The URL can be used to link to this page

Home My WebLink About3367 LARKSPUR ST - Building Permits� 1 ,� , - CITY OF COSTA MESA 4�,�'rtpMs'q BlIILDING DIVISION i�� 77 FAIR DRNE. COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us ° g FOR INSPECTIONS CALL:' (714) 754-5626 '`°'�°"`� PERMIT NUMBER: E10-00302 PERMIT TYPE ELEC APN: 41218254 STATUS: ISSUED DATE ISSUED: 12/23/2010 ISSUED BY: RMD JOB ADDRESS: 3367 LARKSPUR ST CM Suite/Unit: Vicinity: GARAGE + SCOPE OF WORK: ELECTRICAL PERMIT TO EXTEND DEDICATED 20A, 120 VAC LINE FOR AN EXISTING FURNACE LOCATED IN GARAGE. ' - � OWNER: ENGLISH, THOMAS C TR PHONE: 714-556-7183. � APPLICANT: ENGLISH, THOMAS C PHONE: 714-556-1183 . , CONTRACTOR: OWNER-BUILDER Address: Unit: PHONE: Ciry/State: ZipCode: ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $42.80 Reinspection Fee $0.00 TOTAL FEES • $42.80 Address: 3367 LARKSPUR ST Unit: City/State/Zip: COSTA MESA, CA Add255: 3367 LARKSPUR ST Unit: City/State/zZip: COSTAMESA,�CA - ' License No. 000000 CELL: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under 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 ezpiretion of this permil. COOE 1. INSPEC110NTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wall 202 . Final Factory Fire Place � i, . 203 � Final Sign ' " � 204 Final Demolition onre ixnna�s COOEC INSPEGTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electriral 212 Final Fire Prevention 220 Final Planning Approval �, 222:, Final Site 250 FinalOuilding/Occupancy , OATE INTITIFLS )C �-Iq-1 � , �� WORKERS' COMPENSATION DECLARATION: I hereby affrm under penalry of perjury one of Ihe tollowing declarations: ❑ I have antl will maintain a certificate of consent lo self-Insu�e (or workers' compensation, as provided for Dy section 3700 of the Labor Cotle, for the pedormance o( the work (or which this permit is issued. ❑ I have and will maintain v.urkers' compensation insu2nce, ��as required by section 3700 of Ihe Labor Cotle, for the performance of lhe work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Carrier. , (Thrs sepion neetl irof be comdete0 R tne peimrt is valved at one hvntlred 0ollan (St00) w less ) Policy Number: � I�certify ihat in the pertormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subjecl to the vrorkers' compensa[ion provisions o( Section 3700 of the Labor Code, I shayforth itt compl wit� these provisions. C, ��Vy� � Z ,Zold CAppilranfs Signawre i �Dat2; WARNING: FAILURE TO SEC ORKERS' COMPENSATION COVER4GE 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: I hereby aKrm thal I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 ot ihe Business and Professions Code, and my license is in full (orce and eftect. Lic. # Class # Contraaor's Signalure Date CONSTRUCTION LENDING AGENCY: ❑ I hereby affirtn that ihere is a constructbn lending agency for the peAortnance of lhe �+ork fa wfiich Ihis pertnit s issuetl. (Sec. 3097, Gvit Code). Lender's Name: Lender's Atltlress . Da�e OW NER•BUILDER DECLARATIONS: I hereby aHirm ihat under penalty of perjury lhal 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the follovring reason (Sec. 7031.5, Business and Pmfessions Code: Any ciry or coumy which requires a permit to constmct, alter, improve, demolish, or repair any stmcWre, prior to its issuance, also requires the applicant for such pertnit to fle a signed statement that he or she is licensed pursuant to Ihe provisions of the Contractors License Law (Chapler 9(commencing vrith Section 7000) of Division 3 0( the Business and Professions Code) or that he or she is exemp[ therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects �he applicant to a civil penalty of not more than fve huntlretl dollars ($500).): Q�I„as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intendetl or oflered for sale (Sec. 7044, Business and Professions Code: 7he Contractors License Law does not apply lo an ovmer of property who builds or improves thereon, and who does such vrork himself or herself or lhrough his or her ovm employees, provided that such improvements are not intended or ofteretl for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burtlen of proving that he or she did not build or improve for purpose of sale.). ❑ I, as ovmer of the propeAy, am EXCLUSIVELY CONTRACTING WI7H� LICENSED CONTRACTORS ro consWct the project (Sec. 7044, Business and Pro(essbns Code: The contractors License Law dces not apply to an ovmer o/ property who builds or improves thereon, and who cont2cts for such pmjecl with a cmt2cta(s) license pursuant to the Cont2ctors Ucense Lav.s.). ❑ I am exempl under sec. Business and Professions Code for this reason: �it,�►x<,p C� . �„a��.,-�, /Z�/23�20/0 SigpaWre Daley�, y ]05]-46(3/0]) (�—'�/'�� s ..'� Owner ID venfied by driver's license- ❑ Yes ❑ No Ori�ers.C�cense.No. Expires: �� Z$ ZD/'� Verifcation o( Ownership by (type of tlocument, i.e. - propeny tax bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMI7 CERTIFICATION: . ❑ I hereby certify that no excava[ion frve (5) or more feet in depth into which a person is required to descend, will be made in connec[ion with work aulhonzed by this pertnit, and that no building s[ructure, scaHdtling, (alsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sea 347. Title 8, Califomia Atlminislrative Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a permit from ihe Division of Industrial Satety, as noted above, unless such person has a permit to tlo such work from the tlivision. ApplicanYs SignaWre Dale Division of Industrial Safety Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will �he applicanl or present or fuiure building occupant need to file and certify a Business Plan tor emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Sec[ion 25505 of the Cali(ornia Health and Safely Cotle requires, with some exceptions, that a Business Plan be filed with the Cosla Mesa Fire Departmem by every business which has at any one time during 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 (eel of compressed gas at standard temperaWre and pressure�. 2. Does or will the applicant or present or fuWre building occupant need to file a regisiration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Safety Cotle, with some exceptions, requires regis[ra[ion with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous ma�enals equal to or greater than a weigh� of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature antl pressure). 3. Does or will Ihe applicant or present or (ufure building occupant neetl �o prepare an RMPP (Risk Management and Prevemion Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of Ihe Califomia Health and Safety Cotle provides that the Costa Mesa Fire Department may require the preparation, certifcation and (ling with Ihe Fire Department ot an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently requiretl, has Section 25534 of the Califomia Health and Satety Cotle been fully complied vrilh? ❑ Yes ❑ No 5. Does or will the applicant or present or fuWre builtling oCCupant require (or the wnrk which is the subject o( this application a permit tor such conswction or modifcation from the SoWh Coast Air Quality Managemen[ Dislrict or from any omer air polWtion control district or agency? ❑ Yes ❑ No (Section 65850.2 of [he Califomia Govemment Code requires that the requested in�ortnation be fumished on applications fa rron-resitlential builtling permits). 6. Will any part of the facility to be constructed under this permit be wi�hin 1000 teet trom Ihe outer boundaries of a school? ❑ Yes ❑ No Qf "yes", the facility must meet [he requirement of Sections 25534 and 42303 of the Calitomia Health and Sa(ety Cotle). 7. If a permit from the South Coast Air Qualiry Management Districl or other air polWlion control districl or agency is required for the work which is the subject of this application, have all of the disclosures prescribetl by California Health antl Safety Code Section 42303 been made? ❑ Yes ❑ No 8. pf yes", attach certifcate of compliance (rom ihe appropnate air polWtion control offcer). � CERTIFlCATE OF COMPLIANCE: I certify that under penalty of peryury the information given above is correcL I agree to comply with all state laws and city ordinances regarding Hazardous Matenals and Emissions. - CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certi(y under penalty of perjury that I have read ihis application and stale lhat the information given is correcL I agree to comply with all state laws and ciry ordinances relating to building conswction, and authorize representatives of [he City of Costa Mesa to enier upon the above-tlescribed property for inspection purposes. I agree not to occupy or allow occupancy of any building aNh rized by this permit il final inSpEGlion. a+ C . �.L Z .� � Signawre ol Legal q !O�a Je J, ��x��.1'r,...� {� Anplar Au��orrzetl ADP�� r �_�1 City of Costa �I�lesa �uiCding �ivision 77 Fair Drive, Costa Mesa, CA 92626 osta 1V�esa 714-754-5273 / Fax 714-754-4856 OWNER BUILDER VERIFICATION Permit# l/tD�W�v. Disclosures &_Fotms,for Owner- Builders Applying for Construction Rermits �� IMPORTAIVT! NOTICE TO PROPER'iY OWNER � Dear Property Owner: An application for a building permit has been submitted in your name listing ourself as the builder of the property improvements specified at 3 36 ?.La,rkcnu.r S't. .�os�a �ttsa . q26z6-l7yl We are providing you with an Owner-Builder Acknowledgm t and Informaton Verification Form t make you awar� of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. .Z � 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuri�s sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder anii'am aware of the limits of my insurance coverage for injuries to workers on my propeRy. �' � 2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. ��3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. �'� 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. �'£ 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. �£ 6. I understand if I am considered an "employer" under state and federal law, i must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. �J' £ 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the irltent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 3148-30 CALBO Jan t, 2009 OB Packet template 1 of 2 . �� 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. �� 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. �� 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsibl�e for pJopo�e�i construction activity at the following address: d� 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. � �` d�1 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public.•If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. lt is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property ownei's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Signature of property owner��.v►'v��c-4 v• li�...ec(�-ai�. Date: '1. Z3 '�1.OlD Note: The following Authorization Form is required to be completed by the property own2� only wh2n . designating an agent of the property owner to apply for a construction permit for the Owner-Builder. �' AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy o( the owner's driver's license, form , _ notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: 3148-30 CALBO Jan 1, 2009 OB Packet template 2 Of 2 CITY OF COSTA MESA �� p MF q BIIILDING DIY/SION F�� 77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax Q14) 754-4856 • �wwi.ci.costa-mesa.ca.us � FOR INSPECTIONS CALL: (714) 754•5626 4`w.a.aw'�' PERMIT NUMBER: P10-00129 PERMIT TYPE PLUM APN: 41218254 �� ,;�v�' .e�" JOBADDRESS: ='3367_LARKSPUR:ST'�CM'�� Vicinity: � � � - STATUS: ISSUED DATE ISSUED: 09/17/2010 ISSUED BY: KJB Suite/Unrt: SCOPE OF WORK: COPPEa RE-PIPE, WATER LINE FROM METER TO RESIDENCE, NEW WATER HEATER, GAS LINE. OWNER: ENGLISH, THOMqS C TR `� � � Address: 3367 LARKSPUR-ST �,� PHONE: � - � City/Slate/Zip: COSTA MESA, CA APPLICANT: PEPANYAN, ARq� �� Address: � 400 N GLEOAKS BLVD : PHONE: 818-566-1990 " � -, City/State/zZip: BURBANK, CA � , CONTRACTOR: NUMBER ONE STATE PLUMBING WC License No. 818637- _.� Address: 400 N GLENOqKS BLVD ... .. ��PHONE: 818-566-�390 � City/State: BURBANK, CA � ZipCode:� 91_502� � � - - .CELL: - - . ARCHITECT: ENGINEER: License No. . License�No. � � PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: - - $0.00 PERMIT'FEE: ,_ $71.35 TOTAL FEES: $71.35 PHONE: PHONE: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: PERMIT EXPIRES !80 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPEC710N. 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 appmval will result in lhe expiration of this permit. CODE/. INSPELTIONTYPE OATE INTITIALS CODEI INSPEC710NTYGE �ATE INTITIALS 1618 Fixed System Final Fire Prevention 206 Final Mechanical ./ ^ 1266 Pool Spa Final 208 Final Plumbing /� _/ � a�"��% tt-� 200 Final Re-Raof 210 Final Electrica� 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Faclory Fire Place 220 Final Planning Approvai 203 Final Sign 222 Final Site 204 Final Demolition - 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARqTION: I here6y aRrm under penalty of perjury one of [he following declarations: ❑ I have and will maintain a certificate of consent [o self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the peAormance of the vrork for which this permit is issued. have and will maintain vrorkers' compensation insurance, as required by s tion 3700 ot the Labor Code, tor the peAormance of the work for which this pe il is issuetl. My workers' compensation Insurance carrier and policy numher are� -7� �r - [ier. �LtP%c �!� S' � (—tC�QGfif � (ThiSsedionneetlrrofbewmpletetlAlhepemrttisva2luetla�ehu redtlollars(5100)orless) P�oRc�Numbe�:' ,�� / � ❑ I certify lhat in the performance Of the work (or which this permit is issued, I shall not employ any person in gny manner so as to become subject to the workers' compensation laws of Califomia, antl agree that if I should become subject to the workers' compensation pmvisions of Section 3700 of �he Labor Code, I shall forthwith com tb.Wese provisions. -l- ��"�� l � pp ¢anfs SipnaWre '�qale .T� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF 7HE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby aKrm that I am licensed under provisions of Chapter 9(commencing wi[h Section 7000) o( Division 3 of the Business and Pmfessions Code, antl my license is in (ull force and effect. ��:� ��637 �, �-3� -�-�'�- i79�T llS �611�FZ[�OYS ignaWre rDyte-�, 1.i-"' CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrm that ihere is a ConsWction lending agency for the peAortnance of the work fa vfiich this perRiit is issued. (Sea 3097, Civil Code). Lender's Name: Lender's Address: Date OWNER-BUILDER DECLARATIONS: I hereby affrm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW !or fhe following reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires a permit to cons[ruct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires the applicant fo� such permit to fle a signed statement Ihat he or she is licensetl pursuant to the provisions of the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 0( the Business and Professions Code) or that he or she is exempt theretrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant tor a permit subjects the applicant to a civil penalty of not more than fve hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl lhe stmcture is not intentled or offered for sale (Sec. 7044, Business antl Pro(essions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himselt or herself or through his or her own employees, provided that such improvements are not intended or oRered for sale. I(, however, lhe building or imprUvement is sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sa1e.). ❑ I, as ovmer of the property, am EXCLUSIVELY CON7RAC71NG WITH LICENSED CONTRACTORS to consWct the pmject (Sec. 7044, Business and Professions Cotle: The conVactors License Law dces no[ apply to an ovmer of property wfio budds or improves thereon, and wfio contracts (or such project w'�th a contractor(s) license pursuaN to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this rnason: 305]-46�3I01) Owner ID verifed by driver s license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ovmership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby ceRAy that no excavation fve (5) or more fee� in dep[h into which a person is required lo tlescend, will be made in connectan vrith work authorized by Ihis permit, antl that no building sWCNre, scaffdding, (alsework, a demolition or dismantling thereof, will be more than thirty-six (3fi) feet high. (Chap. 3.2, Grp 2, M 2, Sec. 341, Ttie 8, California Administrative Code). ❑ As owner-builder, 1 will not employ anyone to do work which would require a permi� from the Division o( Indus�rial Safety, as noted above, unless such person has a permit to do such work (rom Ihe tlivision. ApplicanCs SignaWre Division of Indushial Sa(ety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will Ihe applicant or present or fuNre builtling occupant need to fle and certify a Business Plan for emergency response to release or threatenetl release oi a hazardous malerial? ❑ Ye5 ❑ No (Section 25505 of the California Health antl Sa(ety Code requires, with some exceptions, that a Business Plan be filed with ihe Costa Mesa Fire Department by every business vfiich has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume ot 55 gallons, or 200 cubic leet of compressed gas at standard temperaNre and pressure�. 