , i 1 � , II I---1L- �..:._'---� -'---•-_ .._. - _...>r,,, _., -- �_ ,, Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA, 1 " i -} S ( "i" • —PERMIT NO. ;TRACT NO. ' LOT NO. i BLDG NO. •� 1 1 I j 7 -S ' CONSTRUCTION PERMIT.• ' • 1 -- j;• ! -• ; M` •9. 7a'�_ , r. .^ f ` , s ' 1 ,1 • "-- • - ' 7 ' 1_I `.-•I •''_' yi ( 1t'-' L , 7;L Applicant's Mailing Address X80 N- N. •Ba.td.V18.:Orange• - T,V PE OF CONSTRUCTION- : ® NEW -LJ ADD L'J ALTERATION r❑`REPAIR' • ' r' ) 1, • 1 - i I -r ts•., • • I • , _❑ CONVERSION :❑ DEMOLISH •❑ OTHER -' } t ' - r I Project Address •- - .' . ' - 1 1 .,9 .; ; - ' ' Ow• ners Name .•_M l± a • Phonel -- - ' °DESCRIPTION'OFWORK rr'rlatA1 f'iripamee' '' - , _ - D- d` n S C CoO 1 - • , 1:1 • - 1 l ?• ' • • ZONING REGULATIONS' i �, • o p - , - • .TYPE OF PERMIT I Li i GRADINGP❑ FOUNDATION 0 STRUCTURAL ? .A,P:9W -. I ` • ., -ZONE .< • i ± Arch/Eng. 1 License NO. .6 • ❑'TENANT ❑ ELECTRICAL ❑ PLUMBING ®:MECHANICAL i ' - ,PLNG,REF ; c. 1 -BUILDING' j; .,;17 ? 1 t .1 • C : - i •.l • _ C, . GFTaer•V r•/l CT Addreul • - '/ I ' - `', i Q-OTHER .- t 'F 1 n. - TO BUILDING ,r, T 1 ' t ��rr I L ,4 ' • : - , - ! 1 -REAR YARD (TO P/L) , 1 E. ' COntractor'sNemPrOdSt' Fi reps HP P Phone .(-11 /R20; !PRQIECT DESCRIPTION SG. FT. ' •- ,OCCUPANCY •I -PROPERTY RTV LINE _ ' Address'Imailingl 'l Ocoin=N N.Rato Vl'A sfl rA 11 s92 67 1 CONSiRVCTION TYPE ' •-` i VALUATIONS I -•LEFT SIDE YARD ' • • • RIGHT SIDE YARD, l '. jIi ) i� 6406 - 1 y. I 1 ;' ZONE GRADING CU.Nibs': - ' .ACRES I - PKC.SPACE REQ, ) PROVIDED j 1 ; ,r� License No: 6 06' 1 LICENSED CONTRACTOR DECLARATION j ' ' ' c ' 1 I I , :STREET WIDTH ' I r { - .PARK FEE' - I I Remarks: '' 1 , I . 1 I - $ 1 • t whereby,affir m 00) ofam licensed under provisions of Charter 9;(comiden oing • - - with section 7000) of, Division 3.of the Business and Professions Code,and , •{ p�•1� ' SPECIAL CONDITIONS: 1 s : m9 license Js In full for -andjaffect 1 , 1 - ' ! I "" -w��D { ' ' .. ; i License CIa ' -• 'ense N .' • S + 1 i - ; .. I , PLUMBING l -, { , f I I ; 1 { r ± { Date :3 Signature - Mc rK 1 Bar Sink { Sewer Cap' I y QRKERS'COMPENSATION DEC . RA ON, . i i '.. i ' _ _ .. I -r ELECTRICAL I r.4'2-Workers' 'C that I have a certificate of consent to d 'Cop care or a certificate I i ' - ; Automatic Washer '.Meter Dover 100 amps i - I ' i 1 `4- ' -'certified:Copy thereof (Section '�' ' -. Backflow Preventer _--�. _-.-. . _Sewer Connection .y - _ - - .. __t. _ . _ _. _. . . t iii Norkers' Compensation Insurance;!cr a - ' \ 00, Lab. C) ]- �(i,8 0CCA ' 1 Backflow Irri anon I Construction Pole { Sub Panel. ( I 5 73 3 /59JC t AeL a. ' 1 i g Solar Collectors Policy No. . ' Company ' I _. - _- . I ; ® Certified copy Is hereby furnished. ' i i \ i 1 1 , Bathtubs 1 $Olar Pipmg ' Cooking Umt r Sub Pole I ( I } Certlfigd copy Is filed with the Lity By}�d7 Difl$tgil. 7 Dishwasher t .'Motors ❑0-1 HP `D 1%-8 • t Date]_ly]_(j/8'3 Apphwnt`�fy 11Z/MM/(,✓y"' Clarifiers -. 1 Solar Tank - • -EXEM . ION:C ROM WORKERS'COM rATIOMDEne TION ' - - , - - - Dryers-❑Gas ❑Electntr - - 1 ; _ • /This section need not be completed If the permit Is for one hundred ($100)or I. ! Dishwasher '� f Swimming Pri01 w/Spa - :I nc:Solar D9�15'HP-❑16=15+ '1 ' Ie certify,that tin the performance of the work for'which this permit Is Issued I ? ; Drinking Fountains ; Urinal ' { 1 Fan{ + a , Microwave Shall.not employ any person In any manner so:as to become subject to the i : - - F.A.U. _ ' 'Pole.Li ht i I Workers'. • Compensation;Lawsof California.) ? I I Floor Digins I Water Cl osetj ' g 1 1 , ( •' Date ' • 1 • Signature i ' ' ' ; i NOTICE:if,after,making this declaration,you should become,subject to the i . - Floor Sinks__ . _ , _ Water Heater __ 1 _ ' I. Fixtures , • I ,Range , I , Workers'. Compensation provisions of the Labor Code, you must forthwith t + • _ i - Device Bozos , comply with; such provisions.:or rthisr'.permit ;snail be deemed revoked. • Gas Service ; Outlets - I E Water Servicer , 1 f Sign I , ' ' i i CONSTRUCTION i LENDING'AGENCY.' - ' • • I hereby affirm that there Is acction lending agency for the performance 1 Interceptors - • I Outlets . Standing Sections ? i of the work, for which,.thisis permit -is issued ,(Section 3097. Civ. CO, -- Lender's Name - - 1 'r •- ' ' ' KitchenlSink- r r: ti 1 V t . 1 ; ! . Switches ' i . Trash Compactor , i I - { Lender's Address' - J. .� , t I OW NE R'BVILDER DECLARATION` I . ' 1 •• : Lavatories ` I - I Garbage Disposal , j F ' I herebylaffirin that I a'm exempt:from the,Contractor•s�.License Law for the F-Tre • ,) Generator ❑0-5 KW ❑5-15 KW • I following reasont(Sectlon 7031.5 Business and ProfessionaliCode: Any city or - p• 1 1 ..• • •r• ; , ' _ j , ' ,county which requires a permit,to construct',alter Improve,demolish,or repair _ - t - i Transformers❑15-50 KW 1 j i any Structure;prior to its issuance, also requires the.applicantfor such permit , - RoOf,Drains t ! !'to file a signed statement that he/she is licensed pursuant to thelprovislons of • ' " - ' • ' , ! i ' •`4 Contractors License Law(Chapter 9(commencing wlthiSection 7000)of , - t r I i - -. - 1 D 5U+ KW; j j ,peinspection Fee $15' { tion'3,of the Business and,Professions Code) ori that he/she;isl exempt : 77 f Showers - i , Reinspection Fee $15 • I _ from and the,basis for the alleged exemption.,Any violation'of Section , , •, ; _ Meter ❑up to 100 amps tissue Fee •$ 3 S 5 by-la ny"applicant for a•permit=subjects the•applicant to' a.civil "' i.- - 1 1 - _ _ r elty of not more than five,hundred dollars($500). ' ' t Service Sink 1 „ { Issue Fee ( $ 3 I' i , c • .. t t Zoning Approved ByDate f •CJ I;lasationer or thelproperty or my employees with intendwageslas their sole I - t - ( 1 compensation' will70 the work;and the structures not intended or offered i . ; k I MECHANICAL• l ' 1 , Application Approved By _ 'Date • r I for sale"(Section 7044', Business!ane Professional Code: The,Contractor's - • - , ' i License Law does not apply to an owner of a property who builds or improves • BOII¢r. it Refrigeration System i • I. '/ I ;t ��/� thereon,'and who does/such.work himself/herself or through his or her own ) ' I I • Applinti. Issued By • P' ,Dat@ /�� salemployees,Ihwever,ded thetouiidi g orh nimprovement I5 sold within one'year of comovements are.not Intended or offered m ' Duct'-Under-Ground • j , D0;100.000 BTU ❑100,000 BTU, t - , , pletion,the owner will have the burden of proving he/she did not build or Im- ' • _ _ - i l I . SUMMARY OF FEES ; '' r LIrove fo;the purpose of,sale)- - 1 . • ' 1 , i ; Duct-Structural • I System Repair/Alteration {BUILDING PERMIT $, I SMIP r $ t I,as owner of the property,am exclusively contracting!with,licensed con- I tractors to construct the,project (Section 7044,Business and'Professions Code: t 1 Duct-Ventilating r t , I - PLAN CHECK, S. 1 ! PERMIT 1 I 1 ' •The'Contractor's-License-Law'does'not-apply to-en owner ofrproperty'who-'- 1 { r ISSUANCE , j $ + 1 ' builds or-improves thereon,and who contracts for such projects with a con- t ! Exhaust System ❑ Multiple D I - I ,PLUMBING . , $ ` ' .'tractor(s) license pursuant to the Contractor's LicenSe Law)S 1 { 1 - s - 1 I i ' = , GRADING . $ ' ❑'l am exempt under Section B.