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HomeMy WebLinkAbout2548 WESTMINSTER AVE - Building Permits CITY OF COSTA MESA 5`""'F BUILDING DIVISION t 4 t.a �I 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 wno PERMIT NUMBER: BC09-00106 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: GRN2_RES DATE ISSUED: 05/08/2009 ISSUED BY: RMD JOB ADDRESS: 2548 WESTMINSTER AV CM Suite/Unit: • APN: 43919211 Zoning: , , Vicinity: ROOF TOP -Primary Occ: R-3 Const Type: V-B SQ. FT: 0 Valuation: $30,000.00 SCOPE OF WORK: INSTALLATION OF A 3 KW PHOTOVOLTAIC SYSTEM FOR A SINGLE FAMILY RESIDENCE WITH THE ASSOCIATED ELECTRICAL. OWNER: WELLS,MICHAEL K Address: 2548 WESTMINSTER ST Unit: Phone: City/State/Zip: COSTA MESA,CA APPLICANT: BUSHNELL, DAN Address: Unit: : Phone: 760-468-4711 City/State/zZip: CONTRACTOR: R E C SOLAR INC License No. 750184 Phone: 805.528.9705 Address: 684 CLARION COURTUnit: Cell: City/State: SAN LUIS OBISPO,CA ZipCode 93401 ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: COMBINATION PERMIT FEE SUMMARY Building Plan Check: $287.46 Building Fees: $442.25 Electrical Fees: $41.70 Mechanical Fees: $0.00 t 1 Plumbing Fees: $0.00 SMIP Residential: $3.00 �1�^ SMTP Commercial: $0.00 s- s1 c S Bldg Std Admin Fund $2.00 t1: TOTAL FEES: $776.41 -Refer to fee receipts for all fees paid for project NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. CODE I. INSPECTION TYPE DATE INTn1ALS CODES INSPECTION TYPE DATE IN1111AL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing / 200 Final Re-Roof 210 Final Electrical / t) ZZ/e/4 tu'd'4 • 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 6/4-74T '+ 7 WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive,s license. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: 11 person is required to descend,will be made in connection with work authorized Carrier �"`a Y�'corkSY i r e by this permit,and that no building structure,scaffolding,falsework,or demolition `I(Tfssepgn need nor 0e completed tune it is valued at one hundred rldbrs($r00)or less) or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp FolicNumber: C . 2-55400 2,Ari 2,Sec.341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify (hat in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers'compen 'on provisions of Section 3700 of Applicant's Signature Date the Labor Code I shall forthwith com.�,f ese provisions. f1 A 1,7 S l I J $ Ion Division of Industrial Safety Permit Number: 1 ot I�rCAp s Signature "l pate HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: �H. WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code,and 2. Does or will the applicant or present or future building occupant need to file my license ''''TIIIIisiin^^^^n^full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑No Lic.#-.' T J «-\ //Cl Gass•#' C.' �� (Section 25533 of the California Health and Safety Code, with some - �- �l) h., 5) exceptions, requires registration with the Costa Mesa Fire Department by S each business which at any one time has on hand a quantity of acutely CCarttractorsSignawre 6Dat hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safely Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure. prior to its any other air pollution control district or agency? ❑Yes 0 No issuance.also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors (Sectionml n befu850.2 of the California Government Code requires dithnt the requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information furnished on applications for non-residential building permits). Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application. have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? El Yes ❑ No thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon.and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. S, tare of Le er(s) Date((( Signature Date 1 C/$ /o4 3057<6(3f07) j- ri±ed licant�...���111\�� l /4 1 [iAndrorAmlieraea Apo tmnt `�Da CITY OF COSTA MESA 4 BUILDING DIVISION $: _,- I + DEVELOPMENT SERVICES DEPARTMENT PE T NUMBER 1. 1 gh PERMIT eqberoarins B05-00983 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2548 WESTMINSTER AV Status: ISSUED Suite: Applied: 06/15/2005 Vicinity: ROOF Issued: 06/15/2005 Primary Occ: R3 Type of Construction: V-N Parcel Number: 43919211 Zoning: Applicant: WELLS, MICHAEL K ISSUED BY: Address: 2548 WESTMINSTER ST Phone: COSTA MESA,CA Zip: 92627 • Owner: WELLS,-MICHAEL K Address '2548 WESTMINSTER ST . Phone:COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: Licenser: 000000 Arch : - - ' Eng: Address: - .Address:- Phone: - Phone: Zip: • License: License: ' SCOPEOF PERMIT REROOF OVER EXISTING 1 LAYER OF COMP SHINGLES WITH COMP SHINGLES. . FEE SUMMARY Plan Check: $0.00Calc Valuation: $4,000.00 Permit: $97.25 - Claim Valuation: $4,000.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: ' $0.00 Inspection: $0.00 Total: $97.75`_ PLANNING &ZONING SETBACKS - MAIN STRUCTURE Front 0-0 , Rear 0-0 . " Left 0-0 . " Right - 0- ACCESSORY Front 0-0 • Rear 0-0 Left 0-0 Right 0-9 PARKING Existing: ,0 Required: 0 Proposed: d - NOTES: •NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain pnsworkers' su compensation nceerdinsurance,olicyasrequiredby season 3700 of the WboTCode,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (Thiezection need not be completed 11 the permit Is valued at one hundred dollars($100)or less.) 4rtify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' --compensation laws of California,end agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith razimcomply with,[ se.provisions. _ Applicant'Signatur : s�!'L-- (ice-C / :-Date: CJ��/OJ WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYERTO CRIMINAL PE ALTIE AND CIVIL FINES UP TO ONE HUNDRED "THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and effect.Lic.# Class# Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit suubj the applicant to a civil penalty of not more than five hundred dollars($500).): I, s owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. y"7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY C NTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not a y to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License s.). ❑ I am exempt oder sec. Business and Professions Code for this reason: Signature CaCut-a-� .��c.Q��i� ( ""�¢ Expires:. ��4 Verification of Ownership by(type of document,I.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 6,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .....or .il.h.. p.i.a..o.present Does will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ......Des or willt the l.. 