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Home My WebLink About3475 WINDSOR CT - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3475 WINDSOR CT Suite No Vicinity: Parcel Nunmber: 47204226 Applicant: PAUL KAMINSKY Address: 11612 KNOTT ST GARDEN GROVE, CA Owner: PRIETO, NESTOR D Address 3475 WINDSOR CT COSTA MESA, CA Contractor: NOCK PLUMBING Address: 11612 KNOTT ST GARDEN GROVE, CA Arch / Eng : . � Address: ISSUE FEE Backflow irriga6on BackFlow Preventer Bathtub Clarifier System Connect pce,Sotla,etc) Dental Units Dishwasher Drain, Floor Drein, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve INSTALL NEW WATER HEATER AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 PLUMBING PERMIT Phone: (714) 8951246 Zip: 92841 Phone: Zip: 92626 Phone: (714) 895-1246 Zip: 92841 License: 707775 Phone: Zip: License: � SCOPE OF PERMIT FEE SUMMARY �TY AMT Laundry Tub / Washer $0.00 0 Landscape Irrigation $0.00 0 P-Trap $0.00 0 � Pressure Regulator $0.00 0 ' Process Piping (per 10 ft) $0.00 0 Receptors 50.00 0 Septic Tank $0.00 0 Sewer Cap for Demo $0.00 0 Sewer Connect $0.00 0 Sewer Private Line $0.00 0 Shower $0.00 0 Sink, bar $0.00 0 Sink, commercial $0.00 0 Sink, Floor $0.00 QTY. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Status: ISSUED Applied: 12/20/2002 Issued: 12/20/2002 ISSUED BY: � I � �� O*� SumpPump Swimming Pool Trap Primer � Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Wasle and Vent System Water Closet (Toilet) Water Heater / vent Water Piping Qnst or Rep.) Water Re-pipe Water Service AMT 30.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $72.30 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: This permit shall automatically ezpire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 780 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetions and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 244W6 (N00) WORKERS'COMPENSAnON DECLARAnON: � I hereby ettirm under penalty of perjury one ol the �ollowing decleretions: ❑ I have antl will malntain e certilicate of consent to self-Insure tor workers' compensatlon, es provlaetl for by section 3700 ot the Labor Cotle, for the pertortnance of the work Por which this pertnit is Issued. ?� I have and will maintein workers' compensetion insurence, es required by bection 3700 of Ihe lebor Cotla, fot Ihe peAOrtnence of the work for which IhiS pertnit is issued. My� ers' compensation Insurence carder and policy num6er ere: Cerrier. ir/F ii(/Sv.Z �0�'� oF d.N POIIcyNumber.rC7C7��72%2� (This sectlon neetl nof be completed i! fhe permif Is valued et ane huntlretl0ollers (5100) or less.) ❑ I certity thet in the peAortnence of the work br which thls permit is issued, I shell not employ any pereon In any manner so as to �ecome sublect to the workers' compensation lews of Celltomia, end egree that If I should becoma subfect to lhe workers' compensetion provisions oi Section 3700 ot Ihe Lebar Code, I shall torthwith complywiththgsaywac�ps� . Applicant Signetura: �-� Date: /`L � z o • o Z � WARNING FAILURE TO SECURE WORKE ' PENSAPOM COVERA�E IS UNIAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINQ PENALTIES AND CIVIL FlNES UP TOIXJE HUNDRED iHOUSAND00LLARE�5100,000),INADDITI ECOSTOFCOMPENSATION,DAMAGESASPROVIDEDFORINSECTION31060FTHEUBOFCODE,IMEREST,ANDATTORNE`fSFEES. LICENSED CONTRACTORS DECLARATION: I hereby attirtn that I em Ilcensed under praWsions of Chepter 9(crommencing wl�h Section 7000) of DMslon 3 oi the Business antl Professions