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Home My WebLink About454 LENWOOD CIR - Building Permits� • • r (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.$(dqLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 454 LENWOODCI Suite: Vicinity: Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Consiruction: V-N Parcel Number: 42515222 Zoning: Applicant: EADIE, MIKE Address: Phone: 949-933-9725 • 2ip: owner: EADIE, MICHAEL J_AND ALLISON H Address 45q LENWOOD CIR � - ' ' Phone: COSTA MESA, CA Zip: 92627 Contractor. OW NER-BUI LDER Address: � Arch : Address: Phone: Phone: ISSUED BY: License: 000000 - Eng: , Address: Status: ISSUED Applied: OS/04/2007 Issued: 06/13R007 Phone: � • � � _ .. � - ' �� , . _ ' Zip: . - License:,_ � � _ License: - SCOPE OF PERMIT 83SF ADDITION TO TryE RELOCATED FAMILY ROOM IN AN EXISTING SFD. WORK TO ALSO INCLUDE INTERIOR RELOCATION OF THE KITCHE� A DINING ROOM, RELOCATION OF A BATHROOM TO ENLARGE THE EXISTING MASTER BATHROOM. REMODEL OF THE EXISTING DETACHED NO ' ADDED SQUARE FOOTAGE AND WINDOW REPLACEMENTS � ` "' � - � � � PLANNING: , - .. . .. � . . ... � __.. r . _ . ..._ . ' . , . LOTSRE=6,081 SQ.FT. -. �. - - .. ` . - �- � - - RESIDENCE = 1,627 Sq. FT. . � - - GARAGE = 400 SQ. FT. , . � DRIVEWAY = 160 SQ. FT. � _ �� . ' . , , . LOT COVERAGE = 2,187 SQ.FT. (36%) , , � - - " " - "` ' _ " - � FEE SUMMARY :. Plan Check: •� $554.94 ---. ' Calc Valuation: SEo,000.00 Permit: $85375 Claim Valuation: Sao,000.00 �SMIP Rgs: $8.00 ' SMIP Com: $0.00 -. •Other: $0.00 Inspection: $0.00 � "' , ' s'`, Total• $1 416 69 ` '' -� '`�� ` ' , re: PLANNWG & ZONING , � " SETBACKS ' � � MAINSTRUCTURE Front, 20-0 ACCESSORY Front 0-0 Rear Rear � � LeFl ,13- 0 Right .� 90- 0 LeR 0-0 �Right ' 0-0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit Shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetiona end flnal approval must be obtained. Failure to obtain inspections and final approval will rasult in the ezpiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 �/ 2d48dfi (6/00) WORKERS' COMPENSAnON DECLARAnON: �' I here6y ettirtn under penelry of perjury one of the following tleclarations: ❑ I heve and will maintain a certiflwte o( consent to setl-Insure for workers' compensation, as provided lor by seciion 3700 of the Lebor Cotle, for the pertortnance oi Ihe wark tor which t�is pertnit is Issuetl. ❑ I heve antl will maintain workers' compensatlon insurance, es required by section 3700 ot the Lebor Cotle, for Iha peAormance of the work for which Nis pertnit Is issuetl. My workers' compensatlon Insurance wrrier anC policy number ere: Cerrier: Poliry Number: (This sectiar need not be completed il the permiNs valued at one hundred dollars ($f 00) or Iess.J �FF. I ce�ify Ihet in the peAormance of ihe work for which Ihis permit is issue4 I shall not employ any person in any manner so es to hecome subject to ihe workers' T compenseUon laws of �a'lifomia, antl agree iha it I should come subject to Iha workers' compensation proNsions of Se tion 3 00 oi Ihe LaDor Code, I shell fort�with wmply with �hese� ' �ns. � - ��. ��1��2�.,��i?/l/� � �b�i—s a7 WAqNINCi: FNLURE TO SEWRE WOPKERS' COMPENSATION COVERAGE IS UNIAWFUL AND SHALL SU&IECT lW EMPLOYEP TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED hKKISAND DOLLARE (E100,000�, IN ADDRION TOTHE COST OF COMPENSATION, DAAMGES PS PROVI�ED FOR IN SECTIIXJ 3�06 pF iHE Ll�BOR CODE, IMEFEST, AND ATTORNEY'$ FEES. LICENSED CONTRACTORS DECLARATION: I hereby eflirtn that I am licensed under pmvisions oF Chapter 9(commencing with Section 7000) of Division 3 oi ihe Business antl Protessions Code, end my license is in full larce en0 ettect. Lic. q Cless # Contractors Signature: Date: CONS7RUCT10N LENDING AGENCY: ❑ I �ereby eflirm Ihai Nere is a construction lending agency for the performance ot the work for which this pertnit is issued. (Sec. 3097, Civil COCe). Lendefs Name: Lentler's Atltlress: Signature: Data: OWNER-BUILDER DECLARATIONS: I hereby etfirtn that unCer penalry of perjury that I flm EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business antl Professians COCe: Any ciry or counry which requires a pertnit to conSWcL alter, improve, demolish, or repair any structure, pnor to its issuance, also requlres lhe flpplicant for such permil to file a signeC stetement thet he or she is IlcenseA pursuant ro the proNsians of the Cantractors License Lew (Chepter 9(commencing with Sectlon 7000) of Division 3 ai the Business end Profeulons Cotle) or that ha or she is exempt therefrom and ihe basis for the elleged exemption. Any violetion of Sectlon 7031.5 Dy eny epplicent for e permit ,�sub�ec Ihe eppllcant to e cidl penelry of not more than tive hundred dollars ($500).): j ,� es owner oi Ihe properry, or my employaes with weges es their sole compensetion, WILL DO THE WOHK, antl ihe siructure Is not intended or otteretl for sele (Sec. 7044, Business end Professions Code: Tha Contractors License Law does not apply to en owner of property who builds or Improves ihareon, end who tloes such work himself or hersell or Ihrough his or her own employees, provided thet such improvements ere not iniended ar aHered far sale. If, howevar, the 6uilding or improvemeni is solC within one year ot completion, ihe owner-builder will have iha burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I, es owner of the properry, em E%CLUSIVELV CONTRALTING WITH LICENSED CONTRACTORS to construq the project (Sec. 7044, Busineu and Protauions Catle: The wnlreGors License Lew tloes not appy to an awner oi pmperty who builds or improves t�ereon, antl w�o contrects for such project with a con[racror(s) license pursuant to ihe Contractors License Lews.). ❑ I em exem under sec. �a" Owner ID ve fied bv tlrtver's I ❑ No BuSiness and Protessions Code for Ihis reason: Date: ' ( ' � % D' e�v �s� ' nse No. �� .( Ezpires; VedTication of Ownership by (type of tlocumeni, i.e. - property ta< bill or deetl): DIVISION OF INDUS7RIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certify that no excavatlon tive (5) or more feet in tlepih in�o which a person is required to descend, will be made in connaction with work euihodzed by ihis permit, an0 that no building siructure, scaHolAing, falsework, or demolition or tlismantling thereof, will be �rore than thirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Calilomla Atlminisiretive Coda). ❑ As owneo-builder, I will not employ anyone to do work which would require a pertnit trom the Division of IndusMel Safery, as noted ebove, unless such person hes e pertnit to do such work from the division. ' SignaNre: Data: Division of Industrial Satery Permit Number: CERTIFlCATE OF COMPLIANCE AND AIJTHORIZATON OF EMAY: I certiry under penalry ot perjury thai I have read this application end state Ihat the information given is correct I egree to comply wi h a state laws and clry ordinances relating to building construction, antl authonze representatives ol the Ciry of Casta Mesa to enter upon the ebq9��nbed roperry t in ection p_ s. I egree not to occupy or allow occupancy ot any building authorizeQ b�this ermit until tinal inspection. /_ P% %%(/% C./ 13 a7 �%'� Slgn�:OhtegafOwner(s� -� Det� e� AnNOr Authorized Applicant Data COOE �. INSFEttI�NTYPE � QSjE �$ 1616 Fiaed System Final Fire Preveniion 1266 200 201 202 203 20E Pool Spa Final Final Re-Raat Final BIocWReiaining Well Final Fectory Fire Place Final Sign Final Demolition GODE� ViSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 270 Final ElecMcal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final�Building�Occupancy Qdg 1[�ELS PERMIT TYPE CITY OF COSTA MESA BDILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754d856 •�wnv.ci.costa•mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER�E07-00576 ELEC JOB ADDRESS: 454 LEN1 Viciniry: SCOPE OF WORK: 83SF ADDITIOI REMODEL THE EXISTING RESIDENCE STATUS: ISSUED _. DATE ISSUED: 06/13/2007 � ' - --�=+ISSUED BY: BJK ,; r,y;. r CM 5'` � Swte/Unit ; . , ,,. �j ',�, iLOCATED FAMILY ROOM IN AN EXISTWG SFD:��WORK TO ALSO INCLUDE INTERIOR )W REPLACEMENTS. REF: 607-00580 25-LIGHT FIXTURESj.30 OUTELTS, 20 SWITCHES, SERVICE TO 200A ' �r ;�,��: '� OWNER: PHONE: APPLICANT: PHONE: Address: City/State: , . . ..,�"; �- . f c_ , ,�, '_,__ f . . �- . . . _: i. EADIE, MICHAEL J AND�ALLISON H�' i�_ Address: . �_454 LENWOOD CIR Uniti- .; ��. t . � -- - , . . ` � _. .,;. � .,_. � ' '.` ".. .bity/State/ZiP.-.- ,.�COSTA MESA CA �_ - ��.� �i ' EADIE MICHAELJANDALGSON�H+;'� Address: 454LENWOODCIR� Unit: �' 949-933•9725 � ' - - - � �-- � City/State/zZip:�- COSTA MESA,�CA , �, R: OWNER,BUILDER ��. � • �� - -� � .: License No..,�.; 000000 �� ;j Umt'+,^. . "� PHONE: . � 2ipCode - - � CELL: - �., :: .. � _ : ...,' .'- : . .. , , _ 4 � - t s; � .� �{ , 1 . _ '� � „ ' :AL PERMIT FEES � , �=: Electrical Plan Check Fee Electrical Permit Fee: Reinspection Fee TOTAL FEES „ � _$0 00 y �4': , ; s" � ' � �. $13095 ;.' �, -• - . ;. ,.-. $0 00 d�� ; � $130:95 - , , ' 4 ' y' — ' lt 'al- - �i. ti . .:i r. r I'l!^* � �.. � ;.