HomeMy WebLinkAbout1013 SECRETARIAT CIR - Building Permits PLAN 4 ELEV B -- Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. _
CITY Ot- COSTAMESA •
PERMIT NO. TRACT NO. LOT NO. • BLDG.NO.- _
•
CONSTRUCTION PERMIT l b it-7 8-7 12011 44 ' •
013- Secretariat Circle • 8906 4/18/84 572.85 TI,
Project Address - TYPE OF CONSTRUCTION Li NEW LJ ADD 'LI ALTERATION LJ REPAIR
Applicant's Mailing Address . 1565 W. MacArthur Blvd. ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A"-P•# 1412--All -51- jZone ki
Owner's Name Standard-Pari fir Corp. Phone 546-1161 DESCRIPTION OF WORK r
S Main Building: • Accessory Building: 2
Address SaroP E .r O1 N
0
TYPE OF PERMIT U GRADING LJ FOUNDATION ❑ STRUCTURAL T Front Imo`
Arch/Eng. Adams/StrPPtPr License No. 25083 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BA Rear 5 r • N
Address 17981 Sky Pack- Circ].e,.:Irvine ❑OTHER GG C Right � / G
Contractor's Name See Owner • Phone PROJECT DESCRIPTION SQ. FT. 2190 OCCUPANCY J 1 R
Address(mailing) • CON ST RUCTION TYPE VALUATION$_1.21:1,2.64_ $ Left '5 2 ^ E
City License No. 008690 ZONE - -- GRADI NG CU.YDS. ACRES Ping. Ref.# -e63 - IOS' Park.Fees $ V5'+5 'LoZ Q
LICENSED CONTRACTOR DECLARATION Remarks: pc 44 �Io-P3,4 Parking Req./Provided 24 nal_
/%%'yyy�ll��y---yyy111r a5 U
I heby affirm that I am licensedsion3 under provisions of Chdrter 9 (commencing
ang Si nG•ll'. R
with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: J 1 / / hi ni (maxi_ E
my license is in full force and effect. PlanningNotes: 111 M
license CI ss - L'O�s t..„ 2 PLUMBING FEES n C E
Date - Signature - ����'s Bar Sink Showers HOLD FOR SPFfiat RcnnrppMRM• w' N
M WORKERS' COMPENSATION DECLARATION - _ • T
, I hereby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer Service Sink _ S
I of Workers' Compensation Insurance, or a certified copy thereof (Section
� 3800, Lab. Backflow Irrigation Sewer Cap ' ELECTRICAL FEES
Policy No. `Wb-84-225-856 company Fremont Indemnity _ __
Certified copy Is hereby furnished. Bathtubs Sewer Connection-
,� - Automatic Washer Transformer 0 15-50 KW
Da Cer ifs cscony Is filed with the city Byydtlin9 Division �yJ, 0 50+KW
Date 1- IY-KG Applicant 'Itandar0 ParifireM0 Clarifiers Solar Collectors.- -- . Construction Pole Sub.
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher
Solar Piping - CookingUnit Meter ❑u to 100 amps
(This section need not be completed if the permit is for one hundred ($100)or P P
less). rFountains '
I aii o that in the performancepersonof the work for to become
permit is Issued Drinking Solar Tank - Dishwasher Meter Dover 100 amps
ortnot employompeanyiperson in any manneria. so as to subject to the
Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric • Sub Panel
Date Signature - . -
NOTICE:If,iafter making this declaration, you should become subject to the Floor Sinks - Urinal - -• Fan - Motors 00-1HP 011/4-8 •
Workers' Compensation provisions of the Labor Code, you must forthwith •
- -
comply with such provisions-or this 'permit•shall be deemed revoked. Gas Service Outlets Water Closet • F-A.U. Inc.Solar 09-15 HP 016-15+
CONSTRUCTION LENDING 'AGENCY
I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures Microwave
of the work for which this permit is issued (Section 3097 Civ. C.)
Lender's Name Kitchen Sink Water Service Device Boxes Pole Light
Lender's Address Lavatories
OWNER BUILDER DECLARATION Outlets Range
I hereby affirm that I am exempt from the Contractor's License Law for the p-Tra •
following reason (Section 7031.5 Business and Professional Code: Any city or p • Switches Sign
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 Roof Drains _• Garbage Disposal Standing Sections
to 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 r Generator ❑0.5 KW ❑5-15 KW
Division 3 of the Business and Professions Code) or that he/she is exempt - Trash Compactor ,
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 Reinspection Fee
enalty of not more than five hundred dollars($500). , Pe $25 Issue Fee $ 3
0 I, as owner of the property or my employees with wages as their sole • Reinspection Fee $25 IssueFee $ 3
compensation will do the work,and the structure is not intended or offered MECHANICAL FEES
for sale (Section 7044, Business and.Professional Code: The Contractor's - PUBLIC SERVICES REQUIREMENT
License Law does not apply to an owner of a property who builds or Improves Boiler Hood or Type I ❑ y-,/ a 14/40/-
employees,
' '1 �y�
thereon, and who does such work himself/herself or through his or her own _ - _ _.. Zoning Approved By - •1 l��l�l J Date 14 �r/LJ7-
employees, provided that such improvements are not Intended or offered for -- Canopy Type II 0 •
sale- If, however, the buildingor improvement is sold within one year of com- Duct-Under Ground
Building Approved By Date
pletIon, the owner will have the burden of proving he/she did not build or im- 42/9/79.4""
drove
for the purpose of sale). Duct-Structural Refrigeration System �- Application Issued By - Q, .� ( Date
LJ I, as owner of the property,am exclusively contracting with licensed con- • ❑0-100,000 BTU ❑100,000 BTU
tractors to construct the project (Section 7044,Business and Professions Code: i Duct-Ventilating SUMMARY OF FEES
The Contractor's License Law does not apply to an owner of property who BUILDING PERMIT
•
builds or Improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration $ 485.50SMTP $ •
tractors) license pursuant to the Contractor's License Law). .