Code, antl my license is in full force end ettect Lic. # Class e Cg6 f� /� Gontractors SigneWre: � 1. Dete: 2•� e� o� CONSTRUCTON LENOING AGENCV: ❑ I here6y alfirm ihat there is a construc�lon le�dinp egency for the peAormence of lhe work for whic� this permit is issued. (Sec. 3097, Civil Code). Lentlef5 Neme: SlgnaNre: _ OWNER-BUILDER DECLARA710NS: Lentlers Address: Date: I hereby attirtn Ihat untler Denelry of perjury thet I am EXEMPT FROM THE CON7RACTORS LICENSE LAW tor t�e following reasan (Sec. 7W 1.5, Business and Pmtessions Code: Any city or counry whic� repuires e partnit b construct, alter, impmve, demolis�, or repalr any sWcture, prior to Its issuance, also requires the applicant tor such pertnit lo file e signed statement that ha or s�e Is Iicensed pursuaN ta the provislons ol tha Cantrectars License Law (Chepter 9(cammencing with Sectlon 7000) of Division 3 oi the Busineu end Profasslons Code) or Ihet he or sha Is exempl therefrom end the besis tor the alle9ed exemption. Any violatlon of Saction 7031.5 by eny applicant for a pertnit subjects the applicant to e civil penelry oi not more than flve huntlretl dollars ($500).): ❑ I, as owner of tha property, or my employee9 with wages es t�elr sole compensatlon, WILL DO 7ME WORK, end t�e siructure is not intentletl or ofFered tor sale (Sec. 7044, Business and Professions Cotle: The Coniractors License Lew tloes not apD�Y �o an owner of property who builds or improves ihereon, and who does such work himselt or hersetl or thraugh his ar her own amployees, providetl thet such Improvements ere not intendetl or offered for sale. If, however, the builtling or improvement is soltl within one year of completion, the owne�-builtler wlll have the burtlen of proving tha� he or she did not builtl or improve for purpose of sele.). - ❑ I. as owner ot the property, em E%CWSlYELY CONTRACTING W ITH UCENSED CONTRAGTORS l0 Constncl ifie prqect (Sec. 7044, Business and P�ofessions Cotle: The conirectors Ucense Law does no� apply to en owner ol propeny who �ullds or Improves Ihereon, antl who coniracts for such project with a contrector(s) license pursuant to t�e Contrectors License �ews�. ❑ I am e:empt under sec. Business and Pmfessions Code for this reason: Siqnature: Date: Owner ID veniietl by tlrivers licensa. ❑ Ves ❑ No Drivers License No. Verificatlon ot Ownership by (type ol aocument, i.e. - prapeny tex blll ar tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CHRT�FICATION: Ezpires: ❑ I hereDy certify Ihat no excevetlon Ilve (5) or more feet In depih Into which e person Is requlretl to descend, wlil be made in connection with work authonzed by this permit, end thet no builtling sWdure, sceflolding, talsework, or tlemolltlon or dismantling Ihereof, will be more ihan ihirty-six (38) teet high. (Chap. 32, Grp 2, Ar12, Sec. 341, TiUe 8, Callfomle Administretive Coae). ❑ As owner-builder, I will not employ enyone �o do work which would require a permil irom ihe Division of Industnel Sefery, es noted above, unless such person hes e pertnit ta do such work irom the divi5ion. , Signatura: Date: Division ot Industrial Safely Permit Number: CERTFlCATE OF COMPLIANCE AND AI7TT10RQA710N OF ENTFiY: I certify untler penalry of perjury that I have read this application end state that Ihe infortnation given is correct. I egree to compy with ell state laws an0 ��ry ordinences relating to building consiruction, and authodze representatives ot ihe Ciry ot Costa Mesa to enter u0on ihe