� n : i. _ � .' NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § t, 12-21•92) � EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must wmpty with all applirable codes, and all required inspectians and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiralion of this permit. COOE /• INSPECTIONTYPE 1616 Fized System Final Fire Prevention 1266 Pool Spa Final � 200 Final Re-Roof 201 Fina181ock/ReWining Wall 202 Final Factory Fire Place 203 final Sign 204 Final Demolition ORTE IN7111AL COOE/ INSPELTONTYPE 208 Final Mechanical 208 Final Plumbing 210 Final Elecirital 212 Final Fire Prevention 220 Final Planning Approval 222 Final Si�e 250 Final Building/OccuOancy D� INiRIALS Z % � WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalry of perjury one of the (ouovnng declarations: - ❑ I have and vrill maintain a certificate ot consent to self-lnsure for workers compensation, as providetl for Dy section 3700 0( the Labor Code, for the pedormance o( �he work for which�this permit is issued. . � � ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of ihe Laboc Code, fw the peRortnance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Carrier. (Ths sedm need nof Ge mmplefe0 el�e pnrnd'a valued al one nurMied cNlars fS100) orless.l Policy Number: �� I certify that in the peRormance of the work for which Ihis permit is Cissued,'I shall not employ any person in any manner so as to become subject to the vrorkers' wmpensation laws of California, and agree that if I shoultl become subject to the vrorkers' compensation provisions of Section 3700 of the Latl9 Code, 1 sh o with co y vrith Ihese provisi ns. '� b-13 6 ApWicanl'a�SpnaWrea.- ' —'Da e+'+- WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLAF25 ($700,000), IN ADDRION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECIARATION: I hereby aKrm that I am licensed under provisions ot Chapter 9(commencing with Seclion 7000) of Division 3 of the Business and Pro(essions Cotle, and my license is in full force and eftect. lic. # Class # Conhacmr's SignaWre Date CONS7RUCTION LENDING AGENCY: ❑ I hereby affirtn ihat there is a construction lending agency fw the peAormance ot the v.ork for which this permit is issuetl. (Sec. 3097, Civil Cotle). Lentler's Name: Lender's Address: SignaWre OWNER-BUILDER DECLARATIONS: I hereby aKrm that under penalry of perjury that I am EXEMPT FROM 7ME CON7RAC70RS LICENSE LAW (or the following reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or coun�y which requires a permit to consiruct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires Ihe applicant for such permit to fle a signed statement Ihat he or she is licensed pursuaN to lhe provisions of the Contractors License Law (Chapler 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis (or the alleged exemption. Any violalion of Section 7031.5 by any applicant for a permit subjects the applicant Po a civil penalry of not more than five ndred dollars ($500).): I„as owner of the properry, or my employees with wages as their sole �wmpensation, WILL DO THE WORK, and the sWCNre is not intended or oHered (or sale (Sec. 7044, Business and Professions Code: The Coniractors License Law does not apply to an owner of property who builds or improves thereon, antl who does such work himself or herself or throuqh his or her ovm employees, provided that such improvements are�not intentled or oNered for sale. If, however, the building or improvemenl is sold within one year of completion, the ovmer-builder vnll have the burden;of proving that he or she did not build or improve for purpose of sale.). �� ❑ I, as owner of the property, am EXCLUSIVELY CON7RACTING WITH LICENSED CONTRACTORS to construct the pmject (Sec. 7044, Business and Professions Code: The cont2clors License Law dces_nol apply [o an owner of property who builds or improves thereon, and who cont2cls for such project wilh a conl2cla(s) license pursuant ro the Contractors License Lavrs.). ❑ I am exempt under sec. Business and Professions Code for this reason: ��i.v��. �, f'l� �' ► �.- Owner ID verifed by drive ise. es ❑ No Driver:s.License No. Expires: ( 0 I O �Verification of OJmership by ype of document, i.e:_property tax bill or deed�: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cert"rfy that no excavation frve (5) or more feel in depth inro which a person is requiretl ro tlescend, will be made in connectbn with work authonzed by [his pertnit, and Ihat no builtling structure, scaffdding, falsework, or demolition or tlismantling thereof, will be more Ihan lhirty-sa (36) feet high. (Chap. 3.2, Grp 2. M 2. Sec. 341, Title 8, Califomia Atlminisl2tive Cade�. ❑ As owner-builder, I will not employ anyone to tlo work which woultl require a permit from the Division of Industrial Safety, as notetl above, unless such person has a permii to do such vrork from the division. Apolicanfs Sl9nalure Division of Industnal Sa(ety Permit Number. _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material7 ❑ Yes ❑ No (Section 25505 of the Califomia Health and Satery Code requires, with some exceptions, lhat a Business Plan be (letl with the Costa Mesa Fire Department by every business v+hich has at any one time dunng a reported year a quantiry of hazardous matenals equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic fee[ of compressed gas at standard temperature and pressure). 