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Home My WebLink About848 TOWNE ST - Building Permits(714) 754-5273 • Feu (714) 754-4856 • www.ci.eosta-mesa.ca.us TI FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 848 TOWNE ST Suite No Vicinity: Parcel Nunmber: 42418111 Applicant: SANDOVAL, EFR,41N Address: 1178 S BIRCH ST SANTA ANA, CA Owner. BARAJAS, MARTIN Address 848TOWNE ST COSTA MESA, CA Contractor: TOOL TIME Address: 1�18 S BIRCH ST SANTA ANA, CA Arch / Eng : Address: PLUMBING PERMIT Phone: 714-240-5014 Zip: 92707 Phone: 949-548-0852 Zip: 92627 Phone: 7�4-240-5014 Zip: 92707 License: 706039 Phone: Zip: License: . . Status: ISSUED Applied: 10/08/2004 Issued: 10/08/2004 ISSUED BY: SCOPE OF PERMIT ADD 352 S.F. TO EXISTING S.F.D. WORK TO INCLUDE: BEDROOM, BATH AND RELOCATE LAUNDRY ROOM. CONVERT EXISTING 3 BEDROOM, 2 BATH S.F.D. TO A 4 BEDROOM, 3 BATH S.F.D. 1 BATHTUB, 1 GAS OUTLET (1-0), 1 LAUNDRY.TUBNJASHER, 1 SHOWER, 1 WASH BASIN,�1 WATER CLOSET .. � ' ,' REF: B03-01780 - � ISSUE FEE Backflow irrigation " � BackFlow Preventer Bathtub Clarifier System Connect pce,Soda,etc) Dental Units Dishwasher Drain, Floor AMT $23.50 $0.00 $0.00 59.80 $0.00 $0.00 $0.00 30.00 $0.00 FEE SUMMARY QTY AMT . Laundry Tub / Washer $9.80 0 Landscape Irrigalion 50.00 0 P-T2p $0.00 1 Pressure Regulator $0.00 0 Process Piping (per 10 ft) $0.00 0 Recepiors $0.00 0 Sep[ic Tank $0.00 0- SewerCapforDemo $0.00 0 Sewer Connect 50.00 QTY 1 0 0 0 0 0 0 0 0 SumpPump Swimming Pool Trap-Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr BkFlow(5+) Wash Basin � Wash Basin Set Wasie and Venl System AMT $0.00 50.00 50.00 $0.00 30.00 $0.00 $9.80 30.00 $0.00 QTY 0 0 0 0 0 0 1 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become volG II work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such vrork must comply with eil applicable codes, and all requlred Inepeetiona end final epprovel must be obtalned. Failure to abtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 , 244Bd8 (fl�W) WORKERS' COMPENSATION DECLARATION: I hereby eHlrm under penalry of perjury ona ot Ihe following declarations: ❑ I have end will maimein a cenificate of consent to sel6lnsure for workers' compensation, es prodded for by section 3700 of the LaDor Cotle, for the peAormance oi the Work fOr which thi5 p8fmii is Issuetl. ❑ 1 have entl will melnlain workers' mmpensation insurance, as requiretl �y section 3700 oi the Lahor Code, lor the pedo�mance ol Ihe work for which this pertnit is issuetl. My workers' compensation Insuranca wrtier and polity number are: Carner: Policy Number: (T�is s tion need nof be comp/efed il fhe permi( is veluetl one hundred dollers ($100) or IessJ I certify that in the ertormance ot t�e work for wh' ihis pertnit is issued, I shell not employ eny person in eny manner so as to become subject to the workers' compensetlon law o lilornia, antl agrea t�a ' I should ecome bjecl Io Ihe workers' compensation prOvl5i0n5 of Sectlon 3700 ot Ihe Labor Cotle, I shall torihwith comply with thes v' ns. /� �� // Applicent Signature� Date: �/� WARNING FAILUFE 5 RE WORKERS' ATION COVERAGE IS UNLAWFUL ANO SHALL SU&IECT PN EMPLOVER TO CRIMINAL PENALTIES ANO CIVIL FlNES UP TO dJE HUNDRED TTIOUSAND DOLLARE ( ,000), IN ADOITION TO THE COST OF COMPENSATION, DMl4GES AS PRWIDED FOR IN SECiION 3]O60F THE UBOR COOE, IMEREST, AND ATiORNEY'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby aHirm Ihat I am li� torce end ettect. Lic. N� Cantractafs Signature: _ Chapter 'commencing with Section 7000) ot Divisian 3 ot the Business e Pmtessions Code, entl my license is in full Clau # � <r _ Dete: � � CONSTRUC710N LENDINCyAGENCY: ❑ I hereby ettirm thel there is a construction lending agency tor the peAormance ot the work tor which ihis permit is issuad. (Sec. 3097, Civil Cotle). Lentler's Neme: Lenders Address: Signa�ure: OWNER-BUILDER DECLARATONS: Defe: I hereby eNirm that under penelty