The URL can be used to link to this page

Home My WebLink About3350 VIA SIENA - Building Permitsa May 12, 2003 G� i'Y OF COSTA MESri P.O. BOX lTaa • 77 FAIR DRIVE • CALIFORNIA 92628-1200 DEVELOPMENT SERVICES DEPAR7MEN7 To: Building Safety Division Code Enforcement Communications County Clerk County Planning and Dev. Services County Registrar of Voters County Tax Assessor Engineering Division (2) ESRI Fire Admin. - Training Officer Fire Admin. - Mark Brown (Station 6) Fire Prevention Irvine Ranch Water District Mesa Consolidated V�,'ater District OLD ADDRESS 1325 Sunflower Avenue AT&T Broadband Newport-Mesa Unified School. Dist.(2) Pacific Bell Police Dept. - Planning & Research Sanitary District Engineer Sanitation Division Office So California Edison Company Southern California Gas State Board of Equalization U. S. Post Office - AIS U. S. Post Office, Adams Thomas Brothers File (2) NEW ADDRESS 3351 Via Merano 3353 Via Merano 3355 Via Merano 3357 Via Merano 3359 Via Merano 3361 Via Merano 3363 Via Merano 3350 Via Trentino 3351 Via Trentino 3352 Via Trentino 3353 Via Trentino 3354 Via Trentino 3355 Via Trentino 3356 Via Trentino 3357 Via Trentino 3358 Via Trentino 3359 Via Trentino 3360 Via Trentino 3361 Via Trentino A. P. NO. 140-Q41-6� Builtling Division (714) 754-5273 • Code enforcement p1a) 754-5623 • Planning Division �714) 754-5245 FAX (7�a) 75a-aB56 • TDD (7�a� 75a-52aa • �.ci.casta-masa.ca.us OLD ADDRESS 1325 Sunflower Avenue NEW ADDRESS 3350 Via Parma 3352 Via Parma 3354 Via Parma 3356 Via Parma 3358 Via Parma 3360 Via Parma 3351 Via Siena 3353 Via Siena 3355 Via Siena 3357 Via Siena 3359 Via Siena 3361 Via Siena 3350 Via Siena 3352 Via Siena 3354 Via Siena 3356 Via Siena 3358 Via Siena 3360 Via Siena 3351 Via Tivoli 3353 Via Tivoli 3355 Via Tivoli 3357 Via Tivoli 3359 Via Tivoli 3361 Via Tivoli 3352 Via Tivoli 3354 Via Tivoli 3356 Via Tivoll 3358 Via Tivoli 3360 Via Tivoli 3362 Via Tivoli 3364 Via Tivoli 3366 Corte Cassis 3368 Corte Cassis 3370 Corte Casshs 3372 Corte Cassis 3374 Corte Cassis 3376 Corte Cassls 3378 Corte Cassis 3380 Corte Cassis 3382 Corte Cassis 3384 Corte Cassis 3386 Corte Cassis 3388 Corte Cassis 3364 Corte Cassis A. P. NO 140-041-60 OLD ADDRESS 1325 Sunflower Avenue NEW ADDRESS 3367 Corte Levanto 3369 Corte Levanto 3371 Corte Levanto 3373 Corte Levanto -- �3375 Corte Levanto 3377 Corte Levanto 3379 Corte Levanto 3365 Corte Levanto 3366 Corte Levanto 3368 Corte Levanto 3370 Corte Levanto 3362 Corte Levanto 1336 Corte Venosa 1334 Corte Venosa 1332 Corte Venosa 1330 Corte Venosa 1328 Corte Venosa 1326 Corte Venosa 1328 Corte Maitera 1326 Corte Maltera 1324 Corte Maltera 1322 Corte Maltera 1320 Corte Maltera 1318 Corte Maltera 1316 Corte Maltera 1314 Corte Maltera 1312 Corte Maitera 1310 Corte Maitera 1308 Corte Maltera 1306 Corte Maltera 1304 Corte Maitera 1302 Corte Maltera 1300 Corte Matlera 1323 Corte Maltere 1321 Corte Maltera 1319 Corte Maltera 1317 Corte Maltera A. P. NO 140-041-60 OLD ADDRESS 1325 Sunflower Avenue NEW ADDRESS 1315 Corte Maltera 1313 Corte Maltera 1311 Corte Maltera 1309 Corte Maltere 1307 Corte Maltera 1305 Corte Maltera 3383 Corte Cassis 3381 Corte Cassis 3379 Corte Cassis 1324 Corte Alemano 1322 Corte Alemano 1320 Corte Alemano 1318 Corte Alemano 1316 Corte Alemano 1314 Corte Alemano 1 312 Corte Alemano 1310 Corte Afemano 1308 Corte Alemano 1306 Corte Alemano 1327 Corte Alemano 1 325 Corte Alemano 1323 Corte Alemano 1321 Corte Alemano 1319 Corte Alemano 1317 Corte Alemano 1315 Corte Alemano 1313 Corte Alemano 1311 Corte Alemano 1309 Corte Alemano 1307 Corte Alemano 1305 Corte Alemano 1303 Corte Alemano 1301 Corte Alemano A. P. NO 140-041-60 Your cooperation in this matter is appreciated. Sincerely, � � � �� B'�e�U.�-�-� /30� i3a6 Willa Bou - dleen ��$ S r Planner / 3 /D l3 ia c: Kimberly Brandt �3 �� Dana Bieber �3 �'6 Standard Pacific �3�� 15326 Alton Parkway /'3a0 Irvine, Califomia 92618-2388 �3aa ��3a� Ce-ti,� Y�r-�� SLWhIUWtX AVEMJt � pI � a 'm 1 T�' T� r , � � 1 '� K � I � �, � I�� I. ^_ � � �I. .I� � � ;_� � ? ; ;� �1�,� �i ,�: � .�, � � ,�� Q �, '�� ,� �� , � �' . . � f � � I � � n � II� I ... ~ I! . � I ..,. ,; . f � ., il . �. � I.� di �-�i��'�. i�1I : 4. �li �I�_..� lil _ i i ,.- i.l ii , .a, ,.�, a, _ �4- r --- �' . y r T. � .: . � - � ' � � i .x� �. ., .: : � � Cone Mallera Y� , • ' i I: .. y � - i - � -. ! t . TM.. ��- y� � ; m .. � : � � i ' t � � . t t ' ? �.:' . ii ' I,.. . i I" �'I' � 'f'" ,'` I _�*�. . ._ �1 } i .I i II , i V , � �li mg � a i �I :� fE i'i!� IJ',L9 I�`��C� a"O Lq Ip � p�,p ' � � • � � '� `�1 l;� �:;' `� ,I � I � = -- � 1- I � � � G ,� , i � ��. j;� ; �� _ -� � �� _ � � � � _ � � � r i P ,I �� ' i " �� , � � �7 � �� i � , 'r I � I o �� i 1 �..r ' i��l� t� � � _ �, . . � _ � , � � �' �� ,��; �� wp� t+' �:�.' �, � � �, '��i I ! l �a � ;. r - , "-. .� _�_-- jI1� . � I� . I q , � - P'�� ,�1 .r �i .._�I.��...t 1 `� � �.e� ConeNemeno I , b�_1— �-- — _, - - - . � ' �r _ , .� ' _ . � �.- f � , ' 'tr—�� t<..1 �� I ' I { I ,t...'� � Ir ' 11 I �. . �, i '�'?'r .. � r�, �w3-�".��-�� i � o �� {��l�l�+ �'-, aIo oI��o o � Na�LAc I V'I J p� „� n��1_ `� -. ' 1. E 1 i� ' ,+7.:.}1��I 1 �'.r . � ` � � , � '�I K ��; 5�7� . #� � # .r L�7_T }_ ..T`�._,.j_-� . —� T ( � � S— G 4 � I i .�-�,.ii i J... � � ' � ~ � I . . . . I' 3 � � �� T �' - — �'��o'��`, `�,� • � , � i'o�o�i � � � �r#'� � l j � •-'^ I I � a� I�fO O � p.O� O C710 O/ lo-'� � . �I' I 1 r �..� `� �� I u, n oxas i 4 ,:i� � �'.:; � .t-.s l .'