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Home My WebLink About2648 WESTMINSTER PL - Building Permits • CITY OF COSTA MESA 1i:1! BUILDING DIVISION 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 1:1 -•••45_ se. . FOR INSPECTIONS CALL: (714)754-5626 . PERMIT NUMBER C08-00185 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: POOLSPA DATE ISSUED: 04/30/2008 ISSUED BY: JOB ADDRESS: 2648 WESTMINSTER PL CM Suite/Unit: APN: 43920111 Zoning: , , • Vicinity: - Primary Occ: R3 Const Type: V-B SQ: FT: 504 Valuation: $57,000.00 SCOPE OF WORK: INGROUND GUNITE POOL AND SPA.504SF OWNER: STOWELL,JIM Address: 2648 WESTMINSTER PL Unit: Phone: 949-283-4521 City/State/Zip: COSTA MESA,CA APPLICANT: MANUEL GRIEGO - Address: 5752 KELLOGG DR Unit: : Phone: 714-936-2703 City/Slate/zZip: YORBA LINDA,CA • CONTRACTOR: EXOTIC WATERWORLDS License No. 384563 Phone: 714-525-3844 Address: 5752 KELLOGG DRUnit: - Cell: City/State: YORBA LINDA,CA ZipCode 92886 • ARCHITECT: License No. PHONE: ENGINEER: License No. - PHONE: COMBINTATION PERMIT FEE SUMMARY Building Plan Check: $450.29 Building Fees: $692.75 Electrical Fees: $73.00 Mechanical Fees: $41.70 Plumbing Fees: $91.00 SMIP Residential: $5.70 SMIP Commercial: $0.00 TOTAL FEES: $1,354.44 "Refer to fee receipts for all fees paid for project NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. cooE S. IMSPECIIUN TYPE egg INTMALs CODE/ Ixs'Ecnox TYPE pAT IN11114.$ 1618 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final f/4- ; /�) /lr'J : � � � 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall _ 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign _ 222 Final Site 204 Final Demolition 250 Final Building/Occupancy v \ r r WORKERS'COMPENSATION DECLARATION: ' Owner ID verified by driver_ ....en; J Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: O 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 ordeed): compensation, ab provided for by section 3700 of the Labor Code, for the performance of Me work for which this permit is issued. tiacI have and will maintain workers'compensation insurance,as required by DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ion 3700 of the Labor Code,for the performance of the work for which this permit is issued My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a e:l 7/ 1 person is required to descend,will be made in connection with work authorized O. J z k��1�v ��^ by this permit,and that no building structure,scaffolding,falsework•a demolition (Ms seas need not be inn (pmnavapvo at one rwiaadmrara(stop)nress) or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp I �� .-•, ° 2,Art 2,Sec.341,Title 8,California Administrative Code). P.C. S Y/ 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that 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 e „,• 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' ir'sation laws of California, and agree that if I should become subj; y ers'compensation provisions of Section 3700 of ``V Applicant's Signature Date the La•• •••- s,3.1 n• Ih comply with these provisi. 5. �T��` Division of Industrial Safety Permit Number: r,i■\, iw�.Q. r' • , HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE 0 SEs URE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND •. SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No ($100,000), 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 li -•se is i' I for e.nnd effect. a registration form for acutely hazardous materials? 0 Yes 0 No �JC_..1d* w Cl. : (Section 25533 of the California Health and Safety Code, with some ��/'x1,Y,p '� exceptions, requires registration with the Costa Mesa Fire Department by ..��!' �E. t each business which at any one time has on hand a quantity of acutely Ca;i •;”-"c?'y*'�e GP hazardous materials equal to or greater than a weight of 500 pounds, or a 4 volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LEN', s AGENCY: temperature and pressure). ❑ I hereby affsm . ;re 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 . •• tch this permit is issued.(Sec.3097,CMI Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ElYes ❑ No (Section 25534 of the Califomia 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 Safety Code been fully complied with? 0 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? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). 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 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 0 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? 0 Yes 0 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 property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. ❑ I, as owner of the LICENSED CONTRACTORS to construct the project(Sec.7044.Business and Professions Code: The contractus 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 Mes. enter upon the above-described property for inspection purposes. I -• -- not to occupy or allow occupancy of any building authorized by this •e ; final inspection. X lil ;• . s) Signature Date - ,�L\ \ 305746(3/07) •.te • O ' �► CITY OF COSTA MESA - 4� BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER Pliqk PERMIT J ,as+' B02-00418 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2648 WESTMINSTER PL Status: ISSUED Suite: Applied: 03/26/2002 Vicinity: Issued: 05/31/2002 Parcel Number: 43920111 Zoning: Applicant: STOWELL, JIM ISSUED BY: Address: 2648 WESTMINSTER PL Phone: 949-642-4481 COSTA MESA,CA Zip: 645-6360 Owner: STOWELL, JIM Address 2648 WESTMINSTER PL Phone: COSTA MESA,CA - Zip: 92627-4643 ' Contractor: OWNER-BUILDER Address: Phone: Zip: License: 0 Arch : Eng: Address: Address: Phone: Phone: • Zip: License: License: - SCOPE OF PERMIT 1090 SO.FT.ADDITION SINGLE STORY ADDITION TO SFR.ADD 2 BEDROOMS,ADD 2 BATHS.REMODEL KITCHEN; REFRAME ROOF OF KITCHEN AND GREAT ROOM;NEW SLIDING DOOR IN GREAT ROOM.RAISE EXISTING FIREPLACE. ROOF ENTIRE DWELLING AS PART OF REMODEL AND ADDITON.ROOF WITH COMP SHINGLES. RE-SHEATH ENTIRE DWELLING. FEE SUMMARY Plan Check: $696.90 Calc Valuation: $113,195.00 Permit: $1,072.15 Claim Valuation: $80,000.00 SMIP Res: $11.32 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $1,780.37 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 44-5 Rear 49-9 Left 15-4 Right 5-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 4 Required: 4 Proposed: 4 • NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) • • DECLARATIONS • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed i/the permit is valued atone hundred dollars($f00)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: _ Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND Dol I ARE($106IXp),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lie.# Class# Contractor's Signature: ' Date: CONSTRUCTION LENDING AGENCY: ' ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): • I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to tie C•ntractors License Laws.). ❑ I am exempt f:j1e Business and Professions Code for this reason: Signature: Date: -•93/4z_ Owner ID verifi=C y driver's license. CI /Yes ❑No Drivers License No. Expires: g/7443 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 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet Of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑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). ..t... .. . 3 Does or will the applicant or present or future building occupant need too prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the Califomia 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 end Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes UNo (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? 0 Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). r .. pollution 11 tin dist. o .. 7 If a permit from av the South Coast s Quality ed Management District l or other air gold tiontoncontrol district3 agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state aws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for in cti oses.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 5/3/ 02- ignature Of Legal Owner(s) Date And/Or Authorized Applicant Date COPE F INSPECTON TYPJ DATE INTm54S CODEC INSPECTIONTYPE QAL INTRIAL@ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site Q r 204 Final Demolition 250 Final Building/Occupancy � . . NEWPORT-MESA UNIFIED SCHOOL DISTRICT N2 4003 CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES PURSUANT TO AB 1600 AND AB 181 To: ( ,4 city of Costa Mesa District Receipt No. ( ) City of Newport Beach ,�p� Q ( ) County of Orange Plan Check N, rJ Applicant: Jirv1 5-1D 11 Q/ Address: 9 wes-im;flS4'v -9 Address: CDM. m1..fG' Telephone Number: Q9 D /2 Val Tract/Parcel and Lot Number(s): }/. Location of Project: v� �e ,�,-/ rnIn re Number of Square Feet of: 40 Residential Space /0 x $1.84 Total 2 DOS, Commercial and Industrial Space x $ .30 Total Commercialllndustrial Project is: (Check One) Warehouse _ Motel _ Preschool R & D _ Bank _ Auto Repair Movie Theater _ Neighborhood Shops _ Hospital Mini-storage _ Racquet/Health _ Large Office Heavy Industrial _ Hotel _ Office Bldg. Regional Shops _ Medical Office _ Restaurant Light Industrial _ Office Park _ Fast Food This project is exempt because This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code sections 53080 and 65995. The Building Pemits for this square footage in this proposed development may now be issued by your jurisdiction. Checks are to be made payable to Newport-Mesa Unified School District. �j � By: urrx �h 4 Aw�o�ed Representative The above representation as to square footage is true. Applicant agrees that if it is later determined that such representations are not true,then this certificate shall automatically terminate and the appropriate City/ unty shall be notified. ce Date: ✓/ JTZ App4ce 0501 F CITY OF COSTA MESA la) BUILDING DIVISION Y • tn./coy/Fria DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER F. jj4 I PERMIT Mtn P02-00325 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2648 WESTMINSTER PL Status: ISSUED Suite No Applied: 05/31/2002 Issued: 05/31/2002 Vicinity: 4. Parcel Nunmber: 43920111 ISSUED BY: drej Applicant: STOWELL, JIM Address: 2648 WESTMINSTER PL Phone: COSTA MESA,CA Zip: 926274643 Owner: STOWELL, JIM Address 2648 WESTMINSTER PL Phone: COSTA MESA,CA Zip: 92627-4643 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 0 Arch / Eng: Address: Phone: Zip: License: SCOPE OF PERMIT 1090 SO.FT.ADDITION SINGLE STORY ADDITION TO SFR.ADD 2 BEDROOMS,ADD 2 BATHS. REMODEL KITCHEN; REFRAME ROOF OF KITCHEN AND GREAT ROOM; NEW SLIDING DOOR IN GREAT ROOM. RAISE EXISTING FIREPLACE.ROOF ENTIRE DWELLING AS PART OF REMODEL AND ADDITON. ROOF WITH COMP SHINGLES.RE-SHEATH ENTIRE DWELLING.REF: B02-00418.PLUMBING TO INCLUDE: 1 BATHTUB, 1 GAS OUTLET(1-4), 1 GAS REPIPE, 1 LAUNDRY TUB/WASHER, 1 SEWER CONNECT, 1 SHOWER,2 WASH BASIN SETS,2 WATER CLOSETS, 1 WATER HEATERNENT, 1 WATER PIPING(INST OR REP). FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $9.80 1 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $9.80 1 Pressure Regulator '$0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set " $19.60 2 Drain, Floor $0.00 0 Sewer Connect $24.65 1 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $19.60 2 Drain, Roof $0.00 0 Shower $9.80 1 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $9.80 1 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $6.15 1 Sink,kitchen $9.80 1 Water Softener $0.00 0 Gas(Over 4 outlets) _ $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $9.80 1 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) §0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access reolierRer&EetyfitippLit8tatItfimul related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRAI ION: This permit shall automatically expteditintvitige,fftdaineeforfociathin 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 / Ff' 2446-46(6/00) V 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 workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F 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.a Class N Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: • ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she ie exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): -19 I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to e ntractors License Laws.). ❑ I am exempt un r Business and Professions Code for this reason: Signature: Date: S'/3./ Owner ID verifie drivers license. 0 Yes 0 No Driver's License No. Expires: F/G�03 Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: O I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). O As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gag at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the Califomia 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 asiplication aparmit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Li Yes LJ No (Section 65850.2 of the Califomia 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 Califomia Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with stat./laws .nd city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for s•- '. p •oses.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ... /1'!a% 3/ 2 D w-2-. /Sign- ure Of Legal Owner(s) Date And/Or Authorized Applicant Date CODES If5PFCTION TYPE LATE INTmALS CODES INSPECTION TYPE DEE INTITIAL@ 1616 Fixed System Final Fire Prevention 206 Final Mechanical (ry/�/`��/y'�'�,,, 1266 Pool Spa Final 208 Final Plumbing 41//7/05 Av V 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 4` 9 CITY OF COSTA MESA BUILDING DIVISION • f{#-77111:11:4)1% •.,,, �war DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT E02-00442 rowan 04. (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2648 WESTMINSTER PL Status: ISSUED Suite No Applied: 05/31/2002 Vicinity: Issued: 05/31/2002 Parcel Nunmber: 43920111 Applicant: STOWELL, JIM ISSUED BY: Address: 2648 WESTMINSTER PL Phone: COSTA MESA,CA Zip: 92627-4643 Owner STOWELL, JIM Address 2648 WESTMINSTER PL Phone: COSTA MESA,CA Zip: 92627-4643 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 0 SCOPE OF PERMIT 1090 SQ. FT.ADDITION SINGLE STORY ADDITION TO SFR.ADD 2 BEDROOMS,ADD 2 BATHS. REMODEL KITCHEN;REFRAME ROOF OF KITCHEN AND GREAT ROOM;NEW SLIDING DOOR IN GREAT ROOM. RAISE EXISTING FIREPLACE.ROOF ENTIRE DWELLING AS PART OF REMODEL AND ADDITON. ROOF WITH COMP SHINGLES.RE-SHEATH ENTIRE DWELLING.REF:B02-00418.ELECTRICAL TO • INCLUDE:28 LIGHT FIXTURES,40 OUTLETS,20 SWITCHES, 1 SERVICE TO 200A. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $27.84 28 up to 50 kva/kw $0.00 0 Recept Outlets $36.60 40 up to 100 kva/kw $0.00 0 Switches $22.00 20 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $30.50 1 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(,gen or ride) $0.00 0 Motors to 1hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $140.44 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) v 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. O I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If 1 should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions, Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DO LORE(5100,000),IN ADDrrlON 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 A Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: • ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Dale: OWNER•BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): I,as owner of the property,Or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). 1/412 I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the on tactors License Laws.). O I am exempt u Business and Professions Code for this reason: Signature: Date: J5/t1/4— Owner ID verified driver's license. 0 Yes 0 No Drivers License No, Expires: 81/4703 Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: O I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341.Title 8,California Administrative Code). ❑ 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 e permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons. or 200 cubic feet of compressed gas at standard temperature and pressure). .. .. . 2 Does or will the applicant or present or future building occupant need too filee a a registration form for acutely hazardous materials? 