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Home My WebLink About2794 LORENZO DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ce.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 2794 LORENZO AV Suite No Vicinity: Parcel Nunmber: 14162602 Applicant: SANCHEZ, JENNIFER Address: 24707 SAN FERNANDO RD Phone: 661-259-7131 SANTA CLARITA, CA Zip: 91321 Owner: LESTER, DAVID W TR Address 2794 LORENZO OR Phone: COSTA MESA, CA Zip: 92626 Contractor: AFFORDABLE WATER HEATERS & PLUMBING Address: 24707 SAN FERNANDO RD Arch / Eng : Address: SANTA CLARITA, CA Phone: (661)259-7131 Zip: 91321 License: 627368 Phone: Zip: License: SCOPE OF PERMIT WATER HEATER CHANGE -OUT. AMT ISSUE FEE $23.50 Backflow irrigation $0.00 Backflow Preventer 50.00 Bathtub $0.00 Clarifier System 50.00 Connect (Ice,Soda,etc) $0.00 Dental Units $0.00 Dishwasher $0.00 Drain, Floor $0.00 Drain, Rainwater $0.00 Drain, Roof $0.00 Drinking Fountain 50.00 Expansion Tank 50.00 Gas Earthquake Valve $0.00 Gas (1-4 outlets) $0.00 Gas (Over 4 outlets) $0.00 Gas Repipe $0.00 Gas Service $0.00 Interceptors (Grease, Oil) $0.00 Interceptors (Sand Auto ) $0.00 QTY Status: ISSUED Applied: 1126/2001 Issued: 11/26/2001 ISSUED BY: V� FEE SUMMARY AMT QTY AMT QTY Laundry Tub / Washer 50.00 0 Sump Pump $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 P -Trap $0.00 0 Trap Primer $0.00 0 Pressure Regulator $0.00 0 Urinal S0.00 0 Process Piping (per 10 R) $0.00 0 Vacuum Brkr Bkflow(14) 50.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) S0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Sewer Connect $0.00 0 Waste and Vent System 50.00 0 Sewer Private Line S0.00 0 Water Closet (Toilet) 50.00 0 Shower So.00 0 Water Heater / vent $12.30 1 Sink, bar $0.00 0 Water Piping (Inst or Rep.) 50.00 0 Sink, commercial $0.00 0 Water Re -pipe 50.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0 Sink, service/mop $0.00 0 OTHER 50.00 Spa (private) $0.00 0 VIOLATION $0.00 Spa (public) $0.00 0 PLAN CHECK 50.00 REINSPECTION $0.00 0 COMMENTS / SPECIAL CONDITIONS TOTAL CALCULATED FEES: $35.80 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections 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 2aa8-ae wool DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Cartier: Policy Number: -iThis section need not be plated if the perMf Is valued at one hundred dollars ($100) or less.) RIIIcenify that in the n mance 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 la Ca nd agree that if I hould a subject to the workers' compensation provisions of S ctlon 3700 01 the Labor Code, I shall forthwith comply with lhes rovisio Applicant Signature: Date: WARNING' LURE TNECURE WORKERS' COMPENSATION OUVEPAE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CR1NNfiL PENALTIES 4 CML FINES UP TO ONE HUNDRED DOLLARE (s ,000), IN ADDITION TO THE COST OF TION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE IIABOR CODE. INTEREST, AND ATTORNEY'S FEES. LICENS6 CONTRA ORS DECL ATION: I hereby all m licensed un r provislons f Chapter 9 co m cing with Section 7000) of Division 3 of the Business and Pr fessloris Code, and my license is in lull force end effect. Lit a Class a Contractors Signature: Date: CONSTRUCTION L NDING A ENCY: ❑ 1 hereby affirm That therei a construction lending agency for th pe ormance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: odors Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish. or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a perry subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Cade: The Contractors License Law does not apply to an owner of properly who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or improvement 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 sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (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 contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document. I.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth Into which a person Is required to descend, will be made In connection with work authorized by this permit, and that no building structure, scaffolding, faisework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 WIII the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a haterdous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Cade requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a re nod year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feat of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to lila a registration form for acutely hazardous materials? ❑Yes ❑ No (Section 25533 01 the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ........................................................... _............................................................ _.._.................... __................................................................................................................................ .......................................................................................... _.. 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? j_-1 Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ...........__....................._.............._.._._—..__............_c___......_......................_..__............................._...................................Ied"....................... ..a s* ...... ......_...........___......___......._. 4 If an RMPP is presently required, has Section 25534 of the CaliforniaCaliloHealth and Safety Code been fully complied with? ❑Ves ❑ No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aEEermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? � Ye9 LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 WIII any pan of the IaUllry to be consimctetl under this permit be within 1000 feet from the outer boundaries of a school? ❑Ves ❑ No (If yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air press Management DistrictHeal or other air pollution control distract or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by Galifomla Health and Safety Ca0e Section 42303 been made? ❑Yes ❑ No .. .................._... __._........ __.___ e (If yes', attach certificate of compliancefrom the appropriate air pollution control officer).-- CERTIFICATE OF COMPLIANCE: I sanity that under penalty of perjury the Information given above is correct. I agree to comply, with all state laws and dry ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is W I afire o comply With II state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above- lesc' d property lo� spection osis. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. S1 Leg Owner s) jot 2 // And/ r uthorized Applicant D to CODE r14SRE09AA INTMAL$ CODE INSPECTION TYPE ga¢, INTITIAL$ 1616)Fma1Rwf Final Fire Prevention 206 Final Mechanical 1266 208 Final Plumbing 200 210 Final Electrical 201 Final Block/Relaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final BuildingJOccupancy (714)754-5273 • Fax(714)754-4656 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Job Address: 2794 LORENZOAV Suite: Vicinity: HOUSE 8 GARGE Parcel Nunmber: 14162602 Applicant: JONES, CRISTAL Address: Owner: LESTER, DAVID W TR Address 2794 LORENZO DR BUILDING PERMIT Zoning: COSTA MESA, CA Contractor: CAL -PAC ROOFING Address: 4091 E. LA PALMA Phone: ANAHEIM, CA Zip: UNIT D Zip: 92807 BUILDING PERMIT Zoning: R1 R1 Phone: Eng: Zip: Address: Phone: Zip: 92626 Phone: 714-978-9274 License: 719716 PERMIT NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 06/29/1999 Issued: 06/29/1999 _ .Arch :. _ Eng: ' Address: Address: Phone: Phone: Zip License: Zip: License: SCOPE OF PERMIT REROOF - PRE -ROOF INSPECTION REQUIRED, NEW ICBO #3409 DECRA SHAKE ROOF OVER EXISTING ROOF. ICBO REPORT TO BE AVAILABLE TO INSPECTOR IN FIELD. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $12,847.00 Permit: $199.75 Claim Valuation: $12,847.00 SMTP Res: $1.29 SMTP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $201.04 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Leh 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections 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 PIFCLARATIONS WORKERS' COMPENSATION DECLARATION: AI hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. ❑ 1 have and 111 maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this Permit Is issued. My work r o p nsallon Insurance Carder If poli gy number are: Q r LI Carrier: Policy Number: O 2-9 C1 5 (This section need not berp/ered if he permit is VUlued of one hundred dollars ($100) or less.) ❑ 1 certify that In the performance 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 I s of Califomfa, and agree that if heuld become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with the e r viSlone Applicant Signature: Date: `-If WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CO E IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST. AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under-pro"sionpp Chapter 9 (commencing with Section 7000) of Division 3 of the Busines ri P�ssions Code, and my license is In full farce and effect. Lic. M l tt Class Contractor's Signature: Data: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a Construction lending agency for the performance of the work for which this permit Is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure 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 