abov - cn e perry tor inspection puryases. I eqree not to occupy or ellow occupancy of eny 6uiltling authorized by this pertnit until final inspection. cooe �, ixsvernoNTrvE 1616 Fixed Syste� 1266 Pool Spa Fin 200 Final Re-Roof iature Of Legal Ow�er(s) /Or Authorized Applicant PAIE iNrnu�s Preventlon 201 Final Block/Retaining Well 202 203 204 Final Feaory Fire Place Finel Sign Finel Demolitian Date ��' j0 •OL Date COOE 1 INSPECTION TYPE 206 Final Mec�anical 20B Final Plumbing 210 Finel ElectnCel 212 Final Fire Prevention 220 Final Planning Approval 222 Final Sile 250 Finel Building/Occupancy PAIE It�lS (714) 754-5273 • Fax (714) 754-4856 • wvrw.ci.cosla-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job nddress: 3475 WINDSOR CT Suite: Viciniry: ROOF Parcel Number: 41204226 Applicant: RON SELL Address: 18032 LEMON YORBA LINDA . CA Owner: PRIETO, NESTOR D Address 3475 WINDSOR CT COSTA MESA, CA Contractor: SELL ROOFING COMPANY Address: 18032 LEMON YORBA LINDA , CA Zip: 92686 Arch : Address: Zoning: R1 R1 Phone: (714)52&7758 Zip: 92686 Phone: Zip: 92626 Phone: (714) 52&1758 � License: 323842 Eng: Address: Phone: ISSUED BY: Status: ISSUED Applied: 07/12I2004 Issued: 07/12I2004 Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL EAGLELITE TILE ROOF, ICBO #4660. MALIBU 5.5 LBS. TILES, REPLACE/REPAIR SHEATHING AS NEEDED. 2,900 S.F. FOR S.F.D. Plan Check: $108.71 Permit: $167.25 SMIP Res: $0.89 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $276.85 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existinq: 0 Rear 0. 0 Rear 0. 0 Reouired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation Right 0. 0 Right 0. 0 $8,900.00 $8,900.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1B0 days. INSPECTIONS: In order tor the work authorized under Ihis permit to be considered legal, such work must comply with all applicable codes, and ell requlred inepaetlone end ilnal epprovel must be obtained. Failure lo oblain Inspectlons and linal approval will result in ihe expiratlon ol lhis permit. FOR INSPECTIONS CALL: (714) 7545626 zaae�ae (eroo) WOFiKERS' COMPENSATION DECLAfiAT10N: I hereby eflirm under penalry ot per�ury me of tha tWlowing tledarallons: t '�� ❑ I heve end will malntain e ceRitiwte of consent to sell-Insure for workerg' compensatlon, es provided tor by section 3700 ot the Lebor Cotle, lar t�e pertortnanca of Ihe work 1or whicli t�ls pertnit Is issuatl. ❑ I have flnd wlll maintaln warker ' compensa6on insurarxe, Qulretl by section 3700 ot the Lelwr Code, for the peAortnance of Ihe work lor whkh Nis pertrtit is Lssued. " My workers' compensatlon � 9nce rrier olicy Uer are: !�� (��, / Ce�,� O PoPcy Number.� j �P �f' �N`s.8ecflon need nat be comp/eted il fhe p rmiNs velued ef one hundred dollers ($f 00) or less.) �.�: .� ❑ I certity thet In Ihe peAarmance ot Ihe work for which this pertnll is Issued, I s�all not amploy any per9on In eny mannor so es to DewmB SuD�ect to the workers' compensetlon laws ot Calllomla, end e Net If I s oultl Decome sub�ect to the workers' compensetlon provislons ot Sectlon 3700 ot��111e LaDor�od e, I shall forthwith complywit� t�ese provisions. .