HomeMy WebLinkAbout3417 WIMBLEDON WAY - Building PermitsqTY OF COSTA MESA -- - - - --� �� -- ,
(,�51pMFsq BU/LD/NG DIVISION . , ,� , . , , �
Y ir.' . '. ":.:" r
i ,. ; 77 FAIR DRIVE, COSTq MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www costamesaca.qov� --�- --- �-�-----� I
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° .°� FOR INSPECTIONS CALL: (714) 754-5626 �-�
,M�4�nxm[c`� ' • �
PERMIT NUMBER: BC12-00018
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: RES_ALT DATE ISSUED: 01/13/2012
• ISSUED BY: MDM
Jos AooREss: 3417 WIMBLEpON WY CM
APN: 41207336 Zon'rng:R1, ,
Vicinity:
Const Type:
SQ. FT: 0
Suite/Unit:
Primary Occ:
Valuation: $2,000.00
SCOPE OF WORK: REMODEL: MASTER BATH: REPLACE 2 WINDOWS, REPLACE SHOWER- HOT MOP, 2 VALVES, 7 LIGHTS, _
2GFI, 1 SWITCH, REPLACE EXHAUS7 FAN, DRYNIALL GUEST BATH: REPLACE TUB/SHOWER,HOT MOP, 2GFI, TOILET, 4 �
LIGHTS, 1 SWITCH, REPLACE EXHAUST FAN, DRYWALL `. �
OWNER: TROLINGER, JAMES D TR
Phone:
APPLICANT: ELINOR GLYCHER
Phone: 818�38-2022
coNraaCTOR: GREEN BUILDERS WC
F{ione: (866) 424-5184
Cell:
ARCHITECT:
ENGINEER: ,
'COMBINATION PERMIT FEE SUMMARY
Building Plan Check:
�Building Fees:
Electrical Fees:
Niechanical Fees:
Plumbing Fees:
SMIP Residential:
SMIP Commercial:
Bldg Std Admin Fund
YOTAL FEES:
"Refer to fee recelots Tor all tees oaid tor oroiecr
Address: 4010 BARRANCA PKWY # 25
City/State/Zip: IRVINE, CA
Address:
City/State/zZip:
Unit:
Unit: :
i �. �3 t °��i'i� �i 2 �
License No. 927446 �
Address: DBA OVERLAND BUILDERSUnit: WOODLAND HILLS, CA
Cily/State: � 22425 VENTURA BWD #413 ZipCode 91364
License No.
License No.
$0.00
$69.25
$42.20
$30.75
$43.10
$0.50
$0.00
$1.00
$186.80
PHONE:
PHONE: - � � �
� HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 • PER CMMC Sec. 13-279 "'' -
Monda thm Fritla 7:00 am thm 7:00 m. $aWrda 4�� r'"j' ��'.�
y y• p ys-e:oo am thru e:o0 pm. Prohibited all hours - Sundays and the following Federal�.holidays: +.s
i^".
Cr":
Si�J4
i :r
' 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) �. .
::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 fnal approval will result in the expiration of this permit.
GppER. INSPELTIONTYPE � INTRIAL CO�EO INSPECTONTYPE �ATE INTITIpLS
1616 Fixed System Final Fire Prevention 206 Final Mechanical ''�' -' I �'�'
�266 Pool Spa Final 208 Final Plumbing �����
200 Final Re-Roof 210 Final Electrical
201 Final 81ock/Retaining Wall 212 Finai Fire Prevention
�202 Final Factory Fire Place 220 Final Planning Approval
,203 FinalSign 222 FinalSite � � ''��� ' � �� � !
�204 FinalDemoli6on 250 Final6uildinglOccupancy �lif�_�].�
xWORKERS' COMPENSATION DECLARATIO� �
I hereby aff�rm under penalry of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to sel!-Insure for vrorkers'
compensation, as provitletl for by section 3700 0! the Labor Code, for Ihe
peAormance of the work for which this permi[ is issued.
❑ I have and will maintain workers' compensation insu2nce. as required by
secibn 3700 of the Labor Code, (a the perfortnance ol the work for wfiich this
pertnit is issued. My vrorkers' compensation Insurance carrier and policy
number are:
Carrier:
(rnis seaibn neee iwl ee wmdeted I u�e pemia a varued a� are nuntlrerl doNars (5100) a�eu )
P�oli/cy� um6er:
L`V I certify that in the pertormance of ihe work tor which Ihis permit is
issued, I shall not employ any person in any manner so as ro become subject
lo the vrorkers' compensation laws of Cali(omia, antl agree thal if I shoultl
become subject to the workers' compensation provisions ot Section 3700 of
the Labor Code, I shall forthvnth comply with these provisions.
� �� ,l�l� � / •z
• po�ican' awre Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATfORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affum 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 antl eNecL
/ ()
Lic. # � �,��� Class # !�
0��-- r, f 3 • /�
� Gontractor�ignaWre Dale
�ONSTRUCTION LENDING AGENCV:
I hereby affum that Ihere is a construction lending agency for Ihe
pedormance of the v.ork ta which this pertnit is issued. (Sec. 3097, Gvil Code).
