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Home My WebLink About866 VILLAGE CREEK - Building Permits(714) 754-5273 • Fax (714) 754-4956 � www.ci.costa-mes��DING PERMIT 77 FAIR ORIVE, COSTA MESA, CA 92626 JobAddress: 866 VILLAGECREEK Suite: Vicinily: BATHROOM Primary Occ: R3 Dweliingsl Cong Res <50 Sype ot Consiruction'. V-N Parcel Number: 93506066 Zoning: Applicant: RONNIE MIRIAM FRIEDMAN Address: 866 VILLAGE CREEK COSTA MESA, CA pwner: RONNIE MIRIAM FRIEDMAN Address 866 VILLAGE CREEK COSTA MESA, CA Contractor: O W N ER-6 U I LD ER Address: Zip: Arch : Address: Phone: � License: Phona: 714-800-6688 Zip: 92626 Phone: Zip: 92626 Phone: License: 000000 Eng: Address: SCOPE OF PERMIT REPLACEMENT PERMIT TO FINAL BATHROOM REMODEL PROJECT. REF: BOS-01432, E05-00896, POS-00656 FEE SUMMARY Plan Check: $0.00 Permit: $0.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $0.50 PLANNING 8 ZONING SETBACKS MAIN STRUCTURE Front 0. 0 ACCESSORY Front 0. 0 PARKING Existino: 0 Status: ISSUED Applied: 03232006 Issued: 03232006 ISSUED BY: Phone: �icense: Calc Valuation: so.00 Claim ValuatiOn: SO.00 Rear 0. 0 Lefl 0- 0 Right 0. 0 Rear 0. 0 Lefl 0- 0 Right 0. 0 Reauired: 0 Pr000sed: 0 NOTICE: The Work authorized by this permit shall comply with all applicable handicap access requiremen�s under Calilornia statutes and related regulations. (Ofd. No. 9248, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire antl become void il work is not commenced within 1 BO tlays, or il work is suspended or abandoned for a periotl ol 1 BO tlays. INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiralion ol ihis permit. ' FOR INSPECTIONS CALL: (714) 7545626 I �� o �dwi WORKERS'COMVENSAnON DECLARAnON: I hereby eftirtn under panalry ol perjury P�e oi the tWlowing tledarations: ❑ I have antl will malntain a ceNlicate at consent to sell�lnsure for workers' campensatlon, es provided lor by section 3700 of the Lebor Cade, br Ne peAormance ol the work for whith Ihis permit is issued. ❑ I heve antl will meintain workers' cOmpensalion insurance, as required Dy Settion 3700 0� the Lebor Code, �or �he peAortnantu of �he work tOr whkh IhiS pertnit i5 i5wed. My workers' compensation Insurence carner anA policy number are: Carner: Policy Num�er. (This seclion nee0 nol be comple(etl il t�e permit is velued et one hundred dollers ($100) or IessJ ,Q� ortily that In the pedormance ol the work lor which Ihis pertnil is issueQ I shell nol employ eny person in eny manner so es to become sub�ect ro the workers' '�" compensetion laws o lifornia, entl egree Net II I sh d become ubject to Ihe workers' compensation pmvisions oi Secll n 3700 f Ihe Labar Cotla, I shall lort�wilh complywit�t�e oH ons. / APP�I�J� ��. .�//�0��_ COa1ere ��Z�l�lp . WARNINO: FFILURE TO SECU WOHKERS� �MPENSATION ODVERAGE IS UNLAWFUL rWD SIULI 5U8JECT AN EMPLOVER TO CRIMINAL PENALTIES RND CML FlNES UP TO pNE HUNDREO i1qUSAND DOLURE �StCO,OfA),IN ADDITION TOTHE COST OF COMPENSAT1pJ, DnMhGESlS PRWIDED FOR IN 5£GTION �OB OF THE LPBDR ODOE, INTERE5T, AND FTTORNEVS FEES. UCENSED CONTRACTORS DECLARATON: I horeDy eflirm that I em licansetl untler provislons ot Chapter 9(commencing wiih Section 7000) o/ Division 3 of the Business and Prolessians Code, entl my license is In lull force end eXect. Llc. a Class a Cantrectors SlgneWre: Date: CONSTRUCTION LENDING AGENLY: ❑ I horeby eRirm that Ihera is a construction lentling egency for ihe peAormance of Ihe work lor which ihis permit is issued. (Sec. 3097, Civil Code). Lender's Neme: Lentlor's Adtlress: SignaWm; Date: OWNER-BUILDER DECLARATONS: I hereby eHirtn Ihat under penalry of perjury that I em E%EMPT FROM T1E CONTRAC70RS LICENSE LAW tor the following reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or counry which requires a pertnit to wnstruct, alter, improve, tlemWish, or repair any structure, prior to its Issuance, also requires the epplicant tor such permit to tile e signed stetement thai he or s�e is licensed Dursuent to Ihe provisions oi Ne Contractors License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 oi t�e Business end Pmlessions Cotle) or thel he or s�e is exempt theretmm and ihe basis for Ihe alleged ezemption. Any violation ol Section 7037.5 by any applicant for a pertnit �su6" c�s the applicaN to a civil penalry o� �ot more then five huntlretl tlollars (5500).): I, as owner oi Ihe property, or my Bmployees with wages as their sole compensation, WILL DO THE WORK, antl ihe strucNre is not intendea or otterad tor sale (Sec. 7044, eusiness and Professions Cade: The Contractors License Law tloes not apply to en owner of property who builds or improves ihereon, and who does such work himselt or herselt or through his w �er own em0�oyees, provided ihat such improvements are not intended or oHeretl for sale. If, howeve�, the building or improvement is soltl within ona year of completion, the ownervhuilder will heve the burden of proving that he or she tlitl not build or improve for purpose oi sale.). ❑ I, as owner ol ihe property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct the prolect (Sec. 7044, Business and Professions Cotle: Tha contractors License Law tloes not epply to an owner of property who 6ulld5 or improves Ihereon, and who coniracts br such project with a contracror(s) licen58 pu/r5 �ani to lhe Con�ractor5 License Laws.). q ❑ I am axe/not Cnder sec. ` �. . �— /�usipess and Professions Code lor ihis reason: —, / _�_� Owner ID ven�leE'6y tlrivers license. ��es � No Dnv' eTs 'Ro. Venfication ol Ownership by (type ol tloCument, i.e. - properry tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cetlity thai no excavation �i�e (5) or more teel in tlepih into which a person is required to Aescend, will be made in connection with work authorized by this permil, and �hal no building sirucW�a, scaHWtling, talsework, or tlemolition or dismantling Ihereot, wili be more Ihan thlrty-six (36) ieet high. (Chap. 32, Grp 2, An 2, Sec. 341, Title B, Calilornia Administreti�e Code). ❑ As owner-builtler, I will not employ enyone to do work which would require a pormil Irom Ihe Division of Indus�nal Sulery, es nototl ebove, unless such person hes e permit to tlo such work from the tli�sion. Signaturo: Date: DiviSion ol InduSiriel Sefery Permii Number: CERTIFlCATE OF COMPLIANCE AND P�110RIZATION OF ENTAV: I certity under penalry ol peryury that I have read this epplicetion anC s�ale lhat lhe infortnation given is correct. I a e compty with all state la�ws� tl city o' ances relating to Duiltling consiruction, end authorize representatives o) the Ciry ol Costa Mesa Io enter upon the ebove-0es rib properry forinspe �on p6r�5es. I egr n t upy or allayi accupancy ol any building authonzed by this�rrtltZil lin I ins�ion. � / I Signature Of Legal Ow f�) `De1e�' ' AnNOr Aut�orizod Applican� Date COpE 1, INSPECTONTYPE Q�E f[�� 1616 Fi:etl System Final Fire Preventlon 1266 200 201 202 203 Pool Spa Finel Final Re-Fool Finel BIaWReteining Well Final Fectary Fire Place Finel Sign 204 Final Demolilion LODE 1 INSPECTION TYPE 206 Final Mechanical 20B Finel PlumDing 210 Final Electrical 212 Final Fire Pravention 220 Final Plenning Approval 222 Final Site 250 Final Builtling/Occupancy P9IE II�ELS /.�jS- p/ `�,3 Z LIj s -pD 89� �� .s- ao 6s� MUTUAL DISOLUTION AGREEMENT This agreement is an official ending to the agreement between Taurus Construction and Ronnie Friedman dated July 02, 2005. Taurus Construdion hereby admonishes complete disassociation from agreement and both parties agree satisfactorily to end the above contract. The foliowing items will be retum to Ronnie Friedman upon closure of this agreement: • � Granite Countertop and black splash, black galazy; �� - Medicine Chest, which lan took away to give to the carpenter, � framed in wood door from cabinet; �� _ Right shower door to be replaced with specified handles; Work order fortn Hermosa Glass Company. I, Ronnie Friedman, mutually agree to amicably end the agreement above and will complete the project mysetf and Taurus Construction agrees to forfeit the remaining balance due them. This agreement releases Taurus Construction from all liabilities pursuant to this agreement. � , �2' - _ � .� �.i..