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Home My WebLink About700 VICTORIA ST - Building Permits (3)(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mese.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 700 VICTORIAST Suite No D002 Vicini�y: 0002 Parcel Number: 93778006 App�icant STEVE SCHNIERER Address: 22911 SAVI RANCH PKWY YORBA LINDA, CA Owner: MARTIN, DEBORAH LYNN Address: 700 VICTORIA #D2 � COSTA MESA, CA Contracror. SERVICE CHAMPIONS Address: 22911 SAVI RANCH PKWY YORBA LINDA, CA REPLACE FAU < �OOK BTU. quantiry ISSUE FEE Insl FAU <700 k BTU Inst FAU >700 k BTU Repair I AII CoolingMeat Inst I Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >700 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm AirHandlers> 10000cfm Floor Fumace � , Floor or Suspentl Heater' 523.50 514.80 $0.00 $0.00 $0.00 50.00 50.00 $0.00 50.00 50.00 50.00 50.00 50.00 50.00 o 50.00 50.00 $0.00 50.00 50.00 50.00 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0' 0 0 0 MECHANICAL PERMIT ISSUED BY: Phone: 7'14-777-7777 Zip: 92887 Phone: 949-722-3531 Zip: 92627-5934 Phone: 714-777-7777 Zip: 92887 License: 799170 SCOPE OF PERMIT FEE SUMMARY Repair I Alt Absorbtion Unit Repair I AI� Refrigeralion Uni� Ventillation System Evaporative Cooler Commercial I ncinerator Domestic Incinerator Comoressors / A65orotion Svstems Upto3hp/100kBTU 3 To 15 hp ! 500 k BTU 15 To 30 hp I 1,000 k BTU 30 To 50 hp / 1,750 k BTU Wer 50 hp! Over 1,750 BTU Boilers Upta3hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechaniwl Fee Investigation Fee Plan Check Fee Reinspedion Fee TOTALCALCULATEDFEES COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: 03/07I2006 Issued: 03/07/2006 Quantity 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 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 538.30 NOTICE: The work authorized by this parmit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Orcl. No. 92-28, § t, 72-21-92) EXPIRATION: This permit shall automatically expire antl become void if work is not commenced within 7 BO 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 Inspeetiona and final approval must be obtainetl. Failure to obtain inspactions and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545828 244&48 (9�00� WORKERS'COMPENSAnON DECLARAnON: � I hereby aHirtn untler penaly oi peryury one of tha tollowing tleclaretions: � ❑ I heve and will malntain a cedillcala of consent to sell-Insure for workere' compensetion, as provided for by section 3700 of the Lebor Cotle, for �he peAormence oi ihe work for which ihis pertnit is 155uetl. �e antl will maintain worke�s' compensetion Insurence, es requiretl by section 3700 0l Ne Labor Cotle, fot the peAortnance oi the work for which I�iS pertnit is Issued. orkers' compensetion Insurence carrier entl poticy number are: ce��er: 1 �or_a �'amnens 'c�nv� Policy Num e�: H N�oco o I 8b � cf/on neetl ot be ro�p/efed i! the rmiNs ve/ued a! wre hundred doltars (5100) or less.) ❑ I terti Ihat in ihe pertortnanGe of the work for which Ihis permi� is issueQ I shell not employ any person in eny manner so as to become suh�eCt to t�e workers' �pensat on oi Celifom�a, antl agrea t�et If I shoultl become subiect to the workers' compenution provisions of Sectlon 3700 oi the Lebor CoCe, I shall forthwith ' hese p vi p1}qr Dlicant Sipnature� Dete: __ 3�7IQ(o W ' SE RE WORKE ' COMPENSATION COVEMGE IS UNLAW FUL ANO SMALL SU61EGr AN EMPL IMINAL PENALilES aND GVI� FlNES UP ip ONE HUNOREO TFKKISAND OOI.LARE (510p.Op0�. IN ADD�T��1 TO THE CQST OF COMPENSATION, DANAGES AS PROVIDEO FOP IN SECTION 3/Ofi OF THE LABOF CO�E, INTEFEST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLAAAnON: ol Chapter 9(commencing with Seclion 7000) of CONSTRUCTION LENDING AGENCV: antl Professions Code, and my license is in lull ❑ I hereby aflirm ihat lhere is a Ganstruction lentling agency for lhe pertormance ot lhe woB for which Ihis permit is issuetl. (Sec. 3097, Civil Code). Lenders Name: Lender's Address: Signature: OWNER-BUILDER DECLARATIONS: Date: 1 hereby aflirtn Met antler penehy af perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE �AW lor Ihe tollowing reason i5ec. 7031.5, Business and Pwfasslons Cotle: Any city or county w�ic� reqVires e permit to consimct, elter, improve, tlemolish, or repair any strucWre, pnor to Its issuence, also requires Ihe applicant for such permit to lile a signed stetement tha� he or she Is Ilcensed pursuant to the pwvisions of ihe Coniractors License Law (Chepte� 9(commencing with Sectlon 7000) of Dlvlsion 3 oi the Business and Professions Code) or that he or she is exempt therefrom and ihe basis for the aileged exemption. Any violetion of Section 7031.5 by any epplicent tor a permit subjects t�e applicant to a civil penelty of not more Ihan five hundred tlollars ($500).): ❑ I, as owner of the O�operty, or my employees wilh wages es Iheir sole compensa�ion, WILL DO THE WORK, antl the strucWre I5 not intentletl or ofleretl for sale (Sec. 7044, Business antl Professions Cotle: The Coniractors License Law does not appry to en owne� of propeny who builds or Improves thereon, an0 who does such work himself or herself or through Ms or �er own employees, provi0etl that such improvements are not Intendetl or oNered for sale. If, however, ihe building or improvemenl is soltl within one yeer of comple�ion, ihe owner-builtler will �ave lhe burden of provinq iha� he or she ditl not build or improve lor purpose ot sale.). - ❑ I, es owner ol the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The comractors LicensB Law does not eppry to an owner ol propeny who builds or Improves thereon, entl who contracts for such D�oject with a contrector(s) licansa pursuent to Ihe Contrectore Litense Lews.). ❑ I em exempt under sec. Business antl Professions Cotle for ihis reason: Signature: Date: Owner ID verified by driver's licenso. ❑ �es ❑ No Driver's License No. Venfication ot Ownership by (type ol document, i.e. - propeny tax bill or tleed): DIVISION OF INDUSTRIAL SAFET�' PERMIT CERTIFICATION: Expires: ❑ I hereby cenify that no excave�ion five (5) or more feet in depih into which a person is required to descend, will be made in connection with work authorizetl by t�is permii, anC ihat no builtling slNcture, scaHolding, lalsework, or demolilion or tlismantling thereof, will be more Ihan thirry-siz (36) leet high. (Chap. 32, Grp 2, An 2, Sec. 341, Tiile 8, Califomie Atlminis��ative Code). ❑ As owner-builder, I will not emp�oy anyone to do work whic� would require e permit irom ihe Division ot Induslnel Safery, es noted above, unless such person hes e permit to da such work Irom the division. Signature: Date: Division ol Intlustnal Safety Permit Number: CERTIFlCATE OF COMPl1ANCE AN� AUTHORVA710N OF EN7AY: I certify under penalry of perjury �hat I have reatl this epplicalion and state ihet ihe informetion given is wrrect I agree to comply with all slate laws entl city ortlinences releting ro building construction, and euthorize representatives ol the City ol Casta Mese to enter upon the ebove-descnbed property for inspec0on puryoses. I egree nol lo occupy or allow occupanry ot any building authonzed by this permit umil final inspaction. COUE t. INSPECTIONTYVE 1676 Fizetl System Final Fire Pr6venUon 1266 Pool Spe Final 200 Flnel Ra-ROot 201 Finel BIocWRetaining Well 202 203 Final Factory Fire Place Finel Sign 204 Finel Demolition p� irrrmn�s CODE 1 INSPECTION TVPE 206 Final Mechanical 20B Finel Plumbing 210 Final Electrical 272 Final Fire Preventlon 220 Final Planning Approval 222 FinalSite 250 Final Building/Occupancy oare �. 1 V:::.... `/� I I (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa��MBING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parce1 Nunmber: ApplicanC Address: Owner: Address 700 VICTORIA ST D002 Pk)tI�I�LIB JOHN MELROSE MARTIN, DEBORAH LYNN 700 VICTORIA #D2 COSTA MESA, CA, Contrector. C AND R DRAINS INC Address: 1525 MAC ARTHUR BL. COSTA MESA, CA Phone: 714-641-1545 Zip: Phone: Zip: 92627-5934 Phone: 714-641-1545 Zip: 92626 License: 531746 SCOPE OF PERMIT BROKEN SEWER REPAIR FOR UNIT#D002, SEWER IS IN DRIVEWAY. ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Connect (Ice,Soda,etc) Dental Units Dishwasher � Drain, Floor Drain, Rainwater Drain, Roof Drinking Founlain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 oullets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Aulo ) AMT $23.50 $0.00 $0.00 50.00 so.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 c�Tv_ FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 fl) 50.00 Receptors 50.00 Septic Tank $0.00 Sewer Cap for Demo 50.00 Sewer Connect 50.00 Sewer Private Line $24.65 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kilchen $0.00 Sink, service/mop $0.00 Spa (private) 50.00 Spa (public) $0.00 on 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: 09114/2005 Issued: 09I142005 ISSUED BY: SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLANCHECK REINSPECTION TOTAL CALCULATED FEES: R RIP AMT $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 548.15 Qiv 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulatlons. (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 1 BO days. INSPECTIONS: In order (or the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inepeetlons end Iinal approval must be obtained. Failure to obtain inspections antl final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zusae �aroo) � � WORKERS' COMPENSATION DECLARATION: I hereby affirtn under penalty of perjury ane ot the follawing deGaretians: ❑ I heve antl wlll maintein e ceNflcete ol consent ro self-Insure for workers' compensetlon, es proNded tor by section 3700 of the Labor Code, lor the pedortnence of Ihe won� ro� wnicn m�s permn is issuea. ❑ I have and will meintain workers' compensation insurance, es raquiretl by sectlon 3700 ot Ue LeOor Cotle, tor cha perfortnance oF the work tor which t�is pertnit L5 Issued. My workers' compen5atlon Insurance ca ner and pollcy number ara: �/� (�[�y Carrier: /�%�i � r r ,�-� YYL � <SG(?Ci4r- CC/ Polity Number !C/ ��O �i �'S (This s dion need nof be completed i/ �e permrt is velue at one hundred dollars ($100) or less.) � ❑ I certify that in the pertortnance oi the work for which Ihis pertnit is issuetl, I shall not employ any person in any manner so as to bacoma subject to t�a workers' cnmpansation laws ot5',glifomie, entl egrea that II I should become sub�act to the warkers' compensatlon proNsions oi Section 3700 oi the Lebor Code, I shall forthwit� comply with ihese r6vEions. �y /� �j ApplicantSlqneNre: Dete: /'--�7 �V � � WARNING: FAIWR ECURE WORKERS' COMPENSATION COVERAOE IS UNLAWFUL AND ALL SUBJECT rW EMPLOVER TO CFIMIWIL PENALTIES AND CIVIL FINES UP TOIXJE HUNDRED T/iOUSAND (5100,000),INADDITIONTOTMECOSTOFCOMPENSATIqJ,DMMGESASPROVIDEDFORINSECTION3lO80FTHELABORCODE,IMEREST,ANOATTORNEV'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby a%irm that I em licensed undar provisio torce ena eHect. ua a_-'��1�� Contrectofs Signelure: � 9(commencing with Section 7000) ot Dlvision 3 01 the Business and Professlons Code, and my licensa Is in full � � Clessa C '',�%i oate:� i,_�—h G^�_ CONS7FiUG710N LENDING AGENCV: ❑ I hereby aHirtn that there is e construction lending aqenty tor ihe performance of the work tor which this pertnit is issued. (Sec. 3097, Civil Cotle). Lentlefs Neme: Lendefs Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby e%irm Ihat untler penelry ot per�ury Ihe� 1 em EXEMPT FROM TME CONTRAC70RS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business antl Professions Code: Any ciry or counry which requires e parmit to wnstruct, elter, improve, tlemolish, or repeir eny structure, pnor to ils issuance, also requires the applicant tor such permit to tile e signetl sretement thet he or sha is Ilcensed pursuent to �he provisions of the Contrectars License Law (Chepier 9(commencing with Sectlon 7000) of Division 3 of the Business end Professions COUe) or thet he or she is ezempt therefrom antl the �asis for tha elleBed e:emption. Any violetion of Sectlon 7031.5 by eny epPlicant for e permit subJects the epplicant to a civll penelty of not more ihen five hundretl tlollars ($500).): ❑ I, as owner of Ihe properry, or my employees with wages as their sola compensatlon, WILL DO TME WORK, end the siruciure is not Intendad or ottered tor sele (Sec. 7044, Business and Professions Cotle: The Contrectors License Law tloes not apply to en owner of Oroperty who builds or improves Ihereon, and who does such work himself or herself or through his or �er own employees, provided that such improvemenis are not Intended or offered tor sele. If, however, ihe building or Improvement is sold within one year oi completion, the owner-builder will heve ihe burtlen oi proving that �e or she did not build or improve for puryosa of sale.