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Home My WebLink About605 THAMES WAY - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 605 THAMES WY Suite No Vicinity: Parcel Nunmber: 93405145 Applicant SCOTT, JEANET Address: 502 S LYON ST SANTA ANA, CA Owner: SENECAL, GENE Address 6 EL GUIRO CA RANCHO SANTA MARGARITA Contractor: CULLIGAN WATER Address: 502 S LYON ST Arch / Eng : Address: ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifer System Connect pce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Orinking Founfain Expansion Tank Gas Earthquake Valve SANTA ANA, CA INSTALL A WATER SOFTNER. AMT $23.50 $0.00 $0.00 so.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 PLUMBING PERMIT Phone: 714-750-2233 Zip: 92701 Phone: Zip: 92688-3211 Phone: 714-750-2233 Zip: 92701 License: 663091 Phone: Zip: License: SCOPE OF PERMIT FEE SUMMARY QTY AMT Laundry Tub / Washer $0.00 0 Landscape Irrigation $0.00 0 P-Trap $0.00 0 Pressure Regulator $0.00 0 Process Piping (per 10 ft) $0.00 0 Receptors - $0.00 0 Septic Tank $0.00 0 Sewer Cap for Demo $0.00 0 Sewer Connect $0.00 0 Sewer Private Line $0.00 0 Shower $0.00 0 Sink, bar 50.00 0 Sink, commercial $0.00 0 Sink, Floor $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Status: ISSUED Applied: 12/10/2004 Issued: 12/10/2004 ISSUED BY: � EXpIRED OA'TE � SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toile[) Water Heater / vent Water Piping (Inst or Rep.) Waler Re-pipe Water Service AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 7241-92) 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 1 BO days. INSPECTIONS: In order tor the work authorizetl under this permit to be considered legal, such work must comply with all applicable codes, an0 all requlred Inepectlona and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 754-5626 2448d8 (fl�00) WORKERS'COMPENSAnON DECLARAnON: 1 hereby eHirtn under penalry of perjury one ot the following declarations: � ❑ eve antl will mainteln a certiticate of consent to sel4lnsure for workers' compensetion, as pmvidetl for by section 3700 oi the Lebor CoOe, for the peAormance oi Ihe work lor which t�is pertnit Is issuetl. ve and will meintain workers' compensation insurence, es required by sectlon 3700 0l the Lebor Code, for Ne pertortnance of ihe work for which Ihis pertnit is issuetl. My orkers' campensation Insu nce carner end poliq nu her are: � N t Ci� /—l-N✓�-QiLi @ h'1 /1% � `7� P ' u ber. ✓Vl i � / � l% T ��O 0 � I naf be compleretl it the permit is veluetl af one hundred dollers ($100) or /essJ in the pedormence oi the work for which,this pertnit is issued, I shall not employ eny person i manner so as to become sub�ect to the workers' m Iaws�aF lilornia, end egre thet if �Sfiould bec e sublecl to ihe workers' compensation provislons ol Sect/lon 3700 0l iha lebor Coae, I shall fotlhwith u,a�o�o��5� � —� � . /a/ �UfO `% e: � ce: � TO SECURE WORKERS' COMPENSATIIXJ COVEfiAGE IS UNLAWFUL AND SHALL SUBIECT AN EM ER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO IXJE HUNDRED IE (S1C9,000�, IN ADDITION TO iHE COST OF WMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 31060F THE LABOR CODE, IMEREST, PND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I herebygtfirerrttrdt I em licensed underpmNsions of ChaO�er 9(commendng wit� Section 7000) Cade, antl my license is in tull CONSTRUCTON LENDING AGENCY: ❑ I hereby aRirm t�at there is a construction lending agenty for Ihe pedormance ol the work br which this pertnit is issuetl. (Sec. 3097, Civil Cotle). Lentler's Neme: Lender's Adtlress: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby effirtn thet under penelry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reeson (Sec. 7031.5, Buslness end Professions Code: Any city or counly which requires a permit lo'constmct, elter, Improve, demolish, or repair any simcture, prior to its issuance, elso requires 1�e applicant tor such permit to file a signea statemeN t�ei he ar she Is Iicensed pursuant to the pmvislons at Ihe Comrectors License Law (Chapter 9(commencing with SecNan 7000) of Divislon 3 of ihe eusiness antl Professions Code) ar that he or she is exempt therefrom end ihe basis for t�e alleged e:emption. Any violation oi Sectlon 7037.5 by any applicflnt for e permit subjecis the epplicent to e civil penelry of not more than flve �untlretl tlollers (5500).): ❑ I, as owner of the property, or my employees with wages es their sole compensetion, WILL DO 7HE WORK, antl ihe siructura I5 not intentletl or ottered lar sale (Sec. 7044, Business and Professions Cotle: The Coniractors License Law does not apDly to an owner of property who bullds or Improves thereon, an0 who does such work himselt or hersetl or through his ar her own employees, provided Ihet such Impravements are not intended or aHerea tor sale. If, however, Ihe huiltling or improvement is sold within one year ol completioq the ownervbuilder will heve the burtlen of Oroving thet he or she did not build or imprave for Durpose of sale.). � ❑ I, a5 owner ot the praperry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the projact (Sec. 7044, Business antl Profeuions Cotle: Tha coniractors License Lew does not apply to en owner of propeny who bulltls or improves thereon, and who con�recis for such pro�ect with a contractor(s) licensa pursuent to the Contrectors License Laws.). ❑ I am e:empt under set. BuSiness and Protessions Code for this reason: Signature: Date: Owner ID verilietl by tlnver's license. ❑ Ves ❑ No Driver5 LiCen50 No. Vedfication of Ownership by (rype of daumen�, i.e. � property tex bill or tleetl): Expire5: DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ 1 hereby certify ihat no excavation five (5) or more feet in deplh into whic� e person is required to tlescentl, will be mede In connection with work euthonzed by this permii, end that no building simcture, scaftolding, falsework, or demolition or dismantling ihereof, will be more Ihen Ihiny�siz (36) feet high. (Chap. 32, Grp 2, Art 2, Sac. 341, Title 8, Califomia Adminis�retive Cotle). ❑ As owner�builder, I wlll not employ anyone to do work which would requlre e permit from ihe Division of Industrial Setety, es noted ebove, unless such person hes a permit to tlo such work from ihe division. Signature: Date: Division of Industnal Safety Permit Number: CERTIFlCATE OF COMPLIANCE AND AUT}IORIZATON OF ENTTiY: I cetlity untler penalry of perjury that I have read t�is epplication and state that the infortnation given is correct I egree to comply wi�h all state laws antl ciry ordinances releting to buliding constmction, end euthorize representetives of the Clty ot Costa Mesa to enter upon ihe ebove-described property lor inspection purposes. I agree not to occupy or ellow occupancy of any building authorized by ihis permi� until finel inspection. I6/6 1266 200 201 202 203 INSPECTIONTYPE Fixed System Final Fire Prevention Pool Spe Final Finel Re-Roof Final BIocWRetalning Well Final Factory Fire Place Final Slgn 204 Final Demolition QAIE 1[�9l8 %a/� COUE� INSPECTIONTYVE 206 Final Mechanical 20B Finel Plumbing 270 Finel Electrical 272 Final Flre Preventlon 220 Final Planning ApprOval 222 Final Site 250 Final Building/Occupency � �