of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business end Professions Cotle: Any ciry or county which requires e permit to constmct, alter, improve, demolish, or repair any siructure, prior to its issuance, also requlres Ihe ap0�icant for such permit b file e signed stetemant Ihat he or she Is Ilcensed pursuant to the provisions oi the Contractors License Law (Chepter 9(wmmencing with Section 7000) of Division 3 oi the Business end Professions Coda) or that he or she is exempt therefrom end ihe besis for the elle9etl exemption. Any violation of Sectlon 7031.5 by eny applicant for a Dertnit sub�ects the applicant to e civil penelry oi not more Ihan five huntlred dollars ($500)J: ❑ I, as owner ot Ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, enC Ihe siructure Is not intended or oHared for sele (Sec. 7044, Business and Professions Code: The Contracbro License Law does not apply to an owner ot property who builtls or impmves �hereon, antl who does such work himsell or herself or thwugh his or her own employees, provided �hat such improvements are not Intendetl or oHered lor sale. If, however, the building or Improvement Is soltl wi�hin one year of completion, the owner-6uilder wiil heve tha burden ot proving that he or she ditl not build or imDrove for purpose ol sale.). ' ❑ I, es owner ot the propetly, am E%CLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS to constmct the prolect (Sec. 7044, Business and Professions Cotle: The comractors License Law tloes not epply to en owner of property who builds or improves thereon, and who coniracts lor such project with a con�ractor(s) license pursuent to the CaMractors License Lews.). ❑ I em eaempt undor sec. Business and Professions Code tor this reason: Signe�ure: Date: Owner ID veritied by tlriver's license. es ❑ No DriveYs license No. Verilicetion ol Ownership by (type ot document, i.e. - pmperty tax bill or tlaetl): Expires: DIVISION OF INDUSTRIAL SAFE7Y PERMI7 CERTIFICATION: ❑ I hereby certity ihat no excavetion live (5) ar more feet in tlepth into which e person is required to tlescenq will be maGe in connection wlth work euthorized by this permit, end Ihat no building siructure, scaHolding, falsework, or tlemolition or dismantling Ihereof, will he more than thirry-siz (36) leet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Tltle B, Calllornia Atlministretiva Cotle). ❑ As owner-builder, I will not employ anyone to do work which would require e permit from the Division ol Indusinel Sefety, es noted ebove, unless such parson hes a pertnit to Oo such work trom the tlivision. Signeture: Date: Division of Indusirial Selery Permit Number: CERTFICATE OF COMPLIANCE AND AUTHORIZA OF ENfAY: I certify under penalry of perlury ihat I have read ihis epplication antl siate thet the infortnetion given is correct. I agree to comply with all state lews entl ordinances relating to building construction, and authorize representatives of �he City of Coste Mese to enter upon Ihe above-described property lor inspection puryose agree not ro occupy or allow occupancy of any building authonzed by ihis permit until finel inspection. COOE 1. 1616 1266 200 201 202 203 204 Fizetl System Final Flre Prevemion Pool Spa Finel Finel Re-Rool Final BIocWRetaining Wall Final Factory Fire Plate Final Sign Final Demolition �� IMtMLS 4Qpf,� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecincal 212 Final Fire Preventian 220 222 250 Final Planning Approval Final Site Final Building/Occupency �Itl I:11,� i �l, /'� (714) 754-5273 • Fex (714) 754•4856 • www.ci.eosta-mesa.ca.us 77 FAIR OHIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber. Applicant: Address: Owner: Address Contractor: 848 TOWNE ST 42418111 SANDOVAL, EFRAIN 1118 S BIRCH ST SANTA ANA, CA BARAJAS, MARTIN 848 TOWNE ST COSTA MESA, CA TOOL TIME Address: 1118 S BIRCH ST ISSUE FEE Temp service test Res. alc 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 t 000a