—y/ , � / _ ' / App�lCffiil5 pnetul re: � �� Dete: l�� WARNINQ' EALLAlPE-70 SEWFE WORKERS' 00lAPENSATION COVEMOE IS UMAWFUL ANO SHAl1 SUBIECT AN EMPL E� CRIMINAL PENALTI 5 AND G FlNES UP TO ONE HUNDRED � D DOLURE (E100,000). IN ADDITION TO THE CQST OF COMPENSATIIXJ, DAMAOES AS P(iOVIUE� FOR IN SECTION 3]OB OF THE UBOR CODE, INTEREST, AND ATTOqNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 9(wmmenGng with Section 7000) ol Division end my license is in full CONSTRUCTION LENDING AGENCY: ❑ I hereby ettirm Ihet Ihere is e consWction lentling egency for Ihe peAormance of the wark Por which this permit is Issued. (Sec. 3097, Civil Cotle). Lender's Namo: Lentler's Atltlress: Signeture: OWNER•BUILDER DECLARATIONS: Date: I hereby effirtn Ihal under penelry oi per�ury Ihel I am El(EMPT FROM THE CONTRACTORS LICENSE LAW for the following raeson (Sac. 7031.5, Buslness end Prolessions Code: Any ciry or counry which requires e pertnit to consiruct, elter, improve, tlemolish, or repair eny sbucture, pdor to ils issuence, elso requires t�e epplicani br such pertnit Io Ille e signetl stetement Ihet he or she is Iicensetl pursuent to the provisions of �he Gontractors License Lew (Chapter 9(commendng wlth Section 7000) of Division 3 ot Ne Business an0 Protesslons Cade) or that he or she is e:empt lherelrom enC the hesis lor the elleged ezemption. Any violetion ol Section 7031.5 by any epplicant far e pertnit sub�ects the eppllcenl to e civil penalry oi not more than five hundred dollers ($500).): ❑ I, es owner ol ihe proDerty, or my employees with wages es thelr sole compensatlon, WILL DO THE WORK, entl t�e structure is not Intended or otteretl tor sela (Sec. 7044, Business enC Protessions Code: The Contractors License Lew does not appty to en owner of property who builds or improves thereon, end w�o tloes such work himsetl or herself or through hls or her own employees, provided that such imprwemenls are not Intended or oMeretl for sale. It, however, Ihe builtling or Imprrnement is sold within one year ot completion, the owner-builder will have ihe burden of proving iha� ha or she did not build or improve for purpose oi sale.�. ' ❑ I, 85 ownBr of lhe pmperty, am EXCLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS lo wnstruct the O�ojeCl (Sec. 7044, Business flnd Pmfessions Cotle: The contrectors License Law tloes not apply to an owner ot pmpeny who builds or improves thereon, and who comrects tor such pro�ect with e wmractoqs) licen5e pursuam to the Comrectors License Laws.). � ❑ I em e:empt under sec. Business antl Pmlessions Coda tor this reason: Signe�uro: Date: Owner ID verilied by drivefs license. ❑ Yes ❑ No Drivefs License No. Ezpires: Vedficetlon ol Ownership by (type of document, La. - pmperty tez bill ar tleetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATON: ❑ I hareby certlfy thet no excavatlon five (5) or more feet In depih into which e person Is requlretl to tlescentl, will be mede In connectlon wi�h work authorized by �hls pertnit, antl t�at no building siructure, scaHolding, lalsework, or demollllon or dismantling thereoi, will be more then Ihirty-six (38) leet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle B, Calllamla Adminlsiretive Cotla). ❑ As owner-bullder, I will not employ enyone ta do work which would require a pormll irom the Divislon of Industdel Sefety, es notetl ebove, unless such parsan hes e pertnit to tlo such work Irom the tlivision. SipneWre: Date: DlNsion of Intlustdal Selery Pertnit Number. ICERTIFICATE OF COMPLIANCE AND AUTTfORQATION OF ENfRY: I certity under penalry ot perjury Ihet I have reatl Ihis epplication antl state that the infortnation given is I COrrect. I agree to comply wil� ell stete laws end ciry ordinences relating to bullding consiruction, entl euthodze reprasentatives of Ihe City of Costa Mesa ta