2. Does or will the applicant or present or future builtling occupaM need to file a registralion form for acu[ely hazardous matenals? ❑ Yes ❑ No (Section 25533 of the Cali(omia Health and Safery Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal [o or greater than a weigh� of 500 pounds, or a volume of 55 gallons, or 200 cubic teet of compressed gas at stantlartl IemperaWre and pressure). 3. Does or will the applicant or present or future builtling occupant need to prepare an RMPP (Risk Management and Prevention Program (or acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 0( the Califomia Health antl Sa�ery Code provides that [he Costa Mesa Fire Department may require the preparatioq cenifcation and filing with the Fire Department of an RMPP by businesses which are requiretl lo register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health antl Safety Code been fully complietl with? ❑ Yes ❑ No 5. Does or vrill the appliwnt or present or future builtling occupaN require tor �he work which is [he suhject o( this application a permit for such construction or motlifcation from me South Coast Air �uality Management District or from any other air polWtion contml district or agency7 ❑ Ves ❑ No (Sectbn 658502 of the Califomia Govemment Cotle requires that Itie requestetl infortnation be fumished on applications for non-residential buildinq permits). 6. Will any part of the facility to be constructed under this permit be within 7000 feet trom Ihe outer boundaries of a school? ❑ Yes ❑ No (If yes", lhe faciliry must meet the requirement of Sec�ions 25534 and 42303 of the Califomia Healih and Sa(ery Code). 7. If a permit from the South Coast Air Quality Management DisUict or other air pollution control district or agency is required for the vrork which is Ihe subject ot this application, have all of the disclosures prescnbed by Califomia Health and Satety Cotle Section 42303 been made? ❑ Yes ❑ No 8. pf "yes", attach certi(cate of compliance trom the appmpriate air polWtion control offcer). . � . . . _ . CERTIFICATE OF COMPLIANCE: I certi(y Ihat under penalry of perjury the intormation given above is wvect I agree to comply with all state laws antl city ordinances regarding Hazartlous Materials and Emissions. �� CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify untler penalry of perjury that I have read Ihis application and state that the information given is correcL I agree to comply with all state laws and city ordinances relating to building construction, and authonze representatives of the City�of Costa Mesa to enter upon the above-described propeny for inspection purposes. I agree not to occupy or allow occupancy of any building autho��y Ihis p�nC inal inspe,slpn. 6/ A// � �niL�fir � �T'�TSigneNr Olvner(s) VDare Anp/or AW�or¢eG ApPGcanl Date CITY OF COSTA MESA . BYILDING DIVIS/ON i � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us �. FOR INSPECTIONS CALL: (714) 754-5626 4q„��,F PERMIT NUMBER• M07-00377 PERMIT TYPE MECH STATUS: ISSUED , W,_,.,� DATE ISSUED: 06/1312007 _ ' '=r'ISSUED BY: BJK r i � JOB ADDRESS: 454 LENWOOD CI`CM � Suit'elUnit } Viciniry: : SQ. FT: 0 ,, ; C)Y a SCOPE OF WORK: 83SF ADDITION�TO,TNE�RELOCATED FAMILY ROOM IN AN EXISTIN�G,'SFD.-WORKTO ALSO INCLUDE INTERIOR REMODEL THE EXISTING RESIDENCE AND WINDOW REPLACEMENTS. REF: B07-00580' t f S.� �. . I+.. �� .. . . . . OWNER: EADIE, MICHAEL J AND�ALLISON H: - � Address : "�, 454 LENWOOD CIR .Unit:��-` PHONE: �`-�e "�j,�,'�, ".,;.,.,. "� City/State/Zip�'��'��COSTA�MESA,CA `��.�� '.. APPLICANT: EADIE, MICHAEL J AND ALLISON�H ,_ Address: 454 LENWOOD CIR Unit: PHONE: 949-933-9725 � .= � " City/State/zZip: COSTA MESA„CA" ' .: :. - ' � - . � ,,; CONTRACTOR: OWNER-BUILDER L'icense No. 000000 . Address: Unit : ��•.', ,� PHONE� ' - - City/State: �s�_ .,, � � c 2ipCode. . :, � .- •� -,._ ' • � ...:.. CELL:.. - �'.