<_. � Robert Hicks Taurus Construction c � Ronnie Friedman 866 Village Creek Costa Mesa, CA 92626 JobAddress: 866 VILLAGECREEK Suite: Vicinity: PrimaryOcc: R-1 Hotels/Apts/Res>100cc Parcel Number: 93506066 Applicant: IAN MANZER Address: Owner: PHILLIPS, ELIZABETH J Address %BURNETT, WILLIAM J COSTA MESA, CA 866 VILLAGE CREEK Contracror. TAURUS CONSTRUCTION Address: 8405 PERSHING DR PCAYA DEL REY, CA Zip: 90293 - Arch ; Address: Zip: Phone: License: Type of Construction: Zoning: Phone: 310-850-0979 2ip: Phone: Zip: 92626 Phone: 877-597-7649 License: 839895 Eng: Address: SCOPE OF PERMIT BATHROOM REMODEL, REPLACE BATHTUB W/SHOWER, REPLACE TOILET AND LAVATORY. FEESUMMARY ISSUED BY: Status: ISSUED Applied: 08262005 Issued: 08I262005 Phone: � � � Plan Check: S0.00 Calc Valuation: sio,000.00 Permit: $18125 Claim Valuation: sio,000.00 SMIP Res: $1.00 SMIP Com: $0.00 Othec $0.00 inspection: $0.00 Total: $182.25 PLANNING & ZONING SETBACKS MAINSTRUCTURE Front 0-0 Rear 0-0 Left 0-0 �� Right 0-0 ACCESSORY Front 0. 0 Rear 0- 0 LeR 0- 0 Right 0- 0 PARKING Existina: 0 Reauired: 0 Pr000sed: 0 NOTICE: The work authorized by this permit shall compty with all applicable handicap access requiremenis under Ca�ifomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void if work is not commencatl wlthin 180 days, or if work Is suspended or abandoned tor a period of 180 tlays. . INSPEC710NS: In order tor the work authorized under ihis permit to be considered legal, such vrork must compty with all applicabie codes, and ali required Inepectlona and final epproval must be obtflined. Failure to obtain Inspections and final approval wil� result in the expiretion of thls permit. FOR INSPECTIONS CALL: (714) 754-5626 64&GB (8'00) WORKERS' COMPENSAnON DECLAFiAnON: I �ereGy eNirm untler penalry ol perjury one oi the tollowing dedaretions: � I hevo entl will malNein a certifcate of wnsent to self-Insure for workers' cnmpensetlon, es provided lor by sectian 3700 of ihe Lebor Cotle, for Ihe pedortnence o1 the work lar whic� this pertnil is Issued. ❑ I �ave antl wlll malntein workers' campensatlon Insurance, es requlre0 by sectlon 3700 oi the Lebor Code, far tha pertortnance ot the work lor whkh Nis pertnit is issued. My workars' com�pens-ation Insurenc�e �carrier entl policy number are: �� —� Cerrler. ��%�j-/ � ��.�/// / ) � Policy Number: (rMs secNon neetl not be completed i l�permlNs velued af one hundreC dWlare (S7 or Iess,J % ❑ I certly Ihet in ihe pertortnanca oi Ihe work tor which this permit I5 IssueQ I shall not omploy any Derson In eny menner so es lo becoma su6�ec1 to the workers' compensation laws of fomia, end egree thet II I should become sub�ect �o Ihe vrorkers' compen5etion provislons oi Section 37 01 the Lebor CoAe, I shell foM�Mth �compty with Ihe roNsi Appllcant Slgnature:� �� / Date: Z�� .i WARNINO: FNLURE 7d SECURE WORI(ERS' COMPENSATION COVEMGE IS UMAWFUL AND SNALL SUBIECT AN EMPLOVER TO CRIMINAL VEWlLT1E5 AND CML FlNES UP TO ONE HUNDRED THd1SrW D DOIURE (E100,000). IN /�DITION TO THE COST OF COMPENSATION, DAAMGES FS PNOVIDED FOR IN SEGTON 3�OB OF TME LABOR COOE, IMEFEST, AND ATTORNEVS FEES. LICENSED CONTRACTORS OECLARA710N: I I hereby eNirm Ihat I em forca entl eHect. Lic. # ,� Contrectar's Slgneture: � Chepter 8(commencing with Sectlon 7000) ol DlWslon 3 0l the B�� /' Cless a f Dete: Prolessions Code, and my Iicense Is in full CONS7RUGTION LENDING AGENCV: ❑ I hereby eflirm t�et there is a canstruciion lending egency tor the peAormance of Ihe work for which Ihis permit is issued. (Sec. 3097, CMI Cotle). Lendefs Neme: Lendefs Adtlrou: Signeture: Date: OWNER-BUILDER DECLAFiAT10NS: I hereby efflrtn �het under Denalry ot Oerjury that I em E%EMPT FROM 7HE CONTRACTORS LICENSE LAW for ihe lallowing reeson (Sec. 7031.5, Businass entl Professlons Code: Any clry or counry which requires e permit to construct, elter, Improve, tlemollsh, or re0air eny structure, pdor to its issuance, also reQuires tha eppliwnt br such permit to flle e signed stetement Ihat he or she is Iicensed pursuam to the provisions of the Contrectars Llcense Lew (Ghapter 9(cnmmencinp wit� Section 7000) 01 Division 3 of the Business end Prolessions Coda) or that �e or s�e Is exempt t�eretrom and the Dasis tor Ihe albged exemption. Any Wolatlon o� Sectlan 7031.5 by eny epplicant for e pertnit su6�ects Ihe epplicant to a civil penalry ol not more then tive hundred dollars ($500)J: ❑ I, es owner ot Ihe property, or my employees with weges as their soie compensatlon, WILL DO TNE WORK, end Ihe sfructure Is not Intendad ar aHeretl for sele (Sec. 70A4, Business and Pmfessions Cotle: The Contractors Licensa Law does not apply to en owner of proparty who builtls or Improves thereon, end who does such work • himsetl or hereelf or through his or har own employees, providetl that such improvements ere not Intended or offered lor sale. If, however, Ihe building or improvemenl is soltl wit�in one yeer of completion, the owner-Duilder will have ihe burden of proving that he or she did not build or improve for purpose of sale.). � ❑ I, es owner ol lha property, am E%CLUSIVELY CONTRACTING WIT}1 LICENSED CONTRACTORS ro construct the pmject (Sec. 7044, Business antl Professions Cale: The contractors License Lew tloes nol appy lo en owner ot propeny w�o bulltls or Improve5 lhereon, antl who contracts tor such project wlth a coniractor(s) licensa pursuant to lhe Contractoro License Lews.). ❑ I am e:empt untler sec. Signature: Owner ID veniied by drivefs licensa. ❑ Ves ❑ No Business and Prafessions Cotla tor t�is reason: Vedflcatlon oi Ownership by (rype ot documem, I.e. - property tex bill or deed): DIVISION OF INOUSTRIAL SAFETV PERMR CERTIFICATION: Drivefs License No. Data: Ezpires: ❑ I hereDy certify thet no excavatian tive (5) or mare leet in depth into which e person Is requiree to descend, will be meda in connectlon with work euthonzetl by ihis pertnit, end that no building structure, sceiloltling, lelsework, or demoli�ion or dismantling thereaf, will be mare than ihlrty�slx (38) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, TIUe B, Califomla Atlministrative Cade). ❑ As owner�Dulltler, I will not employ enyone to tla wark whic� waultl require e permit from the Divislon of Industnal Sefety, es notetl ebove, unleu such person hes e pertnit to do such work from Ihe tlivision. Slgnature: Dete: Division ol Intlustrial Satery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORPAiION OF EMRY: 1 cehify under penalry ot perjury t�et I have reatl this epplication end state Ihat the infortnation gNen Is cortact. I agree to comply with ell state laws aM dry ortllnances relating ro building tonstruction, end euthodza representetives ol the Ciry ol Costa Mesa to enier upon Ihe ebove-0escribed properry for inspection purposes. I egree not to ocaOY or allow occupency ol eny Cuilding euthorized by this permit unlil tinel inspection. COOE 1. INSPEGTIONTYPE Q�g, �fl L.QQ[Y INSPECTIONTYFE 761fi Fixed System Final Fire Preventlon 206 Flnel Mechanical 1268 Pool Spe Final 20B Flnal Plu ing 200 Finel Re-Root 210 ine ricel 201 Flnel 81ocWReiaining Well '%� � e Pr e 202 Final Fedory Fire Place 220 Final Plann Appraval 203 Flnel Sign 222 Finel Si�9 20d Flnal Demolition 250 Final Builtling/Occupenq D�TE Iii�L$ _� � i� �� IS+ f loo� �(ul�,G (La�M �,� �i'Z-S � ��2 D�i C� 50� �PP�tOVED CITY O COSTA MESA SUBJEC'f ' NOTE: ADl OR CORF APPROVED. BY•r� �2M.'��DIL �F� -iDY W � o`^' � 10NS, DELET�ONS, 'TIONS SHALL BE THE PLANNING DIV. li�-N �7'�r cA,3 � ��-��`'� / / „ �j b M �r ON OF Bl: GTY OF Cf ApPK Y � �� VED �v q�..�w.:. d specdicatiom µ�St be kepi an Ihis to6 21 ali times an � rtake anY �9es w altuatio�a on same ��Dlr ��'� �� Sal " sa. �� i� �y� pe� a� spedfications SHALL NOT be heM Io permit o� lo of Ne violalion oi any provisioM ot any Cily ol Cesla Mesa Oidinance an �� p�s y� pe�n� sha� expi�e by lim8ation arid bewme �In� 180 d� vmAc is not commenced and mainla�ed adr2 pe� UBC §303 (d) � �R �61r.J �n.c� ��uo�-- � �r ��x� u� i � �,� an apProva� r Slate taw. e 6uild'Ng or J� ol issuance• kv,�ui� �on� � Uiic�GEcp6st C�lf.� u1�54� CA 9z�2� �i4 —S�v--r5'7 I � l. � V CITI' ' STA MESA, BUILDING SAFET a�ON ' ' POST IN CONSPICUOUS PLACE ON THE JOB NOTICE Schedute inspection one workday in advance. To schedule inspections, call (714) 754-5626. Provide the following information: 1) Permit number, 2) Job address, 3) Inspection item number. Building Permit lt: l`, Mechanical Permit p: NEW ADD � �(.