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No ......e tii..te of ..mora .from... 8 (Ii'yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the e- ascribed property Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permittil finaI iron. �� Signature,tnagafOwner(s) �_ Pate v nd/.' thoriz'W•ricant tr tAry CODE r INSPECTION TYPE PAIS INTRULS CODE INSPECTION TYPE - DATE =ALE 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final _ �, � 208 Final Plumbing 200 Final Re-Roof G-22-0 /�Z`o arca' 210 Final Electrical - 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition _ 250 Final Bullding/Occupancy Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 55 CI-'.47(35--- - •• / CITY OF COSTA MES�At CONSTRUCTION PEMIT G PEST NO. i:. n TRACT� NO. LOT NO. UNIT NO. A P # LOCI' (� "i Zone n .Project Address Z S'1 S `M1/ la safe-4C Q VE ALJ 3 4G,1 I 0 i I '--�- -I-l�. f 1` I �~ ������pppppprrrrrr ,LJ\ S Main Building: Accessory Building: 'A' S4M. TYPE OF CONSTRUCTION U NEW ADD ALTERATION LI REPAIR E Z 'Applicant's Maililll Address ✓� !� OwPer's Name �•I Ke w�'S —0 i4)r��t�(o-7�5/ / ❑ CONVERSION ❑ DEMOLISH OTHER T Front 2�p/ O ..y�� �• ,./ SCR�py�ION F WORK/USE-eF BLrpr; ��� !.O� J.�t� B Rear 6 N Addvss �Z` 540 7A4 id4 /a. 0�- A,✓pF �J L /.� TWOt•r•.. . l- ' :ga A 1 Arch%Eng.A A. 7544-4-2- �j4-4-2 L 4/A License No. C C7 ? ". E OF PERMIT (I GRADING . FOUNDATION IA TRUCTU• - . C Right ik / N AddressL ��O/ t�'eP / fat ga- J Ill TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ ECHANICALe , I $ . Left H1t6 !1 Coi&'tractor'sName OwZec�/p Phone ❑ 'OTHER Ping. Ref.# Parking Req./Provided RE t Address(mailing) SAtit G- PROJECT DESCRIPTION SQ. FT. OCCUPANCY - ' planning Notes: WWII A '},', Q City a� • CON 57�2 V-TIQN TVP A,� V`L TION$ � 1f'Crsjp'�`' 4O eKtl,[ s• -yrC r'd License No. ZONE fic / GRADI NG CU.YDS. ACRES I 00 4/Pl1 Y C�/��••As�'••t_/ �.y -./ ✓ T LICENSED CONTRACTOR DECLARATION — ���III---��� A, �I �� �, dr r' / S. I her. affirm that I am licensed under provi '•• - ar er 9(commencing Remarks: F G ' 'D . • with sectio - •. 3 . a usiness and Professions Code, and my license is in full for • - - ect. • G 2a 2 - : - L ELECTRICAL FEES ' 'SineLicense No. G a PLUMBING FEES • Automatic Washer Transformer 0 15-50 KW e Signature ' WORKERS'COMPENSATION DECLARATION Construction'Pole Sub. • 050+ KW I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink I Showers , of Workers' Compensation Insurance, or a certified copy thereof (Section - Cooking Unit Meter ❑up to 100 amps Backflow Preventer Service Sink 3800, Lab. C.) - _. ..-,- - , Policy No. Company __ Backflow Irrigation Sewer Cap - • Dishwasher Meter Dover 100 amps Certified copy is hereby furnished. - - - , - Certified copy is filed with the city Building Division. Bathtubs Sewer Connection ` - , Dryers ❑Gas ❑Electric Sub Panel Date Applicant' - Fan Motors 00-1 HP 011/2-B EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors ' (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher Solar Piping 7 F.A.U. Ina Solar 09-15 HP ❑16-15+ I certify that in the performance of the work for which this permit is issued I - - - shall not employ anysubjectDrinking Solar Tank - 04 Fixtures p y person in any manner so as to-become to the Fountains Microwave Workers' Co / ttion Laws of Cali or f. 90� ' Date 'at after Y Signature 'sdC_ Floor Drains Swimming Pool w/Spa • - Device Boxes Pole Light NOTICE:If,of er making this declaration,you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal . Outlets Range comply with such provisions or this permit shall be deemed revoked. ' CONSTRUCTION LENDING AGENCYSwitches Gas Service Outlets Water Closet Sign I hereby affirmk that there is apm construction lending Sfor the 97rfCiv. C.) of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater • Garbage Disposal Standing Seciions. _ Lender's Name - Lender's Address Kitchen Sink Water Service - Generator 00-5 KW 05-15 KW Trash Compactor --)..