2. Does or will the applicant or present or future building occupant need to file a registration form (or acutely hazartlous materials? ❑ Yes ❑ No (Section 25533 of ihe Califomia Health and Safery Code, wilh some exceptions, requires registra[ion wi[h the Costa Mesa Fire Department by each business which at any one time has on hand a quantily of acu[ely hazardous materials equal to or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at s�andard temperature and pressure). 3. Does or will lhe applicant or present or future builtling occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 0( the Califomia Health antl Safety Code pmvides that the Cos�a Mesa Fire Departmen[ may require Ihe preparalion, cehification antl fling with ihe Fire Departmen[ of an RMPP by businesses which are required to register awtely hazardous materials with the Fire Department. 4. If an RMPP is presenlly required, has Seclion 25534 of ihe California Health and Sa(ety Code been fully complietl with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subjecl of this applicalion a permit for such consWclion or modification (rom the Soulh Coast Air Quality Management District or from any other air polWtion control district or agency? ❑ Yes ❑ No (Sectbn 658502 ot the Califomia GovemmeN Code requires that the requestetl infortnation be fumished on applica[ions for non-resitlential building permits). 6. Will any part of the facility to be consiructed under this permit be within 1000 (eet from the ouler boundaries of a school? ❑ Yes ❑ No (If'yes", Ihe faciliry must meet the requirement ol Sections 25534 and 42303 of [he California Health and Safery Cotle). 7. If a permit fmm Ihe South Coast Air Quality Management District or other air polWtion control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 6een made? ❑ Yes ❑ No 8. Qf'yes", altach certifcate of compliance from ihe appropriate air pollution control offcer). ' CERTIFICATE OF COMPLIANCE: I certify Ihat under penalty of perjury [he in(ormation given above is correct I agree to comply with all state laws and ciry ordinances regarding Hazardous Materials and Emissions. SignaWre Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penally of perjury that I have read Ihis applica�ion and state that the information given is correcl I agree to comply with all state laws and city ordinances relating to building construction, antl au[horize representalives of the City of Costa Mesa to enter upon the above-tlescnbetl properry (or inspection purposes. I agree no[ to occupy or allow occupancy of any builtlinq aulhorized by ihis permit until (nal inspection. Sgnalure of Le9al Owner(s Date „� ��- ^ o � ' �7 -//J \ n�ne...HWhOlizeOApPliranl zy:, �te� .i� � CITY OF COSTA MESA � BYILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us�;,�, FORINSPECTIONS CALL:(714�754-5626 PERMIT NUMBER: M10-00032 PERMIT TYPE MECH STATUS: ISSUED APN: 4i218254 DATE ISSUED: 03l2412010 ,: ; �ISSUED BY: CAC � �.:� <` . JOB ADDRESS: 3367 LARKSFUR`'ST CM', �. 'Suite/Umt = . ', . Viciniry: , .- " ' _ � SQ. FT: 0 � , SCOPE OF WORK: REMOV-AND��REPLACESPLIT UNIT . 80K BTU FOR THE FURNACE AND 42 �K-BTU FOR THE A/C UNIT � �' _ � OWNER: ENGLISH,THOMqSO�TR��,'I� =?Address: . 3367.LARKSPURST�,Unit: PHONE: 714-556-1783�" . ,.. , ^` . - - .� �� City/State/Zlp: ' COSTA MESA� CA � <;�� _��', . . APPLICANT: ROY DOMINGUE2�: � •' - " - ' - : " Address: . � 7600 GARDEN GROVE BL� Unit: ' PHONE: 714-901-0500 'l��-, �' ' : � ��''` ..: � ' ""City/State/iZip:�,' WESTMINSTER, CA�` _ '��"�` CONTRACTOR: A PLUS HEqTING AND AIR CONDITION LicenseTlo.' 763154-' , �� f"��t1�� Address: 7600 GARDEN GROVE BCUnit '.�;., „ , ,.,,_ . . _ ,. .�PHONE:�.,� .,Z14-901-0500 ';� Ciry/Slate: WESTMINSTER,�CA' . ZipCodeC 92863 ' ' � �CELL: = - � .. . ; �� . ; - � . . . .. .. .. .. . . . ._ . _ . . " � �� ' j. . � �,,�i �:. . . . . - � : ' . MECHANICAL PERMIT FEE SUMMARY - MECH ITEM FEE: , $53.10 PLAN CHECK FEE: .- � � $0.00 - - INVESTIGATION FEE: " $0.00- :-'� - - '� . REINSPECTIONFEE: � � �,!`.$0.00 �� ' � ....- TOTAL FEES: $53.10 � ' r;;� :a�� : �rm r€ ��;_t,"�^;';;t NOTICE: The work authorized by this permil shall comply with all applicable handicap access requiremenls under Cali(omia statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-g2) 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 wmply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiralion of this permit. CODE p. INSPEC710NTYPE UATE INTIIIAL 40�� INSPECTIONTYPE p 'ORTE ��`.�C; '.":;�INTITI S • 1816 Fixed System Final Fire Preven�ion 206 Final Mechanical O��'�� M!/'M_/ 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall - 212 Final Fire Prevention 202 Final Faclory Fire Place 220 Final Planning Approval 203 'FinalSign 222 FinaiSite �',ii_ 204 Final Demolition 250 Final Building/Occupancy � WORKERS' COMPENSATION DECLARATION: I hereby affrm under penalry ot perjury one ol the following declarations: ❑ I haVe 8ntl will m2int2in a C2rtiiIC2IC Of COnSCOt to SEIf-IOSurC (Or wOrkerS' compensation, as provided for by section 3700 of the Labor Code, for the pJeAprmance of the vrork tor which this permit is issued. � � I have and will maintain workers' compensation insurance, as requiretl by Section 3700 0( lhe Labor Code, for the peAormanGe of ine work (or whiCh Ihis pe is issued. My vrorkers' compensalion Insurance carrier and policy r e: Ca (ID�ss ofbecTplC^-fH�lllfhPpCIIIIRISvdI✓MdIO/�PhpIICICOCOIIdIS(S10Of0/1255J Po' ber. ��l J � � � � 7 I certiry that in the peAormance of the work for which this permit is issu , I shall nol employ any person in any manner so as to become subject lo the workers' compensation laws of Califomia, antl agree that if I should become subjec[ [o lhe workers' compensation provisions of Section 3700 of the Labor Cotle, I shall forihwit omply with these provisions. �f �-( �� ign Wre le WARNING FAILURE TO SECURE RKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensetl under provisions of Chapter 9(commencing wilh Section 7000) of Division 3 of the Business antl Professions Code, and m' nse is/ri full f!orce an fect. /'� Lic. # ~ CJ �(� CI� ( / S-�3i=/ / o ractor' Dal� CONSTRUCTION LEN ING AGENCY: ❑ I hereby affrm Ihat there is a constmction lending agency for lhe peAortnance of Ihe v.ork for which this pertnit is issued. (Sec. 3097, Civil Coae). Lender s Name: Lender's Address: SignaWre �ate OWNER-BUILDER DECLARATIONS: I hereby af5rm lhal untler penalry of perjury lhat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe (ollowing reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to constmct, alter, improve, tlemolish, or repair any structure, prior to iis i55uance, also requires [he applicant for such permit to file a signed statement that he or she is licensed pursuan[ to the provisions of the Contractors License Law (Chapter 9(commencing with Seclion 7000) of Division 3 of Ihe Business and Pmfessions Code) or that he or she is exempt therefrom and the basis for the alleqed exemption. Any violalion of Section 7031.5 by any applicant for a permil subjects ihe applicant to a civil penalry of not more than five hundred dollars (5500).): ❑ I, as owner of Ihe property, or my employees with wage5 a5 Iheir 5ole compensation, WIIL DO THE WORK, and the siructure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner 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 are not intentletl or offeretl for sale. If, however, the building or improvement is soltl within one year of, completion, the owner-builder will have the burden o( proving that he or she did not builtl or improve for purpose o( sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRAC70RS to construct the projec� (Sec. 7044, Business and Professbns Code: The contractas License Law dces not appty to an owner of property who builds or improves thereon, and who cont2cts (or such project vrith a coni2cta(s) litense pursuant to the Contractors License Laws.�. ❑ I am ezempt under sec. Business and Professions Code for this reason: 305]-06 (3IW � Owner ID verified by driv�ense. ❑ Yes ❑%�o . Driver's License No. Expires: � Verifcation of Ownership by (type of document, i.e. - property tax 6ill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � ❑ I hereby cetlify that no excavation frve (5) or more feet in dep[h into which a person is required lo descend, will be matle in connection with wnrk authonzed by this pertnit, and that no building strucNre, scaf(dtlinq, falsev.ork, or demolition or dismantling thereof, vrill be more Ihan Ihirty-six (36) �eel high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, California Administ2live Code). ❑ As owner-builder, I will not employ anyone ro do work which vrould require a permit (rom the Division of Industrial Sa(ety, as noted above, unless such person has a permit to do such vrork trom the tlivision. Applitanl's Signa�ore Division of Industrial Safety Permii Number _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant neetl to fle and certify a Business Plan for emergency response to release or threatenetl release of a hazardous ma[enal? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safety Code requires, with some exceptions, that a Business Plan he filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity oi hazardous matenals equal m or greater ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at stantlard temperature and pressure). 2. Does or will the applicant or present or fu[ure builtling occupant neetl to f le a registretion form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Sa(ety Code, with some exceptions, requires regisira�ion wi[h Ihe Costa Mesa Fire DepartmeN by each business which at any one time has on hand a quantity o( acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic (eet of compressed gas at standartl temperaWre and pressure). 3. Does or will the applicant or present or fuWre building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazartlous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safety Code provides that the Cosla Mesa Fire Department may require [he preparation, certification and filing with Ihe Fire Departmenl of an RMPP by businesses which are requiretl to regis[er acutely hazartlous materials wi[h [he Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Califomia Health and Safety Code been fully complied with? ❑ ves ❑ No 5. Does or will the applicant or present or /uture building occupant require for the work which is the subject of ihis application a permit for such constmction or modifica[ion from the Sou�h Coast Air Qualiry Management District or from any other air polWtion control district or agency? ❑ Yes ❑ No (Section 658502 of the Califomia Govemment Code requires that Ihe requested information be fumishetl on applications fa nornre5idential building pertnits), 6. Will any part of the facility to be consUuc[etl under this permit be within 1000 feet from [he outer boundaries of a school? ❑ Ves ❑ No Qf'yes", the facility must meet the requiremeni of Sections 25534 and 42303 o( the Califomia Health and Safery Code). 7. If a permit from the South Coast Air �uality Management District or other air polWtion control district or agency is required �or lhe work which is the subject of Ihis application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf "yes", attach certificate of compliance trom the appropriate air polWtion control oKcer). CERTIFICATE OF COMPLIANCE: I certify tha[ under penalty of perjury the information�given above is correct I agree to comply with all state laws and city ordinances reqartling Hazardous Materials and Emissions. Signalure Da�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify untler penalry of perjury that I have read this application and state Ihat the information given is correcl I agree to comply vnth all state lavrs antl city ordinances relating to buildin9 construction, and authorize representatives of the Ciry of Cos[a Mesa to en[er upon the above-descnbed property for inspection purposes. I aqree not to occupy or allow occupancy of any building au[horized by ihis permit until final inspection. na reolLegalOwneqs) Date � � � —�Antl/orA �orrz nl Date (714) 754-5273 • Fan (714) 754-4856 • www.ci.costa-mesa��CTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: $SG7 LARKSPUR ST Suite No Viciniry: Parcel Nunmber: 41218254 status: ISS U ED Applied: 71/29/2006 Issued: 11/29/2006 App�icant: ENGLISH, THOMAS C Address: 3367 LARKSpUR ST ISSUED BY: Phone: 714-556-1183 COSTA MESA, CA - , - ' � Zip 92626 � - � - � , � � Owner. ENGCISH, THOMAS C TR �, ,' � _ ; , � Address 3367 LARKSPUR ST .-' � � - - �` - � - i � � ' "': � '�'- � �=�Phonei 714-5561183 ' - � �� , ;COSTA MESA,.CA , � �-` Zip. 92626 � - �' � _� ,� � � . � i �� , , - � ti ��` �.A Contractor: OW N ER-BU I LDE R Address: � - � � � , .� .�.� . `�� \ � , �\, , ' ��i� i:,A Phone - �� Zip �� ,j � . , . License�,000000 � � . SCOPE OF PERMIT ' -- � � � � � . ' ,, �� ,` ELECTRICA� pERMIT TO INSTALL 2 LIGHT FIXTURES IN 2 BATHROOMS (t FIXT.IN EACH = . BATHROOM), t RECESSED LIGHT FIXT IN KITCHEN, REWIRE BRANCH CIRCUITS AND CHANGE OUT 3 � , OUTLETS IN KITCHEN AND 5 OUTLETS IN GARAGE AND 1 SWITCH IN KITCHEN FOR A SFD�. ,� , ISSUE FEE . ' Temp service tesl .', Res. a/c package New Res (1-2 units) New.Res (3+units) ' Pool / Spa Lighting Fixts Recept Oullets Switches Non Res Appl, , Res Appl , Service to 200a � Service to t000a . Service over t000a Motors to 1fip , - Motors l0 10hp Motors to 50hp Motors l0 100hp, Motors over 100hp� �, Communication drops_`- Sub panel to 200a �� Pole Lighl Pkg Sign Circuits Temp Pwr Pole In�ermed Pole . � � FEE SUMMARY ` � �Quantlty. -� - • -. _ ''. : �-.' i � : ` �` .Quantlty� ' ` . $23.50 Temp Dist System % Lighting -' $0.00 0 • � � _ - � `-' ; $0.00 � Busway/100fl •� - $0.00 0, � �' ' ' $0.00 � Standing Sedion, � �� ' $0.00 0 '� " - � $0.00 ' 0� '�� = ,- Misc.Electrical Equipment . $0.00 0 � � %' ' -�� _, $0.00 ' � - 0 - '�_ _ - � - � Transfo}mers up to>7 kda/kw-, $0.00 0 °;� , � r " - ' � $0.00 � . ` �0 " � � � .. ` � . up`to 10 kva/kw � � � $0.00 0 < � ; ,-� ",' ; $3.30 3 ...............Lup to`50 kva/kw ' $0.00 . 0,`%,, � `.� �� . , $8.80 8 �...up to 100 kva/kw ��-_, $0.00 d � , r "� -� ., � i $1.10 1 ....... .:.........o'ver 100 kva/kw � $0.00 �0%� ;i� - ,, � $0.00 0 Low Voltage Equipment $0.00 ;!0� � �� ; � �� _ $0.00 0 -�!