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Home My WebLink About3350 VIA PARMA - Building Permits(714) 754-5273 • Fan (714) 754-4856 • www.ci.costa-mesa.Gr7.USCTRICAL PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 tLt Job Address: 3350 VIA PARMA Suite No A Vicinity: BUILDING 10 - HOUSE METER Parcel Nunmber: TPN003185 Applicant: LONG, JEN Address: 505 NORTH TUSTIN AV SUITE 272 � , SANTA ANA, CA Owner: STANDARD PACIFIC � Address '15326 ALTON PKWY Conhactor: Address: IRVINE, CA Phone: 714-245-9760 Zip: 92705 Phone: 949-789-1716 Zip: 92618 Phone: Zip: License: Status: ISSUED Applied: 11/25/2003 Issued: 11/25/2003 ISSUED BY: � - . SCOPE OF PERMIT �FiOUSE METER FOR BUILDING A. FEES PAID UNDER PERMIT NUMBER E03-01108. PERMIT FOR METER RELEASE AND TRACKING ONLY. REF: B03-02035. � ' ISSUE FEE Temp service test Res. a/c package . New Res (1-2 uniLs) ` New Res (3+units) Pool / Spa Lightinq Fixts Recept Outlets Switches ' . _ Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a � Motors to 1 hp Motors to 10hp Motors to SOhp Motors to 700hp Motors over 100hp Communication drops Sub panel to 200a $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ' $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEESUMMARY Temp Dist System / Lighting Busway /100 ft Standing Section ' Misc Electrical Equipment :�- � T2nsformers up to 1 kva/kw . ;`� � ............:...up to 10 kva/kw . . ,_,_ ' ...............:.up to 50 kva/kw .................up to 100 kva/kw,; ..................over 100 kva/kw� ` Low Voltage Equipment Low Volt Wiring System / Ckt Misc. Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride br lights) . Christmas Tree Stand Fireworks Stand Other Electncal Fee Investigation Fee � � ' Plan Check Fee Quantity $0.00 0 $0.00 0 � i $0.00 0 , $0.00 0 $0.00 0 $0.00 , , 0 $0.00,� " �0 $0.00' = 0 �- $0.00 0 ` � $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00- 0 , $0.00 ' , 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order (or ihe work authorized under Ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetlons and finel approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of lhis permit. FOR INSPECTIONS CALL: (714) 7545626 244fi-06 (B/00) WORKERS'COMPENSAnON DECLARAnON: " I hereby attirtn under penalty of perlury ona ot the following tleclaretions: ' I have end wlll meintain a certiilcate ot consent to self-Insure tor workers' compensation, es provided for by section 3700 ot Ihe Lebor Coda, for the pertortnence of the w for which �hi5 pertni� is issued. have 6will maintain workers' c ensation insur ce, as raquiretl by section 3700 of t�e LeDor CoOe, for the peAortnance of th work For which Nis permi[ is issuetl. M rker ' Pm e s�tIlon Insur a1rde,r and ic number are: Y � b %��?x)�-/(0.`.7 Carrier: l�� f� LA PolicyNumber: (This section neetl not b comp/eted il the permif Is v d ef one hundred dollars ($ f 00) or less.) ❑ I certiTy that in the perfo compensation laws comply with Ihes rovi: �Applicent Signature: WARNING: FAILURE T SECURE �e work lor NM1ichlj�is permit is issued, I shall not employ any person in any manner so as to becoma subject to ihe workers' r e that If I s bultl becoma subject Io Ihe workers' compensation pmvisions� f Secti �Op oi� bor Code, I shell fotlhwith Date: ��I XMIPENSATION COVERAGE IS UNLAWFUL rW SHr1Ll5UBJECT AN EMPLOYER TO CRIMINAL P NALilES AA VIL FlNES UP TOONE HUNDRED TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]O6 OF THE LABOR fADE, INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn that I am Ilcensed under provisions ot Chapter 9(commencing with Section 7000) of Division 3 ot t�e Business and Professions Code, antl my license is in full force entl eHect Lic. # Class N i Conirector'sSignaWra: Oate: CONSTRUCTION LENDING AGENCV: ❑ I here6y aHirtn that Ihere is a consWction lending agency for the performance of Ihe work for which ihis pertnit is issued. (Sec. 3097, Civil Code). Lendefs Name: Lenders Address: Signalure: Dale: OWNER-BUILDER DECLARATIONS: I hereby ettlrm thet under penelry of perjury Ihat I am E%EMPT FROM THE CONTFiACTORS LICENSE LAW tor ihe tollowing reeson (Sec. 7031.5, Business and Protessions Code: Any ciN or counry which requires a permit to consiruct, alter, improve, demolish, or repair any strucWre, pnor to its issuance, also requiras the epplicant for such permit to file a signed stetement that he or she is Ilcensed pursuent b the provisions of the Contractors License Law (Chepter 9(commencing with Sectlon 7000) of Divislon 3 ot ihe Business and Professions Cotle) or that he or she is exempt thereirom and the basis tor the alleged axemption. Any violation of Section 7031.5 by eny applicent tor e partnit subjects the epplicant Io e civil penalry of not more than five huntlred tlollars (5500).): , ❑ I, as owner ot iha property, or my employees with wages es ihair sole compensation, WILL DO THE WORK, and the structure is not intentletl or ottared for sele (Sec. 7044, eusiness ana Professions Cotle: The Contractors License Law dces not apply to an owner of property who builtls or improves ihereon, and who tloes such work himself or harseN or through his or har own employees, providetl that such improvements are not intended or oHared for sale. If, however, the building or improvement is sold within one year of completion, the er-builder will have the burden ot proving that he or she tlid not build or improve for purpose of sale.). � s owner ol the properry, e LUSIVEL ONTRACTNG WITH LICENSEO CONTRACTORS to construct Ihe project (Sec. 7044, Business and Professions Cotle: The comrac t r e L w does not appl . o an owner of property who builds or improves Ihereon, and who contracts lor such proJect wlth a contrector(s) license pursue o the t c n s.). am Ownar ID veri Verification oi Business and Professions Cotle for t�is reason: s ❑ No Drivefs License No. i.e. - properry tex bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity that no excevation Five (5) or more feet in depth into which a person is requiretl to tlescend, will be made in connection with work euthonzed by this permi6 end that no building siructure, scattolding, felsework, or tlemolition or dismantling thereof, will �e more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Celifomla Atlminislrative Code). ❑ As owner-builtler, I will not employ enyone to do work which woultl require a permi� fmm the Division of Industnal Sefery, as noted above, unless such person �es e pertnit to da such work from the division. Signature: Date: Division of Intlusiriel Setety Permit Number. CERTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF ENTRV: I cenity untler penalry of perjury that I have read this application and state that the information given is correct. I agree to comply with ell state laws antl ciry ortlinances relating to building consimction, and authonze representatives of the City ot Costa Mesa to enter upon �he ebove-described property tor inspecti�rpose no y or allow occupancy of any building euthorized by this permit until final inspection. COpE I, INSGELTONTYVE � 1616 Fixed System Finel Fire Prevention 1288 Pool Spa Final 200 Final Re-Roai , 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition �g �� ig.l �l c� oe,e Date COOE� INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Eledrical 212 Final Fire Prevention 220 Final Planninq Approval 222 Final Site 250 Final BuildingiOccupency Qeg �i y � � � ' 9R _ . . . � � t .e ' � . _.� . t - . . _ � . ''' . ��:_ � g ,/ n `�-�.w� , .. 4,r '_ '. �, ',r _ ... P.... . ,.1�� , W�.. J3��'V�'. ��"�'� . . ` Sotu��av� _�g gags�e��a ��d �'�.�.nagg, �{aac: � � 10826 South Norwalk Blvd:, Santa Fe Springs,.CA 90670 , ; � , . (562) 941-2990 • (714) 526-8441 • Fax (562) 946-0026 ' ''\ - � - ., SW JobNo: Date � REGISTER�D INSPECTORS'S DAILY REPORT �o/y'd� /d -3i•a� TYPE OF �„' .� � Reinforced Concre}e � ❑ Siructural Steel Assemb ❑ 9uality Control - ' INSPECTION � �. � "_ , ..: � Pos} Tensioned Concrefe�� . ' ❑ fire Proofing -- - � Other . � � � , � � � HEUUIRED ' � � ReinforCed Masonry � ❑ Asphalt � , . � Job Atldreu � - � City 33� i.