&P.C.for this reason Fire I/Fact.Bit. IC80'/k I PLAN CHECK j . I i i I , j 1' p 3195 100 Dater I Owner 1 I I. i Heating System&Ducting ; ELECTRICAL; $ ' $ �- ' 1 i ' 1 '. MICROFILM " $ I • I.hereby certify that-,=have reatl this application aril state that the aDOve_ 00-100,000:BTU 0100,000 BTI'. __ _- - _ ,PLAN CHECK, $ . t 1 information Is correct. Degree to comply with all Citynd county ordinances I t - r '� TOTAL FEE , $ - i 'and state laws relating to bulldl g construction,and hereby authorize repro- : Hood or Type I ' TOTAL$' 7:. 00 1 sentetives of'.t•is' ty-ty ante upon the above-mentioned property for yp ❑ Reins ection Fee ' LESS inspection pur••se , 1 ,,. )[� 1 ) 1 ' Canopy -TVP¢II ❑ P $15 Ip LAN CHECK $ 2. VO ' I t , Signature ,. VVV,(,(/�/� I f Date 11/1AjR3 ( { ADVANCED PC I $ _ ' Drivers' License or S 3F � ? t Registers - ( Issue Fee f J $ 3 { , ` FINAL FEE 1 $ 9 :'00; CMF 0865-46 rev:12/82'3 tAPPlicant;Pink=Accounting;Goldenrod---Assessor -- . - u v - 4 - - --'- -- - --- - - --- - '• •-'•'- -3----'.. . ' — •-• - . - ^ . - -- - -• + - t- _.::. to ,.:• '_S�. Ss n''- .n POOI �A 0CONSTRUCTION AND P,LANNING o t- I .•^,o_� . .a; t ;.,ta _, - ' C7 + %, L m T, ° _ o ; Date, lInspector•: (.2, '1. c Date ' `-Inspector' 14 ,APPROVALS= Permit# r - 1 - �+ � :•��APPROVALS: Permrt'# - r r1.iTemra pory Electrical Ser'vicero7Pole !;,+ 4` 8:: , i@ ;:'2 ; '>_52:=Pool&;Equipment,-Location3c -`•- _ ,� ' ' ,r 12.I Soil Pipe-Undrgrnd' Is '7.'1:t i- `22= ' ,I >" n `r" 1 =53'.TSteel Reinforcement ?' _ _ , , _ f 0; 6LJ� 1 l "r, • : (3.IElectrical Conduit Utility-Undrgrnd. ' s; Y i- Y� .;_ '541-F fl,, • - - • - •, "-1 c4 (Electrical Conduit-Undrgrnd.= >" _ �; '-' Iiir.; S� p L. '55.--Electrical Bonding - > ,` • -(Steel Reinforcement I n 4 ' I - q= ` i §=F - ;•_r.-I-' 256. Rough Plumbing&`Pressure Test-a ?: ' '6.1 Electrical UFER�Grnd'. I rc a=^ ` Lf2 ; r ' ,5•A APPROVAL TO'COVER GUNITE '' £ 7.I Footings : : ! ' i ,1 I u g;,; I• ! 5 ' - a i )` _ ;:,•16-...!.. `58.^ElectricalConduit-Undramd'_ :. _ ; • B.IFoundation 4 1 { • E ? - 259.=Gas Pipe ___41.1,9"drgrnd Test'' - I - 9.IWater Pipe;Undrgrnd I o•'' •- a° •• 1 -. 1 I`--' 60.'Backwash Lines;e-Trap;'0 Undrgrnd. 1 _ Y 5 n. . • 10.IStructural 'Floor SyStein 1 ro S '.. - > ' 1T" '''.:=. '. 1^ ,:61,>APPROVAL = • 'TO'DECK-E • ` - ` I 11.1P• ropertY Sewer Line & House Connection : •' •°t ;62 " I ' I I �A 1. t ! .L 4e. ' wash & ReceptorFinal_" 12.ISewer Cap I I . - ' >_ = 1` 63. 'Heater& Vent-Final i! f 13.IRoof Drains 1 ' , I 1 _ i - !; i-64. Plumbing System:_ Final ;., f, i ! 14.1Rough Plumbing 4 i L•t I : - • "65.-Electrical-Final'-5'- G" . - - ' • - •• - - ! v ` R15. 'Rough-Electrical:Conduit - j -"! r_r7-' 7-TT (66; SolarSystem`-Final`- . I - i - : ' - M' e. -c16R6lo1 ug�ElIectfii ricWl i-�inn .n ' r, {1 . k.J „L.7 - r-4-- - - f _P' !�I T67`Fencin'g &Access.AppFoval 7--,-1.7-..-17.,.i.-:: :, _ _ .1j �17.CRough.Wirng'Sign ' I $1 I; - j_J I r 1•- I i c 1' 168. `APPROVED'FOR FLA.STERING' -t - ✓ `18 u Rough Electrical-T•.•:Bar Ceiling lI •l' iii I' ;. ; ^;', It' ll:t.' 69'. '±POO'USPASYSTEMS FINAL; ' 1 ' ' I ° A , 1 1 ` I ' 1 1 ;3 i I I I I FIRE DEPT! REQUIREMENT • •' 7 ' ,1 1 ' a 19.•Rough,Heating & I'14" 1nditi• it it I d , 1 - 1 •: ' ?0„Rough Factory Fireplace I , I m' /ej /e•ti APPROVALS Permit# I . . 21 11Ducts in'Structure•• `'l I ; I{ I 1 t I //1 ' I 170. Underground Hydro II { , ' s22"Ducts,IVeniilting' { q I I It 1 I ! X71.. Product Piping,DGas ❑Oil t 1.:23,!Ga'Pipe-Rough &Testa I I, •1h i!- - - 1- --- = - '-1' '721 Underground Flush - - - i-- vi ,111 i ' I -, im!, I0244RoofFramng jt1 i ..• ' r; r' ItI -'I' ? 1 - 1 ; - 173. Undergrnd.4storage Tank DGas. obi! • 1 25:Rof.Sheathing I ' + 1' ' ^ !I x • l, ( ! E` . 174. Overhead Hydro ,i , • 1 _ o - I I t I� - i Imo ' a_. R 26. T-Bar Ceiiling'IStructuralhl& Monocoai t ' I I a I' `I { .. 1 'Z5. Dry Chemical ' - - I 1 _27.KFrame and=Flashin9 ; i 1 I I i I ,, i , 1 76. Dry Stan•dpipe, - ,, -• ; ' r , 26.1 Lath & ing Siding n , I 1 ;1 .i i I I I 1 1 I77'. FIXED,SYSTEM FINAL. - • , ' , L. 29 .Insulai:ion" a -- • { { li .1 1 Ii I i 78. FIRE PREV.• FINAL r ' u w30. Drywall Nailing s• , t:•; 1 1 ;I, l; I I ! 1 I I I• i Notes: - 31.:;31:;Plaster Brown Coat • 11 ;I 1 I ; I I i ! • ' • I ' 1 `; `'32'IIEIectrical Power'Meter-Final ia , I i . 1 ' I ! I , . I .! '' ' =-> 33."Final Electric ' 1 , ' L,.t Ii I t L LL _l 'J i 11 II 34. FinalHeatirig,& Air_Conditioning w ! 1 ( I t I -�! ' 35. Final Gas Pipe-Test'- I' 'moo -' ' - C. 1•7' _ • f'k !„ Li.i.7! '' i 1 ' -_ . •_ 36. Hoodor Canopy I r s 4I, -1 F i_ ;; I ' :,I c - - 37. Final Factory'FirePlace; i - 1 ii ;' ' r• {�,274 /mer >; _ I _ . _ 1' - 38. Final:Plumbingl : - 1 1 1 _; u 1,e :• 1 I '�. I II_ i,� : :1 ' • 39. Water�Service-11 Final ' 42' i ; , ; ' I t i i • r .. 40. Gas Service-Final 1 1 1 1 fi 1 ' 1 I 1 + 1 1 I ' 41. SolarDomesticFinal ; 1 L I _ i ' i _ 42. Backflow Preventeir 1 ' '. 1:,,1 ( - • ' 43. Backflow Irrigation T,j s I 1 1 Y•!`_ i...,. I? , • . s! nom, , .;- I i Iii-e•1.- _ ; t , I 44. Landscape Irrlgat!on.SYstemt I �Q.-i I ' '.-, ' •t -' • c i i-' - 45. SoundFAttenuation k _ I 1 1_ I _ 1 _ , - E _ . , I C , , o, , ,. 46. Handicap Regulation's' 1 " { ! '4 •' I I` 1 ' • 1 + I ^! 1 _ ' 47.•FINAL !% ' { yi •• ' ' ' ' ' ' ' - '' 48. Special Requirements;Completeil '! I ! I l 1 '' 1 I + A a 1 1 1 1 I :1 1 1 1 1 49. Elect[iclRelease tot Edisori 1 1 11 {-i_1___L . __4- _:,_11.. 1 _ i I ' I ' ' 50. Gas Releaselto Soothern California Gas'Co i I I ' ! 1 1 • I i I `! ' ' • P 1. , 1 , I , I I 1 I i , I ,, , 51. CERTIFICATE OF OCCUPANCY }- I 4, . I _.1__1_1_ ! _, ! 1 _ 2'" ' , No # 1 !Date{ + „ I 1 . f . ---•_.-.._ � ._�,..�.-_;ice..` ' - _.. __ _�'-_ --- -= ti _, - .. _._.. _ _ _ _ _ _ _ _ AP_Pllcant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. YGr►COSTAMESA• I j,_ t - I _ •ER IT.NO. TRACT NO LOTfNO. BLUG NO 0-7814 : 6/ IAB 33 Oft- ;TL • CONSTRUCTION PERMIT' - ; - •0 { ' '' +p 7s7g ' 1 , , ' I - i - '� , , + T 1 , Applicants Mailing�/A"�d rasa I'U' ?'4 - 1s�>tnfr _TYPE OF CONSTRUCTION" NEW U ADD LJ ALTERATION;-U REPAIR _ _ I Y _ ' r , ' ; ,_i f r- ' • i Pfoject Addri')ss- I 'hPn eX t`�/-1-><l D CON•VERSION ,0 DEM6LISH ❑ OTHER: I i - • _• I - 1I • i r`i'p T1 �{ } - (WS; (,O , _ ! 