`��'.CowVoltWiringSystem/Ckt $0.00 %�<,0� � � ,., � $0.00 0 � � Misc:Conduit $0.00,�%0 �� /� �.� ' � ' $0.00 0 Misa Conductor� $0.00 j%% 0 " -, � � ' $0.00 0. , � ` . � � ' �Cirws ( gen or-ride) „_;,,.. , $0.00 ' 0� � � i r� $0.60. .�'�-� 0; . - --Cirws(mechride"oi�lights)Y;�"" ;,50.00� 0"�. ' j��' ! , $0.00 - 0 � � � � Christmas Tree Stand` ,:,$OAO.-�, 0 /;� j�;' - $0.00 �� - ' � _. 0 � " � �Fiieworks Stand � -� ; ^'��$0.00 �; 0 /, ; % $0.00 ' .' 0� � �� - � � � Other Electrical Fee : �� ";=f:%" $0.00 <�% .; j � $O.QO.. .-.0_,_ _ ' • - ; __-,-�> ".'� � ��,�-��v /: i / ' $0.00 � ` 0� � - - � � -Investigation;Fee'.�. � , . � - $0.00 � �i/ . $0.00 0 ' ' - Plan Check Fee ! $OAO �'i � '$0.00 �_ , 0 � � - Reinspection Fee' r.�i � `t•-'$O.00i,�/ ' $0.00 , 0 - � - - .. � . . - � � � ., �„ � : �� 50.00 0� � - TOTAL CAL'CUL"ATED FEES 53670�' $O.QO��.' 0 _ - _ _.�',A_.... .. �. -�i//%��/, NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 7, 12-21-92) EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or abandoned ior a period ot 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 Inapections and flnal epproval must be obtained. Failure to obtain inspections and final approval will result in Ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � ' Li6WC �GW) WORKERS' COMPENSAnON DECLAfiAnON: � � I hereby eMirm undar penelry of perjury one of the tollowing declaretions: . . � � ❑ I heve entl wlll melntein e cenificete of consent ta setl-Insure for workars' compensetioq es provlded lor by section 3700 of the Lebor Cotla, tor the pertortnence oi the work for which thi5 pertnit Is issuetl. � I have arM will meiniain workers' compensation in5urance, a5 required by 5ettion 3700 of tha Lebor Cotle, �or Na pertortnance of the work for which Ihis pertnit is issuetl. My workers' compensation Insurence carrier antl policy number are: Carner: Polity Number: (Thls sect(ar need no( be completed i! the pemrit is valued et one hundred tlollers ($100) or less.) � ity ihat in the peAortnance ot Ihe work lor which this pertnit is issued, I shell nol employ any person in eny manner so as to become subject to the workers' �ensation laws of Califomia, antl egree that il I shoulE become subject ro the workers' compensatlon provisions of Section 3700 of the Labor Coda, I shall forihwlth iy witli ihese Pr visions. /� - .a :gnelure:— ` `� � rDete: �l�/29/06 °AILURE405ECUREWORKERS'COMPENSATION E GEISUNUwFULAND5HALL5UBIECTANEMPLOYER'TOCRIMINAL�PENAL ESANDqVILFlNESUPTOIXJENUNDRED DOLLARE (5100,000), IN ADDITION TO THE COST OF ENSATIqJ, DAMAGES AS PROVIDED FOF IN SECiION 3706 OF THE UBOR CODE, IMEREST, AND ATTOFiNEVS FEES. LICENSED CONTRAC70RS DECLARATION: I hereby aflirtn Ihet I em licensetl under provisions of Chapter 9(commencing with Section 7000) oi Division 3 of the Business and Professions Cotle, and my license is in tull iorce ana ettect. Lic. p Class N Conirectors Signature: Date: CONS7RUCTION LENDING AGENCV: ❑ I hereby eNirm that Ihere is a construction lending agency for the pertormance of the work for w�ich this permit is issued. (Sec. 3097, Civil Coda). Lenders Neme: Lendels Atltlress: Signature: Data: OWNER-BUILDER DECLARATIONS: I hereby aHlrm Ihat untler penalry of parjury thet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business and Professions Code: Any ciTy or counry which requires a permit to construci, alter, improve, demolish, or repair any structure, pnor to its issuance, elso requires the applicent for suc� pertnit to tile a signed statement that �e ar she is licensetl pursuant to the provisians oi the Contractors License Law (Chepter 9(commencing with Section 7000) of Division 3 of the Business antl Professions Cade) or thet he or she is eaempt thereirom end ihe basis for the allegetl exemption. Any violation of Section 7031.5 by any applicant for e pertnit sub�e��flpplicant to a civil penalty M not more lhan five hunAred tlollars ($500).): ' � I, as�owner ot the property, or my employees with wages es their sola compensation, WILL DO THE WORK, antl the sirucNre Is not imentled or oflered for sale (Sec. 7044, Business antl Profeuions Cotle: The Contraciors License Law dces not apply to an owner of property who builtls or improves ihereon, entl who does such work himsetl or hersetl or through �is or her own employees, pmvided ihat such improvemenis are not Intended or oflered for sale. If, however, the building or improvement is sold within one year ol completion, the owner-builder will have Ihe burden of proving Ihat �e or sha tlitl not build or improve for purpose of sale.). ❑ I, as owner ot Ihe property, am EXCLUSIVELY/CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business and Pwfessions Cotle: The coniractors Licensa Law tloes not 9ppty to an owner of property who 6uilds or impmves thereon, antl who contracts for such pmjec� with a contractor(5) license Oursuant to ihe Contrectors License �aws.). • n Owner ID venfied by dnvers license. Venilcation of Ownership by (type of Business antl Professions Code for this reason: s�0 No i.e. - proparty tan bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cehify Ihet no excavation live (5) or more fee[ in depih into which e person is required to descend, will be matle in connection with work euthorizetl by this permit, and Ihat no building structure, scaHolding, lalsework, or demolition or dismamling thereof, will be more Ihan thirty-si: (36) feet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Tltle B, Cali}omia Atlministrative Cotle). ❑ As owner-builtler, I will not employ anyone to do work which would require a pertnit from Ihe Division of Industnel Safery, as notetl ahove, uniess such person has e permit to do suc� work fmm the divisian. SignaWre: Date: Division of Industnal Selery Permit Number. CERTIFlCATE OF COMPLIANCE AND AUTHORQA710N OF EMAV: I certity under penalty of perjury Ihat I have read Ihis application and state that ihe iniormelion given is correct. 1 egree to wmply with all stete laws end ciry ortlinances relating to building construction, and authodze representatives ot the Clry of Costa Mesa to enter upon the ebove-descnbed properry tor inspection purposes. I egree not to occupy or allow occupancy ol eny building auihonzed by t�is permit until finel inspection. w�v,.�.e-a �` • (.v��. lI�Z4�06 'Signat��re �_ e al Owner(s)-r - � � � �ate.` , .a''' Antl/Or Authonzed Applicant Date COOE I. INSPELTIONTYPE 7616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Finel Re-Fool 201 Finel BIocWRetaining Wall 202 203 204 Final Factory Fire Place Finel Sign Final Demo ition ' P� � INTITIALS CQDE 1 INSPECTION TYGE 206 Finel Mechanical 208 Finel Plum6ing, 210 Finel Electncal 212 Finel Fire Prevention 220 Final Planning Approval • 222 Final Siie 250 ' Finel Builtling/Occupency �� ^— �Pcece RESIDENTIAL KITCHEN LIGHTING VVORKSHEET WS-SR Project Tide Date At least 50°io of the total rated wattage of permanendy installed luminaires in the kitchen must be in luminaires that are high eflicacy luminaires as defined in Table I50-C. Luminaires [hat are not high efficacy must be switched separately. Kitchen Lighting Schedule. Provide the fo!Ic�.vir.g infcrtnation for all lumir.aires tc bc installed in kitchens. Luminaire Type High Efficacy? Watts x Quantiri = High Efficacy Watts or Other Watts Yes No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No o" x Total: A: Rules for Detertnining Residential Kitchen Luminaire Wattage or — v — or or or or � COMPL/ES /F.4 ? B Yes ❑ No 0 Screw Base Sockets §130(c) 1 �(Not containing pertnanently installed ballasts) The maximum relamping rated wattage of the luminaire, as listed on a permanent faccory-installed label (luminaire wattage is not based on rype or wattage of lamp that is used). Permanenriy or Remotely Instalied Ballasts §130�c) 2 The operatinq input wattage of the rated lamp/ballast combination based on values published in manufacturer's ca[alogs based on independent testing lab reports. Line Voltage Track Lighting (90 through 480 volts) §130(c) 3 1. Volt-ampere (VA) rating of the brench circuit(s) feeding the tracks: or � 2. Thehigherof . The wattage (or VA) rating of an approved integral current limiter controlling the track system or 15 watts per linear foot of the track; or 3. The higherof • 45 W per linear foot of the track or . The total wattage of all of the luminaires included in the sys[em. Low Voltage Track Lighting �less than 90 volts) §130�c) 4 Rated wattage of the transformer feeding the system, as shown on a permanent factory-ins[alled label Other Lighting §130(c� 5 (Lighting systems that are not addressed in §130 (c) 1-4) The maximum rated wattage, or operating input wattage of the system, listed on a permanent factory installed label, or published in manufacturer's catalogs, based on independent testing cV��m. EXAMPLE RESIDENTIAL KITCHEN LIGHTING WORKSHEET Project Title Date WS-SR Kitchen Lighting Schedule. Provide the following information for all luminaires to be installed in kitchens. High Efficacy Luminaire Type �v/n) Watts x Quantity = Hi¢h Efficacy Watts or Other Watts CFL-I Yes 26 x 5 = !JO or MR-16 No 55 x 1 = or llp � = or X = or X = or Kes ioentla! C omplmnee Y orms Total: A: /30 B: 110 COMPLIESIFA>_B Yeso h'o❑ Apri!?005 , AIANDATORY MEASURES SUMMARY: RESIDENTIAL (Pa� Space Conditioning, N'ater Heating and Plumbing System Measures: (continued) 5. Insulation musl he pmlected frnm dama¢e. incluAing �hal due lo sunlighl. meislurc, tyuipment mainlenantt, and wind. 6. Insulation for chilled waler piping and refiigerant suclion pipin@ includcs a vapor remrdant or is enclnsed entirely in 7. Solar wa�er-healine svstems/collecwrs are certi0ed bv the Solar Ratine anA ('eniliraiinn C�rry+miinn ' §ISO�m�: DuctsandFans �, pll duc6 and plenums insialled. sealed and inwlated lo meet Ihe reyuirement of �he CMC $ecliorts 601, 602, 603, 6(W, 605 azM S�uidard 65�, mpply-air a�d rctum-air ducts a� plenums are insulated m a minimom inseafkd kve! of R-t 2 or e�foscd entirely in wrditioned spatt. Opeoings shall be sealed wilh mattic. tape or olher duc4closure rystem thal meefs the applicable requirtmrn6 of UL 181, UL 181A, or UL 181 B or aeros0� ua�ant that meets the rzquiremenis ofUL 723 If ma�Uc or tape is 2. Building cavilies, support plat(ortns for air hardlers, and plenums defined or construcled with malerials olher than seuled sheet metal. ducl board or Oexible ducl shall mt be used for conveying conditioned air. Building cavities and support platforms may contain ducB. Ducis inslalled in cavilies and support plalforms shall nol M compressed to cause 3. loin(s and seams o(ducl systems and Iheir components shall no� be ualed wilh clolh back rubber adhesrve duct tapes uniess eu.l� tapt ii iaed in eumbinnliun with maslic and draw bands. y, [cnaus� ian systems have back Oratt or automanc dampers. 5. Graviry ventilaung rystems serving cunditioned space have either automatic or rwdily accessible, manual ly operaied dampers. 6. Proteclion o(Inwlalion. InSulaliun shall be prolected Gom damaee. including Ihal due lo sunlighl, moismrc, equipme mnintenenc<. and wind. Cellular foam insulation shall be prolecled as above or paimed wi�h a cwting Ihat is waler retaMant;md nmviA�<chieldine frnm solar radialion ihai can ceutie deerada�inn n(Ihe maierial 7, Flerible ducLs canno[ have porous inner mres. § I 14t Poo� and Sp� Heating Systems a�d Equipmeot. L A lhermal elLciency Ihat complies wiih �he Appliance EtLnency Regulabons, heater. wea�hemrmfnner:��ine inswnions. noelectric resistance heatineand i 2. System is insialled wilk a. nl Icasi 36" o(pipr hetween filter and heaier (or Iulure solar heaiing b. cover for nmdnor poo15 or ouldi�r spas 3 Pool sysiem hac direclional inlels and a cirtulalion pump time swilch. p 1 15'. Gas f ircd fan-i�pe crnvaf fumaces. }�ol heaters. spa heaurs or householc hnrnine nilnt liohi IFrreminn- Nnntlectrical ennkin¢ unoliances �vith nilM c no � ; I IBIi): Cool Roof material mccts spccificd critcria Residential Lighting Measures: 51 i0(k11: HIGH EFFICACY LUMINAIHES OTHER THAN OUTDOOR HID' conla�n onlp high c0icaq� lamps as � �pllined in Table I50-C. and du noi contain a medium screw base snckei IG24/E?6� Ballact (nr lamps I i wans or erealrr are electron�c and have an out ut fre uenca no less than ZU kHz .�" IiUlk � I: HIGH EFFICACY LUMINAIRES - OU'1'DOOR I11 D: eontmn onlr high el'feacc lamps as omlined m Table 1<0-C. lumina�re has faaon' ms�alled HID hallast � � jO�A)2: Permanendy ms�alled lummaires m kitchens shall be h�@h nlicacy luminaires. Up �0 50 pcsem ofihe wanaee. as dt�ermined in § I JO �c), of permanently inswlled luminaires in ki�chens may be in luminaircs thal are not high etiicacy I uminaires, provided that these luminaires are controlled by s�ritches separale Gom lhose contmlling [he high t((icacy lUminaires. � I>O�k)3: Permanentiv installed luminaires in bathrooms, garages, laundry rooms utiliry rooms shall he high e�licacy I nminaires. OR are coNrolled by an occupam sensor(s) certi�ied lo comply with Seetion I 19�J) �hal dces noi tum on au�omalicallv or have an alwa�'s on o tion. � � j0(k�4: Permanemlv insialled luminaires located other than in kilchens, bathrooms, garages, laundp� rooms, and utiliry� nnm> shall be high ef7icacy luminaims (eKcepi dosels le5s �han 70R'�: OR are confrolled by a dimmer swimh OR are comrolkd by an occupant senso� that complies with Section 119�d� that does not fum on automancally m have an ahvays an o tion. � � i0�k�5: Luminaircs that are reressed imo insulaled ceilings are approved for zero cleamnce msulalion cover ( IC) and are c�ni�ed airti ht lo ASTM E'_83 and labeled az air tieht (AT� lo less Ihan 2D CFM a� 75 Pascals. C IiD(kKi: Luminaircs providing outdoor lighling and permanemly moumed to a residemial building or ro other buildings on �}z same lot shall be high efLcacy luminaires (not includine lighfing around swimming pools/waler lealures or o[her Anicle 6801ocations� OR are comrolled b� cecupanl sensors ��ith imreral phuto comml certi�ed Io comply with Se<tinn p91d1. § �i0(k)7: Lighling lor parking lols for 8 or more vehicles 5hall have liehiing lhat complies wilh Sec. 130, 13:, and 147. Uehtine for arkine earaees for 8 or more vehicles shall ha��< liehtine that com lies w'ith Sec. 130. 131. and 146. 51 i0(k)8: Permanently installed �igh�ing in the enclosed, nomdwelling spaces ol'low-rise residential buildings with four or rturc Jueiline unils shali be hieh eff¢uy luminnircs OR arc commlleel hy occupam unmqs) cenilied locomply wrth Resi�entia! Conrplianre Forms z or2) MF-1R Enforco '' NA� Desi ner menl ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ (714) 754-5273 • Fax (714) 754-4856 . www,ci.costa-mesa�c�i.�sCTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 .lobAddress: 3367 LARKSPURST Suite No Vicinity: ParcelNunmber: 41218254 Applicanc ENGLISH, THOMAS C TR Address: 3367 LARKSpUR ST COSTA MESA, CA Owner: ENGLISH, THOMAS C TR Address 3367 LARKSpUR ST � � " � COSTA MESA, CA �, l� Contrector Y . Address: �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 l0 1 hp � � Motors to 10hp . � Motors to SOhp Motors to 100hp Motors over t00hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole OWNER-BUILDER Phone: 714-556-1183 ' Zip 92626 Phone: Zip: 92626 Phone: Zip: License: 000000 Status: ISSUED Applied: 0425/2006 Issued: 04/252006 n, ISSUED BY: " SCOPE OF PERMIT � REVISIOIJ Tb PERMIT MADE ON 05/04/06 TO REFLECT DELETION OF 2 CONDUIT, ADDITION OF 3 - LIGHT FIXTS, 3 SWITCHES AND 3 OUTLETS LOCATED KITCHEN, FAMILY ROOM AND GARAGE. ELECTRICA� WORK:.ADO 5 OUTLETS FOR MICROWAVE, GARAGE AND FAMILY ROOM AND 2 MISC. CONDUITS. - -� � - - � . � � ' Quantity $23.50 $0.00 $0.00 � $0.00 0 $0.00 0 $O.tlO 0 $3.30 3 $3.30 3 $3.30 3 $0.00 0 �' $0.00 0 ., . �$0:00;,'"'' 0; �„ � .,$0.00��, - 0` � � $0.00 AV-., Qi, $0.00 � -�'. 