PLAN CH ECK�S $ 78 89 PERMIT 8.46
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# PLUMBING $ ISSUANCE $
HeatingDucting _ PLAN CHECK 25% $ ENERGY P.C. $
Date owner System& '
I hereby certify that I have read this-application and state.that the above - - 00100,000 BTU 0100,000 BTL - • _ -- - GRADING $
Information Is correct. I agree to comply with all city and county ordinances - ELECTRICAL $ ,
and-state laws relating to building construction,,and hereby authorizer pre- $ MICROFILM $
sentatives of thiis citl(^to er on the above-mentioned pr per for PLAN CHECK 50% ,
Inspection pLfGElosi�N 9 /C GY
Signature �'��� r Date O MECHANICAL $ TOTAL FEE $ 572.85 I
Drivers' License or SS# Reinspection Fee $25 Issue Fee - $ 3 - PLAN CHECK 25% $
• . \
CMF-0865-46 rev.12/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod•Assessor - -
. CONSTRUCTION AND PLANNING POOL &SPA _
Date Inspector ' Date • Inspector
APPROVALS Permit# APPROVALS Permit#
1' Temporary Electrical Service or Pole 52. Pool & Equipment Location ' - --
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement t4. .` '
3. Electrical Conduit Utility-Undrgrnd. 54. Forms - - - -
., 4: Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5:- Steel Reinforcement - 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO.COVER-GUNITE. - ••
7. Footings 58. Electrical Conduit-Undrgrnd. •
8. Foundation ,Gas Pipe,.O Undrgrnd.,Test ' -
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. - - - -
10. Structural Floor System PTs 4- 6/3/B?, &seM/ 61. APPROVAL TO DECK - _ -
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final '
12. Sewer Cap 63. Heater& Vent-Final
13. Roof Drains 64. PlumbingSystem - Final ,
-
14. Rough Plumbing 65. Electrical-Final --
15. Rough Electrical-Conduit 66. Solar System-Final - - -- : - - - - -
16.--Rough Electric Wiring 67. Fencing & Access Approval -' - -- -
17'-Rough Wiring Sign 68. APPROVED FOR PLASTERING • , '
18, Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL I r
19. 'Rough Heating & Air Conditioning • • FIRE DEPT. REQUIREMENT - '
20:'Rough Factory Fireplace APPROVALS Permit# - • .
21. Ducts,in Structure 70. Underground Hydro .
22. Ducts, Ventilating • 71. Product Piping 0 Gas 0 Oil ,
S
23. Gas Pipe-Rough&Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil ,
25. Roof Sheathing g/7/Y1 VC/ 74. Overhead Hydro I '
26. T-Bar Ceiling (Structural) & Monocoat , / 75. Dry Chemical - , ,
27. Frame and Flashing /0�?/ 62C/ , 76. Dry Standpipe - ' ' ,
28. Lathing& Siding 0Zj Sc! /C-- 77. FIXED SYSTEM FINAL .; ,
29. Insulation %V 07l 4..--, .78. FIRE PREV. FINAL '
30. Drywall Nailing • 3/Si( (t-/ HEALTH DEPT. REQUIREMENT `
31. Plaster Brown Coat /72Q .(/C/ 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUEDJt
33. Final Electric Notes: ' .yl_�, '
34. Final.Heating& Air Conditioning I -""
35. Final Gas Pipe-Test ,
36. Hood or Canopy _ -
37. Final Factory Fireplace -- - -- `
38. Final Plumbing .
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final - .
42. Backflow Preventer
I�' 43. Backflow Irrigation '
44. .Landscape Irrigation System
45. Sound Attenuation •
46. Handicap Regulations i _-
47. FINAL STRUCTURE & BUILDING /L/...)• � oto
48. Special Requirements Completed rg- /cc- � r. " - • �,� • -- -- F -
49. Electric Release to Edison ", JS
50. Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY - - - .,
No. Date -
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 0194 10/12/84 5e 50 TI,
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. _ I TRACT NO. LOT NO. UNIT NO.
1013 Secretariat Circle 1 6 91s -774
Project.Address L J �L. 11 L1 REPAIR
Applicant's Mailing Address TYPE OF CONSTRUCTION NEW O ADD U ALTERATION
—Standard-Pacific Phone 546-1161 CI CONVERSION CI DEMOLISH CI A-P•# Zone
Owners NameDESCRIPTION OF WORK/USE OF BLDG.
