The URL can be used to link to this page

Home My WebLink About362 LA PERLE LN - Building PermitsJanuary 20, 1997 rrA C� OF COSTA MES� CALJFORNIA 9262&1200 DEVELOPMENTSERVICESDEPAqTMENT Building/Safety Division Code Enforcement Communications Continental Cable of Costa Mesa County Clerk/Board of Supervisors County Registrar of Voters County Tax Assessor Engineering Division (2) Fire Administration - Training Officer Fire Prevention File (2) Mesa Consolidated Water District P.O. BOX 1200 Newport-Mesa Unified School District (2) Pacific Bell Police Dept. - Planning. & Research Santa Ana Heights Water Company Sanitary District Engineer Sanitation Division Office Southern California Edison Company Southern California Gas Company State Boazd of Equalization U.S. Post Office -AIS U.S. Post Office - Adams Avenue The City of Costa Mesa wishes to advise you that the following addresses have been changed: OLD ADDRESS 364 La Perle Lane v/ 365 La Perle Lane �� 379 La Perle Lane NEW ADDRESS 362 La Perle Lane 363 La Perle Lane 373 La Perle Lane Your cooperation in this matter is appreciated. Sincerely, `�.� ��-�-- GABRIEL ELLIOTT Associate Planner A.P. NO. 425-312-01 425-312-17 937-800-31 cc: Gerald R. Bays Claudio Arena Judith A. Lang 364 La Perle Lane 365 La Perle Lane 379 La Perle Lane Costa Mesa, CA 92627 Costa Mesa, CA 92627 Costa Mesa, CA 92627 77 FAIR DRIVE ' Building Division (714) 754-5273 • Cotle Enforcement (714) 754-5623 • Planning Division (714) 754-5245 Fnu ��ia� �sa-asss • roo (�ia� �sa-szaa 36 � 3�S 3s� 3.s3 �5� � �� 362. 3�0 � 37g � � 38� f '� 3 8 � � 3�td 3s`� 3�S 31� 3�� 377 37� 3� 3q� � 3�0 3t�� 3�a .3�? I I 3�� I ��7 � � ,� � �usa.w, �►x- . ., (774) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 �ob Address: 362 LA PERLE LN Suite: Vicinity: REAR OF HOUSE Primary Occ: R3 Parcel Number: 42531201 Applicant: RON COLLINS Address: 3908 CALLE REAL Type ot Construction: V-N Zoning: Stalus: ISSUED Applied: 06/2Z2005 Issued: 06/22/2005 ISSUED BY: � , .,.Phone- 949,661-8493 SAN CLEMENTE, CA � y '` � ` Zip � '92673 `�� Owner: BAYS,MATTHEWWILLIAMTR� �� 'r ��h ,� �� k Address 362 LA PERIE LN . `" �e£�' , �"-� ` �' y ' Phone '� � COSTAMESA;�CA``�; � � `�-Zip 926273759 ' ��''�` .�'.'.. `•;' � �.� . _ x �`�;'� �'' � S a - �ntractor � �cCOLLINS CUSTOM,BU�ILDERS �° �� '`;._ ,�F_ � .. . - � Address.'�� 3908 CALLE REAL".r = � `�, , � -r ... �� , Phone: (949)661-8493 .�, -' `�� ' .A . �'.SAN CLEMENTE, CA ;� � Arch�:�.� `��, ., Address: ��. .` a � �;' 'Zi(i:. � a. �DD�244-SF TO EXIS� 'IREPLACE IN THE GI F` i ',� XISTING-3 BEDROO ws ',e R R.� Plan Clieck: � Pe�mit: , � SMIP.Res: ' SMIP-Com "�� Other. " Inspec'tio�: ��;;:. Total:'. ' 368900 � 4.,�;� E: _.. _. ,. Eng: �; '�,,��-� Address: ,�? PhOna �,�•'.. _ ��k.x': K,PP'�-'� ,-I-,.rx�'�"�"" 3„xe '. 1; - �: . -- -- � . _ �� License: �,�� ✓ hY,_ j . � .� - � =�SCOP.E OF.P_ERMIT � IG SINGLE-$TORY S.F.D.-WORK TO-INCLUDE: ENLARGE EXISTING•�Kf NG ROOM�ALSO CONSTRUCT 78 SF COVERED ENTRY:PORCH - ,,,;�`: .. ,_. . -_ �, .. �u.��e rT ,r.�� 2 BATHROOM;S.F.D. TO REMAIN THE SAME. - a;.ar A-� � _ . _ � - � _ SETBACKS �„ MAIN STRUCTURE Front ACCESSORY Front PARKING Existinq 3 � F � :�. YIIYIFIR 1 . �� f� ( �,- ��. ^�a�; €.a�: . �''« �ti��, . �° � ��_^;• � � �.. � : .� � Phone.. �� a "� Se ,��s'�� i a� F�'� � � r r�,a License:, e u b E � � ��,�„{-�' f' �``, :�"' � €": :HEN AND�.INSTALLATION OF A NEW PREFAB ,,,<�a"``3 � '' °�•RLANNING"& ZGJNING ' �� -.� � �, � �,,� r,,. , _ y,' : 20-0.; Rear�-�7=�6 �-, LeftdC 26-�0k T- Right � � �r� � � �, � �. � w. �' , a.. , . � 0-0 �� .��„,__Rear 0 0��`� '`' Cefi- �0 0� RigBt� :,.� � 0 Required� Or��;�m & , .P�oposed -�� 0' � � � �' b` 'Y,` � � � : q �.i 5: " � `�T"'�`� $29,300.i n�` � Szs,3oo.� �� N� y_, , #�.� -:, :a-. NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) , EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a periotl of 1 BO days. INSPECTIONS: In order tor iha work authorized undei this permit to be considered legal, such work must comply with all applicable;�codes, arxl all requlred Inepections and final approval must be obtainetl. Failure to obtain inspections and final approval will result In the expiration of this permlt. FOR INSPECTIONS CALL: (714) 754-5626 zaaaae (doo) WORKERS'COMPENSAnON DECLARATON: . I hereby eHirtn under penalty ot perjury one ot the following tleclarations: ❑ I have entl will mainlain e certiticate of consent to self-Insure for workers' compensatlon, es provided far by seccion 3700 of the Lebor Code, for the peAormence oi the work for whlch Ihis pertnit 15 i55uetl. ❑ I have enC wlll maintain woAcers' compensatlon Insurflnce, as requiretl by section 3700 of Ihe Labor Cotle, for the pertortnance ot Ne woAc tor which tMs permit is issued. My workers' compensation Insurance wrriar end policy number ere: Certier. (Th/s section nee0 not be one orle55.) Policy Number: �,�Ycertity that in the pedom c the rk for which this pertnit is issueQ I shall not employ eny person in any manner so as to becoma subjed to the workars' compensatlon lews oi C ito a, en e ee that ii I shoultl become subject to Ihe workers' wmpenutlon proWsions ot Section 3700 of ihe Lebor Catle, I s�all torthwith compty wiih ihes pr � lon . f--..-s.e;,�µ (� aPPllCarrt:SlOnaLue: '—'-- _ Date�-"�" �/�� W INCi: FNLURE TO SEWFi ORKERS' COMPENSATION COVEiiAGE IS UNIAW NL AND SHALL SUBIEGT AN EMPLOYER TO CRIMINAL PENALTI S AND CNIL FlNES UP TO ONE HUNORED 1NIX1SMlD OOLLARE (f100,00%, IN ADDRION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECiION 3]OB OF THE UBOR CODE, INTEREST, AND FTfORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby eNirm that I em licensed un er provisions of Chepter 9(commencing with Section 7000) ot DiNslon 3 of the Business an� Profjssions Cotle, and my licanse Is In tull torte e��d efj9t[.- Lic. a � y�� lg� � �lassyx' _ /.�� ' _ . � CONSTRUC710N LENDING AGENCY: ❑ I hereby ettirm lhat there is e constructlon lentling agency for lhe peAortnance ot ihe work tor which this permi� is issued. (Sec. 3097, Civil Code). Lendefs Name: Lentlers Atltlress: Signawre: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirm that under penalty ot perjury thet I em EXEMPT FROM TME CONTflACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business end Professlons Cotle: Any ciry or counry which requires e permit to construct, alter, improve, tlemolish, or repair any sirucNre, pnor to its issuance, elso requires tha epplicant for such permit to lile e signed atetement thet he or she Is IlcenseA pursuant ta the provisions at the Cantractors License Lew (Chepter 9(commencing with Sectlon 7000) oi DMSion 3 of t�e Business entl Professlons Code) or Ihat ha or she is exempt therefrom and the hasis for Ihe alleged e:emption. Any violetion of Section 7031.5 6y any epplicent for e pertnit subjects the epplicant to a ciNl penalry oi not more than Bve hundre0 tlollare ($500).): ❑ I, es owner ol the property, or my employeas wi�h wages as t�eir sole compensation, WIL� 00 THE WORK, and the siructure Is not intentletl or oNeretl for sale (Sec. 7044, Business end Professlons Code: The Contractors License Law does noi apply to an owner oi properry who builds or imprwes iheraon, and who tloas such work himself or herself or Ihrough his or her own employees, provitled that such improvemenis are not Intended or ottered tor sale. If, howaver, Ihe huiltling or impmvement Is sold within one year of completion, the owneo-builtler will heve Ihe burden of proving that he or she did not build or impmve tor purpose of sale.). • ❑ I, as owner of the pmperty, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTHAC70RS to coretruct the project (Sec. 7044, Business and Professions Code: The contrectors License Lew does not apply to an owner of properry who builtls or Impmves thereon, and who contrects tor such project with a contractor(s) license pursuant to Ihe Contraclors LicenSa LawS.). ❑ I em exempt under sec. Business and Professions Code for ihis reason: Signature: Date: Owner ID verHied by drivefs Iicense. ❑ Yes ❑ No Dnvels License No. Veritication oi Ownership by (type oi tlocument, i.e. - property tax blll or deed): Expires: DIVISION OF INDUSTRIAL SAFE7Y PERMIT CEHTIFICATION: ❑ I hereby certity that no evcavation tive (5) or more feet In depih into which e person is required to descend, will be made in connection with work euthonzed by thls permii, end that no builCing structure, scattolding, falsework, or demolitlon or tlismantling Ihereot, will be more Ihan thirty-six (36) taet high. (C�ep. 32, Gry 2, Art 2, Sec. 341, Title B, Califomia AtlmlNsiretive Gode). ❑ Ps or.ner-builder, I will not employ enyone to do work which woultl require a permit trom the Division of Industrial Safety, es notetl a6ove, unless such person has e pertnit to tlo such work trom Ihe division. Signature: Date: Division of Indusirial Satery Pertnit Number: CERTIFlCA7E OF COMPLIANCE AND AllTHORIZATON OF ENTHV: I certity untler penalty oi perjury that I have read this application and state Ihat ihe information given is correcL I egree to wmply with all state laws and ciry ordinances relaiing m builtling consiruction, and authodze representatives of the Ciry of Coste Mesa �o enter upon the ebove-descnbed property for inspection purposes. I egree not to acupy or ellow occupency ot any building authonzed by this pertnit until fnal inspection. CODE �• INSPECTIONTYPE pLSE INTITIALS 1618 Flzetl SySiem FIn21 Fre Pf8V8niion 1288 Pool Spe Finel 200 Finel Re-Roof 201 Final BIocWRetaining Well 202 Final Fectory Fire Place 203 Final Sign 204 Final Demolition ��^�/Daiq _ (1 _d� `-Date--��..1- CODE I INSPECTION TVPE 206 Final Mechanical 208 Finel Plumbing 210 Final Electrical 212 Final Fire Pravention 220 Final Planning Approval 222 Final Site 250 Final Building/Oaupanq QAiE II�ELS Job Address: Suite No Vicinily: Parcel Nunmber: Applicank Adtlress: Owner: Address � �`�.:, ConVactor ( r• `'� �Address: 3 / r%' t } �� =i S �-; _ �:': `-_ j ISSUE FEE ''��` . -�` Temp service tesf � Res. a/c package New Res (7-2 un�ts):, - New Res (3+units),-, ' Pool ! Spa Lighfing Fixts Recept Outlets `� � � Switches Non Res Appl Res Appl Service to 200a Service to t000a ServiCe over 1000a Motors to 1hp Motors to 10hp , Motors to 50hp Motors to 100hp tLECTRICAL PERMIT 362 LA pERLE LN KITCHEN a2ssizo� RON COLLINS 3908 CALIE REAL ••�..�., vni vt, WS TA MESA, CA g2626 Status: ISSUED Applied: 07/22/2005 Issued: 07l22/2p05 ISSUED BY: r ✓ -Phon�`(g49) 661 8493 2 x�. „ SAN CLEMENTE, CA�,-, ^� ; z,Zip y2S�2 �� ;;.� ;y... ��i:�::, ��- . _ .,,.n r _ - r � 3 � BAYS MATTHEW WILLIAM TR � . � ' � � ��, --e 362 LA PERCE LN� � r �� „`: � , �� '.-`. � '" ,." m �' a �. > Phone: �z: a, � ` y_ �°., .� �?�> �< y ;OSTA MESA�; CA � Zip: 92627-3759 � �`>��. �� `� ,; �� ., <�%"ti . � �„_,�i .. �� . :�OLLlNS CUSTOM BUILDEFZS �� `'��' .i, 908 CALLE REAL ' � ,;: - , �� ;;e ��, .... . `. '.. -g '- � ♦ ` m� : �. .. -. Phone .(949)�661 8493 � .,_,��` � � AN�CLEMENTk rn .�„ ��". �:: o C°`t a : , "Z�p �92872 x ;, . �, , License:368900 '' "`"xc ,�-_ ,,.,c � Z � � �� ?i''. . . .. E 15 FIGHTING FIXTSx 12 f �.��.`� ��.. , { . . � �\ ' , �� , OLITLETS�"AND 6 SWI7Cf RY� �; Dist System / Lighting . a$6.60 �g '� � s -°Y uP to 1�001. $0.00 . � � ' � �' . over 10D�I +, "- x� � 0� ' : �- "`�"Cow Voltage Equipmf $� �� a��-. Low Volt Wirin S sti $000 `� 0 ��' i� w ��. 9 Y� $0 00 3"rN p �'�- q- t�� Mise� Condwt '�' � , $0.00 r k- �. Misc.�;Conductor ° '''-- � $0.00 � Crrcu`s ( gen or ride);::- � --- F�Grcus-(mech ride p�,ti $�'�� r=�'�� ^_'Ckiristmas�Tree'Stand $0.00 0 Fireworks Shand $0.00 0 Other Electricaf Fee 1 Ckts= $0.00 $0.00 $0.00 $0.00 $0.00 � � �' � �� a. � 3 Z �� f i: �', � >,INCLUDE: � SHE�LIVING `° , 4�� Y �q ± .�� i f � . , �. � �' A `�,�, ; ':'Y. �` N � nty '• 0 _ � q >' 0 ��» , 0 ��, ,;;,.,,` 0 0 0 � NOTICE: The work aulhorized by this permit shall comply with all applicable hantlicap access requirements under Califomia statutes and relatetl ' regulations. (Ortl. No. 92-28, § 1, 72-p7-gp) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspantletl or abanclonetl for a period of 180 days. , � tNSPECTIONS: In ortler for the work authorized under this pertnit to be considared legal, such work must comply xi�th al� a licable � requiretl inspections and final approval musi be o6fainetl. Failure to obtain inspections and final approval will result in the expirafion o( this permit. PP 0 es, antl all FOR INSPECTIONS CALL: (7y4) 7545626 2aa6.ig(g�pp) WORKERS' COMPENSATION DECLARATION: . � I hereby atfirm untler penelty of per�ury one of the tollawing declaretions: ❑ I heve entl will maintain e cenificate of consent m self-Insure lor workers' compensation, es provided for 6y section 3700 of the Labor Code, tor the pertortnance of Iha tor which ihis permit Is issuetl. I Iiev�arM vn'�a�taln wor�' companSaGon insurance, as required by SecUon 3700 of tha Lahor Code, for ihe perfortnanceyf t�e work for whlch Nis pertnit L5155ued. I certity Net in the pertortnance of Ne work for which Ihis pertnit is Issued, I shall not employ eny person in any manner so as to become subiect to ihe workers' compensatlon laws ot Califo , enC ee at It I shoul0 �ecome sub�act to the workers' compensetlon provLalons ol5ection 3700 of the Lebor Cotle, I shall forthwlih wmply wlth these provlsio . Y� � � re: �, De�ete: / �'�Y/ t/� WAANINf3: FNLURE TO SEWRE WORKERS' COMPENSATION WVERAOE IS UNLAWFUL AND SHALL SU&IECT AN EhIPLOYER T�O CRIMINFL PfNALTIES AND GVIL FlNES UP TOONE HUNDRED TlqUSIW D DOLLARE (5100.OW), IN ADDITON TO THE COST OF COMPENSATION, DAM4GE5 PS PROVIDED FOR IN SECfiON 3/O60F THE LABOR CODE, IMEREST, AND ATTOfiNEY'S FEES. LICENSED CONTRACTORS DECLMATION: 1 hereby aHirm�th�at I am licensr�gC untler provislons of Chaptar 9(cammencing with Section 7000) oi Olvision 3 of the Business end Protesslons Code, antl my Iicense is in full fOfCB�'�IBG[. LJC. M , 4 (� Cia� �'s�'°>- h1�J.e� �/�-�"� CONSTRUCTION LENDING AGENCY: ❑ I hereby affrm thet there is a conswction lentling agency for the performance ot the work for which this permit is issued. (Sec. 3097, Civil Cotle). Lentlefs Name: LenGer's Atltlress: �. SignaNre: Date: OWNER-BUILDER DECLAFiA710NS: I �ereby atlirtn ihat untler penelry ot per�ury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe tollowing reason (Sec. 7031.5, Buslness and Professions Code: Any ciry or counry which requires e permit to wnstruct, alter, improve, demolish, or repair any siructure, pnor to its issuance, also requlres t�e apP�icant for such pertnit to file a signetl statement Ihet he or she Is Iicensed pursuant b tha provisions ot ihe Camrecrore License Lew (Chapter 9(commencing with Sectlon 7000) of DlWsion 3 of the Business end Professlons Code) or thet he or she is exempt thereirom and Ihe basis for the alleged exemptlon. Any Wolation ot Section 7031.5 by eny epplicent far a pertnit subjects ihe eppllcant to a cNil penalry oi not more than tive hundred dollars ($500).): ❑ I, as owner o1 the properry, or my employees with wages as their sole compensation, WILL DO THE WORK, and the siructure Is not Intendetl or otfered far sale (Sec. 7044, Business end Professions Cotle: The Contractors License Lew does not appty to an owner ot properry who builds or improves theraon, anC who does such work himsetl or herself