9!?-`�37� DESCRIPTION OF WORK " ' _ • s Owners•Name /'�l� 1 •m -Phone - ' ) ( ' 1 1 , I - - I - .ZesliGR GU a _' - 1 '' ' AddressI "�"l'1�I r'�"r'1 P!1}�( I +� I 1 -1 , T ?TYPE'OF PERMIT. 1 IJ GRADING Li FOUNDATION U,STRUCTURAL _ -A.P:#W' • , r i • `ZONE -; . • • I • [rrnT� _ µ l Arch/Eng - - ` License No. + • i 0 TENANT 0 ELECTRICAL P1_PLUM BING 01MECHANICAL ` PING'. REF.:91- ' . let, ' -. 7BUILDINGI `e ? - 1 - �., a . ,. 1 i - • . • - '( ) 1 • - cc-roarer rn cT ' Addr«essI - '_ ° 1� •OTHER 9 _TO BUILDING' I - - . I r 'R a t S - - i 1 " i PROPERTY LINE REAR YARD (TO P/L) 1 1 ? , i, • ' Contractor i Name! '11 /11.11". "?Pho'n'e 7-3v/�' 7/y� PROJECT DESCRIPTION SQ..FT. - - OCCUPANCY .i.U Igo/. + � -�(', _ 'WV I > CONSTRUCTION TYPE 1 I VALUATIONS I I : • :LEFT SIDE YARD I ' i RIGHT SIDE YARD ' I i n` )(- Address(Wailing) / I PKG.SPACE{REQ. ? ' 7 ' !' ' - ' ZONE t _ GRADING CU.VDS: ACRES I rs I , PROVIDED - (`p C ' License NO. I • a"RfYJLo t , ., r i _ I i 4 ; j . - LICENSED CONTRACTOR DECLARATION • ' ? I • { Remarks: 1 ' • I ' j 75-tato". 1 I i , - STREET WIDTH 1, I I' I 1 'PARK FEE$ i C i . I ';',r I.:herebyiaffirm that-I am licensed under provisions of"Charter 9(commencing - - + - with section 7000) of Division 3 of the Business and.Professions Code,and ? •' ' I r , I • • # , ; - $ / 1 i SPECIAL CONDITIONS: , 1, i : i v , ( 1.-y I . I my Iicense;is in ful for andeffect ; "' + _ - I t Clcen Clas i 7) t icon .:No., .�' 1 1 I . 1 .PLUMBING i t i 1 i _ 1 I i , I i r Q ' Date.j_@• Signature✓` ' �t.I '_ /d ' _.S , I WORKERS'COMPENSATION DEC UCRATION 1 I I I ` Bar Sink = I I SQWer Cap { I i. I I ! + , ; ELECTRICAL i , , ireby'affirm that i.have a certlficate.of.consent to self-insure.oi a.cer ificate-4 -S. - - -;.__ -_ _ Automatic Washer (Meter ❑over 100 amps' • } BeakfloW Prevente'r -; 1 - SewerConnectront- -i- . -- -- - ---- -- - - - -. -•- Workers' Compensation Insurance.:or a certified'copy thereof (Sectlon�' __ ' )0, tab C ' I111,0- 1 =i - - - - i Construction Pole ,I Sub Panel' i I - r I t i• I 4 f Backflow Irrigation I Solar Collectors t - - 1 1 1 r Poll' No 510—V N.1�9(n2iComPabY //II.��i�On ' d� _ _-- _ ' , • I i Cooking Unit Sub Pole I • ; l { Certified-copy Is hereby furnished,/} I ! v. Bathtubs 1 Solar Piping I • _ - ( - , - I i t Certified copy(Vinod with the city Bd lding D�viziyn. y/ , Dishwasher 1 _- ' I 1 'Motors ❑0-1 HP 01X$ { -Date 'Ce----•:-K") Applirarit-4-011;,,-6..".C:�.J �T AID/ y - Clarifiers. p . -. i Solar Tank ' - 1 t i ' EXEMPTIONIFROM WORKERS'COMPENSATION DEE ARATION Dishwasher { f . Swimming Pool w/Spa I j Dryers. ❑Gas ❑Electric ' Il nc.Solar'09-15 HP .016-15+ 1I ' 1 (This section need not be completed if the permit is for one hundred($100 or.1,f • - - less)°, I ; 6-.1 i - ' 1• - - , I - • ' Fan 1 I :Microwave i • , I certify{that in the performance of the work for which this per u Is issuedI4, 1 Drinking Fountains 1 I • Urinal I •) 1 I . I 1 ( s ! Workerst Comp nsatioperson eLaws of;Califormanner so'as to become sublet to the i , I /J i 1 1 �(- F.A.U. I ' "' ' ` 'PolelLight I I I d 1 Floor Drains( I •moi Water Closet) 7 Date t ' i ' Signature t 1 t l I , • ' 1 Fixtures 1 1- - 'Range . '-NOTICE:if;attensatiorlg'this•declaration, Laosrould,become subject•to the-- -•-1. Floor Siks- ---- ' --- --Water-Heater - •Y -"{--- - - '- - - -! ---- - --- -+- g --�-- - -__�.._ _-._ . 1 1 I Workers' Compensation provisions.of the Labor ode,,y 1deemet.,f revok th, ! Device Boxes 'Sign; • comply ,with; such .provisions.or,.this)permit jshalll be'deemep, revoke.'' j i Gas ServiS•I • 'Outlets• - Wates Service '„ - I q- 1 �_ - i F ' 9 I ; t CONSTRUCTION.LENDING AGENCY ' - 1 i I '• - - • 1 heretiy affirm that there is a'constructlonfending a9encydor.the'pertormance » Interceptors , I , ? , - 1 1 'i I „ • .� ' r 1 t r Outlets I ! Standing Sections I t I ? , of the (work tor, which-this permit'is 'Issued ;(Section 6309 a Civ_ C:,'• j / Kitchen Sink c 1 it a 1 I - _. ! ^ - Switches _ I ' 'Trash Compactor I i ' Landers• Name ' - ' ' 'r - _ .Lender s1 Address i I ' ' - - /AJ - - - I r. a t T. .i_. ' u . Garbage Disposal I .' i. I • OWNER:BUILDER DECLARATION. � . ,• r r 1 . h Lavatories•; t'i c, t - - -. t I ( ._ , ` I hereby;affirm that I am exemptt from the'Contraclor's,License Law for the YYYY _ - _ - ; - l I Generator 00;5 KW 05-15 KW I I I I I 1 following reasont(Section7031.5 Business and Professional:Code, Any city or . - i P .Trap. . , ,. I Z. i ; - - , -. • l I. I 'county which requires a permit to construct,alter improve,demolish or repair -- - l . i__ i Transformer 015-50 KW -'any structure;prior to itsissuance,+also requires thelapplicant•for such permit t 1 Roof;Drains, '; • j - i r. I ,., i r-. ' 1 - - c to file a'signed statement'thathe/she Is licensed pursuant to the'.provisions of _ _ - I , 'Ia Contractor's:License Law(Chapter 9(commencingiwith:Section 7000)of - n- I i - ° • , - -: i �5U�• KW! !Reinspection Fee. . ; $75' . I ,sion'3-of the;Business and;Professions Code)'ori that,he/she-Isl exempt ; `-'/ Showers )T { > i 1L t ,;,, I _ ; ; I Reinspection,Fee $15 I !Issuer .afrom-and the.basis for the alleged exemption:Any violation of Section 1 I i I ,+ i i i .Meter ❑up to 100,amps {' i Fee i t i"$ 3. I "ist.:5 by=any applicant for-a,permit,subjects(the',applicant to a:civil. i - 'm --. - -- , , ally of not more than five hundred dollars($500 '' k Service Sink I ' I '- • 1 Issue Fee $ 3 f ' 1 L _ 1 _ 1 I ; { - (r .. I { I , 6, ' I. Zoning Approved BY •Date L-J I;:as;owner of the'property or-my eniployees,with waeeslas their sole I 1 1 I I I 1' I I i '. I I compensation willtdo the work,andn the.it essio els not Code:' -Theintended or offered . I q I ` l j t•, •MECHANICAL 1 i + I, - Application Approved By • ' i 'Date. • for sale,(Section 7044; Business;ands Professional Code:'-The'Contractor's - v -_ { ./ -��, y� License Law does not apply town owner of a grope or through o builds or Improves ' ' I ' , ,0 Refrigeration System I I 1 I f0 O 'thereon,?and ovidedoes,such work himself/herself or through his or her own l •- Boiler, i ' ,- , i' , - i ! 1 gppliration Issued By 'Date employees, provided that such or ements are;not intended or offered for Duct-Under;Ground 1 0Q100,000 BTU'0100,000 BTU , r . 