work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or Improvement 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 sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (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 contracts for such project with a contractors) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person Is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, talsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, An 2, Sec. 341, Title B, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a Permit to do such work from the division. Signature: Dere: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building Occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building Occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Masa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully compiled with? ❑ Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a pgernit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries Of a school? ❑ Yes ❑ No (If yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District Or other air pollution 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 been made? ❑ Yes ❑ No 6 (If yes', attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given Is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for Inspectlon purposes. I agree not to occupy or allow Occupancy of any building authorized by this permit until final inspection. PS TiaIg tura L Owne s (� 2,q Q AndtOr Authonz ,cant \\ ``'''�� Date CODE t. INSPECTION TYPE gAIF. INTRIA CODE? INSPECTIONTYPE PATE Its 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final ��o I 208 Final Plumbing 7 200 Final Re -Roof [ —ff z [ 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 244646 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations CITY OF, COSTA MESA CONSTRUCTION PERMIT Project Address 2794 Lorenzo PER T NO. g3 O TRACT NO. LOT NO. UNIT NO. A.P. # Zone S Main Building: Accessory Building: TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION L REPAIR El CONVERSION 1:1 DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. Applicant's Mailing.Address David Lester Owner's Name Phone 540 -fit 50 Address 2792 Lorenzo E T Front Z 0 13 A Rear N Arch/Eng. License No. Address TYPE OF PERMIT GRADING ❑FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER ; _. PROJECTrDESCRIPTION SQ. FT. OCCUPANCY CON ST RUCTION TYPE VALUATION$ ZONE GRADING CU.YDS. ACRES C Right N K S Left G R ,q?S .T -s 1 Contractor's Nam hone 0 Address (mailing) 502 -S. 'T Cyon Street / 77._ n' i 1t6`t'� -s City License No. 6155 QZ I D Ping. Ref. # Parking Req./Provided E Planning Notes: M S, LICENSED CONTRACTOR DECLARATION Remarks: - I hereby affirm that I am licensed under provisions of Charter 9 (commencing ELECTRICAL FEES with section 7000) of Division 3 of the Business and Professions Code, and my license is in full f@rcr5astl effect. 209983 License Class License No. Date 1-16-90 Signature Q`T\-'>7. ,iTP WORKERS' COMPENSATION L RA N I n m a a certificate o consent to self -Insure or a cer 'yorkers' Compensation Insurance, or a certified copy thereof (Section , Lab.i�I^ ^50- �i , mi .cy No. lAt 4Com pang y � PLUMBING FEES Automatic Washer Transformer 1:1 15-50 KW Construction Pole Sub. ❑50+KW Bar Sink Showers Backflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps Backflow Irrigation Sewer Cap Dishwasher _ Meter [-]over 700 amps Cert'f ietl 6aids filed with the cit y-�J{Jxtl�ing�Divisi n. /r� (/�� Dale 1-10-�� APPlicant'^ "uA �/1 - 19CL �—`--� EXEMPTION FROM WORKERS' COMPENSA N DECLARATION (Thissection need not be completed if the per rifit is for one hundred ($100) or less). I certify that in the performance 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 Bathtubs - Sewer COn vection Sewer Dryers ❑Gas. -❑Electric Sub Panel Clarifiers Solar Collectors Fan Motors ❑0-1 HP Ell % - 8 Dishwasher _ Solar Piping F.A.U. Inc. Solar ❑9-15 HP ❑l6-15+ Drinking Fountains Solar Tank Fixtures Microwave Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - Urinal Outlets Range comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service `- Outlets Water Closet Switches Sign I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address Interceptors-.. Water Heater Garbage Disposal Standing Sections Kitchen Sink Water Service Generator ❑0-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 easiness and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt tr from and the basis for the alleged exemption. Any violation of Section 5 by any applicant for a permit subjects the applicant to a civil .y of not more than five hundred dollars ($500). i, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of cpm- pletion, the