emer upon the ebovo-described property for inspection puryoses. I egree not ta occupy or allow occupency of eny building euthorized by Ihis permit until linel inspection. CODE 1. INSVECTIONTYPE 1878 Flzetl System Final Fire Prevention 1288 Pool Spe Final 200 Final fie-Roo1 201 Flnal BIocWRelaining Well 202 Flnel Factory Fire Place 203 Final Sign 204 Finel Demolltion CODE� INSFECTIONTYPE 206 Flnel MechenlCel 20B Finel Plumbing 210 Finel Electdcal 212 Final Flre PrevenHon 220 Final Planninp Approval 222 Final Site 250 FinalBuiltling�Occupancy 6 I'7.\I�C11117.1�1 \ (714) 754-5273 • Fax (714) 754-4&56 • www.ci.costa-mesa.ce.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 280 E 20TH ST Suite No Viciniry: Parcel Nunmber: Applicant: 42621116 MATT COOK Address: 2035 PLACENTIA SUITE H COSTA MESA, CA Phone: 949-645-5761 Zip 92627 Owner: ZIEMER, ROBERT RICHARD TR Address 258 E 20TH ST COSTA MESA, CA Contractor: NEWPORT COAST ELECTRIC Address: 2035 PLACENTIA ISSUE FEE Temp service tesl Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors l0 1 hp Motors to 10hp Motors to SOhp SUITE H COSTA MESA, CA Phone: Zip: 92627-2218 Phone: 94&64&5761 Zip: 92627 License: 675371 Status: ISSUED Applied: OSI19/2005 Issued: OSI19/2005 SCOPE OF PERMIT CONSTRUCT NEW 3532 SF 2-STORY SFD (1731 SF FIRST FLOOR AND 1801 SF SECOND FLOOR) AND 505 SF ATTACHED GARAGE. ALSO CONSTRUCT 493 SF COVERED LOGGIA/ENTRY AND 3 DECKS TOTALLING 256 SF. SFD WILL HAVE 4 BDRM AND 4.5 BATHS. NOTE: ICBO NUMBER FOR FIREPLACE WILL BE PROVIDED TO INSPECTOR DURING CONSTRUCTION. REF.: 804-01463 ELECTRICAL TO INCLUDE: 1 NEW SFD, 3lIGHT FIXTURES, 6 OUTLETS, AND 4 SWITCHES LOCATED IN THE GARAGE. . 523.50 $0.00 $0.00 $19779 $0.00 50.00 53.30 $6.60 $4.40 $0.00 $0.00 $0.00 $0.00 50.00 50.00 $0.00 so.00 Quantity 3532 0 0 3 6 4 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway/100ft - Standing Section ' - Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw - ..................over'100 kva/kw Low Voltage Equipment Low Volt Wiring�System / Ckt Misc. Conduit Misc. Conductor Cirws ( gen or ride) Circus (mech ride or lights) ChrisVnas Tree Stantl Fireworks Stand Quantiry $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 NOTICE: 7he work aulhorized by this permit shall compry with all applicable handicap access requirements under Califomia statutes and related regulatlons. (OM. No. 92-28, § 7, 12-27-92) / EXPIRATION: This permlt shall automatically ezpire and become void if work is not commencetl wlthln 180 days, or il work is suspended or abandCned for a period of 1B0 days. INSPECTIONS: In order for the work euthorized under this permit to be wnsidered lagal, such work must comply with ail applicabla c 9s, and all required inapeetlone end Iinel approvel must be obtained. Feilure to obtain inspections end final approval will result in the ezpiration of is�permlt. FOR INSPECTIONS CALL: (714) 7545628 zaaase (avo) WORKERS'COMPENSAnON DECLARATON: 'r I hereby aHirtn untler penalry oi perjury ma ot Iha idlowing dadaratlons: ' ' , . � I have end will maintain a ceNficate of consent to selbinsure tor vrorkers' compenseUon, es provided for by section 3700 0l the Labor Cotle, tor the pertormance of Ihe work tor which this pertnit is issued. � , ` � 1 have and vrill maintain wwkers' compensatim insumnce, es requiretl by section 3700 0l Ne LEDor Code, lor Ihe peAortnanca ot itie work br whiGi Ws pemut is iSsueC. , My workers' wmpensation Insurance wrtler end policy number are: Carner. Policy Number: (This sec(ion need no! 6e comp/eted il (he pemuNs valued ef one hundred dollars (5100) or /ess.) '�.'