�. ' ❑ I, es awner of the property, am E%CIUSIVELV CONTRACTING WIT}f LICENSED CONTRACTORS to canstruct the pro�ect (Sec. 7044, Business antl Profeuions Code: The contractors LJcense Lew tloes not apply Io an owner of property who bullUs or Impmves thereon, end who contrects for suc� pmjact with a conlraclor(s) license pursuant to Ihe Coniracior5 License Lews.). ❑ I am exempt under sec. Business and Professions Cotle for I�is reason: SignaWre: Date: Owner ID verifietl by tlrivefs license. ❑ Ves ❑ No Dnvers License No. Expires: Vedfication of Ownership by (type oi document, i.e. - properry tex bill or deed): DIVISION OF INDUSTAIAL SAFETY VERMIT CERTIFICATION: ❑ I hereby cenity that no excavation tive (5) or more feet in depth into which a person Is requirad to descend, will be made in connectlon with work authorizetl by this permit, and ihat no building siructure, sceNoltling, felsework, or tlemolition or tlismantling thereof, will be more then ihirry-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Califomla Atlminisiretive Cotle). ❑ As owner-builtler, I will not employ enyone to do work which would require a permit Irom the Division of Intlustnal Sefery, as noted above, unless such person has e permit to do such wark fmm ihe diNslon. Signature: Dete: Division of Industrial Safery Permit Number: 1 WIII the applicant or present or fuWre building occupent need ta tile antl certiy a Business Plen far emargency response ro release or threatened release of e hezerdous metanal7 ❑ Ves ❑ No (Sedion 25505 of the Calilomia Health entl Salery Cotle requires, with some exceptions, that e Business Plan be filatl with the Costa Mesa Fire Deparimem by every busineu which has at any one tima dunng a reponed year a quantiry ol hazardous matenals equal to or greater Ihan a weight ot 500 pounds, or e volume of 55 gallons, or 200 cuDic feet of compressed gas at standartl temperature end pressurej. ................._".............._....................__..................................................._........'_'.............._.._...........................'_'.........................._...""""___'......._..... .............._....... ..__............'_'.............._.._. 2 Does or will t�e applicant or present or future building occupant need to tile a registretlon form for ecutey harartlous matenals7 ❑ Yes � No (Section 25533 of the Califomia Health end Salery Cotle, with some exceptions, requlres registratlon with the Coste Mesa Fire Department by each 6uslness which et eny one time has on hand e quantiry of acutey hezertlous matedels equal to or greeter Ihen e weight ot 500 pountls, or e volume af 55 gellons, or 200 cubic teet ol compressed gas et stendertl temperetura end preuure). ......................................................................................................................................................_............................................................................................................................................................................................................................... 3 Does or will the applicant or present or tuiure 6uilding occupant need to prepare an RMPP (Risk Menegement end Pravention Program for acutety hazardous materials)? ❑ Yes ❑ No (Section 25534 ot the Celifomia Heelth and Sefery Code provides that �he Casta Mesa Fire Departmem may require Ihe preparation, cenificatlon and tiling with the Fire Depenment ot en RMPP by businesses which ere requiretl to register acutely hazardous materlels wlth the Flre Depariment. ..................................................................................................................................................................................................................................................................................... ........................ ................................................................... 4 If en RMPP is presently requiretl, has Section 25534 0l the California Healih end Salery Code been tully complled with7 ❑ Yes ❑ No ....................................................................................................................................................................................................................................................................................................................................................................................... . 5 Does or wlll ihe epplicant or present or tuture bullding occupant require for the work which la Iho sub�ecl ol this e plicetion e Permit lor such consVuciion or moUlOcatlon tram the Sauth Coas� Air Ouelity Menegemenl Distdct or from eny o�her eir pollu�ion control dis�dc� Or ayenCy7 � Y85 LJ No (Sectlon 658502 of the Calibmia Govarnment Coda requlres thet the requestetl intormetion be Wmished on applicatlons for non-residential bullding permits). ....................................................................................................................................................................................................................................................................................... 6 WIII any part of the faciliry to be constructed under Ihis permit be within 1000 feet trom the outer bountlenes of a school4 ❑ Ves ❑ No (It yes", ihe taciliry musi meei the requirement ot Sections 25534 antl 42303 of the Califomia Health end Salery Code). ......................................................................................................................................................................................................................................................................................................................... . ...................................... . ..................... 7 If e pertnit irom Ihe SoNh Goest Air Quality Menagement District or other air polWtion control tlistdct or egency is requiretl for the work which is the suhject af this eDDlicatlon. �eve all 01 the disclasures prescrlDetl by Califomla Heelth and Safery Code Section 42303 Deen metle? ❑ Yes ❑ No CERTIFICATE reqarding Hau Signeture: _ n the appropdate eir polWlion cnntml oHiter). t�at under penelry ot pe�ury ihe information given aDove is correct. I egree to comply with all state laws and ciry ordinances Date: CERTiFlCA7E OF COMPLIANCE AND'AllfMORKA710M6F ENfftV,:�'Vc� under penalry ol perjury that I heve read this application end state that the inlortnation given is correct. I agree to comply with ell state lews and cily ortlinances relating to building consiruction, and euthodze reDresente�ives of the Clry ot Costa Mesa to enter upon Ihe ebove-descnbetl property for inspeclion purposes. I agree not to occupy or allow occupancy of any building authorized by this pertnit until finel inspection. GOOE I, INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spe Final 200 Final Re-Root 201 FInaI B1ocWRetaining Well 202 Final Fadory Fire Place 203 Final Sign 204 Final Demolition U�TE �yj�Q �Qp�� INSPECTIONTYPE 206 Finel Mechenical 208 210 212 220 222 250 Finel Plumbing Finel Electdcal Final Fire Prevention Final Planning Apprwal Final Siie � Final Builtling/Occupency P9IE 1[�L$ �°p��a�^�� 700 VTCTORIA ST avx€xsx.weira�axx: pACIFIC CREST VILLAS ��u 700 VICTORIA ST C.M 929626 642-1722 �vr�. uuimc woxeu UKNRECT ON F1Md1FFA: �PCN.011 ENG.'4/�DDRE55: uxr: D _ 2 uc. ra: UNT: �+��T«+8� LEE ROOFING ( 714 ) 642-7223 caxmscrorrswuur+o 1653 SOPERIOR �noxEss: COSTA MESA CA uawo.: 349686 92627 uxr: IICEN5E0 COMRACT�NS UECUF�TI�N: � he�ebY eMim uMee pana6y d pxjury thnl l am Ikeneed uMx yvnabna d C�aptx g (oommentlM wil� SscWn ]0001 d Oirnion J d Ne Bueiroa eM Prdessnm Code. erd mY Iberue u in lull lau vM e/letl. cmuc.No.:028751 uc.cuss: C-39 uc.No.: 3496 EXP: 03/96 a� �/—�i�� cw�a�: EN BUILOEN OECLANRTION: 1 Mreby dfiem �Mu perelY d perW e� I em ezemq Imm IM Comrrfae Lioaiue Lew Iw ihe .