Lender's Name:
Lender's Atltlress:
OWNER-BUILDER DECLARATIONS:
I herehy aKrm that untler penalry o/ perjury thal I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW (or the following reason (Sec. 703L5,
Business and Professions Cotle: Any ciry or counry which requires a permit to
construct, alter, improve, demolish, or repair any slrucWre, prior to its
issuance, also requires lhe appliGant for SUCh permit t0 fle a Signed Sla�ement
that he or she is licensed pursuant to Ihe provisions of the Contrectors
License Law (Chapter 9(commencing with Seclion 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt there(rom antl
�he basis for the alleged exemp�ion. Any violation ol Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalry of not more than
five huntlretl dollars (5500).):
❑ I, as owner of the property, or my employees vnth wages as lheir sole
compensation, WILL DO THE WORK, and the structure is not inlended or
oftered for sale (Sec. 7044, Business antl Professions Code: The Contractors
License Law tloes not apply to an ovmer of property who builds or improves
t�ereon, 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, hovrever, the building or improvement is sold vrithin one year of
completion, the owner-builder vdll have the burden of provinq that he or she
tlitl not build or improve for purpose oi sale.�.
❑ I, as ovmer of the property, am E7(CLUSIVELY CONTRACTING WITM
LICENSED CONTRACTORS to consWct Ihe prqect (Sec. 7044, Business and
Professbns Code: The contractors License Law does not apply to an ovmer of
property who builds or improves thereon, and who contracts for such pmject with
a contraclor(s) license pursuant �o the Cont2ctors License Laws.).
❑ I am exempt under sec.
Business and Professions Cotle for this reason:
�
Owner ID verifed by driver's license. ❑ Yes ❑ No
Driver's License No. Expires:
Verification of Ownership by (rype of tlocument, i.e. - pmperty tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I he2by certAy that no excavation frve (5) or mae feet in depth into wfiich a
person is required to tlescend, will be made in connection vnth wurk authonzed
by this pertnit, antl that no huilding swcWre. scaffdding, falsevrork, a demolition
or tlisman�ling Ihereof, will 6e more lhan thirty-six (36) feet high. (Chap. 32, Grp
2, M 2, Sec. 341, Ttle 8, Califomia AOminist2tive Code).
❑ As ovmerbuilder, I will not employ anyone to do work vfiich vroultl
require a permit trom the Division of Intlustrial Safery, as noted above, unless
such person has a permit to do such work lrom the division.
AOOlicanfs Signawre
Division of Industrial Safely Permit Number _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe applicant or present or fuWre building occupant need [o file and
ceRify a Business Plan (or emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health antl Safery Code requires, with some
erceptions, that a Business Plan be filed wilh the Costa Mesa Fire
Department by every business which has at any one time tlunng 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 ol compressetl ga5
at standard temperature and pressure).
2. Does or will the applicant or present or future building occupant need to file
a registration (ortn for acutely hazardous matenals? ❑ Yes ❑ No
(Section 25533 of the Calitomia Health ana Safery Code, with some
exceptions, requires registralion wilh 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 o! 55 gallons, or 200 cubic (eet of compressed gas at s[andard
temperature and pressure).
3. Does or will the applicam or present or future building occupant need ro
prepare an RMPP (Risk Management and Prevention Program tor acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health antl Safery Code provides that the
Costa Mesa Fire Department may require the preparation, ceAification and
fling with the Fire �epartment of an RMPP by businesses which are required
to register awtely hazardous matenals with the Fire Department.
4. I! an RMPP is presently required, has Section 25534 of the Califomia
Health antl Safety Code been fulty complietl with? ❑ Yes ❑ No
5. Does or vnll lhe applicant or presenl or W W re builtling occupanl require for
the vrork which is the subject of this apDlication a permit (or such construction
or motlification from [he South Coas[ Air �uality Management District or (rom
any other air polNtion control district or agency? ❑ Ves ❑ No
(Seaion 658502 of the Califomia Govemment Code requires �hat t�e requested
in(ortnation be fumished on applications for nornresidential builtling pertnits).
6. Will any part of the facility to be constructetl under Ihis permit be wilhin
1000 feet from the outer boundaries of a school7 ❑ Ves ❑ No
Qf'yes", ihe facility must meet Ihe requirement of Sections 25534 antl 42303
of the Califomia Health and Safery Code).
7. I( a permit from the South Coast Air �uality Management District or other
air polNtion contml district or agency is required (or the work which is the
subject of this application, have all of the disclosures prescnbetl by California
Health antl Safety Code Seclion 42303 been made? ❑ Yes ❑ No
8. Qf'yes", attach certificate of compliance from the appropriate air pollution
contmi oKcer�.
CERTIFICATE OF COMPLIANCE: I certify that untler penalty of perjury the
infortnation given above is correcL 1 agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
Signawre Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify untler penalty ot perjury that I have rea0 this application and state Ihat
the information given is correct I agree to comply with all state laws and ciry
ordinances relating to buildinq consWction, antl authorize representatives of
the City of Costa Mesa to enter upon the above-descnbed property for
inspection purposes. I agree not to occupy or allow occupancy ot any building
authorized by this permit until Mal inspection.