( �L Electriwl Pertnit p:�D C — �[� O PlumbingPertndfl: ��j 1�� O(�p REPAIR MOVING �EMOlISH ISSUE DATE Owner. Job Descdptbn p �li�-/Nil..a�� CC+�'v�r� PERMIYS EXPIRE 180 DAYS (6 MONTHS) FROM ISSUANCE OR LAST INSPECTION . . -. nemp STRUCTURAL Date �nspector Mamt POOLBSPA Data In:pector 3 Job Site Consult 94 Pool 8 Equipment Loca6on 4 Foa�ingslUfer Ground 96 Steel Reinforcement 6 Slab 100 Electrical Bonding 8 Structural Floo� 102 Rough Plumb & Pressure Test 11 Pre•Inspect Roof 104 Approval to Cover - Gunite 12 Roo� Sheathing 106 Eiec Conduit - Underground 14 T-Bar Ceiling-SWctural 108 Gas PipeNnderground Test 16 Shear Panel 110 Backwash Lines, P-Trap, 1 Frame & Flashing _�,—o Underground 20 Lathing 8 Siding 112 Approval to Deck 22 Insulation 116 Pool Plumbing System - Final 24 Drywall Nailing 118 Pool Electrical - Final 26 PlaSler Brown Coat 122 Fencing/Access/Alarms Approval 30 Pre•Grout 124 •Approvalior Plastering 33 Disabled Access 126 PooVSpa Systems - Final � -• 1610 Overhd HydrolOverhd Rough 1612 Dry Chemical 1614 Dry Standpipe ELECTRICAL 1616 Final - Fized System 36 Ufer Ground 38 Elec Conduit - Underground • Rough Elec • Wiring P ^� ' � • ' � • • • • Rough Elec. Conduit Z Call (714) 754-5626 for the following: o»e impector 48 Elec T-8ar Ceiling 200 Final Re-Roof 50 Elec Power Final 201 Final Block/Ftetaining Wall 51 Temp Power Final 203 Finaf Sign 204 Final Demoli6on 206 Final Mechanical 208 Final Plumbing pLUM81NG & MECHANICAL 10 Final Electrical 52 Soil Pipe - Underground Call (714) 327-7400 for the following: oau inspector 54 Water Pipe - Underground 212 Final Fire Prevenfion 55 Underground Gas Call (714) 7545671 two (2) working days Date Engineer Rough Plumbing �, 05 prior to final. 63 Prewrap 216 Final Public Svs. Dept. Approval 64 Rough Mechanical Call(714)754-52d5forthefollowing: orte ��npecwr 66 Rough - Factory Fireplace 220 Final Planning Approval 68 Sewer System Call (714� 754-5626 for the lollowing: Drte mapector 72 Gas Pipe - Rough Test 222 Final Site 90 Gas Pipe Test - Final 250 Final BuildinglOccupancy 92 Water Service - Final —1a'O Q NOTES: SEE REVERSE o559�a6 pev.liNd) � NOTES . 1� • • ' ' � • • • `j 2��s rov,�e Ivor t � e e�. ef c.d fee � ��o�.;c��2 oac� d- �f-L,� ovf-�e4- /i �if•' C.)ecd� � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: $uite No Viciniry: Parcel Nunmber: Applicant: Address: Owner: Address Contractor. Address: ISSUE FEE Temp service test Res. a/e package New Res (1 �2 units) New Res (3*units) Pool I Spa Ligh�ing FiMs Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over t000a Motors to t l+p Motors to tOhp Motors to 50hp Motors to 1tlOhp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuit3 Temp Pwr Pole Intermed Pole 866 VILLAGE CREEK BATHROOM 93506066 RONNIE MIRIAM FRIEDMAN 866 VILLAGE CREEK COSTA MESA, CA RONNIE MIRIAM FRIEDMAN 866 VILLAGE CREEK COSTA MESA, CA OWNER-BUILDER Phone: 714-800-6688 Zip 92626 Phone: Zip: 92626 Phone: Zip: License: 000000 SCOPE OF PERMIT REPL4CEMENT PERMIT TO FINAL BATHROOM REMODEL PROJECT. REF: B05-01432, E05-00896, POS-00656 6 FIXTURES, 4 OUTLETS AND 2 SWITCHES $0.00 $0.00 $0.00 $0.00 $0.00 so.00 so.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 50.00 30.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY Temp Dist Syslem / LigMing Busway/100ft Standing SeIXion Misc Electrical Equipment Transtormers up to 1 kva/kw ................up l0 10 kva/kw .................up to 50 kvalkw .................up to 100 kva/kw ..................over 100 kvalkw Low Voltage Equipment low Volt Wiring System f CM Misa Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Eleclrical Fee Investigation Fee Plan Check Fee Reinspection Fee Status: ISSUED Appiied: 0323Y1006 Issued: 0323Y1006 ISSUED BY: 50.00 $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 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES E0.00 COMMENTS / SPECIAL CONDITIONS Quantiry 0 0 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 requirements under California statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void it work is not commenced within 780 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for tha work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all requlred Inepectlone and final epproval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 754-5626 aano-no �aw� WORKERS' COMPENSATON DECLARA710N: 1 hereby a%irm under penelty oi perjury one of the following tleclarations: ❑ I have antl will meintain e certificate of consent to self-Insure tor workers' compensation, es provided tor by section 3700 ot the Labor Code, for the pertormance of t�e work for which ihis permit is issued. ❑ I have and will maintain workers' compensation insurance, as repuired by section 3700 oi the Labor Code, For the pedortnance of the work for which Ihis pertnit is issuetl. My workers' compensation Insurenca carrier end policy numDer are: Carner: PoliCy Number: (This secfion need nof be completetl il the permit is valued et one hundred dollers (5100) or less J � I certity thet in Ihe pedormance of ihe work for which Ihis permit is issued, I shall not employ eny person in any manner so as to become subject to the workers' � compensation laws o Californle, end agree that if I should bacome subject b the workers' compensation pmvisions of Section 3700 of tlre Labor Code, I shall lorthwlth comply with Ihe e rov ion5. �J 2 / Applicen4�Si9natura: �,y�E�-,�/' �Q,[,��' f,.'03�p.-� J 1 �� I(i l� . WARMNG: FAIWRE i0 SECUFE WORKEFS' COMPENSATION COVEPAGE IS UNLAWFUT ANp SHALL SUBIECT Ml EMPCOVER TO GRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDPED THOUSAND DOLLAPE (510D,000�, IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIOED FOR IN SECTION 3]OB OF THE LPBOR CODE, IMEREST, AND FTTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that I am licensed under provisions ol Chapter 9(commencing with Section 7000) ot Division 3 of ihe Business antl Protessions Cotle, and my license is in full force antl eNect Lic. q Class tt Contractor's Signeture: Date: CONSTRUCTION LENDING AGENLY: ❑ I hereby attirm ihat Ihere is a consiruction lending agency for Ihe peAormance of �he work lor which this permit is issuetl. (Sec. 3097, Civil Code). Lendefs Name: Lentler's Adtlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirm that untler penalry ot perjury t�et I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW tor ihe tollowing reason (Sec. 7031.5, Business and Pmfessions Cotle: Any ciry or county which requires a parmit to consiruct, alter, improve, demolish, or repair eny structure, pnor to its issuance, also requires the applicant }or such permit to lile e signad statemant ihat he or she Is Ilcensed pursuant to the Orovisions of the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of ihe Business antl Professions Code) or thel he or sha is exempt therefrom antl the besis for the alleged exemption. Any violation of Section 7031.5 by any applicant tor a pertnit �ects the epplicant to a civil penalty of not more then five hundred dollars (5500).): �es owner of t�e property, or my employees with wagas as lheir sole compensation, WILL DO THE WORK, antl the siructure is not intentled or olfaretl for sale (Sec. �7044. Business end Professions CoUa: The Contracbrs License Lew dces not apply to an owner of property who builds or improves ihereon, and who tloes such work himsett or hereell or through his or �er own employees, provitled that such improvements ara not intended or offered for sale. If, however, the building or improvement is sold within one yeer ot completion, ihe owneo-6uilder will �ave the burden of proving that he or she did nol builtl or improve for purpose of saleJ. ❑ I, as owner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the prqect (Sec. 70d4, Busine55 antl Profe55ions Code: The coniractors License Law does not epplY to en owner of property w�o builds or improves Ihereon, and who contracis lor such pmject with a contractor(s) license pursuant to the Contrectors Licensa Laws.). ❑ I em exe er sec. � Business and Professions Cotle br this reason: Sign f'� 1 (j�,A�ifJ !l(U '�F IA'/LL'1V ��'ae'. � � - Ovmer ID venfietl by dnvers license. Ves ❑ No Drivet�. %�`� �,� �. @��•'� �Q � Veriticefion of Ownershlp by (type of document, i.e. � propetly taz bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenity thet no ezcavation five (5) or more teet in tleplh into which e person is requiretl to tlescend, will be made in connection with work eu�honzed by this permit and that no builtling strucWre, scaffoltling, falsework, or demolition or tlismantling ihereof, will be more ihan thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, California Administretive Cade). ❑ As owner-buildar, I will not employ enyone to tlo work which would require a permil (rom ihe Division of Indusirial Safety, as noted ebove, unless such person has a permit to tlo such work from the division. SignaWre: Date: Division oi Indusirial Safety Permi� Number. CERTIFlCATE OF COMPLIANCE AND AIIT}fORIZATON OF ENTRV: I cenity under penalty of perjury that I have read ihis applicalion anC state ihat �he informafion given is c rec gree to comply with all stel laws end city ordi nces relating co builtling consiruction, and authonze representatives of Ihe Ciry of Coste Mesa ro enter upon the a d cnbetl property i �ai specU purpos 1 egree ot to acupy or allow occupanty of any building authorized by t is pertni until final inspection. �"l��IT.CC %!