0_� ' $0.00 �,� � 0�� .. ` $0.00 : � 0 ' . ��r $0.00"_ ';'0 , � �-� $0.00� 0 � � �, $0.00. � 0� $o.ao o ` � $0.00 0 $0.00 0 $O.DO 0 $0.00 0 FEE SUMMARY � � Temp Dist System / Lighting - - - Busway /100 ft S�anding�Sedion , 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 kva/kw - Low Voltage Equipment Low Volt Wiring System / Ckt � Misa Conduit - ` � -Misa Conductor ' Circus ( gen or ride) . � � � Circus (mech ride or lights)= - � ChristmasTreeStand': - ` ' - Fireworks Stand" ` � � � Other Electrical Fee Quantity 50.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 ' $0.00 ,- 0 ,' • $0.00 0 $0.00 0 $0.00 0 $0.00' 0 $0:00 0� „ $0.00 0 $0.00 �"� 0 . � $0.00_��,0 , $0.00 0 � $0.00 � 0 So.00 , InJestigation Fee , � $0.00 � Plan Check Fee �- $0.00 Reinspection Fee - - � $0.00 - TOTAL CALCULATED FEES E33.40 nn�u¢urn�cnvr�w� rnun�T�nue NOTICE: The work authorized by this permit shall comply with all applirable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-g2) EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a penod of 1H0 days. - �� . , . INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all requlred Inspeetiona and final approval must be obtained. Failure to obtain inspectlons and final approval will result in the expiration of this.permit. FOR INSPECTIONS CALL: (714) 7545626 . zaae-as (aroo) . . � �, 0 � r WORKERS'COMPENSATION DECLARATON: , , — 1 • I hereby attirtn unHer penalry of Oerjury one of the tollowing declarations: '� . � ' . ❑ .I have end will malntflin e cetlificate of consent to setl-Insure tor workers' compensatlon, as provitlatl for by section 3700 of the Lebor Cotle, for the pedormance ot the work tor which this pertnit is issuetl. � � ❑ I have antl will maintain workers' compensa6on insurance, as required by section 3700 of the Lebor Code, tor ihe pertortnance of t�e work for which �his pertnit is issued. My workers' compensation Insurance carrier and policy num6er are: Cerner: � Polity Num08r: (This section nee0 nof be wmp/eretl il the permit is valued af one hundred dollars ($100) or /ess.) � I cenity Ihat in Ihe peAormance of Ihe work for which this pertnit is issued, I shall not employ eny person in any manner so as to become subjecl to ihe workers' rcompenution laws oi Calitomia, antl egree Ihat if I sho Id�become sublec( to [he workers' compensation pmvisions of Section 3700 of the Labor Code, I shall tonhwith comply with these pmvis' � // Appllcant SignaWrTe: � Date:��"':�/`+ /�b WARNINp:•FAILUFE TO SECURE WORKERS' COMPENSATION WVERAGE IS UN WFUL AND SHALL SUBIECT AN EMPLOYEP�TOCRIMINAL PENAL IES AND CIVIL FINES UP TOONE HUNDRED THOUSANDDOLLARE�E100.000),INADDITIONTOTHECOSTOFCOMPB SATION AMAGESASPROVIDEDFORINSECTION31060FTHELABORCODE,IMEREST,ANDFTiORNEI"SFEES. LICENSED CON7RACTORS DECLARATION: I hereby aHirtn that I am licensed under pmvisions of Chapter 9(commencing with Saction 7000) of Division 3 of the Business and Pmfessions Code, and my license is in full . force antl ettect. Lla a Class q CONractoYs Signature: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby attirm Ihat there is a consiruction IenCing agency for the pertortnance of ihe work tor which this pertnit is issued. (Sec. 3097, Civil Cotle). Lenders Name: LentleYs AtlAress: Signeture: Date: OWNER-BUILDER DECLARA710NS: I hereby affirtn that untler penelry of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowinq reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or counry which requires e permit to construc6 alter, improve, tlemolish, or repair any structure, prior ro its issuance, elso requires the applicant tor such pertnit lo tile a signetl stelement ihat he ar she is licensetl pursuanl to Ihe provi5ions ot the Contrectors License Law (Chapler 9(Commencing with Section 7000) of Division 3 of the Business entl Protessions Code) o� ihet he or she I5 exempt therefrom antl the basis for the allegetl exemption. Any violation of Section 7031.5 by eny applicent for a pertnit subjects the applicant to e civil penalry oi not more Ihan five hundred dollars ($500)J: ❑ I, as owner of Ihe properry, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, end the siructure Is nat intendetl or oNeretl for sale (Sec. 7044, Business antl Protessions Code: The Coniractors License Ww tloes not apply to an ownar of properry who builds or improves theraon, antl who tloes such work himself or hersetl or through his or her own employees, prwided ihat such improvements are not Intended or oflered for sale. If, however, Ihe builtlinq or improvement is sold within one year ot wmpletion, Ihe ownervbuilder will have the burden oi proving ihat he or she did not build or improve for purpose of sale.�. �fl; e5 owner ot ihe pro0erty, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct tha pro�ect (Sec. 7044, Busineu antl ProFesslon5 ..-�Cotla: The comraaors License Law tloes noi apply to an owner of property who builds or improves thereon, and who comracts lor such project wit� a contractor(s) licensa pursuant to the Contracbrs License Lews.). ❑ I am ezemp� (ry/(1er sec. _ Sig�eNre: \� A/ � � Ownei�ID venfied by tlnveYs license. Verilicetion of Ownership by (rype of i.e. and Pmfes5ion5 Code for IhiS reason: bill or Aeetl): No. DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby cenify that no exwvation Five (5) or more feet in tlepth into which a person is required to descenq wiil be made in connection with work euthonzed by this permit, and ihat no builtling structure, scattolding, talsework, or demWition or dismantling ihereof, will be more than ihirty-sia (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle e, California Adminisiretive Gode). � As ownerbuilder, I will no� employ anyone to tlo work which wauld require a permit trom the Division of Intlustrial Safery, as notetl ebove, unless such person hes e permit to tlo such work trom the division. Signature: Date: Division ot Indusinal Sefery Permit Number. CERTFlCATE OF GOMPLIANCE AND AUi1iORVATION OF ENTRY: I certiy untler penalry of perjury Ihat I have read Ihis epplication antl state Ihet the intortnation given is correct. I egree to comply with all state laws and city ortlinances relating to building construction, and authorize representatives ot ihe Ciry of Costa Mesa �o enter upon Ihe ebove-describ d proDerty for in ection ses. I agree n�ot to occupy or allow occupency oi any building authorized by this pertnit until tinel inspeclion. ��.aw � �-/�.-� s/�F/o6 — SignaWre Of Leg�l_O ner(s) � -Data .�.- ,. � _ _' —_ And/Or Authorized Applicant Data CODE I. INSPEGTIONTYVE 1618 Fiaetl System Final //x � 1286 �� Pool Spa Final 203 Final Sign 204 . Final Domolition Prevention I R CpDE� INSPECPONTYPE j1s¢, 206 Final Mechanical/��} - 'P �t. 208 Final Plumbing l� ," 1a . L � �� 210 Fi�El�riilJf'�� r�l. %' , ,� i ! E212 Rnal Pire Prevention f' �� R !; ��220�. , F'��nal PlanningtApprovel .. � tr .y �. . �� .. 222 Final Site 250 Final Building/Occupancy, � � s �I r , 0 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT JobAddress: 3SB7 LARKSPURST Suite No Vicinity: Parcel Nunmber: 41218254 Applicant ENGLISH, THOMAS C TR Address: 3367 LARKSPUR ST COSTA MESA, CA Owner: ENGLISFI, THOMAS C TR Address 3367 LARKSPUR ST , COSTA MESA, CA Contractor: OW N ER-B U I LDE R Address: . i. � `... '_, � i ' �� .- '( -,.,, ISSUE FEE Temp service test - Res. a/c package New Res (1-2 units) �New Res (3+unils) Pool / Spa Lighting Fixts Recept Outlets ' . Switches Non Res Appl � . Res Appl Service to 200a . Service to 1000a Service over 1000a Molors to 1hp Molors to 10hp Motors to SOhp Molors l0 100hp . .' Motors over t00hp � �. Communication drops Sub panel to 200a � Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole status: ISSUED Applied: 04/25/2006 Issued: 04/25/2006 ISSUED BY: • Phone: 714-556-1183 Zip 92626 Phone: Zip: 92626 Phone: Zip: , License: 000000 SCOPE OF PERMIT ELECTRICAL WORK: ADD 5 OUTLETS FOR MICROWAVE, GARAGE AND FAMILY ROOM AND 2 MISC. CONDUITS. �uantiry $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $5.50 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 ' $0.00 $0.00 �' � ' , $0.00 $0.00 ,$0.00 $0.00 $0.00 $0.00 $0.00 � FEE SUMMARY Temp Dist Sys�em / Lighting Busway /100 ft Standing Section, Mlsc EleQrical Equipment Transformers up to ] kvalkw ................up to 10 kva/kw .................up to 50 kva/kw .................up,to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment , Low Volt Wiring System / Ckt � � �Misc. Conduit ' Misc. Condudor Circus ( gen or ride) Circus (mech ride or lighis) Christmas Tree Stand ' Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspedion 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 50.00 0 . 50.00 0 50.00 , 0 $36.40 2 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES 565.40 COMMENTS I 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 suspended or abandoned ior a period of 180 days. . INSPEC710NS: In order for the work euthorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapectlons end flnal approvel musl be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. � FOR INSPECTIONS CALL: (714) 7545626 I 2448�48�8/00) � � WORKERS' COMPENSATION DECLARATION: � S � � �- . I hereby aflirm urL'�er penalry oi perjury ona o� ihe following tleclarations: � ❑ I have and will maintain a certificate of consent to selt-Insure for workers' compensation, as provitled for by section 3700 oi ihe LaDor Code, tor Ihe pertormance ai the work tor wdich Ihis pertnit is issued. ❑ I have antl wlll maintain workers' compensation insurance, as requiratl by section 3700 0l tha Labor Cotle, for ihe pertormance of ihe work for which ihis pertnit �s �ssued. My workers' compensatlon Insurance carner antl policy number are: Carriar. Policy Number. (This secf/on need naf be comp/eted i/ the permit is velued a! one hundred dollars �$700J or /essJ ❑ I certify that in the performance of the work for which this permit is issuetl, I shall nol employ any person in any manner so as to become subject to the workere' compensatlon laws of Calitomia, and ag�ee thai if I should bewme subject to ihe workers' compensation pmvisions of Section 3700 of the Labor Cotle, I shall forthwith Comply witP Ihese provisions. Applicant SignaWre: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENPLTIES AND CIVIL FlNES UP TOONE HUNDRED THOUSPIJD DOLLAPE (5100,000�, IN ADDITIIXJ TO T1E COST OF CAMPENSFTION, DAMAGES AS PROVIDED FOR IN $ECTION 3]O6 OF THE L4BOq CODE, INTEREST, ANO ATTORNEI"S FEES. IICENSED CONTRACTORS �ECLARA710N: I hereby aHirm tha� � am licensed under provislons of Chapter 9(commencing with Section 7000) oi Division 3 oi iha Business and Professions Code, and my license is in full � force anC eflea. 4ic. N Class R Contraaors Signatura: Oate: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHi� that there is a construction lending agency for the pertormance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lentler's Address: Signature: �ate�. OWNER-BUIIDEA DECLARA710NS: I hereby aHirm Ihai untler Denalty of perjury that I am E%EMPT FROM 7HE CON7RACTORS LICENSE LAW for Ihe following reeson (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permii to constmct, alter, improve, demolish, or repair any sWcture, prior to its issuance, also requires the applicant for such pertnil to file a signed sta�ement that he or she is Iicense0 pursuant to the provisions of the Contractors License Law (Ghapter 9(commencing with Sectlon 7000) of Division 3 of ihe Business and PmFessions Code) or that he or she is axempt iherefrom antl the basis for the alleged exemption. Any violation of Section 7037.5 by eny epplicant for a permit subjecis the epplicant to a civil penelry of not more �han five hundretl dollars ($500).): ❑ I, as owner of Ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, and ihe sWcture is not intended or oHered for sale (Sac. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and w�o does such work himsetl or herseN or through �is or her own employees, pmvided that such improvements are not Intended or offered toc sale. It, however, the huiltling or improvement is �sold wit�in o�e year of completioq the owner-builder will �ave ihe burden oi proving that he or she did not build or improve tor purpose oi saleJ. I, as owner oi the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business antl Professions �\ Code: The Gontractors License Lew does not appty to an owner of pmpany who builds or Impmves thereon, end who contracts tor such project with a coniractoQs) license pursuant to the Contracrors License Laws.). sec. Bwneri6venfied by dnvers license. Verification of Ownership by (type of Business antl Professions Cotle tor this �eason: ❑ No D vers License property tax bill or dead): DIVISION OF IN�USTRIAL SAFETY PERMIT CERTIFICATION: ❑ I here6y cedily ihal no excavation five (5) or more fee� in depih into which a person is required to descend, will be made in wnnection wit� work authorized by this pertnit, antl �hat no building sWcture, scaflolding, falsework, or demolition or dismantling thereof, will be more �han Ihirty-six (36) feet high. (Chap. 32, Grp 2. Art 2, Sec. 341, Title e, California Administretive Code). ❑ As owner-bVilder, I will not employ anyone to do work which would require a permit from the Division of Intlustnal Safery, as noted above, unless such person has a permit to tlo such work fmm ihe division. Signature: Date: DiviSion of IndusMal Satery Permit Number: CERTiFlCATE OP COMPLIANCE AND AllT}IORIZAnON OF ENTAV: I certify under penalty ot perjury ihat I have reatl ihis application end state �hat ihe information given is correct. I agrae to comply with ell state laws entl ciry ordinances relating to building construciion, and authorize representatives ol Ihe Ciry of Casta Mesa to enter upon the above-described property for inspecii purpose agree not to occupy or allow occupancy of any building authorized by t is per R until finel inspection. _ �• �-.�, ��2��96. 1 Signat V AnNOr Au�horized Applicen� Da�e COUE 1. I�$PEGL4H3YPE � I�p�` i6i6 Fized System Final Fire Prevention 1266 200 201 202 203 204 Pool Spa Final Final Re-R�� Finel Blxk/Retaining Wall Final Fattory Fire Place Final Sign Final Demolition CODEt INSPECTIONTYYE 206 Final Mechanical 208 Final Plumbing 210 Final Elearical 212 Final Fire Prevention 220 Final Planninq Approval . 222 FinalSite 250 Final BuildindOccuoenc� QBSE 1I�AL5 1 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mes�.c�.�TRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No � Vicinity: Parcel Nunmber: Applicant Address: Owner. Address � � . 3367 LARKSPUR ST 41218254 ENGLISH, THOMAS C TR 3367 LARKSPUR ST COSTA MESA, CA" ' � ENGLISH; THOMAS C TR 3367 LARKSPUR ST . COSTA MESA, CA � Contractor OWNER=BUILDER �' Address�- � . /' � ' ". 'i: Phone: 714-556-1183 Zip 92626 Phone: Zip: 92626 Phone: ' Zip: License: 000000 ISSUED BY: Status: ISSUED Applied: 04/25/20D6 Issued: 04/25/2006 ' � � SCOPE OF PERMIT � ' ` ' ' ��• �. , ,� � ELECTRICAL WORK: ADD 3 OUTLETS FOR MICROWAVE, GARAGE AND FAMILY.ROOM AND 2 MISC. . CONDUI7S. ' , . , � � '' FEESUMMARY " ISSUE FEE ;'Temp service tes(. ��Res. a/c package New Res (1-2 units) New Res (3+units) , Pool / Spa _ . , ' Lighting Fi#s . Recept Outlets , Switches � Non Res Appl ,, � Res Appb Service to 200a , Service fo t000a Service over 1000a � Motors to 1 hp �, ; Motors to 10hpt..>> Motors to 50hp�,� ' Motors to 100hp � ��_ �., Motors over 100hp Communicalion drops � Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Quantity - Quantity 523.50 Temp Disl System / Lighting $0.00 0 $0.00 �. Busway /100 ft - � � $0.00 0 � $0.00 � Standing Section " � . $0.00 0 , � $0.00 0 � � . - . . Misc Electrical Equipment $0.00 0 ' $0.00 . -� �0 -- - - -- --, "-Transformers up to-1.kva/kw - . $0.00 0 �� " � ^ $0.00 � . � � tr �- � - - ' .up to 10 kvalkw $0.00 0 �-' � $0.00 0 ..........