0 Yea 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Flre Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health end Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this gpplication agermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? IJ Yes LJ No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 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 8 (If'yes",attach certificate of Compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state I. s and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for ins- o•/nooses.I a.o a not to occupy or allow occupancy of any building authorized by this permit until fir!inspection. area S/ /ignature •f Legal Owner(s) Date And/Or Authorized Applicant Date CODE INSPECTION TYPE 261E INRRAL$ LODE! INSPECTION TYPE RAIL KEW 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ^ 200 Final Re-Roof 210 Final Electrical I/�e"l* 2 'ILS,M-71-k) 201 Final Block/Retaining Wall 212 Final Fire Prevention C)' _ 202 Final Factory Fire Place _ 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy r rEPUTY 1 INSPECT ._,N SERVICE INC. DEPT. OF BLDG. & SAFETY 25121 DE SALLE ST, LAGUNA HILLS, CA 92653 CITY OF 4�sr vVt sQ 1 - 800 - DEPUTY 1 = 1 - 800 - 337 - 8891 COUNTY OF n SPECIAL INSPECTION REPORT Building Permit No. SC1 7- - CO ctlei Job. No. Date ZO U Z Job Indentification/Address STva+F*-l.t 5 .� 2f�`t ‘AJ fr STvN tnt S i Tc2 ('L: I CIA/1 General Contractor/Address O w rtfdi- a57fL Sub - Contractor/Address --- Structural Engineer/Address c faL L e-• fCOU-ctl- Arch. REINFORCED CONCRETE MASONRY HI-TENSILE BOLTING CHEMICAL ANCHORS PRESTRESSED CONCRETE WELDING GYPSUM CONCRETE OTHER WELDER RECEIPT NUMBER WELDER i RECEIPT NUMBER DATE OF INSPECTION DESCRIPTION OF WORK INSPECTED GrZo. 02- 03566LvFP IdlS ,loll off- ( 23 ) WtA- >*f-c( Ie-CBr&g DO 1/4"-) 5 w ( (n t u"�t M • dr .,'t 0 2 e.k EST- 5u-.4'3 L✓�5tcnPsoN S€r _Co'sy tt SZ'Z Pl tC Ot ,1L--S oN A- -3 t ("4-et tt F-• sPtc' . l t-o•--e, 5 lig `I o'/iv-s(t.€ ,' 2 fr s t4 Cv, ✓-vC- C 4-nc Fg7 • HOURS SAMPLES DATE Reg. . OT Time In Time Out Grout Mortar Concrete Block Density V--�1 to Prisms All inspections based on a minimum of 4 hours&over 4 hours-8 hours minimum.Any inspection extending past the noon hour will be billed as 8 hour minimum. In addition,any inspection extending past an 8 hour pe- riod,or Saturday inspection will be billed at time and a halt. ATTORNEY'S FEES - If any action at law or in equity is brought to enforce or interupt the terms of this Contract, the prevailing party shall be entitled to reasonable attorney's fees,costs and necessary disbursements in addition to any other relief to which such party maybe entitled. - /t✓ • SPECIAL INSPECTION REPORT C-= ✓�—\ Inspector's Name: ^g-'1 • ct�-er1ne9-- Inspector's Signature: I.D. No. CZ- 9 3 I has been filed and it states that the above work to the best of er knowl ge complies with the provisions of the - sip Building Code and meets appr. -• plans and specifications. r Respectfully S mined, Approved bowed, jA (' kr By: Project Superintendent Larry Carter 49 41 CITY OF COSTA MESA _ 4 BUILDING DIVISION > %jfritallairli , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER / tt w_Pri I 4 PERMIT M02-00221 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 2648 WESTMINSTER PL Status: ISSUED • Suite No Applied: 05/31/2002 Issued: 05/31/2002 Vicinity: Parcel Number 43920111 ISSUED BY: _A14,4_____ Applicant: STOWELL, JIM Address: 2648 WESTMINSTER PL Phone: COSTA MESA,CA Zip: 92627-4643 Owner: STOWELL, JIM Address: 2648 WESTMINSTER PL Phone: COSTA MESA,CA Zip: 92627-4643 Contractor: OWNER-BUILDER Address: Phone: Zip: License:0 • SCOPE OF PERMIT 1090 SQ. FT.ADDITION SINGLE STORY ADDITION TO SFR.ADD 2 BEDROOMS,ADD 2 BATHS. REMODEL KITCHEN; REFRAME ROOF OF KITCHEN AND GREAT ROOM;NEW SLIDING DOOR IN GREAT ROOM.RAISE EXISTING FIREPLACE.ROOF ENTIRE DWELLING AS PART OF REMODEL AND ADDITON.ROOF WITH COMP SHINGLES.RE-SHEATH ENTIRE DWELLING. REF: B02-00418. 1 INST FAU< 100K BTU, 1 HOOD W/MECH EXHAUST,2 VENT FANS/SINGLE • DUCT. FEE SUMMARY • . Quantity Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 .Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep. Recess Wall Htr $0.00 0 _ Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 - 0 Compressors/Absorption Systems Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $10.65 1 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $14.50 2 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $63.45 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 4 JIB' 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 workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,00e),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.#_ Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: • ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): A' I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. ' 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). R. I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant tot e Contractors License Laws.). ❑ lam exempt u•u!tar. Business and Professions Code for this reason:Aite S/31 J Z Signature: /-,., Date: /0 // Owner ID verified(drivers license. ❑Yes 0 No Drivers License No. Expires: /i A 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 8,California Administrative Code). ❑ As owner-builder, 1 will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such Work from the division. Signature: Date: • Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes jg 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? 0 Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air 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? 