.tcertily lhel in the pertormance ol Ihe wbrk tor which this pertnit is issued; I shell not employ eny porson in eny menner so es to 6owme sublect lo Ihe workere' �crompensatlon laws oi Calitomla, antl agree t�et II I should hecome sub�ect to Ihe workers' compensation provlslons ol Section 3700 0l the Lebor COAa. 1 shall foMvnih compty with these prmnsions. Applicant Sipnature: -�/i/L� � r...oere: y'/4 - o� WARNINO: FAILURE TO SEWRE WORKERS' OOMPENSATION COVEMOE IS UNIAWFUL AND SIULL SUBJECT AN F�.�P.l'OYEA!TO.CNW Wll. PENALTIES AND GVIL FlNES UP TOONE HUNDRED THOUSAND DOLLAflE (5100,000), IN ADDRION TO THE W5T OF QDMPENSATION, DM41GE5 AS PROVIDED FOR IN SEZrION 3108 OF THE UBOR CODE, INiEREST. AN� �TTORNEYS FEES. LICENSED CONTRACTORS DECLARATON: I hereby aHirm that I em.licensed under pmvisic CONSTRUCTION LENDING AGENCV: of Chapter 8(commencing with Section 7000) of Division 3 0l the Business and Professlons Cade, enA my license is ln tull ❑ I hereby ettirm ihat there is e consWctlon IenAing egency tor l�e pertormance of I�e work br w�lch thls permit is Issued. (Sec. 3097, Civll Cada). Lenaer's Neme: Lentler's AtlOress: SignaWra: OWNER-BUILDER OECLARA710NS: Date: I hereby atfirtn Ihat under penelty ol perjury I�eI I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business antl Professions Code: Any ciry or counry w�ich requires e pertnit lo wnstruct, elter, improve, tlemolis�, ar repair eny structure, prior to Its Issuenco, also requires the applicant for such permit to file a signed statement that he ar she Is ticensed pursuant to Ihe pmvisions of Ihe Camrectore License Lew (Chapter 9(wmmenGng wlth Sectlon 7000) of D'Mslon 3 of Ihe Business end Pmfesslons Gode) or that ha or she is e:empt ihorelrom and the basis lor Ihe ellegod exemption. Any violetion of Section 7031.5 �y eny epplicent for a pertnit subjects Ihe applicent to e civll penalry ot not mare then live huntlred dollars (y500).): Q I, es owner ol the pmperty, or my employees wilh wages as their sole wmpensetlon, WILL DO THE WORK, end the structure Is not Intendetl or oNeratl for sele (Sec. 7044, Business end Professlons Code: The Contrectors License law tloos not apD�Y �o en ownur of proporty who builds or improves thereon, end who does such work himself or herself or Ihrough his or her own employees, pmviAetl thai such impmvemenls ere noi inlendetl or ottered for sale. II, however, the builtling or improvemant is sold within one year of completion, �he owneo-builder will have t�e 6urden of pmdng that he or she tlitl not builtl or improve for purpose of seleJ. ' ❑ I, as owner of Ihe property, am E%CLUSIVELV CONTRACTING WIT}f LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Prolessions Cotle: The coniractors Ucense Lew does not apply to an owner of pmpeny who bullds or Improves thereon, end who contrecis for such project with a contractor(s) license pursuant to ihe Contrattors LicenSe Laws.). ❑ I em exemD� under sec. Business entl Professions Cotle for t�is reason: Signature: Date: Owner ID venfied by dnver's IlCense. ❑ Y05 ❑ No Ddvers License No. Expires: Verification af Ownership by (rype ot documenL i.e. � property ta�c 6111 ar tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby ceRlfy that no excavation five (5) or more teet in daplh Imo which e person Is required ta descend, wlll ba mede In connectlan wlth wark euthorized by