� i �.,�fi� o.. �`os,—� ,�,,=ss� � . Job Nome, � � � � � � Permit No. - � Issued By � � � Tf/t �A✓�2�L G P2av�De-.�c�E G/C. 3 0�2D.�S ��: ar C'•Y. � iype.ofStmcfure � - � . . Archifecf � . �� - � . , Mu�. �ri - r"r� H, c y. �5'�assr,�i,�,� L�r co,� � . Maferial Description (type, gratle, source) ' ' . . - � � Engineer ' �� . ' ' . ` .ST•2. 'Si6'•� SPs�CiAG'TY Si6tL_ � � � - a �-.: ' Confractor � ,.� ': "�a" ?O S72a.�n STsl.�D/32.1� r'�'ICiv`/L Inspector(s) Name - � - - Subconfractor � , .C`�. %iCHEi2 A<.r,u.-.' �'o c,�E,-C ' � � . . �. .' ' . � . � TES4S PERFORMED � � � � � � - . ` TYPE OP SAMpLE �. SLUMP � QUANTITV IN SET - ADDITIONAL REMAHKS ON SAMPLES � . �'u.✓L'>e � � �/� - - . '�r�2 �% " . ; . . .S'� • wo Sers' � �� INSPECTION SUMMARV — LOCATIONS OF WOflK INSPECTED, TEST SAMPLES TAKEN, WORK REJECTED; JOB PROBlEMS, PROGRESS, REMARKS, ETC. - -�� ; INClUDESWFORMATI0NAB0UT-AMOUNTSOFMATERIALPLACEDORWORKPERFORMED,NUMBER,TYPE&IDENT.NO'SOF . '' -..- TEST SAMPLES TAKEN: STRUCT. CONNECTIONS IWELD MADE H.T. BOLTS TORQUED) CHECKED, ETC. �� 'X,; ��. �% i.DE' (/,✓��.—.!o ^ oai/,aGS �''�_<i1R ai` �i=Bi2iI. %��f�D�LC•'i �(a 11AiLS S"i�fL "'��ARvwA.P� %� l. L/i u vi S `'�.�y�Li G�I�� Eiv6' S/�cG'/r/C.� � Lv.vS ; - n 5 j 7� v3 OQS"�Rvr"� f/�L�cFf-r�,�� . �� Y�s /��' i y�o o,�ri, o�t %�Lu 6� v.�i : G -�/2�+C ,' 6/ PNAS� J/ /. C�CARAti'CG�' /`fi0/N'iAJNc� % El� d.J LG. E=lG'<3'. � /Zoar2: sa�s 2/fi� ��L �/r�E oi✓ T�vekS' i,csir��i.�' S%�� s' pj'�d w�Ln ' X' %�R,c�C'k,i?. LR/Jij'�./�LD�' j. t/�.�f%rlJ ,�-,(3D.3—U�o,j —/1GG STf�L � �/I/1J%G!f/1R E ..S'i�EL /2�l.e%�4.2C%N 6' ' /3�v2SS � J . � Yd UTS / D US = � : ,r.J�E �.. '.�/ �a sl ilo.�i' /1i= iL F.v�:,' $'��G' r' � � � � � .. � , ..CEanFiCnnoN OF cOMruaNCE "' - ' , `� CONTINUED ON NEXT PAGE Q. .: � - pAGE - - OF. , - �IHEPEBVCEFTIFYTHATIHAVEOBSEPVED�TOTHEBEST�FMYKNOWLEDGEALLOFTHEAAOVEAEPOFTE�,•,� . TIMEIN TIMEOUT flEG.HOUfIS' O.T.HOUR$ �CYLINDERS " � �' WOflK UNLESS OiHEAWiSE NOTED: I HAVE FOUN� THIS WOAK TO COMPLY WITH THE APPflOVEO PIANS, ' �ny' � ' . �.�•SPECIFICATIONS,�AN�qpp�ICABLESECTI0N50F_iHEGOVEflNINGBUILDINGLAWS. _ . __ �'3� � C7 C/. � —` - 'S/%�'. � • .� �, � All inspections based on a minimum of 4 hours and over 4 hours - 8 hour � �'' ` � ininimum. In addition, any inspection extendln past noon hour will be an 8 �. �-/�� /�� ' SIGNATUflEOFflEGISTEflEDIN$PECiOR �. . hourminimum . ' �� "' , � � �� /'�� .C�Ob�/'�v-'i�c - �.?�;'" ' � ��'„!�lA Aporavedb4.. �l� � � ; t- �.SPECIAL7V ..;j., NO - .-AGENLY.. - � � � : Pwject$up=rintendent �. -�. . - �' t ,.�. .�-- �ti� � '�� : WHI1E � :OFFICE-COPY., CANARY.:`.ACCOUNTING COP.Y, PINK :_ INSPGCTOR'S COPY, GOLDENROD - JOB SITF.�COPY _ �� . � .�.. . li .. • ` . - . . . . �_ ,. . �iY.'M:�, ! , . . . . . . . . . .. �. ��. -. , . . . , . .. ,�. . 'S, ... '.n . '.. ..: '. '� ' . ' . ' . ' . ' _ � . . . ... . � . . . .. . �" � . . ?i -}� •. � _ . . . . -' . . , . . ,' ' , � ,. E �.'- �: - . , � , .. . . . - • . � . . . , � , " Cn�iliai�uu.s bispection fi rYlatei�ials Te'stiii; . , ,'`�`[Cy� A �@y� , - :''^,� %: �'� �;:.. �t .1J'.��JLJL, , V'. tl',. �J �..J� s� �. �,�� ...��..y `r3 ? i.'..:. �. ,t!P" ls�... ::i''a i�s*.. v_ `'• , ;7-: � . . . . .. . _ .. . . . . . Tns ection & Testin inc.: . � � , P g' � [03_6 South ��IorN�alk Bh�d:. Santu Fe�Springs.�CtV )0670 _ � � � ' -_ . (562) 941-2J90 • (714j 526-2�4.41 '. • _ , � � � � FAX (562) 946-0026 , l"o Whom It:May Concern:. Encl.osed you�w.ill find copies of Daily Inspeccion.r�eports and or . Compressive Strength Testing Results for.your jobsite . l/1�7J U�l�� '/{'I� LQCl�'�� Y'roNc�P!�� .. ., We have ; -'�--�.- , _ �::enclosed these copies'.for you� records: ` If you,feei you have received any reports irnerror please return them to, us. _ Also, if you have any qu.estions or'comments, piease do not • - hesitate to call us. . Thank you, ' - Southwest'Inspection & Testing.. � .. . . . _. , .;::•.. ' . � . , � .. s > ;. .,; ; .. � � , � �� . �' � , '. - .;-;:�-;: _ ' ki � . . . . . . . , - . . , . ' ' , . . . � � , � ` i - , .. . , . . . , . 1 .. ' .. . . . . . . . J. � _ ' - . . ' ' ' ' ' . . ' . (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-rt�e�Ee��PRESSION PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3350 VIA PARMA Suite: Vicinity: Parce� Number: TPN003055 Zoning: .4pp�icanr. FIRE SPRINKLER SYSTEMS INC ` Address: 705 E HARRISON ST ' � � SUITE 200 . � � ' Phone: (800) 915-3473 � CORONA. CA'- Zip: 92879 ' Owner. STANDARD PACIFIC Address' �15326 ALTON PARKWAY - � �,. � . . _ . . . Phone: 949-789-1716 .. , �IRVINE, CA� � . � Zip: 92818 . i. Contracror. FIRE SP.RINKLER SYSTEMS INC -Address: 705 E HARRISON ST � ' ' SUITE 200 Phone: (800) 9153473 ' � CORONA, CA Zip: 92879 � - �License: 684600 .� � . . _ � enno� nr oconniT Plan Check: $10871 Permit $167.25 Other: $0.00 Total: $275.96 - - . - - �FEE S Sfatus: ISSUED Applied: OS/04/2004 Issued: OS/OS/2004 ISSUED BY: Calc Valuation: 3a,2ao.00 Claimed Valuatiorr. ga,2so.00 � . � , ` :i,�- . � � " , . . � ' ` _ ��' ��. ' ' � � . � , ,�, - `� _ , _ ; . _ ' NO710E: 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) EXPIRA710N: 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 �1 BO 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 requlred inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit. FOR INSPECTIONS CALL: (714) 7545626 !4a646 (6/00) � WORKERS' COMPENSA710N DECLARATION: � I hereby ettirm under penalry ot peryury one of the following declarations: � I have and will maintain e certifiwie oi consent m sell-Insure for workers' compensetion, es provided lor by section 3700 of the Labor Code, tor the pedortnence of the work tor which Ihis pertnil is issued. ! I have and wlll malntain workers' compensation insurance, as required by saction 3700 of the Labor Cotle, for the pedortnance of the work for which this pertnit is issued. My workers' compensation Insurannce wrner antl pdicy numbar are: //, p�/ Carner. STI{-,T� �/�%✓Ii PolicyNumber. �67��07 ��DO� (This section neetl nat be comp/efetll/ the permit Is valued af one hundred dollers ($100J ar leu.) , ❑ I certify Ihat In the pertormance oF the work tor which this pertnit is issued, I shall not employ eny person in any manner so as to become subject to the workers' wmpensetion laws of California end egree lhat ii I should be me /up lect to Ihe workere' compensatlon provisions of Section 3700 of Ihe LaboppCC ode, I shall lorthwith comply with these provisionsi�� t� �_—`L— �� J, � Applicent Slgnature: i� /` �` Date: U WARNINO: FAILURE TO SEC. UREjW ERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AN� dVIL FlNES UP TO ONE HUNORED hKK15AND DOLLAHE (El OdB00( IN ADDRION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3'lW OF THE 1A80R CODE, ItJrEREST, AND ATTORNE`f5 FEES. LICENSED CONTRACTORS DECLARATON: I hereby eNirm that I am force entl etteci. LJc. A_ Gonirectofs SignaWre: of Chapier 9(wmmencing with Section 7000) of Division 3 oi the Business and Class N -� _ Date: CONSTRUC710N LENDING AGENLV: 0 I hareby aRrtn that ihere is a consiruction lending agency for the performance ot Ihe work for which this permit is issued. (Sec. 3097, Civil Cotle). Lentlers Name: Lender's Address: Signature: Date: Is In tull OWNER•BUILDER DECLARATIONS: I hereby aXirm t�at under penelry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7037.5, Business antl Profeuions Code: Any cily or counry which raquires e permit lo consWct, alter, improve, tlemolish, or repair any strucWre, pnor to its issuance, also requires ihe epplicant for such permit to ille e signed statement thet he or ahe Is licensed pursuant ro the provisions of the Contractors License Law (Chepier 9(commencing with Section 7000) of Division 3 of the Bu5in855 flnd Profeuion9 Code) Or that he or she is exempt iherefrom end Ihe ba5is for the alleged exemption. Any violetian ot Seclion 7037.5 by any applicant tor a pertnit sublects the applicent to e civil penalry of not more than five huntlretl tlollers ($500).): ❑ I, as owner of the property, or my employees wlth wages es their sole compensaiion, WILL DO THE WORK, and the strucmre Is not intended or otteretl for