0 Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state law and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for insp i nes.I a ree not to occupy or allow occupancy of any building authorized by this permitti until final inspecon. A 2— lure Of Legal Owner(s) Date And/Or Authorized Applicant Date COVE A INSPECTION TYPE DATE INTITIALS CODE A INSPECTION TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical WIT/0 3 15N 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention _ 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site _ 204 Final Demolition 250 Final Building/Occupancy ADDRESS OF BUILDING: 2648 WESTMINSTER PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT -`D-OVS0 7 v t7NNERSNAME IF*KAN:CHUN—NIEN KING PERM NO: B 087698 e •DDRES& 5 ASH TREE LN • IRVINE PERMIT NO: B 087698 PLAN CHECK NO: N GOVT: N SUPP: N :A 92715 ( 714 ) 786-1167 APDL.MAILDIG ADDRESS CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT merino'OR ENGNEER: UC.NO.: JOB DESCRIPTION : T/O EXISTING & APPLY NEW "G.A. F . COMP" SQ FT: 1 , 500 ARCH.OR ENG.'S ADDRESS: UNIT: CLAIM VALUE: 1 , 500 . 00 CALC—VALUE: 1, 500 . 00 GROUP OCC : R-3 / CONTRACTORSNAME: CONTRACTORS MNUNM COMMENTS: TO CLEAR EXPIRED PERMIT FOR A REROOF, REF: B56072 ADDRESS: UC.NO,: ******************************************************************************* UNIT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of perjury that I sm licensed under provisions of Chanter 9 SETBACKS (commencing with Section 7000)of Cwision 3 of the Business and Professions Code.and my license win full force end effect. Cm LIC.NO.: UC.CLASS: UC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: Contractor LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penaly of perjury thal I am exempt from the Contractors License Law for the 'Skiving reason(Section703t,s Business and Professionscode:Amcity or county which requires a parrot tocarstmct,alto.improve, PARKING REQ: PROV: PARCEL : 43920111 ZNE: REF NO:, demolish,or repair any structure,prior to is issuance,awo requires the applicant for such permit to file a signed statement that he or she S licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commenting with Section 7000)of DNson 3 of the PLANNING NOTES> . Business and Professions Code]or that he or she is exempt therefrom and the basis for the Sloped exemption.My violation el Section > • ': 7031.5 by any applicant for apermt subfeds the applicant to a civil penally o not more than flue hundred dollars 1$5001). ******************************************************************** ********* ❑ L as owner of the propeny omy employees with wages as theisde compensation,will do the work,and the etructuree not intended DEVELOPMENT SERVICES R E Q U I R E M E N;T S or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not appy to an manor of property who bolds or improves thereon,and who does such work himself or hereof or through hi or her own employees,provided that such improvements are not intended oroffered for sale,ff.however.the building or improvement S sold within one year d completion,the ZONING APPROVED BY DATE: '- owner'builder will have the burden of proving he ar she did not build or improve for the purpose of sale). ❑ I,as owner of the property,em exclusively contracting with licensed contractor'to construct the pokes(Section 7044,Business end Professions Code:The Contractors License Law does not epply to an owner of property who builds or improves thereon and who BUILDING APPROVED BY ; DATE; ,, contracts for rads projeds with a contrada(s)licensed pursuant to the Contractors License Law). A /�� )❑ lam 4/I µeaamptuMaSeetiah$P7044 B.aP.e..a,rmwraaeorh:AJORK ?Y OWN R FAMILY APPLICATION ISSUED BY; DATE: `*****�� I do hereby certify thatm laaware of Reath and understand the requirement of Calfomia Meaand Safety Code SediasAi: .25533,and LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y 25534,and that I or any future building ocaipent will/wit not(drab one)need to comply with said date codes and the -•uiremehs for • a permit for construction or modification from the Ar Quality Management Uatdct.Resideial condmdionappkmons areexempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions, PERMIT 48 . 50 . 50 Date: Applicant: S M I P/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby elfin"under penalty of perjury one of the following declarations: PLAN ElI have andwil maintain a certificate of consent tosettinsurekflohem'compensation.as provided for by Section 3700 of the Labor IUILE FEE Code.for the perfomanceof the work for whchthis permtisissued. BUILDING DIV > PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ Ihave and SImaiManworkers'compensation insurance,asrequiredbySectio3700of the Labor Code.for the performance oftM TOTALS > 49 . 00 0 , 00 0 . 00 99 . 00 49 , 00 00 waif for which this permit is issued.My workers'compensation insurance carrier end policy number are: Caner: REVENUE DIVISION TOTALS--> COLLECTED : 49 . 00 OVER/SHORT: . 00 Policy Number: BLDGPMTPLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ;This section need not be completed/Us panne is or one hundred dollars/3700/ot leaf.) 48 . 50 . 