Si na� e al O u4� Date
Signature Daie �{ � '� � � j /� //7
0059-46 (3/0]) � 4'
AnGlor Aul�onaeG AOW��nI Daie
CITY OF COSTA MESA
�5`p'"Fs,p B!/ILDING DIVIS/ON
F`� � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 •�wvw.ci.costa-mesa.ca.us
� FOR INSPECTION$ CALL: (714) 754-5626
�""^"`°"� PERMIT NUMBER: BC11-00022
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: RES_ALT DATE ISSUED: 02/15/2011
ISSUED BY:
�os aoDRess: 3417 WIMBLEDON WY CM
APN: 41207336 Zoning:R1, ,
Vicinity:
Const Type: V-B
SQ. FT: 0
Suite/Unit:
Primary Occ:
Valuation: $20,000.00
SCOPE OF WORK: CONVERT EXISTING BEDROOM TO AN ART STUDIO, ADD AN ACCESS DOOR INTO ATTIC, INSTALL 78 X
10 CUSTOM MADE SKYLIGHT BY CALIFORNIA SKYLINES W ITH t VENT FAN, 1 ALT DUCT, �
4 LIGHTS, 6 OUTLETS.
OWNER: TROLINGER, JAMES D TR
Phone: 714-549•7658
APPLICANT: GREG AUTRY
Phone: 949-643-5081 .
CONTRACTOR:
Phone:
Cell:
ARCHITECT:
ENGINEER:
COMBINATION PERMIT FEE SUMMARY
Building Plan Check:
Building Fees:
Electrical Fees:
Mechanical Fees:
Plumbing Fees:
SMIP Residential:
SMIP Commercial:
Bldg Std Admin Fund
TOTAL FEES:
Address: 4010 BARRANCA PKWY # 25
City/State/Zip: IRVINE, CA
Address:
CitylState/zZip:
Adtlress: Unit:
City/State:
License No.
Litense No.
$208.81
$321.25
$34.50
$30.75
$0.00
$2.00
$0.00
$1.00
5598.31
License No.
Unit:
Unit:
ZipCode
PHONE:
PHONE:
HOURS FOR GONSTRUCTION ACTIVITY: EFFECTIVE 3I18I2010 - PER CMMC Sec. 13-279
Monday thru Friday-7:oo am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitetl all hours - Sundays and the following Federel h0lidays:
New Years Day, Memorial Dav. Indeoendence Dav. Labor Dav. Thanksaivina Dav and Christmas Dav
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulalions. (Ord. No. 92-28, § 7, 72-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under fhis permit lo be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE e. INSPECTION TYiE
1818 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final B1ocWRetaining Wall
202 Final Facmry Fire Place
203 Final Si9n
204 Final Demolition
� INTITIpLS CODE/ INSPELiIONTYPE
208 Final MeChaniwl
208 Final Plumbing
210 Final Eleclncal
272 Final Fire Prevention
220 Final Planning Approval
222 Final Sile
250 Final Building/Occupan�y
OATE INTI11RL5
�-2�-ll mPbyc+�
WORKERS' COMPENSATION DECLARATION:
I hereby aKrm under penalry of perjury one of lhe following declarations:
❑ I have and will maintain a c@rtificate of consent to self-Insure (or workers'
compensation, as providetl for py section 3700 of the Labor Code, (ordhe
peAortnance o( the v+ork tor which this pertnit is issued.
❑ I have and vrill maintain workers' compensaiion insurance. as required by
seclion 3700 of ihe Labor Code, tor the peAortnance of Ihe work for which this
pertnit is issued. My workers' Compensation Insurance carrier and policy
number are:
Carrier
(rnis seciion neee rroi be m e d np e perma is valueC ro, nundred dona�)
ohcy �mber. ��,��
I certify that in ihe peAormance of the woB for which this permit is
� ued, 1 shall not employ any person in any manner so as to become subject
to ihe vrorkers' compensation laws of Califomia, antl agree that if I should
become subject lo he workers' co�9P ation provisions of Section 3700 of
tDe Labor Code iall forthwith fii 1 with lhese provisions.� �� 1
� 2 -
� �M12ni'S; ign ure * ale—
��
WARN G: FAILURE TO SECURE ORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES Up TO ONE HUNDRED THOUSAND DOLLARS
(5100,000), IN AD�ITION TO TH� COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 37pFi OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) o( Division 3 0( the Business and Pro(essions Cotle, and
my license is in full torce and eftect.
Lic. # Class #
Contracmr's Signawre Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn that there is a construction lentling agency fw the
pedormance of the work for wfiich this pertnit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Atltlress:
Da�e
OW NER-BUILDER DECLARATIONS:
I hereby aKrm Ihat under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW lor Ihe following reason (Sec. 7037.5,
Business antl Professions Cotle: qny ciry or county which requires a permit to
construct, alter, improve, demolish, or repair any strucWre, pnor to its
issuance. also requires lhe applicant for such permit to fle a signed statemenl
Ihat he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing vnlh Section 7000) of Division 3 of the
Business antl Professions Cotle) or that he or she is exempt therefrom and
the 6asis lor Ihe alleged exemption. Any violation of Section 7031.5 by any
applicant for a permi� subjects Ihe applicaN to a civil penalty o( not more than
five hundred dollars ($500�.):
� I, as owner of the property, or my employees with vrages as their sole
compensation, WILL DO THE WORK, and the structure is not intentled or
offered for sale (Sec. 7044, Business antl 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 tor
sale. If, however, lhe building or improvement is sold within one year ot
completioq the owner-builder will have the burden of proving that he or she
�did no ild or improve (or purpose of sale.).