• ��la.�h_ 3� 2'�� O�o Signery(B°Ol'.Lega40wner�9�- Date . And/OrAuthorized Applicant Date cooe �, insvecnoNTrve 7616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Rool 207 Finel Blwk/Retaining Well 202 Final Fectory Fire Place 203 Final Sign 204 Final Demalition Pdjf, IMRI>LS CODE♦ INSVECTIONTYPE 206 Final Mechanical 208 Final Plum6ing 210 Final Eleclncal 212 Final Fira Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy P:1I€ 1[�dL$ �z 6 � f -- A �S- D/ �f3 z ,��s- 00�1� ��5�0�6� MUTUAL DISOLUTION AGREEMENT This agreement is an official ending to the agreement between Taurus Construction and Ronnie Friedman dated Juy 02, 2005. Taurus Construdion hereby admonishes complete disassociation from agreement and both parties agree satisfactorily to end the above contract. The following items will be retum to Ronnie Friedman upon closure of this agreement: � - Granite Countertop and black splash, black galazy; �� - Medicine Chest, which lan took away to give to the carpenter, � framed in wood door from pbinet; �� --� _ Right shower door to be replaced with specified handles; Work order form Hertnosa Glass Company. I, Ronnie Friedman, mutually agree to amicably end the agreement above and will complete the project myself and Taurus Construction agrees to forfeit the remaining balance due them. This agreement releases Taurus Construction from all liabilities pursuant to this agreement. �' ., • �`t" _.l,..% �i� �d Robert Hicks Taurus Construction � ♦/ Ronnie Friedman/� � 866 Village Creek Costa Mesa, CA 92626 i (774) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa��TRICAL PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Viciniry: Parcel Nunmber: Applicant Address: 866 VILLAGE CREEK 93506066 IAN MANZER Owner: PHILLIPS, ELIZABETH ;J Address °/BURNETT,�WILLIAM J -' _ COSTA MESA, CA . ' 866 VILLAGE CREEK � _ - � �i � Contracror�,� TAURUS_CONSTRUCTION Addressi- 8405"PERSHING:DR�� - � �'PLAYA DEL REY, CA Phone: 310-850-0979 Zip Status: ISSUED Applied: OB/26/2005 Issued: OBR6/2005 ISSUED BY: Phone , Zip 92626 � -. Phone 877-597-7649 Zip ;��90293 License;,839895 , SCOPE OF.PERMIT ' ' BATHROOM:REMODEL;�ftEPLACE BATHTUB W/SHOWER, REPLACE TOILE7 AND LAVATORY. �INSTALL �. ', � -6FIXTURES,-40UTCETSAND2SWITCHES,RE:B05-01432. .. , � - � . _ �,i- - . . ° FEE SUMMARY �' ` € "� � � � . Quantity � . _ . ; o. ,-:�,.,. . .. ; �uanlily :,. ISSUE FEE $23 50'�.; - � Temp Dist Systerii�/ Lighting , a$000 �' 0 �� , '�� Tertipservicetest ;� �$O.W�� , , ,�' �'Buswayq00ft '�` . $000 �^ 0� ' . � � � _. Res -a/c package - k�- $0.00 � Standing Section�, � � $0 00 : � 0 �"� �� New Res (1-2'umts) ; $0 00�'�" ;;, 0 Misc Elect{ical Equipment ^�, $0 00 P�, � 0 , New Res (3+units) �E,: `- *�$0 00� �.: 0'�:�' :�, �""' Transformers up to 1 kva/kw, ' J,$0.00 � 0; •� Pool/�Spa �-� °�$D.00:,.�� 0. - .. .:`up�tol0kva/kw, . �� '�$0.00 ".0,. Lighting FiMs . $6 60 -.r �" -6 �"" ' 9 � �� -� .....:::�.up to 50 kva/kw--- � $0.00 0;-; � ,- . � Recepl Outlels $4'40� �. 4 .... ....:up to 100 kva/kw $0.00 0�� Switches .... ; - - �°" $2 20�-: � 2 .........'.::.over 100 kva/kw � $0.00 � . 0 � Non Res Appl $0 00 --�--. 0 Low Voltzge Equipment �$0,00 � 0 � Res Appl �� x. $0:00 0 Low Volt Wiring Syslem / Ckt $0.00 , 0 Service to 200a -:' $�.00' � 0 .. .Misa Conduit $0.00,; � �� 0 Service to t000a � .$0 00::- 0 �-' Misc.`�Conductor $0.00 0 . Service over 1000a - $0.00 � � 0 ' ;� � � ��Cirws (-gen or ride) $0.00. 0 Motoretolhp �• $000;. - .. 0 _�� " ��Cirws,(mech;rideorlights) _ � $0.00 ;0: Molors to 10hp , $0 00; --- °� `�:,0, _ °. �'Christmas Tree Stand � : � $0.00 0� Molors to 50hp �'-'$0.00 � 0 -� " �Fireworks Stand ., �� - � $0;00 0 Motors to 100hp �l' <• $0.00 ;� 0 ' •^ Other Electrical.Fee - $0.00 - Molors over 100hp $0 00. - ' 0 "�_._: �^ � � � � � "- � ' - . Communication drops ' _ $0.00 0 ' Investigation Fee?"`�' � � $0.00 - . ,,, Sub panel to 200a "�- $0.00::- . " ' ; 0 _�„ . .. „Plan Check Fee � � , $0.00. Pole Light Pkg -$0.00 0�„��` �"-Rein'spedion Fee $0.00 � SignCircuits $000� - :0, � '-`- �c.'' �°"� ` . TempPwrPole $000_-�;`� 0�= " - _ -''TOTALCALCULATEDFEES .536.70 � Intermed Pole $OAO � w .-0-. ` _.' �'� �" x� �, ?-f `� � ,�" < >''� NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become voitl if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: �n order for the work authorized under this permit to be considered legal, such work must comply with all app�icable codes, and all required inspeetlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaao-ae(ew� � WORKERS'COMPENSAnON DECLAFiAnON: � I hereby aflirm untler penalry of perjury one of the following tleclarations: ❑ I have end will mainteln a certificete ot consent to self-Insure tor workers' compensetlon, es provided tor by section 3700 of tha Wbor Cada, far the pedormance of ihe work for which ihis permit Is Issuetl. ❑ I have end will meintain workers' compensation insurance, as required by section 3700 of the Lebor Cotle, tor ihe perfortnance of Ne work for which this pertnit is issuetl. My wor`kefs' compensallon/ �Insuranc rrier and policy number are: Cerrier: /%!�'��Y/�� PolicyNumber. �2� '—� (ihis section neetl nof be complefed il the permif is velued at one hundred dollars ($f0 or less.) ❑ I certity thet In t�e pertormence af the work for which this permit is issued, I shell not employ eny.parson in any manner so es to become subject to the warkars' � compensatlon laws of Celitomla and egree ihet if I should became sub�ect to the worke�corripensatlon provlsions o;Sect on 3�of the LaDor Cotle, I shall forlhwlth comply with these prov ns. / /� /+� Applicant SignaNre: � �� __ Date: T1 2� C/� WARNING: FAILURE TO SECUPE WORNERS' COMPENSATION COVEMGE IS UNLAWFUL AN� SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUND9ED T}IOUSAND DOLLARE ($100,000). IN ADDITION TO THE COST OF COA9PENSAiION, DAM4GE5 AS PFOVIDED FOq IN SECf10N 3106 OF THE LABOR CADE, IMEPEST, AND ATTORNEV'$ FEES. LICENSED CONTRACTORS DECLARATION: I hereby atfirtn Ihat I em torce entl eNect. Lia N Conirectors Signeture: C�apter 9(commencing with Section 7 oi Divlslon 3 of the Busine� nd Professions Code, end my license Is In full Cless # /7 �! Date: f. /J � CONSTAUCTION LENDING AGENCY: ❑ I hereby attirtn ihat there is a consWction lending aqency For the pertortnance oi t�e work tor which this pertnit is issuetl. (Sec. 3097, Civil Code). Lentlers Name: Lendefs Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby afllrm Ihet under penalry of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business antl ProFesslons Code: Any ciry or county which requires a permit to consiruct alter, improve, demolish, or repeir any structure, prior to its issuance, also requires ihe apDlicant for suc� permit to flle a signetl statement thet he or she is licensed pursuan� to the provisions of the Conirectors License Lew (Chapter 9(wmmencing with Section 7000) of Division 3 of the Business end Professlons Code) or thet he or she is exempt therefrom and the basis tor the allegetl exemption. Any violation oi Section 7031.5 by eny epplicant for e pertnit subjects Ihe epplicent to e clvil penelty of not more then tive hundred dollers ($500).): ❑ I, as owner of the property, or my amployaes with wages as their sole compensaUon, WILL DO THE WORK, antl ihe sirucNre is not intendetl or oNered tor sale (Sec. 7044, Business and Professions Code: The Conirectors License Law tloes not apply to an ownar of propetly who builds or improves ihereon, antl who tloes such work himseN or herself or Ihrough his or her own employees, provided that such improvements ere not Intanded or oHered for sale. If, however, ihe building or improvement is sold within one year of completion, ihe owner-builtler will have tha burden of proving that he or she did not build or improve for purpose ot sale.). ' ❑ I, as owner of the property, em EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business and Professlons Code: The conlrectors License Law does not appty to an owner oi property who 6ullds or Improves Ihereon, antl who contracts for such prolect with e contractor(s) license pursuent to the Gonirectors License Laws.). ❑ I am exempt under sec. Business and Protessions Code for this reeson: Signature: Date: Owner ID venfied