or through his or her own employees, providad that such improvements are not intendetl or ottered lor sale. If, however, Ihe building or improvement is soltl within one year ot wmpletion, the ownerbuilder will have ihe burden of proving that ha or she did not build or impmve for purpose of saleJ. ' ❑ I, as owner of the Droperty, am EXCLUSIVEIV CONTRACTING WITH LICENSED CONTRAC70RS to consiruct the project (Sac. 7044, eusiness and Proteuions Code: The contrectors Llcense Lew does not epply to an owner ot property who builds or improves Ihereon, entl who contracts For such pmject with e contrector(s) license pursuant to tha Comrectors License Laws.). ❑ I em eaempt untler sec. Businass and Professions Code for ihis reason: Signature: Date: Owner ID verified 6y tlnvefs license. ❑ Yes ❑ No Dnver's License No. Expires: Vediication ol Ownership by (type oi document, I.e. - properry ta�c bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I hareby certity that no excavaUon Five (5) or more feet in dapth into which a person is requiratl to descend, will be made In connection wi[h work euthorizad by Ihis pertnit, and that no builtling sirudure, sceflolding, falsework, or demolition or dismantling thereot, will he more than �hirry-six (36) feet high. (Chap. 32, Gry 2, Atl 2, Sec. 341, Title 8, Califomia Atlministrative CoOe). ❑ As owner-Duilder, I will not employ anyone to do work which would require a permit irom ihe Division of Industrial Safery, es noted above, unless such person hes a permii to do such work from the tlivision. Signature: Date: Division ol Industnel Sefery Pertnit Number. CERTIFlCATE OF COMPLJANCE AND AUTHOR¢A710N OF EMAY: I certity under penalry of perjury that I have read this application and state that the iniormation given is correct. I egree Io comply with all state laws end ciry ordinances relating to buil0ing consWction, and authorize representatives ot the Ciry of Cosle Mesa to enter upon the ebove-descnbed property lor Inspection purposes. I egree not to occupy or allow occupency ot any building authonzed by this permit until final inspaction. �___Ot Legal Owner(s) Da _� � �a a—/P�— �aad/Or.numorized�APPucam � UaTe-•�• CODE t. INSPECfIONTYPE 1618 Fixetl System Final Fire Preventlon 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Well 202 Final Fectory Fire Place 203 Final Sign 204 Final Demolition , Q�¢, TIMI IRlS �QQ�( INSVECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Elactrical 212 Finel Fire PreVention 220 Finel Planning Appfoval 222 Final Site 250 Final Building/Occupancy • 0. � (714) 754-5273 • Fex (714) 754-4856 • www.Cl.Costa-mese.Ca.Us // rnin unrvc, ��a i r. moaN, �,n amm Job Address: Suite No Viciniry: Parcel Number: Applicant: Address: Owner MECHANICAL PERMIT 362 LA PERLE LN KITCHEN 42531201 Status: � ISSUED Applied: 07/22/2005 Issued: 07/22/2005 ISSUED BY: � ^— RON COLLINS ` ' a � _ a��-� 3908 CALLE REAL ' -�; � � `"`° a - �.,�., :��y:;,� �rt' a_ - % .� Ptione (949) 661 8493 : `, "�. * �b SAN CLEMENTE CA �"� -' ZiP 9�6�� p �� , _.. :_ . . . �'� ' h� P iYe � . BAYS,'MA HEW WILLIANI TR'� ` � `� & �� T � �<� �' ;,� . � �, �-:-,. Address �36TLAPERLE�LN - �'._ '' �� er i - . "#n m^`�- ; �"� y ,�;�4':_; Phone: `.';, rg " t ,�:• - ° ,,,COSTA MESA, CA Zip: 926273759 <°� .-�'� a r�'_ Mi'e "_. '.'. � ,, x,�,. Cont�actor COLLINS CUSTOM BUILDERS r?i ', a= ,� , r �,m ., Address 3908 CALLE REAL . -"' `"�"'4 a � %�'°. '., �' �� '� FNone (949)�8678493 " ,.� ° x a t� .s `� � - 3 .�,�, SAN CLEMENTE CA �, - ;�*,��a'� � 'Zip 926�2 g � 3 , . � 3; � : � ��;� , License:368900 °s�`i`' -. : a . .r =t � � `�".. � �MECF �f_�IiVCLI �THE L g REFB � a =' �- � `_.. z, WORI �,..,. � ISSUE FEE '-- � `ti" � I�st FAU <100 k BTU ' Inst FAU >100 k BTU Repair 1 Att CoolmglHeat y, t/R RecessWaIIHU _. ., . ..... �;CONSTRUCT 78 SF COVERED ENTRY PORCH„ __F _.. �'�,3z.� `.: t�J .�� ACTORY FIREPLACE AND.t HOOD;W/MECH EXHAUST ., .. .. ., ss�...:, � . > . _a�;i.. . . :�:. ��.� �� -; QuaMity �' $23.50 �' $0.00 0 ,'4$0:00 0 : :a�$0'00 . 0 Ins ep. 12efrig Sys <100 k BTU , ,�,. Refrig Sys >100 k BTU�•�= - ; ��F_- Gas Piping �y '- Factory Fireplace � Hood w/Mech Exhaust � --, : � y ' VAV Box Vent Fan / Single Duct �"'"'-� F.::'y qppliance Fire Dampers Smoke Dampers Iqst or Relocate Appl Vent Air Handlew < 'I OOOOcfm Air Handlers > �OOOOcfin FEE SUMMARY .,,,' ' .: . Repair / Alt Absorbtion U �rr� ' �;, Repair / Alt Refrfgeration ;Ventillation System ...,�.. , r.�; ' --`-- ^—'-' 1 �� «�157o30tip`�71,OOOk�.BTU a 0 �� '�""�� 30 To 50 hp,/,1,750 k BTU� 0 �� .a�. . -��:Ovec50 tip./Over 1,750-BTU O � Y"�, a'a•'"�_Bodersa'�"v,".:: ' � d�"i .' O.ce ,.. ;>� ' :GWp to 3 hp" .. ,�,;�� ,. >„ 0':�.m.�'..,.... .. �3To75hp�, .,.„-,. $0.00 0 • �, z;,::.=`"��• x:"15 to 30 hp $0.00 0 � - . "-�^=30 to'S0 hp $0.00 0 Over 50 hp f« <� ��, CE IN ' k a s t-: �� "`z � �yjb` f"a � : „ r C s:� ;' ��$0.00.;. � 0 ...,.�$0.00� i0 . '�°$0.00� � 0 ^� �,.�> $0.00-" 0 � $0.00 0 �,_ :,$0.00 0 �:;r �.: s':+ � �`�$0.00 0 � � !" $0.00 0 �,,�,�'�'� $0.00 0 ,,,F. $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 i';j�; � �t NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended�oi abandoned for a period of 780 days. . INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicaDle codes, and el1 requlred Inspectiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpir8�tlon of this permit. FOR INSPECTIONS CALL: (714) 754-5626 264W6 (N00) WORKERS'COMPENSAnON DECLARAnON: I hereby aHirtn under Denelry oi perjury one of Ihe following tleclarations: ❑ I heve enA wlll malnlaln e certiNcete of wnsent to self-Insure br workers' compensation, es provided tor by section 3700 of the Lebor Cotle, for the peAortnence of the work for which Ihis permit is Issuetl. ❑ I have and will maintein workers' compensetion Insurance, as required by section 3700 of the Lebor Coda, tor the pertormance of the work for which this pertnit is issued. My workers' compensatlon Insuranca carrler and policy number ere: Certler: (This sectlon neeC�not be comp/eted!/ the Oermlt /s va/ued Poliry Number: or less.) �4��ce�tlty Ibat in Ihe pertortnanca of the work for which this pertnit is issued, I shall not employ eny person in any manner so es lo become subl� �o ihe workers' compensetion laws oi Calitami9;-a�d eaf681that If I s�oul7 hewme subjed to the workers' compensation provlsions of Sectlon 3700 of Ihe Labor Code, I shell forihwith Comply wilh Ihese provi5ion5 � � �� /.�J 7�1Ptnfc✓ent' p �: �� i� pate:�::- I[J ��0� AW RNINQ: FAILURE TO SECURE WORKERS' COf.IPEN5AT10N COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMP�OYER TO CRIMINAL PENAL ES AND CNIL FlNES UP TO ONE HUNDRED TIqU$ANO DOl1ARE (E100.000). IN ADDITION TO THE WST OP COMPENSATION, OAMAGES A$ PROVIDED FOR IN SECTION 3106 OF TNE UBOR CODE, IPREREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATON: I here6y aMkm�l�d� � am Ilcensed untler provisions of Chapter 9(commencing with Section 7000) oi Divislon 3 of the ��0� �,��d,. eMeclrLJc. M ��f (�A /— Claae GMUac�oPs3�lgn�al(�ir�e: '�� _ fa�Dnie: Cotle, end my license Is In full CONS7RUCTION LENDING AGENCY: ❑ I hereby ettirtn that there is a construction lending agency for the perfortnance ot t�e work tor which this pertnit is issuetl. (Sec. 3097, Civll Coda). Lentler's Name: Lender's Addreu: Signature: Date: OWNER•BUILDER DECLARATIONS: I hereby ettirm thet under penelry of perjury that I am EXEMPT FflOM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions Code: Any city or counry whlc� requires a pertnit to consWct, alter, improve, tlemolish, or repair eny structure, pnor to its issuance, also requires the epplicant for such pertnit to tile e signed slatement thet he or she is IlcenseO Dursuan� to Ihe Drovisions of ihe Contractors License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 01 tha Business and Professlons Coda) or that he or she is exempt t�ereirom anC the hesis tor t�e alleged exemption. Any violatlon of Section 7031.5 by any applicant For a pertnit subjects Ihe epplicant to a cMl penalry ot no� more than tiva hundred dollars ($500).): ❑ I, as owner of Ihe properry, or my employees wlih wages as thelr sole wmpensation, WILL DO THE WORK, and the structure is not intended or ottered for sale (Sec. 7046, Business end Protessions COCe: The Contractors License Law does not apply to en owner oi properry who builds or improves Ihereon, and who does such work himsatl or herself or through his or �er own employees, providad ihat such improvements are not inteneetl or ottered for sele. It, however, ihe building or improvement is sold within one year o1 completion, the owner-builder will have ihe burden of proving ihat he or she did not build or improva for purpose of sale.). ' ❑ I, es ownar of ihe pro0erty, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions Code: The contrectors License Law does not appry to an owner ot property who builds or impmves thereon, end who comrecis tor such project with e conirector(s) license pursuam to the Contrectors Licensa Laws.). ❑ I am exempt untler sec. Business and Pmtessions Code for this raason: SignaNre: Date: Owner ID verified by drivef5liCenSe. ❑ Ves ❑ No DnverS LicenSe No. ExDires: Vedticatlon oi Ownership by (type oi tlocumen6l.e. - properry tax bill or deed): DIVISION OF INOUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I hereby ceM1lfy that no excavation five (5) or more feet in depih into which a person Is reqWretl to tlescend, will ba made in connection with work euthonzed by thls partnil, anC tha� no building sirudure, scaHoltling, falsework, or demolition or dismantling �hereof, will De more Ihan thirty-si: (36) teet �ig�. (Chep. 32, Grp 2, Art 2, Sac. 341, 71t1e 8, Califomia Adminisiretive Cade). ❑ As owner-builder, I will not employ anyone to Co wark which wauld require e pertnit Irom the Division of Industnfll Sefery, as nated above, unless such persan hes e permit to do such work trom the division. Sipnature: oate: DMsion ot Industnal Satery Pertnit Number. CERTIFlGATE OF COMPLJANCE AND AIlTHORVATON OF ENTTiY: I certify under penalry of perjury that I have read this epplication end state �hat Ihe infortnation given is corted. I agrae Io comply with all siate laws end ciry ordinances relating m building construction, end euthorize represematives of the Ciry ol Costa Mesa to enter upon the ebove-descnbed D�operty tor inspection purposes. I agree not to occupy or allow occupancy of any building authonzetl by this permii until final insDection. COQE 1. INSPELTON TYPE 1816 Fixed System Flnal Fire Prevenlion 1286 Pool Spa Finel 200 Finel Ra-Rool 201 FIna181ock/Retaining Well 202 203 Final Fectory Fire Place Final Sign 204 Finel Demolition P!I€ 1[�LT1aL$ COOE� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 270 Final Electncal 212 Final Fire Prevemlan 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy �.1 i111. i � �� (�14) 754-5273 • Fax (714) 754-4B56 • www.ci.costa-mesa.ca.us Job Address: 362 LA PERLE LN Suite No Vicinity: KITCHEN Parcel Nunmber: 42531201 Applicant: Address: Owner Address �t z- Contractor , �+§'Addre55 � y �k : s � �? ._::__�� '. �4 <w1 S _ 4_ � PLUMBING PERMIT /! rn�n uwvc, �.vo � I+ mcar., �.r. awco Status: ISSUED Applied: 07/22/2005 Issued: 07Y22Y2005 ISSUED BY: �'�..� y.h,,.. RON COLLINS , �� -- *- 3908 CALLE REAL -'T � � :_�� '� - sa�.. -'• �Phone (949)661,8493 ) ry- $ SAN CLEMENTE CA e Zip 92672 � �>nys � � - �� - a,',�., �. s�x g Si € -. � �;_ .a�e <-, a6 � �iX �4`'i6jw " zT..� y3,�,,a.._. B/aYS, MATTHEW WILLIAM"TR `' � �,:;W - 362�.LA PERLE LN� 3� r�n '� »� ,< .: _ Phone: „h " ��.s��, � = COSTA M,ESA CA Zip: 926273759 � - ��'�� k� �,o �°, <°` £ � � p x a . x y.:�:...,. ;�,� �.�g, � .i � F ��AL i . COLLINSkCUSTOM BUILDERS � �' y � �° � � '" 3908 CALLE REAL ' � -� } 4 +, �� .�w�� b` � � �' �.� � � � � ' : ��„+' ��'. "'- ` Phone: (949) 661-8493 r• ' § .. � � s �`� �, � ' ' �n � , t - SAN CLEMENTE GA ZiP'. 9267z � � F _ a y � �� {,s3 v , � '' � - •;� � License 368900 a � � � � g ' o- ''.� ° ��.. ' r•a x: � - �e-� : �i e, i^�$I�y`� 3 �P �a' �;_ ,� .7 .. ,;, , :. r . .<. . . : , 4 ¢' �t.',,. �.x... � «� Y "_ .. ' . . _ , �.,n ,+.� e r �t�. .. ." .. 4 a . Y .. . . .r . r� ") , .; REI -' "�s "�` WC ?�;' �, � ,y'. ISSUE FEE ` Sackflow irriga6on �. 6ackflow Preventer'��„ �athlub `"' Clarifer System "�� Connect pce,Soda,etc) pental Units pishwasher praiq Floor prain, Rainwater prain, Roof prinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) AM h � L $23.50 $�.��, $0.00 $0.00 $0.00 $0.00 $0.00 $6.15 ` `SCOPE OF PERMIT� - a ^s�":^ ' FOR ADD 244 SF TO EXISTING SINGLE-STORY S.F.D. WORK�i � KITCHEN AND INSTALLATION,OF A NEW PREFAB FIREPLACE TRUCT785FCOVEREDENTRYPORCH�6_� �"��;'- ... t�W�" x , -.- �� ;� 7 DISHWASHER, 1 GAS (b4 OUTLETS)'AND 1 KITCHEN SINK' n.e; ...:� �� T��anaacayc:my _��c,.vv.�v "7 ,. p �'�' - �P Trap-. - ' , $0 00 0 :-0 � �PressureRegufator° .-_ �$000,�__0�;;� -:�0 . ,Process'Piping (pe�.10 fl)_�$000 "',, 0 W . 0 +-�„ ��Receptois ��:�; e"�=� $0.00• J�;O � "0 �� . i�-Septic Tank�'-" ,,, ��_x � �=$0.00 0 . � � a � N° •.r Sewer,Cap for Demo $0.00 � . �-.- � , . � ="0> *.Sewer Connect '� 50 00 .�, � 0 �� - s "�0 ��Sewer Pnvate Line r ` � $0.00�-,�-�0�" o `.��"3.�»:Shower = ,..' •`' ° wz �?. $0.00 0.. .: 0 0 0 1 Sink, Floor - -��N"��-��-'-µ'� 50.00 0 Sink, kitchen $9.80 1 a� � � : UDE`a�? :. ��. LIVING tk '� y� '� � .:� _ .—:i Brkr '.- AMT � ;` $0.00 '--� -�' $0.00 $�.