�.......up to 50 kva/kw $0.00 0 � - $3.30 � 3 ............. '.:up to 100 kva/kw . $0.00 0 " " $0.00 0 ................:.over 100 kva/kw $0.00 0�� $0.00 � 0 Low Voltage Equipment ,$0.00 ,0�� '� $0.00 0 �- Low Volt Wiring System / Ckt $0.00 !% 0 � . � $0.00 , 0 . , , , Misc.�Conduit $36.40 .",,�2 � ��. $0.00 0 , � Misa Conductor, $0.00 � 0 � � � ,�$0.00 0 �� . Circus ( gen or iide) $0.00 �' 0 _ - $0.00_. �y,:.;=01,'�_ � ' Circus(mech,ride�orlights).:_=( �_= $0.00.' 0' � . : � � �$0.00= � : 0� � � -ChristmasTree Stantl . =�$0:00 0 � , �/ $0.00 0 `.. � ' ^ FireworksStand �- �$0.00� ^' 0 /. � . , 50.00 �=�, �0; � `= . - Other Electrical Fee �� _ , $0.00 ;�- � - $0.00� `0�. � , � . , . -. . � , � $0.00 � ., 0 �-- ' = -, : `�- . � Investigation Fee � - _ , $0.00-, � � ' . � . $0.00 : 0 . .. - � Plan Check Fee , ,, . $0.00� , " � �,$0.00' - . 0 - Reinspecfion Fee ` � � ; $0.00-'� - � : $0.00 0 .- - � ' �, $0.00- ,, 0-� ; ' " � � �TOTAL CALCULATED FEES 563.20, .' Intermed Pole $0.00 . , , � 0 , , ' . - COMMENTS I SPECIAL'CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access. raquiremenis under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) � � � EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned tor 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 applicable codes, antl all required Inspeetiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zawas (doo) WORKERS'COMPENSAnON DECLARATON: . � � ' � . I hereby affirtn unddr penalry ot perjury one of the following tleclarations: �' , ' . . . ❑ I heve.and will meiniain a certificate ot consent to setl-Insure for workers' compensation; es provitled for by seciion 3700 of the Labor Code, for ihe pertortnance of ihe work tor which t�is permit is Issuetl. . " � ' ❑ I have antl will meintain workers' compensation insurance, as requiretl by section 3700 ot ihe Laiwr Cotle, for Ihe peAortnance of Ihe work for which t�is pertnit is Issuetl. My workers' compensailon InSuranCe terner and policy number are: Cerrier: ' � Policy Number: (lhis secfion need not be completed i( fhe permit is velued et one hundred dollars ($100) or less.) ❑ I certify Ihat in the peAormance of the work for which t�is parmit is issueQ I shall not employ any person in eny manner so as to become subjad to ihe workers' compensation laws of Califomia, end agree thet it I should become suDject to ihe workers' compensation provisions oi Saction 3700 0l the Lebor Cade, I shall forthwith wmply with these provisions. Appliwnt SipnaWra: Data: WARNING: FFILURE TO SECURE WORKERS' COMPENSATIIXJ COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPIOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOIXJE HUNDRED TIIOUSMlD OOLLAFE (5100.000�. IN ADDITION TO THE CQST OF CAMPENSATION, DAMAGES AS PROVIOED FOR IN SECTION 3108 OF THE LABOR CODE, IMEREST, AND ATTORNE'f5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm that I am licensed undar provislons ot Chapter 9(commencing with Section 7000) of Division 3 ot the Business and Professions Cotla, end my license is In full forca entl ettect. Ua x Class x Conirectofs SignaNre: Date: CONSTRUCTION LENDING AGENCY: - , ❑ I hereby aHirm Ihet ihere is a construction lending e9ency for ihe pertormence of ihe work for which this permit is issued. (Sec. 3097, Civil Cotle). Lenders Name: Lender's Adtlress: Signature: Date: OWNER•BUILDER DECLARATIONS: I hereby eftirtn that untler penalty of perjury that I em EXEMPT FROM TME CONTRACTORS LICENSE LAW tor �he tollowing reason (Sec. 7037.5, Business and Protesslons Code: Any ciry or counry which requires a permit to construct, alter, improve, tlemolish, or repeir any stmaure, pnor to its issuance, also requires t�e appliwnt tor such pertnit to tile a slgnatl slatement that he or she is licensed pursuent b the provisions of the Contractors License Lew (Chepler 9(commencing wilh Section 7000) of Divislon 3 ot ihe Business end Profeuions Code) or ihat he or she is exempt Iherefrom antl the 6asis for the elleged exemption. Any violatlon of Sectlon 7031.5 by any applicant for e permit subjects the applicant to a civil penalry ot no� more than five �undred tlollars ($500).): ❑ I, es owner of the propeny, or my employees with waqes es their sole compensation, WILL DO THE WORK, and the siructure is not intentletl or otferetl for sale (Sec. 7044, Business and Protessions CoOe: The Contractors License Law does not apD�Y �o en owner of properry who builds or improves Ihereon, end who aoes such work himself or herselt or ihrough his or her own employees, provided that such improvemenis are not intended or oHeretl for sale. Ii, however, Ihe building or improvement is �sold within one year of completion, the owner-builder wiil have tha burtlen of proving that he or she did not build or improve for purpose oF saleJ. � I, as owner ot the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to conswct the pmject (Sec. 70C4, Business antl Protes5i0n5 Code: The contractors License Law does not apply to en owner oi propeny who builtls or improves Ihereon, entl who wntracts for such pro�ect with e contrector(s) license pursuant to ihe Coniractors License Laws.). , � I am exempt un er ec. _ SiqnaWre: � Owner ID ventied by driver5liCense. Vedfiwtion oi Ownership by (type ot and Professions Code tor �his reason: s� ❑ lo Drivers License No. i.e. - properry taa bill or deed): Ezpires: DIVISION OF INOUSTRIAL SAFETV PERMIT CER7IFICATON: ❑ I hereby cenify that no eacavation �ive (5) or more teat in tlepth into which a person is required ro tlescanq will ba mede in connection wit� work euthonzed by this pertnit, and that no builtling structure, sceMolding, talsework, or demolition or dismantling Ihereo�, will be more then thirry-six (36) feet high. (Chep. 32, Grp 2, Atl 2, Sac. 341, Titla 8, Calitornia Administrative Code). � ❑ As ownar-builder, I will not employ anyona to do work which would require e permit irom ihe Division ot Indusirial Sefery, as notetl above, unless such person hes a � permit ta do such wark irom the tlivision. Signature: Date: Division of Indusirial Satery Pertnit Number. CEHfIFlCATE OF COMPLIANCE AND AUfHORVA710N OF ENTAY: I cenity under penalry oi perjury that I have read t�is appliwtion end state that the intormatlon given Is correct I agree to comply with ell state laws end city ortlinances relating to builtling construction, entl aut�orize represemativDpes of the Ciry oi Coste Mesa to enter upon Ihe above-describetl pr\�spection Durpos I agree�or allow occupancy oi any building authonzed by�/ rmit unti�nel inspection. l° Ci Z� � Signature Oi Legal Ow r(s) -� Data And/OrAuthorizetl Applicant Date CQOE A. INSPEGTIONTYPE �6�6 Fixetl System Final Fire Prevention 7266 Pool Spe Final 200 Final Re-Roof 201 Flnel Block/Retaining Wall 202 203 Final Factory Fira Place Final Sign 204 Final DomoliGon PAg " � � . � PAIE L�LS 206 Final Mechanical �� 208 Final PlumDinq Fin cinca 1 F' Fire P vention 220 ' YPI roval 222 Final Site 250 � � ELECTRICAL IMPROVEMENTS 336? LARKSPUR STREET APRIL - JUNE 2006 (PERMIT E06-00376) �Fr,,,,,,C�e,� G/�/v( GFCI � O �l_1/ overhead GARAGE LARKSPUR STREET LIVING ROOM BEDROOMS, HALL, BATHROOMS, DINING ROOM for microwave oven � KITCHEN � FAMILY ROOM . ♦ � � � DUPLEX OUTLET O SINGLE-POLE WALL SWITCH O RECESSED CEILING LIGHT A � ELECTRICAL IMPROVEMENTS 3367 LARKSPUR STREET FAMILY ROOM DETAIL APRIL - JUNE 2006 (PERMIT E06-003T6) New branch line from attic box KITCHEN �EXISTING O O DUPLEX OUTLET SINGLE-POLE WALL SWITCH RECESSED CEtLING LIGHT (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address� Suite No Vicinity: Parcel Nunmber: 3367 LARKSPUR ST 41218254 ELECTRICAL PERMIT Applicanr. ENGLISH, THOMAS C TR Address: 3367 LARKSPUR ST ',, i� -_-'� " �� - �,��-� - -�Phone� i-"i, _.. COSTA MESA�„CA' ' ` Zip:� / � � , � � � . '�,; � - _ . .- owner: /�ENGLISH; THOMAS C TR ' � � , Address ' �3367�LARKSPUR-ST �- - � �� Phone: , � COSTA,MESA, CA" Zip: Contractor OWNER BUILDER ' �� i Address: , . ' 714-556�1183 - 92626 "` 92626 ,Phone: ` ; � . ��' Zipi License: 000000 Status: I SS U E D Applied: 07/23/2007 Issued: 07/23/2001 ISSUED BY: � SCOPE OF PERMIT INSTALL 3 CEILINGFANS'ONE�W SHE FAMICY ROOM/KITCHEN AREA;�ONE�IN THE MASTER �� . BEDROOM AND ONE IN AN ADDITIONAL BEDROOM OF A SING6E FAMILY DWELLING. ADD 3 SWITCHES �' � ALSO. , - _ � � - , -- - FEE SUMMARY , - `_ � Quantity ',G� � Quantity��,� - . � ISSUE FEE $23.50 Temp DisCSystem / Lighting . $0.00 0 � ' . Temp service test _ $0.00 � Busway /100�ft � $0.00 0�� , � Res. alc package $0.00 Standing Section " $0.00 0, _ , � New Res (1-2 units) � $0.00 0 , � Misc Electrical Equipment $0.00 <�,0; � , , New Res (3+units)� � _ ,$0.00 0 . - � Transformers up to 1 kva/kw $0.00 �"?0 - � - . ..,z...�. - Pool / Spa; , � ��$0.00 0 �` �� ' � � � _._._._.....up to�10 kva/kw $0.00, �,'� � 0 � � Lighting Fixts , � $3.30 , 3 , _ � � � , .................up to 50: kva/kw :, $0.00, , 0 � . Recept Outleta �� ' �$0.00 ��. � -"' • 0 -- ' - .................up fo900 kva/kw' � ` ` $0.00' 0 = % � Switches V` i�, $3.30 � 3 ' � - '........._:..._.over 100 kva/kw . $0.00, �. 0 � ',' Non Res Appl'. � �� , � " $0.00 " _ 0 - � � � Low Voltage Equipment - � �. $0.00 ', 0 - . Res Appl ,' � � , ,i 50.00 � -0 - � � Low Volt Widng System / Ckt. � � $0.00 � ��0 ' Service to 200a ' � $0:00 -0� ., Misc. Conduit � . �$1820 1 - ' Service to 1000a � � , $0.00 .� 0 � - Misc Conductor , $0.00 0 � � Service over 1000a , , $0.00 � , 0 � Circus ( gen oF ride) . � � $0:00 0. ' Motors to 1 hp ,$14.25 � 3 , Circus (mech ride oriights) �$0.00 '; 0 Motors to 10hp ' i0.00- 0 . Christmas Tree Stand $0.00 � 0 Motors to 50hp $0.00 '. 0 Fireworks Stand � $0.00 0 Motors [0 100hp $0.00 � � . 0 Other Electrical Fee � . � §0.00 Motors over 100hp $0.00 - -0 � - _ _ � � . � - Communication drops 50.00 0 � � .: Investigation Fee 50.00 Sub panel to 200a $0.00 0 Plan Check Fee 30.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $62.55 Intermed Pole $0.00 0 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremants 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 780 days, or ii work is suspended or abandoned for a penod of 180 days. � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable cotles, and all requlred Inapections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 zanane (aroo� WORKERS' COMPENSATION DECLARATION: — 1 hereby affrm under penalry oi perjury one of ihe following declarelions: ❑ I heve end will mainlaln e certiticete of wnsent ta self-Insure for workers' compensatlon, as proNAed for by senion 3700 oi the Lebor Cotle, tor the paAormance of ihe work Por which t�is pertnit is issued. ❑ I have arW will meintain wodcers' campensetion insurence, as requireC by sectlan 3700 ot the Lebor Cotla, far ihe perfartnance oi the work for which this partnil is issued. My workers' compensallon Insurance cartier entl poliry number are: Carrier. � � y Policy Numbec (This secNon need not be completed ll Ne permlf !s ve/uetl ef one huntlred dollers ($100) or less.) � I certify that in Ihe peAormance oi the work for which this permit is issuetl, I shall not employ eny person in any manner so es to become sublect to Iha workers' y�compensation laws o1 Celifomia, end agree that tl I shoul ecome subJect to the workers' compensation provlsions ol5aqlon 3700 f the Lebor Code, I shell torthwith jComD�' ��h these provjil . - ^'7 P I ADD��eMSigneture: �• Date: l / 23/0 WARNIN(3: FAILURE TO SECURE WORKERS' WMPENSATION COVERAG UN WFUL AND SHALL SUBJECT PN EMPLOYER TO CFIMINAL PENALTIES PND CML FlNES UP TOONE HUNDRED hKK15PNDDOUARE(5/00,000),INA�DfTIdJTOTHECQSTOFCOMPEN TION PMAGESASPROVIOEDWRINSECTION3]O60FTHELA90RCODE,IMEREST,ANOATTORNE`fSFEES. LICENSED CONTRACTORS DECLARATION: I hereby efllrtn that I em Iicensetl untlerp rovislons ot Chapter 9(wmmencing with Sectlon 7000) of Divislon 3 0l the Business end Professlons Code, entl my Ilcense Is in full forCe entl eHect. LJc. N � l �_ � � CIa55 k �o�}t a�t Gs�iarf�ux0:/7 oate: CONSTRUCTION LENDING AGENCV: ❑ I hereby aMirtn that there is e construciian lending egency for Ihe pertormance oi Ihe work for which ihis pertnil is issuetl. (Sec. 3097, qvil Code). Lender's Neme: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eHirtn thet under penalry ot perjury Ihet I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW tor the tollowinq reason (Sec. 7031.5, Business end Professions Cotle: Any ciry or county which requires e partnit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also raquires �he epplicant for such pertnit to flle e signed stetement that he or she Is Ilcensed pursuant to the provlsions of ihe Contredors License Lew (Chepter 9(commenWng with Section 7000) of Divlsion 3 of tha Business antl Protesslons Code) or Ihet he or she Is eaempt iherefrom and tha basis for ihe alleged exemption. Any violation af Sectlon 7031.5 by any applicent for e pertni' subjects the epplicant to e ciWl penalry of not more t�en five huntlretl tlollars (5500).): ❑ I, as owner of the properly, or my employees with weges as Ihelr sole compensation, WILL DO THE WORK, end Ihe strucNre Is not IMended or oRered for sele (Sec. 7044, Business and Protessions Code: The Coniractors License Law tloes no� apply to en owner of property who builds or improves Ihereon, flnd who does such work himseN or herself or Ihrough his or her own employees, provided that such Improvemenis ere not Intended or oflered lor sale. If, however, Ihe building or Improvement is sold within one year of completion, the owneo-builder will heve Ihe burden oi proving that �e or she tlid not build or imprwe for purpose of saleJ. I, as owner of the property, am E%CWSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to construct the pmject (Sac. 7044, eusiness antl Protessions � Cotle: The contrectors LJcense Lew does not appty to en owner ot property who builds or improves ihereon, entl who wntracts for such proJect with a contrector(s) license pursuant �o ihe Contractors License Laws.). ❑ I em e:emB i der sec. Businqs antl Professions Code for ihis reason: Signature: - � Date: Owner ID verifiad by driver's license. ❑ Yes ❑ o Drivefs License No. Expires: Verificetion of OwnershlD by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereDy certify ihat no eacavation flve (5) or more feet in tlepth into which a person is required to descend, will be made In connectlon with wark euthonzed by this pertnit, and that no building structure, scaHoltling, falsework, or demolition or tlismantling mereof, will be more than thirry-six (36) teet hig�. (Chep. 3z, Grp 2, An 2, Sec. 341, Title e, Califomla AdminislratNe COEe). ❑ As owner-builder, I will not employ anyone to do work which would require e pertnit from the Division of Intlustrial Satery, es noted ebove, unless such person hes e permit to do such work irom the divislon. Signawre: Date: Division of Industnal Safety Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF EHTRY: I cenity under penalry ot perjury ihat I have reed this epplication and state ihat the intortnation given is correct. I agree ro comply with ell sWte laws end ciry ordinances relating ro bullCing construction, and euthonze representatives of the Ciry of Costa Mesa to enter upon Ihe above-tlescnbed property lor inspection purposes. I agree not to occupy or ellow occupancy of eny huilding authorized by Ihis perT il until tinal inspection. �/23��J SlgnaNre Of Legal Owner(s) �e And/Or Aut�orized Applicant CO�E �. INSPECTIONTYPE 1816 Fixetl System Finel FifO Pf0v00ibf1 1288 Pool Spe Finel 200 FIn61 Re-Roof 201 Flnel Block/Retaining Well 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition ��IIIII.IFj CppE I INSPELTION TYPE 206 Final Mechanical 20B Final Plumbing 210 Final Elec�rical 212 Final Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy �� , J1�� ; 4 a � , (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COS7A MESA, CA 92626 Job Address: Suite No Vicinity: iki3a A_\:�:t�9111:�91 FRONT & REAR YDS Parcel Nunmber: 4�218254 App�icant ENGLISH, PEG Address: 3367LARKSPUR ST COSTA MESA, CA Owner: ENGLISH, THOMAS C TR Address 3367 LARKSPUR ST COSTA MESA, CA Contractoc OWNER-BUILDER Address: Arch / Eng : Address: PLUMBING PERMIT Phone: 714-556-1183 Zip: 92626 Phone: Zip: 92626 Phone: Zip: License: 0 Phone: Zip: License: ISSUED BY: Status: ISSUED Applied: 10/02/2000 I ssued: 10/02/2000 SCOPE OF PERMIT -' 1 LANDSCAPE IRRIATION FOR FRONT & REAR YARD SPRWKLERS. , � � � ", r FEE SUMMARY.,:. AMT� QTY ' AMT �.QTY ,`./� • , AMT QTY ISSUE FEE . $23.50 Laundry Tub / Washer , $0.00 0 -'; '�='�?