Address 1565 W. MacArthur Costa Mesa, CA 92626 -� S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT GRADING��--7❑7 FOUNDATION CI T
IDFront - 0
Address CI TENANT CI ELECTRICAL 4d PLUMBING CI MECHANICAL B Rear N
Contractor's Name New Plumbing Phone 528-1140 CIOTHER
CityZID License in. 7102 N. Fee Ana Anaheim,
PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N
K Left
( 32871 CON ST RUCTION TYPE VALUATION$ $ R
City LlCens¢NO. ZONE GRADING CU.YDS. ACRES
Ping. Ref.# Parking Req./Provided E
ILICENSED CONTRACTOR DECLARATION
I herebyaffirm that I-am licensed under rovisions harter 9 (commencing 0
P ( g Remarks: RI Z�F1 (33 ..5—G Planning Notes: M
((t' with section 7000) of Division 3 of the Busine an Professions Code,and VJ T 1 ' T
my license Is in full force and effect.
License 11aas 10- 36 're se No. 42106 $•
Date 11 `+ Signature PLUMBING FEES
WORKERS'COMPENSATION DECLARATI Bar Sink Showers ELECTRICAL FEES
I hereby affirm that I have a certificate of consent to self-insure or a certificate
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
Automatic Washer Transformer 0 15-50 KW
3800,lisLab. C. 0 50+KW
Policy No. WC-1777141 Company HOIRP Backflow Irrigation Sewer Cap Construction Pole Sub.
iCertified copy is hereby furnished.
Cert{ft4d qpY S filed with the city g iltlin glvislp2 Bathtubs Sewer Connection f Cooking Unit Meter ❑up to 100,amps
Date 1U-fU-t54 Applicant I'iew Plumbing
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit Is for one hundred ($100)or -
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric -
Sub Panel
I certify that in the performance of the work for which this permit is issued, I - -
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan • Motors ❑01 HP 01%-8
Workers' Compensation Laws of California.
Date Signature Floor Drains l Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+
NOTICE: If,after making this declaration, you should become subject to the -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY -1 Gas Service 6 'Outlets Water Closet 2 50 Device Boxes Pole Light
I hereby affirm that there is a construction lending agency for the performance -
of the work for which this permit is issued (Section 3097 Clv. C.) Interceptors Water Heater Outlets
Lender's Name Range
Lender's Address Kitchen Sink Water Service Switches
OWNER BUILDER DECLARATION. . Sign
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories
following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal 'Standing Sections
county which requires a permit to construct,alter,Improve,demolish or repair P-Trap
any structure, prior to its issuance, also requires the applicant for such permit Generator ❑0-5 KW❑5-15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9(commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt
therefrom and the basis for the alleged exemption. Any violation of Section ,
7031.5 by any applicant for a permit subjects the applicant to a civil _
LJenalty of not more than five hundred dollars($500).
I, as owner of the property or my employees with wages as their sole Reinspection Fee - I $15 Issue Fee $ 3
compensation, will do the work,and the structure Is not intended or offered Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL L FEES
License Law does not apply to an owner of a property who builds or improves _. ._-
thereon, and who goes such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS:
employees, provideg that such improvements are not Intended or offered for Boiler Hood or Type I 0
sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved ByDate
LIrove for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date.W
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00100,000 BTU 0100000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con-
tractor(s) license pursuarit to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# PLUMBING $ S•SO ISSUANCE $
Date ew - Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $ _
I hereby certify that I -ve read this application and state that the above 00100,000 BTU 0100,000 BTLELECTRICAL $ GRADING $
information is correct. a• ee to c imply with all city and county ordinances
and state laws relating to : ilding construction, and hereby authorize repro- - PLAN CHECK 50% $ MICROFILM $
sentatives • • e er pan the above-mentioned prop rty for rr
inspection purpose
Signature . �'
Reinspection Fee $15 Issue Fee 111—
PLAN CHECK 25% $
CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor
- CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
• • 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
-2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms k
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - r
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd. .r
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test .�
9. Water Pipe-Undrgrnd. -� 60. Backwash Lines, P-Trap, ❑ Undrgrnd. .!
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final r
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
'15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final JZ//tf,i'i (-CO
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
r.
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
y'f' /&// ,4/ --_ e➢r 116 p it Tle '•y v r �r 9
Applicant to fill in all spaces exc t s w nin a o a r lines and si n all appropriate declarations.
CITY°OF COSTS MESA CO STRUC N PE• MIT •
- PERMIT NO. TRACT NO. LOT NO. UNIT NO. •
• Project Address/O", get) Pt 3350
Applicants Maili_• `.•rens J TYPE OF CONSTRUCTION '•NEW U ADD U ALTERATION U REPAIR
/ • - -3-440/ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# - I Zone
Owner's/Nam StL !� ��''�CC�LL _ Phone /y,, DESCRIPTION OF WORK/USE OF BLDG.
Addre/S /�# 1/ J '/Z/s-f� S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING FOUNDATION III STRUCTURAL E Front 0
Address �r
LI TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL BA •Rear N
Contractor's Na ./J e• Al ❑ OTHER C Right N
SNOWs - PROJECT DESCRIPTION SQ. FT. OCCUPANCY K C
•\� Address(mailing) i/ . Left
CONSTRUCTION TYPE VALUATION$ S R
T`cc City License No. S,2S / ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E
• LICENSED CONTRACTOR DECLARATION ..ff ,r-s Q
I I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: ( �i 9�� Planning Notes: M
— with section 7000) 0f Division 3 Of the Business and Professions Code, and ` [ T
I my license is In ful r•rc¢ - effect. a
t``Y. License Class if : ic- se N•l.� i S.