- Jowiq reefon (Setlon ]0�1.5 &nnne eM PMestbne Code: /M' c oouMy wfiiM nWiiw e VertnC lo mnhuG. Mer. imqwe. '`l�Wnh. a repv eery avieiiae. pria b ea'sWaim. ebu reG� t ' fa ach pemm to fJe e ppned MtemeM Nel he a Me $'�icenseE Wmient lo �M povisiorn W Ihe G�redan Licen�e lew ICheqer 8(commenen0 wnA Sepun ]000) d Dineian � d the E��nea eM Prdeubu Cade� a tlw he a 1�a u exemq ihereham arM tM bub Iw Ne ellepeE exempion. My violetion W Seeion 'l091.5 by eiry eppliraY lar e prmtl wbpUa iM apd� lo e wJ pef Wiy W no1 maa tAan Iwa hundretl EOAv� �5500�). ❑ I.mow�wrdlMpapnYamY�dM�°'^�hwepeaeaihaiedecomperomion.WldoNsxork.eM�Mn�uauroum�imeMed «olimed lor eda (Seciion )OCd, Buaima e�d Proleaeiona CoCa: TM Comredon timrua lew Eoes rot eppyto en owner d popary wfp buida a inpwes iMieon. W Ma �e suM nork Nmeetl u henetl a Nrouph he a Aer awn amplvysw. poviEed thm wch impwemmia ue iM imeMetl a d1aaE �a eeb. M.Iwwewr, iM puitli�q «inpwwnam u eold r.a�in aro yw d canpluion, tln owner-0uikbr will hero t�e Euken ol pmvinp M or ahe d'd � Wild a impmro la tM WTae d aNe). � I. ea armar d ihe pWeM. em utlusivaN conveu�q wnh 4cenaed contreclon �o wnaruC Ihe V�led (Seeion )OM. Bus'uw� eM Proleaiau Code: TM Coniredm Licenb lew dou rwi epply io en owner d popeny x1w buiNa a unpovea tMreon uM who wnVecis br vud� D�q�e wil� e mnirecwKe) IcensaC W�uenl lo IM Gontredae Licenee law�, � I em exemq uMer Seciion: B. 8 P.C., la Nia reawn: De�e: O.mer. � eo nueW c«Nv uw � am ew.rc a ene una.r.iena me na�aro a cd�omy Hewn end smar coa. s.a�on. zssos. zssaa..m 2553a. eM Mei 1 u em' hnun buikuq omqu'�. will / wil rwi (acb me) roeE to comWY w�n uid pNa mEm ud ihe na�mnrro br epermGlwwnavucUonamoddre�ionM1omlMA e�y e�ememDiantl.ReeMeMieloonn�ionappicatiwaueeaemqtmmNeae aa;,�,. Dme: Mp�� W ONKEP'S CONPFNSATION DECI�RATION� ��sbY dfirm uMx perW�y d pe�vy one q IM Idbv.'vq detleretum: ❑ I hm aM wi1 meinien s unfwe d od�� to �atlimure br wvken' comW�ion, m VwidaE Ia W Secian J100 W IM leEa J coda i« in. wn�K. d in..,on� iw wn�n my v� „��a. �f in.wenawme'vii.bwwk.n•mno�a,�^w,•^�.%�aoineMseaimaooau.�mc.coe..win.c.�«m.�weau» /. wak tor whiM Nu O�a u iuutl. MY wakms' canPemation'usurerce wrier eM VdKY mimber ue: \ c�er: STATE FUND EXPIRES Pdiry NumEer: i i n��— 0 6/ 3 0/ 9 6 (1M1'iseclian neeE irol Ee canPbled / IM G+��l'q M aro huMred ddbn (SI00/ a Im.f ❑ I cMAy ihel in Ihe peAamence W tM woA la whch Ihu pa�mn ia iseued, I ehell � empby eiry pemn in eny menner eo m to becm�e wbjee io iM wrkers comM�'ution lewa d CdNania, eM e0ree thq� (Ilhoy�d becoms w4� to iM xaken' cwnVenution Dm+iaons d Sedion 3)00 W IM Lebor COEe. I��(y vmh Ijy% proviu� a: nvoi�m: i/ % �i.�--�--� —� InO� F�Nun M s1cun woM1ui rompwM�Hon rov�rp� Is vn/awNl, d �It� ICI III N11p10/I! f0 MMN) pN1IlOq �I1C elv I flrn� up ro om huntlrod thouv�M CdUn /J104000). In eedltlon ths cwt ol rompnw0on, Wnrp� u prov/Astl br In S�ctlon JIfM ol Ms lebor CoOs, InMut, �ntl �ttomry'� Isu. CONSTFUCTION LENDINO �OENCY: I hereM dfirm uMer d perjury Ihtl �Mro u e mnnwfion bMiip aperKy br tM Pono��, d me wo� iw .n�m m: ro�� ie owaa (sea� aoa�, ca. c). LENDEWS NAYE LENOEP'S ADORE54: 1<eetM Rim 1 hew rtai No eDdc+Ym end qtls 11� Ne ebwa'uJmretion u eonw.l Nrea �o ea^dV xi1M1 eA tlIY enE oowvYadinarieen ud staie kxs relmip to buiNM emmurmn rod haraM eWar¢e n0��ea d �he mY to emm uD� �M ebwe-meNiand pop�ty la insGd=un WrD�es. M �C�HAEL HURI{E �eia: [i�'7� WAne-Buik�q 8 SalelY: Green-Fle: Cerery-AOW�I: Fnk-Ravenue: GolEenraFAevevor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: B 075037 PLAN CHECK NO: N PERM NO: H 075037 GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : ROOF 1LAYER COMP OVER EXIST 1 LAYER COMP SQ FT; 1,528 CLAIM VALUE: CALC—VALUE; 1,528.00 GROUP