.1�� 1 j�� ., -' ":, � �., ., �.. .. . -- :�;'' 1i�.�._ � .i,!r!.' ' �' . " •- h . ._ . _ ). l C IeVe�osa . . i . -v u �B ' , ., i '� E , . .�E " . 't ' ..� �- - +' - ' , " �_-c�' � _ - I I, � j E— � � � i� � S '� I � ; i � �� " � p 7 A II I � .. _' I� . . .- E I ,r . ...— . � �� i i.l a � I II i I I� I� e� . � a a a I E � Dq: `a .' ' � i i � °7� � I 5� � 3P �� , � � � � � • �� I � I � a. �I � ' I a v �: � �� ° :',I ��I �-0�� a., �'� I �� ?• � - s° �� d a �lii ? a5i �I��m�`., �'9� I}li �m7� I u�� O i 7 tQ I a . �� A j i i : II �I . � � d 9 � � II �� , 7� 3 � I I� n�5 } .� �,, � �' � I a^ .� � ^ � a� Q I �� e � �' °� i'� I� � o � � � o ,� �� o ,� � � ; � � � � . " ' --�--_��,, ,; o�,, �. - - % � � i 7 uuis ' ' ' � - . : o a��y� •�imiei LO�eNovara �i� i j � f i I! ' IM � I' ' � mis ' i I Y .1MS 1]Y �64 Corte Cassis (Pai Job nddress: 3350 VIA SIENA Sui[e: Vicinity: 3350,3352,3354,3356,3358 AND 3360 - BLDG �j Parcel Number: TPN003053 Applicant: LONG, JENNIFER Address: J.L. HARE AND ASSOCIATES SANTA ANA, CA 505 N TUSTIN AVENUE SUITE 212 Owner. STANDARD PACIFIC Address 15326ALTON PARKWAY � - -IRVINE, CA ConUactor: Address: � ' Zoning: Phone: 714-245-9760 Zip: 92705 Phane:� 949-789-1716 Zip: 92618 Phone: Status: ISSUED Applied: 10/30/2003 Issued: 11/10/2003 ISSUED BY: `� � Zip: License: _ Arch : BASSENIAN/LAGONI ' Eng: RICHARD MOORE/MCE CONSULTANTS Address: 2031.ORCHARD DR Address: 1100 S COAST HWY, 318 � SUITE 100 ' ��. Phone: 714-553-9100 � Phone: 949-376-6407 NEWPORT BEACH, CA LAGUNA BEACH, CA � 'Zip: 92660-0753 License: C8395 92651 License: C23971 SCOPE OF PERMIT CONSTRUCT NEW 9,476 S.F. 6-PLEX WITH ATTACHED GARAGES AND 134 S.F..PORCH/DECK. "BUILDING TYPE - A". BLDG 8. INCLUDES: 3360,3358,3356,3354,3352 AND 3350 VIA SIENA. - SEE PA-02-41/T-16416 ' - � 3360/UNIT 47 - 684 SQ FT'IST FLR, 1023 SQ FT 2ND FLR, 455 S� FT GARAGE, 11 S� FT�PORCH. TOTAL LIVING 1707 SQ FT. (3A) 3358/UNIT 48 - 560 SQ FT'IST FLR, 917 SQ FT 2ND FLR, 436 SQ FT GARAGE, 4 S� FT PORCH�. TOTAL LIVING 1477 SQ FT. (1A) . 3356/UNIT 49 - 589 SQ FT 1ST FLR, 965 S� FT 2ND FLR, 436 SQ FT GARAGE; 20 SQ FT PORCH. TOTA� LIVING 1554 S� FT. (2A) 3354/UNIT 50 - 589 S� FT 1ST FLR, 965 SQ FT 2ND FLR, 436 SQ FT GARAGE, 20 SQ FT PORCH. TOTAL LIVING 1554.5� FT. (2B) 3352/UNIT 51 - 560 SQ Ff 1ST FLR, 917 SQ FT 2ND FLR, 436 SQ FT GARAGE, 7 SQ FT PORCH. TOTAL LIVING 1477 SQ�FT. (18) 3350/UNIT 52 - 684 SQ FT 1ST FLR, 1023 SQ FT 2ND FLR, 455 SQ FT GARAGE, 16 SQ FT PORCH. TOTAL LIVING 1707 SQ FT. (3B) , , ' FEE SUMMARY. . � � � Plan Check: $867.43 �� ' , Calc Valuation: �. Ssa2,3sa.sa Permit: $5,338.00 � ' ' �Claim Valuation: ' So.00 SMIP Res: $94.24 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $6,299.67 PLANNING & ZONING � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related � regulations. (Ord. No. 9248, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abantloned i for a period of 180 days ' INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapections and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2nas�as (sioo) WORKERS'COMPENSAnON DECLARAnON: � �� I hereby ettirm under penalry of perjury one ot the following tleclarations: � ❑ I have and will malntain a certificata oi consent to setl-Insure for workers' compensation, es provided for by section 3700 of the Labor Cotle, for the pertormence of the /� work tor which Ihis permit is issued. ❑ � I hava and wiil maintain workere' compensa�ion insurance, as required by section 3700 of the Lebor Code, for ihe peAormance of Iha work tor which Ihis permit is issued. ]�1 My workers' compensation Insurance wrder and policy number ere: Carrier: Policy Number: (This section need nof be comp/eted i/ the permit is va/ued af one hund�ed dollars ($f 00) or less.) ❑ I cenity Ihat in the peAo n Tha� wor�t r which this pertnit is issued, I shall not employ any person in any manner so as to become subject to tha workers' compensatlon lews all(o� � d a ree th t ii I should bacome subjact to the v2rkers' compensetion provisions ol Section 3700 of the Lebor Code, I shell forthwith comply with ihesa i '6n / / //� ApplicanlSignaWre: Date: `�' !( JD� WARNING: FAILURE TO CURE W (ERS' OMPENSAT1qJ COVERAGE IS UNLAWFUL AND SMALI SUBJECi PN EMPLOYER TO CRIMINAL PENALTIE$ AND CIVIL FlNES UP TOONE HUNDRED h10U5AN�DOLLARE($1 AO TOTHECOSTOFCAMPENSATION,DAMhGESFSPROVIOEDWiiINSECTION3]O60FTHELABORCODE,IMEREST,ANDATTORNEV'SFEES. LICENSED CONTRACTORS DECLMATION: I hereby ettirm that I am licensetl untler provisions of Chapter 9(commencing with Saction 7000) ot Division 3 of the Business and Professions Cotle, and my license is in full force antl ettect. Lic. # Class a Contrectols Signature: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby attirm that there is a construction lentling agency for Ihe pertormance of the work for which ihis pertni� is issued. (Sec. 3097, Civil Code). Lentlefs Neme: Lender's Atldress: Signature: Date: OWNER•BUILDER DECLARA710NS: I hereby effirtn that under penalry of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Busineu enC Professions Code: Any ciry or couny which requires a permii to construct, alter, improve, demolish, or repair eny structure, pnor to its issuance, elso requires Ihe applicant tor such permit to tile e signetl statement ihat he or she is licensed pursuent b Ihe provisions of the Contractors License Law (Chapter 9(commencing with Sectlon 7000) oi Dlvislon 3 of Ihe Business entl Professlons Code) or that he or she is enempt thereirom