Y+ Date J Signature . lli, Init,„s, PLUMBING FEES .
WORKERS' COMPENSATION DECLARATION • Bar Sink / Showers M VO ELECTRICAL FEES '
I hereby affirm that I have a certificate of consent to self-insure or a certificate
of Workers' Compensation Insurance, or a certifie opy thereof (Section Backflow Preventer Service Sink -
3800, Lab •��/,y/y� / yyAutomatic Washer Transformer ❑ 15-50 KW
Policy N:4 /,/7/S/ Company Backflow Irri anon 0 50+ KW
Irrigation Sewer Cap Construction Pole Sub.
Certified copy is hereby furnished.
CCertLt/f1¢d copy i�L/�f(i/tgtl with thea iltli visional ,g. Bathtubs / Sewer Connection Gini Cooking Unit Meter Cup to 100 amps
Date P 3}_T KERS' p�/ /N DLAV
Date TION R WORKERS'COMPEN TION DELLhundred 1111($100) or
less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to became subject to the Drinking Fountains Solar Tank Fan Motors❑9.1 HP 1:11%-8
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP ❑16.15+
NOTICE:If,after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be•deemed revoked. / Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets 2 Water Closet ('0 Device Boxes —
Pole Light
1 hereby affirm that there Is a construction lending agency for the performance n
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors / Water Heater e[ f� Outlets Range
Lender's Name , /
Lender's Address Kitchen Sink / Water Service 7 Switches
OWNER BUILDER DECLARATION ' , JV Sign
I hereby affirm that I am exempt from the Contractor's License Law for the 4/ Lavatories 3 Garbage DisposalStanding
following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Sections -
county which requires a permit to Construct,alter,Improve,demolish or repair P—Trap Generator ❑0-5 KW❑5-15 KW
any structure, prior to Its issuance, also requires the applicant for such permit Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt
therefrom and the basis for the alleged exemption. Any violation of Section '
7031.5 by any applicant for a hermit subjects the applicant to a civil -
enalty of not more than five hundred dollars($500).
I, as owner of the propertyoi my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work,and the structure Is not intended or offered • Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL ja FEES
License Law does not apply to an owner of a property who builds or improves —
-
thereon, and who does such work himself/herself or through his or her own — DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0
sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- • Duct-Under Ground Building Approved By • Date
prove for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System - Application Issued By___ AM> Date_91ZZ
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or Improves thereon,and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof oftheir Worker's Compensation insurance should be provided to me.. PLAN CHECK $ ^ /
PERMIT
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBI1/ `IS
\•° f
Date Owner _ Heating System& Ducting PLAN CHECK 25 1111\\\ft's'b3b3b3../
�f1 `� ` ' jtGNFISC`Jh”
I hereby certify that I have read this application and state'that the above DO-100,000 BTU 0100,000 BTU ELECTR R $
information is correct. I agree to comply with all city and county ordinances
and state laws relat'ng to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ _
sentatives of the it o enter upon th ab• e-m-nti•netl ptgpyyy for
Inspection purp., r /, �`j ertj� MECHANICAL $ 'TOTAL FEE $
Signature .&A _ /
Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev.4/84 White-Building;Canary-Apppplliica�nt;Pink-Accounting;Goldenrod -Assessor
r•
CONSTRUCTION AND PLANNING POOL&SPA
l• APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location
•
'2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings : 58. Electrical Conduit-Undrgrnd.
8. Foundation , , - 59. Gas Pipe, O Undrgrnd., Test
J .
•
9. Water Pipe-Undrgrnd: 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final •
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank O Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
•
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78, FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
•
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED I{
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test f2//&/5.{ Gro)
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final •
42. Backflow Preventer
43. Backflow Irrigation _
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations '
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Plir
Ltly Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
CITV,OF COSTA MESA. PERMIT NO. TRACT NO. LOT NO. BLDG.NO.