I, as owner of the property, am EXCLUSIVELY CONTRAC7ING WITH
D CONTRACTORS to ConsWct the project (Sec. 7044, Business and
Pro(essbns Code: The contractors License Law dces not appty to an owner of
property who builds or improves thereon, and who contracts for such project with
a contractor(s) license pursuant to the Contractors License Lavrs.l.
❑ I am exempt untler sec.
Business and Professions Code for this reason:
��
Owner ID veri(ed by driver's license. ❑ Ves ❑ No
Dnver's License No. Expires:
Verifiwtion of Ownership by (rype of Oocument, i.e. - propeAy tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby ceeify that no excavation (rve (5) or more feet in tlepth into wfiich a
person is requiretl to descend, will be made in connection with v.ork au[trorized
by ihis permit, and that no building stmcNre, sc�idding, falsev.ork, or demolition
or dismantling thereof, will be more Ihan thirty-six (36) feet high. (Chap. 32, Grp
2, Art 2, Sec. 341, Ttle 8, California Atlministra[ive Code).
❑ As ovmer-builder, I will not employ anyone to do vrork which would
require a permii from the Division of Industrial Salety, as noted above, unless
such person has a permit to do such work irom Ihe division.
AppliWnf55igiuWre Da�e
Division o( Industrial Salety Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICAiION:
1. Will the applicant or present or fuWre building occupant need 10 fle and
certi(y a Business Plan for emerqency response to release or Ihrealened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Safety Code requires, with some
exceptions, that a Business Plan be filed wilh lhe Cosla Mesa Fire
Department by every business which has a[ any one time during a reported
year a quantiry of hazardous malerials equal [o or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature antl pressure).
2. Does or will the applicant or present or /uture builtling occupant need to Ne
a regislration form (o� acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Cotle, with some
exceptions, requires regis[ration with Ihe Cosla Mesa Fire DepartmeN Dy
each business which al 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 stantlard
temperaNre antl pressure).
3. Does or will the applicanl or present or future builtling occupant need to
prepare an RMPP (Risk Management and Prevention Program lor acutely
hazartlous malerials)7 ❑ Yes ❑ No
(Section 25534 0( Ihe California Health and Safety Code provides that the
Costa Mesa Fire Department may require the preparation, certificalion antl
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous matenals with the Fire Department.
4. If an RMPP is presently require0, has Section 25534 of the Califomia
Health and Sa(ety Code been fully complied with4 ❑ Yes, ❑ No
5. Does or will Ihe ap0�icanl or present or future builtling occupant require lor
the vrork which is t�e subject of this application a permit for such consimction
or modifcation (mm the South Goast Air Quality Management Dislrict or from
any other air pollution conirol district or agency? ❑ Yes ❑ No
(Sectbn 65850.2 of the Califomia Govemment Code requires that the requestetl
infwmatbn be fumished on appliwtions fa rron-residential builtling pertnits).
6. Will any parl of Ihe faciliry to be constructetl under this permit be wilhin
1000 feet from the ouler bountlaries of a school? ❑ Yes ❑ No
Qf'yes", the faciliry must meet the requirement o( Sections 25534 and 42303
of the California Health antl Sa(ery Code).
Z If a pertnit from the South Coast Air Qualiry Management Dislrict or other
air pollution control districl or agency is required for the work which is the
subject o( this application, have all of the disclosures prescribetl by California
Health and Safety Code Section 42303 been made? ❑ Ves ❑ No
8. (It "yes", attach certificate of compliance (rom the appropriate air pollution
contml oKcer).
CERTIFICATE OF COMPLIANCE: I certify that un0er penally of perjury the
information given above is correct I agree to comply with all state laws and
city ordinances regartlinq Hazardous Materials and Emissions.
Signalure Dale
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penal�y of perjury thal I have read this applicati0n antl state that
the information given is correct. 1 a9ree to comply with all state laws and city
ordinances relating to bwlding nstmction, and authorize representatives o!
the Ciry of Co a Mesa t er upon the above-described property tor
inspection pu��es. I aq t to�ccupy or allow occupancy of any building
Z��S-!�
Date
Date
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
JobAddress: 3417 WIMBLEDON WY
Suite No
Vicinity:
Parcel Nunmber: 41207336
Applicant
Address:
Owner:
Address
PAULEY,SHANNON
17390 MT CLIFFWOOD
FOUNTAIN VALLEY
TROLINGER, JAMES D TR
4010 BARRANCA PKWY # 25
IRVINE, CA
�.. r
� 1/� .
:, �
��.
Phone: 714-241-1414
Zip: 92708
Phone:
Zip: 92604-0711
Contrador: COAST ROO7ER PLUMBING HTG AND AC
Address: 17390 MT CLIFFWOOD
Phone: 714-241-1414
FOUNTAIN VALLEY Zip: 92708
License: 529127
SCOPE OF PERMIT
WATER HEATER CHANGE-OUT IN AN SFD.