and the hesis for the elleged exemption. Any violetion of Section 7031.5 by eny applicent for e parmit suDjecis Ihe applicant to e civil penalry of not more Ihan five hundred dollars ($500).): ❑ I, es owner of the properry, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, antl the slrucNre is not intended or oHeretl tor sale (Sec. 7044, Business and Protessions Code: The Coniractors License Law dces not apply to an owner of property who Duilas or improves Ihereon, and who does such work , imself or herself or through his or her own employees, provitled that such imDrovements are not intended or oHered for sale. H, however, the building or improvement Is old within one year of completion, the owner-builder will have ihe Durtlen oi proving ihat he or she did not build or improve for purpose of sale.). ' as owner of the property, am E%CLUSNELY CONTRAC7ING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Prolessions Code: The contractors n noi apply to an owner ot pmparty who huilds or impmves thereon, antl who conirects for such project with e contractor(s) license pursuent to�o rectors Lice se Laws.). ❑ I am exempt Signature: Owner ID verified � Venficatian of Ow� Business antl Professions Cotle for this reason: �a. ❑ Ves ❑ No Driver's License No. ot document, i.e. - pmperry taa 6ill or deetl): Eapires: DIVISION OF INOUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certity ihat no eacevetion five (5) or more teet in depih into which a person is required to descend, wiil be mede in connection with work authorized by Ihis permil, antl Ihat no 6uiltling structure, scattoltling, talsework, or demolition or dismantling thereot, will be more Ihan �hirty-six (36) feet high. (Chap. 32, Gry 2, Atl 2, Sec. 341, Tltla 8, Calitornia Adminisiretive Code). ❑ A5 owner-builder, I will not employ anyone to do work which would require e permit from t�e Division of Industnal Safery, es noted above, unless such person �es e permit �o do such work from �he division. Signature: Date: Division ot Indusirial Safery Permit Number: CEH7IFICATE OF COMPLIANCE AND AUTHORVATON OF ENRiY: I cenify untler penalry ot perjury that I have read this application and state that ihe information given is correct. I agree to comply with ell state laws end ciry ordinances relating to builtling conswction, antl authorize representetives of �he Ciry of Costa Meu to enter upon �he ebove-descnbed properry for inspection pyq{oses. I agree not to ocapy or allow occupency of any building au�honzed by ihis permi� un�il final inspection. COOE 1, 161fi 1266 Fixetl System Final Fire Prevention Pool Spa Final 200 Finel Re-Roof 207 Final BIocWRetaining Wall 202 Finel Factory Fire Place 203 Finel Sign 204 Final Demolition o�re 1t�6@ ll - /� ' C��°-�' Date COOE 1 INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final Fira Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency i411�1:111��i<7 ��F NEWPORT-MESA UNIFIED SCHOOL DISTRICT CER7IFICA7E OF COMPLIANCE OF OEVELOPMENT FEES PURSUANT TO AB 1600 AND AB 181 To: ( ) City of Costa Mesa ( ) Ciry of Newport Beach ( ) County of Orange Applicant y��xv�l'�r C Address: � Telephone Number. � TracUParcel and Lot Number(s): Location of Project: �/; Number of Square Feet bT�` Residential Space Commercial and Industrial Space � v i 0� ?�1-� ��X a+.aa CommerciaUlndustrial Projed is: (Check One) _ Warehouse _ R8D _ Movie Theater _ Mini-storage _ Heavy Industrial _ Regional Shops _ Light Industrial This project is exempt because x $ .30 _ Motel 8ank _ Neighborhood Shops _ RacqueVHeatth _ Hotel Medical Office Office Park N° 4917 DisUid Receipt No.I�-�1 U� � PlanCheckNoV`-�-� '�)O/� Total _ Preschool _ Auto Repair _ Hospital _ Large Office _ Otfice Bldg. _ Restaurant _ Fast Food This certifies that the above-named Developer/Applicant has paid school NaaNty fees in comp6ance with Government Code sections 53080 and 65995. The Builtling pemtils for this square footage in this proposed development may now be issued by your jurisdictlon. Checks are to be made payable to Newport-Mesa Unified The above representacon as to square footage is ttue. Appticant agrees that if k is later determined that such representations are not true, then this certificate shall automatically terminate and the appropri � oun s n�e� �883/3:11 PN/f 55025.28 RCPT#:�1-A123372 l y� � 128887 Date: ! v A ' / (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR ORIVE, COSTA MESA, CA 92626 PLUMBING PERMIT 1ob Address: 3350 VIA SIENA Suite No Vicinity: TR 16416 BUILDING 8 Parcel Nunmber: TPN003053 Applicant: LONG, JEN Address: Owner: �,STANDARD PqCIFIC Address � 15326 ALTON PqRKWAY Contractor: Address: Arch / Eng : Address: ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifer System Connect pce,Soda,etc) Den[al Units IRVINE, CA Phone: 714-245-9�60 Zip: Phone: 949-789-1716 Zip: 92618 Status: ISSUED Applied: 11/05/2003 Issued: 11/10/2003 ISSUED BY: Phone: Zip: � License: ' . . .. _ . . - . . Phone: 2ip: - - License: SCOPE OF PERMIT REF: B03-01891. 6 UNIT MULTI- FAMILY BUILDING. INCLUDES ADDRESSES: 3350 VIA SIENA; �, � . 3352 VIA SIENA, 3354 VIA SIENA, 3356 VIA SIENA, 3358 VIA SIENA, 3360 VIA SIENA. TR ' �� 16416, BLDG 8 _ . PLUMBING WORK TO INCLUDE: 8 BATHTUBS, 6 CONNECT�(ICE, SODA, ETC.), 6 DISHWASHERS, 6 �� GAS SERVICES, 6 GAS (1-4 OUTLETS), 6 GAS OUTIETS OVER 4; 6 LAUNDRY TUBNVASHER, 6 . , PRESSURE REGULATORS, 6 SEWER CONNECTS, 6 SHOWERS, 26�WASH BASINS; 6 KITCHEN SINKS,18 : WATER CLOSETS, 6 WATER HEATERSNENTS, AND 6 WATER SERVICES. � . � AMT $23.50 $0.00 $0.00 $78.40 $0.00 $58.80 $0.00 aTY 0 0 8 0 . 