�� y $0.00 t-0) $0.00 5+) $0.00 $0.00 Wash Basin�Set $0.00 Waste and Vent System $0.00 Water Closet (Toilet) • $0.00 N%ater Heater / vent $0.00 Water Piping Qnst or Rep.) $0.00 Water Re-pipe $0.00 WaterService $0.00 Water Sokener $0.00 a QTY 0 � 0 0 0 0 0 0 0 0 0 0 0 0 0 PiOTICE: The werk authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) - EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned fof a period ot 180 days. , INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable coee FW ell required Inspections end tinal approval must be obtained. Failure to oblain inspections and final approval will result in the expiration ot t' ermit. FpR INSPECTIONS CALL: (714) 7545626 24d6-08 (fl�00) WORKERS'COMPENSAnON DECLARAnON: I hereby attirm under penalry of perjury one ot the tollowing declarations: ❑ I heve antl wlll maintain e ceRiflcete oi wnsent to self-Insure (or workers' compensatlon, as provided for by sectlon 3700 ot the Lebor Code, br Ihe pertormence of the work far which this permit is issuetl. ❑ I have entl wlll maintain workers' compensatlon Insurence, as redulrea Dy section 3700 of Ne Lebor Code, for ihe pertortnance of Ihe work tor which t�is pertnit is Issuetl. M workers' compen5ation Insurance cerrier and policy number are: �� ' Certfer: Policy Number: (Thls secNon need nof be complefed I/ the permit Is valued ef one hundred dollars ($100) oNess.) I ce Ihet in the pertor nce o1 th ork for w�ich thls permit I5 issueQ I shell not employ eny person in any manner so as to hecome subjact to ihe workers' '- "'oompensatlon lews oi Ii mla, d gree t�at If I s�ould become subjecl to the workers' compensatlon provisions of Sectlon 3700 oi the Lebor Code, I s�all forthwlth compty with Uese pr slon . �E,��,��:c� ��,�:�-�._�T� � WAfININO: FAI�URE TO SECURE WORKERS' ODMPENSATION COVERAGE IS UNLAWFUL M1D SMALL SU&IECT AN EMPLOVER TO CPIMINAL PENALTIES AND GVIL FINES UP TOONE HUNDRED T/IIXISAND DOLLARE (E100,000), IN ADDRION TO THE COST OF COMPENSATION, DAMAGES AS PfiOVIDED FOR IN SECf10N 3/O6 OF THE IABOR CODE, IMEREST, AND ATTORNEI^S FEES. LICENSED CONTAACTORS DECIARATON: I hereby ettirm thet I em licensed und��mvislons oi Chapter 9(commencing with Section 7000) oi Division 3 ot Ihe Business and Professions Code, entl my license is in full CONS7RUCT10N LENDING AGENCY: ', ❑ I hereby attirm ihat there is a construction landing agency for the pedormence ot the work for which this permit Is Issued. (Sec. 3097, Civil Cotle). � Lenders Neme: Lentler's Adtlress: Signeture: Date: OWNER•BUILDER DECLARATIONS: I hereby aHirm thal under penelry of perjury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions CoOe: Any ciry or counry which requires a pertnit lo construct, alter, improve, tlemolish, or repair any strucNre, pnor to its issuance, elso requires t�e applicent for such partni� lo tile e signed atatemem ihat he or she is Ilcensetl pursuent to the provisions of the Contrecrore lJcense Lew (Chapter 9(commencing with Section 7000) of Dlvislon 3 ot the Business antl Prolesslons Code) or Ihat �e or she is exempl therefrom end Ihe basis for Ihe alleged exemption. Any violetion of Section 7031.5 by eny epplicant for e pertnit sub�ects the epplicant to e cNil penelry ot not more ihan five hunOretl dollers ($500).): ❑ I, es owner of Ihe property, or my employees with waqes as their sole compensation, WILL DO THE WORK, and the siructure is not imentletl or offeratl for sale (Sec. 7044, Business and Pmfessions Cotla: The Contradors License Law dces not appty to an owner ot properry who builds or improves Ihereon, flnd who tloes such work himselt or herself or through his or her own employees, provitletl that such improvements are not Intended or oHeretl for sale. If, however, t�e building or improvement Is sold within one year oi wmpletion, the owner-builder will heve the hurtlen ot proving ihat he or she did not build or improve tor purpose of sale.). ' � I, es owner of the proparty, em E%CLUSIVELY CON7RACTING WITH LICENSED CON7RACTORS to construct tha pro�eq (Sec. 7044, Business and Profeuions Code: The comraclors License Law tloes not appty to an owner of property who builtls or Impmves thereon, end who wmracts tor such projeci with e contrector(s) license pursuent to the Contractors License Wws.). ❑ I am exempt under sec. SigneNre: Owner ID veniied Dy tlrivefs licen5e. ❑ Ye5 ❑ No Business and Prolessions Code tor Ihis reason: Vedtication o1 Ownership by (type ot document, I.e. � properry tau bill or deed): OIVISION OF INDUSTRIAL SAFETV PERMR CER7IFICA710N: Driver's License No. Date: Expires: ❑ I hereby certify that no eacavatlon flve (5) or more feet in depth into which a person is required to descend, wlll be made in connectlon with work euthorized by this permlt, anO lhat no building strucNre, scaHolding, talsework, or demolition or dismantling thereot, will be more ihan ihirry-six (36) feet high. (Chap. 32, Gry 2, Ah 2, Sec. 341, 71t1e e, Califomia AOministrative Coda). ❑ As ownar-builder, I will not employ anyone to do work which would require e partnit from tha Division of Indusinal Sefery, es notetl abova, unless such Oerson hes a permit lo do such work irom the division. Signature: Data: Division of Industnal Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHOR¢A'I10N OF ENTRY: I certity under penalry ot perjury that I have reatl ihis applicetion antl siate that the information given is wnect I egree to comply with all stete laws and ciry ordinances relating to builCing consirudion, and authonza representatives of ihe City oi Coste Mesa to enter upon tha ebove-described property for inspection purposes. I egree not to occupy or ellow occupancy ot any building euthorized 6y Ihis Dermit until final inspection. COUE �. INSPECf10NTYPE 1618 Fixed System Final Pire Prevention 1286 Pool Spe Final 200 Final Re-Root 201 Final BIocWRetaining Wall 202 203 Final Factory Fire Place Final Sign 204 Final Demolilion COOE� INSYECTIONTYPE 206 Final Mechanical 208 Final Plumbinq 270 Final Elecirical 212 Final Fira Prevention 220 Final Planning Approval 222 Final Site 250 Final Buildinq/Occupancy �g �� (714) 754-5273 • Fa�c (714) 754-4856 CITY OF COSTA MESA BUILDIN6 DIVISION DEVELOPMENT SERVICES DEPARTMENT. PERMIT BUILDING PERMIT Job Address: 362 LA PERLE LN Suite: Vicinity: PROPERTY LINE WALLS Parcel Number. 42531201 Applicant: RON COLLINS Address: 3908 CALLE REAL SAN CLEMENTE, CA Owner: BAYS, GERALD R TR Address 1060 LA SOMBRA DRIVE SAN MARCOS, CA Contractor: COLLINS CUSTOM BUILDERS Address: 3908 CALLE REAL SAN CLEMENTE, CA Zip: 92672 Arch : Address: Zoning: Phone: (949) 661-8493 Zip: 92672 Phone: Zip: 92069 Phone: (949)661-8493 License: 368900 Eng: Address: Phone: NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: OS/04/2000 Issued: OSI04/2000 ISSUEDBY: �/✓ / Phone: Zip: - License: License: � SCOPE OF PERMIT CONSTRUCT 52 LF OF 6' HIGH BLOCK WALL AT REAR PROPERTY LINE AND 40 LF OF 6' HIGH CONC BLOCK WALL ALONG LEFT SIDE OF PROPERTY(LA PERLE PL). Plan Check: $43.03 Permit: $66.20 SMIP Res: $0.00 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $109.23 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existina: 0 NOTES: Rear 0-0 Rear 0-0 Required: 0 FEE SUMMARY PLANNING 8 ZONING LeR 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation Right 0- 0 Right 0- 0 $1,840.00 so.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-92) . EXPIRATION: This permit shall automatically expire and become void if work is not�commenced within 7B0 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 inapeetlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSATON �=CLARA�ON: � '� r � I hereby attirtn un�er penelry of perjury one ot the following tleclarations: ❑ I have and wlll mflinWin a certificate of conseni to sel4lnsure tor workers' compensation, as provided for by sectlon 3700 of ihe Lebor Cotle, for the paAormance of the work for which this permil I5 issued. . ❑ I have and will maintaln workere' compensatlon insurance, as requiretl by sectlon 3700 ot the Labor Code, for the pertortnance of Ihe work for which ihis pertnit is issuetl. My workera' compensation Insurance carrier antl policy number are: . Carner: Policy Number: (This section neetl not be comp/eted i! (he perml( is valued at one hundred tlollers ($100) oNess.) �'�I certify that In ihe peAo ce oi the work for which this permit is issued, I shall nol employ any person in eny manner so as to become subject to Ihe workers' compensatlon laws of Ca o a, entl hat if I should become su6jaq to the workers' compensation provisions ot Section 3700 oi the Labor Code, I s�all forthwith comply with ihese provis' . ,�i � r Applicant Signature: c� Dete: �� 0 � WqRNINd: FAILURE TO SECURE WORKERS' COMPENSATIIXJ COVERAGE IS UNLAWFUL AND SHAll SUBJECT AN EMPLOVER TO CRIMINAL PENALT7E AND CIVIL FINES UP TO ONE HUNDRED THIXISAND DOLL<AE ($100,000), IN ADDfTION TO THE COST OF CqMPENSAiION, DAN.AGES AS PROVIDED FOR IN SECTION 3IO60F THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm that I am force and ettect. Lic. k_ Contracrors Signature: of Chapter 9(commencing with Section 7000) of Division 3 oi the Business and Pfyfessio�s Code, antl my license is in full class a �S r Date: R�%�/�/ CONSTRUC710N LENDING AGENCV: ❑ I hereby aflirm that �here is a constmction lending agency for iha partormance of the work for which Ihis permit is issuetl. (Sec. 309), Civil Code). Lentler's Name: Lendefs Atldress: Signelure: Da�e: OWNER•BUILDER DECLARATONS: I �ereby affirm ihat untler penalry ot perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Profassions Code: Any ciry or wunty which requires a permit Io wnsiruct, alter, improve, demolish, or repair any stmcWre, pnor to Its issuance, elso requires the applicant tor such permit to fila a signeC statement Ihet ha or she is licensed pursuant to the provisions of the Contractors License Law (Chepter 9(commencing with Section 7000) of Division 3 of the Busineu end Professions Code) or thet he or she is exempt therefrom and ihe basis for the alleged e:emption. Any violation of Sedion 7031.5 �y any epplicant tor a permit sub�ects the applicant to e clvll penalry ot not mora ihan five hundred tlollars (3500).): ❑ I, es owner ol the property, or my employees wit� wages as their sole compensation, WILL DO T1E WORK, entl the structure Is not intended or oHered for sale (Sec. 7044, Business and Professions Code: The Gontrectors License Law dces noi appty to an owner of property who builds or improves thereon, and who does such work himself or herself or thmugh �is or her own employees, provitled Ihat such impmvements ere not intendetl or oReretl for sale. If, however, the building or improvemant is soltl within one year oi completion, the owner-builtler will have tha burden of proving that he or she did not build or improve for puryose of sale.). ❑ I, es owner of Ihe property, em EXCLUSIVELV CONTRACTING WITH LILENSED CONTRACTORS to construct ihe project (Sec. 7044, Business and Professians Code: The coniracbrs License Law does not apO�Y to en owner of properry who builds or improves thereon, and who contrects for such project with a contrector(s) license pursuant to Ihe Contrectore License Laws.). ❑ I am exempt untler sec. Business antl Professions Code for Ihis reason: Signeture: Data: Owner ID verified by drivels license. ❑ Yes ❑ No Dnvefs License No. Verification ot Ownership by (type ot document, i.e. - property Iau bill or deed): � DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICA710N: Expires: ❑ I hereby certity Ihat no exwvatlon INe (5) or more feet in tlepih into which e person is requiretl to tlescend, will be mada in connection with work euthorized by this permit, antl that no building structure, scaflolding, talsework, or demolition or tlismantling thereof, will be more than thirry-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, Celifomia Atlministretiva Code). ❑ As owner-builder, I will not employ enyone to do work which woula require a permit from �he Division oi Industnal Safery, as noted ebove, unless such person has a permit to tlo such work irom the tlivision. Signawre: Date: Division of In�ustnal Safery Pertnit Number: CERTIFICATE OF COMPLIANCE AND AIJTHORVATION OF ENTRV: I cenity under penalry of perjury that I have read ihis application end state that the informa�ion given is correct I egree to comply with ell state laws and ciry ordinances relating to building construdion, and authorize representatives ot Iha Ciry ot Costa Mesa to enter upon Ihe ebove-tlescnbe0 propery tor inspectlon purposes. I agree not to occupy or ellow occupancy of any builtling euthorizetl by this permit until iinal inspection. CO�E t. INSPECTIONTVPE 7816 Fiaod Sys�em Finel Fire Prevention 1266 Pool Spa Final 200 Finel Re-Roof 207 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 204 2a&ae Flnal Sign Final Demolition P9I& IrrtmAGs � � / CQOE � INSPECTION TYGE 206 Finel Mechanical 200 Final Plumbing 210 Finel Electncal 212 Final Fire Prevention 220 Finel Planning ApOroval 222 Final Site 250 Final BuildinyOccupancy 0 INTRIRL$ Insulation Certifica "� �� --f3 ��-�-� L.�r,�i2 c �i S � ri- r� �s /-� C�T Number and Sveet Ciry Ct� �r'l�nr F �' County Subdivision [,o� �unbec DeScription of Installation aooF Material Brand Yame Thickness (inches) � 'Ihermal Resistance (R-Value) CEILING �C4��S �/� Bat[ or Blanket Type �j �� Brand Narne � KP'-S I��4i n/�/I ��t� 7'hickness (inches) � (i• 'Ihermal Resistance (R-Value) r3 Loose Fill Type Brand Narne Contractor's minimum installed weight/h` lb Minimum thickness inches Manufac[ucer's installed weight per square foot to acheive Thermal Resistance (R-Value) EXTERIOR WALL Material � � �i�-C�SS R,1�� BrandNarne �1��i/f5 /�'�.r.��/lu-4� 'I'hickness (inches) �/� 'Il�ermat Resis�ance (R-Va]ue) ---� RAISED FLOOR Macerial Thickness (inches) SLAB FLOOR Material 'Ihickness (inches) Width (inches) FOUNDATION WALL Macerial 'ihickness (inches) Declarafion Brand Name Thermal Resis�ance (R-Value) Brand Narne Thermal Resistance (R-Value) Brand Name ihermal Resistance (R-Value) I hereby cenify that the above insulation w3s installed in Ihe building a[ the above location in confomance ai[h the current Building Ener�y Efficiency Standa;ds for new residential buildings contained in Tide 24 of the Califomia.4dminisvative Code. C� l� �— N i/ 1� f3/�-S' ��'$ �'J �v J G r Coneactor(6vildz:) LicenseNumber -O �.- r-� �/ a-� � v � $ign and7'itle Da�e SubConvacmr (Insulacion Ins[aller) and Title License Nurnber Compliance Forms I�uary 1, 1995 a; � PHOJECTRDOHESS: 3(j4 LA PERLE LN OWNEP'S NAME: BAYS GEAALD R TR rnooness:313 �IAMOND AVE ' BALHOA ZSLAND,CA 92662 AflCHIENGMEEfl: aooxess: HEG.NO.: UNIT: uxiT: ', PEflMiTTEE:R.C. ROOFING (714)534-6205 aooness: i 1782 REVA GARDEN GAOVE CA 92640 LICENSEO CONTflACTOB OECLANATION: I hereby a�tirm Ihal I am licensetl under provisions of Chap�er 9 �commencing with Section 7000� oi �rvision 3 of Ihe Business antl Professions Cotle. and my Iicense is in full force and effec�. ciTvuc.:040926 sraTeuc.q56490 "'� �c�upss":C��3��9 �aie'. �' � b—�13 Signa�ure: �(yb11•�— ^� — WOflNEFS' COMPENSATION OECLABATION: I hereby afiirm Iha� I have a cenilicate o� consent m selbinsure or a certilicate al Workers' Compensalion Insurance. or a cetli�iee cop Ihereoi Seclion 3800, La�. C� eoucrNo.:285-93 UNI'!� 16�/ E%P.DFTE:OIIOSI9A comvnxr:STATE FUND ❑ Ceni�ied copy is hereby fumishee. � Certilietl copy is file0 wi�h Ne ci�y Building �ivision. Ja�e'. � �� b�13 ApplicanC _�1t1./�MI'K A.