OCC: R-3 /M-1 COMMENTS: SMOKE DETECTORS ARE REQ�UIRED AS PER U.H.C. 1991. ***�t*�t**�-x-x�***it�***at*******�r***�- �t+e�t�tit*�t*�tatat*at**�t*r*****�****atit�et****itit*+eitat*i�*� Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT: FT ZN LEFT: FT IN RGHT; FT IN PARKING REQ; PROV: PARCEL: 93778006 ZNE: REF NO: PLANNING NOT£S> � i 1f 1f IE i! 1E 1k iE iE 1E 1E 1E iE iElE iE 1E IE IE iE 1E iE iE iE iE iF 1E 1E 1F 1E 1E 1E iE IE iE iE 1E 1E 1E IE 3E fE iE jf 1F iE iE 1E ik it iE k iE iE iE fE 3E 1E 1E iE iE 1f iF iE iE IE IE 1E 3E if 7f,iE iE jF iE iF iF iE 1E iE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N•'f S ZONING APPROVED BY DATE: r� BUILDING APPROVED BY : DATE; APPLICATION ISSUED HY; �� DATE: ��F��'i iEiFiFiFiBiEiE1EiE1EiE1E1F1E1E1f-iE9f1ElElEiE��F��F��{�$� iE �f��fifiblElfiElElhfElEiE1F IEiE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 37.00 ' .50 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CIiECK TOTAL PAID DUE TOTALS----> 37.50 0.00 0.00 37.50 , 37,50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 37,50 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 37,00 .�50 IEk1F1f1E1fiEiElfiFlElEiE1E1EiEiEiEfE�E1EfEfE1E1ElEiEiElEiE7E1F1FfEfEfEfE1E1E�E1ElElEififikiklfiE�EiE1ElfiEk1E1F1Ek1E1E1FlElElEIEIEfEfEiEkiElElEif7E1E1F1E I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 1528 REROOF BY VALUE RESIDENTIAL NOZONE �1.00 1,528.00 END OF FEES U1 Jr.i�t��'-"OiS?]?E .-�z'-� - n,�e: Lv�o�-, 7s��. �;-. , - CONSTRUCTION AND I'LANNING .� - POG . SPA - � Date Inspector Date i�spector APPROVALS Permit � � � APPROVALS Permit # 1. Temporary Electrical Service or Po�e 52. Pool & Equipment Location 2. Soil Pipe�Undrgrnd. .- 53. Steel Reinforcement 3. Electrical Conduit UtilitY-Undrgmd. 54. Forms 4, Electrical Conduit�Undrgrnd. 55. Electrical Bonding • . 5. 5teel Reinforcement.. 56. Rough Plumbing & Pressure Test - -" 6: "Electrical UFER Gmd. 57. APPROVAL TO C6VER-GUNITE 7. Fbotings � .� 58. Elearical Condv7t�Undrgrnd. 8.' Foundation - �� 59. Gas Pipe, O Urrdrgrnd., Test , ' : 9J4Vater Pipe�Undrgmd. `. 6p. Backwazh Liner, P�7rap, f� Undrqrnd. T0. Struttural Floor System ,,! 67. APPROVAL T(��pECK . ' 71. Property Sewer Line & House Connection 62. Backwash & Receptor-Firral 12. Sewer Cap 63. Heater & Vent-Final � 13. Roof Drains - . 64. Plumbing System � final' � 74. Rough Plumbing- � 65. Electrical�Final � 15. Rough Electrical_Conduit 66. Solar SYstem�FiPa� 16. Rough Electric V�iring 67. Fencing & AccesvApproval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrica4T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Canditioning _ , � . FIRE DEPT,�FtEQUiREMENT , 20. Rough Factory FiF�place '� . � � - ' qppFi�V.L�(y5'_.. Permit # - - 21 . Ducts, in Structur8 - ' - ' �- � ��' * � 70. �jlndergraund Hydro � 22. DucYs; Vantil�tin � �' ' � "' _ .. g- r f�. �� V 71. ProductPiping CIGas ❑Oit 23. Gas Pipe•Rough & Test - - 'h � �� 72. Undcrgro}�nd Fltish' � ' ' 24. Roof Fra ' � � - " n1��9�� ;�r �r. 73�, Undergrnd.StoraA��anMOGas ❑Oil 25. Roof Sheathing � � �� r = ' 74. Ove[.head. Hydro .. 26. T-Ba: Ceiling (Structurel) & Monocoat , � 75, Dry Chemical -- 27. Erameand�Flashing � ' _. ' - 76. DryStaridpipe - � "' � .7�� - 28. Wthing&Siding � ;. ' . " ... - - .. .. .. 77: flXED1`ST�tv�plNA�., . 29. Insulation� c�" . '_ ' 7g FIRE PREV. FIN�L = � 30. Orywall NBiling = �y � ` - HEALTH DEPT. F#EQUIREMENT 31.PlasterBrowrtCoat' : ^ "79.FINALtNSPECT10N - r. � 32. ElectricahPower MeterF��ai ,` � F' 80.. FOOD CERT�FICATE ISSUE0. �� 33. Finat Electric, . * . � Notes: - � • - - "�� • r � 34. Pjnal Heating & Aii Conditioning=� " � - � ` , = � - 35. FinalGas�Pipe•Test •� - • � --�� - 36. Hood or Canopy _ ' t -� a ✓ ; : � - � 37. Final�6actory Fireplace - � ��^� ' ." 38. Final Plumbing, , � � . 39. Water Service-Finaf � ; _ ` . _ � �s � � � .. � - 40. Gas Service�Final '' ` " - � - ,' F . - 41. Solar �omesticFinal' -' `-r� •r - -. - - � ' i 42. Backflow�Freventer� _. ' �, /� '7^� � �ek � �,�, �L,` /'�/i l ! 5�.,:_,_.__- � �a� �� o� 43. Backflow Irriqation �- � - a, 44. Landscap� Irripation'+System �" � ` - �, u, n , . ' � �5. Sound Atrenuetion � .