by driver s license. ❑ Ves ❑ No Drivels License No. E:pires: Vediication of Ownership by (rype ot daument, i.e. - properry tax bill or deetl): DIVISION OF INDUSTRIAL SAFETV VERMIT CERTIFICATION: ❑ I hereby certify ihat no excavation five (5) or more feat in depih into which a person is required to descend, will be made in connection wilh work authonzed by this pertnit, and ihat no building structure, scaftolding, falsework, or demolition or dismantling thereot, will ba more than thirty-six (36) feet high. (Chap.32, Grp 2, Art 2, Sac. 341, Ttle 8, California Adminisiretive Cotle). ❑ As owner-builtlar, I will not employ anyone to do work which would require e permit from the Dlvislon of Indusirial Safery, as noted a6ove, unless such parson has e permil lo da such work from the tlivision. Signature: Date: Division of Industnel Safety Permit Numbar: CERTIFlCATE Of COMPLIANCE AND AUiHORIZA710N OF ENTRY: I certify undar penelty of perjury Ihat I have read this application and state that ihe intormation given is correci. I egree to comply with ell state laws entl city ordinances relating to builtling constmction, end authorize representetives of the City of Coste Mesa to enter upon the above-describetl property for inspection purposes. I agree not to occupy or allow occupency of any building euthorized by this permit until finel inspectian. Owner(s) � �/� / �s c.r0 Annlir.ant -�� Da�e CODE t. INSVEC110NTYGE 0� I�Q7�S� f,Qpf,� INSPELTIONTYiE Qd¢, 1616 Fixetl System Final Fire Prevention 206 Finel Mechanical � 1266 Pool Spe Final 20B hal-Plom�� I 200 Final Re-Root 210 inal lec i I 201 Final BIocWRetaining Well ina FI raventio 202 Final Fectory Fire Place 220 Final Planning App val 203 204 Finel Sign Final Demolition 222 Final Site ' 250 Final Builtlin<yOccupancy �1111_ (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us , 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: Addr05s Conlractor. Address: 866 VILLAGE CREEK BATHROOM 93506066 RONNIE MIRIAM FRIEDMAN 866 VILLAGE CREEK COSTA MESA, CA RONNIE MIRIAM FRIEDMAN 866 VILLAGE CREEK COSTA MESA, CA OWNER-BUILDER Phone: 714-800-6688 Zip: 92626 Phone: 2ip: 92626 Phone: 2ip: License: 000000 SCOPE OF PERMIT REPLACEMENT PERMIT TO FINAL BATHROOM REMODEL PROJECT. REF: BOS-01432, E05-00896, POS-00656 1 SHOWER, 1 LAVATORY, 1 WATER CLOSET, 1 WATER PIPING ISSUE FEE Backflow irrigation Backflow Preventer Bathlub 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 oullets) Gas (Over 4 outlets) Gas Repipe Gas Service Intercepiors (Grease, Oil) Interceptors (Santl Auto ) AMT $0.00 $0.00 50.00 50.00 $0.00 50.00 50.00 $0.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 50.00 $0.00 gN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY AMT LaundryTub/Washer $0.00 Lendscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator 50.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connecl $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, wmmercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, servicelmop 50.00 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 Status: ISSUED Applied: 03232006 Issued: 03232006 ISSUED BY: SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Sel Waste and Vent System Water Closet (Toilet) Water Healer / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION TOTAL CALCULATED FEES: AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 50.00 $0.00 50.00 50.00 � 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorizetl by this permit shall comply vnth all applicable handicap access requirements undar Calilornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abantlonetl tor a periotl ol 180 tlays. INSPECTIONS: In order for the work authorized untler Ihis permil to be considered legal, such work must comply with all applicable codes, and all requlred inapeetlone and Iinal epproval must be obtained. Failure lo obtain inspections and final approval will result in the expiration oi this permit. FOR INSPECTIONS CALL: (714) 7545626 �.,,, „"..,,,� WORKERS'COMPENSAnON DECLARAnON: I hereby atfrtn under penalry oi perjury one ol the following tleclareilons: ❑ I have end wili maintain a certificate of conseni to selt-Insure lor workers' compensation, es provitleA tor by section 3700 of Ihe LeDor CoAe, tor the peAortnance of the work lar which this permii i5 is5ued. ❑ I nave end will maintain woecers' compensation insurance, es requiretl 6y section 3700 ot ihe Lehor Cotle, tor ihe pedortnanca ot ihe work tor which Nis pertnit I5 iswed. My workers' compensation Insuranta tarner and poliry number are: Carner. Policy Number. (T�is section need nat be complefeU i1 the permi( is va/ued et one hunCretl tlollers (S700J or less.) ;B' ertiy that in the performance of the work for w�ich this permit is issued, I shall not employ any porson in any menner so as to 6ecome sublect to t�e workers' compensation laws 1 Califomia, and agreB that il I sh ultl become subjecl Io t�e workers' compensation pmvisions ot Section 3700 of the LaDor Code, I shall brt�wilh complywiththes pr hsior�s. ' �y �wbr— �-'sre��e: lyl�,i �G1. '//GCL iv1+/ �o : 3 � Z3�oCo WARMNCa: FAILURE TO SECUHE WORI(EP5 COfdPENSATION COVERAGE IS UNLHW FUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINA� PENALTES AND CML FlNES UP TO ONE HUNDRED TViOUSAND DOIURE (5100,0OO�.IN ADDITION TO THE COST OF CORIPENSnTION, DMNGES 0.5 PROVIDEO FOR IN SECTION 31O60F THE UBOR CODE, INfEREST, AND FTTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I heraby aHirm Ihat I em licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, antl my licensa is In tull force antl eNecl Lic. N Cless a Contractors SignaNre: Date: CONSTRUCTION LENDING AGENCV: ❑ I �ereby aMirtn t�at Ihere is e construction lentling agency br Ihe peAormance of the work for whic� this permit is issued. (Sec. 3097. CiWI Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDEFi DECLARATIONS: I hereby attirm Ihat under penalry ot perjury Net I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5. Buslness antl Protessions Cotle: Any ciry or counry whic� requires e pertnii to construct, alter, improve. demolish, or repair any structure, prior to its issuance, also requires the ap0licant lor such permil to fila a signetl statement ihat he or she is licensed pursuani to the pmvisions ol ihe Contractors License Law (Chapter 9(wmmendng with Sacuon 7000) ol Divisian 3 ot the Business and Professions Code) or Ihat he or sha is exempt therefrom entl the basis for the elleged ezemplion. Any violetlon of Section 7031.5 by any applicant for a pertnit su ' ts the applicant to a civil penalry of not more than five huntlretl dollars (5500).): -J, as owner of the property, or my emplqrees with wages as their sWe compensation, WILL DO TT1E WORK, antl the strucwre is not IntenCed or ofleretl tor sale (Sec. �./ 7044, Business and Pwfessions Code: The Comractors License Lew tloes not apply to an owner ot property who �uiltls or impmves thereon, entl who does such work himsell or hersefl or Ihrough his or her own employees, pmvided that such improvements are not imended or oMerea for sale. II, however, tha builtling or improvement is sold within one year of completioq lhe ownerv6uilder will have Ihe burden of pmving that he or she did not build or improve for purposa ot sale.�. ❑ I, as owner ot ihe pmperty, am EXCLUSIVELY CONTRACTNG WIT1 LICENSED CONTRACTORS b conslmct ihe project (Sec. 7044, Business and Pmfessions Code: The comraaors Licensa Ww does not appty to an owner of pmperty who builds or improves t�ereon, and who comracis for such prqea with a contractor(s) license pursuant to ihe Con(ractors license Laws.). ❑ lam O`wneFlD veriliaCb�y dnver's license. Verification of Owners�ip by (typa of �--�f� Busin ss antl Professions Code for this reason: � LlJyn� �% � properiy taz bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I here6y certily that no axcavetion five (5) or more faet in depth into which e person is required to descentl, will be mede in connection with work eu�horizetl by this pertni�, and that no Duilding structure. swttolding, falsework, or demdition or dismantling thereof, will be more then Ihirry-sin (36) teet hiqh. (Chap. 32, Grp 2, Atl 2, Sec. 347, Tille 8, Celifomia Atlminisira�ive Code). ❑ As owner-builtler, I will not employ enyone to tlo work which would require a permit from lhe Division al Industnal Satety, as noted e6ove, unless such person hes e permit to tlo such work from the division. Signature: Dale: Division oi Intlustdal Safety Permit Number. CER7IFICA7E OF COMPLIANCE 7D AI7THORIZAiION OF ENTAV: I certity under penalty oi periury that I have reatl this appliwtion and state ihat the infortnation given is correct gree to comply wit al tate laws ciry ordinences relating to building consimction, and amhorize represemetives of �h Cily of Coste Mesa to enter upon ihe a� v-tle Eribed Propem � i� ection pury s s. I agree not to ocaDY or allow occupancy of any building euthorizad by ihis per��il final ink�ction. —� j' / b SfBnaiuteiOf: Legal Owner(sJ.