- OWNER BUILDER DECLARATION •I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash , _ `nilowing reason (Section 7031.5 Business and Professional Code: Any city or inty which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays ' 7 structure, prior to Its issuance, also requires the applicant for such permit - file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9 (commencing With Section 7000)of 'Division 3 of the Business and Professions Code) or that he/she is exempt therefr and the basis for the alleged exemption. Any violation of Section Pection Fee $15 • Issue Fee �� $ 3 7031 by any applicant for a permit subjects the applicant to a civil - • e ty of not more than five hundred dollars($500). I ,DEVELOPMENT SERVICES REQUIREMENTS;_., illI, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 r• compensation, will do the work, and the structure is not intended or-offered Zoning Approved By L,,,,,,///��, / Date g for sale (Section 7044, Business and Professional Code: The contractor's' MECHANICAL FEES . Building Approved By c $j e/1/8 /� a r i ' Date ri I �� License Law does not apply to an owner of a property who builds or improves V �-• �.S J 'r" J thereon, and who does such work himself herself or through his or her own 7 employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ _ Application Issued By ' Date sale. If, however, the building or improvement is sold Within one year of con- • Canopy Type II 0 ` pietion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground SU M r FFEES prove for the purpose of sale). - , BUI LDING PERMIT $ � SMTP $ y 63 ❑ 1, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN to construct the project (Section 7044,Business and Professions Code: CHECK $ PERMIT The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU • ISSUANCE $ builds or improves thereon. and who contracts for such oroiects with a con- PLUMBING $ • • tractor(s) license ` Opursuantrk 'sto the Gainsurancea License should be I provided aware that Exhaust System ❑ Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ iProof of their under Section compensation 0. P.C.for this reasonto me. ELECTRICAL $ GRADING $ 0 I am exempt under B. & . .for this Firepl/Fact.Blt. ICBG# Fire Dampers q PLAN CHECK 50% $ • MICROFILM $ Date Owner •0 ��y f•`- II'� Heating System& Ducting Registers MECHANICAL $ TOTAL'FEE $ /`x• 63 I hereby c rti y that 1 haveve read this application and state that the above ❑4100,000 BTU 0100,000 BT . information is correct. I agree-to comply with a I city and county ordinances PLAN CHECK 25% $ and State laws r mg to building •nstruCtio• and hereby authorize repre- sentatives of t it /o enter n the -3 e-mentioned property for _ inspectio r as ��/�� v-'- Signature .. ' � •ate -t :ii�IJ, .wily E t..( Reinspection Fee $15 Issue Fee $ 3 (1 74,E��D- 46. Drivers' License or SS `=, = L'<' �f;l'('4��* �?. ' 0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor • CONSTRUCTION AND PLANN IOL&'SPA ' APPROVRLS .Permit# Date Inspector -APPROVALS Permit# Date Inspector 1. Ternpo:ary Electrical Service.or Pole - 52. Pool & Equipment Location - , 2. Soil Pipe-Undrgrnd. • ' • 2 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms -' 'r 4iElectrical C6nduit-Undrgrnd. I1 55. Electrical Bonding 5. Steel Reinforcement ', 56. Rough Plumbing & Pressure Test 6. Electrical UFER,Grnd. )' /O/ F5 ©c4 57. APPROVAL TO COVER-GUNITE • . 7. Footings.' 4. trns_g_ ipr /fl 58. Electrical Conduit-Undrgrnd. , 8:-Foundation ( - 59. Gas Pipe, O Undrgrnd.,Test 9...Water Pipe-Undrgrnd. t t 1 60. Backwash Lines, P-Trap, 0 Undrgrnd. ' • ���[�n/��'}��%// 10.