sele (Sec. 7044, Business and Professions Code: Tha Contractors License Law dces not apply to an owner of properry who builds or improves thereon, and who does such work himseli or herseN or thmugh his or her own employees, providetl that such improvements ere not in�ended or ottered for sale. If, however, t�e building or improvement is soltl within one year ot completion, ihe owneo-builtler will have the burden of proving that he or she tlitl no� build or improve for purpose of saleJ. ' ❑ I, es owner oi the properry, am EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRAC70RS to wnstruct the project (Sec. 7044, Business and Professions Gode: The wnirectors License Law tloes not appty to en owner of pmperty who builds or improveslhereon, antl who contrects tor such project wit� a contractor(s) license pursuant to ihe Contrectors License Lews.). , ❑ I em exempt under sec. Business and Professions Cotle tor this reason: Signature: -" �ate: Owner ID verlfied by dnvers licensa. ❑ Ves ❑ No Onver's LiCense No. Vedticetion of Ownership by (type of tlocument, i.e. - pmperty tan bill or tleed): Expires: UIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby canify thet no excavetion Five (5) or more feet in depth into which a parson is required to descenq will be matle in connection with work euthonzed by Ihis permit, and that no builCing swcWre, scattolding, falsework, or demolition or tlismantling thereof, will be more Ihen ihirty-si: (36) fee� high. (G�ap. 3.2, G,ry 2, Art 2, Sac. 341, Ttla 8, Calitomia Adminisirative Code). ❑ As owner-builder, I wiil not employ enyone to do work which would require a pertnit trom the Division of Indusinal Safery, as notetl ebove, unless such person hes e partnit to do such work trom the division. Signature: Date: Division of Industrial Satety Permit Numbar: CERTIFlCATE OF COMPLLWCE AND AIJTMORIZATON OF ENTRY: I certily under penalry ot perjury that I have read this ap0liwtion and stafe that �he informetion given is wrrecL I agree to comply with ell stete laws and ciry ordinances relating to builtling construc�ion, and authonze representatives oi ihe City of Costa Mesa to enier upon ihe ebove-descnbed property tor inspection purposes. I agree not to acupy or allow occupancy ot eny building authorized by ihis permit until tinal inspection. COOE I. INSPECTION TYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spe Finel 200 Finel Re-Rooi 201 FInaI BIocWRelaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Dem0lition PEg INfiTULS !� �� a �, Date COpE1 INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Eleciricel 212 Final Fire Preventian 220 Final Planning Approval 222 Final Site 250 � Finel Building/Occupency D�TE � " / o D 6' (714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.$.�LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3350 VIA PARMA Suite: Vicinity: 3350,3352,3354,3356,3358AND3360 j5C.04%� Parcel Number: TPN003055 npp�icant: LONG, JENNIFER Address: J.L. HARE AND ASSOCIATES SANTA ANA, CA ' 505 N TUSTIN AVENUE SUITE 212 , Owner: STANDARD PACIFIC Address 15326 ALTON PARKWAY IRVINE. CA Contrector: Address: Zoning: Phone: 714-245-9760 Zip: 92705 Phone:- 949-78&1716 Zip: 92618 Phone: Status: ISSUED Applied: 11/24/2003 Issued: 12/03/2003 ISSUED BY: �� ' �� . Zip: License: - � � . . Arch : BASSENtAN/LAGONI ' Eng: RICHARD MOORE/MCE CONSULTANTS Address: 2031, ORCHARD DR � Address:, 1100 S COAST HWY, 318 � SUITE 100 . Phone: 714-553-9100 � Phane: 949-376-6407 NEWPORTBEACH,CA LAGUNABEACH,CA , - � Zip: 92660-0753 � License: C8395 92651 License: C23971 SCOPE OF PERMIT CONSTRUCT NEW 9,476 S.F. 6-PLEX WITH ATTACFiED GARAGES AND 134'S.F.'PORCH/DECK. "BUILDING TYPE -A". BLDG 10 INCLUDES: 3350, 3352, 3354, 33.56, 3358 AND 3360 VIA PARMA - �' � � - � � SEE PA-02d1lf-16416 - 3360/UNIT 59 - 684 SQ FT 1ST FLR, 1023 SQ FT 2ND FLR, 455 SQ FT GARAGE, 11 S� FT PORCH. TOTAL LIVING 1707�SQ FT. (3A) 3358/UNIT 60 - 560 SQ FT 1ST FLR, 917 Sp FT 2ND FLR, 436 SQ FT GARAGE, 4 SQ FT PORCH. TOTAL LIVING 1477 SQ FT. (1AR) 3356/UNIT 61 - 589 SQ FT 1ST FLR, 965 Sp FT 2ND FLR, 436 SQ FT GARAGE, 20 SQ FT PORCH. TOTAL LIVING 1554 SQ FT. (2A) 3354/UNIT 62 - 589 SQ FT 1ST FLR, 965 Sp FT 2ND FLR, 436 SQ FT GARAGE, 20 SQ FT PORCH. TOTAL LIVING 1554 SQ FT. (2BR) 3352/ UNIT 63 - 560 SQ FT 1ST FLR, 917 54 FT 2ND FLR, 436 SQ FT GARAGE, 7 SQ FT PORCH. TOTAL LIVING 1477 SQ'FT. (1B) 3350/UNIT 64 = 684 SQ FT 1ST FLR, 1023 SQ FT 2ND FLR, 455 SQ FT GARAGE, 16 S� FT PORCH. TOTAL LIVING 1707 S� FT. (3BF2) - PIan:Check: . $867.43 Permit: $5,338.00 SMIP Res: $9424 . SMIP Com: $0.00 Other: $0.00 Inspection' $0.00 Total: $6,299.67 - FEE SUMMARY PLANNING & ZONING Calc Valuafion: $9a2,3sa.sa Claim Valuation: ' ,` So.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period o( 180 days. -� " / INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl ell requlred inapections end finel approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaa�w (a�oo) WORKERS'COMPENSATION DECLARAnON: � ' ' . I hereby aHirm under penelry oi peryury one of ihe followinq declarations: . ❑ � I heve and will meintain a certificata ot consent to setl-Insure for workers' compensation, as provided tor Dy section 3700 of t�e Labor Cotla, tor the peAormence of Ihe ork tor which Ihis permit is issued. I have and wlll main in workers' compen C n Insurance,-a required by sectlon 3700 oi Ihe Labor Code, for the partortnance of the work for which this permi�ued. My workers' �nsIatio/n/Insurance � d alicy ber are: /�n� O�� Cerner. G�✓!�l l� I Policy Number. ��V (Th/s secfion need not be com efed i/ the permit is valued o B hundred dollers ($100) or leu.J ❑ I certity lhai In the peAormance of the compensalion lews of Califomla, and comply with these provisions. Appllwnt Signature: 'J WARNING: FAILURE TO SECURE WORKER CG T/KK15AND DOLLARE (E100.000). IN ADDITI T( LICENSED CONTRACTORS DECLARATION: rtnit is is etl, I shall not employ any person in any manner so es to be ome subject lo Ihe workers' ecome s ject to the workers' compensetion provisions ol Section 37 0 of rye La� ode, I shall fotlhwith Date: I 3/ � E IS UNL4WFUL ANO SHALL SUflIECT AN EMPLOVER TO CRIMINAL PENALTIES ANO GVIL FINES UP TOONE HUNDRED iATION, DAfMGES AS PROVIDED f-0R RI SECTION 3]O60F THE LABOR CODE, IMEFEST, ANO ATTORNEI"S FEES. I hereby affirm Ihat I am licensed undar provisions of Chapter 9(commencing with Sectlon 7000) of Division 3 of the Business end Professions Code, end my license Is In full torce and ettect. Lic. q Class # Cantrectofs Signeture: Da[e: CONSTRUC710N LENDING AGENCY: ❑ I hereby ettirm that ihere is e consiruction lending agency For the pedormance ot the work br which this permit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lenders Address: Signawre: Date: OWNER-BUILDER DECLARATIONS: 1 hereby aHirm Ihat untler penalry of perjury that I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which repuires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the epplicant for such pertnit to tile a signetl atatement that he or she is Iicensed pursuant to Ihe provisions of the Contrectors Licensa Lew (Chapter 9(commencing with Section 7000) of Divislon 3 of the Business en� Professions Code) or that he or she is exempt therefrom and the basis for tha alleged ezemption. Any violation of Section 7031.5 �y any applicant tor e permit subjecis Ihe epplicant to e civil penalty oi not more than Bve hundred tlollars ($500).): ❑ I, as owner of ihe properry, or my employees with wages as �heir sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Protessions Code: The Contractors License Law does not appty to en owner ot properry who builds or improves thereon, and who does such work hi self or herself or t�rough his or her own employeas, provitletl ihat suc� improvemenis ere not Intended or oHered tor sele. If, however, �he building or improvement is old wit�in one year of completion, the ownerbuilder will have the burden ol proving that he or she ditl not �uiltl or improve tor purpasa of sele.). I, as owner of tha proper�y, a IVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The crontray �ors se Law tloes ot appry tws.l o an owner oi pmperry who bulltls or improves thereon, and who conirects for suc� project with a contractor(s) license oursQ�o1A o rectors License ❑ I em ew SigneturB: _ Owner ID ven Venflcetion Of _ eusiness and Professions Code for this reason: Date: � ❑ No DnverS LiCenSe N0. Ezpi 1.6. - prOperty �ax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certity ihat no excavaiion tive (5) or more feet in de0�h into which e person is requiretl to descen4 will De made in connection with work authonzed by this pertnit and that no building stmcture, scattolding, falsework, or demolition or tlismantling ihereot will be more than thirty-six (36) feet hlgh. (Chap. 32, Gry 2, Art 2, Sec. 341, TiUe B, Califomie Administrative Code). ❑ As owner-builtler, I will not employ anyone to do work which would require a pertnit from the Division of Industnal Sefery, es noted ebove, unless such person hes e pertnii �o do such work frOm the division. Signawre: Data: Division ot Industnal Safety Permit Number: CEHTIFlCA7E OF COMPIllWCE AND AUTHORRA N OF EMRV: I cenity under penalry ol perjury ihat I have reatl Ihis application entl siate Ihat Ihe information given is correct. I egree to comply with all stete laws and c' ting to building construction, end authonze representatives of the City of Coste Mesa to enter upon the ebove-described property for inspecti�.pmpo�es gr e not to occup or ellow occupancy ot eny 6uilding authorized by ihis permit until final inspeciion. CODE 1. INSPECTIONTYPE 1616 Fixetl System Final Fira Preven�ion 12fi8 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 FinalSign 204 Finel Demolition PAIE 1ti�EL9 LOUEI INSGECTIONTYPE 206 Final Mechanical 208 Finel Plumbing 210 Finel Elec�rical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency PeIE It�ALS :t To: Applicant: Address: Telephone TracUParc Location o Number af Square Feet of: Residential Space Commercial and IndustrialSpace NEWPORT-MESA UNIFIED SCHOOL DISTRICT CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES PURSUANT TO AB 1600 AND AB 181 N° 4924 ( Ciry of Costa Mesa DisUict Receipt No. �,�'Q� ( ) City of Newport Beach I-� ��` ( ) Counry of Orange Plan Check Nc�3. VZv'� CommerciaUlndustrial Project is: (Check One) _ Warehouse R8D _ Movie Theater _ Mini-storage _ Heavy Industrial _ Regional Shops _ Light Industrial _ This project is exempt because 1��x a,.ea x$.30 _ Motel Bank _ Neighborhood Shops _ RacqueUHealth _ Hotel Medical Office Otfice Park Total L1� ��`rJ T Total _ Preschool _ Auto Repair _ Nospital _ Large Oifice _ Office Bldg. _ Restaurant _ Fast Food This certifies that the above-named DevelopedApplicant has paid school facidry fees in comptiance with Government Code secGons 53080 and 65995. The Building Pemils for this square footage in Mis proposed development may now be issued by your jurisdic6on. Checks are to be made payable to NewpoA-Mesa Uni6ed School RapreseMative The above representation as to square (ootage is hue. AppNcant agrees true, then this certificate shall automatically terminate and the ap Date: � �/ e �e determned that such representations are not �Shdll be ��fi�1 ��83/9:38 pN/f 1�435.84 (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 3350 VIA PARMA Suite No Vicinity: BUILDING 10 Parcel Nunmber: TPN003055 Applicant: LONG, JEN Address: Owner: STANDARD PACIFIC � Address 15326 ALTON PARKWAY � IRVINE, CA Contractor. Address: Arch / Eng : Address: Phone: 714-245-9760 Zip: Phone: 949-789-1716 Zip: 92618 Phone: Zip: License: � . . _ . . . . . , . . Phone: Zip: License:, Status: ISSUED Applied: 11/25/2003 Issued: 12/03/2003 ISSUED BY: � �. , �. . � , ', � REF: 602034. 6 UNIT MULTI- FAMILY BUILDING. INCLUDES ADDRESSES: 3350, 3352, 3354, ;� ." � ' ' 3356, 3358 AND 3360 VIA PARMA. - " - , TR 16416, BLDG 10 � �� . - �, PLUMBING WORK TO INCLUDE: 8 BATHTUBS, 6 CONNECT QCE, SODA,-ETC.), 6 DISHWASHERS, 6 . GAS SERVICES, 6 GAS (1-4 OUTLETS), 6 GAS OUTLETS OVER 4, 6.CAUNDRY TUB/WASHER, 6 � PRESSURE REGULATORS, 6 SEWER CONNECTS, 6 SHOWERS, 26 WASH BASINS, 6 KITCHEN SINKS,18 � WATER CLOSETS, 6 WATER HEATERSNENTS, AND 6 WATER SERVICES. "� , " - ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Conned pce,Soda,etc) AMT QTY $23.50 $0.00 0 $0.00 0 $78.40 8 $0.00 0 $58.80 6 FEE SUMMARY AMT QTY Laundry Tub / Washer $58.80 6 Landscape Irngation $0.00 0 P-Trap $0.00 0 Pressure Regulator $58.80 6 Process Piping (per 10 k) $0.00' 0 Receptors $0.00 0 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) AMT �TY $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandonad for a period of 180 days. INSPECTIONS: Ifl O�de� fo� the work authorized under ihis permit to be considered legal, such wOrk rtlust cortlply wifh ell dppllCdblB COdB3, end all required Inspectiona and flnal approval must be obtained. Failure to oblain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 244&46�N00� WORKERS' COMPENSATION DECLARATION: � � • I hareby aRirm un0er penaliy of perjury one of the following tleclarations: ❑ I ve end will maintein e certificate of wnsent to SelFlnsure for workers' Compensalion, as provided for by section 3700 of ihe Lebor Coda, for the pertormence of ihe ork for which Ihis permit is issued. I have entl will eykaln worker ' compensa' msurarRs, as equirgA by section 3700 of the Lebor Cotle. for the pedormance o the work br which this pertnit is issuetl. My workar ' ompensation In ur nce car � d policy nu er ere: G7� /� `� � Cerrier: PolicyNumber. C��U�V/J�� (This section need nof be compl tetl i! (he pe � velued o e hunOretl dallars ($100) oi less.) ❑ I cetlify Ihat in ihe peAo compensatlon laws oi C comply with these provi Applicant Signature: �� WMNING: FAILURE TO SECURE hKK1SAND DOLLRRE (5100.000�. ch NSis p it is isSueQ I shall not emD�oy eny person in any manner so ag to become subject to lhe workers' I �ould b come subject to t�e workere' compensation provisions of Sec on 37P 0 of the Labor Cotle, I shall forthwith Date: � �/ v - l COVERAGE IS IINLAWFUL AND SHALL SUBIEGT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOIXJE HUNDRED F COMPENSATION, DAMAGES AS PROVIpED FOR IN SECTION 31O60F THE LABOR CODE, INiEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm that I am licensed untler provisions of Chapler 9(commencing with Section 7000) oi �ivision 3 oi the Business antl Profeuions Cotle, antl my license Is in full torce entl eNecL Lic. p Class # GontrectoYs Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that there is e construction lending agency for Ihe Dedormance of ihe work for which this permit is issued. (Sec. 3097, Civil Code). Lentlefs Neme: Lentlers Atltlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby flttirm Ihet untler penalry oi perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business end Professions Cotle: Any ciry or counry which requires a pertnit to consiruct, alter, improve, demolish, or repair any stmcture, prior to its issuance, also requires ihe epplicant tor such pertnit to flle a signed statement that he or she is licensed pursuant to the provisions ol the Contrectors License Law (Ghapter 9(commencing with Sectlon 7000) of Divislon 3 oi the Business and Professions Cotle) or that he or she is exempt therefrom and the basis for the allegad exemption. Any violation of Saction 7031.5 by any applicant tor e permit suDjecis Ihe applicant to a civil penalry ot not mora than five hundretl dollars ($500).): ❑ I, as owner ot Ihe property, or my employees with wages as t�eir sole compensation, WILL DO THE WORK, entl the structure is nol intended ar atteretl for sale (Sec. 7044, Business antl Professions Code: The Coniractors License Law dces not apply to an owner ot properry who 6uilds or improves thareon, and who does such work himself or herself or through his o� her own employees, provided that such improvemenis are not intended or ottered for sale. Ii, however, ihe building or improvement is sold within one year of completion, ihe owner-builder will have ihe burden of proving ihat he or she did not build or improve tor purpase oi sale.). I, as owner of the property, am