= Sump Pump , �� . $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $14.80 1 Swimming Pool . '.$0.00 0 Backflow Preventer , .'$0.00 , 0 P-Trap - $0.00 0 -, �Trap Primer , i , ,� $0.00 0 Bathtub - � $0.00 0 Pressure Regulator $0.00 0 ".- Urinal ' � ; � � $0.00 0 Clarifer System � � $0.00 �� 0 Pmcess Piping (per 10 ft) $0.00 . 0 � - Vacuum Biki Bkflow(1-4) $0.00 0 Connect (Ice,Soda,etc) $0.00 0 Receptors $0.00 0 � Vacuum Brkr.Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic 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 Draiq Floor $0.00 0 Sewer Connect � �$0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closel (Toilet) $0.00 0 Drain, Roof $o.00 o Shower $0.00 0 Water Heater / vent $0.00 0 Drinking Fountain $0.00 0 Sink, bar g0.00 0 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 (1-4 outlets) $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0 Gas (Over 4 outlets) $0.00 0 Sink, service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa (private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa (public) - $0.00 0 PLAN CHECK $0.00 Interceptors (Grease, Oil) $0.00 0 � REINSPECTION $0.00 0 Interceptors (Sand Auto ) $0.00 0 TOTAL CALCULATED FEES: a38.30 COMMENTS I 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 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 an applicable codes, and all requlred inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaasos 1�✓00) WORKERS'COMPENSAnON DECLARAnON: I hereby aMirtn under penalry oi perjury one of the following tledarations: ❑ I have entl will maintain e certiticate of consent to self-Insure for workers' compensetion, es provided for by section 3700 of the Labor Cotle, tor the pertormance of the wofk tor whiCh IhiS permit is issued. ❑ I �ave antl will mflintain workers' compensatlon Insurence, as required by section 3700 oF the Labor Code, for the peAortnance ot the work tor whic� this permi[ is issuetl. My workers' compensation Insurance carrier end policy number are: Cafnef: POlity NUmber: (This section need nof be comp/etetl i/ the permil is valuetl a! one hundred Gollare ($700) or less.) ❑ I certify ihat in �he pertormence ol the work tor which this pertnit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensetion laws ot Celltomia, and agrae that if I should become subject ro the workars' compensation provisions ot Section 3700 of the Lebor Code, I shall torthwith comply with Ihese provisions. Applicam Signawre: Date: WNRNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNL4WFUL AND SHA11 SU6IECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE HUNDRED THOUSAND DOLLPAE (5100,000�. IN AODITIIXJ TO THE COST OF COMPENSATION, DPMAGES AS PROVI�ED FOR IN SECiION 3105 OF THE L4BOq CADE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I here6y attirm that I am licensetl under provisions of Chapier 9(commencing with Section 7000) of Division 3 of the Business and Professions Cade, end my license is in full force antl eflect. Lic. k Glass k Contractor's SignaWre: . Data: CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirm that Ihere is a consiruction lending agency for the peAormance ot Ihe work for which this permit is issued. (Sec. 3097, Civil Cotle). Lendets Name: Lendefs Address: Signeture: ' Date: OWNER-BUILDER DECLARATIONS: I here6y a%irtn that under penalry ot perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires a permit to tonstruct, alter, improve, demolish, or repair any sWciure, prior to its issuance, also requires the appiicant for such permit to file a signed statement thai he or she ISlicen5e0 pursuant to Ihe provisions of the Contracrors License Law (Chapter 9(commencing with Section 7000) of Division 3 ot Ihe Business and Professions Code) or ihat �e or she is exempt therefrom and the basis for Ihe alleged ezemption. Any violation of Section 7031.5 6y eny applicent for e permit subjects ihe applicant to a civil penalty of not more Ihan five hundretl dollars ($500).): ❑ I, es owner of lhe property. or my employees with wages es their sole compensation, WILL DO THE WORK, and Ihe structure is not intentled ot ottered tor sale (Sec. 70a4, Business antl Professions Code: The Contractors Licensa Law dces not apply to an ownar ot property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, providad ihat such improvements are not intentlatl or oHeretl for sale. II, however, ihe building or improvement is sold within one year of completion, the owner-builder will have ihe burden of proving Ihat he or she did not build or improve for purpose ot sale.). ❑ I, as owner ol the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Busines5 end Profession5 Code: The contractore License Law tloes not apply to an owner of property who builds or improves thereon, and who contracts tor such pmject with e contractor(s) license pursuant to the Coniractors license Lews.). ❑ I am �mpt� Signature: Owner ID�vetifietl,Dy tlrivers Verificetion af Ownership by Business and Professions Code for this reason: Date: �/0 �— O� ❑ Yes ❑ No Driver5 LicenSe No. Expires: oi documeni, i.e. - pmperry lau bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenify that no excavation five (5) or more feet in depth into which a person is requiretl to tlescentl. will be made in wnnection with work authonzed by this permit, and �hat no building sirucNre, swffolding, falsework, or tlemolition or tlismantling ihereot, will be more ihan thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle B, Califomia Adminisirative Cotle). ❑ As owner-builder, I will not employ anyona to do work which would require a permit irom the Division oi Industnal Salety, as notetl above, unless such person has e permit to tlo such work fram Ihe division. Signature: Date: Division ol InduStnal Safey Pertnil Number: CERTIFlCATE OF COMPLIANCE AND AUTHORVATON OF EMAY: I certify untler penalty ot perjury that I have read fhis application antl state Ihet ihe information given is correct. I agree to comply with ell stete laws antl city ortlinances relating to builtling construction, and au�honze represantatives ot the Ciry of Costa Mesa to enter upon Ihe above- escribed roperty for inspection purposes. I egree not to occupy or allow occupency ot any builtling authonzed by this permit until final inspection. �Q� a/' �� /O =,�'C `Bf� Signature Ot Legal Owner(s) Date And/OrAulhorizetl Applicanl Data CODE I. INSVECIIONTVPE �jE 1NIDELS 1616 Fixetl Sysiem Final Fire PrevenNon 7266 200 201 202 203 204 Pool Spa Final Final Re-Root Final BIocWRetaining Wall Final Factory Fire Place Final Sign Final Demolition COOE � INSPECTION TYPE 206 Final Mechanical 20B Finel Plumbinq 210 Finel Elecirical 212 Finel Fire Prevention 220 Final Planning Approval 222 Finel Site 250 Final Building/Occupancy BAffi L�AL4 �� rrc, uuncaa: 3367 LARKSPUR ST OWN 'SNpME: ENGLISH, THOMAS CRANDALL y�, nooeess: ENGLISH, MARGARET L � � � 3367 LARKSPUR ��. COSTA MESA,CA 92626 AHCNIENGINEEF: aooeess: UNIT: NEG.NO.: UNIT: PEflMITiEE: LEE ROOFING (714)642-7223 - nooeess: 1653 SUPERIOR COSTA MESA CA 92627 LICENSED CONTBACTOB UECIABATION: I here0y affirm Ihal I am IicenSeA untler pmvi5ion5 0� Chapter 9 kommencing wi�� Section 7000) of Dimsion 3 0l Ne Business ane Professions Cotle. and my ense is in lull brce anU eflec�. ciTru/c.:02875 sTaTeuc.:349686 cuss: —39 Oale: L��' �'�� Signamre: _ _ WOBREflS' COMVENSATION DEGLAPNTION: I hereby aiflrm �hat I have a cenific I consen� Ia sell�ins re or a cehificate o� Worker5' Compensa�ion Insurance. or a cenified copY �hereo� (Sec�ion 3800. La�. C). voucvNo.: 1300948-93 E%P.OATE: O /30/94 comraxv: STATE FUNDr� � Ce�Itllea copy is hereby WmiS�eA. yq Gertliled copy is �il hh �he ciiy B llding Division. �ate. �Q—�—� � APVlicanL �/ ENEMPTION fHOM WONHEPS' COMPENSATION DECLAflATION: Qhis Setlion neeA no� Oe toy e�e0 il�he permil is la hwaretl (S1W� or less). I cetlify Ihal m ihe petlormance o� Ihe work �or which �his permi� is i55ueA. I shall not4mploy any person in any manner so as lo become sublec� �o �he Warkers' Compensaiion Laws oi Cali�omia. �aie'. SignaNre: NOTICE: I�, alter making �his tleclaraiion, you shoulU become suble�� o the Workers' Compensa�ion provisions al �he La6or Code. you must fon�wiih compty wi�h suc� provisions or ihis permi� shall be tleemed revaketl. CONSTPUCTION LENOING RGENCY: I here�y aifirm ihal ihere is a con5lmclion lending agency �or �he petlormance of the waB tor which this permii is issued �Seciion 3097. Civ. C�. LEN�EP: AOUNE55: OWNEfl BWLDEN OECLANATION: I here�y a�firm Ihal I am exemp� �rom the ConVac�ors: S�a�e License Law for Ihe �ollowing reason �Seciion 7031.5 Business antl Pmfessional Code: Any ci�y ol caun�y w�ich requires a permit �o cons�mci, alter, impmve, Demolis�, or repair any simcWre. Drior to iis issuance. also re0uires ��e applican� �ar such permil to lile a signe0 statemenl tha� he/she is licensetl pursuanl �o I�e pmvisions oi Ihe Comracrors Siale License Law (Chapter 9(commencing with Section 7000) o� Division 3 0� IAe Business antl PmfesSions Code) or �hal he/she is exempt Iherelmm ana ��e basis for Ihe allegea eremD��on. Any viola�ion o� Section 7031.5 by any applican� tor a permit sublacts the applicani �o a civil penalry al noi more ihan �ive hunOred tlollars (5500�. I, as owner of �he propetly or my employees wrt� wages as Iheir sole compensation, will do �he work, antl the ❑ s�mcwre is no� in�enUee or offereU for sale (Section 70a4. 9usiness antl Pmlessional CoOe: 7Ae Contractars' State License Law tloes nol apply �o an owner oi a DmDeny who bui105 or imD�oves Ihereon, and who does Such work himSelVhersel� or Ihmugh his or her own employees, prOviO¢tl thal Suth impmvemenl5 are nol inlendetl o� ofl¢r¢tl tor Sale. If, howev¢r Ihe builtling or impmvemen� is 5010 wilhin one year ol complelion, Ihe owner will �ave Ihe burtlen oi pmving he/she tlitl not build or impmve lor Ne purpose o1 sale�. I, as owner of �he pmperty. am eMclusively controc�ing with I¢ensetl contraclors lo cans�mct �he prolac� (Sec�mn 7044, Business ❑ antl Pmlessions Code: The Conirac�ors' Siate License Law aoes not appty to an owner oi pmpetly who builtls or impmves Ihereon and who contracls �or such pmlec�s wi�h a contrac�oqs)license pursuanl to Ihe Conirac�ars' S�ate License Law�.l am aware Ihai prool of Iheir WorkeYs Compensa�ion insurance should be D�ovidetl �o me. � I am erempl under Section: B. 8 P. C. tor �nis reason: Oate: Owner I tlo hereby cenity that I am aware ai ana untlers�an0lhe requiiemenls ol California Heal�h and Safely Cotle Seciions 25505, 25533, anA 2553a and �nal I or any fuiure Dmlding occupan� wiil/will nat (circle one) need to comply wi�h sai0 siale cotles antl �he reQuiremen�s inr a permii lar consimclian ar motltlicalion imm the Au Ouahry Managemenl DisUict. Fesitlenlial constmction applica�ians are exempt fmm IAese provisions. �ate: ApPlicanl: _ I �ereby cetlify Ihai I haverea0 Ihis aOPlitalion antl Sla�e I�a��he ortlinances anA stalelawsrelating�o builaing constmclion and �eret pfOp¢fly �Of i05pCL�iOn pUfjja5C5.--7 �ate:`�—/2—c�/ \ SignaWre'.� oriver's Lmense or Social Secuniy x: � iniormation is correcL I agree lo comply wi�h all ciry antl counry )rizerepre5en�aiive5 Oflhis ciryto enierupOnlh¢ above-mentionetl 164i-46 W�ne—BuAOrng; Green—Cotle Enlomemem; Canary—HOPllcam; Pmk—Revenue: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 064421 PERMIT NO: B 064421 PLAN CFIECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION ; T/O, RESHEATH G REROOF W/COMP, SHINGLES SQ FT; 5,080 CLAIM VALUE: 5,080.00 CALC—VALUE: 5,080.00 GROUP OCC; H-2 / COMMENTS: SMOKE DETECTORS ARE REQUIRED AS PER U.B.C. 1991. �t****�e**�***�t�*�t******�***�**�r�t�r***��f*********+t**��********��c*******�*****��*� Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR• FT Itd LEFT: FT IN RGiIT: FT IN LEFT: FT IN RGAT; FT IN PARKING REQ• PROV: PARCEL: 91218254 ZNE: REF NO: PLANNING NO'I'ES> —� � . fE 1E iE if 1E 9F iE 1E if jE iE iE iE 1E iE if iE iF jk iE if �f �E 1E ff 1f iE 3k 1f iE 1f if fE iE iE if iE 1E iF i! iE if if if iE iE iF iE if iE �E iE iE if ff !E iE k iF iE if if 3E 1E iF iF iE 3F iF if �!E iE if if iF aF * iF 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 ZONING APPROVED' HY DATE: �s% BUILDING APPROfC�ED BY : DATE: � APPLICATION ISSOED BY: DATE: :O �i � iEiEifitiEiFififiEiEiEiEif.iEififiEjElflfifiF �ffF�7a{faFjEiEifiE�E iEiF if 1f !f if if 1t 1f 1t it 1t 1! 1E 1E !f!E iflf iE ik iE iE iE iE 1f 1E if �E 1! 1t i! iE jE if af 1E #° 1f if iE iE iE 1E if 1E 9f if if !F!f if 1E fE if �k iE iE 1E if 1f ff !! if i! jE �E ff fE jE 1E iE 1E iF if iE M!E �)E if if LEGALIZATION;N F E E S U M M A R Y STRUCTURAL,SEGMENT;Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES�� GRADING PER IT 81,00 ,51a � PLAN SMIP /NON,f—RES ISSUE FEE ' HUILDING—DIV—> PERMIT ISSUE PLAN—CAECK TOTAL PAID DUE TOTALS—,---> 81.51 0.00 0,00 81.51 81,51 '' .00 f,� REVENUE DIVISION TOTALS--> COLLECTED; 81,51 OVER/SHORT: ,; .00 BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING''PLAN—CHECK 81,00 � .51 � :: ifif�lfikiElfiEiEifiEff�fitiFlEffitifafifiFifit itifiEiEiEiklEiEfEkklEjfififfflEilfliFiElfiEffififiEiEifiEililiFiEiEiEiFiEifiElEiEiEifiFlEiEiEifitlElf�f1E1! I N D I I D U A L F E E B R E A K D O W N ,.r�3 TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 5080 REROOF BY VALUE RESIPENTIAL NOZONE 1.00 �.' S,080.0¢ END OF FEES %� f�•� I �MOKE DETE�CTO�i REQUIRE'D �� 01 o�tt374i—Oq1-374<^ T C�'f .fiATE: 2p;i3/93 7TCIE: 16:3d !� ! -S7NSTRUCTION AND PLANNING � POOL PA '• ,� APPR�`1VALS Permit #_,_ Date Inspector AppROVALS Permit # Date Inspector i. Temporary Electrical Service or Pole � 52. Poo� & Equipment Location . ,, ; , 2. � Soil Pipe-Undrgmd. - � � - '� 53. Steei Reinforcement , 3. Elecirical Conduit Utitity-Undrgrnd. . 54. Forms ' 4, Electrical Conduit•Undrgrnd. � 55. ElecVical Bonding � 5.�Steel Reinforcement �� 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. 57. APPROVAI TO COVER-GUNITE ' 7. Footings - . 58. Electrical Conduii�Undrgrnd. � 8. Foundation . 59. Gas Pipe, O Undrgmd., Test 9. Water Pipe-Undrgrnd. ti - 60. Backwash Lines, P-Trap, O Undrgmd. - 70. Structura� Floor System �� - 67. APPROVAL TO DECK 11. Properry Sewe� Line & House Co�nection 62. Backwash & Receptor-Final 12. Sewer Cap .� �' 63,� Heater & Vent-Final ' 13. Roof Drains . 64. Plumbing System � Final 14. Rough Plumbing ' .. - 65. Electricai-Pinai 15. Rough Electrical-Cond�it ,/ 66. Sola� System-Final �. , i 6. Rough Electric Wiring 67. Fencing & Access Approval � 17. Ro�gh Wiring Siyn 68. APPROVED FOR PlASTER WG 18. Rough Electricai-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - -' 20. Rough Factory F�ireptace � � �APPROVALS '_ �Permit � 27. Ducts,in Structure . �. 70. Underground Hydro � � 22. Ducts, Ventilating ' 77. Producb�Pipinc� QGas ❑'Oil 23. Gas Pipe-Rough &'Test . 72. Underground Flush ,. � . 24. �Roof Framing � - 73. Undergrnd. Storage Tank L Gas ❑ Oi! ` 25. Roof Sheathing �' � .��Z�/d� � 74, Overhead Hydro � (7 %��' 26. T-Bac Ceilin9 (Structurali & Monocoat � 75'Dry Chemicai • � . ' 27. Freme and Flashing .. 76. Dry Standpipe ' ' � � 28. Lathing & Siding , � 77.. FIXED SYSTEM FIN4L '29. Insulation ' C 78.�'FIRE PREV. FINAL ":v � � 30. Drywall Nailing ' HEALTH DEPT: REQUIREMENT �� %�.J.� 31. Plaster Brown Coat � ' � - 79. �FINAL INSP_ECTION ' � ' -�y 32.