` ; , .,; _ ' . .. . _ � -- MECHANICAL PERMIT FEE�SUMMARY � MECH ITEM FEE: �, $97 85 , � _. - PLAN CHECK FEE: � ' ��,��:.:$0 00 - - INVESTIGATION FEE: •�':' $0 00 ' �° ",' � `�' REINSPECTION FEE: � .; _ $0 00, �_ - - TOTAL FEES: $97.85 , `� r ��„ ' ." NO710E: The work authorized by this permit shall comply vrith all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authonzed under this permil to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE/. INSFELTONTYPE DRTE IN7fMl CODEt INSPECTIONTYPE ppTE INATIpLS r1.Y( 161fi Fixed System Final Fire Prevention 208 Final Mechanical ��"�'� ��J � 1266 Pool Spa Final 200 Final Re-Roo( 201 Final BIxklRelaining Wall 202 Final Factory Fira Place 203 Final Sign 204 Final Demolition 208 Final Plumbing 210 Final Elettriwl 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARATION: . I hereby affirtn under penalty of perjury one of the foiiowing declarations: ❑ I have antl will maintain a ceRifcate of wnsent to self-Insure for vrorkers: compensation, as provided for by section 3700 of the Labor Code, for the performance of the vrork for which this permit is issued.. ❑ I have and will maintain v.orkers' compensatbn insurance, as required by seclion 3700 of Ihe Labor Code, for the peAortnance o( [he woB fa which �his permil is issued. My vrorkers' compensation Insurance carrier and policy number are: Carrier (Tha seam rieM �1 ee o7nde�ed aMe perrM a valued a� are nurwred tlonars (S�oo) a iess ) Policy Number: I•certi(y lhal in the peAormance of the work for which [his permit is issuedLl shall not employ any person in any manner so as to become su6jec[ to the vrorkers' compensation laws of Califomia, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the}� r Cotl�e, I shjJ I fo th com I with these rovisio . //�/l/V�/W/ /l�[� v� P b _ . �. 'c pnature�-a '—'Oa1 a` WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLP,WFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNORED THOUSAND DOLLAF2S ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEI^SFEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed under provisions o( Chapter 9(commencing wilh Section 7000) of Division 3 of the Business and Protessions Code. and my license is in full torce antl eRect. Lic. # Class # Contracmr's SipnaW re Date CONSTRUCTION LENDING AGENCY: ❑ I hereby affrm that there is a construclion lending agency for Ihe peRortnance of the �+ork (a v.fiich this pertnil is issued. (Sec. 3097, Civil Code�. Lentler's Name: Lender's Atldress: Signalure Dale OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Protessions Cotle: Any city or counry which requires a permit to construct, alter, improve, demolish, or repair any structure, pdor to its issuance, also requires lhe applicant (or such permit to file a signed statement thal he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and ihe basis (or Ihe allegetl exemption. Any violation of Section 7031.5 by any appliwnt (or a permit subjecls ihe applicant to a civil penalty of not more than five huntlred dollars (5500).): � a owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl lhe s[ruc[ure is not intended or oHered (or sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law does not appty to an owner of propeny who builds or improves thereon, and who Coes such work himsel( or herself or through his or her ovm employees, provided that such improvements are not imentled oroRered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builtler will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS lo construct the pmjecl (Sec. 7044, Business and Pro(essions Code: The contraclors license Law dces not appy to an ovmer of property who builas or improves lhereon, antl who cont2cts for such projett with a contracta(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code (or this reason: /�/�� I ' / ' Ovmer ID venfied by drive ise. Yes ❑ No DriveCs:l:icense:No.�/�� Expires�--10 ly J ��Venfcation of Ovmership by (rype o! document, i.e. - propeAy tax 6ill or tleed): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certi(y that no excavation frve (5) or more feel in depth into wtiich a person is requiretl to descend, will be made in connectbn with work authorizetl by this permit, antl that no building sWCNre, scaf(dding, false�+ork, or demolitbn or dismantling Ihereof, vrill be more than thiAy-six (36) feet high. (Chap. 3.2, Grp 2, !vt 2, Sec. 341, TiHe 8, Califomia Administrative Code). ❑ As owneo-builtler, I will not employ anyone to do wrork which vrould require a permit from the Division of IntlusMal Safety, as noted above, unless such person has a permit to do such vrork from the division. ADPliranl's SignaNre Division of Intlustnal Safety Permil Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fWure builtling occupant need to fle and certify a Business Plan (or emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 ot the Califomia Health and Safery Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time tluring a reported year a quantity of hazardous matenals equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet o( compressed gas at standard temperature and pressure). 