50 ❑ 1 certify that in the performance of the work for whch this permit is issued.'shall not employ any person in any manner so as to become subject to the workers'compensation Laws of California,end a0ree dw t I should become eubjed to the wo.Mrse ***************************************if*************************************** compensation prods ns of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. INDIVIDUAL F E E BREAKDOWN D ale: Applicant; _ ___ Warning:Failure to secure workers'compensation coverage/s unlawful,end shall subject en employer to criminal penalwwea end TYPE QTY D E S C R , I P T I O N UNIT COST TOTAL COST civil Rhes cc to one hundred thousand dollars(3100,000A In addition to ths cost of compensation,damages as provided ler In Secton3706ofthe Labor Code,lmet esandatronay'alee. SFR 1500 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 1 , 500 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a c.mndon lading agency for the END OF FEES performance of the work for which this perms is issued(Section 307.Co'.C), ( LENDER'S NAME: y LENDER'S ADDRESS: ` cents that I have read the application and male that the above information is coned.I agree to comply with all city and county ordinances fand stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property r . or inavadion papnsea. VOIL{t1 El . • 04-14-1998/11:59 A8/$49.00 RC4:01-0022372 .. c. PERMIT:087698 i . - Signature of s' -r Ageno/AppicanVContr.Sfi'r (5151-48.WP) Whta-Build'ug 8 SSaly:OreerrFtle:Canary-Applrarht:Pink-Revenue:Oaf ennad-Assess C4)NSTRUCTION AND PLANNING POOL ,PA APPROVALS Permit # Date Inspector • APPROVALS Permit # Date Inspector • 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. • 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER•GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. • 8. Foundation • 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection . 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System • Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring , X67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe • 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION I _ 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 111 33. Final Electric Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final •• 41. Solar Domestic-Final 42. Backflow Preventer • 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING I-5is cum-- 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECTAODBESS: 2648 WESTMINSTER ,& P_kp.rr. f ,•UNIT: ' CITY OF COSTA MESA — BUILDING PERMIT L't:RM NU: 8 UDbU /4 ^BWxie•sNAME: CHUN—NIEN KING • ,ADDRESS: 5 ASH TREE LN PERMIT NO: B 056072 PLAN CHECK NO: N &UVJ. ; N SUYJ'; N IRVINE ' CA 92715 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE; ALT ( 714 ) 786-1167 ARCH/ENGINEER: i - REG.NO.: JOB DESCRIPTION : T/O EXISTING 6 APPLY NEW "G.A. F. COMP" SQ FT: 1 , 500 ADDRESS: ,2 UNIT: CLAIM VALUE; 1 , 500 . 00 CALL—VALUE; 1, 500 . 00 GROUP OCC: R-3 / PERMITTEE: CHUN—NIEN KING ( 714 ) 786-1167 ADDRESS: 5 ASH TREE LN COMMENTS: SMOKE DETECTOR(S ) REQUIRED IN HOME. IRVINE CA 92715 ****************************** **********aF*TE*** *>ETF**********TF***TF*****i<"*iE* *** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CUSS: MAIN BUILDING ACCESSORY BUILDING Date: Signature: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell-insure or a certificate of Workers' LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT• FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). POLICY EXP.DATE: PARKING REQ• PROV; PARCEL: 43920111 ZNE; REF NO: COMPANY: PLANNING NOTES> ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. > Date: / Applicant: DEVEILOPMENT SERVICES REQUIREMENTS EXEMPTION FROM WORKERS'COMPENSATIONIODECLARATION: (This section need not be completed if the permit is for one hundred(SVP or less). I certify That in the performance al 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. / 1 �/ � ZONING APPROVED BY DATE; Dale: Z ' 3 -412- Signature: Com^' (.JH^�'�x �" BUILDING APPROVED BY ; i DATE: NOTICE:If.after making this declaration,you should b come subject to the Workers'Compensation pr ns al the Labor —Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICATION ISSUED B Y; / CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for .►�. < .s-—, _ DATE: 3,( ,_ which this permit is issued(Section 3097.Civ.C). ***********'***}**-*'*-*X** 4 * '' *'*x'****'*** ;7C �F ** LENDER: *************.**")x'************************ **** ******************************** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SNIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 35 • 00 _ ,50 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMI P/NON- RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business p LAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by x - any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 35 . 50 0 . 0 0 0 . 00 3 5. 5 0 35; 50 . 0 0 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through hisorherownemployees.provided that such improvements are not intended or offered for sale.If.however the building or REVENUE DIVISION TOTALS--> COLLECTED • 35 . 50 OVER/SHORT• 00 orimprovementthe is soldf within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOOT GRADING PLAN-CHECK for the purpose of sale). I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 35 . 00 . 5 O ., ❑ and Professions Code: The projects fate License Law does not apply loan owner of property who builds or improves thereon *********************************************************+.********************* and who contracts Ior such projects with a e Lice contractor(s)license pursuant to me Contractors'State License Law).I am aware that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN in I am exempt under Section:B P 7 0 4 4 B.S P.C. WI this)reason: WORK BY OWNER FAMILY TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date �7 �12— Owner: 7/ C.L+�'�C-rid SFR 1500 REROOF 8Y VALUE RESIDENTIAL NOZONE 1 . 00 1 , 500 . 00 I do hereby certify that I am aware of and understand the requirements of CalAornia Health and Safely Code Sections 25505,'Ay: ,and 2' END OF FEES25534 and Inst or any future builtling occupant will/will nal(circle one)need to comply with said state codes and the requirexe is forarIH Lf' • permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from \ - -X P ( RED _ these provisions. 