-Electrical'Power Meter-Pinal � �• 80. FOOD CERTIFICAiE ISSUED � ��e 33. Final Electric' ' • `�" : Notes: � `� �_� , 34. Final Heating & Air Conditioning . ' - " _ -, , � �� % � 35. Final Gas Pipe-Test � � . . . . . . , �:L, 36. Hood or Canopy 37. Fina� Factory Fireplace , ' i � , � 38. Final Plumbing , , � . . � ' � -. � 39. Water Service-Final� � �� ' ' 40. Gas Service-Final ' . . . , . , " 41. Solar pomestic-Fina! _ � 42. Backflow Preventer � , � � . � -- 43. Backflow Irrigation " , � 44. LandscapelrriqationSystem... . . " - , 45. Sound Attenuation � � � ' � - ' ' 46. Handicap Regulations � � �� . •- �� , . 47. FINAL STRUCTURE & BUILDING �a_29-Q3 6u%�� s�,�-,✓� �i (q�� ^� / r��c,�L as. FinIAL PLANNING. � � � � � . ' - '�- 49. Electric Release to Edison - ' � 50. Gas Reiease to Southern California Gas Co " .� - 51. CERTtFICATE OF OCCUPANCY ' No. Oate ! 1 L i PflOJECT AOUHESS: 3 3 6.� LARKSPUR ST uxiT: OWNEP'S NRME: ENGLISH THOMAS CRANDALL aooncss:ENGLISH� MARGARET L 3367 LA�2KSPUR COSTA MESA{ CA 92626 AflCH/ENGINEEfl: � 7 1 4� S S G— 1 1 S 3 pEG.NO.: nooeess:THOMAS CRANDALL ENGLISH NOI�T, 3367 LARKSPUR ST PEHMITTEE:COSTAMESA CA 92626 nooecss: THOMAS CRANDALL ENGLISH ( 714 ) 556-1183 r336p7 LARKSPUR ST 9 LICENSEO WNTHACTde��unbnoMESA Y am�m mai i am r�e�sea ��aCAo��s� � 6 t`h6�e� e�commencm9 wan secron 7000) ol Orvision 3 of the Business and Pmfessions Code. and my litense is in WII force antl eflecl. CITY LIC.: STATE LIC.: CLASS: �aie: Signaiure: WOPNENS' COMPENSpT10N oECIAPPT10N: I hereby ailirm Iha� I �ave a cerliticate of consenl to sel6insure or a cehificate oi Workers' Compensation Insurance. or a cetlifietl copy thereof (Seclion 3800, Lao. C1. POLICY NO.: E%P. OATE: COMPANY: ❑ Cenifiea copy is �ereby furnis�etl. ❑ Cenihetl copy is filed wilh ihe ciry Building Division. '�ate: ApDlicanf. E%EMPTION FHOM WOFREBS' COMPENSRTION OECLAflPTION: (This section neeA nat be cam0leletl if ihe permit is far one hunOree (5100) or less�. I cehity Ihai In Ihe pedormance a� �he work lor w�ich �his permii is issued. I shall no� emDloy an erson in any manner so as to become sublect l0 1�e Worpkers' C�jompensalion Laws ot Califomia. (/�" Daie: � Z6 / � Signature: U"�-�� `-' ' NOTICE: II, af�er making Ihis 4eclaraiion. you should become su6lect �o ihe Workers' ComDen531ion pr eions o� �he Labor Coae. you musl lorlhwilh comply wit� such Omvisions or ihis Oe�mi� shall be tleemetl revpketl. CONSTflUCTION LENOING FGENCY: I here�y aflirm Ihat �here is a wnsimction lentling agen y br the pe rmance af t�e woB lor which ihis permn is issue0 (Section 3097, Civ. C�. LENOEP: ADDFESS: OWNEB BUILOEP OECIAFATION: I hereby aflirm Iha� I am exempt Irom the Contracmrs' State License Law for Ihe following reason (Seqion 7031.5 Business and Prolessmnal Cotle: Any ciry o� counry which requires a permi� to conslmct, al�er, improve, tlemolish, ar repair any S�mcWre. prior Io iis issuance. also requires the apPlican� br such permit to file a signea sta�ement Ihat he/she is licensed pursuanl Io ihe Dmvi5ion5 0l lhe Con�raCtOrs S�ale liten5e Law (C�apl¢r 9(commenCing wiih SeC�ion 7000) Of Division 30� Ihe Busine55 an0 Prolessions Cotle) or ihat �elshe is exemp� iherefmm antl Ihe basis lor (he allege0 exempiion. Fny viola�ion o� Sec�ion 7031.5 hy any applicanl for a permil SUDlec�S Ihe applican� to a civil penalry ol noi more �han five huntlretl Dollars (3500). I, as owner ol ihe proDehy or my employees with wages as their 5ole compen5aiion. will tlo ��e work, and the ❑ s�mctoreis notinten0ed oroffere0forsale(Section 7044, Busness and PmlessionalCoOe: The Contractors' S�a�e License Law tlaes not appty �a an awner oi a pmpeny who 6uilOs or improves �hereon, antl who does such work himsel�/herselt or Ihwug� his ar her own employees, pmviaetl Iha� such impmvemenis are no� inlen0etl or offered �or sale. I�, �owever �he builtling or impmvemenl is saltl wilhin one year ol compleiion, �he owner will have �he burden of proving he/s�e ditl not buil� or impmve for Ihe purpose a� sale�. � L as ownerol the propeny, am excWsively conlraciing wiih IicenseU coniracbrs �o constmct Ihe pmjett (Section 70M, Business and Pmfessions Cotle'. The ConVacmrs' Siate License Law does nol apOty b an owner oi propetly who builtls or imDmves thereon antl who conlrac�s �or such pmle��s wi�h a conVac�or(s) license pursuan� Io Ihe Con�mctors' Sta�e License Law�. I am aware �ha� pwaf oi �heir Worker'S Compensation insurance shauld �e pmvided to me. � I am exemp� unaer Sec�ion'. B. 8 P. C. .. �Or IhiS r¢a500'. //•t : Oaie_ .5 'Z S •• 9J ��d,y� 1 , . '_ � ' � ��-v��, I Oo hereby cerii�y Ihai I am aware of anJ underslan0 �he requirements oi Calilom 255�A ana Ihat I ar any Wlure buAemg occupani wilVwill nol �circle one) neee to c permil br con5imclion or modilication Imm Ihe Air Oualiry Management Dis�ricl. Ihese pmvisions. 25505,25533,an0 reQuirements 1ar a s are exemv� ��om Oaie. Applicani: I hereby cetlity I�at I havereatl Ihis application antl s�ale Iha� Ihe above in�armation is correcl. lagree�o comply wi�h allci�y and counry ortlinances ana slaie lavrs relaUnq to bwltling consimction antl hereby aulharize represenia�ives of �hiscil lo enler upon ��e above-men�ionetl pmpetly for inspection purpases. ^ �aie: ��' 2 $- 9� Signaiu - Driver'S License or Social Secunty 6Gi-a6 Whi�e—Builtling; Green—CoOe EniorcemenC Canary—Applican�; Pink—Revenue: Goltlenrotl—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 062393 PERHIT NO: B 062393 PLAN CHECK NO: 01925-93 S GOVT: N SUPP; N CONSTRUCTION TYPE; 5—N PERMIT TYPE: STR PURPOSE: AI.T JOH DESCRIPTION : ADD NEW FOLDING LADDER ATTZC ACCESS SQ FT: 390 CLAIM VALUE: 390,00 CALC—VALUE; 390.00 GROUP OCC: R-3 / CONMENTS• INCLUDES 'FILL—IN' OF THE ORIGINAL ATTIC ACCESS, �e�rr�r******�rr****�r�r*�r**��*******r**�r�r**�r�e**+rr�*+��r*�r��r*�r�r�r�r��***��r�r�r�r�r�e**�rx��e** Z O N I N G R E(J U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL; 41218254 ZNE: REF NO; PLANNING N01'ES> � ._ iF iE If k iF �F�F 1k�Fit�E iE itltiE �lt ik 1t k!f *1t 1f iE iEif M If it �E it iE it if iF itlE iE �tlf �f fF �kik 1ElElflF iEiE iE 1E ik iF if k iEiF fE if iF 1k�f iF �k If �F 1f �E if'iF iE �E iE iE * �F iF 1F 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 �>.. ZONING APPROVED BY , BUILDING APPROVED BY : DATE: DATE :. AYYLICA7'lUN 1SSUr:ll l3Y: � DATE: �i�;�itiF 1flt �t k iF iF k iE iF iE iF1FM iF 1E iF IF itlt ff iF 1E iFif iE if ik k ik.if iF M, ititkltlf�tltltlF�tltlf�F�tMitlfit�f�flEitik�f�fltlE�fifltltltltlF�klFkifk�k�FlF�k itlF�kiflfitlflF�FkiFifkit�EiFiFiflfiFiFifiFlf'dfifMifikk***�F LEGALIZATION;N F E E S U M M A R Y STRUCTUItAli SEGMENT;Y BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE. SMIP/RES GRADING PERNIT 15,00 SHIP/NON—AES ISSUE FEE 9�75 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECR TOTAL PAID DUE TOTALS----> 15,50 0.00 9,75 25,25 25.25 ,00 iREVENUE DIVISION TOTALS--> COLLECTED• 25.25 OVER/SHORT: 00 BLDG PHT PLUHBING ELECTRIC MECHANI� FIRE SMIP/TOT GRADING PLAN—CHECK 15,00 .50 9,75 MlF�Fif±flFiFikif if kiFif if �f iF1f iF1f 1Fit if if if 1flf if k k �flFfF M iF iF iF iFikiFif iF iFk NiF 1f if if ik if if if 1f if iflk iFiF�f 1FMitlf iF k if ik k k ik ff M 1f if ff if ik�F �f I N D I V I D U A L F E E B R E A R D O W N ITYPE ISFR QTY D E S C R I P T I O N 390 ALTER HY VALUE RESIDENTIAL NOZONE END OF FEfiS UNIT COST TOTAL COST 1.00 390,00 Oi 001400E5—OOI40D87 TO T 25.?5 DATt: OS/23l93 iIt1E: 12:24 � i � V � r 1 CONSTRUCTION AND PLANNING POOI a� SP(y- � '. APPROVALS Permit �# ' Date Inspector qppROVAIS Permit # . Date Inspector t._Temporary Electrical Service or Pole '• 52. Pool & Equipment Location , " r V ?„ ,�ikg�pr�:�lnrrc�u�d,.; 53. Stael Reinforcement ,'r � � S�� f '-+P•�th icfr a��r,`'!1 i-Lit%Iity�Undrgmd. �� 54. Forms - �'" .. ,�� ., �,. �4i�tett�fica�or��j� -f'�i drgrnd. 55. Electrica� Bonding _ �.t'�S�-3=��5: Q5r S,�iY,�tfntt��n3.(�eLM 56. Rough Plumhing & Pressme Test •- ,25�:�. .. i��r�c�'.i;asUFEEF ,�n�l. 57. APPROVA� TO COVER�GUNITE '�= ,�. 'i botDn�c� y,J 58. Electrical Conduit�Undrgrnd. . 1 n, - - � � v8i�oundatiap, `%,� ^ 59. Gas Pipe, O�Undrgrnd., Test .� ` " -i 'L' ' Ft`-Water Pi�-Und�i�d. � 60. Backwash Lines, P-Trap, O Undrgrf_d. '-. � I i� Stru�urak Roo�System 61. APPROVAL TO DECK =' , 1` Propjrt `e�w�Lin�& Ho�se Connection �+ 62. -Backwash & ReceptorPi�al .--j � 12. Sew�c Cap u ch 63. Heater & Vent•Final � �� • 13. Roof Drains �,� �� 64. Plumbing SYs.em - Final `'. i '_ . 14. Rough Plumbirn 65. E�ectrical�Finai � � ' I 15. Rough �ectrica�Conduit �" `'" 66. Solar SYstem•Final . � S � ._ '\, �- 16. Rouqh Eleciric%�iring 67. Fencing & Access Ann�oval ' 1 1 f 17. Rou9h Wiring St9n . 68. APPROVED FOR PLASTERING ' � 78. flough Eiectrical•T Ba� Ceilin9 69. POOL/SPA SYSTEMS FINAL 79. Royqh H@atiny &�A� Conditio�n� 'U,� � _ .�x ; ,7 ��DS,�T. REQUIR�v1EN,T� ,�� Jr ' � � � > -� .^ - t �_ �_ :; ,i x i r�n .- ' �. ... 20.`:%toit�h F.acto�V F�sy�lace i S_ --�� :; r �-� x ��PPR�UA�tj�Q'eri;iit ��_3,�_ y_F�: - �-.c_. ^�2 T .. .. 21."Ju',cty, in_`r�Structu �'y � .. .. �� * � ix *y, 0. nder r ��-+ � . r! �- 9 �y�r{;HY.�'o % i t '� �� x x �y � ., ., . 22.�u�, ��ti�t.ind� � i t� ,: .; {-� FM :.;Jl. Product:r't�im9 ❑ s G.Qii z .. i--:+��-t-�. r. E} 23. �as�?ipu-ftoCgh & h�st � T r ln..YS, _`r T 6 OY x�2. Undergro�d•F�t'��Lfi"n r v 24. �ioo'Fr�yning S" '`'F ��in x� � z�..,,,x x S73.yJndergrna Srora,�i%r�"��k 0.�Gas O0� i 25. Ro6�Sh+3Sthing :)F ¢ .+ � L� :J=� �qt",r3qerheadHydro'�-� ` T. ^. X C T "' ' T �K-�^ �ti ' 'C 7 !7> ,f r ' "7 a _ l7' 4 26.�-Bi� Cej(ing IStrYiNy?urall &��Scoat x` �, �,: � 75 �.�y fr}errri�af y ..� 27.cFrame ar Flashi�i � _,�r, . >� ;�� >: ,�-G�-i-x-s-�-i�- �, 9 76� Dry Stanc.�F%iCD � � ca ^C� - �28. Lat�inq�i Siding•�� ;,: -„_` C ,'e ? •.I . ..` x 77 jFIXED S.'-rr-�j`" EMa�NA�.r .- cl to 29. Insulatic3n �• �� \ .^ y• � . � +� x 78.fFIflE PRE NFIV. , 4,� -r> •� � '�0. Drywall.��ailil�g SK .� : ` � / r . y � �,i-p�' LTF�EPTtF�FEQ�R `E..�`,AENT -,--- ' �:31. Plaster Ba�wh`.Co�x S i Cr;^ n � i.c ;rJ9 � FINAL If�SLS_CTI�I < v' r �"ri' 2:�lettric`eCPo�er Me,�ef�t��a! � � ' � �. ! �� '$0.'�OOD CERTIFI�_r�,TE IS�I�€D�� c� ' �__ _,.?�' - �3.Sin�; Electrip :r::c �n � S � � � NoCCs: -c: x- c� ,Ur - -'" - - -r.� t - �'$4 �in� H�tin� F�r''Cor47itionii?�� , ': :� ^ S c"`.::. x S JO �Q r: � ..K .r, r x ' ' �. N .. ' �-Q �: :� ' 35.' in I Ga PiPe�T .: ' - • , -" : � ('� pJ QSSx � ]f - 1`-•: � �l✓ �J1- .!t �.+t[` � . - . � r - . _S1.�ue(� `--it� � �36.,f1o� ��anopy .S`x rJ!� P� vY :� k`£ � (�(i } dT 1 �YK ♦' ��T % X af Y-.� %� ♦��lj � C TY. � �7.'�fnaf.Faciory FireR�ece;e � ;�i- ' x n; - - .( •r c G« :� x t: : C! o: . ... S r-� M i7 C1 � 8._ in5'r Plumb(ng ^ � � � .: ,, t fi z � .,� �„ N K a. .. r�. J--� Y J '39.�tiNatel S�Yice�Fina1;� z � �� . Y ;� t Y - I [�AO. Gas SerQrue�Finabt�K rr, y-:�.r 5 z:rI x r _�,� � cnCo x '� � 6 � c s: �..• • nJ7 X�L �11:".�olar po�}nes�c�F'i�S�Y , T~ • .� 4' X � •_,� � � f p 42.� Backflow PrevenYe"rfi Cv � � •z = �-' • � �- %-� -�� .k r• t x '7�.�J x L - t ��$ x~ xx -v x� . _ 43. Backflo•.v irri�atio�„ ?. ,� � � r ;; �' _ � • ,R14. landsc�,Se I�Gatio� SYstem?�t% s <-- a o� % v � � se� � S cc o . ..� �� F!� �Y V �45. ;ound !`ltertyatio ; � .. .. `� � � �; =.f �- � = •Z : E•a : . -'•i-` _/_/-_ ' _�. c?l6. �Handicap•Regnlations -• � " � - 'F •� � =' � K ' _ y / /I -�w �V nl X �i7.�If�L STRE�CTU�E & BUILDING ! ///f�/ q�jl ; K : � '� " " L! ! ! � '� � 48.=rINAL PLANNiNCi� i : - > , i �v ¢ � �- , - f� �F;,�,, S . Q , . =�s * �?t9.=Eleciric Rele3se to �dison , . � ^ � ;% .� ^S ., ; R ^ � :.50. �ar Release to SouFhern CaliSornia Gas Co Y � .�-` � + - = '- �+ • = !Y • * �• • 1 C � O K lJ C'i '•51. CERiIfICATE OFOCCUPANCY ' • x ?' � =� ;^;� , �- No. Date PflOJECT ADOPESS: j 3 6 OWNEH'S NRME: ENGL ROOflESS: r.vr. L 92626 UNIT: l/19/�7b—lltl.7 AflCH/ENGINEEfl:THOMAS CRANDALL ENGLISH AEG.NO.�NOI�' , nonsess: 3367 LARKSPUR ST '' PEflMITfEE:COSTAMESA CA 92626 aooness: THOMAS CRANDAI,L ENGLISH ( 714 ) 556-1183 3367 LARKSPUR ST COSTA MESA CA 92626 UCENSEU CONTflACTOP OECIAPATION: I here�y alhrm thal I am licensed un0er pmvisions o� Chapter 9(commencing with Section 7000� oi Division 3 a� ��e Business and Professons CoOe. anA my license is in full lorce and efleci. GTY LIC.: STATE LIC.: CLASS: Date: Signamre: WOHNENS' COMPENSpTION OECIABATION: I �eieby afiirm �ha� I have a certificate oi consent m seli-insure or a certilicaie at Workers' Compensalion Insurance, or a cenitietl copy ��ereof (Sec�ion 3800. Lab. C�. POLICY NO.: E%P. UqTE: COMPANY: ❑ Cenitied ropy is hereby furnished. ❑ Cehified caDY is filetl with Ihe city Building �ivision. Oate: Applicani: E%EMP710NFqOMWOFREBS'fAMPEN5p710NUELNBFTION: Qhissectionnee0nolbecompleteAiflhepermi�isioronehuntlretl(8lqqorless). I wrtify Ihai in �he pedormante o� �he wOrk for whiCh IhiS Dermii is issued. I Shall noi empl0y any erson in any manner io a5 �o OecOme 5u01ec1 Io ihe Nlorkers' Cnompensation Laws ol Calilomi � � �( Oaie' ��2� �7 � Signa `�"-'r� � NOTICE: I( atler making this declaralion. you ShoWd become sublec� to the Workers' Compensation pm isions of �he Labor Cotle. you musl forthwnh camply wiih such pmvisians or �his permit shall be Oeemed revoke0. CONSTBUCTION LENDING RGENCY: I hereby aflirm IOat ihere is a cons�mc�ion lending agency for Ihe pertormance oi ihe work for which Ihis permrt is i=suetl (Sectian 3W7. Civ. C), LENDEP: p00FES5: OWNEfl BUILOEfl DECNPATION: I hereby alfirm that I am eremp� Imm �he Conlracmrs' S�a�e License Law for the following reason (Sec�ion 70315 Business and Pmfessional Cotle: Any city of county whic� re0uire5 a permit to cons�mct, al�er, impmve, 4emoliSA, or repair any slmclure, Drior Io iis issuance, also repuires Ihe applicani lor such permi� �o file a 5igneA s�atement Iha� helshe is licensetl pursuant �a ihe prwisions a� Ihe ConVaclors' Sla�e Licenre Law (Chap�er 9(commencing wi�� Section 7000) o� Division 3 oi Ihe Business ana Prolessions Code) or I�ai he/she is exemp� Iherefmm anOl�e 6asis for �he alleged exemp�ion. Any viola�ion a� Sec�ion 7031.5 by apy aDPlJi� nifor a permi� SubleCls Ihe aDP�iCan� Io a tivil penally of n0� more than five huntlred tlollars (5500�. J,� //I, as awner o1 Ihe Dmperty or my employees wilh wages as tlleir sole compensation, will tlo ine woB, antl me LV S�rucWre is noi inientletl or o��ered far sale (Seclian 7064. Business an0 Pro�e55ional CoOe: T�e Contfac�oR' $�ate License Law tloes not apply to an owner ol a pmpetly who builtls or impmves therean, and who does such wo�k himseli/herseli or Ihrough his or her own emplayees, pmvidetl �ha� sucA impmvemen�s are noi in�endetl or olfere0 tar sale. I�, however IAe OuilOing or impmvement is soltl witAin one year o� comple�ioq the owner will have the burAen oi pmving he/she Uid nol build or imOmve � ipr t�e purpose af sale). �� K� �� 'I. as owner oi �he pmperry, am exclusively contrading with licensed contraclor5lo cons�mci �he D�oled (Seclion 7044. Business � and Pmiessions Cotle TAe Comrac�ors' State License Law does not appty m an owner of pmpeM who builUs ar improves ��e2on antl wha comrac�s lor suc� pwleds wit� a coniractoqs) license pursuam m �he ConVacmrs' State License Law�. I am aware ��al pmo� o� Iheir WOrker'S Compensati0n insurance Shoultl De providetl �o me. � I am exempi unAer Section: B. 8 P. C. ' br �hi5 f¢d50n: /-�p /a 1 oTie:_Jr-2 $��%3 dL4.