NO OTHER WORK AUTHORIZED WITH THIS PERMIT.
ISSUE FEE
Backflow irrigation
Backflow Preventer .
Bathtub
Clarifier System
Conned (Ice,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (1-4 outlets)
Gas (Over 4 outlels)
Gas Repipe
Gas Service
Interceptors (Grease, Oip
Interceptors (Sand Auto )
AMT
$23.50
$0.00
so.ao
$O.DO
$0.00
$O.DO
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
QN
FEE SUMMARY
AMT
Laundry Tub / Washer � $0.00
Landscape Irrigation $0.00
P-Trap $0.00
Pressure Regulator $0.00
Process Piping (per 10 ft) $0.00
Receptors $0.00
SepticTank $0.00
Sewer Cap for Demo $0.00
SewerConnect $0.00
Sewer Private Line $0.00
Shower $0.00
Sink, bar $0.00
Sink, commercial $0.00
Sink, Floor $0.00
Sink, kitchen $0.00
Sink, service/mop $0.00
Spa (private) $0.00
Spa (public) $0.00
�
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
COMMENTS / SPECIAL CONDITIONS
ISSUED BY:
.�
Status: ISSUED
Applied: 12/30/2005
Issued: 12/30/2005
SumpPump
Swimming Pool
Trap Primer � �
Urinal
Vacuum Brkr Bktlow(7�)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater I vent
Water Piping (Inst or Rep.)
Water Re-pipe
Water Service
Water Softener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$o.00
$12.30
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES: 535.80
QTY
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 1 BO days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
enatirn �wuu�
WORKERS' COMPENSATION DECLARATION: . _
I hereby eftirm under penalty of perjury one of the tollowing declaretions:
❑ I have and will maintain a certificale of consent to self-Insure for workers' compensation, as provitled for by sedion 3700 of ihe Labor Code, tor �he pertortnance ot ihe
/work for which this permit is issued.
�J I have and will maintain workers' compenution insurance, as required by seclion 3700 ot Ihe Lebor Code, for ihe pertormance of ihe work for which this pertnit is issuetl.
My worke/rs�' compensnation Insurance carrier and policy number are: `/
Carrier. r'T(� �„'� Ai� � eC� PolicyNumher ��n lf ��i� ��r7 h�
(This section need nof be comp/e(ed il tPe permit is valuetl at one hundred dollers (5/00) or /ess.)
❑ I certity that in ihe pertortnance of Ihe work tor which ihis pertnit�a�1� d, I shall not employ eny person in any manner so as to become subject to Ihe workers'
compensation laws oi alit a�d agrea Ihat if I should eEme s 6ject to Ihe workers' compensation provisions ot Section 3700 ot ihe Lebor Code, I shall forihwith
comply with Ihes visions.
Applicent Signetu � Date: f Z—� D 'O �
WARNING FAILUR CURE WORKERS' �MPENSATI COVERAGE IS UN�,41MF A SHA�L SUBJECT AN EMPLOVER TO CPIMMAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
7HOUSAND OOLLARE �E100,OpD), IN ADDITION TO THE COST OF COMPENSAtIQ61'W. 5 NS PROVIDED FOR IN SECTION 3]O60F THE IABOR CODE, INTEFEST, AND ATTOFNEY'S FEES.
LICENSED CONTRACTORS DECLARAnON:
I hereby affirm ihat I em licensetl untler r vi lo
torce and eHect. Lic. # _—S:''.c�[�
Contractor's SignaWre:
CONSTRUCTION LENDING AGENCY:
Section 7000) of Division 3 of the Business antl P fessions Cotle, and my license is in full
Class # � — � �n
�_�, Dete: ( �L '�U " �.S
❑ I hereby eHirm Ihet there is a construction lentling agency for Ihe peAormance of Ihe work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lender's Adtlress:
Signatura:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby aHirm thet under penalry ot perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business and Protessions
Code: Any ciry or counry which requires a pertnit to construct, alter, improve, demolish, or repair any sWcture, pnor to its issuance, also raquires Ihe epplicaN for such pertnit
to tile a signed statement that he or she I5 licensed pursuant to the provisions of lhe Contrectors License Law (Chapter 9(commencing with Section 7000) of Division 3 of ihe
Business antl Professions Code) or thet he or she is exempt thereimm and the basis for the elleged exemption. Any violation of Section 7031.5 by any applicant for a pertnit
subjecis ihe applicant to a civil penalty o� not more than five hundretl dollars ($500).):
❑ I, as owner oi �he properry, or my employees wi�h wages as iheir sole compensation, WILL DO TME WORK, antl Ihe simcNre is noi intended or ofleretl for sale (Sec.
7044, Business and Pmfessions Cotle: The Contractors License Law does not apply to en owne� of property who builds or improves ihereon, and who tloes such work
himself or herselt or ihrough his or her own employees, pmvitled that such improvemen�s ere not intended or oNered for sala. tl, however, ihe building or improvement is
sold within ona year ol completion, the owner-builder will have the burden of proving that he or she did not build or improve tor purpose of sale.�. '
❑ I, as owner of Ihe property, em E%CWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business and Professions
Cotle: The contractors Licensa LaW tloes not apply to an owner of pmperty who builtls or Improves ihereon, and who coniracts tor such pmjact wlth a contractor(s)
license pursuant to the Coniractor5 License Laws.).