1 1 sale. If however,the building or improvement is sold within one yeanof mm- } I • 1 ) i ; 1 f I ) i. SUMMARY OF FEES ' 1 prove ,the wnerlwlll have the burden of proving he/she did not build or im- I • Kove for the purpose of sale), ; i { 4? t i � 1 Duct-Structural • 1 ' System Repair/Alteration 1 I I - 'BUILDING PERMIT $ I r I SMTP' r j $ 1 ! ' LJ I, as owner of the property, am exclusively contractingiwithllicensetl con- ' , Th i ,-tractorsto.construct the project (Section 7044,.Business.and.Protessions Code:.,; Duct.,Ventilating ,_ -_ - t _ -_ j _,j. •i _.,Iu _i - i • I PLAN CHECK $, - PERMIT I i The Contractor's License Law does not apply to an owner of.property who , I + + 'J , ISSUANCE ' ' $ ! builds or improves thereon,and who contracts for such projects with a con- , ; Exhaust System 0 Multiple 0' -1 1 ' { PLUMBING $ �` ! I. tractor(s)_ license pursuant to the Contractor's License Law). t 1 - • _ I ' I . 1 I ' ' 67......-- + GRADING ' • $ 0 Cam exempt under Section I •- ' D.&P.C.for this reason t i Flrepl/Fart.BIS. ICBG`* 1 j f 1 I I t• 1. 'PLAN CHECK)' $, - / _ { r I ,' I I i I. ! I - _ i + I $ I- - ' ` ELECTRICAL $ . Date ' ' Owner' • - ' I I Heabng;System&Ducting' I , r I I • 1 I ! 1 i ! MICROFILM $ I �,. - _ 'PLAN CHECK!, I $, • 1 I-hereby-certify-that-p have-read-this application and-state•thatunty ordinances 00.100,000{BTU ---- ( 1 I I 1 1 '_ information is correct. I-agree to comply with all city and county ordinances t' + f 1 - ' i i I $. I t TOTAL iFEE $ and state laws relating to building constructionoand hereby authorize repro- Hood or T + MECHANICAL ' f sentatives of/,.£his city?to enter,upop•the .bove-mentioned property for t I VPe l 0'. ,i I. Reinspection Feel $15 I. i LESS 1' Inspection puj••se, i ! dt , 16,--/.51-83 Canopy Type II ❑i I' r + 'PLAN CHECK $ , Signature • _a• /, i, : Date : - I I i i ' i I ; '' t` I I' i- ADVANCED PC $ 'I_ t Drivers' License orSS i I 1' • i. ; Registers I i 1 I Issue Fee I I. I $ 3 :4 ( • ,, i ! FINAL FEE 1 $ '- �-�', CMF 0865-46 rev.;12/82 ' White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - - . r . . _ .. r- 2,CONSTRUCTIONiAND!,PL'ANNWG1 ° 3 . SL74c, lIiz�ti>1 it7a- --t?n-,oA r` - ^'.g- 1 _tip 9 n L z 8, • n a - 0-__ _r o :;Date,g = rinspectoi :"a ` =` ' 113,= ! '-.Date :Inspector. ' i• °=APPROVALS ,n Permit#= - - ' - o Ig' tiyAPP ; -•r:co"'Permit#-'- , n '' - .-, U110 _ U „ 31 wn C.7: :� ! m:`<7 r ._ _ v, a•o�+ , -.r.v .: 1 1.. - .. - :. s n ''i ,1 Temporary:Electrical Service orjPole,.4 t M9 `l22 - 172 ;;`rc, 1 1152n Pool &.Equipment'Location :rtrt c; - I I raw ,__ii m rtla :25 Soil Pipe-Undrgrnd= A 1 X-o, I I z7t it:, 6/zS/ f ,rt i 53c Steel Reinforcement -;-'1--11,=.1f2.,-;a r : ''. 1 1 . _ - , M ',t-_ • « . , a.. .1 ,1 s_ j c, .j> r .1.j. 1 ru 6 .37: 3? . --,ica• ,-- onduitUr-,-, -• I• cc nrl.l ' sv; y -IFy >0 �y3 • .$4vrForm• s 'Ira_ ;- - !:� 4 . _ ;; , 1 ,i,�` , IQ4 Electrical Conduit-Undrgr'r d� - �C� V :; . - 1;•'• 'lin _,_3 1 tt5t Electrical Bondin '�' 2 1 - ' 1 - ' • rr, + # _-1 I 1 I n 1.....":5 1 zL “'Iln I -':- -C 'f l( - I tl `4, , r r eiii -per , a x Ic ` ¢° c o - I -. 57 Steel Reinforcement . . "1 m -0 1 42:19 { P. ;_-t, ,'56' Rough Plumb- & P�essiire;',rr. - _` i.,-;• ' 6: Electrical LIFER Grnd`) 1 4 252':,{ 4,-.1. 3 -It, 'S Of '- X57°'APPROVAL$TO'COVER GU.NITE; 11‘ 1 ' i , '' n1' ` b_ 7. Footings 1 � 1, 1 I o =a 15 1 _1 4- ' ° a`. ss : 1• '`58'.Electrical Conduit=Undrarrd.=-Lt ;c !�a 1 8. Foundatiori i � 1 } I a=c t °: m ; Q 5 r 1 : 59. Gas Pipe ❑f Undrgrnd + -t11-`- est _ 1 ] • 9.•Water Pipe-Undrgrnd." 1 .,tet c 1 ! 'L . I :+'j S - i ;r60. Backwash Lines,RTrap, O-Undi'grnd.; ..r i, 1 • r, t a I i �^ ;Li . 61 APP.ROVALPTO DECK 1 ', r_ 1 .L ,` 10. Structural Floor System I ,; - o- 1 _ 1 . q 11. Pro ert Sewer Line& House'Connectiod, - ' ¢ ;L, ' 1 - 1 11-1‘1F''' _-' , - r,`. r 1' a i p, Y. ! I m 7,: I m ¢;; -' X62. Backwash&=Recepor- nal _ cc. _ r, - 12`Sewer Cap I ' I '. i E(3 14 " -. o" "� I -'63 Heater& Vent Firal 'c - y, 'c - I I 1 cA - ii n. � .. I 0 - 13. Roof•Drainsi _ --o ;.6q. Plumbing System -Final::f+f'' - i i 0 G 14. RoughPlumbing1�� I 1 s2 it; ' a;.//(,y 6t.irt 165. Electrica1Final2 'L r Vi;C. }:: `� 7 ---r.: ',. ' "15`."Rou h-Electrical-Conduit-"-'r- -''l - !---y----; -t'- -- ----- - - -•-- • ---_r_ 0T e 9 es 1 : i I'. I ti r ! 1 ; 66.E Solar SYsj'em=Final--,- 1 I I a46-'Rough,Ele mrici Wirin9' .4 „ 1 i11-1-1-!.; 1Y45 3-.347:-11/4.; ! I_ -67T Fencin '& AccessrA 1 . t''4.7:7 r ': -41 ' x,;147„.<8-8119117W itiTg�Signti N s l "- I i! II 1 ' i 4s l,',i "z, I_^1 o '4,444;8,8.1 APPROVED FOR;PLASTERING' 1 i '. 1 '- I ' I r i ri" a 181.1Rra 9h�'Electriclsal;TlBa^Ceiling) i1- 11 1 ;1 1 i i `#I a „ I.' 69{POOL/SPA SYSTEMS F,I NAL i ` 1 ' ; ' i • i ••v 1 , 1 ! : - G 9 1,9.11Rough'Heating&.Air Conditioning Ii I -'. ( ;' 1 I I I I 1 1 : i (FIRE DEPT.REQUIREMENT 1 r • ! , ; ',1, ' I•, 20. [Rough;Factory Fireplace' 1 I II 11 1 1 - 1 I 1 APPROVALS! ' Permit'# I '• i - 1S'.. 2 V n' I CI _ . Ni. > I t 1 I I 1 = 1 1 1 t I 1 1 21 rDuctpe n Structure-: f1 ! I' 1 I 11 1 I 715.1 Under round H dro r 1 1 ' k ' `^ ' - i c, it ; u , (9. i. l I {I II I I 1 1 I 1 I g y 1 I - , ' ii22. Ducts, Venfilafing T 1 41 1 J II U j I I I # I 71.' Product Piping O Gas 17011 I ;--- 1 1 ' F a 1 Und r rO isz - s ; , •r -r---•-' ..11-�23. 4 ... ipe-Rough&Test 4 l'""I !"'1{ I r I 1 '.1.14.4! 72.1 Underground Flush' I f u •- r e • 1 1 - i. ,. 1.71 I I I I � .. I Qt24. Roof Faring I .1 1 o 1111;:s4 IR II cr 11> 1 J 1 0 1 ty 41??1 is 73.1 Undeigrrid.Stotage Tank O Gas:D O_il! I i ' 1 : ' r • iii .� , r_# • I r 1 ` • U. . t i o 125.jRoof Sheatliingr. 1 I 1 > It-.1 IIn 1L. I , 1„IPI,W I F I I ,t- 174.1 Overhead Hydro ! 1 ,q c 1 ' 11 1 1 i l L26. FT-Bar Ceiling (Structural).&Monocoat 1 [1: 1 vI 1:. 1 1221 ;775' Dry Chemical 1 , 3 ;, 1 1 i i I I . 1 . -1 t 1 1 ] I I ) u # I I i 1' 27. Frame and�Flashig� e 71 ! ( 1 II 1i 17'I I I lir I � 1 176.7 Dry Sta• ndpipe I 1 i r, i1 ._ _ -1,i, 1 1 1 1 ' T i ^q� r I `tit , , 1 , - .. 1 1;:-. 1 1 Y5 28. L•athing &'Sid}ng 1 o i 1 Ii (; I_ 1 1 1 �') i 177. FIXED SYSTEMFINAL j: c 1 1 • I 9 ' SS 1rm ¢ 1 II, 1 1 1 I } i 1 I - I I I L l • 1 I I ' 29�lhsulation S. i < i R I I I, 11 1 I 1 I 1 ,78. FIRE PREV. FINAL H ;, , I I I i 1 I c ?'30..Drywall Nailing I I > I I II ii I I I I _' 1 ' I i - :Notes:! 1 , + ! 7 i ! I I I i `? X31. Plaster Brown Coat , 1 1 1 ; 11. •I- i - r I t--- -i- ?7--T -i- '0--7- ,•--I- -1:- --i...t-..-i-; 132. Electrical!Power MeterFinal I 11 11 I I (- 1 '-..1 I I. •i i it L. . , i 1 I i 1 f��i 1 I I"�1 i i _I I I 1 1 1 I ' r1-33.iFinal Electric ii ( ! i 1.1.,,,.1 11.,'.J 1._..1.-�J..._L_ 1 i 1 I I I i 11 % . _ . _.- -.J_. _, - ! - .__ _ b ' - 11• i I 1 1 1i £ 1� 1 1 I . I I ' � ! 1 :q '1- 1. 34. Final Heating & Air Conditioning - , I 1 k I) l:tltCi m. I }. 171 1 (_ 1 1 1 I I 1 1 � .. .1, ._? 