6 0 FEE SUMMARY AMT Laundry Tub / Washer $58.80 Landscape Irngation $0.00 P-Trap $0.00 Pressure Regulator $58.80 Process Piping (per 10 k) $0.00 Receptors $0.00 Septic Tank $0.00 QTY 6 0 0 6 0 0 0 / AMT .. Sump Pump - � $0.00 Swimming Fool $0.00 Trap Primer $0.00 Urinal $0.00 Vacuum Brkr BkFlow(1-4) $0.00 Vacuum Brkr Bkflow(5+) $0.00 Wash Basin $254.80 QTY 0 0 0 0 0 0 26 NO710E: 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 antl become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 tlays. . INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapectiona and finel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (774) 7545626 zaaaae (sroo) WORKEAS'COMPENSAnON DECLARAnON: � � I hereby effirm under penalry oi perjury one of the following declarations: � ❑ I have end will malntaln a certificate of wnsent to selt-Insure for workers' compensation, as provided for by section 3700 of ihe Labor Cotle, for the perfortnence of the ��qq work for which this-permit is issued. 0/ � I have entl will maintain woAcers' compensation insurance, as required by section 3700 ot Iha Lebor Code, for the perfortnerroe of ihe work for which this pertnit is issued. Iu My woMere' compensation Insurance carner antl policy number are: damer: Policy Number: (Thls section neetl not be crompleted i! the permit is ve/ huntlred dollars (S7o0) or less.) ❑ I cartify thet in the peAorma� • work tor which this pe it is issued, 1 shall not employ any person in eny manner so as to become subject to Ihe workars' compensation law i C G(o�ni,�n rea that It I shoultl b ome subject to the woAce�s' compensalion provisions of Section 3700 of the Labor Cotle, I shell fonhwith comply with Ihese r 5' 755. --- 1 Applican� Signature: " Date: l � � �O '�� WNRNING: FAILURE TO 5 CURE WOFK ' CA PENSATIpJ CAVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED TKKISANDDOIURE�$1 000),IN I ON TMEWSTOFCOMPENSATION,DAMAGESASPROVIDEDWRINSECTION3]O60FTHELABORCODE,IMEREST,ANDATfORNEV'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that I am licensed under provisions of Chapter 9(commencing with Sedion 7000) ot Division 3 of the Business antl Protessions Code, entl my license Is in full force antl ettecL Lic. k Class N Comracmr's Signewre: Data: CONSTRUCTION LENDING AGENCV: I❑ I hereby aHirtn Ihat Ihere is a consWction lending agency for the pertormance of t�e work for which this permit is issued. (Sec. 3097, Civil Cotle). i, LendeYs Neme: Lentlefs Atldress: ! SigneWre: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirm Ihet under penalry of perjury that I am EXEMPT FROM THE CONTHACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business entl Protessions Code: Any ciry or county which requires a partnit to construct, alter, impwve, tlemolish, or repair any structure, pnor lo its issuance, elso requires ihe applicant for such pertnit to file e signed statement thal he or she Is licensed pursuanl to the D�ahsions of the Coniractors License Law (Chapter 9(commencing with Section 7000) of Dlvision 3 of [he Business and Protessions Cotle) or that he or she is exampt therefrom antl the besis for the alle9ed exemption. Any violation of Section 7031.5 by any apP�icant for e pertnit subjects iha epplicant to a civil penelty oi not more Ihan five huntlred dollers ($500).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the structure Is not intentletl or otteretl for sela (Sec. 7044, Business and Professions Code: Tha Contractors License Law tloes not apply �o an owner of property who builds or improves Ihereon, and who does such work himself or herself or through his or her own employees, provided ihat such improvements are not intended or oHered for sale. If, however, the builtling or improvement is sold within one year of completion, ihe owner-builder will have the burden of proving that he or she tlid noi build or improve for purpose oF sele.). I, es owner of the prope SNELV CONTRACTING WITH LICENSEO WNTRAC70RS to constmct the project (Sec. 7044, eusiness antl Professions Code: The coniraclo n5e Lew do not appty to en owner of propeny who builds or Improves thereon, and who contracls lor such project with a con(rector(s) license pursuan ra o s Licen e Lews.). ❑ I am exem e se ` Business and Professions Coae for ihis reason: Signaiure: Exoires: 6• �%� �u Venficatlon ot O ip e of aocument, La. - property tau blll or deed): -- --� DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATON: � I hereby cenlfy Ihat no excavation five (5) or more teet in depth into which a person is required to descentl, will be maae in connectlon with work authorized by this permit, and Ihat no buildinq siructure, scaRolding, talsework, or demolition or dismantling t�ereot, wiil be more ihan thitly-si: (36) leet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title B, Califomia Atlministrativa Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a permit trom ihe Division ot Intlus�rial Safery, as noted aDove, unless such person has e permit to tlo such work irom the division. Signature: Date: Divisian ot Industrial Safery Pertnit Number: CERf1FlCATE OF COMPLIANCE AN� AU7MORVJITON OF EMAY: I cenity under penalry ot perjury that I have read ihis application and state ihat the infortnation given Is correct. I agree to comply with all stete laws antl ciry orAinances relating to builtling consWciion, antl authorize representatives