❑ I am eaempt under sec. _
Siqnature:
Owner ID veritied by tlriver's license.
Venfication of Ownership hy (type of
Business and Professions Cotle for this reason:
Yes ❑ No
i.e. - property tax bill or tleatl):
Drive(5 LiCensa No.
Date:
Ezpires:
DIVISION OF INDUSTRIAL SAFETY PEAMIT CERTIFICATON:
❑ I hereby cenify that no excava�ion fi�e (5) or more feet in depth into which e person is requiretl to descend, will be made in connection with work authodzed by this
permit, end ihat no builtling s�ructu�e, scaMolding, falsework, or tlemolition or tlismantling �hereoi, will be more ihan thirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Title 8, Celifornia Administreti�e Code).
❑ As owner-builder, 1 will not employ anyone to do work which woultl require a permil Irom Iha Division of Industrial Safery, as noted above, unless such pereon has e
pertnit to tlo such work irom ihe diNsion.
Signature: Date:
Division of Intlustrial Safery Permit Number.
CERTIFICATE OF COMPLIANCE AND AUTMORVA710N OF ENTRY: I cenify under penalty of pe�ury ihat I have read Ihis application and state Ihet ihe iniormation given is
correct. I agree to comply wit� ell state lews end city ordinances relating to building consimction, end authorize representatives oi ihe City of Costa Mesa to enter upon Ihe
ebove-descri6ed prop�urfqr inspeaion puryoses. I agree not to occUp�y�nr allow wcupancy of eny buildinq authorized by this permit until final inspection.
COOE 1, �xsvecnoxTrve
1616 Fixed Syslem Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Well
202
203
204
Final Factory Fire Place
Fnal Sign
Final Demolition
�� oate�� ' D r
l
Date
cooe� ixsvecnoxTrve
206 Final Mechanical
208 Final Plumbing
210 Final EleCiriCal
212 Finel Fire Prevention
220 Finel Plenning Approval
222 FIna1511a
250 Final Building�Occupancy
p9IE 1[�94fl
�— �
.
.�
,
CITY OF COSTA MESA
P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMENTSERVICESDEPARTMENT
BUILDING DIVISION
COURTESY NOTICE OF PERMIT EXPIRATION
February 9, 2007
James D Trolinger
4010 Barranca Pkwy #25
Irvine CA 92604-4711
PERMIT NUMBERS: P05-01042
FOR: Water Heater
PROJECT ADDRESS: 3417 Wimbledon Wy., Costa Mesa
Our records indicate the above listed permits were obtained for property improvements
or alterations at the above address. Per the 1997 Uniform Building Code, Section
106.4.4 Expiration, permits are valid for 180 days from the date of such permit, or the
date of your last inspection for the project and additional fees will be required to finalize
expired permits.
According to our records, the permits listed above have not had an inspection for a
period exceeding 180 days. If you have a signed inspection card indicating an
inspection was conducted within 180 days from the date of this letter, please contact this
office so we may correct our records.
If you need to request an inspection please call our Inspection Request Line at
714-754-5626. If you wish to request an extension, requests must be made in writing
addressed to Ed Petros, Chief of Inspection, at the above address, detailing
circumstances and listing an estimated date of completion. If you do not have an
approved final inspection, your permits will expire on February 26, 2007.
If you have any questions, please contact the Building Division at 714-754-5273,
between 8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. The
accuracy of records affecting your property is our goal and we appreciate your working
with us to resolve this matter.
Sincerely,
���������E�2J�
Mary Jane Weidenkeller
O�ce Specialist II
cc: CoasfRoote� Plbg Htg 8 A/C
17390 Mt Cliffwood
Fountain Valley CA 92708
Building Division (714) 754-5273 • Cotle Enlorcement (714) 75A-5623 • Planning Division (71G) 756-5245
PA%f7141754-0856 • TOD (7141754-5244 • wvnv.ci.costa-me5d.ca.u5
MJW BuiltlingSffietyDivision
CITY OF COSTA MESA
a.o. sox ixoo
COSTA MESA, CALIFORNIA 92828-1200
ADDRESS SERVICE REQUESTED
016H26503147
� $ 00.390
A 02/09/2407
mailedFrom 92626
US POSTAGE
JAMES D TROLINGER
4010 BARRANCA PKWY #25
IRVINE CA 92604-4711
..._. rvinic o<� ....a .... v< v�/tolvr
RETURN TO SENDER
ZNSUFFICIENY ADDRESS
UNqOLE TO FORWARD
BC: 9^s62B120000 '�'1908-12,31-09-42
u!C��-FS'-F'+,.���i��.' ��i�ini�����{n�i����i��iiu���i{i��{�ui�i���in���in�{u�i
; ;
��ia��sa-s2�s • Fax(�ia)�sa-aess
CITY OF COSTA MESA '
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
JobAddress: 34i� WIMBLEDON WY
Suite:
Vicinity: HOUSE & ATTACHED GARAGE
Parce� Number: 41207336
Applicant: SELL, RON
Address: 17072 ROSEBUD
YORBA LINDA . CA
Owner: TROLINGER, JAMES D
Address 3417 WIMBLEDON WY
COSTA MESA, CA
Contrectoc SELL ROOFING COMPANY
Address: 17072 ROSEBUD
YORBA LINDA , CA
Zip: 92686
Arch :