E% SIV TRACTING WITH LICENSED CONTRACTORS �o construct �he projec� (Sec. 7044, Bu5in85s end Profession5 Code: P e contractors " ns s no�ppl'to owner of property who builds or improves ihereon, and who conirads for suc �project wit� e cnntrector(s) license ursuant to a C nse ws. . ❑ I am exempt Signature: _ Owner ID venfied I Verification ot Owr and Professions Code for this reason: is ❑ No Dnver's License No. i.e. - pmperty tax bill ar tleetl): Ezpires: DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby cenity ihat no excavation five (5) or more feet in depih into which a person is required to tlescend, will be made in connection with work euthonzed by this permit, and ihat no building sirucNre, scaHoltling, falsework, or demolition or tlismantling thareot, will be mora than thirry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, TM1Ie 8, Califomia Atlministretive Cotle). � As owner-builder, I will not employ enyone to do work which would require a permit from the Division of Intlustrial Satety, as noted above, unless such person hes e permit to tlo such work irom the division. Signawra: Date: Divislon of Indusirial Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AIJTHOBIZATION OF ENTTiY: I certify under penalty of perjury that I have reatl this application and state Iha� lhe iniormation given is correct. I agree to wmply wlih ell state laws end5jly.cr9iaa¢Ees relating to building consiruction, antl au�honze representatives ot Ihe Clry of Coste Mesa to enter upon ihe ebove-descnbed property lor inspecti u s�. I egree not to� cupy or ellow occupancy of any building authorized by Ihis permit until final inspection. ign Le n ) � � An r �od d AODIiCant Det COOE1, INSPECTONttPE `/ 1616 Flxetl System Finel Fire Prevenqon 1266 Pool SOa Final 200 Final Re-Root 201 FInaI8locWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition UATE I � COOE/ INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 2�0 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuildinryOccupancy PAiE II�ALS 8� � (714) 754-5273 • Fax (714) 754-4856 • Www.ci.costa-mesa.ca.us 77 FAIR DfiIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: 3350 VIA PqRMA BUILDING 10 Parcel Number: TPN003055 Applicane LONG, JEN Address: Owner: .STANDARD PAGFIC Address: � 15326 ALTON PqRKWAY � . IRVINE, CA . Contractor: Address: � � MECHANICAL PERMIT Phone:'714-245-9760 � Zip: Phone: 949-789-1716 Zip: 92618 Phone: Zip: License: ISSUED BV: SCOPE OF PERMIT REF: B03-02034. 6 UNIT MULTI- FAMILY BUILDING. INCLUDES ADDRESSES: 3350, 3352, 3354, 3356, 3358 AND 3360 VIA PARMA. - � . � - - , . � TR 164'16, BUILDING 10. ' • . � Status: Applied: Issued: MECHANICAL WORK TO INCLUDE: 6 A/C COMPRESSORS UP TO 3 HP, 6 FAU'S LESS THAN 100 K BTU, 24 VENT FANS, 6 APPLIANCE VENTS, 6 FACTORY FIREPLACES. ISSUE,FEE . Inst FAU p100 k 8TU ,. Insl FAU >100 k 8TU Repair / Alt Cooling/Heat Inst/Rep>RecessWallHtr � Refrig Sys <100 k BTU , ' Refrig Sys >100 k BTU Gas Piping � , , Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance � Fire Dampers �. Smoke Dampers ' Inst or Relocate Appl Vent Air Handlers < 10000chn Air Handlers > 10000cfm Floor Furnace Floor or Suspend Heater Quantity $23.50 $88.g0 6 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00-�:•,0 - $0.00 0 $63.g0 6 $0.00 0 $0.00 0 $174.00 24 $0.00 0 $0.00 0 $0.00 0 $63.90 6 $0.00 0 $0.00 0 $0.00 0 $0.00 0 FEE SUMMARX Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit ...Ventillation System �� -' - �' � Evaporative Cooler , . � - � Commercial Incinerator ' � Domestic Incinerator " , , Campressors % Absorption, SYstems - � � Upto3hp/100kBTU - , 3To15hplSOOkBTU „ 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU ; Boilers - � ,�.-.. Upto3hp - 3To15hp , - - 15to30hp - - , 30 to 50 hp . Over 50 hp Other Mechanical Fee � Invesligation Fee ISSUED 11/25/2003 12/03/2003 - - _Quantity • $0.00 0 $0.00 0 = ' � � $0.00 0 � , . : ` $0.00 0' $0.00 0 $0.00 0 $0.00 - 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 ! $8820 $0.00 $0.00 $0.00 $0.00 $0.00 6 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and ralated 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. � INSPEC710NS: !n order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable calas, and a11 requlred Inapectiona 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) 7545626 zaasa6 (s�oo) WORKERS' COMPENSATION DECLARATION: � � I hereby attirm untler penalry of perjury one oi the following tleclarations: . 0 1 heve end will malntain a cenificate ot consent to self-Insura for workers' compensation, as provided for by section 3700 ot the Labor Code, for the pertortnance o1 the work to which t�is permit is issued. ava antl will mainfain workere' compery�lion insurenc , as requiretl by section 3700 of the Lebor Cotle, for the pedortnance oi t e ork For which Ihis pa it is i ued. Carrier. (This section need nof be c plete ❑ I cenity that in Ihe pedormanc compansalion laws of Califon comply with ihese provisions. Applicant Signature: ' WARNING: FAILIIRE TO SEGURE W THOUSAND DOLLARE (5100.000), IN D[ antl po i wmber are: {� T�// .`�J� Policy Number: _ � �'�-�� '�� / : va/ af o hundred Collars ($100) or /ess.) ich lhi5 per iI is issued, I shall not empl0y eny person in eny manner so as to become sy bject to the workers' uld be ome sub'ect to [he workers' compensation provisions of Section 3700 ot t/p§ Wbo Code, I shall fort�with Date: I �/��OT_ 4T COVERAGEISUNLAWFULANDSHALLSUBJECTANEMPLOVERTOCRIMINALPENALTIES�ANDQVILFlNESUPTOONEHUNDRED T OF fAMPENSATION, DAMAGES AS PROVIDEO FOR IN SEGTION 3]O60F THE IABOR CODE, IhTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I �ereby attirm thet I am licensed under provislons of Chapier 9(commencing with Section 7000) of Division 3 of the Business and Professions Cotle, end my license is in tull force antl eHect. Lic. q Class x Conlractors Signeture: Dete: CONSTRUCTION LENDING AGENCV: ❑ I hereby affirtn that there is a consimction lentling agency for the peAormance of the wotic for which �his permit is issued. (Sec. 3097, Civil Code). Lenders N9m8: LBndefS Addre55: Signature: Date: OWNER-BUILDEF DECLARATIONS: I hereby affirtn that under penalry oi perjury that 1 am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the lollowing reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or county which requires a pertnit to consirud, elter, improva, demolish, or repair any sWCNre, prior to its issuance, also requires the applicant for such permit to file e signed stetemant that he or she Is Ilcensed Dursuent lo the provisions ol Ihe Contractors License Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 of the Business antl Protessions Code) or that he or she is eaempt iherafmm and ihe besis lor ihe alleged examption. Any violation oi Sedion )031.5 by eny epplicant for e permit su6jects the applicant to e civil penaliy of not more than five hundred tlollars (5500).): ❑ I, as owner of the propeny, or my employees with wages as thelr sole compensation, WILL DO TME WORK, and Ihe sWdure is not intendetl or oHeretl for sale (Sec. 7044, Business and Professions Code: The Coniractors License Law dces not apDly to an owner of proparty who builtls or improves thereon, end who does such work himsetl or herseli or thmugh his or her own employees, providetl that such impmvements are not intended or oHered for sale. If, however, iha builtling or improvemant is d wit�in one year of completion, the owner-builder will heve ihe burden of proving ihat he or she ditl no� build or improve tor purpase af sale.). I, as owner ot the property, e CC SIYE CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 70d4, Business antl Protessions Cotle: The coniractor w tloes not ep ly to an owner ot property who builds or improves Ihareon, and who contracts for such project with e contrector(s) license pursuan o! a r Li nse Lew .). ❑ I am exemp r Business end Prof855ions Code tor �his reason: Signature:� Expire5: Vedficatlon of Ownership by (tfpa�6f document, i.e. - properry tax bill or tleed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cenify Ihet no excavetion five (5) or more feet in depth into which a person is requirad to descentl, will be made in connection with work euthorizetl by this permit, and Ihat no building siructure, scalfolding, ffllsework, or demolition or dismantling thereoi, will be more ihan thirry-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Ttle B, Celifornie Atlminisirative Coda). ❑ As owner-builder, I will not employ enyone to do work which would require a permit irom ihe Division ot Intlustnal Satety, as noted abova, unless such person �es e permit to do such work from the division. SignaNre: Date: Division of Intlustrial Satery Permit Number. CERTIFlCATE OF COMPLIANCE AND AUTHORVATON OF EHTRY: I certify under penalry of perjury that I have reatl this application end siate t�at the inFortnation given is correct I agree to comply wi�h ell state laws end ciry ordinances relating to builtling consiruction, and authorize representatives of t�e Clty of Costa Mesa to enter upon iha above-descnbed property for Inspection purposes. I agree not to occupy or altow occupancy of any building euthonzetl by this permit until finel inspection. SQOE L INSiELTONTYPE I 1616 Fixetl System Final Fire Prevention 1268 Pool Spe Final 200 Finel Re-fiooi 201 Finel BIocWRetalning Wall 202 Final Faqory Fire Place 203 Finel Sign 204 Final Demolition �� § LOOEI INSFECTONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Electrical 212 Final Fire Prevenlion 220 Finel Planning Approvel 222 Final Site 250 Final Building/Occupancy �. 1 1111. i � tt N (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��sCTRICAL PERMIT %� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber. 3350 VIA PARMA A BUILDING 10 - HOUSE METER TPN003185 Applicant LONG, JEN Address: 505 NORTH TUSTIN AV SUITE 272 , , SANTA ANA, CA Owner:� STANDARD PACIFIC Address" 15326 ALTON PKWY IRVWE, CA , " Contractor: Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 uniGs) New Res (3+units) Pool / Spa Lighting Fizts Recept Outlets Switches Non Res Appl ' ` Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Fhone: 714-245-9760 Zip: 92705 Phone: 949-789-1716 Zip: 92616 -Ptione: Zip: License: Status: ISSUED Applied: 11/25/2003 Issued: 11/25/2003 ISSUED BY: � . _ ' �A � ` � �� , , � . . , . , , ,�. � � < SCOPE OF PERMIT HOUSE METER FOR BUILDING A. FEES PAID UNDER PERMIT NUMBER E03-01108. PERMIT FOR METER RELEASE AND TRACKING ONLY. REF: 803-02035. -'- $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 � $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 0 0 `0 0 0 0 0 0 0 0 0 0 0 0 0 Temp Dist System / Lighting Busway /100 k. Standing Section Misc Electrical Equipment '� Transformers up to 1 kva/kw .. �` `� � ................up to 10 kva/kw ....:.t� .� .� ..............:..updo 50 kva/kw �� .................up to 100 kva/kw-: � .........:........over 100 kva/kw " . Low Volfage Equipment Low Voll Wiring System / Ckt Misc. Conduil Misa Conductor - Circus ( gen or ride) Circus (mech ride �or liqhts) ' . Christmas Tree Stand � . Fireworks Stand � Other Electrical Fee Investigation Fee � Plan Check Fee Quantiry "- " $0.00 0 $0.00 0 �- � � $0.00 0 �.� - , � ' $0.00 0 - ,' .' , $0.00 �' 0 , , . $0.00 :�. �'p. . $0.00 � - , 0 . . $0.00'- � 0 � " $0.00 0 $0.00 ' 0 � $0.00 0 ' $0.00 0 , $0:00 , 0 � -$0.00 , -0�� . . $0.00 � 0- $0.00 , ' 0 $0.00 0 $0.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements unde� 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 7 BO days, or if work is suspended or abandoned for a penod 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 ot this permlt. FOR INSPECTIONS CALL: (714) 7545626 2446d6 (6/00) WORKERS'COMPENSArON DECLARAnON: ` — I herehy attirm untler penalry ot perjury one oi ihe following declarations: � . ❑ I heve and will mainlain a cenificate of consent b self-Insure for workers' compensetion, as provitlatl for by section 3700 of iha Labor Cotle, lor the pertormence ot ihe work for which this permit is issuad. ❑ I heve and will malntain workers' compensatlon insurance, as requiretl by section 3700 ot Ne Lebor Code, for the peAortnance ot Ne work tor which this pertnit is i5sue0. My workers' compensation Insurence wrder entl policy numbe� ere: Cartier: Policy Number: (This sectlon neeU not be completed i! fbe permi! is velued at one hundred dollars ($100) or less.) ❑ I certity Ihat in ihe peAormance of the work for which this permit is issuetl, I shall not employ any person in any manner so as to become subjea ro the workers' compensetion laws ol Celifomla, entl agree that if I should become sub�ect to the workers' compensation provisions of Section 3700 oi the Labor Code, I shall fort�with comply wiih Ihese provisions. Applicant SignaNre: Data: WARNING PAIWPE TO SECURE WORKERS' CO'dPENSAiION CAVERAGE IS UNLAWFUL AND SHP1L SUBJECT AN EMPLOVEF TO CR�MINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED TFKKISAND DOLLARE (5100,000), IN ApDITION TO THE COST OF CQNPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]O60F THE UBOR CODE, IMEHEST, AND NTTORNEI"S FEES. LICENSED CONTRACTORS UECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Protessions Code, end my license is in full force and ettecL Lic. # Class x Comractors SignaWre: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby atfirm thet there is a wnsiruction lending agency for the performance of the work for which this permii is issued. (Sec. 3097, Civil Code). Lenders Name: Lentler's Aadress: - Signawre: Date: OWNER-BUILDER DECLARA710NS: I here6y eHirtn Ihat untler penalry of perjury that I am E%EMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end ProfeSsions Cotle: Any ciry or counry which requires a permit to conswa, alter, improve, tlemolish, or repair eny structure, prior to its issuance, also requires the epplicant for such permit to tile e signetl statement thet he or she is licensed pursuant to the provisions ot ihe Coniractors license Law (Chapter 9(commencing with Sectlon 7000) of Divisian 3 ot the Business and Professions Cotle) or that he ar s�e is ezempt therefrom and the basis tor the ellegetl e:emp�ion. Any violetion of Section 7031.5 by any epplicant for e pertnit subjects the applicant to a civil penalty of not more Ihan five hund�ed dollars ($500).): ❑ I, es owner ot Ihe properry, or my employees with wages es their sole compensation, WILL DO THE WORK, and the structure is not intentletl or offered for sele (Sec. 7044, Business and Professions Cotle: The Contractors License Law dces not apply to an owner oi properry who builds or improves Ihareon, and who tloes such work himself or herseH or ihrough his or her own employees, provitletl that such improvements are not intentletl or oHeretl tor sale. Ii, however, Ihe building or improvement Is sold within one year of complation, ihe owner-builder will have ihe burden of proving Ihat he or she did not builtl or improve for puryose oi saleJ. ' ❑ I, es owner of lhe pro0erty, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Protessions Coda: The contrectors License Law tloes not apply to en owner ot properry who builds or improves thereon, and who contrects for such prolect with a contrector(5) license pur5uan� to ihe ContraCtors LicenSe LewS.). ❑ I am exempt under sec. Busineu antl Protessions Code for this reason: Signature: Date: Owner ID verified by dnvers license. ❑ Ves ❑ No Drivers Licensa No. Verification ol Ownership by (type of daument, i.e. - pmperty tax bill or deed): Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CEFTIFICATION: ❑ I hereby certify that no axcavetion five (5) or more faet in depih into which a person is required to descend, will be mede in connection with work authorized by Ihis parmit, and that no building stmcture, scettolding, falsework, or demolition or dismantling Ihereoi, will be more ihan thirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia ACministrative Cotle). ❑ As owner-bulltler, I will not amploy enyone to tlo work which would require e permit irom the Division of Indusirial Safety, as notetl above, unless such pereon has e permit to do such work from the tlivision. Signature: Date: Division ot Industnal Sefery Permit Number. CERTIFlCA7E OF COMPLIANCE AND AUTHORVJ1T10N OF EMAY: I cenify untler penalty of perjury Ihat I have reaa this appllcation and state ihet the intormatlon given is correa. I egree to comply wlth ell state laws and ciry ordinances releting to building consWction, and authorize representatives of Ihe Clty of Coste Mesa to enter upon the abwe-descnbetl property for inspection purposes. I agree not to occupy or allow acupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) AnNOr Authonzetl Applicant COOE �. INSPECTIONTYPE 1616 Fiaed System Finel Fire Prevention i2es Pool Spe Final 200 Finel Re-Roof 201 FInaI BIocWRetaining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demoli�ion Q�IF L�L$ COUE I INSGECTION TYPE 206 Final Mechanical 20B Flnal Plumbing 210 Final Eleqrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency p9IE Iti�L4 (714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.��SCTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: 3350 VIA PARMA BUILDING 10 TPN003055 ,app�icant: LONG, JEN Address: Owner: STANDARD PACIFIC Address ' 15326 ALTON PARKWAY � IRVINE, CA- Contractor: Address: Phone: 714-245-9760 Zip: Phone: 949-789-1716 Zip: 92618 Phone: ZiP: .. License: Status: ISSUED Applied: 11/242003 Issued: 12/03/2003 ISSUED BY: � SCOPE OF PERMIT , REF: B03-002035 - NEW 6 UNIT MULTI- FAMILY BUILDING. INCLUDES ADDRESSES: 3350,3352,3354,3356,3358 AND 3360 VIA PARMA: �� TR 16416, BLDG 10. ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a ELECTRICAL WORK TO INCLUDE: 6 LIGHT FIXTURES, 12 RECEPT-OUTLETS, 6 SWITCHES, 1- 1000 AMP SERVICE, AND 7- 200 AMP SUB PANELS. RES ELECTRICAL S�UARE FOOTAGE IS 9566 � S�. FT. INCLUDES SUB PANEL FOR HOUSE METER. HOUSE METER IS ADDRESSED AS 3350 A VIA PARMA. $23.50 $0.00 $0.00 $0.00 $478.30 $0.00 $6.60 $13.20 ss.so $0.00 $0.00 $0.00 $62.15 $0.00 Quantity '�'' 0 9566 0 6 , 12 6 0. 0 0 1 0 Temp Dist System./ Lighting:; Busway /� 00 ft - ' - Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up l0 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw . ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit � Misa Conductor � Circus ( gen or ride) Quantity $0.00 � 0 $0.00 0 so.00 � o $0.00 0 $0.00 0 $0.00 0 $0.00 -�0: � $0.00��- �0-- $0.00 ,-'0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 NOTICE: The work authorized by ihis 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 780 days, or if work is suspended or abandoned for a period of 180 days. / ' INSPECTIONS: In order for the work authorized undar this permit to be considered legal, such work must compy with all applicable codes; and all required Inspections and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2A464fi (&00) WORKERS'COMPENSAnON DECLARAnON: — ' ' I hereby aRirtn under penalry of perjury one oi the following declarations: I have antl will maintain a certitiwte of consent to setl-Insure tor workers' compensation, as provided tor 6y section 3700 of the Labor Cotle, for the pertormence of �he work for which ihis permit is issued. I have and will maintain workers' corype nsatlon insurance, as required by section 3700 ot ihe Labor Code, for the pertortnance of the work for which this permil is issued. My worke pensatl n Insuryfc9 cartier anA' 61icy num . /�� J� "7��f cema�: �".�Q PP ;� PolicyNumber: C��[ / (This sectron need nof be mp e etl B the permR �5 af one hundred Oollars ($100) or leu.) ❑ I certiTy that in ihe perfortnance compensation laws ot Calif � comply with these provis Appliwnt SignaWre: WAfiNINO: FAILURE TO SEC FE WORKE TFIOUSAND DOLLAHE (E100, , IN�DDI' which thi ermit is issued, 1 shall not employ any person in any manner so as t become subject to the workers' 1 ii 1 shoul become subject to ihe workers' compensation provisions ot Sectio 3700 oi the Labor Cotle, I shell torthwith � Date: ION COVERAGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMI ENAL ES AND CIVIL FlNES UP TOIXJE MUNDRED �T OF CAMPENSATIIXJ, DPMAGES AS PFOVIDED WR IN SEGTION 31060F THE LABOii COOE, IMEREST, AND ATTORNE`f5 FEES. LICENSED CON7RACTORS DECLARATION: I hereby attirm ihat I am licensed untler provisions of Chapter 9(commencing with Seciion 7000) of Division 3 of the Business and Prolessions Code, and my license Is in full �i lofcd�antl eC LiC. q Cleu k Con ra o igna Date: CONSTRUCTON LENUING AGENCY: ❑ I hereby aKrm thet there is a consiruction lentling agency for the pertormance of the work for which ihis permit is issued. (Sac. 3097, Civil Cotle). Lendefs Name: Lentler's Atltlress: SigneWra: Date: OWNER•BUILDER DECLARATIONS: I hereby eXirtn thet under Oenalry ot perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business antl Protessions Code: Any city or counry which requires a pertnit to construct, alter, improve, demolish, or repair eny structure, pnor to its issuance, also requires the epplicant for such permit to flle e signetl stetement Ihat he or she is Iicensed pursuant to the provisions of the Contractors License Law (Chepter 9(commencing wiih Sectlon 7000) of Division 3 oi tha eusiness end Professlons Cotle) or ihat he or she is exempt therefrom and the besis for Ihe elleged exemption. Any violetion of Sectian 7031.5 by eny epplicant for a pertnit subjects ihe applicant to a civil penalty of not more than five huntlretl dollers ($500).): ❑ I, as owner ol the property, or my employees with wages as iheir soie compensation, WILL DO TME WORK, ena Ihe structure is not intentletl or offered for sale (Sec. 7044, Business an0 Professions Code: The Coniractore License Law does not apply to an owner of property who builds or improves iheraon, antl who tloes such work himsell or herselt or ihrough his or her own employees, provided ihat such improvements are not intended or olfered for sale. If, however, the builtling or improvement is �sold within one year of completion, the owner-builder will have the burden oi proving thal he or she tlid not build or improve for purpose ot sale.). I, as owner of the propert , am E) 61VEC7'9 TRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business and Prolessions Cotle: Tha conlrec ice tl'es not apply en owner of property who builds or improves thereon, end who coniracis for such projeci with e contractor(5) licen58 pursuant e Co e Laws.). ❑_ I am exempt u tler s. Business end Protessions Code for this reason: _ � Signature: � / ! �� Expir�� Verificatian of Ownership by (type of ument, i.e. - propeny tax bill or tleed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATON: ❑ I hereby certity Ihat no e:wvation five (5) or more feet in depih into which a peroon is requlretl to tlescend, will be made in connection with work authonzetl by ihis pertnit, and Ihat no building structure, sca%olding, falsework, or demolition or dismantling thereof. will �e more ihan thirry-six (3fi) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle B, Calitornia Adminlsirative Code). ❑ A5 owner-builder, I will not employ enyone to do work which would require a permit irom the Division ot Intlustrial Satety, as notetl above, unlau such person hes e permit to do such work from the division. Signawre: Date: Division of Industnal Safery Permil Number: CER7IFlGATE OF COMPLUWCE AND AUTH�Oy1ZAAL1[iOF EMAY: I certity untler penalry of perjury Ihat I �ave reatl this application end steie ihat t�e information qiven is wrrecL I agree to comply with all st s and ciry ortlin�e elating to building constmction, end euthorize representatives of t�e Ciry of C0.5ta Mesa to enter upon Iha ebove-descnbed property for i ion rposye� I egree not to�or allow occupency of eny building authorized by Ihis pertnit until Final inspection. COUE I. INSiELTWNTYPE 1616 Fixed System Final Fire Praventlon 7286 Paol Spa Final 200 Final Re-Root 201 Fina1 BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition PAIE R+�.