2. Does or will the applicant or present or future buil0ing occupaN need to file a registration fortn for acutely hazardous matenals? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Salety Code, wilh some exceptions, requires regislration wilh the Costa Mesa Fire Depariment by each business which at any one time has on �and a quantiry of acutely hazardous malenals equal to or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at stantlard temperature and pressure). 3. Does or will the applicant or present or future building occupant neetl to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safery Code provides l�at the Costa Mesa Fire Department may require the preparation, certifcation and filing vri[h the Fire Department of an RMPP by businesses which are required to register aculely hazardous matenals with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of ihe Cali(ornia Health and Safety Code been (ulty complied with? ❑ Ves ❑ No 5. Does or will the applicant or present or future building occupant require for Ne work which is the subject of this ap0lication a permit for suc� consWclion or motlification from the South Coast Air �uality Management District or from any other air pollWion control disMct or agency? ❑ Yes ❑ No (Sectbn 658502 of the Califomia Govemment Cotle requires that Ihe 2questetl infortnation be fumished on applications fa ran-residential building pertnits). 6. Will any part of the facilily to be constructed under this permit be vnthin 1000 feet from the outer boundaries o( a school? ❑ Yes ❑ No (I('yes', Ne facility must meet Ihe requirement o( Sections 25534 antl 42303 of the Cali(omia Health and Sa(ery Code). 7. If a permit from the SoWh Coast Air Quality Management DisMct or other air polWtion control district or agency is required for the vrork which is the subject of this application, have all of the disclosures prescnbed by Califomia Health and Safe[y Code Section 42303 been made? ❑ Yes ❑ No 8. pf "yes", attach certificate of compliance (rom the appropnate air polWtion control offceq. , - CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is corzect I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. �� Da�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury that I have read this application and state that the information given is correcL I agree to comply with all state laws and city ortlinances relating to building construction, antl authorize representatives of the Ciry of Costa Mesa to enter upon the above-tlescnbed property tor inspection purposes. I agree not ro occupy r allow occupan y of y builtling auth �f by th' permit u �I �Fal inspec ' ' _. . � . - 1. �vna�me a �egai owne sl __' w� '� Antllor Aulhorrzetl Appbwnt Dale CITY OF COSTA MESA B{/ILpING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • wv�rw.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER. P07-00406 PERMIT TYPE PLUM STATUS: ISSUED DATE ISSUED: 06/13/2007 ' �- �<-:=1SSUED BY: BJK ' � r '- _ � l ( � - JOB ADDRESS: 454 LENWOOD CbCM _ Suite)tlnit vicinity: i - ' - � i e SCOPE OF WORK: 83SF ADDI�TION TO THERELOCATED FAMILY ROOM IN AN EXISTING SFD.��N%ORK TO ALSO INCLUDE INTERIOR REMODEL THE EXISTING RESIDENCE AND WINDOW REPLACEMENTS. REF,B07-00580)�- r' , � .. •i' � � OWNER: EADIE, MIGhiAEL•J AND'ALLISON H;�, ,-�-� Address ;� ��.'454 LENWOOD CIR �.�" .- . ., :•.�: �•� ' .. - PHONE: ��, � " �'�.: , � __„-: .� -"" Ciry/State/Zip� �-"COSTAMESA,,CA. - - '�' APPLICANT: EADIE, MICHAEL J AND ALLISON H.,_ Address: 454 LENWOOD CIR �: � PHONE: 949-933-9725'. . . , City/State/zZip: COSTAMESA„CA-. �� CONTRACTOR: OWNER-BUILDER � -- Cicense No. 000000� .. -' Address: + `- - � � � � ' - - PHONE: �" . City/State: PLUMBING ..':Vt ', , ZipCode , - CELL: �.: � . �,�3 ..... ... �.. .