Address:
BUILDING PERMIT
Zoning: R1 R1
Phone: (714)993-3328
Zip: 92686
Phone:
Zip: 92626
Phone: (714) 9933328
License: 323842
Eng:
Address:
� /
PERMIT NUMBER I
B00-00006 v
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: Oi/04/2000
Issued: O7/04/2000
ISSUED BY:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE 8 ATTACHED GARAGE (29 SQ). TEAR OFF EXISTING ROOFING &
RESHEATH WITH 1/2 INCH OSB. INSTALL 1-LAYER OF 30# FELT UNDERLAYMENT & REROOF WITH -EAGLELITE-
MALIBU (5.5 LBS) ICBO #4660.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$0.00
$167.25
$0.89
$D.00
$0.00
$0.00
$168.14
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existinq: 0
Rear 0-0
Rear 0- 0
Reouired: 0
FEE SUMMARY
PLANNING 8 ZONING
Left 0- 0
Left 0. 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
$8,900.00
$8,900.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days. '
INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
requlretl Inapeetlona and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
WORKERS' COMPENSATION DECLARATION:
I hereby aHirm under penalty of perjury one ot the following tleclarations: � �
❑ I have entl will maintain a certificate ot consent to self-Insure for workers' compensetion, as provided for by sectlon 3700 0l ihe Lahor Code, for the pertormence ol ihe
work tor which this permit is issued.
❑ 1 have end will i tai workers' com ation msu ca, as requiretl by section 3700 of fhe Lebor Code, foi �ho peAortnence of the work tor which this pertniyyy���s iuuetl.
My workers' c � n Insura /,a�rn�er eAnd p cy number ere: �G �!���i
Carrier. " — v/ Policy Number. �� �
(This section need not be comp/etetl i/ the peimrt is valuetl et one hundred dallers ($f 00) or less.)
❑ I certity that in the peAortnance of Ihe work for whic this pertnit is iuuatl, I shall not employ eny person in eny manner so as to become 5ubjecl to Iha workers'
compensetion laws oi Celifomia, a ea ihat if I s uld be e subiett to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with ihese provisions. /� - /
ApplicenlSignature: Date: / ^l � � d
WARNING FAILURE TO SECURE WORKEFS' WtdPEN$ATION COVERAGE IS UNLAWFUL PND SMALL SUBIECi AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FINES UP TOOfJE HUNDRED
T}IOUSAND DOLL4FE (5100,000), IN ADDfTION TO THE COST OF COMPENSAiION, DAMAGES AS PROVIDE� FOR IN SECiION 31060F THE LABOR CO�E, IMEREST, AND AiTORNEYS FEES.
LICENSE� CON7RACTORS DECLARA710N:
I hereby aNirm that I em licensed
force antl eHecL Lic. a
Contractor's Signature: _
9(commencing with Section 7000) of Division 3 of the Business an Prof on Cotle, and my license is in full
Class p � � �
,� oeie: /'(j=3 / - o s
CONSTRUCTION LENDING AGENCY:
❑ I hereby attirm that thera is a consiruction lentling agency for tha peAortnance oi the work br which this permit is Issued. (Sec, 3097. Civil Code).
Lender's Name: Lenders Atldress:
SignaWre: Date:
OWNER-BUILDER DECLARATIONS:
I hareby aHirm ihat under Denalry ot perjury ihat I am EXEMPT FROM 7ME CON7RACTORS LICENSE LAW tor ihe tollowing raason (Sec. 7031.5, Business end Professions
Code: Any city or counry which requires a pertnit to construc�, alter, improve, demolish, or repair any sWCWre, prior to its issuance, elso requires Ihe applicant for such permit
to file a signed statement ihat he or she is licensed pursueni to ihe provisions of the Comractors License Lew (Chepter 9(commencing with Section 7000) of Division 3 0l the
Business and Professions Code) or lhat he or she is e:empt iherefrom end the basis tor the alleged exemption. Any violation ol Seciion 7037.5 by any applicant for e permlt
subjects the applicant to e civil penalry ol not more than five hundred tlollars ($500)J:
❑ I, as owner of the property, or my employees with wages as their sole compensalion, WILL DO THE WORK, end the structure is not intentled or offerad tor sale (Sec.
7044, Business end Professions Cotla: The Conirectors Licensa Law tloes not apply to an owner of property who builds or improves thereon, and who does such work
himself o� herself or ihmugh his or her own employees, provitled that such improvemenis ara not intended or olfered for sele. If, however, the huilding or improvement is
sold within one yeer of completioq the ownerbuilder will have ihe burden of proving that he or she ditl not builtl or improve for purposa of sale.).
❑ I, a5 owner of the properry, am E%CLUSNELV CONTRACTINC WITH LICENSED CONTRACTORS Io constmct the projecl (Sec. 7044, Business entl Protessions
Cotle: The coNrectors License Law does not apply to en owner of properry who builds or improves t�ereon, antl who contracts for such projeci with a contrector(s)
license pursuam to Ihe Comractors License Laws.).