� D �—�—^" Authonzetl Applicant CO�E �, INSPECTIONTYPE 1616 Fizetl System Final Fire Preventlon 1266 Pool Spe Final 200 Final Re-Roof 201 FInaI Block/Re�aining Well 202 203 Final Factory Fire Place Finel Sign 204 Final Demoli�ion fZAg AL GOpE� INSPECTIONTYVE 206 Final Mechanicel 208 Finel Plum6ing 210 Final Electrical 212 Finel Fire Preventlan 220 Finel Plenning Approval 222 Fina15i�e 250 Finnl Builtling/Occupency QAIE a4 �s-D/�3z ,�ds'-oo �96 ��S-oa6s6 MUTUAL DISOLUTION AGREEMENT This agreement is an official ending to the agreement between Taurus Construction and Ronnie Friedman dated July 02, 2005. Taurus Construction hereby admonishes complete disassociation from agreement and both parties agree satisfactorily to end the above contract. The following items will be retum to Ronnie Friedman upon closure of this agreement: � Granite Countertop and black splash, black galary; �� - Medicine Chest, which lan took away to give to the carpenter, � framed in wood door from cabinet; �� _ Right shower door to be replaced wkh specified handles; Wo�fc order form Hermosa Glass Company. I, Ronnie Friedman, mutually agree to amicably end the agreement above and will complete the project myself and Taurus Construction agrees to forfeit the remaining balance due them. This agreement releases Taurus Construction from all liabilities pursuant to this agreement. '� ' .d. --� ! j� �'i..� � Robert Hicks Taurus Construction Ronnie Friedman 866 Village Creek Costa Mesa, CA 92626 (714) 754-5273 • Fax (714) 754-4856 • w�vw.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT JobAddress: 866 VILLAGECREEK Suite No Vicinity: Parcel Nunmber: 93506066 App�icant: IAN MANZER Address: owner: PHILLIPS, ELIZABETH J Address °hBURNETT, WILLIAM J COSTA MESA, CA 866 VILLAGE CREEK �. Contractor. TAURUS CONSTRUCTION Address: 8405 PERSHING DR PLAYA DEL REY, CA Phone:- 310-850-0979 Zip: Pfionei � - .�. Zip: 92626 Phone: 877-597-7649 Zip: 90293 License: 839895 '. ISSUED BY: Status: ISSUED Applied: OS/26/2005 Issued: OS/26/2005 � BATHROOM REMODEL, REPLACE BATHTUB W/SHOWER, REPLACE TOILET AND LAVATORY. INSTALI 1 �SHOWER, t LAVATORY, 1 WATER CLOSET AND 1 WATER PIPING, RE:BOS•01432. � ISSUE FEE BackFlow irrigation Back(low Preventer Bathtub Clarifer System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valye Gas (1-4 outlets) - Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $23.50 50.00 $0.00 $0.00 50.00 50.00 50.00 $0.00 $0.00 so.00 $0.00 50.00 '30.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 9n FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 . P-Trap . � - '� � - $0.00 . Pressure Regulator - , �$0.00 Process Piping (per 10 k) $0.00 Receptors $0.00 SepticTank $0.00 Sewer Cap for Demo $0.00 Sewer Connect 50.00 Sewer Private Line � 50.00 Shower ..� -. � 59.80 Sink, bar� 59.80 . Sink; commercial - �- $0.00 � , , �Sink, Floor , $0.00 Sink, kitchen - 50.00 .. Sink, service/mop � $0.00 Spa (private) $0.00 Spa (public) _ _ ., $0.00 � 0 0 0 0 . 0 0 0 0 0 0 1 1 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS SumpPump � , Swimming Pool� Trep Primer �- � Urinal Vacuum Brkr Bkflow(7-0) 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 - WaterService . Water Sokener OTHER VIOLATION . PLAN CHECK. REINSPECTION AMT $0.00 50.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 50.00 $9.80 $0.00 $9.80 $0.00 30.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: E62.70 Qn 0 0 0 0 0 0 0 0 0 1 0 7 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) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 780 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit. FOR INSPECTIONS CALL: (714) 754-5628 zasss�am� WORKERS'COMPENSAPON DECLARAnON:� I hareby eHirtn undar penalry of perjury one of the following declaretions: � I have antl will maintain a certiticate ot wnsent to selt-Insure for workers' wmpensetlon, es provitled for by section 3700 of Ihe Lebor Code, for the pertortnence ot ihe work for which this permit is issuetl. ❑ I �ave an0 will maintein workers' compensatlon insu2nce, as required by SecUon 3700 ot the Lebor Cotle, tor Ne pertoimance of Ihe work for which Ihis pertnit is issuetl. My warkers' mmpensatlon Insurance carrier enA policy number ere: �, _� Cerrier. � or 1e55.) Polity Number. � ❑ I cenity t�at in the perfortnance of the work lor which this permit is issued, I shall not employ eny parson in any manner so as to become sub�ecl lo Ihe workers' compensetlon lews ot Califomla, antl egree that if I should become subJect to the� ' compensatlon provisions of S�n 37� Ihe Lebor Code, I shall fonhw� camply with these p sions. Applicant SlgnaNre: `� — � —. Date: � � dS � � �_ WARNINQ: FAILURE T URE WORKERS' COMPENSATIqJ COVERAQE IS UNLAWFUL M1D SMPLL SUBIECT AN EMPLOYER TO CFIMINAL PENALTIES AND GVIL FlNES UP TOIXJE NUNDRED TlIOUSrW D DOILAHE (5100,000), IN ADDIiION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3IOB OF THE UBOR CODE, INTEREST, ANO ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I �ereby aflirtn that I am lorce entl eflect. Lia a_ '�9 Contractor'sSigneWre: / � of Chapter 9(commencing wilh Sectlon 7000) ot Division 3 af the Busines�nd Professions Code, end my license is in full Class # .. / oate: 2G /i C � CONSTRUCTION LENDING AGENCV: ❑ I hereby eMirm that there is a construction lending agency for the pedormence of ihe work for which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: _ _ Lentler's Atltlress: . . . Signeture: Date: I hereby aHirm t�et unCer pen@Iry et perJury Ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Protessions Code: Any ciry or counry which reqyires'e permii to construct, alter, improve, demalish, or repelr any strucWre, pnor to its issuance, also requires the applicant for such pertnit lo tile e signed statemBnt Ihet he or she Is Iicensetl pursuant ta Ihe provisions ol the Contreclors License Law (Chepter 9(commencinp with Sectlon 7000) of Divislon 3 of the Business end Profe551aii Cotle)'octhet he d she, Is exempt therefrom entl lhe Dasis tor the ellegetl exemption. Any violation ot Section 7031.5 Dy any eOD��nt for e pertnit sub�ects Ihe eDPlicanJta e civil panalry of not more then five hundretl tlollars ($500).): �. _ ❑ I, as owner ot the properry, or my employee's with wages as their sde compensation, WILL DO 7ME WORK, anC Ihe sirucNre is nm imendetl or oHereO for sale (Sec. 7044, Business and Professions Code.'The Contrectors License Lew tloes not aOPly to en owner of proDerry who builds or improves thereon, and who does such work himselt or herself or Ihiough �is ar her ovm employees, provideA t�at such improvements are not intentled or oHerad for sale. If, however, the building or Improvement is soltl within one year of comp�e�on, the ownerbuilder will heve the burden of proving that he or she did not builtl or improve for purpose ot saleJ. • ❑ I, a5 owner of �he property, am EX�LUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, BuSinesS entl Professions Cotle: The contractore License Lew does not appty ro en owner of propeny who �uiltls or Improves thereon, and who con�rects for such proJeci with a comrecior(s) liten5e putsuant to Ihe Contrectors License Lews.). ❑ I am azempi under sec. Business end Prole55ion9 Code for thi5 ree5on: Signeture: Owner ID verilied by drivars license. ❑ Yes ❑ No OriveYs License No. Vadficetlon of Ownership by (type of document i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFE7Y PERMITCERTIFICATION: Date: Ezpires: ❑ I hereby certify t�ai no excavetion tive (5) or more feet In tlept� into which e person Is requlretl Io aescentl, will be made in wnnection with work euthorizetl by this permit, and thet no building simcture, scalloltling, talsework, or demolition or dismantling thereot, will be more than Ihirty-sia (38) feet high. (CheD� 32, Grp 2, Atl 2, Sac. 341, lltle B, Calitornle Administrative Code). ❑ As owner-huilder, I will not employ anyone to do work which would requlre e permit irom the Division oi Industnal Salery, es noted ebove, unless such person hes e parmit to do such work irom tha division. Signeture: Date: Divislon oi Industrial Safety Permit Number. CER71FlCA7E OF COMPLIANCE AND AUTHORIZATON OF ENfAY: I certify under penelry of perjury that I have reatl this epplication and state thet the informatlon given is correct. I egree to comply with ell slate laws and ciry ordinences relating to builtling conswction, and authodze representatives of the Ciry of Costa Mese to enter upon Iha ebove-descnbed praperry for inspeciion purposes. I agree not to occupy or ellow occupancy of eny building authorized by ihis permil until final inspection. GOOE �. INSPECiION TYPE 1616 Fi:etl System Final Fire Prevention 1266 Pool Spa Final 200 Final RB-Roof 201 Flnal Block/Reteining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demoli�ion Qdjf � COpEI INSPECTIONTYPE 206 Finel MeChanical _ 20B Pinel Plumbina 220 Final Planning A�al 222 Flnal Site 250 Final BuildinryOccupancy PAg ItRIINLS 0�/27/2008 12:10 FA% 7149271159 GDIAC MORTGAGE �002 10i09i91 i5t19 MAR. .