owner will have the burden Of proving he/she did not build or im- prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who build$ or improves thereon. and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. L]I am exempt under Section B. & P. C. for this reason _ Lavatories Auto -Wash P -Trap - Laundry Trays % Roof Drains Reinspection Fee $15 Issue Fee $ 3 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved ey Dat Application Issued By Dat Reins cion Fee Pe $16 Issue Fee $ 3 MECHANICAL FEES Boiler Hood or Type I ❑ Canopy Type I I ❑ Duct - Under Ground - - SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT � PLUMBING $ 5. COISSUANCE $ MW PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ 5.00 PLAN CHECK 25% $ Duct -Structural Refrigeration System Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU - Exhaust System El Multiple El System Repair/Alteration Firepl/Fact. Bit. ICBO # Fire Dampers Date Owner 1 hereby certify that I have read this application and state that the above information Is correct. I agree to comply with all city and county ordinances - and sta construction, and hereby authorize r reIIIIIIIIIIIIIIMMMMMMEMN Heating System & Ducting Registers 00-100,000 BTU E3 100,000 BT sC e5 Of Ln15 CIIy Ip ¢n ¢I ' pection pu as. \v —cn 1a.3 Reinspection Fee $15 Issue Fee $ 3 . Signature N1R�1 ,� Ayers' License or SS 01 00052609-00052609 TGT 5.00 DATE: 01/25/90 TIME: 10:12 Goldenrod - Assessor 0865-4 ite -Building; Canary -App lican n ing; CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL ✓_• SPA APPROVALS Pe. ., # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement -, 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. _ 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backw sh & Receptor-Final - -12. Sewer'Cap +, +.f ' i .{" - .Y' 'r, ' 63."- HeaterI Vent-Final t t 13. Roof Drains ', 64. Plumbing System - Final 14. Rough Plumbing 1 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18} Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning r FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace r' 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas OOil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Cheroical�_- - 27. Frame and Flashing _ 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat I 79. FINAL INSPECTION 32. Electrical Power Meter-Final= 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 3 ZQ QO Z.Er -' iia C'"&' L 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing %f%�� Lip) 39. Water Service-Finalt'T, 40. Gas Service-Final-- t7 i 41. Solar Domestic-Final' rr 42. BackflowPreventerr7 3 43. Backflow Irrigation C, ^ 44. Landscape Irrigation. ystem _v 45. Sound Attenuation 46. Handicap Regulatior[,-, ! 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - 1 50. Gas Release to Southern California Gas Ca 1 r� 51. CERTIFICATE OF OCCUPANCY No. Date _7 19410 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX STT COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT. ADDRESS ADDRESS 2794 Lorenzo Avenue COSTA MESA, CALIFORNIA MARL 3800 E. Coast Highway MAIL a ARCH OR ENIGINEER MaCCO Realty Co. Tr,D R 34220' same as above E r)—a" MAY 2 1963 F1NANI"T DEPT. APPLICATION F,I Y PERMIT* MESA BUILDING For Office Use Only RECEIPT NO. I . PiRmw.�j/Q EY ZONING zon[ o. I UEE N Puneor 2 Bull LEGAL ,DN Lot 2 - Trac NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STAL� NO. 207343-A-SBl 30' TO SIDE S REAR P. L. NH`bR 34220 LIG. EAVES 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. THE AMOUNT SHOWN UNDER VALUATION 15 FOR THE £ PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O n SIZEOF qqyy I NO OF BLOYOne ALLOWED (U. S. C. REQUIREMENT) LOT 6B' X 96' NOW ON B ^J PLAN CHECK 5 .J ^�.r O YARDSAPPROVED YARDS APPROVED USE OF none MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. ( FROM C/L STREET) SETBACK LINE FROM I FRONT O PT. FT. cervrER of BTaeET 50 REAR YARD 35 / SIDE YARD I LHPT 9' I RIGHT I R. SIDE FT. FT. [6 DESCRIPTION OF WORK L.SIDE -1 FT. FT. X REAR 3� FI'. FT. NEW ALTERATION ADDITION DISTANCE BET. BET. MAIN @ MAIN SLOGS. ACCESS. BLDGS. REPAIR MOVING DEMOLISH VAR. # DATE SUI6ZELDD"°54'X41'611 Rooms— 7CC.. STORIES C.U.P.# APPROVED EXTERIOR WALL APPROVED COVERING StnCCOI COVOERIN6 Shin a BY 'V' -""FI DATE USE OF BUILDING AND WORK TOOK PERFORMED fM dL Sin le Fam.Rea. W/Att. Cara a PLAN No. 500-B Dwelling -2266 S.F. Gar -460 S.F. m SCI. FT. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. THE AMOUNT SHOWN UNDER VALUATION 15 FOR THE £ PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O VALUATION m SIGNATURE OF MACCO REALTY CO. PERMITTE s 23,925.00 PERMIT FEE S B ^J PLAN CHECK 5 .J ^�.r O AUTHORIZED AGIENT Bv;�5 „y.—` - /, 1 �� I`