11 1r 11 r+ 1 C 1 II O 1 1 ',1 'I' 1 C ' - _ 35. FinalGaslPipe=Testihl;,; lmi ri IEI}� 1 � 1.S):1 . rI � !•� 1� i>i�= l_ Ir:i � • IP% 'r �! �' „ _ _ .. ,1 1 • 36. Hood or ICanoPY_.., gig ! . 2' 1 . I^ - 1 ,x.1 ,. 1 I-' 11 .f, 1 'Thi: - ' �• " 1; I '•Ir i e "r = ' 1' -, M' ll I' .rv�� r 1 r 1'----1 of R. I.!: ..4 1- Ic I i ! i I �°11 � I x- 1 ..I E r q - '!1 - . t. .- -. i Y r `0. Iq ' t- j� _c > i �i I :Im I 2 .1 `,1 1 ,. m c. 37. Final Factory Flrepla •0 1.7 oI I V 1a ii' 1n II_..J 1 I 1 •' I I 1 1`0 1 - - ! .2:2 ? �"# 'c `' r .I .• 38. Final Flambing l r..i _I • I I 1 & I ":19%/011! O'i I .I I J I--: i 's 1,s, , #1. , .• . . - 39. Water Sevi31 II ce-FinaI1 i I 1' '1 11. I I . 1 I I• : 1 i 1 1 1 1 I Ir:110 : . I 1;t 40. Gas Service-Final i I. i t 1 n I 1 1 '1 ! I 1 • i I I _ t ! ; I i I I . , I I . .iii I 41. SolarDiimesticFinal 1 1 1 1 1• 1 i I 1 1 I ' 1 I' • H 1 '--L'1; • ,I 1 ' s ,, 1 I. 1 6 I- t-^-1-•-t --r---r- �---s I -#--+-'s- 11 , I ! . I 1.'i 1 I IF i M I 1 !' . !_I-I--1-1--i' ( ' # -'•' '' i „ 42. Backf POW Preventer 1 1 I I emI- i 1--I-- -�'- 1 '--.- . - t , -:II '- ; ' 3 I . YK;i .. 1 I I 1 1,., 'a `' SIr ala % IT . r_.I 1 1 I .. :•, '� 43. Backflow Irri atio`n ° 1 ' 1 ' I u } ,, , 9 - 1 .I wl .1 1 I MIVI I�N IfIPI 1 1 ��l �a T 1iS1 � C [:. -vl 1 1 1 , � , n-+a 12:1 •.1 ta, 1 1= O I-- u - a I , {1 I ,i c 1 4 rt 44. Landscape Irrigation System 1 I,nI--, m 11- 1 -I Jr n 1 • nwr _ .. ,� I 40.3:-: 4! ir-, , ' 1 , 13- L _ PI 1 I• I I ,i1 �.. ,u.G �� i, n °: _ . _.*io ? I rd I r1 . ( :7 3i I r I rl it I 11i 1, 1111 1 11; :0 6 = J _ -' IC es? q 45. Soun ,11,11 n.t.! tion m I I 1 I 8011 .c:-1 �_. = 1._ I � I ,� I i lel yl i 1 _ i2 , ?' - ' C'• -t v 1 1 + ' 1 I ` 1 I 11 , 1 1 1P -1 1 El 1 I Cl -i' 46. Handicap Regulations 1 • -311 1^ - 1 9 IS i I_. I I r I 1 1 !1 1 + 1 t -' ''- .::'.1 r r' �� ^" r47.'FINAL STRUCTURE& BUILDINGI1 '0 1 1 ` I 1 ! -11 II g' I 1 1 1 ' i ! c e r 1 tilt •' I i I i i. I 11 11 48. Special Requirements Completed i 1 1 I I- I "I I 1 . i I I I ' 1 " i 1 i - ,a :. ,, .. :, 'a .1 u 1 r I I 1 I I # i ! 1 - ! 49. Electric Releaseto'Edisonl rp' 3 f `I i. i I I. HI', ' ' 1 ' ' # ,, it 1 . i I I I 1 I' i�- 7!"-I--1-1 --"I `1--� I _ r I 1 �'-' � i 1 ! i 1 :1 P re III ! ! ! a I I I i 1 I ! . 1 1 1 1 : pp # ! i + 1 50. Gas Release to Southern California Gas Co 1 1 1 1 1 � 1 1 I .: 1 r'tl 1 1 ;I i I 1 51. CERTIFICATE'OF OCCUPANCY 1 I_ i--.. .-i_i-. - . 1 1___I__i 4....1.-- 1-4!c- ":ir I '{ . ' ! - 1 4: No ii Il 11 1 Date ' ! t I. 1_ I I ._.r--' I. : 1 r -. I 1 • i iii t . ' I�C7 T '�: ,•Yal...i� . 1_A.".-:K'GC�i•F+�- . _..._ _4 ._L� . �L--.•1. • �,.-_s 1 'LS�.Y_____'Y_ - .� .rv..- -..`.-,-_.- _ _ Applicant to fill in ail spaces except those within heavy border lines and signal;appropriate declarations. CITY OF COSTA MESA �, ' - a PER I Np� TRACT O. LOT N - BLDG.NO. 72 of I Q/13/B3 -3o'UJ- ;TL CONSTRUCTION PERMIT. ' !d 9 Q�7� a • , Applicant's Mailing AddressC ��Iv -/310 r 0 ' AWOL- TYPE OF CONSTRUCTION •NEW [ADO IJ ALTERATION' REPAIR ' ' m - ' t` ? Project Address 1��n7 / -.-30- l a/ , ' ❑ CONVERSION :❑ DEMO H ❑ THER '� ' • Owner's Name '• 7V!•'n• lit�Jv Phone ' 79 J376 DESCRIPTION OF WORK �1.�-// - V' - � ZONING REGULATIONS" - • i r • Address ,r "Al; _ �A1 ��. _ - TYPE OF PERMIT U GRADING ❑ FOUNDATION ❑ STRUCTURAL , . -A,P.qW - - 'ZONE '• • - - - Arch/Eng; License NO. ' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL PLNG.REF.# - BUILDINGI 2. ❑,OTHER CFTrrerie P!1 CT Address I ' ; - TO BUILDING- - .. ti_, r - •• - - - . s i , •REAR YARD(TO P/U _ - a - - PROPERTY LINE Cont:actor's Nam- • 4-I 4 �e� s-d •'u� - -hone PROJECT DESCRIPTION SQ.FT. - • " OCCUPANCY ' ' Address(mailing) • fnr, vv. / -• -�/LYI. !lam 4� CONSTRUCTION TVPP VALUATION$ /S � 'L'EFT SIDE YARD - RIGHT SIDE YARD C' ' /s, ,(/ . ZONE GRADING CU.YDS-. ACRES - PKG.SPACE REQ. PROVIDED License No. __ _ - /� - ._ - • LICENSED CONTRACTOR DECLARATION • i , Remarks: i U' +- 7J' Q ' STREET WIDTH ' _ PARK FEE•$ , I _ , • ',hereby affirm that'lam licensed under provisions of Charter 9(commencing ' - . - : with section 7000) of Division 3.of the Business and Professions Code,and • SPECIAL CONDITIONS: 1 i' my Iicenze'Is In fulyJo1gtLantl effect. ' - - - . . License Class l,_ (J L en o. PLUMBING ' ' • - ' Date;�i Signature : "- i ORKERS'COMPENSATION DECLARATI 1 - '' Bar Sink Sewer Cep I 1 ELECTRICAL erebyaffirm40 that I have a.certificate of consent to sen-Insure or a certificate . - , Backflow PreJenter j' ' Sewer Connection' - . Automatic Washer ' .Meter Dover W amps Workers' Compensation Insurance„or a certifl copy that of (Section ConstructionPole • Sub Panel 00, Lab. C (.7/// /��/y�[^��-p/ i Backflow Irrigation Solar Collectors I Polley No. �ive/0” : " Company 1-lu/Y<-G. V'r 41. • �r ' Cooking Unit Sub Pole ' Certifiedcopyis hereby furnished. ' Bathtubs 1 Solar Piping I Certif)ed�qqo y-s filed with the city Bylldin1.g Division. / % Dishwasher ' , Motors 00-1 HP ❑1%-s Dae /D`4 ' t Applicant ' y1A141112 0: �f'/tri 1 1 Clarifiers ' ' 1 Solar Tank : j ' 1 EXEMPTION:FROM WORKERS'COMPENSATION DECLARATION -- - Dryers 0Gas ❑Electric ' Inc,Solar ❑9-15 HP ❑16-15+• ' : (This section need not be completed if the permit is for,one hundred($100)or I Dishwasher Swimming Pool w/Spa ; - less) ., 1 r I ,1 , - L- Fan' i Microwave I i certify that in the performance of the work for which this permit is Issued I •, Drinking Fountains Urinal shall:not employ any person in any manner so as to become subject to the • - q F.A.U. Pole Light '1 • Workers',Compensation:Laws of California., Floor Drains l' Water dose[ - Date' ' Signature - - comply with; such Compensation provisions of sh permitDrCode, y u,must forthwith Gas Service Outlets ,Water's eater '-: Fixtures anile _ ' „� ,- • NOTICE,If,after Makin this declaration,youshouldbecome subject-to-the - Floor Sinks . - Water H - --_ . - -, , -. ._ R ' 'pr sions e 'deeme Service Device Boxes Sign _ , , CONSTRUCTION LENDING AGENCY -shall - - 1 , Y _ lending 9 $ - Interceptors , Outlets rStandin Sections 1 of the affirm that there is a construction a (Sects or the, 7. Civ:ance 1' 9 . 'I ,work for.which tp{s-_permit is •issuetl (Section 30 7. C-), - -' - , - • i ' Lender's Name- -' • - - i • Kitchen Smk. .. - - ' - Switches 'Trash Compactor tender's Address' c - - ' Y , `. 