this permiL antl ihat no 6uilding strucWre, sceMolding, taLsework, or tlemolitlon or tlismentling thereol, will Oe more Ihen �hirty-slx (38) feet high. (Chap. 3.2, Grp 2, An 2, Sec. 341, Title B, Celltomia Adminisiretive Cotle). ❑ As owner-builder, I wlll not employ enyone to tlo work w�ich would require a permll Irom Ihe Division ol Industnel Sefety, es noted above, unless such person hes a pertnit to tla such work Irom the division. Signature: Dale: Division oi Industrial Selery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUiHOR¢A710N OF ENTRY: I cenily under penalry of perjury t�al I have reaa this application end state ihat Ne Information given is corred. I agree to wmpty vrith all sWte laws and ciry ordinances relating to building consWction, end authodze representatives of t�e Clry of Costa Mesa to enter upon the above-Described pmpetly lor inspection pur{�ases. I agree not to accupy or ellow occuDancy ot any building euthonzed by INs pormit until linel inspection. CODE �. INSPECTIONTYPE ' ' 1616 Fixetl System Final Fire Preventlon 1266 Pool Spa Final 200 Final Re-Root " ' 201 Final BIocWRetaining Well 202 203 20A Final Factory Fire Place Flnel Sign Finel Demolllion �� Date �-r9—or COOEI INSPECTIONTYPE • 206 Final Machanical 200 Finel Plumbing 210 Final Electdcel 212 Flnel Fire Prevention 220 ' Final Planning Approvel . � 222 Finnl Sile 250 Finel Builtling/Occupanry �7.tl �ii�il.1S� / �„ I� � � L a � y y F 0 � F Q C� > r .� n: � a °a G. z W S 3 , b7�S II/14/79 �69.�4 a ' COSTA MESA BUILDINGSAPETY DEPARTMENT APPL[CATION FOR STRUCTURAL PERMIT o n nnv �onn rncrn enecn rn� �vnoeun eoeoc .•" �'"' '�" "�•�•••_��, ��_•• �•••••� �� RECEI VED BV PER IT �� For Applicant to FHI in Completely — Use Ink Only eui�oiN� n•P• rvo• ��= 6�--0 � ADDRESS Tract 10278, Lot 25 OWNEROR ADDRE55 ��"'�S �(•Yj��I� G'�, TENANT McLain Development Co. UNIT OR ADDREss 1470 Jamboree �. SPACE NO. TEL. TR.N�n�� LOT �G BLK. V `) CITV Ne OYt Beach N�' � NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRl1CTION LENDER BRANCH OWNER ADDPESS VALUE ARCHITECT TEL. USE E ORENGINEER Corbin/Yamafuji 7 ADORESS 20NE � M TVPE GROUP APPROVED CONTRACTOR MCLain Development Co. ev DATE ADDRESS 1470 Jamboree rd ��T� Newport Beach No�640-6800 STATE CITV APPROVEDSETBACKS LIC. NO. z LI0. NO. SI2E NO.OFBLDGS IFROMC/LS EET) OF LOT NOW ON l0T NT FT. VSE OF � EXISTNG BLDG. Separate permits are required for L. SIDE S FT. electric, plumbing and heating work. REAR � FT. VSE OF BUIIDING AND WORK TO BE PERFORMED P{_qNNING ACTION Single family residence, APPROVED New house �'ROVE I Q �g I�hereby acknowletlga that I �ava reatl thia eppllcation entl stata that tha above information Is corract entl a0ree to comply wiih all laws re8ulating b�iltlin8 connruction, end I shall not amploy any person in violatlon of the workman's compenaaiion lawe of the Stete of Celifornie. I haroby certity that I am pro0erly licensad as a eontraeior untler S�. FT. the State of California Business entl Ptofessions Cotle, Division 3, THE AMOUNTSHOWN VNDER VALUATION IS FOR Chapter 9, antl Na< such licenses are in full force entl effect, or I THE PUflP06E OF ESTABLISHING A PERMIT FEE ONLV: am exempt trom ihe provisions of the State of Celitornia Business VALUATION PERMIT FEE E �fr� end P�ofessions Cotle, Division 3, Chapt 9 I�- K/ Signature ot III�� PLAN CHECK $ Permittea � �� $// �6 TAX S ar �P�pf Authorizatl nt Date TOTALPAID 3 64-1 � m ^ � v > O m � m � � �V m � y e f/ a N � m m 0 LL M, � I�Y U t