�l�s�o �. I do AeBby certily Iha� I am aware oi and unders�ane Ihe requiremen�s o� Cahfomia Heal�� anU Sa�ety C e Sectio 25505, 25533, antl 25534 antl �hat I or any W�ure buil0ing occupanl willlwill nol (circle one) neetl Io comply wiih sai� Slate c e requiremenis lor a permii for conslmclion or motlilica�ion Imm Ihe Air Oualiry Managemem Disirict. FesiAemiat conslmciion applica�ions are evemp� irom Nese provisions. �a�e: ppplicanl: I here�y cerlity I�ai I have reaA Ihis applitaiion antl Stale Iha� ihe above informalian is Correti. I agree ta COmpty with all Ciry and tOunly orainances an0 5�alelawsrelaiing�a �uiltlinq consimc�ion antl �ereby authorizerepresentalives olihis ciryto enierupon��e above�mentionea propeny loi inspeciion purposes. � Oale'. _d ' ZC �� Sig � �river's L¢ense or Social Secun�y #: 1fiat�a6 Whne—Builtling, Green—Cotle Enforcemen�; Wnary—Apphcam; Pink—Revenue; Goltlenrotl—Assessor CITY OF COSTA HESA — BUILDING PERMIT PERM NO; E 062394 PERHIT NO; E 062394 PLAN CHECK NO; N GOVT: N SUPP: N CONSTRUCTION TYPE; 5—N PERMIT TYPE: ELE PURPOSE: OTH JOB DESCRIPTION ; MISC. ELECTRICAL APPARATUS SQ FT; CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 / COMMENTS: RE• B62393 �e+r****�r**�e*�e**�r*****r*�e**�******+e�r�r*�r*�e�r�**�r�e*�e*�r*�e***r*�r*r***�e***�e�r***�*�r�r*�*� 2 O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT ;�IN FRNT; FT IN REAR; FT IN LEFT; FT IN RGHT; FT 'p IN LEFT: FT IN RGHT; FT IN PARKING REQ• PROV; ��PARCEL; 91218254 2NE: REF NO; PLANNING N01'E5� �� iklf iF iFM 1F if k if M!F �f itlf 1Eit if if �tlFftlFit iF k!f iflf if ikM if iklflkif �t ikiF iF it if ft itikfk iFif if iFif k if it MiF if K�t �F iF iE iE iE iEiE IF k iflE iElFiFlElf k iE if M D E V E L O P M E N T/=S'E;;R V I C E S R E Q U I R E N E N T S �' ��:/'' P ZONING APPROVED BY . ' "' ! DATE; BUILDING APPROVED BY • � _ . DATE: APPLICATION ISSUED BY: �' � ��•' DATE: Z-$ � iliflkiklFif�t�Fikffif�F�klFifltiFlklkitMiF ifiFiFkiklfklFifiF �F1F �fltMitM�f�FiflfMil�flflfitiflfiflfltMlfiFMlfiFMikiFlFiFiFiFMN.iFMMk 1FifiF k iFkk�tkikikififklk�tltkiFikiFiF1i1f1F�FiFiFMikiF�Fiflkafikif LEGALIZATION;N F E.E.' S U H N A R Y STRUCTURAL SEGMENT:N HLDG PMT PLUMBING "ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT '� Z�`O2 SMIP/NON—RES PLAN ISSUH FEE 15,00 BUILDING—DIV—> PERNIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 2.25 15,00 0,00 17.25 17,25 .00 REVENUE DIVISION TOTALS--> COLLECTED• HLDG PNT PLUMBING ELECTRIC N&CHANI� 1%,25 17.25 OVER/SHORT• 00 FIRE SMIP/TOT GRAD�NG PLAN—CHECK k k k it �f ik 1k 1f it M iF M 1f if 1E iF it 1t itlflt �t It fE �Flt1t �f 1t �t 1F iF itlk 1F if If k k �t iF�t �f 1f 1f 1f 1t �f iF itlF Mit iflkit �t iFik k k iF �f it �F �f iFiFiE iE iE �f �t 1f if iFiF ikiF I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 FIXTURES LIGHTING 1 ST 20 EA, .75 .75 ELE 1 RECEPT/O�]TLET 1 ST 20 EA, .75 .75 ELE 1 RECEPT/SWITCH 1 ST 20 EA. .75 ,75 -' - END OF FEES 01 001400&4-00140UE4 T� T 17,25 DATE: Q5128J93 TItiE: I2:23 ' , , � �= ; CONSTRUCTION AND PLANNING � �pOOC&SP� Da[e 6ospecior ��' '` ." ' Date lnspec or APPROVALS Permit # . APPRdVALS PxrmM# � �! t. Temporary Electrical Service or Pole �� ' 52. Pool & Equipment Location � � ' Y, °j.,ne_Un arnd 53. Steel R�inforcement "a ?;;r,��i', `�C1r Cl � 7 ..� ::Ci.C"cfocltiu�'[k''Xanty�wl,r,;iity-Undrgrnd. ' 54, Forms ' � -��j��ec4�iEa:�` o�,i�:<t,'�.�,drgrnd. 55. Electrical Bonding �•� '� V: Q�r �t.cai7�intt.n:m�o7 � 56. Rough Plumbing & Pressure Test s_°.C. ��.�4��ES'�i�d 57. APPROVAITOCOVER�GU�lITE --�� p.�?��s - 58. Electrical Conduit-Undrornq. ` CJ.tA'2(19 t� Q.:r . � --� d 'Q-4 �� '7rs: - �, -- S?'�oundati�n '��, 1� 59. Gas Pipe, O Undrgmd., Test �.:.y �� -' R ." r'.' Water PiAe�Unct��md. 60. Backwash Lines, P-Trap, L� Urdrg� �q'��d. ; 1� Strycmr"� Floor��System 61. APPROVAL TO DECK . � 1� Prot'.�ertySe�y��in�& House Conneciion 62. Backwash & Receptor-Finai •' 12�. Sewct Cap c.• a• 63. Heater & VenFFinal %� ' 73. Roof Drains2� � \.r� 64. Plumbing SVstem � Finai ` n 7 14. Rough Plumbir+� � V 65. Electrical-Final '. �� 75. Rough �t�ctriCa?-Conduit �"t �� 66. Sofar System-Final � � � .:� 76. Rough Eiectric�y iri�g , � � 6�. Fencing & Access ApProval �� l 77. Rough Wiring �n ' 68. APPROVEp FOR PLASTERING � 18. Rough Electric��-T Bar Ceiling 69. POOUSPA SYSTEMS FlNA� i 79. Rouah Heating & Air Conditioni� FI ,E PT F,��QUIREtv1EM11j � �- �_.�� , (�* � cr :T. � c� � x : _ cr �..-P��- • a� mm 20:r or'h E ct F' `�lace '''��'' Q� ' v '�'� �` PPR"'V �S�'�G, ' y F' � �4 � QYY ��i � S.� T.'6 .c S r+ rJ� M� Sl �.J.-[-fer-'3�'ii � x _�,��j ( !"E.'t--_`.C-5 � :-r -'r_ ��i�Q T , � 21t-Dut!s,iF7Strgctw�> i .•.. '-s • S .:, r�y� .0. 'hderg��'��HSro ' c. Y 'r; �c= � �- c � , v� � i-. F...0 ,� � n.s �: s a,.: T �, ; 22...Du=', ":nt" �tirig: y � Y r � .� YY t. � C � 6 c� Fa ic,4„%71. Prociuc ,y�i(ig f.�'F.:is CA,Oii 23. �6a p-Ro-trdh &�est .T�S x[r n' tr_5.* > 72, Undergro�i_ FI��- -' 3 24:''iiootFiSming '?� ��" �'R �� ,t,',..J3:yUnderg;n�'.Stor�jgTank�7Gas ❑t)ity� �-��- _ , , .; � -a-- . 25. Ro•? ShSathing m �c Q v v-> � O> :us x 7q�T,pverhead HydrdJ > I ^ r �c i .�;y i:•-.. 'D O :*1x �� _ __ >: H �7 iT'7. . � 26�Tf•Bor Ceiling (St�Yur;l) &-.+�Scoat x C� �, �x r 75aDry Cher�Fca1 �,., � --[v , 27 ra e a J Flash � � `� _r �- ` � `'��-"_S `��' c� � s tp9k ^r� } x t 76. Ory Sta�cx'4�e > ^ r r�jy z ' ^t- y �: t �-'28. La4Siny� Siding •. . �"t? '� " £ . .." x 77n FIXED �1 Ef�SiNAI# y s`� r.� �: r O z- G ac s. ;Zi 7� r� ;l mii �29. Insulation x ' S •••• ' ' � �* a� 787EPIRE PflEV. FINF!Z �= � '=j- -C^ ��-5- v=7� - `30. Dry�,vallmJailing �. F � � F ^a � a � �.�LT�EPTY iREQi�IR�,�.�T � . � < - - - i. --r„� T ..•-� -,;r->. _ "37. Plaster Y:,o�+�nCoata S �:-[n r kr79. �INAL Ifi.'aCTI�,�• �c u-a-�•.r �' " ' - _ - - : -z . ,r,��___ �.� ;-scy_ma�y..,_ �'32.'^Electri '�Po� er Mc;�r'�;�na�� ``: h" .� OOD CERTIFCF4�i� IS�S�ED,,_ � � t4 � � c� - � `.. - _.L,�_�':�-.__ g33.S'��1�+1 EI�'irin < t7 1!�' •ct �� i wcCR+S: -- --;r, :^ v .a ' -��"C ,. '� '-t�(.1 _ . .+5--_T1C-'_ ----5 :v34ifin�3 He�tin�& Ai7�Co�i2idnasS ^ % x�: �--� •S i�._ x S t7 �* - J ;c �s; r ,,c a i c tii�_^.. C 1 i-��:: rc �:....... i35`{-�, in31 G==Pi�P'�Test �'� .: : . x �- r��'�F�: � .+. � x � `� F < O a: ,l:�i�J;[T -c.��-x-Q - _ -. c , � n _ _ _ xi36. Ho� orE:anoPY Y � ' [�^ k C1 � • � C10 * � .� x n � z x .7 .c�� m v.�n�n^;, T p � u ,' �.� x�r� - . i x--C:^ �' �7..rin.. F�tory Fire�iiace� i F•:- �-• x -:* ,x �' N � - z +---- . � - • 6 F�' - �--- r38. Fin�i Plum6ing 4 r^= �� %-.. �� _ s � * y t-39. Wath Service-Fina,r � a ° - x , u �` � `� F_ i x S �� Y Yf i � :i r, �n _ K `±30. Gas Service-Final r ;h SM:' S = !� � � c:+%• NN x � • • • -�. _ r z i^ '. T�„ � •i g41. Solar pomestio-Firi�IS n �' c'�' �` � � x _r �: x'.� {T '7�J II' x i'. �-�-- - A-� � 42. ackfiow Preventew ^� F . K * �: �F > : - - '� 'i74'-_. F' ..�.. � • . y� _ c p .. �S: .: �:x .� •, 43. Backflow Irf�atior� y ;; x x : ,. �' , . . �o � z-- =� '. �.: ;-^-; ' - __. rn34. Landscai3e IYti9atio'ti SVster�'�� Q �'^ O C' e�x K� :+, :• ^-(� w .?_ ?J'JL �---CJ n�+ . .�si"- . x it x _i S_ -� C..0 :i S e- ..r_'� r. �.ic� �- �5_ i- F. F.x*� �.,� N SV ��.�.'�C ,c ':�. �45_c;�ound Atte�atior� ,y.... « .nx; ._ . _.� < _ ' �_ �-� =-----`��----'-+ � : ;y36.�•NandicaPRegulations !- O > x x S ^�v S x r- - i .� � n � � - .n 7.�11�1L ST�CTUf3E & BLf�DING �I`.' � ;3 J �„. F� x � r,^ „ 1 I:�a : =- 48:fiN�l PLANNINCx i 6-= -K ?7 � K+. r d = F� * S ,,,�'-49.=Eleciric Rele3se to �dison � f �' ` ". r � � �� :.b0�,as�ietease to Soufhem Califor�nls Gas Co s 1 i� «_ .` �, � c'a x ;:; ••• - �- : x , x -v a51. CEFt.TIfICA7E OF�OCCUPANCY = a. ! r ��c x s [- -.. -.. No. Date 10P�..a _� .�'� . 351 � I ;il; 15-7?_cnsa001056�� * 142.85 ' COSTA MESA BUILDING-SAFETY DEPARTMENT SOLA - P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 AP,LICATION FOR BUILDING PERMIT ForApplicanttoFillinCompletely REc iveo V DATERECEIVED - ' DAT ISSU D ' BUII.DING ��z��.7 � ��'7.� ADDRESS Larks llT' Street ' OWNER liarwin So. Calif. �Inc. ^.P."o. MAIL � � BUIIDING � aooaess 16255 Ventura Bivd, nooaess_ z : a� cirv Encino Calif N�L $(— TRACT Zz W ADD A Q CONSTRUCTION _ � N LENOER L8iW111 So. Calif. Inc. am �� BRANCH 1625 Ventura Blvd J � OWNEfl ' ADDRESS Encino . J APCHITECT TEL SE a OR ENGINEER N . — U Q FIRE w¢ ADDRESS 9100 Wilshire Blvd. Bev.Hills ZONE a w APPR VE � J O CONTRACTOR Larwin So. Calif.�Inc.' BY m Z �� ADDRESS 16255 Ventura Blvd PEFMIT f�19.� � I � /1.�5 1�/L S� LOT BLOCK �� 1 VALUE ` � $ �C GROU� ✓ DATE��/I �_L w W TEL. Z�NE NO.OF USE OF NEW S/N Fh �= CITV NO. � P�� BUILDING(� � Z H — w � STATE CITV YNF705 APPROVED VARDSAPPROVED N 2 ��c. uo. 191311 LIC. NO. B_1 MAIN BUILDING ACCESSORY BUILDI 7 O (FROM C/L STREET) SIZE NO.OF BLDGS. �S OF LOT NOW ON LOT FRONT USE OF L EXISTING BLDG. SI F SIZE OF NO.OF Z NEWBLDG. 17�FO FOOMS STORIES 1 L.SI�E EXTERIOR WALL ROOF WOOCI ! t V COVERING SCUCCO COVERING Shin 12 REAR d USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. MAIN BLDGS. � �( VAR. � � Construct Sin le Famil dwellin c.u.P.# � . ' �APPROVED /, y ln. z 0 U1 hereby acknowledBe that I have reatl this application antl state HOLD FOR = thai the ebove information is correct and agree to comply with � all lawz regulating building conshuction, antl I shall not employ � any persan in violation of the workman's compensation laws ot Me Sta[e ot Calitomia. zI hereby certify that I am�properly licensed as a conttactor untler �n' the 52a2e oi Calitornia Business antl Professions Cotle, Divisicn 3, THE AMOUP Chapter 9, and thet such licenus are in tull force antl eftect, or I THE PURPOSE am exempt trom the provisions of the State ot California Business VALUATION and Professions Coda, Division 3, Chapter 9. Signature ot� Mt�-- D. Downs $�� C/� Permittee Sf��G��ae'�cE � _ Auffiorizatl Agent & DATE � � T. o $HOWN VNDER VALUATION IS FOR � IF ESTABIISHING A PERMIT FEE ONLY: p � m � PERMIT FEE $ j m PLAN CHECK $ E �,� `o � LL TOTAL FEE $ • � 3a4aJ COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 z . a U z Z Q ON am J � J N Q' C UN Z a W � p, w W Z J Q m Z J � W W � _ Z f- w� 70 F z a U J ,.�� 4ir! -3-74cn� 00 015,r {: � * ��5.50 APPLICATION FOR BUILDING PERMIT For Applicant to Fil/ in Completely RECE��'J D/ATE'R�EIVE ppTF� �� ADIDFE35�� L�QI'KS G�Y� CY �`' J� U� � �� PERMIT N . OWNER • .�G� A.P. NO. BUIIDING "1 aooaEss 3�('o Y t1 �•- /aDDRESS ��(fl LCC�r S V� TEL. ✓z�3— TRACT J LOT � BLOCK cirv , (� No. GS.2-S3' CONSTRUCTION �t �n�� W .4DD A P LENDER BRANCH ' / OWNEFL/ �' ADDRESS � /� VALUE �D � ARCHITECT TEL SE � Q LUVPi S OR ENGINEER NO. FIRE '/ ADORESS ' ZONE TVPE Y GROUP APPROVED CONTRACTOR C BV DATE ADORESS�S 0 �k�L( � S'�' n / TEL. ZONE /_ / PI.A� ` gUILDING EW�O 4O1( CITY Q C�. NO. S�x'�—By��J l� STATE CITV � �'P.:IDSAPPFOVED VAIiDSAPPROVED LIC. NO. � Z IIC. NO. S MAIN BUILDING ACCESSORV BUILDING SIZE /�O � � I NOWONLOTS ' (FROMGL TREET) OF LOT FRONT F� L� FT. USE OF ' EXISTING BI.DG. R Q S 1 e n c e S FT � FT. SIZE OF NO. OF ' �J / NEWBLDG. ROOMS STOFIES L.SIDE P_!J FT. EXTEflIOR WAIL ROOF COVERING COVEFING REAR S FT. � PT. USE OF 8 ILDING AND WOFK TO BE PERFORMED DISiANCE BET. BET. MAIN & '�/L� I� r^ MAIN BLDf35. ACCESS. BLDGS. VAR.# DATE C.U.P.� APPROVED APPROVED �� "� -� � I hereby acknowledBe that I have reatl this applicaxion antl state . � that ffie above intormation is correct and agree to wmply wiffi - all laws regulatin8 builtling conshuction, antl I shall not employ � any person in violatian ot the workman's compensation laws ot the Staie of California. ��il T� � I hereby certify that I am properly licensetl as a contractor untler �J SQ. FT. ' the State ot Califomia Business and Protessions Cotle, Divisicn 3, THE AMOUNTSHOWN UNDER VAWATION IS FOR Chapter 9, antl that such licenses are in full force antl eftect, or I THE PUFPOSE OF ESTABLISHING A PERMIT FEE ONLV: a am ezempt trom the provizions ot ffie S[ate of Calitornia Business and Professions Cnoe, Division 3, Chapter 9. VAWATION ��,� � PERMIT FEE $ � OO Signature o� • � � ° Perm(ttee t $� O � PLAN CHECK $ � E / � Autharized Apent ��' u TOTAL FEE $ . ►CONSTRUCTION AND PL.ANNING • P601 & SPA � �,. � Date-. Inspector Date Inspector APPROVALS Permit # Ir APPROVAIS �� Permit #_ �. ► . .- . �--1� Temporary Electrical 5ervice or Poie � 52. Pool & Equipment Location� . �• :? . q 2. Soi� Pipe-Undrgrnd. �� - 53. Steel Reinforcement � �' � , -� - . j „ ' :'��3�;�lectrica� Conduti;,U�ility�Undrqmd. � � 54. Forms , � '' �. r4. �@lectrical Conduit.U��9md. .� - , 55. Electrical Bonding I �� . �• p. � y;�•��teel Relnforce�ent� - 56. Rough Plumbing & Pressure Test � L'%�-+.iv V.-+1J ^ 6�;•�lectrical UFE (�iTnd. � � 57. APPROVAL TO COVER•GUNITE �7 ' "'Ty�Footings '�� 58. ElectricahConc�i�Undrgrnd. � � 'U vv�..-r � ��n8;, Foundation ,� ,j . ,�- � 59. Gas Pipe, C Und�r,�Bmd., Test. ' � � 9. Water Pipe�Undrgmd.� j f' 60. Backwash Lines,;t�'Trap, C Undrgrnd. i0. Structural Floo� Svstem ""� � pECK .�� . t%.�.� 67-. APPROVAL TO�_ �"' '. . 1 L�Property Sewer Line�& Hous�Connec{ion . -62. Backwash & Recpptor•Final � 12•;6��+'e� �P �� y-?, _ � 63. Heater & Vent-Final - �- �8�3. Roof Drains •- ' 64. Plumbing System � Final ; ', ' '�4. Rough Plumbing �� - 65. Electrical-Final ' � � ''� �� - < /" �7.5. Rough Electric�Coi�iuit .. 66. Soiar System-Rinai ' ' (y . '�6. Rough Electric'WiriiS�q �67. Fencing & Acc�,i1.�ApProval � j ,�7. Rough Wiring S�n ; 68. APPROVED F,QF7^PLASTERWG �' iB. Rough ElectricaFT Bar Ceiling ' 69. POOUSPA SYSTfh9S FINA� � 19.�.�ough He}tipq &,Ai� Conditio�ur}� ipi� .fl �� i_� ,�'; ' �S qfRB�flEAT�.�2EQUIREMEN.T �u . __ . . �7 �-�.3:-•Q IT: 4' :.� �v 20.�.�3ough Piittocy Fiz.ePl2ce i [;� '^d .� ; �-+ 4 �.c i APPftOVia•4S-+� PBtmit # �K '� ��' <' ti' (ti ' Y 1 :�1-. �� r '4 Iti �i �� F .F. .C:�' � i:. .R i'7 � ��. tr} :� 1.. .. H,5 -% ,S H t: hi �LTj' �' \ 21.:j?uct�, in;Str�Cturg r I :5:-+ ."n i� �� il r� 70.i-Undergnt3urqd h{ydro n u 22.;�ucR, �AentilaTingJ r 1 y: �'r' �� t i� t-• a� 77, produM��iping�'ias _I�`,70i1 ,�, .-. � �.. �- i i^ � „- � i ,:. •� 23. Gas�Pipe��-pou4h &��st ;*1;' �v iT] �^ �� ,��k � �7 � � � ; �nfr � 72. Under9r,nund Fl�ifha^. �y �;. ,� �� T' � 7��J �Y z; :S'X '' 24. oof'Framing :j�i � � IT7 �' � ': �� -+�� • 7;� UndergrBd.Stot%ge�'ank�Gas ❑Oil .i �'[i i�t �'� .k 1 f.-� �-f•-�� 25.�Roo�Sheathing �'; �� `J S_�f�^)� '�;t i4.,�verheadHydr�i� ,� � � �.� � � .. . 26.��'BaaCeiRng(St�r�tuiall&�I�i�¢Coat i:�) :>. ��% 75'.�-OryChEBtiCall-'�- 's :T7 � � . n �1'S '•� M 27. `�rart3E air8 Fla'shi '�'^'r, �i� �� ;'� �� `� �.1Pipe ��v e : , .7 �L i ��e !�I:?i.J �T 'k �a.k J6. �ty $t3 �I-i �U �'j �' 28. Lathin9:& Siding;� }' � �71i-+ �� .; �i ..' ..� ..ki. 7fl. F�XED'�$VSTEM�FINA�U-+ �� '- " �n 29. Insulatiori i1'.` " •� •• ` r I rr F�RE PREV. F,11�AL .v'> �'. :„ r ) ' z 'S tK I {.. �' 30. Drywall,Nailing ;r 4 r+ r '.a'-. i � 'r ;S ,vkiEAlTAi DEPT� REQUIREMENT : r 31. Ptaster 9"r�� wr7::CoaY.� `' i!'�� ,` � �' � k�., 79. FtNAL ��PECT�ON :r :� �� ; r� � .= iT'�i �� . e ... f " . - * � 32. ��IectricaGPower Mpter�Final ; c � -; � K 8B� FOOD CERTI�}CATE Ifi3�UEDi �� 33.�ina�Ele�iric?; i� �' r •r .� ,.. � �.�� N�tes: `7 �7'� �r �� '� �ti�!� * 4' I�� k 1T'. k -4 iZ lTlt'1 ;K i-� z ' 34.'�inat;He��ing$ AirC¢Flditionin'g ;;j � 5 k �� 'i ,-,;� 'p " i�' �ti < �.� 35.•Final Gas'Pipe=Test "�^ " � "' � f° � '"� ��'"' �� -�T' �S' :7 °' � � rY �T] ' ..1^� f ITI H J 'N F i� I i�� •�. 'f' I 1 1 K a .. .. .�,. 36.�Ioodor,�anoPY : . i�.t-: ;. � fr i*� :[•o ;-�a '7m t ir. � 37. Finaf•Factor Fire lac?, r ��''j� •a .r �U K � " „� Y P ' g . 'S :n d: .S �" .r .0 i :n - ' - 38. Fina�'Plui�bir�g �; �:� � iu :v � �t � i� .i� .K•" ri � 39. Water Service=Final t :=' � . . 'i' « ' i{k > �-+ +v. . • .• S � �•� t I fK H�.: 'c I: IT ; � 40. Gas Service-F pal .� �r ��;�i� �= v � ' � � �� . ,�� , � �a 41. Solar DOmestic-Final �� ?� J I �' �" 7 � "�' �+� �^ �� Y• I-a .).r 'Y .S 42. 8ackflow Preventer.� ,:r i,�� 4 �� i tg I� �:70�� t �- 43. Backflow krigation :. . � � � � ' �� 't � * ^ � � • y I: (Y p '1: i �1! :1: r.� '�l vi .� ' ��44.,-�Landsca�e IrriQatior�SYstem�:� � �;. k �� 'y y S, r �_ ,t � � �j�x �� S •-V+ •f L� . . e �� . . . . . . . . . 45.:�ound Rtten�tlation� �::.. . 'r '� �'��x'' '%' .'' � . �"`=� ' r_ r '1 �< c �. - . i-� �. .•H .i '46. HandjcaP'Regulatio�js _ � k _ ..� ..� _�t � ,n, ��j �, �� « ;47.�FIN.pLSTRUCTURE&BUItDING � �fg�� i �t� ~ • � T > �� - � �rr.� � .: �. •� � q � Ir � 1 • • 1` 1^ •i .F �' 48.�F,IN;/,�L P.LANNINGy. ' �t: v i �'Y4't ir '? :K �y - r�. �49.�Plectric�Releaseto 6dison � �� t j� •;, K n - > f I v�c �y ' k �l ] '-,.-/ 'i: I � L.-yi: r i� ' i. �� . ,.50. 6as�gelea'se to Soutfiern Calif�oc��GasCo �. x ,S �; ,� . ;i .� 51. CERTIFICATE OF bCCUPANCY ' ' ' ' No. Date