CONSTRUCTION PERMIT 'yr— • IQ 1 732j S co 0934 5/23/84 ' 38.00 TL
Project Address I0I 5 �JL- fl.t , a, y: t4Jt4!.kO - TYPE OF CONSTRUCTION LGWEW U ADD LI ALTERATION Li REPAIR
Applicant's Mailing(�Tddre,�g5,' ❑ CONVERSION ❑ DEM LISH ❑ OTHER A.P.# l Zone
Owner's Name `+"'^'��"""'c/ 1"Ce ' b�� 1�/ DESCRIPTION OF WORK
I! �� Phone l3'lS Main Building: Accessory Building: 2
AddressTYPE OF PERMIT 0I GRADING(�❑ FOUNDATION LI STRUCTURAL T Front N
Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL Lp-PLUMBING: ❑ MECHANICAL B Rear
Address' ,,yy+�� C ❑ OTHER / - A N
Contractor's Name ':A/kYlt ^ PhonCll /r PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right G
/ �A, •�� - ' s, ,� K Left R
Address(mailing) �J{, IV. to- ac-fr.... CON ST RUCTION TYPE VALUATION $ $ E
'1s•• &IS. I ZONE GRADING CU.VDS. ACRES Ping. Ref.# Park.Fees $ Q
City License No. 000"`"'• J� nn
LICENSED CONTRACTOR DECLARATION Remarks: U 1 2-7 Q .7 Parking Req./Provided I
I hereby affirm that I am licensed under provisions of Charter 9 (commencing u 1 c� R
with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: E
my license is in full forts and effect. oZ Planning Notes: E
License Claps n om -• License No. 19691 PLUMBING FEES E
M
Date CP-JP tt Signature (g
WORKERS'COMPENSATION DECLARATION � Bar Sink II Showers �—
I hereby affirm that I have a certificate of consent to se -insure or a certificate - . - - - - - - T
of Workers' Compensation insurance, or a certifiedd''copy thereof (Section Backflow Preventer Service Sink S
3800, Lab. C. --ss I��r {//I Backflow Irrigation Sewer Cap .d' • ELECTRICAL FEES
Policy NoWd- .5i O9(•1`TO . company lit - -•
sny Certlfletl cop •is hereby furnished. r' Bathtubs I Sewer Connection :� —
Automatic Washer Transformer 0 15-50 KW
ICer -tl co lied with the city B 'I ins Divisi -- ❑ 50+ KW
ate Applicant Clarifiers Solar Collectors Construction Pole Sub.
EXE PP ION 6rWORKERS'COMPENSATION DEC LA RATIONDishwasher Solar Piping Cooking Unit Meter ❑up to 100 amps
(Thissection need not be completed if the permit is for one hundred($100)or ,
Iacs) -
I certify that in the performance of the work for which this permit is issued, I Drinking Fountains • Solar Tank Dishwasher Meter Dover 100 amps
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 Dryers ❑Gas ❑Electric - Sub Panel
Date ' ' Signature _ _ -
NOTICE: If,iafter making this declaration,you should become subject to the- .• Floor Sinks- - - Urinal - -Fan -' Motors 001 HP ❑1'/a-8 ' '
Workers' Compensation provisions of the Labor Code, you must.forthwith. 1 _
comply with such provisions or this permit shall be.deemed revoked. Gas Service. Outlets 3 Water Closet' '40-
CONSTRUCTION LENDING AGENCY � F.A.U. Inc.Solar 09-15 HP 016-15+
I hereby affirm that there is a construction lending agency for the performance Interceptors I ( Water Heater -. o - Fixtures ; ' Microwave '
of the work for which this permit is issued (Section 3097 Civ. C.).
Lender's; Name f• Kitchen Sink I Water Service • ' 4-4 — Device Boxes Pole Light
Lender's -Address " 4 Lavatories.. [ - C/
OWNER BUILDER DECLARATION J - O — Outlets Range
I hereby affirm that I am exempt from the Contractor's.License Law for the p-Trap following reason (Section 7031.5 Business and Professional Code: Any city or - p - _ - r. Switches Sign ,
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 - Roof Drains . - •Garbage Disposal Standing Sections
to 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 . . Generator ❑0-5 KW❑5-15 KW
Division 3 of the Business and Professions Code) or that he/she is exempt _ • .- Trash Compactor
'therefrom:and the'basis for the alleged exemption. Any violation of Section - - - •
I • '
7031.5 by any applicant for a permit subjects the applicant to a civil • Reins coon Fee $ 3
0 enalty of not more than five hundred dollars($500). - . pe , .$25 • 1 Issue Fee
I,as owner of the'property or my employees with wager as their sole MECHANICAL • Reinspection Fee $25 Issue'Fee , $ 3
compensation will do the work,and the structure is not intended or offered FEES
for sale (Section 7044, Business and Professional Code: The Contractor's - - - ----- - - — PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to an owner of a property who builds or improves Boiler - ':fs Hood or Type I ,0 • I . - I
thereon, and who does such work himself/herself or through his or her own Zoning Approved By Date._
employees, provided that such improvements are not intended or offered for • - - Canopy . Type II 0 i :
Duct-Under Ground
sale. If, however,the building or Improvement is sold within one year of com- , - i Building Approved By — Date
pletlon, the owner will have.the burden of proving he/she did not build or Im- - '
rove for the purpose of sale). ' Duct-Structural Refrigeration System '^. ' Application Issued By 91'e] Date ' �7 --2�7
o I,as owner of the property, am exclusively contracting with:licensed con- ' ❑0-100,000 BTU ❑100.000 BT,U '
tractors tO 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 whoi
builds or Improves thereon, and who contracts for such projects with a con- ' Exhaust System ❑ Multiple 0 I System Repair%Alteration , BUILDING PERMIT $ SMIP $
tractor(s) license pursuant to the Contractor's License Law). i PLAN CHECK $ _ PERMIT
0 am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# i PLUMBING•
�$ -.'> -�O ISSUANCE $
Date Owner Heating System& Ducting _ PLAN CHECK 25% 1$ tr-00 ENERGY P.C. $ ' -
I-herebycertify that 1 have read-this application and state-that the above- JD1OO.0O0BTU 0100,000 BT '"' GRADING $
information is correct. I agree to comply with all city and county ordinances lI I� ELECTRICAL $
and stat: laws relating to building construction,and hereby authorize repre- I I - II.