�-�--�� E%EMPTIONFflOMWOBNEPS'COMPENSRTIONOECIABATION: (ihisseclionneeAno�becompletetlil�hepermi�isforonehunaretl(5700)orless�. I cetlify Ihai in I�e Oerbrmance ol ��e work tor whic� �his permit is is5ue0, I 5hail nol employ any person in any manner so as to become 5u0ject to Ihe Workers' Compensalion Laws of Califomia. � Date: Signa�ure: NOTILE: Ii, zner making Ihis Oeclaraiion. you shaultl become sublec[ �o the Warkers' Compensatian pmvisions ol ihe Labor � Cotle. yQu must fonhwi�h comply with such pmvisions or inis Dermit shall 6e �eeme0 revoketl. CONSTBIlCTION LENDING AGENCY: I here�y a�hrm Iha� Ihere is a consimc�ion IenOing agency for �he peAormance of t�e work �or whiCh �his p¢rmil is i55u¢tl ($¢GIiOn 3097. Civ. C). LENOEP: A�ONE55: OWNEP BUILDEB OECLAPATION: I hereby af�um ihal I am exempt imm Ihe Conlmctors' Slate License Law tor �he following reason (Section 703L5 Business antl Pmiessional Code'. Any ci�y ol coun�y which requires a permii to con5imct, alter, impmve, aemolish, or repair any structme. D�wr to rts issuance, also reQuires �he apDlican� for such permit Io lile a signetl statement thal he/she is licen5etl pursuanuo Ihe pmvisions oi IM1e Coniractors' Slate License Law (Chap�er 9(commencing with Sec�ian 7000) ai Division 3 of ��e Business anU Pmlessions Catle) or �ha� he/she is exempt therelmm and �he basis �or Ihe alleged exemption. Any violation o� Section 7031.5 �y any applican� 1or a permil 5u6jeqs Ihe apDlicantlo a civil penatly o� not more t�an live �untlretl tlollars (5500�. , I, as awner o� �he pmpeny or my employees wi�� wages as �heir sole compensation, wiil do �he woB, and Ihe ❑ slmcWre is no� in�enaetl ar atteretl �or sale (Sec�ion 7044, Business an0 Pm�essional CoOe- The Coniractors' $late License Law � Ooes n01 apply Io an Owner o� a pmperty wha build5 Or impmves [here0n, and who Does 5uch work �imseli/hersell or IhrOugh his or her own employees. pwvi0etl ihat such improvemenis are nol inlen4e0 or aflere0 (or sale. If, however t�e buitAing or imDmvemen� is soltl wi�hin one year o� comple�ion. the owner will have the bur0en oi D�oving helshe did nai build or impmve lor me ourvose of salel. I, as owner o� Ihe pmpeny, am exclusively coniracting wi�h licensetl coniraclors Io consimc� �he prole�� (Seciion 7044, Business ❑ an� Pmlessions Cade: The Conlractors' S�ale License Law does not apply to an owner oi proDe�Y who builtls or improves �hereon and who Conlracis br such pmlects wiih a conlractor�s) license pursuant�o Ihe Contraciars' Slale License Law�.l am aware Ihai pmol ol I�eir Worker's Compensation insurance ShoWe be providetl �o me. � I am eeemp� untler Seclion'. B. 8 P. C. tor tnis reason: oaie: ow��: I do hereby certily Iha� I am aware oi an0 untlers�antl ��e requiremenis o� Cali�omia,Heallh an0 Safe�y CoOe Sec�ions 25505, 25533, antl 2553a an4 i�at I or any 1uWre �uilding occu0an� wilUwill nol �circle one� neetl ta compty wi1� saitl staie codes and Ihe requiremeNs for a permit for con9mc�ion or motltlica�ion Irom Ihe Air �ualiry ManaAemeni �i5inct. Hesidential consimc�ian applications are exemp� �mm Ihese provi5ions. Dale: Appl¢anl: I hereby cetlify I�at I have reatl Ihis applicaiion and 51aie �hal Ihe above iniormation is correcL I agree lo comply with all city antl counry ordinances anU slate laws relating lo builtling can5imction antl here6y aNhorize representa�ives ol lhis city �a enter upon Ihe a6ove�menlioned property larinspectian purposes. Dale: �''4—�'� Signalure �, � oriverS �icense or Socia� Sewriiy t6<606 W�ite—Builtlmg; Green—Cooe Enlorcemem; Canary—Applicant Pink—Revenue'. Goldenmtl—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO; B 064008 pLAN CHECK NO: N CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR PERM NO: H 064008 GOVT; N SUPP: N PURPOSE: ALT JOB DESCRIPTION : REROOF COMPO OVER COMPO SQ FT: 2,250 CLAIM VALUE: 2,250.00 CALC—VALUE: 2,250.00 GROUP OCC: R-3 /M-1 COMMENTS: SMOKE DETECTORS REQUIRED PER THE 1991 EDITION OF THE UBC g��'*�*�O� ***w****+t*****�r*****+t**rr��*�**�***�r**r+t***+t***��r�****�c�r**+t��/�{�� *V �— Z O N I N GS ERTEBQAUCIKRSE M E N T S Vf��- REC�UIRED '------------ MAIN HUILDING ---------- --------- ACCESSORY BUILQING �FRNT: FT IN REAR; FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGE[T: FT IN PARKING REQ • PROV: PARCEL:-42,531201 ZNE: REF NO: PLANNING N6TE5> �� i {' ifiE�FiFiFititiFiFiEiEif3fiEffififlfkMlt4k4iFifif�fifiFitiFMMitiFiFMlFMftiEffiEMiFM%lkitiiitMit%1tiFifiEK1E1E%iFiFiE1EiF1EiEiFMiFiEffM*** 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 T S --i_.� 20NING APPROVED BY, DATE: BUILDING APPROVED BY : DATE; APPLICATION ISSUED BY; f DATE; � 6 iFlFlflkiklfil'if1F1f1f1t1t1k!!ikltlFifdFMN ii'1f1f1E1t1EilihlFlE il'iF lfifififkifkiflkiFikikltitlFlfihiFikiFitffitiflFifitMiFlfffiFNikkkMikfhltMitftiF iFiflEiflfMlEMM1f1Ek1f41fif1fitMMfFIFiEifitMlEitiflElFif LEGALIZATION:N F E E S U M•M A R Y STRUCTUAAL SEGMENT:Y ; BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE �' SMIP/AES GRADING PERMIT 54.00 , ' S0 �-''� SMIP /NON—RES PLAN ' ISSUE FEE r�. BUILDING—DIV—> PERMIT ISSUE PLAN—C1iECK TOTAL PAID DUE TOTALS----> 54.50 0,00 0.00 54,50 �•'� 54.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 54.50 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/TOT��GRADING PLAN—CHECK 54.00 ,50 /' . if 1f K k it M k ik if ik if iFlk i!!F if M!F i! if k if �k 1E iElE if if !f k k if M k iE M M 1f ik 1f 1f M itlf iE 1E if M if if M fE iF M if if 1f k if iF fE iE if iflF 1F if iF if 1E iF %iElf fElE iflt ik I N D Z V I D U A L F E E H R E A K D O W N TYPE F�Y:1 (JTY 225�. � D E S C R I P T I O� REROOE BY VALUE RESID NTIAL N020NE E X P I R E D END OF FEES �I'ICOfii :19t8 �RS�CtlOf1S `�-�� ! � UNIT COST TOTAL COST i."oo z,zso.00 r , � �' (1 /+ /1 7 i1 � O1 0014.7Q4F—0014710�J T� �T C�ATE: �J9li6l93 TI11[: 1::`9 54.5Ct CONSTRUCTION ANO PIANNING ""'"` "" />PPROVALS Permit � Date I.nspector APpROVALS Permit # � Daie Inspector i 1, Temporary Electrical Serv�eor PoZEn; 52. Pool & ERuipment Location -�� , _Spil Pipe-Undrr�r��.� � . "�"� � 53. Stee� Reinforcement � � .�.�...�t0ctrical Conc.ni trU�.Ility•Undrarnd. � � 54. Forms ` 4��tectrical Conc�ri,^•+��drgmd. "� 55. Electriwl Bondin9 �� c;,:�. t¢el Reinforc�ErrtanD 'c+� . 56. Roagh Piumbing & Pressure Test ;,�� I �s`.��ccrica�UFE�'��d ` _' 57. APPROVALTOCOVER�GUNITE ^ .j 7,�;Eyotings ' u� 58. Electrical Conduit�Undrgrnd. � � �' ' �f8��1fc�'undaUon � 59. GasPipe,[7U�drgmd.,Test . T"9. Water Pipe•Undrgrnd. 60.. Backwash Lines, P-Trap, 1.',_. Undrgrnd. 10. 53ructural Floor System 61. APPROVAL TO DECK � it. i?(�perty Sewer lir�e:& Hc�se Co� ection � 62. BackLva>h & Recep,or�Finai � �Z• S-"'"ie� CaP �-' 63. Heater & VenbFinal � 13. Roof Dreins �',v� 64. Plumbing System - Final 14. Rough PlumbiF� 65. Electrical-Final ' ' 15. Rough Electrical-Contluit 66. Solar Systxm-Pinal � 16. Rough Elec[ri�Viring 67. Fe�cin� & Access Approval f 17. Rough Wiring ngn 68. APPROVED FOfl PLASTERING 18. Rough Electri¢a,l-T Bar Ceiling 69. POOL/SPA SYSTEMS FINA� 19. Rough Heating & Air Conditionin �,FI(i� C?,E�',T. �QUIREMEN� c� I ^ 1 ., . � �) h' • C C' -. :Ti t s � - : p :� � �;Pi �J # � ^� ir 'r �� r�. r,. �. 20�3?0 �h F�ctQ�Y P+r�piace i-�c., cr,.. r _-+ :.,* r � PPR.�VFLf�`j :`:�Pe�.-c�it �_,.�w-�2, . ' iJ " : 'R-�j ' ^ "�-i'r'_=�7n' , i H -:q- I 211-Ouf^ys, i�StrfictWB: � .. .. `^S x � G ^' ; �70. �hder io�; G° H1�ro ' � �� t �',-+ t C� r+ � i s 9 �-� � r 22.�-0u�s, �,nt,�t-tir�.�. i '':1 k '7 „ .:� E;� ;- ;71. Product��sin9 �U� is �il � F�-�--c�-'-1-� .-.i-�- -t-i=+F? 23.�GaH'iP'-RoU�h &�est i ni� t. t� R' C r �Y Y 72. UndergroL?�� FIF?i�J�' �* f� V' --� .-+ ^.L! i rL_ �' s - rz . . � �. : ;. ^' 24.�^�loU`' Fr,a]nin E+ i:•f� ..;-� r: v �' i,'= • :-+-' .73:;Undemrn . Stor T�a k� Gas ❑ Oil 9 t.' x „ t l � --� i x� �� .�'i� _l� - . •�--+=�---�: -� 25. RooS Stiv.athing r� �r G v�� - y c7 - :.� s v 7q��,erhead Hydrd� , + � � - r: :7a . c^ ^ W-� G t^ � 26,T'f-�'p} Ceiling (St�� uraq &�vt^r�coat r, z • � r�, Y Jt. . 75�_�e3v Chem�jral ;,_i .�; . 27:�ranEea:,J Fleshinry �o�c = t+ !, i r �� . � 76. Dry Stan`�w�iye F3i s� � O �. - . �. . �� , ..,�� .., .ri•� Lr� , -t n; -i r28. Lat±+in�5`;qinc,�A�� .7at- �; `..� ...�.� 77.�'-iFIXED.��!"E�a'r�iNAl,,-, i� � I 29. Insulatibn V n%t �� 5 •• � � I � 78� FiRE PREV. FI ,�1_ ' = � - � . � -J . �- ,_ k . t:' �' l "�30. DrywallVda�Rng �.� �� t`„ I ( �; � ft,�%F.y�LTI-�'{-l�EPTxFt�Qt71R�NE�4VT. I M • c�F1�--' CYit. Piaster �*owlcC�te _: � :*�^ _ �s r '79 �FINAL �f^�.z,"uYCTiGN > ::a i .i -n:n- ... , .., a_,;. E'�.3`2�IectricajPo�:er��er`F.�nal; '� `�' � �� _ �, � '80;�OOD CERTIFIqATE IS�U�L-D�y ,.. �"' � `�� .� �V ,--� ; i, � 4. .s ..�--Sti--�--rr?- �l3�=ina1 Ei;,ycri,c. . ;.� � �: ,• � �s a �'N 's: �, •� -y J ::c± - - • � „' �y ._ . . ;ri ., I : ��-:.�t x _. .- - �q:�in31 Heatin5"-& ,F5]rCo�itidn�na�- :'• E X P I R!E D 's * _, - ,'�:� o ;� -,.• :t: r+ • � � �. DJ ��iilli � � i �C < h� i 'r•.Z' i ;W � �_ .� -. ` � ��B"�ftS�QCi � . � � .- _ ,35' inal GaePi�a�Tesi� Ca� `-�. r� � � �r x co �-, +` ;�;n -r._� �� ,_ .,-, ,_:n =' =1 �'c36.�Hoc" or:Canopv,� e ❑ �'__�� .� -.:�. ;� _ cx x �� i a; n v ..^NJ�, �� r o +.-t �- m -1, L ' f > ` �`' �i "�" � y7.�., in�.� Factory fi��acea� : F�[- F ll t�` � ti I �38. Fin�} Plumb�g �:i 'Pr�i3`.' ;-.._.. a � � � i. _; � '+,� i� ---...� a i � . Fe �i '39. �Vate7 Service�Fir�i' � -• .f � i? � �� : ,.. � ,,1 �.. s u: �� -� r � ;� rtl0. Gas Service-F.�na^* �+' Cv : = + '7 � � � �: 0= 'vn% � �, �� . � i � �.� •n #� I �t ,. 4, . J � x. : 'jit. Solar pome�;c-F�'e�ls :y x" f � i, i r+ •sj'�> r• y;: �� -• b- ^ : < 42. Backf�owPrevenc�rx^ N � i 1 i� ^ �: :�=' ' ,:-i t� t� r' i 11-:-. ��i i.i= ITl [*i(ii i� �- � ^ a. C: <_[ S + ,� . ///�� `_'_ • 43. Backflow Irrtt�atio�; ',, v �; �t. .: z� /�-L/�=y^ :D�`� ^�: `j.te_�O y(�� -^:-s,-.--��c �; . ' G. L � : U4. Landsca�ie Iii'i4atibhSYster��:T!r :r, r tn � �� _,��+ ^ N n: �•:i� a :i; o �� r� .• ' ' ' -r + C; " •.� t S _. T .�_'. J �.1.T �. S '45�Sound Qtte,�ivat� � -: "�'' � * ,`1, `� r' ` .�"� ` `-��- 4. ! ^f • "S C�f .. ♦ :-. C U` e-' C ; " ' i' . . -..u''" _ CA6. :iandicapReg�latiosiC' ! � -' C• ^ � �� a: •:� Cc :S » „"+i.; .� r i �. n. p�•.J i.� � �� Y w7.�1f�'�' LSTRI'jCTU�E&�U1�.DING a r. � �' f'j, f n" � r� « ��:... 48.'SlPtiaL PLANNINC7 , -'� . :� N i � � �t ? �Ti P7 �' : - -� �� . > r. r, � • � 9. .�lec;�'ric�f�el�se co �diso7' i � � � �'�, r ;� y ;; ' � ` � Q �60.'_(iascRel6�se tn $oui��erp,�litUir,a Gas Co r. � I ` a= ^.-�t�' • �+ . -+ .. i y ' �:> ('1 Y C' U ='61.'CER4iFICATEOF�CCUPANCY ' ' = � � •• ^ r^ •- No. Date : October 10, 1994 CITY OF COSTA MESA CALIFORNIA 9262&1200 P.O. BOX 1200 DEVELOPMEN7 SERVICES DEPARTMENT Dear Costa Mesa Property Owner: In reviewing past permits, we find that work has been done on your property located at 364 La Perle Lane, Permit No. B64008, for a roofing permit. The permit is valid for 180 days from issuance or your last inspection, per Section 303 (d) of the 1991 Uniform Building Code. Should we not hear from you within 10 days, your permit will expire as stated herein and additional fees will be required to finalize the permit. Failure to final a Building Permit could possibly impact the future sale of your property. To activate the above permit, please follow these steps: 1. Telephone (714) 754-5626 or 754-5627. 2. Request an inspection; state address, permit number, and type of inspection. 3. Be sure to have working smoke detector's as required per Section 1210(a) of the 1991 Uniform Building Code. 4. Have an adult present at the property at the time of inspection to provide us access. Should you have any questions regarding this process, please contact me at (714) 754-5273. Thank you for your cooperation. Sincerely, ��a�� - o anda Huapaya�� mit Processing Specialist 77 FAIP. DRIVE Builtling Divlsion p14) 754�5273 • Cotle Enfortemen� (714) 754-5623 • Planning Oivision pt4� 754�52a5 PAX (714) 556J508 • TDD (714) 754�5244 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.�ppLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 ,lob Address: 362 LA PERLE LN Suite: Vicinity: REAR OF YARD Primary Occ: R3 Parcel Number: 42531201 npp�icant: JIM SCHWARZ Address: P O BOX 28437 Type of Construction: V-N Zoning: Status: ISSUED Applied: 10/04/2005 Issued: 10/04/2005 ----Phone: . 714-241-7665 ISSUED BY: � SANTAANA.CA ... .,'-�"�,.� 'Zip 92799::"'....... Owner: BAYS, MATTHEW WILLIAM TR Address 362 LA PERCE CN -- �� ' '. .. . ' ' . -Phone� � . ., . COSTA MESA, CA ��, ; - _ Zip 92627-3759 -< - - , -9.:°,-- �� .. . .: ..�, 'r; = ��,.� t•. ,. • _ ` ;r � . Contracroc S6HWARZ CUST,OM_PO�OL Addres's: ' P,O BOX 28437 . - , , - Phone: 714-630-6100 ' - - , � � �' � SANTAANA,-CA � �"' �` Zip: 92799 � - License: 770413 . � nrcti : ; y'' Eng: TODD L LACHER'� Address: ' � , , Address: 1201 N TUSTIN'AV ,' � , � � . ' �" � � � � �� Phone: � „ ' ' ��Phone:�.,°774-630-6A00 �?� � - - �. - , ,. " � . . ANAHEIM, CA - - . . _ Zip. .'. } ; License� ,. . ,: -- 92807 ... License: �_67656 _ �:''>,; � - � ' SCOPE OF PERMIT � '"``� °' � , ��;512SF INGROUND GUNITE POOL AND SPA FOR SFD. STANDARD POOL, SP-97-001. .� ;. , 3� , ,, � _ ��. ; ,�,.�� _ �? � �- .f ' .� ,. .. .. ': Plan Check:", .$254:31 ` ;E' ' Perrriit. �$391.25 - . ", " , SMIP Res ' ' $2 50 � SMIP Com: _ � $0:00 � � Other. �� `$0.00 � ` Inspection $0 00 • _ � � Total $648 06 #`�e FEESUMMARY � �� luation. ° Sze,000.00 ` I aluation $zs,000.00` � � �` , _ - � ., � " ... � ` � � . � r � , � �: `'' PLAND'}1NG & ZONING SETBACKS MAIN�STRUCTURE Front - 0, 0� � Rear 0 0-.--: -� • Left ., 0= 0;. Right -.0. 0-� -- ACCESSORY - Front 0-0--� °� �Rear - 0-0 - - �. LeR 0 0 ��r,� .,Right ; 0-0� - �� ... , ' l � 'P Y v _ PARKIN� Existina: - 0 Reauired. ". .0 . ' .- �Pr000sed ;Oq „ :' - , , � - ° �:'� ' � - �� ... , . . . � �i., , . . ' ✓.- ... - � ° � __._ . �._ _ i�,.<. <' `a t, �: . . � .. - .. - - F _ . NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiramenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is s� nded�or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorizad under lhis permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2a66d818�00) WORKERS'COMPENSATION DECLARATON: � I hareby effirtn under penelry of perjury one oi Ihe following declareUons: ' � ❑ I heve end will maintein e certllicete of consent to self-Insure br workers �compensaion, es provitletl for 6y section 3700 oi Iha Labor Cotle, tor ihe peAortnence of the �vP6rQfor whlch Ihis pertnit Is Issuetl. ❑ I have antl will maintan workers' compensatlon Insurance, as required by section 3700 oi Ne Labor Cotle, for t�e perfortnance ot the work tor which this pertnit Ls iswed. My workers' compensatian Insurence wrtler and policy number ere: fsrtier:�'•' PaNOYN"�umbeG'�� ecfiwr need nof be comp/etetl il the permit /s ve�ued at one hundred dollars ($100) or less.) �1 cenity thet in Ihe pertortnance ol the work for which this pertnit is issueq I shall noI employ any person in any manner so as to becoma sub�ect to tha workers' compense0on laws oi Calitamia, end agree t�at If I should become sub�ect to tha workers' compensation provislons of Section 3700 oi the Lebor Code, I s�ell forthwith comply with these provisions. 