� , , .. . . r PERMITFEE;'SUMMQRY' '':, `, PLAN CHECK FEE: `' $0 00 �, , ^ PERMIT FEE: $120.35 - y - :; , s:: TOTAL FEES: $120.35 ' ' � , NO710E: The work authorized by this permit shall comply with all applicable handirap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) . EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permil. SopE�. INSPEC710NTYPE DATE INTITIRLS 1616 Fixed System Final Fire Prevention 1268 Pool Spa Final � 200 201 202 203 204 Final Re-Roof Final BIaWRetaining W all Final Factory Fire Place Final Sign Final Demolition 40DEf INSPEG710NTVPE 208 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 �� FinalSite 250 FinalBuilding/Occupancy DATE INTITIRLS WORKERS' COMPENSATION DECLARATION: I hereby affrm untler penalty of perjury one of the fouowing Oecla2tions: �� ❑ I have and will maintain a certificate of consent to self-Insure for workers' compensation, as provitletl for by section 3700 of the Labor Code, (or the pertormance of Ihe work (or which this permil is issuetl. . � ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for lhe pedortnance of lhe vrork (or which this pertnit is issued. My workers' compensation Insurance carrier and policy number are: Carriec (iMs sec(qn neetl nofOe mmpetetlllhe pemN a vaNed at me hunWed �Fars (5�00) w IessJ P�a/lic'y Number: ry1%I certify Ihal in the peAortnance of ihe vrork for which this permit is lissued, I shall not employ any person in any manner so as to become subject to the workers' compensafion laws of Califomia, and agree that if 1 should bewme subject to the vrorkers' compensation provisions of Section 3700 of the„�a�}or Code. I s II fort h com th these rovisions ///// �/ P P � �6 p7 �Ap IbM ignalure - G Oate WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 1 hereby aKrm that I am licensetl under provisions of Chapter 9(commencing wilh Seclion 7000) of Division 3 of the Business and Professions Code, and my license is in full force and eHect. Lic. # Class # ConUaclor'S SignaWre Daie CONSTRUCTION LENDING AGENCY: � I hereby af(vm that there is a constructbn lending agency fw the peAortnance of the v.ork fa v.hich this pertnit is issued. (Sec. 3097, Civil Code). lender's Name: Lender's AdCress: OWNER-BUILDER DECLARATIONS: I hereby aKrm that untler penal[y of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions CoOe: Any city or counry which requires a permit ro construct. alter, improve, demolish, or repair any strucWre, prior to its issuance, also requires the applicant for such pertnit to file a signed statement �hat he or she is licensed pursuant to [he provisions of Ihe Contractors License Law (Chapter 9(commencing wi�h Section 7000) of Division 3 of the Business and Pro(essions Code) or that he or she is exemp[ lherefrom and [he basis !or the alleged exemption. Any violation of Section 7031.5 by any applicaM for a permit subjects Ihe appliwnt to a civil penally of not more than 6ve dred dollars (5500).): / I, as owner o( the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or oftered for sale (Sec. 7044, Business and Professions Code: The Contracrors License Law does not apply to an ovmer of property who builds or improves thereon, and who does such vrork himself or herself or through his or her own employees, provided that such improvements aie not intended or oRered for sale. If, however, the buildinq or improvemenl is sold within one year of completion, the ovmer-builder will have the burden of proving that he or she did not build or improve (or purpose of sale.). ❑ I, as ovmer of lhe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRAC70RS to construct the pmject (Sec. 7044. Business and Professbns Code: The contractors License Law dces rrot apply to an amer of propeny who builtls or improves thereon, and who contracls for such project with a contractw(s) license pursuant to the Contractas License Laws.). ❑ I am exempt under sec. Business and Pro(essions Cotle (or this reason: �� /�� 'A Owner ID venfied by drive �se. ❑ Yes ❑ No Driver's license No. Expires: Verifiwtion of Ownership by (type of tlocumen[, i.e. - property lax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify tha[ no excavation frve (5) or more (eet in depth into wfiich a person is required to descend, will be matle in conneclion vrith work authorized by Ihis pertnit, and [hat no building structure, scaf(dding, falsev+ork, a tlemolitbn or dismantling thereot, will be more than thiAy-su (36) feet high. (Chap. 32, Gry 2, M 2, Sec. 347, Ttle 8, Calitwnia Atlminist2tive Code). ❑ As ovmer-builder, I will noI employ anyone to do work which vrould require a permit from the Division of Industrial Safety, as noted above, unless such person has a permi[ to tlo such work fmm lhe division. ApPliranCs SignaWre Division ot Industrial Safety Pertnit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will I�e applicant or present or WWre building occupant need to fle and certify a Business Plan (or emergency response to release or Ihrea[ened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, vnth some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantiry of hazartlous matenals equal to or greater than a weight of 500 pounds, or a volume o( 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2. Does or vnll the applicant or present or future builtling occupant need to fle a registretion tortn tor acu[ely hazartlous materials? ❑ Yes ❑ No (Section 25533 ot the Califomia Heal[h and Safery Code, wilh some exceptions, requires registralion with the Cos[a Mesa Fire Department 6y each business which at any one time has on hand a quantity of awtely hazardous materials equal to or grealer ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at stantlard temperaWre antl pressure�. 