PLAN CHECK 50% $ MICROFILM $
sentativ:s of his'city to enter upon the above-mentioned props y for �/�
inspects• .' - I , 0 0MECHANICAL $ TOTAL FEE I$ -38`-`"1-/
Signature ,J4. .�.4a s� •ate-7, _ JIT
Drivers' License or 55# �. Reinspection Fee - $25 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46 rev.12/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor
V" _ _
. CONSTRUCTION AND PLANNING • ,‘ . _ - POOL& SPA ., _ t: .-tr i • -
Date Inspector . 7 - - " •Date4' .Inspector) -
�• 'APPROVALS Permit# ' APPROVALS I Permit.#
- 1. Temporary Electrical Service or Pole12-• • -9 - '52:' Pool & Equipment Location 'I.-- • - 1 - ,
t-2. Soil Pipe-Undrgrnd. c/ 51.400 . GED .53..Steel Reinforcement II : -
- 3. Electrical Conduit -Undrgrnd.)- " 54. Forms �- - '
` 4. Electrical Conduit-Undrgrnd. 4- 55. Electrical Bonding - - _ "
5. Steel Reinforcement _ , 56. Rough Plumbing.& Pressure Test - I - . '
. 6. Electrical UFER Grnd. 57. APPROVAL TO,COVER-GUNITE. • _ t.I
-7. Footings - _ - 58. Electrical Coriduit-Undrgrnd. . i -,
- 8. Foundation 59. Gas Pipe, 0 Undrgrnd:,Test
9. Water Pipe-Undrgrnd. t // 1 • C.&2 60. Backwash Lines, P.-Trap, D Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK - • ..
11. Property Sewer Line & House Connection - •• .: ,_
(,����'/ , [� 62. Backwash
- 12. Sewer Cap 63. Heater &Vent-Final_ • -
13. Roof Drains -64. Plumbing System,=Final •- - •- .
14. Rough Plumbing , I 65. Electrical-Final - • . -
15. Rough Electrical-Conduit , 66. Solar System-Final • - "" " -
16. Rough Electric Wiring 67. Fencing & Access Approval . u c` -- - ; - -,- ;
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING- ' -
18. Rough Electrical-T Bar Ceiling 691 POOL/SPA SYSTEMS'FINAL - _
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT . i I i
I
20. Rough Factory Fireplace • APPROVALS Peimia# - ,
21. Ducts, in Structure 70. Underground Hydro i = - -
22. Ducts, Ventilating 91. Product Piping 0 Gas.°D Oil ' I '
_
•
.23. Gas Pipe-Rough &Test - - 72: Underground Flush ii i ,
24. Roof Framing 73. Undergrrid.Storage Tank.D,Gas 0Oil;
25. Roof Sheathing . . y4. Overhead Hydro - -
1
26. T-Bar Ceiling (Structural) & Monocoat • - 75., Dry-Chemical ' - - - .: • 1 -
27. Frame and Flashing • 76. Dry Standpipe I . - - ,
28. Lathing& Siding 77. FIXED SYSTEM FINAL , 1 =1 '
29. Insulation • 178. FIRE PREV. FINAL i .
30. Drywall Nailing HEALTH DEPT. REQUIREMENT '
31. Plaster Brown Coat • 79. FINAL INSPECTION •
-
32. Electrical Power Meter-Final 80' `FOOD CERTIFICATE ISSUED
33. Final ElectricNotes: I
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test Waal- - . ' `'
36. Hood or Canopy - •- -
37. Final Factory Fireplace I
38. Final Plumbing .
39. Water Service-Final - • 1
40. Gas Service-Final ' -
41. Solar Domestic-Final - -
-42. Backflow Preventer
43. Backflow Irrigation '
. . -
44. .Landscape Irrigation System 1 . I
. -
45. Sound Attenuation I _ I I • ' I f i 1 1 I '
46. Handicap Regulations • - i i •- •
47. FINAL STRUCTURE & BUILDING I '
• 48. Special Requirements Completed ,1 i ' -
49. Electric Release to Edison - ) `I-- 1 i
50. Gas Release to Southern California Gas Co I .
51. CERTIFICATE OF-OCCUPANCY . H -I - , - -- ,;
No. Date - - -_ .
' Job #0722 c yl Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 6449 9/ 19/84
CITY OF COSTA�M/�) p%,1 C�`��J C• 10 RMT PERMITnNO.
" G TRACT NO. LOT
/N/JO.../ UN�iJ77 Nip{ 1 7'0 Ja PL
Project Address )`-'�/ '' 4_, l r 1 1 ✓ 2 ` 1 Q-1 rl�`> TT "7"7�
Applicant's Mailing Address P.O. Box 2426 TYPE OF CONSTRUCTION �EW u ADD U ALTERATION U REPAIR
Standard Pacific ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone
Owner's Name Phone DESCRIPTION OF WORK/USE OF BLDG.