1 naa • ia a �re: .4- R\-�^-�-��i ( o • 4� �S WARMNCi: FAILURE TO SECUR WO RS' COMPENSATIIXJ WVE E IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER � O CRIMINAL PENALTIES AND QVIL FlNES UP TOONE HUNDRED TqU$M!D DOl1.ARE (f100,000),IN ADDRION TO THE COST OF COIdPENSATION, DAMAGES AS PROVIDEO FOR IN SECTION 3)OB OF iHE LABOR CODE, IMEREST, AND ATTORNE`fS FEES. LICENSED CONTAACTORS DECLARATION: I hereby aHirm ihat I em Iicensed untler provisions of Ghapter 9(commencing with Section 7000) of Division 3 of the Business and Prolessions Code, antl my license is in full ro�o�;Sa"�xa�. s a c�a -�a► G S 3 Contracto igneWre: Byt� / 0 �.4- . �'� CONSTRUCTION LENDING AGENCY: ❑ I hereby aNirtn thai there is a construction lending agency tor fhe peAortnance oi the work tor which this permit is issued. (Sec. 3097, Civil Cotle). Lenders Name: Lender's Adtlress: Signeture: Date: OWNER-BUILDER DECLARA710NS: I hereby eNirm that under penalry of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW For Ihe fallowing reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or counry which requires e pertnit to construct, elter, improve, tlemolish, or repair eny structure, Orior to its issuance, also requires the applicant tor such permit to Nle a signetl statement Ihat he or she is licensetl pureuant ta the provisions of the Contrectors License Lew (Chapter 9(commencing with Sectlon 7000) of Divlsion 3 of t�e Business and Professions Coda) or thet he or sha is exempt therefrom and the basis for the alleged eaemption. Any violatlon of Section 7031.5 by any applicant for e permlt subjects Ihe eppllcant to e civil penalry of not more Ihan five hundred dollars ($500)J: . ❑ I, as owner of Ihe property, or my employees wlth wages es iheir sole compensation, WILL DO 7HE WORK, and the siructure is no� intendad or ottered for sale (Sec. 7044, Business and Protessions Code: The Contractors License Law tices not apply to an owner of properry who builds or improves ihereon, antl who does such work himsetl or herseli or through his or har own employees, provided ihat such imprwements are not intended or ottered for sale. If, howevar, the bulltling or improvement is sold within one yeer ol complation, the owner-builder will have the burden ot proving that he or she did not build or improve tor purpase ol sale.). � ❑ I, es owner ot the property, em E%CIUSIVELV CONTRACTNG WITH LICENSED GON7RACTORS to construct iha prolect (Sec. 7044, Business and Protessions Cotle: The contractors License Law tloes not apply to an owner o1 propeny who builds or improves ihereon, and who contracts for such pmject with e wnirector(s) license pursuant to the Contractors License Lews.). ❑ I am e:empt untler sec. Business and Professions Code for Ihis reason: Signa�urB: Da�e: Owner ID verifietl 6y drivefs license. ❑ Ves ❑ Na Drivers Licensa No. Vedfication ot Ownership by (rype oi document, i.e. - properry tax bill or deed): Expires: CEHTIFlCATE OF COMPLIANCE AND AUfHORIZATION OF ENTRY: I certify under penalry ot perjury t�at I have reatl this application and state ihat the infortna6on given is correct. I egree to wmply with ell stete laws end ciry ordinences relating to building consWction, and authonza representatives of Ihe Ciry oi Costa Mese lo enter upon Ihe ebove-Cescnbad property for inspeclion purpases. I egree not to occupy or allow occupancy ot any building authorized by this permi� until final ins0ection. SigneWre Ot L� `�l �� (�ptl�Or�nmpon CQOE1, INSFECTIONTYYE 1818 F7xetl System Final FIfB PfOVentlOn 1268 Pool Spa Final 200 Final Re-Rool 201 Final BIocWReteining Wall 202 Flnal Factory Fire Place 203 204 Finel Sign Final Demolition PdIE 1tIIIDi« COOE I INSGECTION TYPE 206 Final Mechanical 20B Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuilCingiOccupancy � �$ Accnr:niren TEST SPECIMEN AND COMPRESSIVE STRENGTH DATA SHEET GROJECTNAME: B3y5 INSPECTIONfIRMORC�IENT: LtliZI05pBCf1005 PROJECT AODRE55: 3B2 Ld PBflO Ld118 INSPEGTOR'S NAME: COS12 MC52, CA INSPEClOR`5 LICENSE NO.� PERMIi NUMOER: BOS-017G7 SET IOENTIFICATION NUMBER: N(A CAST DATA (ATTACH DATA SMEET OF OTXERS WHEN AVAILABLE) CPSTOATE 11/7/�5 �ESCRIPTION Con<reta Gmul Mortar Snoluata MasonryPnsm O��ecGllNrtE CON[RAC�OR SChW22 SPECIFIEDFc�P51 2,000 CEMENTSYPE V SUBCONTRACTOR TIIFOfCB CASTBY C2d05 ADMI%TURE N/A ENGINEER Lacher NO.OFSAMPLES 2 WATERADOEO N/A CONQ SUPPLIER N/A TOTALYOS.PlACEO N/A SLUMP N/A PLnNT N/A TICKET NUMBER N/A nIR CONTENT N/A MIX�ESIGNNO. 41/Z'1 CASTTIME N/A qIR/CONC.TEMP. N/A �ocnnon u+ e�oc.: Botlom of the Swimming Pool r+ores: NR = Not Reported � Test specimens were cast using grout square boz. Results relate only to the tested specimens. , COMPRESSIVE STRENGTH DATA SPECIMEN AGEAT TEST TEST SGECIMEN�IMENSIONS�N.' �EA LOAO F�C BREAK IDENTIFICATION TEST DATE TIME 1 I � 0 SO.IN. LBS. PSI TVPE' NUMBER OAYS 5 6 ] ! (NQ 3.165 3.332 3.168 3.329 10.55 E016488A 28 12/5/05 12:18pm ---.--- 65,160 6,179 d 5.504 5.512 5.509 5.510 (�-�I E0164888 28 12/5/OS 1221 m 3.43fi 3232 3.459 3229 11.14 P 5.644 5.600 5.547 5.600 � (i.sel 64,865 5,824 d Avg. F'cze = 6,00� � c ... w:........:....n � �_...:w�F ....w I......�w n1 nnnF Innn al mi�IFninAl. d�hm....w Y- ene..:....... ��i�u �� :a.:�� 'Break rype tlesignatbn per ASTM C39 Figure 2: a=Cone, b=Cone anE SpIH, c=COn¢ an0 Shear, d=Shear, e=Columnar COMPLIANCE WITH SPECIFIED STRENGTH/COMMENTS: Complles AUTNOR $IGpATtlRE xa5 V) � ��=�',1';�f'.r*.,,.y.�.a;;,�1��1t�:,,•. �'''i� , ,i f-y , � �� < ::.. ,.r,� ,'ti. �k,. � ,� , RICHARO LUIZ 5071 IOYOIA AVENUE WESTMINSTER, CA 92683 Report of Special Inspection ?roject �'amc & Addrtss s�1CS}�S� �IOZ LA�4,Qj�4- LI°t"`��C- — �-C��iPe MtisA Pz V'�� N�.bcr �Jp'7" Q 11�01 !�spcciionTypc(s) Gunite !nspcciicn Dau(s) �1 1—�S [ j Pcriodic [ XXX J Coniinuous Dcscrib: !nspcc�io�Madc, including Locations:?ns L s; Tcs.s Madc: ?o�,=_I Inspec�ion'fimc Each Day: ion of the swimm on U--1— '_Is�, I�cros Rcqulrfng Corrcctlon, fncludc uncorrcc�cd i�cros prcviously lis�cd Co^ime :is. 't.C.-Zl. �J �1 iJ OTl To ihc bcsi of my knowledge, �ht work inspecled �i�as in accordance with the Building Dcpanmcn�. znpro�cd dcsign drawings, spcciicalio and applicable workmanship provisions of ihe U.B.C. ;xc:pi zs notcd abov . S 3"-� Datc ��— 1 Z"�O� Z.C.B.O. # P-i��.rul!.�'zmc: Richard T. Luiz RcgislrationNo 1075691-99 Concrece r'oRM s c� ;: 0 (714) 754-5273 • Fax (714) 754-4856 . www.ci.costa-mesa.��sCTRICAL PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vidnity: 362 LA PERLE LN POOL Parcel Nunmber: 42531201 Status: I SSU ED Applied: 10/04/2005 Issued: 10/0M2005 Applicant JIM SCHWARZ Address: P O BOX 28437 ., �:-:.�� -�. .- ISSUEDBY: �-�:Phone:" 714-241=7665`"�"• SANTAANA, CA . ... - - Zip • 92799 �� ... ��.. .. " E . .... .'. . , Owner BAYS MA7THEW WILLIAM TR ,' � Address 362 LA PERLE LN .� - � '� - . ,'Phone " - - � �" COSTA MESA„CA - `" Zip: 92627-3759 � _ "�-.. . . .. ��. � ... . Contrador SCHWARZ CUSTOM POOL �Address. P O BOX 28437 �� . „�-�� Phone �=.714-630-6100 �.. , , - . : � SANTA ANA, CA Zip -92799 ' , , - ... ... License:-770413. . . . .,,�„,��, . .. .. . � � � � 'g, � SCOPE�OF PERMIT=,- s;� � � _ � �� E6ECTRICA� pERMIT.FOR�512SF MGROUND GUNITE POOL AND SPA FOR SFD. -�- - � - �� • . REF# BOS-07767 - � � � � . . . � . . . �>: a - WORK TO-INCLUDE: 1 POOUSPA AND.2 RECEPT OUTLETS. - _ � - " . . . . . . , - _ . .� . . � � ,. � FEE SUMMARY � � � '° � ., � , , �,�;- � . , ,: � � ,� ' '� � a �^ Quantity - ; � � � Quanhty ` �' �s: � ..t. ISSUE FEE �$23'S0 �-�� ' . Temp Dist System'/ Lighling . $0 00: �> 0 .. ,. � � � �;= Temp service test ;` $0 00`� � - . .� ' Busway /100 fl - ' $0.00 ^;� 0 � ,d� � • .' "Res. e/c package -,$0 00'� - , ' - ° Standmg Section ' � $0 00_ i. � 0 g , , , New�.Res (1-2 units) �:$0.00. 0��--� - - - Misc Electrical Eqwpment � �� ,-�$0.00 � � �, • 0�% , ��..• � Ne�'v Res (3+unda) ��' �"�$0.00 : 0 Transformers up to 1 kva/kw $0.00 �.' :0;� ,'4 Pool/Spa- -':'.,.,;��.:$49.50�' 1 ................uptol0kva/kw �.�_$0,-00:��-�p ..; _" �,:�. LigF-iting Fi�qs ��^ • �:� � $0.00 -- 0 .... ..:up to 50 kva/kw '$0 00 �, y_ �0, ; ' � Recept Outlets, . ` � : � � �.... $2.20 - 2 ...... ...up to 100 kva/kw $0 00 -:� 0� � � , Switches ". .. . :', ....: . $0.00 - 0 :................over 100 kva/kw '$0.00 0 ' � : Non Res Appl - __ � � � � $0.00 0 - Low Voltage Equipment $0.00 ' - 0 �- _ " � Res Appl, � ' ' $0.00 0 � � - Low Volt Wiring System / Ckt $0.00.� � - 0 Service to 200a -'y$0�.00 � ' 0 - - � � • -^ ` Misc. Conduit $0.00. �,. - 0 . ' Service to 1000a �$0.00 ' ..-0�:�. b, � - °�-- Misa Conductor'-.� , , .`- $0.00� 0 - � . Service over 1000a • $0.00 0�"`� '. ' � - ' � Circus�( gen or ride) .. .: $0.00 - 0 Motors to 1 hp � _ : � $0.00 - �. �0 � - -. � Circus.(mech�ride or hghts) ' � . � $0.00 0 � Motorsto10hp -. - - '� $0.00 . �0--� � : �"� ,�. � Christmas�Tree,Stand ,� � $0.00 �' ,'0 - Motors to 50hp - ; . $0.00 �- 0.. �� ' Fireworks Stand • . - ��$0.00 �c.-� 0 Motors to 700hp �� $0:00 . - 0 � �' � � Other�Electrical �Fee ��•� ,$0.00,-. . � Motors over 100hp - $O:pO � � . 0 . � , ` - ��"- r `� ` , .. . Communication drops � $O.QO ' � F>,0 � � �Investigalion Fee, �. v„ -.$0.00, �� Sub panel to 200a $0.00 � A,' D: - �-Flan Check Fee „- �. $0.00- - Pole Light Pkg , °�$0.00 0 - .�-' " � -Reinspection�Fe'e' ." , " ��;$OAO Si9n Circuits $O.QO.,. ,.0 � ` �� - � ' Temp Pwr Pole $0.00 ' 0,'�, g,� � TOTAL CALCULATED FEES' �575.20 Intermed Pole $0.00 0 .:- � -' -. �� . -� ' - � . � �- ` nnu�¢u�rc�cnoru� nnun�r�nun NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutef.and related regulations. (Ord. No. 92-28, § 1, 12-21-92) �9 EXPIRATION: This permit shall automatically expire and become void if work is not commenced vnthin 180 days, or if work is susp _ d d or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all epplicable codes, and all required Inspeetlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration Ot this permit. FOR INSPECTIONS CALL: (714) 7545626 zaaare laoo) WORKERS'COMPENSAnON DECLARAnON: ' I hereby ettirtn undar penalty ol perjury one of the tollowing tledarations: ' ' ❑ I have and will maintein a certiticete 01 rqnsent to self-Insure tor workers' compensation, as provitled for by section 3700 of the Lebor Code, for ihe peAortnance of ihe w—o�-rk�-t�o�r which this pertnit is issuetl. ��i,pava flnd wJl maintain workere' compensatlon insurance, es requiretl 6y sectlon 3700 ot Ihe Labor Cotle, for Ihe pertortnance of the work for which Ihis permit is issued. ��My workers' compensation Insuranca ��er entl policy number ere: Cerrier.�t P � icy�� (Zhhaec(!on neetl not be completed i! Ihe Oeimi! is va/ue0 et one huntlretl dollars ($100) orless.) . � I certily ihat in the paAortnance of the work for which Ihis permit is issued, 1 shall not employ any person in any manner so es to become sublect to the workers' compensation laws of Calilomie, entl agrea that it I should become subject to ihe workers' compensation provislons oi Saction 3700 ot the Labor Code, I s�all forthwit� comply with Ihese provisions. AppN,,c�eM9-�iplfeiure: �w Da�e��^">+� "�� ' 'Q ' �% S W��ARNINO: FAILURE TO SEWRE WOW RS' MPENSATIIXJ WVERA E IS UNIAWFUL AND SHALL SUBIEGT AN EMPLOVE � CRIMINAL PENALTIES PND GVIL FINES UP TOONE HUNDRED T/IOUSAND DOLLAPE (5100,000),IN ADDRION TP THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]O60F THE LABOR CODE, IMEREST, AND ATTORNEVS FEES. LICENSED CONTRAC70RS DECIARATIaN: I hereby eHirtn Ihet I am licensed under pm�islons of Chapier 9(commencing with Section 7000) of Division 3 oMhgBusiness antl Professions Code, and my license is In tull force antl eH�ect.e.�1c.^,t• � Cla� Co'�itrect�-tgnatu�e: � Da� � � . � . �]� CONSTRUCTION LENDING AGENCV: ❑ I hereby attirtn Ihat there is a wnsWC�ion lentling agency for the pertormance of the work for which this pertnit is issued. (Sea 3097, Civil Cotle). Lentler's Nama: Lenders Address: SlgnaNre: _ Date: OWNE{YBUILDER DECLARA710NS: I hereby@ �tyi that untler penelry ol perjury Ihat I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Protesslons Cotle: Aily�city or county which requires e permit to consWcl, alter, improve, demolish, or repair any structure, prior to its issuance, also requires t�e appliwnt for suc� pertnit to flle e signed statement Ihet he or she is Ilcensed pursuant to Iha provisions of the Contradore License Lew (Chapter 9(wmmencing with Section 7000) ot Division 3 of ihe Business flnd ProlOssions Cotle) or that h9 or she is ezempt ihereirom and ihe besis for the allaged exemption. Any violation of Saction 7031.5 by eny epplicant for a pertnit subjecis the epplicarit to a civil penelry ot nP� mora than tive hundred dollars ($500).): . ❑ I, as owner of the properry, or my employees with weges es their sole compenution, WILL DO THE WORK, antl the structure is not intendad or oflered for sale (Sec. 7044, Business end Piotessions Code: The Goniractors License Lew does not appty to an owner of pmperty who builds or improves thereon, antl who does such work himsetl or herself or ihrough_bis or her own employees, pmvided ihat such improvemenis are not Intentletl or oNered tor sale. If, however, the building or improvement is soltl within one year of completion, tha owner-builder will hava the burden oi proving ihat he or she did not builtl or improve for Durpose of sale.). ' ❑ I, as owner oi ihe property, am EXOLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the projact (Sec. 7044, Business and Professions Cotle: The contrectors License Lew d�oes,nol epply to en owner of pmperty who builtls or Improves ihereon, end who contracts for such prolect wlih a contrector(5) license pursuant to tha Contractors Li�en§e�Laws.). ❑ I em eaempt under sec. Business antl Professions Coda tor this reason: Signawre: Date: Ownar ID veniied by drivers license. ❑ �es ❑ No Drivels License No. Eapires: Vedficatlon oi OwnershiD by (rype ot documem, I.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERM�T CERTIFICATION: ❑ 1 hereby certily that no excavation fiv9 (5) or more feet in depth into which a person is required to descend, will be made in connection with work euthorized by this pertnit, and thai no building siructure, scatfo�ding, talsework, or demolition or dismantling �hereot, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomla Atlministretive Cotle). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industnal Safery, as noted above, unless such person hes e permit to Co 5uch wOrk irom the tlivisian. SignaNre: Date: DiNsion of IndusMal Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AllT1�ORVA710N OF ENTAV: I certih/ untler penalry of perjury that I have read this applicaiion end state t�at ihe intormatlon given is wrreci. 1 agree to comply wlih all staie laws and ciry ordinances relating to building consWction, and euthonze representatives of the Ciry ot Costa Mesa to enter upon Ihe above-descdbed property for inspection purposes. I egree not to occupy or allow occupancy ot any building authorizetl by this permit until final inspection. 40UE �. INSYECTIONTYFE ifi18 Fizetl System Final Fire PreventioP 1266 Pool Spa Final� 200 Finel Re-Root 201 Final BIxWRetaining Wall 202 Final Fattory Fire Place 203 Finel Sign 204 Finel Demolition ' Q� IMRIALS COOEf INSPECTIONTYPE 20fi Final Mechanical 20B Final Plumbing 210 Final Elecirical 212 Final Fire Preveniion 220 Final Planning Approval 222 Final Site 250 Final6uilding/Occupancy :1'C:SLIO � � (714) 754-5273 • Fax (714) 75d-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 362 LA PERLE LN Suite No Viciniry: POOL Parcel Number: 42531201 MECHANICAL PERMIT Status: ISSUED Applied: 10/042005 Issued: 10/04R005 � ISSUED BY: N �'/ Appncanr. JIM SCHWARZ < K . Address: P O BbX 28437 ��:i- • �.. - Phone�"714-241-7665 .... SANTq ANA; CA - � Zip: ° . 92799 , , - . owner BAYS,,MATfHEW WILLIAM TR � � � � Address.� 362LAPERLELN , z- ' `' -- � - , �-_ -= _- ' ...� = Phone: � •�,� =� � COSTA MESA, CA � Zip: 92627-3759 , , � Contractor SCHWARZ CUSTOM POOL � . �, 'Address - P O BOX 28437 � � - �-' Phone �714-630-6100 � �,�, � SANTq ANA, CA Zip: . :�92799 . � S.' � , - _ License:770413 � � , ,� :� ° � � � � � � � =SCOPE OF PERMIT� „� , ., _ ?` �� - - � -MECHANICAL PERMIT-.FOR�5�12SF�INGROUND GUNITE POOL AND.SPA.FOR SFD. - �,�:7r , .` .. ��µ: ��;°REF#:BOS-01767�� ; . '�VJORK TO INLCUDE.�1 INST FAU GRATER THAN 100 K BUT. FEE SUMMARY 'i � ,,�i� � � �Quantity _ . .. _ _ _. =' ,.'' � i, i: --- Quantity_.� ISSUE�FEE��,� ` .„�$23i50 Repair/AltAbsorbtionUnit�" " -'� '-�Ig0.00� �0 . Insb.FAU�<700kBTU ,�-'��$000 0 - � �„ , � Repair/AltRe(rigerationUnit - � -�'.$0.00 0 InsfFAU >100 k BTU - - �: '$1820 1 ' ' � - - Ventillation System � ; „ . - � $0.00 0 Repair/Alt Cooling/Heat,:- �, ��•�� $000 - 0 . . ,. � � , � � :.Evaporative��.Cooler �� - ' .$0,00 0 , . Inst/�Rep. Recess WalfHtr . � $0.00 0 - Commercial Incinerafor � � � - $0.00 0 Refrig-Sys <700 k BTU��, �:.,, $0.00 0 Domestic Incinerator . $0:00 � _0 - Refrig Sys >100 k BTU' -' -- �$0.00 0 Compiessors / Absorption Svstems � �' � - - � Gas Piping �, �� -'�$0.00 0 Up to 3�hp / 100 k BTU . °r �_$0.00' 0 - Factory Fireplace ' � � � �� -_ $0.00 0 . 