ot Ihe Ciry of Costa Mesa to enter upon the above-descnbed properry for inspection purposes. I agree not to occupy or allow occupancy of any builtlinq euihonzetl by ihis permit until tinal inspection. COOE I, 1816 1286 200 201 202 203 Fizatl System Final Fire Prevention Pool Spe Finel Finel Re-Rooi Finel BIocWRetaining Well Final Feaory Fire Place Final Sign 204 Final Demolition o�rE LHIR� �l - /� � C�2 Da CODE� INSPECTIONTYPE 206 Final Mechanical 208 Finel Plumbing 210 Final ElecMcal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuildincyOccupancy pA� 1[� -9,04 � (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT JobAddress: 3350 VIA SIENA Suite No Vicinity: BLD 8,3350,3352,3354,3356,3358,3360 Parcel Number: TPN003053 npp�icant: LONG, JEN Address: Owner.' STANDARD PACiFIC � Address: � 15326 AL70N PARKWAY Contractor: Address: IRVWE, CA - ISSUED 8Y: Phone: 714-245-9760 Zip: Phone: 949-789-1716 Zip: 92618 Phone: ZiP License: Status: ISSUED Applied: 11/06/2003 Issued: 11/10/2003 SCOPE OF PERMIT REF: 803-01891. 6 UNIT MULTI- FAMILY BUILDING. INCLUDES ADDRESSES: 3350,3352,3354,3356,3356 AND 3360 VIA SIENA �, -�- . � TR 16416, BUILDING 8. BLDG TYPE A � -- -� - � 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. ISSUEFEE �, Inst FAU <100 k BTU Inst FAU >100 k BTU � Repair / Alt Cooling/Heat � Inst / Rep. Recess Wall Htr . 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 < 10000cfm Air Handlers > 10000cfm Floor Furnace Floor or Suspend Heater $23.50 $88.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $63.90 $0.00 $0.00 $174.00 $0.00 $0.00 $0.00 $63.90 $0.00 $0.00 $0.00 50.00 Quantity 6 0 0 0 0 0 0 6 0 0 24 0 0 0 6 0 0 0 0 FEE SUMMARY Repair / Alt Absorbtion Unit � Repair / Alt Refrigeration Unit Ventillation System ., � � � Evaporative Cooler . , , � � Commercial Incineretor Domestic Incinerator � '� " �"Compressors/:AbsorptionSystems� � - , Upto3hp/100kBTU � ; 3To15hp/SOOkBTU 15 To 30 hp / 1,000 k BTU �' � 30 To 50 hp / 1,750 k BTU � Over 50 hp / Over 1,750 B7U ' Boilers ` �...... Upto3hp " � 3To15hp - 15to30hp � � 30 to 50 hp ' Over 50 hp Other Mechanical�Fee� Investigation Fee 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 6 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § i, 12-27-92) EXPIRATION: This permit shall a4lomatically expire and becoma void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, ana an required inepectlons end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2d46�4fi(N00) WORKERS'COMPENSAnON DECLARAnON: — � I hereby aflirm under penalty of perjury one ot the following declarations: ❑ I have end will maintain a cenificete oi consent to self-Insure for workers' compensation, as pwvided for by section 3700 ot tha Labor Code, for t�e pertormence o1 ihe �/� work tor which Ihis permit is issued. �\ I heve and will maintain workers' compensation insurance, as required by section 3700 ot ihe Labor Code, for the perfortnance oi the work for which this partnit is issued. �`� My workera' wmpensation Insurance carder end policy number ere: Carner: Policy Number: /Thls sec[ion neea nat be complefed i/ the permit is valued at one hundred tlollars ($100) or IessJ ❑ I cenity that in ihe pertormance � 11 oe�7�dcTr� ich this pertnit is issued, I shall not employ eny person in any manner so as to become subjact to the workers' compensation laws oi d agree that I I s�ould become suDject to the workers' compensation provisions ot Section 3700 oi the Labor Code, I shall forthwith comply wiih thesa pro ons. Applicant Signeture: Date: t�' ��' D� WARNING: FAILURE TO SE 11RE WOP ERS' C MPENSATION COVERAGE IS UNLAWFUL AND SHPLL SUBJECT AN EMPLOVER TO CFIMINAL PENALTIES AND qVIL FlNES UP TOONE HUNDRED T/qUSANDDOLLARE(5100, TION THECOSTOFCQNPENSATION,DNMGESASPflOVIDEDFORINSECTION31060FTHElABORCODE,IMEREST,ANOATTORNEY'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby effirm thal I am licensed under provisions of Chapter 9(commencing with Seclion 7000) of Division 3 of the Business and Professions Code, end my license is in full force and ettect. Lic. k Class a Cantrectofs SignaNre: Date: CONS7RUCTION LENDING AGENCV: ❑ I here6y aHirm that there is a construction lending agency for ihe pedormance oi ihe work tor which this pertnit is issuetl. (Sec. 3097, Civil Cotle). Lenders Name: Lentlefs Atltlress: SignaNre: Date: OWNER•BUILDER DECLARATIONS: I here6y aHirtn Ihat under penelry ot perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business entl Protessions Code: Any city or counry which requires a permit to construct, elter, improve, demUish, or repair any structure, pnor to its issuence, also requires the applicant tor such pertnit to file e signed stetement ihat he ar she is licensetl pursuent b the provislons oi the Contradors License Law (Chapter 9(commencing with Section 7000) 01 Division 3 of �he Business and Professions Code) or thet he or she is exempt thereirom and tha Dasis for ihe ellegeA exemption. Any violetion of Section 7031.5 by eny applicent for a pertnit subjects Ihe applicent to a civil penelty of not more ihan live �untlretl tlollars ($500).): ❑ I, es owner ot the property, or my employees with wages as thelr sole compensatlon, WILL DO THE WORK, and ihe structure is not intantletl or ofrered for sale (Sec. 7044, Business antl Professions Code: The Contractors License Lew tloes not apply to an owner of property w�o builds or improves thereon, antl w�o tloes such work himself or �erself or ihrough his