3/O/,L"��/1 0 s)� ElEplf;p��Q IfL5pE3Ct10�15 • Dale: Applicant: ��?f t1 �]n!;?' • - i I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ,/ x/V '!' 7:: •, - ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentionedp ��/ - ,.> S Ordinnys torinspection purposes.ningt I/ (—•I `- _. 'r r. �� Date: Z�; Z Signature: f7'�>...., 1 11j�\� . 1 uH-1_. r‘lii \J^/y/�/ 1 ^, Driver's License or Social Security a: ( �/' 4 ' - -••�ww—RruNina:Green—Code Enlorcemenl;Canarv—Aoolicant:Pink—Revenue:Goldenrod—Assessor \X,(nJ` " " r 4 - - ri t CONSTRUCTION AND PLANNING POOL A ' APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector '11., Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding • 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7, Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 110. Structural Floor System ' 61. APPROVAL TO DECK • - C'11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final • 12. Sewer Cap 63. Heater & Vent-Final . • 13. Roof Drains 64, Plumbing System - Final r 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval .' 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVALS Permit# • . 21. Ducts, in Structure 70, Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil • 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil .. 25. Roof Sheathing 84-72_ a,L..4. 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78, FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - 79. FINAL INSPECTION _ ) 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED {I 33. Final Electric ; Notes: 34. Final Heating& Air Conditioning I 35. Final Gas Pipe-Test 36. Hood or Canopy - 37. Final Factory Fireplace - - 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation I 44. Landscape Irrigation System EXPIRED/ 45. Sound Attenuation tr�ampl e'Inspecttolfl 46. Handicap Regulations , to J _ -F-'sig 47. FINAL STRUCTURE & BUILDING `.• ii 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co , . 51. CERTIFICATE OF OCCUPANCY ' No. Date UwNER HORTON, GERALD J. DATE 10-10-66 JOB ADDRESS 2648 Westminster Place BUILDING PERMIT NO. 26244 GENERAL CONTRACTOR owner ti DESCRIPTION OF WORK Biding & add to res AP No.119-163-18 LOT TRACT FIRE ZONE VALUE $400.00 "i'' 'SECTIONS Signature Date GROUP 57 7 TYPE V ZONE pi satI PERMITS ISSUED Gas SUBCONTRACTOR Date Number I Signature Water _ Plumbing Rough Plumbing Prop. Swr. Line 0 House Con.0 Sprinkling System Miscellaneous Rough Heating and Air Conditioning Temporary Service or Pole Underground 0 Power 0 _ Rough Wiring Heating and Vent. Trenches, Forms Dia Steel Reinf. 0 I •,713 X /0-/J-- A Floor System Bond Beam ❑ Steel Reinforce ❑ Sheathin: a . I Frame and Flashing C %4�j/s >.� anLr Lathing--In ❑ Out ❑ Plaster, Brown Coat — S' 'ural, Final i Electric Ii, ang, Vent., Refri:. and A.C., Final Plumbing, Final and Gas Test 0 Electric, Final Building, Final t'J SilLT.A7 Ilpirr, 26244 OCT 10 GST 1�- 6492Q�)4`�2 �(j) COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1201 COSTA MESA, CALIFORNIA 92620 - For Applicant to FM In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING ■uILDINa For Office lin Only ADDf�IHHoc Sp 6/(/ �r5%/)//evil Cl"<• , RECEIPT NO. PERM Y NO. / COSTA MESA. CALIFORNIA /r{�/T� //s^ ) RE E • Y GATE RECEIVED -DA ISSU[p/ / OWN1111&/�i '4'ta J • / ,C/O.d —7 7t-c �,4 d/ 'Y' o MAIL / /3_ y / V BUILDING ADDRESS P ' U� ,[�(�3a WIRE AADDRESS'CITY$. ' LrUol�( InikAP ° NOLJT -/P?? ZONE TYPE j/ GROUP f APPROVED it /CJ_/O ARCHITECT TEL BY DATE/el-AO d OR ENGINEER NO, , L i „--- ',DRESS ZONING V DRESS p �y�I� fi SON, 1/ NO.OF USE OF NEWPLA CONTRACTOR — ✓ L/l/ /Leif/ L�'e� ...- LEGAL � INE/ /,y'ITL-DING ESP.O a DESCR Lc� i / 77� ADDRESS; DESCRIPTION �y /// /,�{q�y�I CITY i� A.P.NO. //9— Y/3—/3. STATE TEL. NOTE: NO EAVE OVERHANG SHALL BE L888 THAN LIG.NO. �� NO. 30'TO SIDE&REAR p.L. VES SIZE b /6 i I NO.ON LOTS. / ALLOWED (U.S.C.REQUIREMENT) OF LOT 6 V NOW ON LOT USE OF ��TT�� / YARDS APPROVED YARDS APPROVED EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING (FROM C/ REET) SETBACK LINE FROM ///� I Q • CENTER OF BTRT lig REAR YARD /O FRONT PT. FT. EE SIDE YARD I LEFT /y. 6RIGHT 1/. S R.SIDE /1 Fr,S IR. DESCRIPTION OF WORK L.HID . Fr. _' I ALTERATION ADDITION /..> REAR PT. DISTANC BET. arr.MAIN& REPAIR MOVING I DEMOLISH MAIN BLOGH. ACCESS.BLDGH. BUILDING NO.OF VAR.# DATE SIZE ROOMS STORIES C.D.p.# APPROVED EXTERIOR WALL I ROOF APPROVED COVERING COVERING ST DATE ![i/J. _ USE OF BUILDING AND WORK TO BE PERFORMED IL Pat Trx Tcicc ..7 —// Sib 4710‘ w 641 /=.eo.r-a—j.t:0,-5 , £ iec't kt/T.c7'eimL 7 it pO re,,s- Aaas4,' .OP UTitiT7. j4e . GO.PT. I HERESY ACKNOWLEDGE THAT.1 HAVE READ n4111 APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE C AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CON. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY OR AND RATS LAWS REGULATING BUILDING CONSTRUCTS p.��I VALUATION GO p SIGNATURE OF //�� PERMIT PEE S W PERMITTEE L /// S Q/7 PLAN CHECK S 'Sc) w' AUTHORIZED AGENT (/ '? TOTAL PEE S c7 UWNCN Ml; ALV I/ W1111am DI. UAIC IL-11–14 JOB ADDRESS 2648 Westminster Place BUILDING PERMIT NO. 39405 GENERAL CONTRACTOR Ownr.-Bldr. DESCRIPTION of WORK Leg. Ger. & Storage V 'o•119-163-11 LOT 68 TRACT 376 FIRE ZONE VALUES 4,6000.00 U. ECTIONS Signature Date •TYPE V GROUP ,J ZONE R-1 SOIL SUBCONTRACTOR PERMITS ISS4ED GAS _ Date Number (_Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. ❑ _ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE • UNDERGROUND ❑ POWER 0 OUCH WIRING Heating and Vent. ` TRENCHES [, FORMS 0 STEEL REINF. 