3 To 15 hp / 500 k BTU : �� $0.00-- 0 � . -- Hood w/Mech�Exhausl .` :�; $0.00 0 � 15 To 30 hp / 1,000 k BTU • . ' '$0.00 0 VAV Box - � _; , $0.00 0 . . - _ 30 To 50 hp / 1,750 k BTU - - $0.00 � 0 Vent Fan ! Single Duct•. . .' � $0.00 0 � � - .OJer 50 hp / Over 1,750 BTU � - . $0.00 �+' 0 Appliance � � " • $0 00 0 - � - .�Boilers � - Fire Dampers � - � � $0 00 � 0, -�,; _ , ' '� :Up to 3 hp _, � % $0.00 0 Smoke Dampers � - $0 00 0 -�- - � � . �„ � �- 3 Tod5�hp - �� $0.00� 0 Inst or Relocate�Appl Vent� $0 00 0--. - -+� � 15 to 30.hp,�' -.. _ ;$0.00 - 0 Air Handlers < 10000c(m - � $0 00 0 z. . - � �."30 to 50 hp ` �� . - � ."" $0.00 0 Air Handlers > 10000cfm . $0 00 0 ' - - -: �:- Over 50 hp.��;: . - � ' ; $0.00 0 Floor Fumace ,,, $0.00 . 0 ' , � '- Other Mechanical Fee �� -' Floor or Suspend Heater� • �� $0 00, - �0. , ' - �- -- Investigation Fee � �. , � $0.00 �� - � �• PIan,CheckFee=� '� � �.� $0.00 � � � � _ � . - • Reinspection Fee: ; ' $0.00 � _ :�.e >',.. � � � , . � � '707AL CACCULATED FEES E41.70 COMMENTS9-SPECIAL CONDITIONS NOTICE: The �work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspend� or abandoned for a period of 180 days. INSPEC710NS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all licable codes, and all required Inepectlona and tinal approval must be obtained. Failure to obtain inspactions and final approval will result in the ex�' tion of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaas-ae (a�oo� WORKERS'COMPENSAnON DECLARAnON: � I �ereby aHirtn under penalry oi perjury one of tha tollowing tleclarations: � , ❑ I have end will maintain e certificete oi consent to self-Insure tor workers' compensation, es provitletl tor hy section 3700 0l the Lebor Code, for ihe pertormance ot Ihe ;�e�^T work tor which this pertnit is issued. 'p I have end will maintflin woAcero' compensatlon Insurence, as required by section 3700 of tha labor Code, tor ihe pertortnance oi Ihe work for which Ihis permit is issued. My warkers' compensatlon Insurance certier end policy num6er ere: /Cerner� `-\� ppliiy;7u� ��iti�l��need nof be complefe011 the permit is va/uetl a( one huntlred Dollars ($100) or less.) . � 6X I ceNty that in Ihe peAortnance of the work for which this permit is issueQ I shall not employ any person in any manner so as ro become subject to tha workers' �� compensetion lews ol Celifornis, entl e ree that tl I should become sublect to Ihe workars' compensation provisions oi Sectlon 3700 of the Lebor Code, I s�ell forthwith comply with these proNslon Ap��liaem+�9'1�!§I�Tre: � �L - " ' ate: _ / � ' �{ • O S WMNINO: FAILURE TO SEWRE ORKER COMPENSATION COVEM NLFWFUL AND SHAl1 SUflIEGT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED T/qUSANDDOLLARE(5100,000),INADDITIdJTOTHECQSTOFCAMPE ATIIXJ,DAMAGESASPROVIDEDFORINSECT1qJ3lO60FiHELABORCODE,INiEREST,ANDATTORNE`f$FEES. LICENSED CONTRACTORS DECLARATION: I hereby�eflfiri?the -�am Ilcensea under provislons of Chaptar 9(commencing with Section 7000) of Dlvision 3 ota e Business antl Professions Code, end my license Is in full torce entl'eflect. uc. a 1 Ciess N � !" S� � orrtrsC�Igp}hu� d.�.: �_ �_� ��..C� � � C 0 CONSTRUCTION LENDING AGENCV: ❑ I hereby aflirtn that there is a construction lendinq egency br ihe pedormance of the work for which ihis pertnit is issuetl. (Sec. 3097, Civil Coda). Lenders Name: Slgnature: _ Lenders Address: Date: I hereby aHl t�under penelry ot perjury that I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business end Professions Cotla: Any ciry wunry which requires e permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant 1or suc� permit to tile a signed slatement �hat he or she is Iicensed pursuant to the provislons of Ihe Contradors License Lew (Chepter 9(wmmenGng wlth Sectlon 7000) of DlNsion 3 ot the Business end ProFeui�3lCotle) or that he or she is exempt thereFrom and ihe besis for the allaged exemption. Any violation of Section 7031.5 by any applicant for e permit subjecis Ihe epplicant ta'�civil penalry of not more than tiva hundretl tlollars (5500).): . ❑ I, es owner of the property� �or my employees with wages as t�eir sole compensation, WILL DO THE WORK, and tha sWCWre Is not imended or oHered for sale (Sec. 7044, Business and Prol�s5ions Code: The Contradors License Law tloes noi apply to an owner oi property who builds or improves Iheraon, antl who does such work himselt or hersetl or through his;or her own employees, provided that such impmvements are not intentled or ottered tor sale. tl, however, ihe building or improvemem is soltl within one year ot completfori?the owner-6uilder will have ihe Durden of proving ihat he or she ditl not build or improve for purpose of sale.). ' ❑ I, es owner of the property, am EICCLUSIVELV CONTRAC7ING WI7H LICENSED CONTRACTORS to consiruct ihe pmject (Sec. 7044, Business and Pmfessions Cotle: The contrectors License Lew doee�t epply to en owner ot property who builds or Impmves thereoq antl who comracts for such projact with e comracror(s) license pursuant to Ihe Conirectors Licen e Laws.). �A" ❑ I am exempt under sac. •U' Business and Protessions Code for ihis reason: Signeture: Date: Owner ID veritiea by tltiveYs Ilcensa. ❑ Ves ❑ No Dnver'S LiCenSe No. Ezpires: Vedfication oi Ownership 6y (type oi tlocument, i.a. � property tax Dill or deed): DIVISION OF INDUSTRIAL SAFETY PEflM1T CERTIFICATION: ❑ I hereby certify Ihat no excavation tive (5) or more feet in depih into which e person is required to tlescentl, will be made in connection with work euthonzed by this permit, entl ihat no building structure, scattolding, falsework, or demolition or tlismaniling ihereot, will be more ihan thirty-six (3fi) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title B, Califomie Adminisiretive Code). ❑ As owner-builder, I will not employ anyone to do work which woultl require e permit from the Division ot Intlusinal Safery, es noted above, unless such person has a permit to do such work from the division. SigneWre: Date: Division ol Industrial Safery Permit Number: CERTiFlCATE OF COMPLIANCE AND AUTHORVA710N OF ENTRY: I certity under penalry of perjury ihat I have read this ep0lication end state Ihat ihe intormation given is correct. I agrae to comply with ell state laws and ciry ordinances relating to building construction, and euthonze representatives of the Ciry of Costa Mesa to enter upon the above-dexnbed property tor inspection purposes. I egree not to occupy or allow occupancy oi any building authorized by this permit until final inspection. CODE �. INSPECfIONTYYE 7818 FIxeC System Final Fire Prevention 1268 Pool Spe Final 200 Finel Re-Roof 201 Finel Block/Retalning Wall 202 203 204 Final Factory Fire Place Finel Sign Finel Demolitlon Owner(s) A"pplicant � •'. PAg �i COUEI INSPECTIONTYGE 20fi Final Mechanical 208 Final Plumbing 210 Final Elecincal 212 Final Fire Prevention . 220 Final Planning Apprwal 222 Final Site 250 FinalBuilding/Occupency n � W� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��s MBING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: $G2 LA PERLE LN Suite No Vicinity: POOL AND BBQ Parcel Nunmber: 42531201 npplicant: JIM SCHWARZ Address: P O BOX 28437 »r SANTA ANA, CA ' --°' ..<,-_: ,� „ f. � Phone 71�4-241 7665 � " � ; ;'Zip. �•.92799 � ... owner: BAYS;�MATTHEW WILLIAM TR � � �� 92627-3759 Address 362 LA PERLE LN ,.. -� _ a ; . �"..,- . Phone: , .... r;::.- . COSTA MESA; CA" - Zip: Contractor. SCHWARZ CUSTOM POOL � Address. P O BOX 28437 - � _ Phone . �714-630-6100 � -' SANTA ANA, CA Zip :92799 � 4 � , ,License 770413 �.. . : _ , .., , . . . .. �- .. -'s t ' '- __ _. . 'Ir�,.,. Status: ISSUED Applied: 10/042005 Issued: 10/04/2005 ISSUED BY: /(/U/ , � ,� � � � - `_ ' SCOPE OF PERMIT � � t, .�; �' � PWMBING PERMIT FOR 512SF INGROUND GUNITE POOL A• GAS FOR BBQ FOR�SFD. �'� � ' � ,- e �.... ,'. REF#. B05`-�01767 . , . ' . ;^ �` -_, , y r�'_> . .. ... ..:. . . . . _ . .. � _ . � WORK TO INCLUDE: 1 GAS�(1-4 OUTLETS); 1 P-TRAP, t SWIMING POOL AND 1 PRIVATE-SPA . _ . FEESUMMARY._ _ , � ,F . A�N7 pTY � � AMT QN �, `,. , �' AMT ', QTY ISSUE FEE " � _� $23.50 � Laundry�Tub /,Washer . $0 00= � 0 Sump`Pump � " � - $0.00 � .0 Back((owirrigation . $0.00 �"'0� -. -Landscapetrrigation , � $000` 0 --�.''�Swirtiming.Pool ;.'t�' '�$60J5 -� ��1 Backtlow Preventer r $0 00 �� , "::.0 � ' � P-Trap �� ,.. $9.80-- ' 1 -� � -- -��-- ; 7rap,Primer � � •- $0:00 �-0 Bathtub : -- - $0.00 . , 0-�� Pressure Regulalor $0.00 ' 0 Unnzl �• � ,,.'�,� . � $0.00 -. .0 Clarifier System � �$0 00 � �....0 - Process Piping (per 10 k) � $0.00 - 0 : Vacuum�Brkr BkFlow(1-0), n- .. $0.00. • �� 0 Connecl Qce,Soda etc) �� ,�.�: $0 00 ' � �- 0 Receptors : $0.00 �� 0 Vac"uum.Brkr Bkflow(S+)��., . $0.00-� . � 0 Dental Units - �,-.$0.00 ; � � � 0: Seplic Tank - $0.00 �0 Wash Basin � ' '�' $0.00� 0 Dishwasher - ��$0 00 :,. ;. 0� Sewer Cap for Demo �- $0.00 0 Wash�Basin SeT " �$0.00 0 Drain, Floor � --� $0.00 �, 0�� Sewer Connect � - � 50.00 0 Waste and Vent System r�� $0.00 0 Drain, Rainwate( $0.00 ��. 0• Sewer Private Line , "�$0.00 0 Water Closet (Toilep -$0.00 0 Drain, Roof � � $0.00 - �0-. Shower . � , $0.00,,; . , 0 Water Heater / vent � ; $0.00 0 Drinking Fountain � $0 00 , . -�0 �; Sink„bar. - - $0 00 ` �. A -'<;Water Piping (Inst or Rep.).. '�$0.00 0 Expansion Tank $0.00 �� -��-0 , . Sink, commercial ' $0 00 � --"0 � ' Water Re-pipe - - --$0.00 0 Gas Earthquake Valve .�$0.00 �� 0 Sink, Floor �. $0 00 ,.-:0 :,` Water Service -$0.00 0 Gas(1-4outlets) ' _$6_15-- 1 „�;,y�� Sink-kitchen'> ; ; ",- 5000 �.0 , "'�"4VJater�3oflener ° $0.00 0 Gas (Over 4 outlets),- .�. � $0.00- "-� -0 � �� Sink; service/mop " � - � $0 00 �°2,0 OTHER - . $0.00 GasRepipe ' �_ -. $0.00-- -� 0 �'---��Spa(private) -, � $3025 ;:: °1 �� ,:VIOLATION - $0.00 Gas Service --,$0.00--= 0 •� ;s�.,,, Spa (public)-' . .' _ ' -_ $0.00 �-� 0 � � "�.PLAN CHECK � $0.00 Interceptors(Grease,0ilj`�:,$0.00 0 - � =,.'.REWSPECTION $0.00 0 Interceptors (Sand Auto ) $0.00 �, . , 0 �� _ - - - • ' . � - ' TOTAL CACCULATED FEES: §730.45 a, COMMENTS / SPECIAL CONDITIONS- ' NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) ^� EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is s�nded or abandoned for a periotl of 1 BO days. INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspectiona end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 zens�ae lwoo) •�t WORKERS'COMPENSAnON DECLARAnON: � I �ereby aHirm under penelty oi perjury one oi the lollowing tleclarations: ❑ I have and wlll maintaln a certifiwte oi consent to setl-Insure for workers' compensatlon, as provided for by section 3700 of the Lebor Code, for Ihe pertortnence of the work for which lhis pertnit is Issuetl. ❑ I have antl wlll melnttin workers' compensation insurance, es requlred by sectlon 3700 ot ihe Labor Cotle, for the peAortnance of the work for w�ich ihis pertnit ISlssued. My workers' compensatlon Insurence cerrier and pollcy number ara: Cartier: Policy Number: (fhis sed/on need no( be completed i! fhe pe�mit is veluetl at one hundred dollars (Sf 00) or less.) d✓ I cenity that in t�a pedormanca ot ihe work tor which this pertnit is issued, I shall not employ any person in eny manner so as to become subject to the workers' �t compensetion laws of Califomia, end agrea that it I shoultl bewme subject to the workars' compensation proWsions at Section 3700 of the Labor Code, I shell fonhwith Comply wilh Ihese provi5ions. Applicant Signeture: � � Date: / � �'4 ^� � WARNINp: FAILURE T0 $EWFE WORK RS' ENSATIIXJ COVERAGE IS UNLA D SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED TIIdISAND DOLIME (S10U.000�. IN ADDfT10N TO THE CO5T OF COAIPENS4TION, OAMAGES AS PHOVIDED FOR IN SECTION 3106 OF THE LABOR CODE, IMEPEST, AND ATTORNEI^5 FEES. LICENSED CONTRACTORS DECLARA710N: I hereby ettirm that 1 am Ilcensetl untler provisi[ torce ena enect. uc. a —7—�� 4 Cantractofs Signeture: d� Chapter 9(commencing with Section 7000) oi Division 3 ot the Business and Professions Code, entl my license is in full Class a C_� 3 Date: � `c • t� • G'C CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn that Ihere is a construction lending egency for the peAortnance of the work tor w�ich ihis permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lendefs Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirm Ihet untler penalry ol perjury thet I am EXEMPT FROM THE CONTqACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business entl Professions Code: Any ciry or counry which requires a permit to construct, alter, impmve, tlemolish, or repair any siructure, pnor to its issuance, also requires the applicant tor such permit to file e signetl stetement thet he or she is licensad pursuant ta the pravisions ot �he Conirectors License Lew (Chepter 9(commencing with Section 7000) 01 Division 3 of the Business end Professions COCe) or ihet he or she is exempt thereirom and Ihe basis for t�e allegetl e:emption. Any violation oi Section 7031.5 by any epplicent for e pertnit sub�ecta the applicent to a civil penalry of not more Ihan five hunOreO dollers ($500).): ❑ I, es owner ol the properry, or my employees with weges as Iheir sole compensation, WILL DO THE WORK, and the siructure Is noi intentle0 or otteretl for sele (Sec. 7044, Business e'�Protesslons Code: The Coniractors License Law does not apply to an owner oi properry who builds or improves ihereon, and who tloes such work himseN or herselt Ahrough his or her own employees, provided ihat such improvements are not intended or ottered for sale. If, however, the building or improvement is soltl within one yea cnmpletioq the owneabuilder will have Ihe burden of proving that ha or she did not build or imp�ove for purpase of saleJ. ' ❑ I, as owner ot the p� , am E%CLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to consiruct the project (Sec. 7060, Busin85s and Prolessions Code: The wntrecio 'cense Law does not appty to an owner of propeny who builtls or Improves thereon, and who contracts for such pwject with a coniractor(s) license pursuam to the Contr oys �cense Laws.). ❑ I am exempt under sec. � Business end Professions Code for t�is reason: Signature: r � Date: Owner ID venfied Oy tlriveYs license. ❑ No DriveYs License No. Expires: Vedflceiion ol Ownership by (rype ot tlocumem, i:6ljTproperty,tyc bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICAT�tl� 0 I hereby certity that no eacavation five (5) or more teet in dep h into which a person is required to descend, will ba matle in connection wi�h work aut�onzed by this pertnit, and ihet no building structure, scaflolding, talsawork, or demolition or dismantling ihereot, will be more than �hirty-si: (36) teet hig�. (Chap. 32, Gry 2, Atl 2, Sec. 341, Title 8, Celifornia Adminisirative CoOe). � As owner-buildar, I will not employ anyone to do work which would require a permit irom the Division of Industnel Safery, as noted ahove, unless such person hes e permit to tlo such work trom Ihe tlivision. SignaNre: Date: DiNslon of InCusMal Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORVA710N OF ENTRY: I cenity under penalry of perjury that I have read this epplication entl state that ihe information given is correct I agree b wmply with ell stata laws and ciry ordinances relating to building consiruction, and euthonze represeniatives of the Ciry of Costa Mesa to enter upon the ebove-0escnbed property lor inspection purposes. I egree not �o occuOY or ellow occupancy of any building authorized by this pertnit until finel inspection. Signatur 1 L al Owner(s) Date /O 'l-1 • a� An r Au honzed Applicanl � ate —� COUE t. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1288 Pool Spa Final 200 Finel Re-Rooi 201 Final BIaWRetaining Well 202 Final Factory Fire Place 203 Finel Sign 204 Finel Demolition 2A� U�JdI.@ COOE 1 INSPECTION TYVE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy Q� It�LS O�p F 4 � 0 > r J •�nm��.N°� � - CITY OF COSTA MESA BIIILD/NG DIV/S/ON DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-5273 • Fa�c (714) 754-4856 BUILDING PERMIT Job Address: 362 LA PERLE LN Suite: Vicinity: BEDROOM & HALLWAY AREA Parcel Number: 42531201 Applicant: COLLINS, RON Address: 3908 CALLE REAL SAN CLEMENTE, CA Owner: BAYS, GERALD R TR Address 1060 LA SOMBRA DRIVE SAN MARCOS, CA Contractor. COLLINS CUSTOM BUILDERS Address: 3908 CALLE REAL SAN CLEMENTE, CA Zip: 92672 ,4rcn : LA COMBE, DARLENE Address: 2022 ORCHARD DR. NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Zoning: . � ISSUED BY: Phone: (949)661-8493 Zip: 92672 Phone: Zip: 92069 Phone: (949)661-8493 License: 368900 Eng: Address: Phone: p14) 9713016 NEWPORT BEACH, CA Zip: 92660 License: SCOPE OF PERMIT 120 SF ADDITION & REMODEL TO CONVERT EXISTING DUPLEX INTO SINGLE FAMILY RESIDENCE. Status: ISSUED Applied: Ot/04/2000 Issued: 02/182000 Phone: License: TWO CAR GARAGE EXISTING AND CONSIDERED LEGAL NON-CONFORMING. ALTHOUGH 3-BEDROOM UNIT REQUIRES 4 PARKING SPACES, NO PARKING WILL BE LOST AS A PART OF THIS REMODEUCONVERSION AND THE SITE IS BEING BROUGHT INTO CLOSER CONFORMANCE WITH PARKING STANDARDS SINCE ONE UNIT IS BEING REMOVED. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $385.94 $593.75 $4.50 $0.00 $0.00 $0.00 $984.19 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 Rear 6-2 Rear 0-0 FEE SUMMARY Calc Valuation: Sas,000.00 Claim Valuation: $as,000.00 PLANNING & ZONING Left 0- 0 Right Lett 0- 0 Right 5- 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. � INSPECTIONS: In order tor ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all I required Inapeetlona antl final approval must be obtained. Failure to obtain inspections and final approval will result in �he expiration ot this permit: FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSAnON DECLARAnON: I hereby attirm untler penalry of perjury one ot �he following declarations: ❑ I have and will maintain e certificate of consent to self-Insure for workers' wmpensation, as provided tor by section 3700 of the Labor Code, for ihe pertormance of the work for whiCh this pertnit is issuetl. - ❑ I have antl will mainlain workers' compensation insurence, as required by sactlon 3700 of Ihe Labor Code, for ��e pedortnance of Ihe work for which this permit is issuetl. My workere' compensation Insurance carrier and policy number are: Carner: Policy Number. (This sectlon need no( be comp/e(etl il the permif Is velued at one huntlred Uollers ($100) or less.) c rWy that in the peAortnance of the work tor which this permit is issued, I shall not employ eny person in any mannar so as to become subject to Ihe workars' rti�pensa�ion laws of Califo antl ree that if I shoultl become subiect to the workers' compensation provisions of Section 3700 of Ihe LaDor Code, I shall torihwith �wgna'wr�se provision . � Date;; _ �/ � (Y � WARNING: FAILURE TO SEGURE WORKERS' COMPENSATION COVEMGE IS UNLAWFUL AND SHALL SUBIECT AN EMPL R TO CRIMINAL P NALTIES AND qVIL FINES UP TOONE HUNDRED THOUSAND OOLLAFE (5100.000). IN ADDITION TO iHE COST OF COMPENSATION, DAMhGES AS PROVIDED FOF IN SECTION 3]O60F THE IABOR CADE, IMEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS DECLARATION: I hereby atlirm th d u�Qergw v�ip n�S of apter 9(commencing with Section 7000) of �ivision 3 fo¢e antl eNeci. 'c. #��` /� S. b 71 '1 � � Cotle, and my license is in full CONS7RUCTION LENDING AGENCV: ❑ I hereby aHirm Ihat Ihere is a conslruction lentling agency for �he pedormance of Ihe work for which ihis permit is issuetl. (Sec. 3097, Civil Code). Lendels Name: Lendels Atltlress: Signeture: Date: OWNER-BUILOER DECLARATIONS: I hereby aHirtn Ihat under penalry ot perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Busineu and Professions Code: Any ciry or couniy which requires a pertnit to conswc6 altar, improve, demolish, or repair any s�ructure, pnor to its issuance, also requires the applicant tor such permit to file a signed statement Net he or she is licensed pursuant to Ihe pmvisions of the Contractore License Law (Chapter 9(commencing with Section 7000) ot Division 3 oi Ihe Busineu and Protessions Code) or thet he or she is exempt theretrom and Ihe basis for ihe allegetl exemption. Any vlolation ot Section 7031.5 by any applicem tor a permit sub�ects the epplicant to e clvil penalry of not more than five hundretl dollars (5500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO 7HE WORK, and the strucWre Is not intended or oMered for sale (Sec. 7044, Business and Professions Code: The Coniractors License Ww dces not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided ihat such improvements are not intendetl or oHeretl for sale. If, however, ihe builtling or imprcvement is sold wi�hin one year of comple�ion, the ownerbuiltler will have the 6urden oi proving that he or she did not build or improve for purpose of sala.). ❑ I, as owner ol the pmperty, am EXCLUSNELV CONTRACTING WITH LICENSED CONTRACTORS lo consiruct the project (Sec. 7044, Business and Professions Cotle: The comractors License Law does not apply to an owner of property who builtls or improves ihereon, and who contracts for such project with a comractor(s) license pursuant to the Coniractors License Lews.). ❑ I am exempt under sec. Business and Professions Cotle for ihis reason: Signature: Date: Owner ID venfied by dnver's license. ❑ Yes ❑ No Dnver's License No. Verifiwtion of Ownership by (type oi document, i.e. - propeny taz bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMI7 CER7IFICATION: Expires: ❑ 1 hereby certiry that no excavation five (5) or more feet in depth into which a person is requlred to tlescend, will be made in connection with work authonzetl by Ihis permi6 end that no builtling sirucNre, swHolding, falsework, or tlemolition or tlismantling thereof, will ba more ihan thirty-six (36) feet high. (Chap. 3.2, Grp 2, An 2, Sec. 341, Ttle 8, Calilomia Atlministrative Code). ❑ As owner-builder, I will not employ anyone to do work which would requlre a permit irom Ihe Division of Industrial Safery, as noted above, unless such person has a permit ta do such work from the tlivision. Signature: Date: Division of InduS�rial Safety Permil Number: CERTIFlCA7E OF COMPLIANCE AND AUTHORIZA710N OF EN7HY: I certify untler penalry of perjury Ihat I have read this applica�ion antl state ihat ihe information given is correct. I agree to comply with all stare laws and city ordinances relating ro 6uilding construction, antl authorize representatives oi the Ciry oF Cwta Mesa to enter upon the ebove�aescnbetl property lor inspection purposes. I egree not to occupy or allow wcupancy of any building authorizetl by Ihis permit until final inspection. CODE �. INSPECTIONTYVE 1616 Fixed System Final Fire Prevention i266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Feciory Fire Place 203 Final Sign 204 FinalOemolition 2d46-d6 Q/yFT NTLRI� CODEI LNSPECTIONTYPE _ . . 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final FIrB Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy � s S Oa INTRIALS (714) �54-5273 • Fax (714) 754-4856 Job Address: Suite No Vicinity: Parcei Nunmber. Applicant: Address: � 362 LA PERLE LN 42531201 RON COLLINS CITY OF COSTA MESA BU/LDING DIV/SION DEVELOPMENT SERVICES DEPARTMENT PERMIT ELECTRICAL PERMIT Owner: BAYS, GERALD R TR Address 10601A SOMBRA.DRIVE SAN MARCOS, CA Contractor: COLLINS CUSTOM BUILDERS Address: 3908 CALLE REAL SAN CLEMENTE, CA Phone: 949-661-8493 Zip: Phone: Zip: 92069 Phone: 493-6520 Zip:- 92672 License: 368900 NUMBER 0130 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 02/18I2000 Issued: 02l18/2000 ISSUED BY: � SCOPE OF PERMIT � 120SF ADDITION AND CONVERSION OF DUPLEX TO SFR, RE:B00-00007, INSTALI 1A/C UNIT, 16FIXTURES, i50UTLETS, 13SWITCHES, 1'-200AMP SERVICE. ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting �Fixts Recept Outlets Switches Non Res Appl _ Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1hp Motors to 10hp Motors to 50hp Motors to 100hp Motors aver 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole $23.50 $0.00 $54.50 $0.00 $0.00 $0.00 $17.60 $1 fi.50 $14.30 $0.00 50.00 $30.50 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 Quanlity 0 0 0 16 15 13 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY =-- i Temp Dist System / Lighting Busway /100 ft Standing Section - - ' Misc Electrical Equipment � Transformers up to 1 kva/kw . . .......:.._....up to 10 kva/kw .................up to 50 kva/kw ....::...........up to 100 kva/kw � � ..................over 100 kvalkw Low Voltage Equipment Low Volt Wiring System / Ckt Misc. Conduit Misc. Conductor Cirws ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantity $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 $0.00 ' 0 $0.00 $0.00 50.00 $0.00 TOTAL CALCULATED FEES E156.90 COMMENTS / SPECIAL CONDITIONS INOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements undei California statutes and related regulations. (Ord. No. 9248, § 7, 12-27-92) , EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned I for a period of 180 days. INSPECTIONS: In order for ihe work authorized under �his permit to be considered legal, such work must comply with all applicable codes, and all � required Inspectlone and final approval must be obtained. Failure to obtain inspections and (inal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � � y WORKERS' COMPENSATION DECLARATION: I hereby attirtn under penalry of parjury one oi the (ollowing dedarations: ❑ I have antl will maintain a certificate ot consent to self-Insure for workers' compensation, as provitletl tor by section 3700 of the Labor Code, for �he pertormanca of tha work for which Ihis permit is issued. � ❑ I have antl will maintain workers' compensation insurance, as requiretl by section 3700 ot ihe Labor Code, for ihe peAortnance of lhe work for which ihis pertnit is issuetl. My workers' c.oym�Densation Insurence carrier and poliCy number are: �/� �� Cerrier. S I i�i �i C�LM��ltiSLIJ-A�P-YR / PolicyNumber. �`T d (This section neetl not be completed i! the permrt �s valued af one hundred Collars (S f ) or /ess.) ❑ I certiy that in tha peAormance of �he work tor which Ihis permit is issued, I shall not employ any person in any menner so as to become subject to the workers' compensation laws ot Califo , and a ree thei if I should become subjeci b the workers' compensation provisions oi Section 3700 ot t�e LeDor Cotle, I shall fotlhwith com0ly wiih these provision r� Applicant Signature: � / Date: a/ WARNINGFWWRETOSECUREWORKERS'COMPENSATIIXJCOVEMGEISUNLAWFULPNDSHALLSUBIECTANEMPLOVERTOCFIMIN PENALTIE ANDGVILF�NESUPTOONEHUN�RED THOUSNND DOLL4RE ($100,000�. IN ADDITIIXJ TO THE COST OF COMPENSATION, DAMAGES PS PROVIDED FOR IN SECiION 3106 OP THE LABOR CODE. IMEREST, AND ATTOiiNEYS FEES. IICENSED CONTRACTORS DECLARATION: I hereby affirm that I em torce and eftect. Lic. a_ Contrepors SignaWre: of Chapter 9(commencing wiih SeciiotN000) of Division 3 oi the Business and Professions Code, antl my license is in full � Class # 2 ""l / — � � Data: �" � �� . CONSTRUCTION LENDING AGENCY: ❑ I hereby aNirm that ihere is a consiruction lentling agency for Ihe Derformance oi the work for which this permit Is issued. (Sec. 3097, Civii Code). Lenders Name: Lentlels Atltlress: , SignaWre: Date: OWNER-BUILDER DECLARA710NS: I hareby aflirm iha� under penalty ot perjury that I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires a pertnit to construct, alter, impwve, demolish, or repair any siructure, prior to its issuance, elso requires the applicant tor such pertnit to file a signed statement Ihat he or sha is licensed pursuant ro the provisions ot ihe Con�rectors License Law (Chapter 9(commencing wlih Section 7000) of Division 3 of the Business antl Prolessions Cotle) or that he or s�e is exempt therelrom and the basis for t�e allaged exemption. Any violation of Sedion 7031.5 Dy any applicant for a pertnit sub�ecis Ihe epplicant to a civil penalry of not more than five hundred Collars ($500).): ❑ I, as ov+ner of the propeny, or my employaes with wages as their sole compensation, WILL DO THE WORK, and Ihe structure is not intended or oHeretl for sale (Sec. 7064, Business antl Prolessions Cotle: The Contractors License Law does not apply to an owner of property who Duilds or improves ihereon, and who tloes such work himself or herseli or through his or her own employees, providetl that such improvements are not intended or ottered for sale. If, however, the builtling or improvement is sold within one year oi completion, the owneo-builder will have the burden of proving that he or she tlitl not 6uiltl or improve for purpose of sale.). ❑ I, as owner of ihe propeRy, am E%CLUSIVELY LONTRACTNG WITH LICENSED CONTRACTORS to consiruct ihe project (Sec. 7044, Business end Professions Code: The contractors License Law tloes not appry to an owner of property who builtls or improves ihereon, and who comracis for such project with e contrector(s) license pursuant to the Comraclors License LawsJ. ❑ I am exempt untler sec. Business antl Professions Code tor this reason: Signature: Date: Owner ID varifietl by tlriver's license. ❑ Ves ❑ No Dnver's License No. Verilication ot Ownership by (type of doamen�, i.e. - property tau bill or deetl): Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity that no excavation five (5) or more feet in depth into which a person is required to descentl, will be matle in connection with work aulhorized by ihis permit, antl ihat no builtling sWCNre, scattolaing, falsework, or demolition or dismamling thereof, will be more ihan ihirty-si: (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tiile B, California Administrativa Code). � ❑ As ownar-builder, I will not employ anyone to ao work which would require a permit from the Division of Indusirial Safery, as noted above, unless such person has a permit ro do such work tmm �he division. Signeture: Date: Division ol Industrial Safery Permit Number: CERiiFICATE OF COMPLIANCE AND AUTHORVATION OF ENTRV: I cenity under penalry ot perlury that I have read this application and state ihat Ihe information given is correct. I agrea to compty wiN all state laws and ciry ortlinances relating to building constmction, and authonze represenlatives of the City of Costa Mesa ro enter upon Ihe above�describad pmpeny for ins0ection puryoses. I agree not ro occupy or allow occupency ot any 6uilding amhorizetl by this permit until tinai fnspection. awre Oi Leg �- t� D�G AnNOr Authorized ADPlicant � �^� CODE Y. INSVECTIONTYPE 1616 FiKetl Syslem Final Fire Preventian 1266 POoI Spa Flnal 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 