1 Lavatories Garbage Disposal 1 •I 1 } OW NE RIBUILOER DECLARATION'RATION " - - 1 I herebyaffirm that I am exempt from the,Contractor's License Law for the' . - 1 _ - Generator❑0-5 KW ❑5-15 KW ' - ' l following reason:(Section 7031:5 Business and Professional,Code: Any city or P-Trap. _ ' 1 I - - 4- ; 1 county which requires a permit to construct,alter,improve,demolish'or repair - Transformer ❑15.50 KW 1 I any structure; prior to its•issuance,'also requires the applicant for such permit' . ' Roof'Drains - , l - ' ; _ to file a signed statement that he/she is licensed pursuant to the provisions of , - I - �5U+ KW' the Contractor's License Law;(Chapter.9(commencing with Section-7000) of r i •' - I - { 1 1 I , einspec'tion Fee $15' vision I3 of the Business and Professions Code) or that he/she'is exempt. , Showers _ Reinspection F•ee •: $15 • refrom-and the'basis for the alleged exemption- Any violation of:Section I : - - _ '- �: Meter ❑up to 100 amps ' Issue Fee' ' i '$ 3 • 31,5 byr any applicant fora:permit subjects the,applicant to' a'.civil i _ ,. - - — • penalty of not more than five hundred dollars($500): - .:. I ' Service Sink 1 "1 Issue Fee $ 3 Zoning Approved By '' ' I 1 I •Date I • LJ I,,as'owner of the property or.my employees with wages'as their'sole , _ j compensation will do the work,and.the structure,' J. '- - MEC•HANICAL GSystem__ Application Approved By Date , for sale (Section 7044', Business;and Professional Cotle•iher'Contractor's , - - - - - - --- -----, App , y I , rs not intended or offered `�7�, Cleanse Law does not apply to an owner of a property who builds or Improves Boiler. 1 - RefrigerationApplication Issued B :Lila✓ I Date to -/ _ thereon,land,who does-such work himself herself or through his or her own I - i ..employees, provided that such improvements are not intended or offered for Duct-Under;Ground ' Do-100,000 BTU ❑100,000 BTU I 1 , sale. If, however,the building or improvement is sold within one'yearlof com- { SUMMARY OF FEES : • 1 • i l elation,the owner will have the burden of proving he/she did not build or im- , I I . I - $ ' ' glove for the purpose of sale)', ' Duct-Structural i ; System Repair/Alteration - I BUILDING PERMIT 5 - SMTP i 1 , U I,es owner of the property,am exclusively ctinglwlth•Ilcensed con- ' 'tracors to cctor'sctchee Lawt,(Section 7044,Business and ProfessionsCode: , 1 Duct_Ventilating __'-_ " , - _ _ _ j, 1 _ _ 'PLAN CHECK' - $ ' , , PERMIT l 1 I , The Contractor's License does not apply to an owner of property who ` - - '' -i ' ISSUANCE I $ I ' • builds or improves thereon,and who contracts for such projects with a con- . Exhaust System 0 Multiple 0 • PLUMBING $ - 1 tractor(s)license pursuant to the Contractor's License Law): .i 1 4 I GRADING $ 1_ ' ❑Yam exempt under Section B.& P.C.for this reason ' Firepl/Fact,Bit. ICBG# , 1 ,PLAN CHECK i $, , • 1 ' ' • ' Heating System&Ducting i t .ELECTRICAL ( $ 4 $ Date owner ,1 9 I 1 MICROFILM $ 1 • -I hereby-certify-that l'have•read-thlsappiication'and-state that-the above -4- -i- 0-100,000 STU 0100,000 BTL• - + -' - --. PLAN CHECK $ ' I information is correct. I agree to comply with all city and county ordinances - �,-•-_r i ,y�O �fOD TOTAL FEE, $ _ • and.,state laws relating:to building construction,,and hereby authorize repre- .1 MECHANICAL $ / '.sentatives of:this city/ • enter upo• the above-mentionetl property ,for ' , Hood Or TypeI ❑ r 1 inspection purposes. • - ' ' ' - Cano .Type II ❑- t Reinspection Fee: _ �- l1 •pp py. r $15 ,PLAN CHECK • $ IXJs • ADVANCED PC , $ 1 t Signature a/�I / / / _ { /plate '¢ �I , , , 1 - I_ p e et Registers I" Issue Fee ' , $ 3 I ' I , FINAL FEE • $ I_ / Drivers' License or155 I 1 • r f _ _,_ / __ _ _I_ CMF 0865-46 rev.12/82 White-Building;Canary-Applicant Pink-Accounting;Goldenrod-Assessor . , `. OCONS_TR'UdTIONAND➢PLANN=NGT 9 o, p• 'c 1 � py:3 • c<- _ -•Y -P,OOLsa"`'i>A _-c ' -2''.2-7 •-" l'- s- __ '-I. . < ', } n ,. _ = a -*trite n fl nspector .- ''2.r.' '' n n - r,. Date Inspector, c y GAPPROVALS fr Permit;# ^ - - 'ik - scAPPROVALS Permit# � Qi I .1 O f_ S'a E ' Fi � [ -- Ii 'i >l_ •..II - - - 9 `• (O x , .. ;� T •1- T• emp"oraryiElectrlcal Sin-ill,or,:Pole a. <„ i-.'52�1Pool &:Egwpmenf'Locafiorc;. ' t:,-� p• „ 'r _ I • c Y I = - na.. '. cl . -� - '� -I := t1 .. 1 Zrk,' 2: Soil Pipe-4ndrgrnd3 ;Ti, I S Lo_ ..4 [ " O Y t ta� I r53� Steel R_ cin_forc'ementF ` �: : • ' ` ` _ J _ C _ - r I : ¢-! E• lecyical•Conduii Utility-Undrgrnde. ' ; r y= ' 1 3e d if ; ,54^ Forms'Q,-' -: - ,a : _ - ,` r - , - 'i -+ . R4'.'. Electrical d Conduit-Unrgrndl.-t2 I n' c I f.-13;G"ib 5 1T:2°^z,': 1553 Electrical,Bondmg :- ` ' ;57 ' ac_ - ; " • 1,6.-7( .F 5S Steel Reinforcement �' I a � ' � I � �� �?_i K▪ ' dr 5 ',..5.p.:: Rough Plumbing.& PressuteTest :c•-• ,` ,� , : :JO" ;`:, . i ..i 1 -S 1 I .tec-: I n: e e F • Pr •6: IElectrical LIFER Grnd. ' 0- 4s� 2 V. o= ;;57� APPROVALTO'COVERrGUNITE-- = < _ _' if is s :rt II , 7.'Footings 1 f 1• i I• to 'n I, I ' g E. 9 'rQ :`+ I •`58' 'Electrical;Cpnduif-Undrarnd :,--.1:.: I ,^^ ^I s 8...F oundation I i 1.71 o< L4 , -;.7.),; ? > u ; ,...^ _ • 59. GasiPipe ❑ Un'drgrnd- Test'=n •C:::.-d- ; 1 • - 9. Water Pipe Undrdrnd- I ie I ' " 1- ; •: t; l' j " 60. Backwash Lines,P,-Trap;`O Undrg`rnd 1 . o-' ' , 10. Structural Floor System ' A. J I i o • „ ;: •61 APPROVAL TO DECK -7 o .- 11. PrPpirty'S_ewer Lin;&0HouseConhection' _ ' j ?' ti62. Backwash“ .&'Recepto_ r-Final ' '2_ , - I' 12. Sewer'Ca I - `a^ .i o ' r - t > ,I - I I t,1 -! I I•• •1 H 1 c n ' O- ! ' 63. Heater& Vent Final o°? -_ , ::I •1 13. RoofiDreins i I ! n • I o - I 1,64. Plumbing.System,- Final ', - -- '" i r I .I r 1e 1 -i I 1 Cry 14. Rough Plumbing' .1 I 1:;1,;' ! i - - • t65. Electrical=Final" ':-.;-_ , -- - • - '1 Co 'T15 iiRougti Eleca ical:C'ond'uit i Ti •.1-7-"{" I I 1 "T?•-T- '66 Solar Sysiem--Final ' ..___ - 1,---7-- -_ - ----:-..--1 .i I A IIf46:YRrt n ugh.Electric,Wiriog, 1 E I. II li c l';1:1i I A I 1'rn'7T� 167.'Fencing &'Access-APploval'.71-.c 1,-- 'e- 1'-3 'f- ,, i-7--f_ ,- '' QST 4m ' t. ` i ._ c 1 ' I r. „ - I 1 1 c 417.. 1i-tough Wiring Siggni_ „ m I • I Ii •'G I•- ' 11• ' 1.1 I : 1,.: 1681 APPROVED FOR 19LASTERING• ; , i ' ' ' 1 *, I 691 POOL/SPA SYSTEMS;FINAL : 1 4 • - ,-1• i ` 18:,jRough• i 2: ina[Tr n Ceiling• Ii 3 i 1 i I : I I v i i I �. a .6...4 .r 7 19.::'Rough`Heating &Air:Conditioning II • I :iv74/? i I I FIRE Dl ' IjjEPT.'REQUIREMENT, '2 17. I i 1 7 I ' i ! ii i 20_• Rough;Factory Fireplace' i 1 11 '1 I 1 i 1 I I APP�ROVALSI ' Permit# ` ! 1 ' ' I .t '�_ , Ain' r - P _> 11 i II i - . 1 ` 1 '31 1 `7.7 [ 21. Ducts Yin SLructuPe- n I I I 11 1 i 1 I• 1 : I 170.1 Underground Hydro t - ' I I $ , u i y 1 I , i' 1 i I I . G; , c ia 1,22:IDucts, Vennilating , to I .1 ' Ii I ' I I I I ; j71.1 Product Piping.D Gas ❑Oil I ! 4 , •w.. .P I : -, 1 I i X23.iG's-Pipe-Rough&Test o I t kill- I 11 1 ;72; Underground Flush! r , X24.;Roof:Fran-14pg I I I '3 IIS lav iI i m, :.II oJ ' s. - 1 1 , I I 1 I. I ,cn i I o•( o K ,?I - ,. 