or her own employees, provided that such improvements are not intentled or oHered for sale. If, however, the building or improvement is sold within one year of completion, ihe owner-builder will have ihe burden of proving that he or she did not build or improve for puryose of sale.). I, as owner of the pmperty am E WSL1(�LY CONTRACTING WI7H LICENSED CONTRACTORS to consiruct the O�oject (Sec. 7044, Business end Professions Code: The comractors L w tloes nd� apply to an owner of property w�o builtls or Improves thereon, and who contracis lor such projecl with e contrector(s) licansa oursuant ractors License Laws.l. ❑ I em exemp Signeture: Owner ID verifi by Verificatian ol nei � Business entl PwfesSions Code for �his reason: Expires: • 7- of document, i.e. - properry tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certify ihat no excavation five (5) or more faet in depth into which a person is required to descend, will be matle in connection with work euthorized by this permi�, and ihat no builtling siructure, swffolding, falsework, or demolition or dismantling ihereof, will be more �han thirry-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Title 8, California Atlministretive Code). ❑ As owner-builder, 1 will not employ enyone to do work which would require a permit irom ihe Division ot Indusirial Satety, as noted above, unless such parson hes e permit to do such work trom the division. Signature: Date: Division ol IndusMal Safery Permit Number. CERi1FICATE OF COMPLIANCE AND AUTHORIZA710N OF EHTRY: I certify under penalry ot perjury Ihat I have read Ihis application and state thet the information given is carrect. I egree to comply with all state lews end ciry ordinances relating to building consiruction, and authonze representatives of Ihe Ciry of Casta Mesa to enier upon the above-descnbed property for inspection purposes. I a rg ee not to occupy or allow acupancy of any building authorized by Ihis permit umil finel insDection. CODE 1, INSPECTIONTYPE ' �/ 1618 Fixetl System Finel Flre Preven110� 1266 Pool Spa Finel 200 Final Ra-Rooi 201 Final BIocWRetaining Well 202 Final Fectory Fire Place 203 Finel Sign 204 Final Demolition DpTE II�.94S l (O' � Date CODE 1 INSPEGTION TYPE ' 206 Finel Mechanical 20B Final Plumbing 210 Finel EleciriCal 272 Final Fire Prevention 220 Final Planning Approval 222 250 Final Sita Final Building/Occupancy 6-9'�0 � (714) 754-5273 • Fax (714) 754-4856 . www.ci.costa-mesa.��gCTRICAL PERMIT �� FAIR DFIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: 3350 VIA SIENA BLDG 8 - 3350,3352,3354,3356,3358,3360 TPN003053 Applicant: LONG, JEN Address: Owner. STANDARb PACIFIC Address ,15326 ALTON PARKWAY Contractor: Address: � ISSUE FEE Temp service tesl Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lightin9 Fizts �. Recept Outleis , Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to thp IRVINE, CA Phone: 714-245-9760 Zip: Phone: 949-789-1716 Zip: 92616 . Pfione: Zip: .. License: Status: ISSUED Applied: 11/OS/2003 Issued: 11/70/2003 ISSUED BY: SCOPE OF PERMIT . REF: 603-01891.�TR 16416 - BLDG 8. CONSTRUCT NEW 6 UNIT MULTI- FAMILY BUILDING. INCLUDES ADDRESSES: 3350, 3352, 3354, 3356; 3358 AND 3360 VIA SIENA. ELECTRICA� WORK TO INCLUDE: 6 LIGHT FIXTURES, 12 RECEPT OUTLETS, 6 SWITCHES, 1- 1000 AMP S�RVICE, AND 7- 200 AMP SUB PANELS. RES ELECTRICAL SQUARE FOOTAGE IS 9566 SQ. FT. INCLUDES SUB PANEL FOR HOUSE METER. � _ - HOUSE METER IS ADDRESSED AS 3350 "A" VIA SIENA. ,, $23.50 $0.00 $0.00 $0.00 $478.30 $0.00 $6.80 $13.20 $6.80 $0:00 $O.QO $0.00 $62.15 $0.00 $O.QO Quantity 0 9566 0 6 12 6 0 0 0 1 0 0 FEE SUMMARY � Quantiry `` Temp Dist System / Lighting $0.00 �� " 0 Busway/100(t ��- - $0.00�,� 0 Slanding Section" . ' � � $0.00 0 � Misc Electrical Equipment $0.00 0 Transformers up to 1 kva/kw $0.00 0 ................up to'IO�kva/kw $0.00 � 0 .................up to 50 kva/kw $0.00� � 0 .................up to 100 kva/kw' $0.00 � 0' ��, ..................over 100 kva/kw . $0.00 �. 0 , Low Voltage�Equipment $0.00 " 0 � Low Volt Wiring System / Ckt $0.00 -" 0 Misa Conduit $0.00 0 � Misa Conductor $0.00 0 CircuS ( gen or ride) - 50.00 0 Circus (mech ride or lights) $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable coaes, and eii required inapectlons antl final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of ihis permit. FOH INSPECTIONS CALL: (714) 75M5626 zaae�as(aoo) WORKERS' COMPENSATION DECLARATION: � � I hereby aHirm unde� penalty ot perjury one oi ihe following tleclarations: �- ❑ I heve entl wlll malntaln a certificate of consent to seH-Insure for workers' compensation, as provitletl tor by section 3700 of the Lebor Code, for Ihe pertortnance of the A work tor which Ihis permit is issued. ,�j� I �ava antl will maintain workers' compensation insurance, as requiretl by section 3700 ot Ihe Lebor Code, for ihe pertortnance of the work for which this pertnit is iuued. My workers' compensatlon Insurence cerner antl policy number are: Cercier. Policy Number. (This section need not be comp/eted i! Ne pe 't Is valued at one hundred dollars ($100) or less.) ❑ I certity thet in the pertormance of t w ic rmit is issue0, I shall not employ any person in eny manner so es to become subject to the workers' compensetion lews of lifarp' egr Ihat if I should b come sublect to Ihe workers' compenseiion provislons of Seclion 3700 of Ihe Labor Cotle, I 5hell totlhwith comply with these provi i r __ Applicant Signature: Date: �I ' �D '�� WARNINQ: FAILURE TO SECU E WORKE S' PENSATIpJ COVERAGE IS UNL4WFUL AND $HALL SUBJECi AN EMP�OVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED T}KKISPNDOOLURE(5100, INAD NT ECOSTOFfAMPENSATION,DAhNGE5A5PROVIDEDFOPINSECTION3]O60FTHELABORCODE,IMEREST,ANDAiTORNEY'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby aNirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Pmfessions Code, and my licanse Is In full force entl ettect. Lic. M Class N CONrectors Signature: Dete: CONSTRUC710N LENOING AGENCY: '� ❑ I hereby aftirm that ihera Is e construction lending agency for the performance ot the work lor which this permit is issuetl. (Sec. 3097, Civil Code). Lentlers Name: Lender's Address: SignaNre: Date: OWNER-BUILDER DECLARATIONS: '�� I hereby aflirtn Ihat under penelry of perjury ihat I am EXEMPT FROM THE CON7RACTORS LICENSE LAW For the following reason (Sec. 7031.5, Business and Protessions �'� Cotle: Any ciry or counry which requires a pertnit to construc6 elter, improve, demolish, or repair any sWeture, pnor to its issuance, also requires the flpplicant for such pertnit ro file a signetl stetement that �e or she Is licensetl pursuam to Ihe pmvisions of the Comrecmre License Lew (Chapter 9(commencing with Section 7000) of Divislon 3 ot the Business entl Professions Code) or that he or she is exempt iherefrom end Iha basis for the alleged exemption. Any violation of Section 7031.5 by eny epplicant tor e permit sublecis ihe epplicant to e civil penalry of not more than tiva hundretl dollers ($500).): ❑ I, as owner ot ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, and Ihe siructure is not intentletl or oHeretl tor sale (Sec. 7044, Business and Pmfessions Code: Tha Contractors License Law does not apply to an owner ot properry who builtls or improves theraon, and who does such work himself or herseN or through his or her own employaes, provided ihet such improvemems ere not imended or oflered tor sale. If, however, the building or improvement is �� (/�� sola within one year ot completion, the owner-bullder will have ihe burden of proving Ihat he or she did not build or improve tor purpose of sale.). � JI, as owner of Ihe pmDerry, am E%CLUSNELV CONTRACTING WITH LICENSED CONTRACTORS to wnslmct the project (Sec. 7044, Business and Profeuions i Code: The comractors " does not eppty to an owner oi propeny who builtls or improves thereon, antl who comracts for such projact wlth a comractor(s) license pmsua Contractor License Laws.). ❑ lem Signature: Owner ID � —' Business and Protessions Code for this reason: _�_ Expire5: _ '�T' S� of tlocumeN, i.e. - property taz bill or deetl): DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certify Ihet no excavation five (5) or more feet in depih into which a person is required to descend, will be made In connection with work euthonzed by Ihis pertnit, antl ihat no builtling siructure, scattolding, falsework, or demolition or dismantling thereof, will ba more than thirry-siz (36) feet hiqh. (Chap. 32, Grp 2, Atl 2, Sec. 341, Title 8, Calitomla Atlministrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a pertnit from t�e Division oi Intlustnal Satery, as noted above, unleu such person has a permit to do such work from ihe division. Signature: Date: Division of Industrial Safety Permit Number: CER71FlCA7E OF COMPLIANCE AND AUTHORVA710N OF ENTRY: I certity under penatry of perjury that I have read this application and state that the information given is correct. I aqree to comply with all state laws and ciry ordinances releting to building consWction, and authonze representatives of the Ciry ot Costa Mesa to entar upon ihe ebove-descnbed property tor inspection p�*=o= �_��» not to acupy or allow acupency ot any building authorized by Ihis permit until final inspection. COOE I. 1618 1288 zoo 201 202 203 Fixed System Final Fire Prevention Pool Spa Final Final Fe-Roof Flnal Block/Retaining W ell Finel Fectory Fire Place Final Sign 204 Finel Demolition Applicant o�re IIiIlIl�4$ f / - /C7 - �e� Date CODE� INSPECTIONTYGE 206 Final Mec�anical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Finel Planning Approval 222 Final Site 250 Final Building/Occupency PSIE 1t�L$ (714) 754-5273 • Fax (714) 7541856 • www.ci.costa-rr�e�.�e��pRESSION PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 3350 VIASIENA Suite: Vicinity: Parcel Number: TPN003053 Zoning: Status: ISSUED Applied: OS/04/2004 Issued: OS/OS/2004 ISSUED BY: Applicant: FIRE SPRINKLER SYSTEMS INC Address: 705 E HARRISON ST --� � � SUITE 200 . � : � Phone: (800) 9153473 � CORONA,.CA , Zip: 92879 � , � Owner: ,STANDARD PACIFIC ' Address � - 15326 ALTON PARKWAY- "- - - -- - � ' " � , � � - � � � -- " Phone: 949-789-1716 � ' . " � � � . � - IRVINE, CA . - Zip: 92618 ' _ , " ' ' ' i -� � Convacror. FIRE SBRINKLER SYSTEMS INC � � � . Address: 705 E�HARRISON ST . ; , � , � � SUITE 200 Phone: (800) 9153473 � � � . CORONA, CA � Zip: 92879 ' ' � " � � � License: 684600 ^ �� SCOPE OF PERMIT � . � INCLUDES: 3360.3358,3356,3354,3352 AND 3350 VIA SIENA. -. Y Plan Check: $108.71 Permit: $167.25 , Other: $0.00 TotaL•' $275.96 , � \� � • � � , FEE SUMMARY - Calc Valuation: $a,2ao.0o Claimed Valuation: Sa,2ao:oo '/ ,. . NOTICE: The work authorized by this permit shall comply with all applicable handicap access raquirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void if woik is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under ihis parmit to be considered legal, such