•Structural Floor System , 'I /072, `"i" " 61. APPROVAL TO DECK I• 11,. Property Sewer Line & House Connection '' •• ! • 62. Backwash & Receptor-Final ...- 12.,Sewer Cap_ t ,63. Heater & Vent-Final . 13:-Roof Drains 64. Plumbing System - Final e 14. Rough Plumbing / 65. Electrical-Final •/ 15. Rough Electrical-Conduit 66. Solar System-Final 16, Rough.Electric Wiring 67. Fencing &Access Approval •f 17. Rough-Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough'Electrical-T Bar Ceiling,,' 69. POOL/SPA SYSTEMS FINAL 19' Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ,20. Rough.Factory Fireplace . i / . APPROVALS Permit# r 21: Ducts, in Structure . _ , 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas O Oil 23. Gas Pipe-Rough 8/Test t 7 .,' 72. Underground Flush 24. Roof Framing t:.: 1 73. Undergrnd.Storage Tank O Gas ❑Oil 25.1 Roof Sheathing t i fir///c,4. 19 le 74. Overhead Hydro . 26. T-Rar.Ceiling (Structural) &-Monocoat 11/ ( �_� 75. Dry Chemical 271 Franie'and Flashing _•1 e y., r� OA' 76. Dry Standpipe 28. Lathirig& Riding ' I 71 40 77. FIXED SYSTEM FINAL 29. Insulation 3� � 78• . FIRE PREV. FINAL 30. DrywallNailing `{' yrt tQ" / HEALTH DEPT. REQUIREMENT 31. Plaster BrOwn ko t J Zdui// 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CER IFICATE ISSUED 33. Final Electric , Notes: ! f e s &it., 34. Final Heating & AirConditioning / -I' .� 35. Final Gas Pipe-Test •a - /r 911 �/ j Olc .514- 36. Hood or Canopy (/%' v`i 37. Final Factory Fireplace 38. Final,Plumbing 39. Water Service-Final :40. Gas Service-Final i 41. Solar Domestic-Final- 42. Backflow Preventer , i 43. Backflow Irrigation 44. Landscape Irrigation System So 45. HandicapndAttenulatio / 41 V'w 3oi 46. Regulations � � � 47. FINAL STRUCTURE & BUILDING . r. / �r7 -'JC 48. Special Requirements Completed ` 49. Electric Release toEdison . r ..50. Gas Release to Southern California Gas Co 1- %-' ? ' 51. CERTIFICATE OF OCCUPANCY - I , No. Date 1 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. — P RM T N TRACT NO. LOT an UNIT NO. F COSTA MESA CONSTRUCTION PERMIT 138 ( I Z A.P.aW L}7)L1 - 14z--// Zone_________ Address 25'54175 . -` t I.�l.arl`-+z �C• ���� S Main Building: Accessory Building: pplicant's Mailing Address 'w-sE TYPE OF CONSTRUCTION U NEW I'DD Li ALTERATION U REPAIR E Front - z �A 1� � (A- ---1-4-4 �s 4449-4/1� 0 CONVERSION 0 DEMOLISH 0 OTHER - • T O Owner's Name A � .^Phone DESCRIPTION OF WORK/USE OF BLDG. Rca-A- .srT) C11 Uhl' I B Rear N Address ZS-Cite) L -rF�d I NSVal- Al- . A I {�. -Th rt c2 ��- C•Sil7Z TYPE OF PERMIT 0 GRADING LYFOUNDATION/LJ STRUCTURAL i C Right N Arch/Eng. License No. IrJY �" K Left G Address 3006 12' s4+Ic 0 TENANT ELECTRICAL PLUMBING MECHANICAL s R Contractor's Name S ~-E Phone 0 OTHER Ping. Ref.# Parking Req./Provided E Address(mailing) PROJECT DESCRIPTION SQ. FT. qr8.1# OCCUPANCY M CONSTRUCTION TYPE VPlanningNotes: __ - •y VALUATION$ T City License No. ZONE Q"-1 GRADING CU.YDS. ACRES S. LASED CONTRACTOR DECLARATION I here., firm that I am licensed under prov" - arter 9 (commencing Remarks: If." 3t ' ef. with section s0) of Division 3 • zusiness and Professions Code, and l `P Z eis , • license is in fu • e .•, ect. ELECTRICAL FEES se Cl, s License No. Signature PLUMBING FEES Automatic Washer Transformer 0 15-50 KW •RKERS'COMPENSATION DECLARATION Sink Showers Construction Pole Sub. ❑ 50+KW I hereby affirm that I have a certificate of consent to self-Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section . Cooking Unit -• Meter ❑up to 100 amps 3800, Lab. C.) _ —Backflow Preventer Service Sink ���� Policy No. Company Backflow Irrigation Sewer Cap ' • Dishwasher r I Meter Ltlover 100 amps i 8. 