�2s ESCROW � D T � A - �v0.519 P002i005 , OCT-6i �I Ot:BePN PPalFlf AIBRICAM TITLE +i14 B00 4iBa T-668 P.oat/ooe F-TOD ' �111°�� R rdsd' C 0 eee cn OfAdd R000rda, our�r of r�ye ,�� I��I��I��II0��1`�24 00 �� 2�1010432277 04:30pm p6/28/Q1 �� 1194 A1ZA644 195.E515S9!l 0.00 0.00 &00 D.00 O.CO D.00 M ➢64afOp&I�dA�ca� .� � � iaaq 7� {In�t K ppn raOQiNOR Nltt.�8 Lecao� AtYn — --�..�wmrewas.waq �P 081,SA� ♦ mcam4e�Inl �y a t� dnL. d �9 �NOP� �m �d �Wi4ea ,R Rm1iMt �d , ��W'if�woio 0.�IYIOxCcuaat�lcblQi{IEh1�DriYJl. m� m AaW6�aadiut�R111�e�+,�alm�ata uld 1mo. 1Pa. t�, to da pp' A 4� M� Omnb al Iw:b 7e mi�6 �l�lc�la�eurll�, Ip }ia dOht 71bav�fiia�nwtb►GomomlmnplPW nstdtl m eoek 7A� t�O �I AoW 7 obo�4 ��J ..l� / tObwSaphlmotY�4 0�/27/2008 12:11 FA% 7149271159 � GMAC MORTGAGE 10�09�91 i5r19 M9k. .n'S ESCR�J � D T _.. xt-Qoai AS:BBPW PR9M-IS �kERICAN flTlf A.RN.: �:Oi466 +rie eoo atea �SCt01i1dl�IT CCN1'a1U� �SMaOi AND A�X[ ..,.,�. ;,. w�iv�. . �/ ,/i. . -'= �L / i:��•..:.a--. -- D%Y8110fGqk � - ..I.. . _��L.fr� ' � MM� f1i 1 � ' iw s� W` .\\.�..� @ �d.,�.�' .�` i { � 7Mam�d6tlmrAdod v �+��Iy• �� Ny, � r,�� YYMPI�.N� •^ �'�e.f: f: e.1...M�M �( C .n.e+ • �� .. . .�. +y �dooa N0.519 P00a�ee5 s-eaa v.ocaroas �-ne � qN 0 � 05/27/2008 12:10 FA% 7143271159 . GMAC MORTGAGE 10/09/91 15'19 MaR- 125 ESCROW � D f •^ IOCf-OO�df 0� �BiPM ��M^li hl@RIGN TI7L6 � 1��►� r�i ��w � +fl/ BCO d7Ba r�oo� N0.519 P003i00r f-b68 P.Oasfio6 F-Ta9 Gaverriment Code ?y3l�l. 7 I c�ertity uuder peoalty of porjut3' tiiat the ant�tcy sc�l on du docwmeat ta whicb tbis state�ae�nt ie atteched x+oads aa follo�ovs: . - . . ei �L_� � ,f � , Ootam.iaeioai Nuznber: L._°��9G�/ ._ Caunty Whes�e � is FYlai: •�/� �� ,�� Dab� Coumaiasion Expires: 3��— v 3'� Var+3or Nwnbez: � . ��{ � , Plec�o of Execution: _ _ 4�r�2'-- Dstc: � s�u�tura� C� � �~�s m Oa/Z7/2006 12:11 FA% 719�271153 . GMAC MORTGAGE -� ) 1Hi09iy1 I5 20 MRf�. _RS E5CR�W � D T . A - -04T'pD-�1 BZ;06Pq Ft�-I$ h1ffRICM1 TIiIE �.�r� �mpe�n► ' �� til4 800 416� T-A6A Governr�ee�t Code 2T36X.7 r�fY �a 8��' � P�7�Y tbat tha uotary seal an the documeut w which tiu�s atatetacat is attached reads as %llaws: : �� " . i:� . ..a � , �� i J• � �f�� U . ��1 lA t .1 (� � ' ! /` � � f tj� � � I � ��J I'i.. ^. ��. 1 : HII 1• "1 �il � �1 i� ,r ,., ,,,., � Placc of BxectstioA: ��,.. nese: � — ,�P•o / Signature: �� _. � i � r�oos a - -s.� P.096/GC4 FTUfl ,, 02:89PIi fR01f-li AIERICAA TITLE �Rv+�mNwr { � �� +sa vm.�c a..e . cxw t�,a, c� 9x» 7m w4�do� ��KU I Ao�'�tw� Sat u 00 ee�aed on HII nu�e er Q � m iYii..hID 1.. Aq �7 of Qem� 1dea4 �I � M ► � • / , � `/ � I i � i / tT14 B99 4)Be T-6E8 Recmdsd in OTildat Repardo,County oi Or�pe L s 01 -Recorder ��1��11�8�( I�q� I��I� 24.00 »aan�aQi2�ao�32217 Q�:30pm �6/28/01 135.651SS.QS U.00 0.00 8.00 0.06 0.9Q D.OD � �F bGYB C4�J. Ot sm. ma .owmmylw �afatot s �im. or »le. fwl�rae.r. u. oyr 1 FOR VAWADI.B COIVlM '1'�N. wodpt of+�Wab d L�nby dmolid[rl, tm �ma.nl�se wlAlan J flumMs �od �� vue�a ��,.eeaaw...� • • W n{w. au. me Imn.c er uoaa.+�a �+ �aw. h wa a10n J�t ms�m Jot. ameo at.mb U. IYn . amra.a aa Jw.l.1s7� 800k U491. f01. 9�I1 +aM �IO afQlonW 6�amd. o� onap, Caltart�M, �aa m�edmat m WA Laro, K �07� demAq p IhCu�, wi� P�rod {: Aa �� 8�(iP1II�IG 7il� /�/� f6� of OIAdN R�tb af i .� � � A4v�17+ lholt K a �lvra TOORTNAR WlL1.�0 4� m at�na W O�d to Le! 1 at n�ii 1Q4. p61. W�/ Ciq' d i��4 AtM1. =mmy el � w0 �� bolaak �l7� ►�f�+7A� 70 W 1f er 1�a�coas 114R W fIM �Rn Ub4 3 W�a� 377 m.tow� n� q� Cw�onp ?pa nowd�a m Bm4 37331� !1�{e I Cow1f- Coudum�dm F1W nllmod m lq Hucd 7 npa�4 wd aAa 1� ea ald lod. W f .. � ' ' ' 1 1 AiYararaaAda�nlr lal. ■Mil �or u �. rru� p.aotloae F-T ,� 02:88P11 FROp-15 A1ERn.nA SITLE �9RIIAi04/�/ I � �� ,�m. r� �� baW�mp�r'1tm�i' Ta u 04 � on fdl nWsa 0 mt�mpd w Odl vvm lw P�l �' of Llew He� �W � 1�0.VwWAB6R�DNlrol � �� i iI{ dEY. fito�o0 6�tq�a Ni dwsl. Is7s. Boak Il�i� ! If rf. �CA Y Po11uiw. 0 � Faad 1: Ae m�OJ/1� �Oc�tf Bw��at m .6.��. � i4eAL UWtKw�pwn 'ro01tTNFR W1t1.�0 WY A�P� m +T14 B00 4T88� T-6E6 p-002/006 F-i0! Recaded in Olfidal Reoordo,Caurrty of Ormtpe 9�l��N�lBli�i�l��1�24. �0 »e a2�^0 �z ��2277 Q4:30pm 06/28/01 195,051SS.d3 0.00 0.00 8.00 0.00 O.OR 0.0� ra�.wo.ti �T O9 LIIAa6 �0.� ooe � wdot� a ��s af W0. r bLm6f Wmoaitdpd.fmmamlpme W111Wn l. BwnMs oa 4 � � �Oi17�o , ` IaodQaQbfuo617.IY1l. � m � C�tmr�� utl weoCaMat w aiq law. iana.aawoaca, ar �►.a Ro. +�w. m� aq� or c� au.a �na � Nrm�p rsordtl fo 1ooU k/� � 2�. J0 mA1i af l�p�a��oa M�p, lu tlA OAG� Co�b• hC4l1L�v�liim�noa/L�Coadm�lntp?hn tartq io Eook 1i117r:tiio Qmdcmloh� Aab ttlbnd m!0 (lucd 1 qLm1, !.._ .,.� .. . ......... ... .... �� .� �� mro.e.mo�rt�r w. T PHOJECT NOOflESS: 8(j ( VI LLAGE CREEK OWNEP'S NFME: VZLLAGE CREEK HOMEOWNERS nooness: ASuOCTATION 3429 TIMHER LAKE CM VA 92626 UNIT: AflCH1ENGINEEP: CHESTER CARVILLE flEG.NO.: C].H3OS aoon¢ss: �9zZ ARMOUR ST uNir: S,D. CA 92111 PEHMIiTEE: FIHOENIX ENTERPRIa�ES INC. ( 713 ) 690-9559 aooness: 411. CQMERCIAL WAY I,A HAF3RA CA 90631 UCENSE� CONTBACTOH UECIAHpTION: I hereby affirm that I am li ed untler provisions of Chapter 9(cammencing wi�h Sec�ion 7000) of �rvision 3 0l Ihe Business antl Prolessions Code, antl m c se � m WII �orce and c�. CITYLIC 0 , 7$8 ,�n�uc.:376639 5 . Dale: �`� �_ Signamre: — WOBKENS' COMPENSATION OECIAflATION: I here0y a um ��a� I hd�e a certi�icate ol cOnsem to selFinsure or a certiticaie ol Workers' Compensatian }-n}��{aAc c rtihed copy Ihereol (Section 3800. Lad � POUCY NO.: ^ r�/ �� E%P. UAYE: 7 I U S I 9 S ,vC,OMPANY: CA COMP 6 FIRE L^J CeiLfi tl copl �s hereby im h ❑ Cerlitietl copy is til �i h c 8uilding 9ivi 'alf, �� ✓� ' J �ate: Applicam: E%EMPTIONFBOMWOAREflS'COMPENSATIDNDECUflATION: �Thissec�annee nal�ecompleteUiltheDermilisforon untlretl�5700�aNess�. I ceni�y Iha� in ihe pedormance o� the work lor which Ihis permii is is5ue4. I shall no� employ any person in any manner so as �o become • subleq Io ihe WorkeR' CompenSaiiDn LawS a� Cali�omia. Dale: SignaWre: NOTICE: I�, a�ter making ihis Oeclaraiion, you should 6ecome suble�� o ��e Workers' Compensa�ion pmvisions o� Ihe LaDor Code, you musl torihwiih comply wi�h such provisions or this permi� shall be tleemed revoketl. ' CONSTPUCTION LENOING RGENCY: I hereby a��irm Inal there is a cons�mction IenOing agency for �he performance ol the work for whit� �his permii is issuetl (Semion 3097. Civ. C�. � LENDEP: aoonEss: OWNEP BUILOEB oECIABATION: I hereoy aflirm ihal I am eaempl imm the Coniractors' Slate License Law for the (ollowing reason �Seciion 7031.5 Business and Pmfessional Cotle: Any [ity of coun�y which repuires a permil Io conSVuct, alter, impmve, tlemolish, or repair any SirutWre. prior �o i�5 issuance. aiso require5 Ih¢ applicant �or suCh permii l0 Iiie a SiAneO Sla�emen� that he/5he is IiCen5e0 pursuam to Ihe D�a�isions of �he Contractors' Stale License Law (Chap�er 9(commencing with Sectian 7000) o� �ivision 3 of ��e Busine5s antl Prolessions CoOe) a� t�al he/s�e is exempt Iherelmm an0 t�e basis for the allege0 exemD�ion. Any violation af Section 7031.5 by any applican� �or a permii suble��s Ihe applicani to a civil penalry o1 noi more Ihan live hundre0 Uollars (3500�. I. as owner of Ihe pmpeny ar my employees wilh w5ges as iheir sole compensation, will do ihe wmk, an0 the ❑ s�mc�ure is noi in�entletl or afferetl br sale (Section 7044, 9u5 ness antl Pmlessional Cade'. The Contracmrs' Staie License Law does nol ap01y �o an owner of a propehy who OuilAs or imploves thereon, antl who Ooes such work himsel�/hersel� or Ihmugh his or her own emDloyees, pwvitle0 Ihat Suth impmvemen�s are noi intentletl Or Ofiered for 5ale. If, hDwever the building or impmvemen� is sold wi�hin one year o� complelion, Ihe owner will have Ihe burUen o� proving he/she Oid no� builtl or impmve br Ihe purpose of sale). I, as owner o� t�e pmpetly, am excWsively conlraciing wilh IiCensetl coniraclors to conslmcl lhe pmlec� (Sec�ion 7044, Business ❑ anU Pmfessions Code: 7he Contracmrs' Staie License Law anes not apDly to an owner of DmDerty who builds or improves ihereon antl wh0 tOnlratls br 5uth prole��s wiih a tontraC�or(s) licf.nse pur5uani l0 �he ConiraClors' Siate License Law�. I am aware I�a� O�ool ol iheir Warker's Compensation insurance s�oultl be pmvided �o me. � I am exempi unaer Sec�ion: B. 8 P. C. lor Ihis reason: Daie: dwner. I tlo herehy cenify I�at I am aware a� antl untlerslantl Ihe requiremen�s ai Calilomia Health antl Safety CoOe Sec�ions 25505. 