� j � ;�. , � � • �t � 46. Handicap ftegulations _ - � " �,t, _ - ' � 47. FINAL STRUCTUR� & BUILDING �2_�'...� �� " 48. PINAL PLANNING � � ; ' � '. 49. Electric R,elease to Ebison '', , 50. Gas Release to Southern CaliforniaGas Co - ' � ' - " - 51. CERTIPICATE OF OCCUPANCY No. Dace �v,u�7- COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 For Applican[ to Fill in Completely — Use Ink Only ADDRESS D(O' � �,/`� `' – OWNER O TENANT MAILING Z ADDRE55 TEI. arrAAltt�rni \1�� ln Ncn^l.n_� BRANCH CONTRACTOR ADDRESS TEI.. CITV NO. F STATE CITV � IIC. NO. LIC. NO. (,z� SIZE NO.OFBLDGS. �+ OF LOT NOW ON LOT a USE OF „�„i EXISiING BLDG. h FSeparate permits are required for � electric, plumbing and heating work. F USE OF BUILDING AND WORK TO BE PERFORM D a Q � } � C W _� APPLICATION FOR STRUCTURAL PERMIT 7EC V P �,u� �8� �O 4 A.P. NO. I I.'S— ��7— I G� _ �i Z UNIT OR SPACE NO. TR.NO. � u�o"�.� NEW ADD �.ier�. �� Z / BLK. .TER REPqIR MOVING DEMOlISi IV '�j � VALUE � s 3 d� TVPE- GROUP-1�� DATE ci % •7 —T APPROVEDSETBACKS (FFOM C/L S�TRyEE_ �7) . � �� FROM G[�.T4�u�C--�� R. SIDE �� FT 0 L. SIDE �FT. � REAq �/' /SQ�.C�20� PLANNING ACTION DATE APPFOVED APPROVED �� r� ^^T � /� � I hereby acknowletlge that I have reatl this apPlication antl state ttOLD 1 � (y� ihat the above intormetion is correct and agree to comply with � ell laws regulating builtling consttuction, and I shall not employ z eny perwn in violatton of ihe workman's compensation laws of � the State of Californie. 3 I h¢reby cartify that I am prope��y licensetl es a contractor untler the State of Californte Business antl Professions Cotle, Division 3, THE AMO Chapter 9, antl thai such licen5es are in full force antl etfect, or I THE PURPI am exempt from the provisions of theState of California Business VALUATION end Professions COtle, Division 3, Chapter 9. Sig^ature of � Pe�mittee $ ` � or T 3 c Authorized Ageni Date � � 57 TL C JYC�.inY au.\N�uv.•••••••••• m � v' I m FT.�J � a O f SHOWN UNDEF VALUATION IS FOR m O OF ESTABLISHING A PERMIT FEE ONIV: e � PERMIT FEE S q N (�I ( � PLAN CHECK $ l"T� p v` 7„ LL \ TAX S 7J ' f ( n�1 U TOTALPAID E y� /_ A4 H � W 6� a y y r 2 F G f"i a > �' ..1 C W � �. a z � 3 �298 3/14/8� 169a0G TL ., COSTA MESA BUILDINGSAFETY DEPARTMENT pPPLICATTON FOR STRUCNRAL PERMIT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 REC V PERM T � D For Applicant to Fill in Completely — Use Ink Only BUILDING �/ /� � � A.V. NO. ADDRESS /O � I G A /.� BUILDING � t� T� NAN OR�j• L/,/�_ `r � ^w' ADDRE55 /J / N�� l.t�K �X� VNIT OR •}�^ MAILING SPACENO. _y ADD RE55 TR.NO. LOT BLK. TEL. CITY NO. NEW ADD ALTER REPAIR MOVING �EMOLISH CANSTRUCTION LENDER BRANCH C � S OWNER ` ADDRESS UE � ARCHITEC7 TEL. USE S OR ENGINE %� N � ADDRESS ZONE YPE � GROUP / V APPROVED � /y �]ti CONTRACYOR BV DATE J QV ADDRESS TEL. CITY NO. STATE CITV APPROVEDSETBACKS LIC. NO. LIC. ND. SI2E NO.OF BLDGS. (FROM C/LSTREET) OF LOT NOW ON LOT FROM FT. USE OF EXI5fING BL�G. Separate permits are required for L SIDE cr. electric, plumbing and heating work: REAR FT. USE OF 9UILDING AND WORK TO BE PERFORMED PLqNNING ACTION �� y �. A` /� IJ• DATE a�n7■�. -•v �,r.r� a.PPaoveo APPROVED I hare0y aeknowledge ihat I have reatl this application antl stete thet ihe ebo�e informetion is correct anC agree to comply wlth all laws re8ulating builtling consvuction, and I shall not employ any person i� ��olation of tha workmen's campensation laws of tha Siete of Celifornie. � �� y �� I hereby carx�fy ffiai I am prOperly Iicensetl es a contractor untler $Q. FT. tha State of California eusiness entl Professions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, a�tl that such licenses are in full force antl affact, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: em exempt f�om She provisiOnsottheState of California Business VA�UATION PERMIT FEE E antl Professia�s Code, Divislon 3, Chapte� 9. • � SiB^atura of ��% s/�'/��C/ .y� �J PLAN CHECK E � Permlttae f/� "�/ '' $ Y) TAX E ► AuMorizetl Agant Dat¢ �/�----_"� r TOTAI PAID $ Q� 7 m e N n m 0 LL f U