work must comply with all applicable codes, and all required inspectiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 !46696 (6/00) WORKERS' COMPENSATION DECLARATION: . ' I hereby eMirtn untler penalry oi perjury one of the tollowing declara�ions: ❑ I heve and will maintaln a certificate of conseni to salf-Insure br workers' compensetion, as provided tor by section 3700 of the Lebor Code, for ihe pertormance of the {�ork for which IhiS pertnii is issuetl. I have and will maintain workero' wmpensation insurance, as required by section 3700 of the Labor Code, for the peAortnance of the work for which t�is pertnit is issued. My wor!kers��m�atio�lnsu�� cerrier end policy numbar ere: /�/ q. Carrier: d9 / c. � v� policy Number. �6 /�/ �� —2D 0 j (This sectlon need not be complefed i( Ihe Oermit is va/ued at one hundred dollars ($f 00) or /ess.J ❑ I certity Ihat in the performence of the work tor which this permit is issuetl, I shall not employ any person in eny manner so as to become su6ject to Ihe workers' compensetion laws o/Cal� � a� that It I shoultl b to the workers' compensetion provisions of Sectlon 3700 O� a Labor Code, I shall torthwith comply with these Dro ons. '\ ! Applicent SiBnature: � � Date: � l\J 1� WARNINO: FAILURE TO §ECU� W 5' COMPENSATION COVERACaE IS UNLAWFUL AN� SHALL SUBIECT AN EMPIOVER TO GRIMIW�L PENALTIES AND GVIL FINES UP ONE HUNDRED THOUSAND OOLIARE (S1DB,'QOO�. IN ADDITIIXJ TO THE COST OF COMPENSATION, DAMNGES AS PROVIDED FOfi IN SEGTION 3]OB OF THE LABOR CODE, IMEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I here6y attirtn that I am force and eHecf. Lic. a_ Contractofs Signeture: of Chapter 9(commencing with Section 7000) ot Division 3 ot the Business qass a . _ _ _ _ _ .. Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm that thera is a constmdion lending agency for the peAormance of the work for which this pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: Lentler's Adtlress: Signeture: OWNER-BUILDER DECLARA710NS: Date: my license is in tull I hereby aHirm ihet under penelry oF perjury Ihet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires a pertnit to consirucL alter, improve, demolish, or repair eny siructure, prior to its issuance, elso requires the applicant tor such permit to file a signetl sletement that he or she is licensed pursuent to the proWsions oi the Contrectors License Lew (Chapter 9(commancing wi�h Sectlon 7000) of Division 3 oi the Business end Professions Code) or Ihat he or she is exempt therefrom and the basis tor the elleged e:emption. Any violation ot Section 7031.5 by eny applicant for a pertnit subjects the applicant to a civil penalry ot not more ihan five hundred dollers ($500).): ❑ I, as owner of Iha property, or my employees wlih wages as Iheir sole compensation, WILL DO THE WORK, and Ihe sWqure Is not intentled or oHered for sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law does not apply to an owner of property who builds or improves thereon, antl who does such work himself or herself or through his or her own employees, provitletl i�ai such improvements are not intendad or oflered for sale. If, however, ihe builtling or Improvement is sold within one year ot wmpletion, ihe owner-builder will have the burtlen of proving that he or she tlitl not build or improve tor purpose ot sele.). � ❑ I, es owner at ihe propetly, em EXCLUSIVELV CONTRACTING WITH LICENSED CON7RAC70RS m consiruct the pmject (Sec. 7044, Business antl Professions Code: The contractors License Law tloes not apply to en owner of property who bullds or Improves thereon, and who contrads tor such project with a contrector(s) license pursuant to the Contractors License Wws.). ❑ I am exempt under sec. Signature: Owner ID venfied by dnvers license. ❑ Yes ❑ No Business and Protessions Code for ihis reason: Venfication of Ownership by (type af document, i.e. - properry tex bill or deetl): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: Drivefs License No. Date: Expires: ❑ I hereby certify Ihat no escavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authonzetl by this permit, antl that no buildinq structure, scattolding, lalsework, or demolition or dismantling thereoi, will be more ihan thirry-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Administrative Code). ❑ As owner-builder, I will not employ enyone to do work which woultl require a permit from the Division oi Indusirial Safery, as no�etl ebove, unless such person has e permit to do such work from the tlivision. Signature: Date: Division oi Intlustrial Safery Permit Number: CERTIFlCA7E OF COMPLIANCE AND AUTHORIZA710N OF ENTSiV: I cetlify under Denalty of perjury that I have read this application and state that ihe Iniormetion given is wrrecL I agree to comply with all siate laws and ciry ordinances relating m building construction, antl au�horize represen�atives ot Ihe Ciry ot Costa Mesa ro enter upon the above-descnbed property tor inspection puryoses. I agree no� �o occupy or allow occupancy of any builtling eut0onzed by this permit until final inspection. 1616 Fixetl System Final Fire Prevemion 1266 Pool Spe Finel 200 Final Re-Roof 201 Final BIocWRataining Wall 202 203 Final Fadory Fire Place Final Sign 204 Final Demolition UATE � .uu /_ `�at� . �� Date COOE 1 INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final Fire Preventlon 220 Final Planning Approval 222 250 Final Site Final Builtling/Occupancy Q�jj INTRLILS (P' J ' J' Q`( '(�c