25533, antl 25534 ana Iha� I or anY �uWre 6uiltling occupant wlll/wlll no� (ctrcle one) neetl �o comply wi�h seitl sla�e catles antl ��e requirement6 for a permit for consimction or motli�icaiion irom Ihe Air Quali�y Managen�en� �isVicL Fesitleniial conslmction applications are exemp� imm IhQS¢ pfOVI510f15. �aie: ADplicant: _ I hereby cenily Ihal I �ave reatl Ihis appliwlion antl slale I�ai II orAinan[es ana slale laws relating �o building conslmclion an� pmpe�y�� insp�en' n' p{y�pases �ate: � �'i_—.� Signamre: � �� v onver's Liconse or Social Secunt a. ma�ion is correcL I agree Io compty wi�h all ciry and county repre5eniatives o� I�i5p1Pry enler upon �he aDove-men�ioneC 164t-46 Wltlte—Builtling�, Green—Code Enlorcement: Canary�APPllcan�: Pink—Revenue', Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: B 050609 PLAN CHECK NO: 00102-91 A CONSTRUCTION TYPE: V—N PERN,IT TYPE; 5TR PERM NO; B 0506U9 GOVT: N SJPP: N PJRPOSE: REP JOB DESCRZPTION : REPAIR SETTLEMENT DAMAGE SQ rT; 143 CLAIM VALUE: 14,300.00 CAL(:—VALUE: 14,300,00 GROUP OCC: R-3 / COMMENTS; HUILI7ING SETTLEMENT REPAIR/FOUNDATION ****�x*��*��*��x�**+��**�x�*��**��x*�*x-��********x�**�x x*��+�*�r *�� x*x�*��x�**+�* Z O N I N GS E�TEH�AUCIKRSE M E N T S ------------ MAIi�t BUILDING ---------- --------- ACCESSORY BUILDING --------- ERNT: FT IN REAR; FT TN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN PARKING REO• PROV; PARCEL; 93506124 ZNE; R2 REF NOc PLANNING N6'PES> FOUNDATION REPAIR, ,. dF 1F # iE IE 3F �1f iE 3F 9E 1f �E fF 3FiE iF 3f iF�F iF i6 jE iE dF iE jF 3ElF IE iF 3f if if if 3f -0f lElE IE �E �� # iF 3E #� if 3E K i4 3f iE )E �(� i4 iF fF if if� iF 3F iE iFlE 3F aF iE iF 1f # k� �E 3E iF if 3E iF 3E iE iF D E V E L O P M E N T S E R V I C E S R E{� U I R E M E N T S 20NING APPkOVED BY ;� �--� DATE; �7 J � S� I BUILDING APPROVED BY ; L.� (� DATE:. � APPLICATION ISSUED BY �� DATE: �If3EiEiE3EiE�FiEiEiE3FiE-1F�E�E�IEiElfiEiEiEiE r �F'£�iFiFifiF#ifiEiFdE1FaE --��it'�IF*af -IF�If3f�lEiEfF�lFiEififiFif�iEiEiE3fiflF�fie3F1E-)E�1F%3Fii�M�7Fi4iE3F�7k�E�IFiEiEififiF �iEiEiF�(�aFaElEtEif�-IfifiE�lk3E�}F1EiEiE#3fiFiEdEiEiM1af�!!-iEiflFif3F3EiEiFK3FiE LEGALI2ATION:N F E E S M M A R Y STRUCTURAL SEGMENT;Y BLDG PNiT PLUMHING ELEC IC MECHANIC FIRE SMSP/RES GRADING PERMIT 162.00 1,00 SMIP/NON—RES PLAN 76,33 ISSUE FEE BUILDING—DIV—> PERNZT ISSUE PLAN—CAECK TOTAL PAID DUE TOTALS----> 163.00 0.00 26,33 189.33 189,33 .00 REAENUE DIVISION TOTALS--> COLLECTED; 189.33 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRAAING PLAN—CAECK 167.00 1.00 26.33 iE 1F iF iF iF �3E 3E �E iE iF if �ElF if iE �F ie jE iE IE iE iE )E aE iE iE �(� �1F iF 3E it� 3F #�t i(� �E iE !E i(� jf 3FlElF iFjE �E 3E # if 3E iF iE iE iE?E iE 3f iE 3F 3E jE iE iF iE if if jF IE #E 3f if iE jE jF iE jE if 3E iE I N D I V I D U A L F E E H R E A K D O W N TYPE QTY D E 5 C R I P T I O N UNIi COST TOTAL COS'T SFR 143 STRUCTURAL BY VALUE PER 5104,00 100,00 14,300.00 END OF FEES � U! t'O�J7E'29t—��OiC496 FLsz ,�,.. DA7E= aI/^:+'91 r;ii:: 1�:�7 CONSTRUCTION AND PLANNiivG POOL & SPA APPROVALS Permit #�_ Date Inspector qppROVALS Permit # Date Inspector ` 1. Temporary Electriwl Service'or Pole 52. Pool & Equipment Location � 2. Soil PiPe•Undrgrnd. ..� � � 53. Steel Reinforcement -" � 3. Electrical Conduit Utility-Undrgrnd. �. � 54. Forms � � 4. Electrical Condui[-Undrgrnd..-. � 55. Electrical Bonding t�^"- 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE ' 7. Footings . _ 58. Electrical Conduit-Undrgrnd. 8. Foundation % ,�,, 59. Gas Pipe, O Undrgrnd., Test '' i. • . 9. Water Pipe-Undrqrnd. •� :�'-, •! �� 60. Backwash l.ines, P-Trep, O Undrgmd. , �'., , li � 10. Structural Floor System" J / j� 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection it 62. Backwash & Receptor�Final 12. Sewer Cap - ��-, ' 63. Heater & Vent-Final 13. Roof Drains i � �� - � �� 64. Plumbing System � Final ; 14. Rough Piumbing - '� 65. Electrical-Final �" 15. Rough Electrical-Conduit '� 66. Solar System-Final .i 76. Rough Elearic Wiring � 67. Fencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure . 70. Underground Hydro 22. Ducts, Ventilating � �77. Product Piping � Gas ❑�Oil 23. Gas Pipe-Rough & Test �� ' •� 7z, Underground Flush 24. Roof Framing • ' 73. Undergrnd. Storage Tank O Gas ❑ Oil - 25. Roof Sheathing _ ' � . , '7q, Overhead Hydro � 26. T-Bar Ceiling (Structural) & Monocoat , 75. Dry Chemical 27. Frame and Flashin9. . 76. Dry Standpipe 28. Lathing&Siding � � � 77, FIXEDSYSTEMFINAL 29. Insulation � I 4, 78, FIRE PREV. FINAL 30. Drywall Nailing � � I� HEALTH.DEPT. REQUIREMENT 31. Plaster Brown Coat �I I 79. FINAL INSPECTION ' i - �32. Electrical Power Meter-Final� � � � 80. FOOD CERTIFICATE ISSUED . 33. Final Electric - � � I ' Notes: 34. Final Heating & Air Conditioning ., � � 35. Final Gas Pipe�Test � I � 36. Hood or Canopy ' �• . � _ •�_ 37: Final FactorY Fireplace i . 38. Final Plumbing • � � i 39. Water Service-Final � I � 40. Gas Service-Final � � ' � i �41. Solar pomesticFinal � � � I 42. Backflow Preventer� ' � I i' 43. Backflow Irrigation ' � 44. La�dscape Irriqation System . . � 45. Sound Attenuation 46. Handicap Regulations . . 47. FINAL STRUCTURE & BUILDING � / � 48. FINALPLANNING � 49. Electric Release to Edison �� 50. Gas.Release to Southern California Gas Co I i i 51. CERTIFICATE OF,OCCUPANCY , , No. Date [�1"I�l�� AP No. Iti6-hSta-C1Y'"t0T TRACT GAS W ATEP PROP. SWR. LINE U HOUSE CON. SPRINKLING SYSTEM ING AN� Alfi CONOITIONING UNOERGROUND U POWER ROUGH WIRING FLOOR SVSTEM BONO BEAM n STEEL RE FRAME AND FLASHING LPTNING - IN �,/( PLASTER,BROWN COAT PWMBING, FINAL AN� GAS TEST EIECTRIC. FINAL DATE 4_7R- FIRE ZONE VALUE TYPE V GROUI SUBCONTRACTOR z . d U za ON am J � J N Q W QI J m J Q U N Za W ¢ aW WZ J Q m Z J ¢ W w o= Z F— w� N � �O H Z Q U J a a Q O N Z O H U � � H y Z -��iai.� COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Comp/etely Ao�oRE"se'866 Village Creek OWNER State-Wide Developers, Inc. AooREs59461 Grindlay CITV Cypress � NOL� HZG—Q BRANCH ADDRES: ADDRESS 17g48 SkvPark Blvd Irvine CONTRACTOR State-Wide Developers,Inc. ADDRE55 9461 Grindlay TE`.826-4550 CITY Cy�press NO. LIC NO. 2247�0 IIC.(NO. OF LOT 12.093 aCt'25 NOW ON LO� 0 USE OF EXISTING BLDG. SI2E OF NO.OF NEW BLOG. ROOMS STORIES EXTERIOR WAIL d EI' ROOF COVERING 00 COVERING Shake USE OG BUILDING AND WORK TO BE PERFORMED New construction-Condominiums 1 Residence w/att gar YGIC ;!1Y 13-7h�,N-;OO 776 � *'�`�'210.E! APPLICATION FOR BUILDING PERMIT RECEIVEDB�' DA7ERECEIVED nnrcwcimn A.r.rvU. L—L//— O/ �+c ..l BUILDING /' � � I AODRESS s 6 j// DI¢ � (6 � TRACT � SS LOT BLOCK X � OWNERCl/f/t✓iC �'✓/a� ei�lf/O VALUE • �s� att ar a FIRE � ZpNE TVPE GROUP APPROVED BY DATE ZONE NO.OF VSE OF NEW/(/p� W �Z (�J PLANS 'L BUILDING VAFDSAVPROVED VARDSAPPHOVED MAIN BUILDING ACCESSORV BUILDING (FROM G'L QSTREET) RONT �'O FT. FT. FT L. SIDE �I FT. FT. . i DISTANCE BET. MAIN BLDGS. VAR. qp c.u.e. vaZE — APPROVED HOLD FOR S I heraby ecknowleGpe that I have reatl [his epplicetion antl rtare Met the above infOrmatlon is correet antl aB�ea to comply with all laws ragulatinp builtlinB ��^rtruction, antl I chall not employ eny person in violetlon of the workman's companfatlon Inws of the Stata o} Califo�nia. I hareby carN(y [hat 1 em proparly Iicansetl es a contracior untlar 1254 SQ. FT. the State of Californle Bualnesa entl Profasslons Code, Divlsicn 3, THE AMOUNT S Cheptar 9, entl Mat such Iicenses are in full force tl otfact, or I THE PVRPpSE OF em ezempt from Me proWsbns of the Sinte ot Ca t rnin Bminaaa �LUA�ON _J antl Protesslons Cotle, Divi6lon 3 Chaptar 9. at Wide �evelo e , nc. /� ' Slpnetura �� w Parmittae � $� Aumorixedagant Vice President BET. MAIN ACCESS. BL DATE l� —J — �22�i �+ J-655 ; /N VNDER VALUATION IS FOR ; ABLISHING �+ PEFMIT FEE ONLV: ¢ m PERMIT FEE $ � j m PLAN CHECK $ � �� E 0 LL TOTAL FEE S O � ��