3. Does or will the applicant or present or future building occupant neetl to prepare an RMPP (Risk Management and Prevention Program (or acutely hazartlous materials)? ❑ Yes ❑ No (Section 25534 of [he Califomia Health and Satety Cotle pmvitles that Ihe Costa Mesa Fire Department may require the preparation, certification and filinq wiN the Fire Department of an RMPP by businesses which are required to regisler acutely hazardous materials wi[h [he Fire Department. 4. If an RMPP is presenUy require4 has Section 25534 of the Cali(ornia Health antl Safety Cotle been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future builtling ocwpant require for Ihe vrork which is the subject o( this application a pertnit for such construction or motlifica[ion from the SoWh Coast Air Quality Management Distncl or fmm any other air pollution control tlistrict or agency? ❑ Yes ❑ No (Section 658502 of Ihe Cali(omia Govemment Code requires Ihat the requested in(ormation be fumished on applications (or nornresidential building pertnits). 6. Will any part of [he faciliry to be consWctetl under this permit be within 7000 (eet (rom the outer boundaries of a school? ❑ Yes ❑ No (If'yes", the facility must meet the requirement of Seclions 25534 and 42303 of the Califomia Health and Safety Code). 7. If a permit from the South Coas[ Air Quality Management Dislrict or other air pollution control tlisMct or agency is required for t�e vrork which is the subject ot Ihis application, have all of the disclosures prescrihed by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (If "yes", attach certifcate of compliance from the appropnate air polWtion control oKcer). � . CER7IFICATE OF COMPLIANCE: I certify that under penalty of perjury�the information given above is cortect. I agree to comply with all state laws and cily ordinances regarding Hazardous Matenals and�Emissions. JignaNre oale. . CERTIFICATE OF COMPLIANCE AND AUTHORIZATION .OF ENTRY: I certify under penalty of perjury that I have read this application and state tha[ the information given is correct I agree ro comply with all state laws and cily ordinances relating to building construction, antl authorize representatives of Ihe Ciry of Costa Mesa to enter upon Ihe above-descri etl property for inspection purposes. I agree not o occupy allow occupa y ot ny building author' by ihis permit u f inspec � / (7 Q Signatj�yf L� l7J e� �Dai n�aro. n„mo��ee naoi�wm oa�e Costa Mesa Building Department :�PPLICATION FOR PERMIT t.�. P. O. Box 3!' ��'�-�- U B��,. � I N� ' , � ' � � COSTA MESA, Ci �RNIA FOR OF1� iCE USE ONLY �� FOR APPLICANT TO F`ILL IN Receipt No. Permft No. nadae� y.54 Lenirood Cir(1e 525 � Costa Mesa, California Received by I Date Rec'd�^I Date Issued W, Koll Construc�ion Co. Address tng�neer 4111QC � T. VLa. No. A b Address 2025 n�etaport Avenue City Lic. Contractor O�;;ner No. Address� $alt'i� Legal I Lat I I oescrintion No. 11 Block � Tract 3137 — Size of Lot Use of X Building Now on Lo} Ptone No.of No.of F,amilies Room� Rear Yard _ g � � Demolish � No. of Rooms r7 Stories 1 � Costa 1Vlesa, California Plans Covering Frat,e & Stuccb oovering Shakes APPROVALS Use of New Building $.�ri 12 :�3*i!11 �" ��ri FoundationLocation Inspector Forms, Materials, Under-Pinning Frame: Fire Stops, '� Bracing, Bolts I her y acknowledge that I have read this Application and state that the above is correct and agree to comply Lath. Int. with all City Ordinances and State Laws regulating building construction. �ath. Ext. Signatureof Permittee � Plaster, Int. Authorized Agt. Plaste�, Ext. Valuation Permit Fe � ,3 O� Masonry Reinforced $ `�, �j�o ^ Plan Check $ .i i gond Beam � Total � Fee �E� � FINAL flM 209 10�55 D. P/M1 5. �_ Date Date ...1 � IStreet PLOT PLAN 6how tocatlon and distancea irom property Iine and between buildings � N -� G �; r 'i r ^ n� .�a � ' ; OWNER K ,�.i, xnrt rnrz��^ JOB ADDRESS ��J Leri4700 GENERAL CONTRACTOR Same ircle DATE 6-6-57 _ SUILDING PERMIT NO. 525% VALUES l9_91�(l_fl(1 AP. No. LOT 11 1'RACT 3137PIRE ZONE DESCRIPTION OF WORK REs, h/det. �2T. GROUP j� J TYPE V ZONE RI1 PLAN NO. ��qn I I I PPRMITS ICRl1FI) INSPECTIONS House Final Gas DATE � SUBCONTRACTOR �.sic