203 204 26a6-4fi Final Factory Fire Place Final Sign Final Demolition PLIE nrtmnLS COUE� INSPECTIONTVPE 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 FinalBuilding/Oaupancy � NiiTIAL y*p M6 4 � o. > _ r J �,ro.ano �,; (714) 754-5273 • Fax (714) 754-4856 Job Address: Suite No Vicinity: Parcel Nunmber: Applicant Address: 362 LA PERLE LN 42531201 , RON COLLINS CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT PLUMBING PERMIT Owner: BAYS, GERALD R TR Address ' 1060 LA SOMBRA DRIVE SAN MARCOS, CA Contractor: COLLINS CUSTOM BUILDERS Address: 3908�CALLE REAL SAN CLEMENTE� CA Arch / Eng : Address: Phone: 949-661-8493 Zip: Phone: Zip: 92069 �Phone: 493-6520 Zip: 92672 License: 368900 Phone: Zip: � License: , � � 77 FAIF DRIVE, COSTA MESA, CA 92626 , Status: ISSUED Applied: 02l18/2000 Issued: 02/18/2000 ISSUED BY: � SCOPE OF PERMIT : 120SF ADDITION AND CONVERSION OF DUPLEX TO SFR, RE:B00-00007, INSTALL 16ATHTUB, iGAS OUTLETS, 1 LAUNDRY TUB, 1 KITCHEN SINK, 2WASH BASINS, 2WATER CLOSETS. � ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifer System Connect Qce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-0 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Aulo ) AMT $23.50 $0.00 $0.00 $9.80 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $6.15 $0.00 $0.00 $0.00 50.00 $0.00 QTY 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 FEE SUMMARY - AMT Laundry Tub / Washer $9.80 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator � $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 SewerCapforDemo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower � $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor � ' �$0.00 Sink, kitchen $9.80 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 1 0 0 0 0 0 0 0 0 0 0 0 0 ' 0 1 0 0 0 COMMENTS / SPECIAL CONDITIONS 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 RepJ Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $19.60 y0.00 $0.00 $19.60 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $98.25 QTY 0 0 0 0 0 0 2 0 0 2 0 0 0 0 0 C NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoneOd tor a period of 180 days. INSPECTIONS: In order for the work au�horized under this permit to be consideretl legal, such work must comply with all applicable codes, and all required Inapeetlons and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this� rmit. FOR INSPECTIONS CALL: (714) 75h5626 y � WORKERS' COMPENSATION DECLARATION: I hereby attirm under penalry ot perjury one of the tollowing declarations: ❑ I heve and wlll maintain a certificate of consent to self-Insure for workers' compensation, as D�a��tled for Dy section 3700 of ihe Labor Code, tor t�e peAormence of ihe work for which this permit is issuetl. � ❑ I have and will maintein workers' compensatlon insurance, as required by section 3700 of Ne Labor Code, for Ne peAortnance oi t�e work tor which Ihis pertnit is issuetl. My workars' comp nsation Insurance carner entl poli number are: / Carrier. �Jr�� ivG � �� / PolicyNumber: �� 1�� (Thls secfion neetl of be wmp eretl i e Oermit is valued et one hundred dollars (5�0) or /ess.) ❑ I catlity that in Ihe pertormence of the work for which ihis permit is issued, I shall nol employ any person in any manner so as fo become subject to the workers' compensation laws oi C' omia, ree that if I should become su6ject to the workars' compensation provisions of Section 3700 of ihe LaDor Code, I sha0 fonhwith comply with these prov ia s. / �/� � Applicant Si9nature: �� Date: � -,� - WAPNING: FAILURE TO SECURE WORKERS' CAMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJEGT AN EMPLOYEF TO CRIMINAL PENALTI 5 AND dVIL FINES UP TO ONE HUNDRED THOVSPND DOLLARE (5100,000), IN ADDRIIXJ TO THE COST OF CQNPENSATION, pAMAGES AS PROVIOED FOR IN SECTION 3'l06 OF THE IABOR CODE, IMEREST, AND ATTORNEI"5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm that I am lorce and ettect. Lic, a_ ContracroYs SignaNre: of Chapter 9(commencing with Section 7000) of Division 3 ot iha Business� d Profgssions Code, antl my license is in full � Class x � �� i �ate: �Llf CONSTRUCTION LENDING AGENCY: ' ❑ I hereby aMirm that there is a constmction lending agency for ihe pedormance of the work for which ihis pertnit is issued. (Sec. 3097, Civil Code). Lender s Nama: SignaW re: OWNER•BUILDER DECLARATIONS: lendets Address: Da�e: I hereby aHirtn that under penalry of perjury that I am EXEMP7 FROM 7HE CON7RACTOFiS LICENSE LAW for the following reason (Sec. 7031.5, Business and Pmfessions Code: Any ciry or county which requires a permit to consiruct, alter, improve, demolish, or repair any sirucWre, prior to its issuance, also requires the applicant tor such permit to file e signetl statemem ihat ha or she is licensed pursuant to the provisions of the Comractors License Law (Chapter 9(commencing with Section 7000) of �ivision 3 of the Business antl Protessions Cotle) or thai he or she is ezempt thereirom end lhe basis lor the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subJects tha epplicant to e civil penalry ol not more than tive hundred dollars ($500).): ' ❑ I, es owner of the pmperty, or my employeas with wages as their sole compensation, WILL DO TNE WORK, and the stmcture is not intentled or oNered for sale (Sec. 704a, Business and Pwfessions Cotle: The Contractors License Law does not apply to an owner of properry who �uiltls or improves ihereon, entl who tloes such work himself or herself or thmugh his or her own employees, provitled that such improvements are not intended or oHered for sale. If, however, the building or improvement is sold within ona year of completion, ihe owner�builder will have the burden of proving ihat he or she did not build or impwve tor puryose oi saleJ. ❑ I, as owner oi tha property, am EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions Cotle: The contractors License Law dces not epply to an owner of property who 6uilds or improves thereon, and who contracts for such project with a coniractor(s) license Oursuant to the ConVactors License Laws.). ❑ I am exempt un0er sec. SignaWre: Owner ID verified by driver's license. ❑ Yes ❑ No Business and Professions Cotle for this reeson: Verilication oi Ownership by (typa of document, i.e. - propetly tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Orivels License No. Date: Expires: ❑ I hereby certity t�at no excavation five (5) or more teet in tlepth into which a person is required to descend, will be matle in connection with work authonzed by ihis pertnit, end ihat no builtling stmcture, scattolding, talsework, or tlemolition or dismantling thereof, will be more ihan ihirry-siz (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 347, Title B, California Administrative Code). ❑ As owner-6uiltler, I will not employ anyone to do work which would require a permit irom Ihe Division of Industnal Safety, as noted above, unless such person has a permit to do such work trom the tlivision. SignaNre: Date: Division of Industrial Safery Permit Number: � CER7IFICATE OF COMPLIANCE AND AUTHORIZATON OF ENTRY: I certity under penalty of perjury Ihat I have read Ihis application and state ihat the infortnation given is correcL I agree to comply with all state laws and ciry ordinances relating to builtling construction, antl authonze representatives of the Ciry of Costa Mesa to enter upon ihe above-describetl property lor inspection purposes. I agree not to occupy or allow occupancy of any building authonzed by fhis permit until final inspec�ion. ig Ot Legai Owner(s) / �� d�te nd/Or Authorizetl Applicant � Date COpE M. INSPECTIONTYPE 1676 Fixetl System Final Fire Prevention 1266 Pool Spe Final 200 Final Re�Roof 201 Final BIocWRetaining Wall 202 Final Factory Fira Placa 203 Final Sign 204 Final Demolition 2E46 d6 � IMRIALS COUEY INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevenlion 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy D� Ixrma�s S oo � �� / (714) 754-5273 • Fax (774) 754-4856 � CITY OF COSTA MESA - BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT .lob Address: 362 LA PERLE LN Suite No Vicinity: Parcel Number: 42531201 � Applicant: Address: Owner: Address: RON COLLINS BAYS, GERALD R TR 1060 LA SOMBRA DRIVE SAN MARCOS, CA MECHANICAL PERMIT Contractor COLLINS CUSTOM BUILDERS Address: 3908 CALLE REAL Arch / Eng Address: , UMT, 1FAU, 1HOOD. �SAN CLEMENTE, CA Phone: 949-661-8493 Zip: Phone: Zip: 92069 .Phonei- 493-6520- - Zip: 92672 License: 368900 - � Phone: Zip: License: NUMBER 00-00075 77 FAIR DRIVE, COSTA MESA, CA 92626 - - � Status: ISSUED Applied: 02/18/2000 Issued: 02/18I2000 ISSUED BY: � � SCOPE OF PERMIT 120SF ADDITION AND CONVERSION OF DUPLEX TO SFR, RE:B00-00007, INSTALL 1A/C ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 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 < 10000Gfm Air Handlers > 10000cfm Floor Fumace Floor or Suspend Heater $23.50 $14.80 $0.00 $0.00 $0.00 � $14.80 $0.00 $0.00 $0.00 $10.65 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 1 0 0 0 1 0 0' 0 1 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY,' Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Commercia l I ncinerato r Domestic Incinerator Compressors / Absorotion Systems Up to 3 hp / 100 k.BTU 9 To 15 hp / 500 k BTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 7,750 BTU Boilers Up to 3 hp 3To15hp 15 to 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTALCALCULATED FEES COMMENTS / SPECIAL CONDITIONS Quantity $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 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $63.75 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1. 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 780 days. - INSPECTIONS: In order for Ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this /permit. FOR INSPECTIONS CALL: (714) 754-5626 " WORKERS' COMPENSATION DECLARATION: I hereby altirtn untler penalry oi peryury one ol the lollowing declarations: ❑ I have antl will mainiain a certificate oi cronsent to self-Insure for workers' compensation, as provided for by section 3700 of ihe Labor Code, for ihe pedormance ot t�a work for which Ihis permi� is issuetl. � ❑ I have and will maintain workers' compensauon insurance, as requiretl by sectlon 3700 of the Labor Cotle, for Ihe perfortnance of the work tor which this pertnit is issued. My workers' compe/n� �ti�on. .In�suranca carner and policy number are: ' r' n I O� Carrier. �✓a f�NVE C L�� /� Policy Number: �t� � (This seclion neetl not be comp/eted i! fhe permit is valued et one hundred dollars (3700) or IessJ � � ❑ I certity Ihat in Ihe performance of the work for which Ihis permit is issued, I shall not employ any person in any manner so as to becoma subject to the workers' compensation laws ot Califo and agree that if I should become subject to ihe workers' compensation provisions ot Section 3700 ot Ihe Labor Cotle, I shall forthwith comply with these provision �/ r B/ aa � � Applicam SigneNre: Date: � WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNL4WFUL AND SHP1L SUBIEGT MI EMPLOYER TO CRIMINAL PENALTI S AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (5100.0001. IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDEO FOR IN SECTION 3/060F THE LABOR COOE, IMEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm Ihai I am licensed under pmvis IofCB 3ntl eflOCL Lit. M� � Coniractor's Signaiure: Chaptar 9(commancing with Sect�00) of Division 3 of Ihe Business antl�Prof-S� ons Code, antl my license is in )� qass M C—� � Date: '�/f � !l I CONSTRUCTION LENDING AGENCV: ', ❑ I hereby aflirtn that there is a constmction lending aqency tor ihe peAormance ot i�e work for which ihis permit is issuetl. (Sec. 3097, Civil Code). Lentler's Name: Lentler's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aNirm t�at under penalry of perjury that I am EXEMP7 FROM TME CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or counry which requires a permit to consWct, al�er, improve, tlemolish, or repair any structure, pnor to its issuance, alm requires the applicant for such permit to fila e signed s�atement ihet ha or she is licensed pursuant to ihe provisions oi the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of �he Business and Pmtessions Code) or that he or she is exempt iherefrom end the basis tor ihe alleged e:emption. Any violation of Section 7031.5 by eny epplicant for a permit subjects ihe applicani to a civil penalty ot noI more than five huntlretl tlollars (5500).): ❑ I, as owner of the propeny, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, and ihe sirucwre is not intentletl or oNeretl for sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law tloes not apply to an owner of property who builas or improves thereon, antl who does such work himsetl or herself or thmugh his or her own employees, provided that such impmvements are not intended or oftered for sale. If, however, the building or improvement is sold within one year ot wmpletion, the owner-builder will have the burden of proving that he or she did not build or improve for puryose of sala.). ❑ I, es owner oi the propetly, am E%CLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to wnstmct the project (Sec. 7046, Business antl Pmfessions Code: The coniractors License Law dces not appy to an owner of propeny who builds or impmves thereon, antl who contracts for such project with a coniractor(s) license pursuani Io the Coniractors License Laws.). ❑ I am ezempt under sec. Business and Professions Cotle tor this reason: SignaNre: � Date: Owner ID veritietl by drivefs license. ❑ Ves ❑ No Drivers License No. Ven�iwtion ol Ownership by (type ot document, i.e. - property tax biil or deed): OIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: Expires: ❑ I hereby certity that no ezcavation (ive (5) or more fee� in Gepth into which a person is required to tlescena, will he matle in connection wlth work auihorizetl by this permit, antl thai no building siructure, scattoltling, falsework, or demolition or tlismantling thereof, will be more Ihan ihirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, T�le B, Calilomia Administrative Code). ❑ As owner�builder, I will not emploY anyone Io do work which would require a permii fmm the Division of Intlustrial Safety, as note� above, unless such person has a permit to tla such work irom Ihe tlivision. Signature: Date: Division oi lntlusinal Safery Permit Number: CERTFICA7E OF COMPLIANCE AND AUTHORIZATON OF ENTTiY: I certify under penal�y of perjury that I have read this application and state ihat the information qiven is correcL I agrea to comply with all sta�e laws and city ordinances relating to builtling consiruction, and authorize representatives of Ma Ciry of Costa Mesa to entar upon Ihe abwe-tlescribed property lor inspection purposes. I agree not to occupy or allow occupancy oi any Duilding authorized by this permit until final inspection. COOE 1. INSVECTIONTYPE 1676 Fized System FinalFire Preven�ion 1266 Pool Spa Final 200 Final RB-Roo� 201 Final8locWRetaining Wall 202 Final fectory Fire Place 203 Final Sign 204 Final Demolition 24d6�4fi p�jE INTR L CODE� INSPECTIONTYVE 206 Final Mechanical 208 Final Plumbing 210 Final Elecinwl 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy Date