Address 1565 W. McArthur Blvd S Main Building: Accessory Building: Z
�
"1 Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING L I FOUNDATION Li STRUCTURAL T Front 0
"" Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING 701NB Rear N
1 Contractor'sName Santiago. Air-.COndPhone 957-6560 ❑OTHER _ _ _ A
PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N
Address(mailing) P.O. BOX 2426 • ' K G
_I C O N ST RUCTION TYPE VALUATION $ s Left R
1` City License No. 015264 ZONE GRADING CU.YDS. ACRES Ping. Ref.# ParkingReq./Provided E
LICENSED CONTRACTOR DECLARATION - Q
I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: PO j2.P)-7 • Planning Notes: M
with section 7000) of Division 3 of t-e Business and Professions Code,and �s✓✓ .
my license is in ful or2O nd effect. ' - T
License Cla.�s Licens ! 6.9496 S.
Date - y- -`z ignature la:.(. ' S. getr�_-_ . PLUMBING FEES
WORKERS'COMPENSATION DECLARATION Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section -
3800, Lab. C.pWC1089859 Home Insurance Backflow Preventer- Service Sink Automatic Washer Transformer 0 15-50 KW - -
Policy No. Company Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
Certified copy is hereby furnished.
Certified copy is filed with the city BuildlrlgJaI1island O Air COnd - Bathtubs Sewer Connection •
Cooking Unit Meter ❑up to 100 amps
61 g
Date Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors . • Dishwasher Meter Dover 100 amps' '
(This section need not be completed if the permit is for one hundred ($100)or
less). Dishwasher . Solar Piping I i Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank ' FanMotors❑0-1 HP 011/2-B
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP 016.15+
NOTICE: If,after making this declaration,you should become subject to the
Workers' Compensation provisions of the Labor Code,.you must forthwith Floor Sinks -Urinal . Fixtures
comply with such provisions or this permit shall be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY - Gas Service Outlets Water Closet Device Boxes Pole Light
1 hereby affirm that there is a construction lending agency for the performance - 9
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater •
Outlets
Lender's Name None Range
Lender's Address Kitchen Sink Water Service
OWNER BUILDER DECLARATION .ARATIO - Switches Sign
I hereby affirm that I am exempt from the Contractor's License Law for the LavatoriesGarba ,
following reason (Section 7031.5 Business and Professional Code: Any city or ge Disposal
Standing Sections
county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Generator ❑0-5 KW❑5-15 KW Trash Compactor
any structure, prior to its Issuance, also requires the applicant for such permit .. P
to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law (Chapter 9.(commencing with Section 7000)of
Division 3 of the Business and Professions Code) or that he/she is exempt
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil
enalty of not more than five hundred dollars($500). •
I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee - $ 3
-
compensation, will do the work,and the structure is not Intended or offered Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's • MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself or through his or her own / DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I ❑
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By nate
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date
DI,
for the purpose of sale).
D I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By (" b Dat
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating . ❑0-100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or Improves thereon,and who contracts for such projects with a con- -
tractor(s) license pursuant'to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $
proof o their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt.ICBG# PLUMBING $ ISSUANCE $
Date Owner - Heatin tem& Ducting ENERGY P.C. $
414-::
r, PLAN CHECK 25% $
I hereby certify that I have read this application and state that the above 100,000 BTU 0100,000BM - ELECTRICAL $ GRADING $
Information is correc I agree to comply with all city and county ordinances
and state laws rel ng to building constr i on,and hereby authorize repre-
sentatives of this ity to enter upon(,yp�� ab yve-mentioned property for mpg _ -.��-
inspection purpos r'�O �/ ,/- / C 3aik
- TOTAL FEE $ Li-f-
..,—
Signature_ V!W-�H• fC-u/ Date A-1 1 -84MECHANICAL r G� �
Drivers' License o SS Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ ,.:?=:==. Z.$� ��
CMF 0865-46,rev.4/84 White- Applicant;Pink-Accounting;Goldenrod-Assessor 17 r 2,8
r
CONSTRUCTION AND PLANNING POOL& SPA
Date Inspector Date Inspector
, APPROVALS Permit# APPROVALS Permit#
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
t2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding •
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE •
7. Footings • 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap - 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final •
15. Rough Electrical-Conduit 66. Solar System-Final - -
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning ckeel (CEO FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace •
APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough &Test I 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27.. Frame and Flashing 76- Dry Standpipe
28.- Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED -
•
33. Final Electric • Notes:
34. Final Heating & Air Conditioning f2/�74//V/OttL�
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
• 50. Gas Release to Southern California Gas Co -
' 51. CERTIFICATE OF OCCUPANCY
No. Date
•
(I
fl Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
•
PhPEeIT NO.3 2— TRACT NO. LOT NO. UNIT NO. 7341 8/29/84 86,,,85 Ti.
CITY OF COSTA Y1 ESA NSTR UCTION P R IT `iI lAl
Project address / c e_e. e__. --Cc olId,
t l'p tt �
Applicant's Mailin• •ddre OEC., r,'4 as ',icier il. U/ ' FU TYPE OF CONSTRUCTION des.NEW IJ ADD ❑ ALTERATION U REPAIR f
_� rn. ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone
Owner's Name III �2 �� PhO ���/ DESCRIPTION OF WORK/USE OF BLDG.
s- Jz7rd-rpt/-I r4-hA.r 4 {I., I. mesa- •
rr � S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT LI GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front ZO
Address • II) TENANT C ELECTRICAL III PLUMBING ❑ MECHANICAL
B Rear N
Contractor's Name s� LL� ICC- Pho -7-n3 ❑ OTHER C Right - N
I,, / ' / r PROJECT DESCRIPTION SQ. FT. OCCUPANCY g
Address lmailinglagS 6Iia . IU2r �nl I / � IY) K Left
G
p /� //''�� C ON ST RUCTI ON TYPE VALUATION$ s R
City License No. Ua50SI s^�c/e/ ZONE GRADING CU.YDS. ACRES ping. Ref.# Parking Req./Provided E
LICENSED CONTRACTOR DECLARATION - - -
n I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: - M
1.0 with section 7000) of Division 3 of the Business and Professions Code, and - T
my license is in full fo e and effect. ^ • - S.