73: Undergrnd.Storage Tank-OGas,:❑Oil 1 i 1 S ( 25.IRoof Sheathing • I ; I. _.I 1i J F I 1 1_ a m ' . 1 74 Oyerhead Hydro I ":. ',i,' �; ' I i __..2, u R, i .f t I IIn r I`- I .. I n: i i. II I n tel el �BaI Ceiling•IStructural1,I Polon l I. I - ! r V , ,-; : 175! Dry Chemical e: I 1'- > i I ' , K 1 1 11 i - t I w i 1 t n I. I I t I I - I 1 4 an 11 , IIiI • I o Ii I ; J,, - 1 - , and El:,1 r i i I t 1 176: Dry Standpipe r AJ,, - 1 - , ; :_ :,1 I. • 1_. r Iv I 1 , _ 1 u 1 26.1 Lathing &Siding} n o I 11 li I ! i I Iii i I 177 FIXED SYSTEM•FINAL .1• I. , , 1 '; I i dt . 11 Ifll , _ •1 29. Insulatiori - n i ". Ni ° I i 11 !1 i ! I 1 I I i 1781 FIRE PREY. FINAL E i ', . ' I ' - I ! -'30.(•Drywall Naili- '4. • 04..-1121 ;g 1 444 -II l - ii 4 I I 7I I I I 1 :Notes: I 1 • I I i • o �[`31_�PlasterlBrown Coatis II I A I I I I I i i - .: . . i I- r--' •--[•-- --- -- - - ,-1- ---i d32. Elect __ _ t d r rical!Power Meter;-Finial 1 II 11 I , L 1 I I I I 1 1 ; i t ::; ! "-- , >' FF=F i_33.IF'ianal Electric a..I„ .--ili�Jt<,`� .� ! 1 _._1 ...1._.1 .x,._.} .�. 1 .1 i_ i :"1 34. Final Heating&JAir Conditioning A ( tt// 1� 1" I I , ii I -1 tr,. **W.: I Fi v, 1 ._7.l?L1 //(/1_ -7, I ' I I cl' - i i t ` i; r r !O t Q I V • J I'" I" 1 . I a -•n r: - I-2• - - c• .I . 35. Fina• 17 I;,,e=.r-'• ^ ,_, ( _ i _I c 17 .` t= , ci ` • ! •t1 : . '_i = = i _I : . _ -• u I' i ^ry10 a1 ' I I IE :� X ; I- ala'{t tj ' W , I • _ 36. Hood for it I .�>, "•'IM if.-.-101 - II I= , _ iml _ ;,•- I I " ie,! I . t '12I iii . • i r ? n 37. Final Fa 1 1 Fiieplacen I i of '. 1;" '' i n 1 a I 1 ',..!1.-',- i ` l';' s ' . 1 n -ct 38. Final Plumbing' I I I .1 -4I - r! I - I-- I I I , , i i I i I `I ' :: ' ii rJ -- 39. Water Service-Final I I . I ; 11 I IL1 1 F : ' . � • 1 it 1 1 1 I i 1 • ii i l '' , I _ � ,. . M •1 1 • 1 I 1 I I i I ( 1 i • '. 1,! 40. Gas Secv1. final I I I I I I I _ i i I I I f I i�: i- I -• , i . 1 , 1 • 41. Solar Dornestic:Final I 1 I t ' i 1 1 ' _ l' t 11 ' p p.y1 • .I . 1 1 ( I -''d - t--t, t _i... _.I--•.-_t-__ _I'.---•a -i^ I.--I1 ', I I !.. "`. t 42. Backflow P,reventer - 1 11 I +''.'I- 1--1 -1 - - 14_ 1_ 1 th ♦t. I Q' Z I i I Ai, li itr--4 1� -1-: I' i ::2; •,.., c•, "1 i 1 I . 6i 43. Backflow Ir;lgayion �1Q I I ,;' I- {.- f � i -• i - E1 r ! � - qa 1?rationS I I I . n is ; - 1^ ; ', I , I I `ir'' ' I ( " ! { 44. landscape Ir- i -,n,,,> 1ml _ In r•1 , I 1 - •17^17 ISI- a 1 t '.3. 45. Sound Attenuation 4 I rt 1 a I 8 1 ! ' i G l I I i !•',1 '! I 1 - i • I " - �_`i• ' 46. Handicap Regulationd l I a 1 'i Io ! I''' I _'; ' ! I 1 I - I ' I ' . I '„ = ,,,••' ;i, ', - :n R II I _I ,1 1 , i by I I 1 I .'- I > 47. FINAL STRUCTURE'& BUILDING�p IF ' 'IL' : _,i •' I I : i 1 ° I - ry a i I i 1 _ I •t 3 I'• 1 1 r I -- I I 1 I , 48. Special Requirements Completed i ( S ; 0 ' I ' i "• ; - -, - Y I I 1 I i I 1 i i I V} I,1 I I I 1 1 1 I ! 1 1' � . 49. Electric elease to Edison N 1 i 1 :4._..!___!...,. i j„_ _ ' 4- -- 1 Y ' , " + I ' I ' P 11 II i i ! I 1 I -Z ,•JI�- 1- � 1 '+--'1-. i M 6 t ' I I I. I I I I . 1 I . t - � : 9 S 50. Gas Release to Southern California Gas Co , 1 I ' I I I I I I I i : I ' I 1, 11 1 I I 1 1 1 I , 1 "it , I I • 51. CERTgF.ICATEIOFI OCCUPANCY r y-� � _1_1. . -- r_rti _ T 1 ! I I ' • " No Date ! 1 _ i I i 1_ 1 - I + I 1 I ' 1 _ . • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • CITY OF COSTA MESA-( ' T -- - -- . -- ' -- PERMIT NO. ' '' •_ - TRACT NO-: LOT NO. - BLDG.NO: - ••- I . •• - , ' 9'c!,•,"i--.� �tj'T�87N " . pU„ c;Pill TI_ COJVSTRUCTION PERM.' - ,9G iZS: ' __ Y • - t > r t- Project Address • :1-111 I. ' ,s TYPE OF CONSTRUCTION ,-kr-NEW,• U ADD. Li-ALTERATION. U REPAIR• f , Applicant's Mailing A dress • , tic__ 1 f'r-- El CONVERSION ❑ DEMOLISH ❑ OTHER - A P•# , '' Zone ' • Owner's Name ' �' Ph�ne _ DESCRIPTION OF WORK • - , ' _ S Main Building' -Accessory Building. • Z \ • Address• , _ t E, _ , I r TYPE OF PERMIT ,/❑ GRADING' ❑'FOUNDATION El,STRUCTURAL L T Front- I N Arch/Eng.' I ' _ 'License No. , ❑ TENANT. ELECTRICAL 111,PLUMBING ❑ MECHANICAL B' Rear - -n � '1' ._ Address '❑ •OTHER A _ N (� G (. „\ l < I 1[�t. _ C Right -• Conttactor's Nam ' eras -���� - I •hon- J a - PROJECT DESCRIPTION SQ. FT, -• , OCCUPANCY ` � r�,P.4 �'� f , CONSTRUCTION TYPE VALUATION$ S Left • - - r E- Address(mailing) i - - - //�� ' ZONE ' GRADING CU.YDS. :ACRES • Ref.# Park.Fees Si ' ' City-License No. 0( - i - - - - Ping. U j LICENSED CONTRACTOR DECLARATION • Remarks: /5 7,5.3- Q ,a I ' t i Parking Req./Provided - . i. c - I' I hereby affirm that I am licensed under provisions of Charter 9 (commencing - - - . R Q with section 7000) of Division 3 of the Business and Professions Code d r • • • , • Use of Building: • E my license is in f •rce a • effect. _ • - Ucens• I. • f a License • • " � - . . •• PLUMBING : ;I FEES Planning Notes: , ! - ;s E l Date ' '7` I►:C Signature •_ ______l.-.s . - 'u , yyORKE-5'C•MPENSATIONDECLARATION i . I \ ` . _Bar Sink Showers ' ` - i N ::rereby affirm that I have a certificate of consent to self-insure or a e ti(Icate Backflow Preventer - Service Sink' , I ' S -3.-Workers' Compensation Insurance,-or a-certd•copy t ereof-(S ctiom- - - - 800, Lab. I j\/,\Q� r ' Backflow Irrigation - I 4 FEES Policy NO. 1��.� t-z•� �• • - g. • Sewer Cap • ELECTRICAL , Company — , eer - ed py is hereby furnished • Bathtubs - Sewer Connection ' L- / 'Automatic Washer . f Transformer ❑ 15t-50 KW '1 ert' i♦tl w�v i with the ci :.'ding Division, I_-ev - c I ❑ 50.1-KW I ' Date ' I LL Applicant a��� le i i({{{{{{f.�& Clarifiers Solar Collectors •L Construct qn Pole Sub. ' -EX EM PTI N.FR M WORKERS'-COM PENSATIONb EC LARA I � Dishwasher • ' - - Solar Piping `' . -- 1. • - - :1 JCfip'to•400 amps-- ,- (This section need not be completed if the permit is for one huntl •• $100)or , P g " - - 'I ' _ Cooking Unit's Meter , less) • , , , - , ' 1 certify'that"in the performance of the work for which this permit is issued, I 1 Drinking Fountains t Solar Tank t_ -'• Dishwasher ( ,Meter Dover 100 amps ' • l shall',not employ any person in any manner so.as to become subject to the •_ � ) Workers' Compensation Laws of California. ' Floor Drains) '' Swimming Pool w/Spa t S Dryers ❑Gas' GElectric / ISub Panel i ' 1 / 0 '— Date - Signature ' - - — j ' NOTICE:If,'after making this declaration,you should become subject to the Floor Sinks : f - -,. Urinal i ' / Fan' 1 Motors D0-1 HP 011/2-8. Workers',•Compensation provisions of the Labor Code; you must forthwith-- - '- - -' - - - - , comply ,with such_provisions.or.this-permit`shall be deemed, revoked. Gas Service Outlets ,.