8 Certified copy Is hereby furnished. - 1 ((nq�� TI. e ■ C• Sub Panel O Certified copy is filed with the city Building Division. 2• Bathtubs gsELpr d.Tt) a 1 Sewer Connection 1 o� K�. Date Applicant 3 Motors❑0-1 HP ❑11A-8 p. o EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors I, �v (This section need not be completed If the permit is for one hundred ($100)or 1 M Inc.Solar 09-15 HP ❑16-15+ less). I Dishwasher C __OCA..' ) Solar Piping OC..K_.. • I certify that in the performance of the work for which this permit Is issued 'I' — — Iq shall not employ,any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fe-++ Fixtures Microwave j3 s Workers' Co a sate Laws of Califors"a. - pp r}B ,.,_� - Pole Light Date ¢ of Signature — . Floor Drains Swimming Pool w/Spa 9 NOTICE: 1 after making this declaration, you should become subject to the Rtlets ange Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - 9 . so comply with such provisions or this permit shall be deemed revoked. /_ CONSTRUCTION LENDING AGENCY Gas Service Outlets T. Water Closet(1 RF4.oCz42T� (9, pQ /o Switches Sign . •si I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) I Gailbage Disposal Standing Sections 2 Lenders Name Interceptors • I Water Heater(RteI-COCA76) DO_ - 3, 00 Lender's Address 1 Kitchen Sink(PELOcfl Lam) Water Service a_40 _ Generator ❑05 KW 05.15 KW Trash Compactor OWNER BUILDER DECLARATION n I hereby affirm that I am exempt from the Contractor's License Law for the 4 Lavatories((eEL_,OC..Afl 7 ./ Auto-Wash (rz -ria O ID ` 'wing reason (Section 7031.5 Business and Professional Code: Any city or v fly which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays li structure, prior to its Issuance, also requires the applicant for such permit le a signed statement that he/She is licensed pursuant to the provisions of • Roof Drains • Contractor's License Law (Chapter 9 (commencing with Section 7000) of - , J ` 'Division 3 of the Business and Professions Code) or that he/she Is exempt Reinspection Fee ! $15 Issue Fee ' -,tis-' $ et j therefrom and the basis for the alleged exemption. Any violation of Section .. 7031 by any applicant for a permit subjects the applicant to a civil •e ty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: Sa I, as owner of the property Reinspection Fee I $15 Issue Fee $ 3 o .SaLt a_will do the work, and the structure is not Intended or offered Zoning Approved By -cmee "Date for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES )Building Approved By Date_ License Law does not apply to an owner of a property who builds or Improves r^� // thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 -A$plication'Issued By 'Date 4` �( employees, provided that such Improvements are not Intended or offered for . sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 • r' SUMMARY OF FEES pletion, the owner will have the burden of proving he/she did not build or In- Duct-Under Ground prove for the purpose of sale). BUILDING PERMIT $ SMIP .` $ 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU PLUMBING $ 3 _op ISSUANCE $ builds or improves thereon, and who contracts for such oroiects with a con- ENERGY P.C. $ tractor(s) license pursuant to ere Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I' PLAN CHECK 25% $ o�1 proof of their Worker's Compensation Insurance should be provided to me. ELECTRICAL $ 1�C S� GRADING $ ❑ 1 am exempt under Section B. & P.C.for this reason Firepl/Fact.BIt. ICBG Fire Dampers , /,.