DLicense Class It • CEn( /NO
Date . Signature ��/��� 'W/t,- PLUMBING FEES
•
WORKERS'COMP NSATION DECLARATION •
'Bar$ink Showers ELECTRICAL FEES
ti I hereby affirm that I have a certificate of consent to self-insure or a certificate
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
3800, Lab. C.)�j(/--7(„� Sj�J _ p- I - Automatic Washer Transformer 0 15-50 KW -
Policy No. Y' / WC--p Company- 1EC1_C 1 Backflow Irrigation Sewer Cap - 0 50+ KW
__, Certified copy is hereby furnished. Construction Pole Sub. I CO
Ger;i�d(Qo is filed with the city fill,ra 4.n. • Bathtubs Sewer Connection / Cooking Unit Meter Dup to 100 amps ./ /0
Date 74( (1,. Applicant �hntl
EXEMPTION FROM WORKERS'COME SATION DECLARATION Clarifiers • Solar Collectors Mover/ Dishwasher / Meter over 100 amps' R
(This section need not be completed if the permit is for one hundred($100) or MM
less). • / DryersX Sub Panel �'
Dishwasher • Solar Piping. ❑Gas Electric
I certify that in the performance of the work for which this permit is issued, I �'
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank - -3 Fan / ' Motors D0-1 HP$,1'h-8 ' 5' 60
Workers' Compensation Laws of California. — —
Date Signature Floor Drains - Swimming Pool w/Spa F.A.U. Inc.Solar D9-15 HP 016-15+
NOTICE: If,after making this declaration, you should become subject to the
Workers''Compensation provisions of the Labor Code, you must forthwith Floor Sinks - Urinal • - Fixtures - / Microwave /�/!/`
comply with such provisions or this permit shall be deemed revoked. - S+',s�v�"
CONSTRUCTION LENDING .AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light f,/^Ll
I hereby affirm that there is a construction lending agency for the performance — 9
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater _ Outlets J Range /7OV
Lender's Name �J
Lender's Address - - Kitchen Sink Water Service -3f' Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - 1 i.
following reason (Section 7031.5 Business and Professional Code: Any city or / Garbage Disposal 'Standing Sections yv
t�v
county which requires a permit to construct,alter,improve,demolish or repair P-Trap DO-5 KW D5-15 KW Trash Compactor
oy lstructure, prior tom its he/, also requiresicestheapplicantt for such vi permit p - - P
to file a signedr statement that hapte is licensed pursuant to the provisions of Roof Drains
'the Contractor's License Law (Chapter 9 (commencing with Section is of
Division 3 of the Business and Professions Cocie) or that he/she is exempt I
therefrom and the basis for the alleged exemption. Any violation of Section •
7031.5 by any applicant for a permit subjects the applicant to a civil - -
peenalty of not more than five hundred dollars($500).
O I, as owner of the property or my employee's with wages as their sole Reinspection Fee I . $15 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICALFEES
License Law does not apply to an owner of a property who builds or improves • -
thereon; and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date
pletion, the owner will'have the burden of proving he/she did not build or im- Duct-Under Ground
move for the purpose of sale). Building Approved By SUMMARY
R Date I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration [Application Issued By titA-1) Dahl• C5I 2-8
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 0100,000 SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ ISSUANCE $
Date Owner - Heating System " Ducting PLAN CHECK 25% $ ENERGY P.C. $
1 hereby certify that I have read this application and state that the above 0 0-100,000 : 00,00 B GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to b Iding construction, . d hereby authorize repre- $ C MICROFILM $
sentatives of this city�to fn r u•on - abo e-mentioned property for/ PLAN CHECK 50%
inspection purposes./ h/ , f ^2�G ps.( 0/
Signature 11 Date Gf "L l MECHANICAL $ TOTAL FEE $ 44; 415
Drivers' License or S # -..r��.�_�% Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor
POO• CONSTRICTION AND PLANNING L& SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
.
, 1. •Temporajy Electrical Service or Pole • 52. Pool & Equipment Location
Soil Pipi Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. - 54. Forms
4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding
5: Steel.Reinforcement - • 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVE R-GUNITE
7. Footings. - 58. Electrical Conduit-Undrgrnd.
8: Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains i 64. Plumbing System - Final
14. RoughPlumbing , 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring
q1.11/15-9 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. RoughHeating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70.' Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72.,Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monoboat 75. Dry Chemical
27. Frame and Flashing • 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 'li' I 80. FOOD CERTIFICATE ISSUED
riy33. Final Electric Notes:
34. Final Heating & Air Conditioning - - - •
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer . • - ..
43. Backflow Irrigation
44. .Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
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No. Date