- '' / CONSTRUCTION'LENDING AGENCY. - - .Wat¢r Closet' / F.A.U. • Inc.Solar ❑9-15 HP ❑16-15+ f11 I hereby affirm that there is a•construction (ending agency for the performance • Interceptors • I t Water Heater, 10 Fixtures • f / Microwave ' f J �• of the work for, which this permit;.is,issued (Section,,3097 Civ, C.) I - _ ,. Lender's Name v - - - . Kitchen Sink - I I , ;Water Service - Device Boxes ' • Pole Light . • Lender's Address •- ' - I I - L • avatories ' • 7 pT OWNER BUIL-DER DECLARATION [ !_ t , : 1 ., c. _ Outlets Range ` , J V i I hereby areaso that I am exempt from the'Contractor's'License Law for the ' P-Trq I - following reason (Section 7031.5 Business and Profesprove'Code: Any city or - p - II/ Switches , Sign • , county which requires a permit to construct,alter,improve,demrlish,or repair - I . ,.f• - / 'any structure; prior to its issuance, also requires the applicant for such permit ; • Roof. Drains -- - .- I , Garbage Disposal , ) I Standing Sections 4o file a signed statement that he/she is licensed pursuant to the provisions of • - the Contractor's License Law(Chapter 9(commencing with Section 7000) of ' '•' I - " • livision 3'of the:Business and Professions Code) or that oe/she is exempt ' } - , _ • _ ' l- , - • - Generator ❑0.5.KW❑5-15 KW Trash Compactor aerefrom and the basis for the alleged exemption. Any violation of Section . _ , /0311.S by-any applicant for;a' permit: subjects the.applicant to a civil - - ' - t - ' • I • e-laity of not more than five hundred dollars($500). -• -.Reinspection`Fee ., I $25; , Issue Fee. $ 3 - 'Li,I, as oWner of the property'or-my employees with wages as their sole • Reinspection Fee $25 Issue Fee i • $.3 compensation, will do the work, and the.structure is not intended-or offered • I •- ,MECHANICAL I FEES - - - - - -for sale (Section 7044, Business and. Professional Code: The Contractor's - W.. - PUBLIC SERVICES ES REQUIREMENTS: License Law does not apply to an owner of a property who•builds or improves Boiler : 1 Hood or Type I ❑ 1 r - thereon, and who does such work himself/herself or through his or her own . . • I Zoning Approved By Date ' employees, provided that such'improvements are not intended or offered-for • - _ •Canopy ' -Type II' ❑ I sale. If, however,the building or improvement is sold within one year of con- Duct- Under Ground , Application Approved By - Date 1 pfjove f, the owner will have-thel . burden of proving h¢/she did not build or im- - -- , Dat rove for the purpose of sale). I Duct-Structural Refrigeration System -' Application Issued By ,. U I,as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BT_U tractorsto construct the project (Section 7044,Business and Professions Code: • Duct-Ventilating -SUMMARY OF FEES • The Contractor's License-Law.does not apply to an owner of property.who. _ _. _ _ l ' -builds.or improves thereon,'and who contracts for such projects with a con- I Exhaust System ❑ Multiple❑ ' System Repair/Alteration • BUILDING, $ SMIP, $ ,, tractor(s) license pursuant to the contractors License Law). • -• PLAN CHECK $ . PERMIT • ❑(l'am exempt under Section B.& P.C.for this reason i Firepl/Fact.Bit. ICBO11# t ' I f PLUMBING 1 - I $ • •ISSUANCE ; $ Date ' I ' Owner' - ' - ' Heating System&Ducting • 1 PLAN CHECK $ r•� . ENERGY,P.C,-• $ - • I hereby certify that .1 have read this application and state that the above ' ❑0.100,000 BTU ❑100,000 BT ELECTRICAL $ 3 /i 8- GRADING ' $ • information is correct:I agree to comply with all city and county ordinances-' - -�- • and state laws relating'to building constr'ucti• an. hereby autho ize r- re- PLAN CHECK ' $ • / 7, 42' MICROFILM $ sentatives ' • city to enter, ••-•he .t.,v-1 -enti..ed r, rt ' inspection our se 9 1� ]f��.{ I . , , Signature �� • 1 ' - - - .. CMF 0865-46 rev. 7/83 •`- White-Building;Canary-Applicant;Pink-Accounting;-Goldenrod-Assessor - ._t_ _ - - - - ,, t _ - _ _. ., ' . . r^ . • "CONSTRUCTION AND PLANNING • - ' POE. . SPA • _ '-3 z Date• Inspector• - ' m - Date Inspector • APPROVALS". Permit#. - - , APPROVALS •Permit# - • 1. Temporary Electrical Service or Pole • - • 52. Pool.& Equipment Location - - - . ''2. Soil Pipe-Undrgrnd. - - ;.> . • 53. Steel,Reinforcement , 3. Electrical Conduit Utility-Undrgrnd. 54. Forms - ' ,4: Electrical Conduit-Undrgrnd. , - . 55..Electrical Bonding - • • ' - -5. Steel Reinforcement ' - - - 56. Rough Plumbing & Pressure Test - • 6: Electrical UFER Grnd.': _ • _ • 57. APPROVAL TO COVER-GUNITE - 7. Footings r , - • 58: Electrical ConduitsUndrgrnd. . 8.-Foundation ' " • 59'Gas Pipe, 0 Undrgrnd., Test • 9. Water Pipe-Undrgrnd. • ' - '. 60: Backwash lines, P-Trap, 0 Undrgrnd. 10: Structural Floor System _ 61: APPROVAL TO-DECK ' 11. Property Sewer Line & House Connection ` 62. Backwash.& Receptor-F,inal - ' • 12' Sewer Cap • _ -. •63. Heater & Vent-Final 13-r Roof Drains . . - . 64.:Plumbing System: Final •, • 14. Rough Plumbing. - _- - _ • 65: Electrical-Final - •_ . ' 15: Rough Electrical-Conduit - • • • 66. Solar System-Final "- . 16:'Rough Electric Wiring f1' 3 :67.-Fencing & Access•Appr`oval', - /j /&3 �C ,r , 17:TRough Wiring Sign ` ' - . I - 68.,.APPROVEQFOR PLASTERING 18. Rough Electrical-T Bar Ceiling . ' - `69. POOL/SPA SYSTEMS FINAL ' - _ 19. Rough Heating &-Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace I APPROVALS Permit# 21. Ducts, in Structure' i - 70. Underground Hydro 22. Ducts, Ventilating > 71. Product Piping 0 Gas 0 Oil ' 23f 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: i - , 27. Frame and Flashing i . 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 //. I 80. FOOD CERTIFICATE ISSUED 33. Final Electric � - Notes: - ' • - 34. Final Heating & Air-Conditioning - - -- - - . . 35. Final Gas Pipe-Test ' - _. - 36. Hood or Canopy - 37. Final Factory Fireplace . - l 38. Final Plumbing • '• , • - - 39. Water Service-Final - - ' • • 40. Gas Service-Final . - • , , 41. Solar Domestic-Final . . . _ , _ , ' : _ - 42. Backflow Preventer ,� --, - . • s 43. Backflow Irrigation • ' ' , 44. •Landscape;Irrigation-System • - ' 45. Sound Attenuation • 46. Handicap Regulations. . ' - 47. FINAL'STRUCTURE & BUILDING , I -- • • • 48. Special Requirements Completed '- • : , . ' ' 49. Electric Release to Edison , - -' - - - • - -- 50. Gas Release to Southern`California Gas Co •• $ 4 • 51. CERTIFICATE,OF OCCUPANCY'. r _ L. . ' - , ._ _ ' No. • - " Date • -'' 1- - - - - .. ..__..7._ ... .7---•••::"..;:s. • r fil...ilEert . -/X , -6) / , ei ___-..*---- C••,.'t PC.ti EOP' .._:F.: . ., ,- F., / -1,4 L • C...Ca _.,:i....43, "c;-"CNE -. _ . .`,/: .-1.-.‘r.-- "R.% tr.:11:1 Z. _ I OIBL..E:F4K. 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