❑ 1 am exempt untler sec. Business and Pmfessions Cotle for this reeson:
SiqnaNre: Date:
Owner ID veritietl by drivafs liCense. ❑ Yes ❑ No Drivet§ License No.
Verification of Ownership by (rype of document, i.e. - property �az bill or deed):
DIVISION OF INDUSTRIAL SAFETY VERMIT CERTIFICATION:
Expires:
❑ I hereby certiry that no ezcavation five (5) or more leet in depth into which a person is requiretl to descend, will be made in connaaion with work authonzetl by this
permic, end Ihat no Duiltling sWCWre, scaflolding, falsework, or demolition or dismantling thereot, will 6e more �han thirty-sis (36) teet high. (Chap. 32, Grp 2. Art 2, Sec.
341, Title e, California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit irom the Division of Intlustrial Safery, as noted above, unless such person has a
permit to do such work irom �he tlivision.
Signature: Date:
Division of Indus�nal Safety Permit Numbec
CERTiFICA7E OF COMPLIANCE AND AIfTHORIZATION OF EMRV: I certify untler penalry of perjury that I hava read this application antl siate ihat the information given is
correcL I agree to comply with all state laws and city ordinances relaling to building construction, and authonze represen�atives ol the Ciry of Costa Mesa to enter upon the
ebove-descri6etl propeny for inspection purposes. I egrae not ro occupy or allow occupancy ot any builtling authorizetl by this permit until final inspaction.
Signature Of ner(s) � _ ! / Date�G
�^ 7
And/Or AuthonzedApplicant Date
COOE t. INSPECTIONTYGE
1676 Fixed System Final Fire Preventim
1266 Pool Spa Final
200 Final Re-Roof
201 Final Block/Retaining Wall
202 Final Fectory Fire Place
203 Finel Sign
204 Finel Demolition
2aa6<8
PAIE INiITIpLS
� �
400E� INSPECTIONTYVE
206 Final Mechanical
20B Final Plumbing
210 Final Elecincal
212 Final Fire Prevantion
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
�� INTR RL
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Appllcant to Fill in Completely - Use Ink Only
ADORESS TYdCt LOZ�%� LOt SH
OWNER McLain Development Co.
MA�� 1470 Jamboree Road
ADDRESS
TEL.
cirv Newport Beach No. 640-6800
CONSTRUCTION
BRANCH
TEI.
ADORESS 3661 Spruce St., Newport Beach
CONTRACTOR MCLdlrl DEVEIOL2IIt CO.
nooaess 1470 Jamboree Road
TEL.
ciTv Newport Beach No. 640-6800
STATE CITV
LIC. NO. 2735%S LIC. NO.
OF LOT �IS X IZE) NOWON LO
USE OF
EXISTING BL�G•
Separate permits are required for
electric, plumbing and heating work.
UILDING AND WORK TO BE PERFORMED
Single family residence,
New House
I �areby ncknowledBe ihat I have raatl thla epplication enA stata
that the ebova intormation is correct antl a8rae io comply with
alf lowa repulPtl�q builtling conscruttlon, entl 1 5ha11 nOt emploY
nny panon In �Iolotion of ihe workman's compensatlon laws of
tha Smta of Celtfornla.
I horoby certlfV that I em properly IlcansaC ea e eonbactor undar
the Steta of Celifornie Buainexi entl Profeufons Cotle, Dlvision 3,
Chapter 9, and Met such licenses era in full force and aftact, or I
em ezampt from the Orovlsions ot the Stata of California Business
entl Profession� Code, Division 3, Chapcer 9.//�]
SlBnatura ot � G �.✓ (`� �
PBrmlttee l U� /' 6.J
/�/y �
AuthoAzatl Aq9�i `
�
APPLICAi[ON
A.P. NO. �%��' � ��J�' O
BUIIDING 3 y � �
ADDRESS
TflACT ZOZ%�%
FIRE
ZONE
APPROVED
2/21/79 342.31 TL
2/21/79 3k2.31CKTD
u�IlI�xUREf�41�T � IA
IV DATE ISSUED
PERMIT NO.
LOT SH BLOCK
�
VALUE
5
GROUP Y�
DATE
ZONE NO.OF VSE OF NEW /�
pQ�rn� PLANS BUILDING ROS
VARDSAPPfiOVED VARDSAPPFOVED
MAIN BUILDING ACCESSORV BUILDI
(FROM GL STpEET)
S
FEAR VD FT. �
DISTANCE BET. BET. MAIN
MAIN BLOCS. ACCESS. BL
VAR.# o DATE
C.U.P.#LE.%lf��� APPROVE�
APPROVED
D FOR SP'CIAL REOUIREMth�'
N
n
m
House 2190 0
SQ. FT. C'dY E SES N
THE AMOUNT SHOWN UNOER VAlUAT10N IS FOR m
THE PURPOSE OF ESTABLISHING A PEFMIT FEE ONLV: �
VALUATION pERM1T FEE 5 e
n
L n
$� ���0 a PLAN CHECK E JlD ^�
0
/ TAX E LL
f
U
TOTALPAID 5