0 FLOOR SYSTEM BOND BEAM (] STEEL REINFORCE ["I r SHEATHING FRAME AND FLASHING LATHING — IN n OUT n PLASTER. BROWN COAT 4 S' MURAL, FINAL Elactn%�A�'�l�-09 �q yy aap HE. dG, VENT., REF RIG. ANO A.C., FINAL _ (Jj/L�f /"'4*w' [l•JJ/$ ✓Q.,y p PLUMBING, FINAL AND GAS TEST [1 ` ELECTRIC, FINAL J-�A 7� 4 A-'17 BUILDING, FINAL bL -&/-')7 •—_- _ PA Iii "C.0 11-74c1sr00 610- ****73.00 { 39405 COSTA MESA BUILDING-SAFETY DEPARTMENT s P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 AP LI ATION FOR BUILDING PERMIT For Applicant to Fill in Completelyl� R I E DATE RECEIVED D /TE ISSUED BUILDING ADDRESS N-(0�18 WC tont h S�sr ` I, !�-11 7 ' ' 11 / i OWNER W l I ., l . LI A.P. NO. �i "'-(V.c3\-A JI��—P 9M' t a l 1 BUILDING ADDRESS C.c48 V`ie's njsr — Tc, MAILDAl ADDRESS Sdvv� ^ //--pp,�( 0 W �t TEL TRACT 3-/( 'PI.OT 'S BLOCK IiU CITY ` os 1 0. Nikes et___ CAI -No.G//S 726 Z Q CONSTRUCTION NEW ADO ALTER REPAIR MOVING DFMOI ISN 0 to LENDER ! a m /I I m y1t`/� `,� J BRANCH V lJ L 1 _LV I(FLv Y a W ADDRESS OWNER T Lia t VALUE (�A CO•m ARCHITECT TEL. USE( AMM`= ORe erne$ I'(f0a J a OR ENGINEER NO. U Q FIRE '�\\� W 11: ADDRESS �J0_Ly ,('� // ZONE T PE GROUP �J Z CONTRACTOR Ly / I� BYAPPROV ED �� DATE ' _ ( 1-7(-- LU m- z ` To �E \ 1 NSr?Ecr J Q ADDRESS ppplll�� Ill = TEL. Z0,01.&1 (NO.OF PLANS 2 BUILDING USE OF NEW EL a j- - CITY NO. I` wO STATE CITY YARDS APPROVED YARDS APPROVED co m LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLDUS. (FROM WI_STREET) [/' f� OF LOT I NOW ON LOT FROM FT. S / FT� G USE OF EXISTING BLDG. R.SIDE FT. 2. 0 FT. I- SIZE OF Z0.3(21 'ft NO.OF 1.,cZ NEW SLOG. /� f e 2'y ROOMS 3 [)STORIES 2 I L.SIDE FT. - y FT. UEXTERIOR WALL/a�� lI COVE (t/, Ad I L1 {- 3 !. _ COVERING (({G.-. COVERING I`fttfdt� ID'iv REAR FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED ((// CL L_>^ AL1�1 til Cr DISTANCE BE . MAIN BLOCS. BET.MAIN& ACCESS.BLOCS.ST"G rr 0 Q /� T� VAR.# DATE O Ga r'L(s) C. -t- S ( o : a. r C C.U.P.#P+ APPROVED fj z ROVED/J Lel _ / DATE ( �/^/ O N V (/�N" F I hereby acknowledge that I have read this application and state S1,/It rthat the above information is correct and agree to comply with 'J-�(/l� CC all laws regulating building construction, and I shall not employ r any person in violation of the workman's compensation laws of N the State of California. �/ /, m ZI hereby certify that I am properly licensed as a contractor under LYr SO.FT. _TAX o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR b Chapter 9. and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; 2 am exempt from the provisions of the State of California Business VALUATION I--V o�jLe f/// m and Professions Code,Division 3,Chapter 9. PERMIT FEE $ D Signature om Permittee 1->•'lI� $ �V U PLAN CHECK $ / 16LL Authorized Agent TOTAL FEE $ lI 1. _' OWNER William N. McKelvy DATE 10 _75 JOB ADDRESS 264$ Weatmini er PL BUILDING PERMIT NO. 40659 GENERAL CONTRACTOR Owner/$ldr, DESCRIPTION of WORK Family Room A ..fg_163_u LOT 66 TRACT 376 FIRE ZONE VALUE $ 11,000.00 INgrECTIONS Signature Date ,TYPE V GROUP I ZONE Rl SOIL SUBCONTRACTOR PERMITS ISS ED GAS Date Number I Signature WATER Plumbing ROUGH PLUMBING Or.PROP. SWR. LINE Q HOUSE CON. fl SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND LI POWER 0 ROUGH WIRINGJL-ftp-753 / Heating and Vent. TRENCHES 0 FORMS 0 STEEL REINF. [4 WIRINGSi- 7 7 FLOOR SYSTEM ��'///l��T� BOND BEAM n STEEL REINFORCE n SHEATHING // Gl/�men'24. r FRAME AND FLASHINGe / , d/D.27, J1 LATHING - IN 1 UT Q/2-1- 7 PLAe-YR, BROWN COAT STI 1RAL, FINAL HEATING, VENT., REFRIG. AND A.C., FINAL &LJ-wt.l _ /0-6-75 3 9,59/.---- PLUMBING, ,59/-/PLUMBING, FINAL AND GAS TEST Il ELECTRIC, FINAL '. C/ 1 -1-6-75 01111 nIur. riu&I £21 r-- ., • , PAIL Ou 4%55 tri -6-75--00 2149* ir:::ry 8 .77 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only /,// •I ^� .�J RECE DATE RECEIVED (/T/�) BUILDING/26 7d48.! )657-m ciIS(�'r&x /e• �4 DA I I AG'S -_,37- 0 ,� OWNERS t/�,/,/�lrlr/ AI, 4, erl I41 / A.P. NO.II 1 - 1W3- PERMIT NO. MAIL �j /',/ I,�-/ ,y7 p �J BUILDING J (y r. ADDRESS f.67p /.!/i�)v 4'uin7i/v /,.t ', ADDRESS Me 7 l t).)2 N. -L BA S�C✓ at CITY 6Q$yn /1/ESA ND. 61/6":7261 TRACT 37 I PLOT 4,9 BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVINf; DFMOLISH LENDER ADARCS .st o OWNERO I I II QI'N 1,f .V I\L eha ADDRESS t I4I� -{� VALUE /� ARCHITECT TEL. USE rQMt 60s11 $ OR ENGINEER NO. FIRE ADDRESS ZONE J TYPE .GROUP CONTRACTOR ©w .�r r, / eh t 1de�r ' BPPROVED / DATE ` `‘ ADDRESS ZO Nppp��t NO.OF //�1 USE OF NEW ' / TEL. r/ 1 PLANS _/ BUILDING (Odin ead CITY NO. „ 4 Qw, "'"^^^"'..."'!!! uee STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE / I / / NO.OF BLDGS. (FROM C/ALS EET) /e n/ Os OF LOT 4 a x �r0 NOW ON LOT FRONT N cif?(�.{'1 FT. a USE OF fie EXISTING BLDG. _R.SIDE 3T. FT. .-. EI-. Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. • W PFT.T. b ( FT. [..� USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& QMAIN BLDGS. ACCESS. BLOCS. a 7i,71).-± /�0-con ..23C UNP.9W DATE APPROVED APPROVE ' >+ r _ BY �I/l0� DATE 10- in-7-5-- ...I IX 40 I hereby acknowledge that I have read this application and state to CL that the above information is correct and agree to comply with m M all laws regulating building construction, and I shall not employ Z any person In violation of the workman's compensation laws of E V frji the State of California. �q� m I hereby certify that I am properly licensed as a contractor under ((�� SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business VALUATION a and Professions Code,Division 3,Chapter 9. PERMIT FEE $ sG �- Ji w J Signature of N.`` ��//)tt f /� PLAN CHECK $ ' - 'o ^ Permittee 1.l LJL.zwi..h- )111�� $ TAX $ 2 f U Authorized Agent TOTAL PAID $ 7 5477