�,. �j q PLAN CHECK 50% $ MICROFILM $ c-St Date yl�_____ Owner MNF-C•iLe-c.4 /G. (AWE-�� H,,..eeaatting System& Ducting Registers MECHANICAL $ . .koD TOTAL FEE $ I&O-DV I hereby(certify that I have read this application and state that the above I L 0-100,000 BTU 0100,000 BTU Information is correct. I agree to comply with all city and county ordinances • PIAN CHECK 25% $ , and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for y • Inspection purp0}e5.. 2 n�J ' 7 ' Signature �Gc �1�+---••" Date��o, `/ •, , _ _. _ _ _- Reinspection Fee $15 Issue Fee > •$ q y.,...7.72, � L - >tZ.!Orivars' License or 55 4f iA9 ppp�• „ ...�' - - ' fia65-4R-....u..SIRR_ white • Building: Canar.v -Aoolicant:.P.ink_Accounting; Goldenrod - Assessor J / STRUCTIONNAND PLANN• L&SPA/•Date • Inspector Date Inspector APPROVALS Permit# ` APPROVALS Permit# 1': Temporary1Electrical Service or Pole • 52. Pool & Equipment Location c�f 1 2. Soil Pipe-Undrgrnd . jjony 53. Steel Reinforcement - 3f1Electrical Conduit Utility-Undrgrnd. .p. 54. Forms r _ 46,Electricl Conduit..-Undr rnd. "r ii, „� 9 '1 55. Electrical Bonding • 5:;Steel Reinforcement ,, 56. Rough Plumbing & Pressure Test 1 6.i Electrical-UFER1Grnd. r 57. APPROVAL TO COVER-GUNITE ; 7`- 7 t ; .7.,Footings g . I B. Fpundation t l. 59. Gas Pipe, 0 Undrgrnd;Test � 9:'WateS Pipe-Undrgrnd. f i 4///44 *''<" 60. Backwash Lines, P-Trap, 0 Undrgrnd. (!' r ,, • %il 10',Structural Floor System 1 ' 61. APPROVAL TO DECK • 11-.i Property Sewer Line & House Connection ,br�/rf r' 62. Backwash & Receptor-Final • 12:,Sewer-Cap-- a 63. Heater &'Vent-Final .' ' / s 13. Roof Drains t 64. Plumbing System - Final e1 14. Rough Plumbing 'j,�2tosq (,e0 ' 65. Electrical-Final ' ' 15. Rough Electrical-Conduit l/ 66. Solar System-Final '1'6.•Rough Electric Wiring ?4J 67. Fencing & Access Approval 17.E Rough Wiring Sign J 7^' 68. APPROVED FOR PLASTERING ii 18. Rough Electrical-T Bar;Ceililhg i1 69. POOL/SPA SYSTEMS FINAL 19: Rough Heating & Air Contl�inning Z q�. �q., r.- FARE DEPT. REQUIREMENT 20:• Rough Factor Fireplace i- ` / tt 1 9 Y P 0 APPRO P ALS Permit# 21j! Ducts, in Structure v 70. UndC;rgound Hydro - 22. Ducts, Ventilating > Ill71. Proeluct•Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Tat - 74 Underground Flush 24. •Robf Framing L 73. Undergrnd.Storage Tank 0 Gas 0 Oil r 25.'Roof.Sheathing C 74. Overhead Hydro - . 26. T-BarCeiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame`and Flashing .'Qry Standpipe 28. Lathi g & Siding • 77.LFIXED'SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing �j3 \l1 HEALTH DEPT. REQUIREMENT r7 ' 31. Plaster Brown Coat 79. FINAL INSPECTION ' 32. Electrical Power Meter-FinalWu/a/Lk80;,F`OODvERTIFICATE ISSUED 33:Final Electric $11yfff/ . )�"^"'".-i°fes; ui/u /n fw t a.' 4.44X 7S ' 34. Final Heating & Air Conditioning >� p� / �y fjj� �� /[ V f Otn,27-.27 /� �r/s /lii tl, t'7 35. Final Gas Pipe-Test (2 kg (.ail -w6. Hood or Canopy 11 - to ' r _ est. /5".2:- • t37• . Final Factory Fireplace (V\ f 38. Final Plumbing 4043/41 _ r M X59. Water Service-Final r 240. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer - - J 43. Backflow Irrigation ) ` 44. Landscape Irrigation System N 45. Sound Attenuation ��/�- 46. Handicap Regulations ^ _� .Alia 9� moa r--r 47. FINAL STRUCTURE & BUILDING ty� ellir- ��,,���.�-�a-"-- 1. 48. Special Requirements Completed 49. Electric Release to Edison .• .a I. 50. Gas Release to Southern California Gas Co - - i f 1j 51. CERTIFICATE OF OCCUPANCY , ",� No. Date "3 ' 1 rU i .s-• i �