�4 COUE� INSPECTIONTYPE 206 Final Mechanical 208 Finel Plumbing 210 Finel Electrical 212 Final Fire Prevenlion 220 Final Planning Approval 222 Final Site 250 FinalBuilding/Occupency 8 S-aY � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��sCTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 3350 VIA PARMA Status: ISSUED Suite No A Applied: 11/25/2003 Vicinity: BUILDING 10 - HOUSE METER . - Issued: 11/25/2003 Parcel Nunmber: TPN003185 Applicant: LONG, JEN Addr@ss: 505 NORTH TUSTIN AV. � SUITE 212 . � , _ SANTA ANA, CA: � � Owner.,�STANDARD PACIFIC Address- �15326ALTONPKWY -��.-�� / � � ,' � IRVINE,CA�i� COli�(dC�OC Addr�ss: ISSUE FEE Temp service test Res; a/c package New Res (1-2 units) New Res (3+unit�) Pool / Spa � , . Lighting Fixts , Recept OutleLs� Swilches � � Non Res Appl ,� ` � Res Appl Service to 200a Service to 1000a �� Service over 1000a Motors to 1 hp Mators to 10hp Motors to SOhp Motors to 100hp Motors over 100hp Communication tlrops Sub panel to 200a ISSUED BY: Phone: 714-245•9760 Zip: 92705 - � � �. _ '. -. � - . . � � `. , � ��;,� � .�� ,� Phone: 94&789-1716 . � . � � . � j�- �,; , Zip: 92618 • �, �� -. � � " . ' � - � � � ` v • \ V� ' . � . : � � � . . � `., � . � . �-Phone: � � , � ' . . . Zip: . . ` . , . � � � � � License: � . • . , �. �, ' . _ SCOPE OF PERMIT HOUSE METER FOR BUILDING A. FEES PAID UNDER PERMIT NUMBER E03-01108. PERMIT FOR ; METER RELEASE AND TRACKING ONLY. REF: B03-02035. �- � - - ' . $0.00 $0.00 $0.00 $0.00 $0.00 , $0.00 . '.��:$0.00 � � $0.00 $0.00 , $0.00 � $0.00 $0.00 $0.00 $0.00 $0.00 � $0.00 ' $0.00 $0.00 $0.00 $0.00 $0.00 FEE SUMMARY � � Quantily . ' ' ' - - -- Quantity � . � , � ; 0 0 0 0 0 _.,0 0 0 . 0 0 0 0 0 � .- , 0 0. .,.p . 0 Temp Dist System / Lighting $0.00 0 . � � - � � Busway /100 ft �. $0.00 0 : , ,� - ' � � Standing Section � $0.00 0� ' __ - , � � Misc Electrical Equipment 50.00 .0; �; � , _ � ; �.Transformers up to 1 kva/kw 50.00 �,`,�0, � - � � •... � ..'.�..�� ................up to 10 kva/kw $0.00 . .� 0 �, ,� i � .r .�t �^. >' � .................up to�,50 kva/kw $0.00 �;=". 0 , ' � . .... :...........up to 700 kva/kw �= ,$0;00'/ 0 '• . �, � ' . ::................over 100 kva/kw � � $0.00� 0 - ' � Low�VOltageEquipment �.$0.00 " 0 "j� -Low Volt Winng System / Ckt' � . $0.00' '� 0 . Misa Conduit � - '� $0.00� � - 0" , � Misa Conductor � . $0:00" 0 � Circus ( gen or ride) ��$0.00� -0� j"� _ Circus (mech ride or lights) �. -$0.00' �; 0. Chnstmas Tree Stand` $0.00 " '0 � , � �� Fireworks Stand� $0.00 -� � 0 Other Electrical Fee � �, " $0:00 , Invesfigatlon Fee � � : � � $0.00 Plan Check Fee $0.00 � 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 780 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 appllcable codes, anC all requlred inapeetfons end final approval must be obtained. Failure to ob(ain inspections and final approval will result in the expiration of lhis permil. FOR INSPECTIONS CALL: (714) 7545626 241&<fi (N00) WORKERS'COMPENSAnON DECLARAnON: � � ' • I hereby aflirtn under penalry of perjury one of the followinq declarations: _ ❑ I have end will maintain a certificate of cnnsent co self-Insure for workers' compensation, as provided for by section 3700 ot Ihe Lebor Cotle, for the pertormance of the wOrk �or which thi5 permit is issued. _ ❑ I have antl will maintein workers' compensa[ion insurance, as required by section 3700 of [he Lebor Code, tor the perfortnance oi Ihe work for wh�h this pertnit is Issued. My workers' wmpensatlon Insurance carner and policy number are: Carrier: Policy Number: (Th/s sectlon neetl not be cromplefed i/ the permit is valuetl at one Aundred tlollers ($100) or less.) ❑ I cenity that in ihe Dedormance of Ihe work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to ihe workers' compensetlon lews of Califomie, entl egree that H I should become subject to the workars' compensation provisions oi Section 3700 of Ihe Lebor Code, I s�all forthwith comply with these provisions. Applicent SipneWre: Dete: WARNING: FAILURE TO $ECURE WORKERS' C/JMPENSATION COVEMGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CFIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED T/qUSAND DOLLARE (810p,00p), IN ADDITION TO THE COST OF COMPENSATION, DPMAGES A$ PROVIDE� FOR IN SECTION 3]O60F THE LABOF CODE, INTEREST. AND ATTORNEY'S FEES. LICENSED CONTRACTOHS DECLARATON: I hereby attirm Ihat I am licensed under provislons of Chapter 9(commencing with Seciion 7000) of Division 3 oi ihe Business antl Professions Coda, and my license Is In tull ' force and eHecc Lic. a Cless q ContractoYs Signawre: Da[e: CONS7RUC710N LENDING AGENCV: . ❑ I hereby aHirm ihet there Is e consiruciion lentling agency for the pedormance of the work for which this permit is issuetl. (Sec. 3097, Civil Cotle). Lendefs Name: LenGer's Atltlress: Signawre: - Date: OWNER-BUILDER DECLARATIONS: I hereby affirtn that untler penalry of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business entl Profeuions Cotle: My ciry or counry which requires a permit to construc6 alter, improve, demolish, or repair any sWcture, prior to its issuance, also requires Ihe epplicant for such permit to tlle e signed statement tha� he or she is Ilcensed Dursuant to ihe provisions of the Conirectors License Lew (Chapter 9(wmmencing with Section 7000) of Division 3 of the Business end Professions Cotle) or ihat he or she is exampt tharefrom antl the basis for the alleged exemption. Any violation of Section 7031.5 by eny applicant for e pertnit sub�ects t�e applicant to e civil penalry of not more ihan five hundrad dollars ($500)J: ❑ I, es owner of the property, or my employees with wages es Iheir sole compensation, WILL DO THE WORK, and the siruclure Is not intentletl or ofleretl for sale (Sec. 7044, Business and Professlons Coda: The Coniractors License Law does not apply to an owner ot propeRy who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided Ihai such improvemenis are not Intended or oNered for sale. If, however, ihe building or improvamen� is sold withln one year of completion, ihe owner-builder will have ihe burden of proving that he or she ditl not 6uild or improve tor purpose ot sale.). ' ❑ I, as owner ol the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business and Professions Code: The conirecbrs License Lew does noi appry to an owner oi properry who builds or improves thereon, and who contrects tor such project with a contrector(s) license pursuam to tha Contrectors License Lews.). ❑ I am exempt under sec. Business antl Proteuions Code for this reason: Signatura: Date; Ownar ID venfietl by dnvers license. ❑ Ves ❑ No �rivers License No. Expires: Veriticatlon oi Ownership by (type of tlocument, i.e. - property taz bill or deetl): DIVISION OF INDUSTRIAL SAFETV PERMR CERIIFICATION: ❑ I hereby certify ihat no exwvetion five (5) or mora feet in depih into which e person is required to descend, will be made in connection with work authonzed by this permit, antl that no builtling siructure, scaHolding, falsework, or demolition or dismamling Ihereoi, will be more ihan thirty-six (36) feet hig�. (C�ep. 32, Gry 2, Atl 2, Sec. 341, Ttle B, Calilamia Administretive Cotle). ❑ As owner-builder, I will not employ enyone to Go work which would require a pertnit from the Division of Indusirial Setary, es notetl ebove, unless such person has e permit to do such work fmm the division. SignaNre: Date: Division of Industrial Satery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORVATION OF ENTRY: 1 certify under penalry of perjury that I hava read ihis application antl state that the infortnation given is correct. I egree to compty with ell state laws and city ortlinances relating m building construction, and authonze reprasentatives o1 the Ciry ot Costa Mesa to enter upon Ihe ebove-descnbed property for insDection purposes. I agree not to occupy or allow occupancy of any building euthorized by this permit until final inspection. Slgnature Ot Legal Owner(s) Date AnNOr Authodzed Applicant Dale COOE t. INSPECTIONTYVE 1616 Fixed System Final Fire Preventlon 1266 Pool Spa Final 200 Final Re-Rooi 201 Final Block/Retaining Well 202 Final Fectory Fire Place 203 Finel Sign 204 Final Damolition Q�j�, � ' I�TQj9L� �� MSPEGTONTYPE � 206 Final Mechanical 20B Final Plumbing 210 Final Eleclrical 212 Final Fire Prevenlion 220 Final Planning Approval 222 Final Site 250 Finel Builtling/Occupancy ��