Service over 1000a Motors to 1hp Motors to 10hp Motors to SOhp Motors to t00hp SANTA ANA, CA ELECTRICAL PERMIT Phone: 714-240-5014 Zip: 92707 Phone: 949-548-0852 Zip: 92627 Phone: 714-240-5014 Zip: 92707 License: 706039 ISSUED BY: Status: ISSUED Applied: 10/0&2004 Issued: t0108/2004 SCOPE OF PERMIT ADD 352 S.F. TO EXISTING S.F.D. WORK TO INCLUDE: BEDROOM, BATH AND RELOCATE LAUNDRY ROOM. CONVERT EXISTING 3 BEDROOM, 2 BATH S.F.D. TO A 4 BEDROOM, 3 BATH S.F.D. 4 LIGHT FIXTURES, 7 OUTLET, 4 SWITCHES, 1 RES APPL REF: 803-07780 523.50 50.00 50.00 $0.00 50.00 $0.00 $4.40 57.70 54.40 50.00 $a75 $0.00 $0.00 30.00 $0.00 $0.00 50.00 50.00 Quantity 0 0 0 4 7 4 0 1 0 0 0 0 0 0 0 FEESUMMARY Temp Dist System / Lighting Busway I100 fl SWnding Section Misc ElecVical 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 Misc. Canduit Misc. Conductor Cirws ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Quantity 50.00 0 50.00 0 $0.00 0 30.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 30.0o a 50.00- 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 NOTICE: The work authorized by ihis permit shall comply wlih all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIHA710N: This permit shall automaticelly expire end become vold if xrork is not commenced withln 780 tlays, or if work is suspended or ebandoned tor a pedod of 180 days. INSPECTIONS: In order for Ihe work euthorized under this permit to be considered legal, such work must comply with ali applicable eodes, and all requlred Inspeetlona end final approvel must ba obtalned. Failure to obtain inspections and tinal approval will result in lhe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 2ae.�e (eroo) WORKERS'COMPENSArON DECLARATON: '— � �"� I hareby effirm untler penalry oi perjury one of the tollowing deUerations: " ❑ I heve end wlll maintain a cenificate ot consent to self-Insure for workers' compensation, es provitletl for by section 3700 ot t�e Labor Cotle, tor the pertortnence ot the work for whlch Ihis pertnit is issueA. ❑ I have and will maintaln workers' compensaUon insurance, es reQulred by SecUon 3700 ot the Lebor Code, lor Ihe perfortnance ot Ne work ta whkh fhis pertnit is Issued. My workers' compensation Insuranca carrier entl pollcy number ere: Cerdor. (Thls se or less.) Poliq NumCer: �bcanity thet in the pertormance o4the work lor ich this permit is issued, I shall not employ eny person In any menner so es to become subjoct to ihe workers' compensetbn laws f Cellfomia, and agree t II I sho Id b om subject to the workers' compensetlon provisions ol Section 3700 of ihe Lebor Cotle, I shell torthwith comply with these ' �0 5. h /� / / ApplicantSignature: Date:�/�/�/J�/7 �-1 WARNINO: FAILURE TO WORKERS' PENSATION ODVEMGE IS UMAWFUL PND SHALL SUBJECT AN EMPLOYER TO CRIMINqL PENALTIES A 0 pVIL FlNES UP TO IXJE HUNORED THOUSANDDOILARE(51 ),INA�DITIONTOTMECOSTOFCOMPENSATIQY,DAMAGESASPROVI�E�FORINSECTIQY3]OBOFTHELABORCADE,IMEREST,PNDATTORNEY'SFEES. LICENSED CONTRACTOR$ DECLARATION: I hereby eflirm thet I em Ilce e er ' 4 ot Chepter � commencing with SecUon 7000) of DlWslon 3 af the Buslness a rofessions Cotle, end my license is In full fOfCB 9ntl BHBCI. LIC. p� CI849 M ConlractoYs Signature: Date: � CONSTRUCTION LENDIN AGENCY: ❑ I �oreDy aNirm ihet there Is a wnsiruction lending egency for Ihe pedortnance ot Ne work lor which Ihis pertnit is Issued. (Sec. 3097, Civil Cotle). Lentlei s Neme: Lenders Atltlress: Signemre: OWNER•BUILDER DECLARA710NS: Dete: I hereby eitirm ihat under penalry of perjury thet I em E%EMPT FROM THE CONTRAC70RS LICENSE LAW lor iha following reason (Sec. 7031.5, Business entl Prolesslons Cotla: Any ciry or county which requires e permit to construct, elter, Improve, demolish, or repair eny stmcWre, prior to its issuance, elso requires Ihe applicant lor suc� permit to tile a signed stetement thet he or she is licensetl pureuant to the proNsions oi the Camractore License Law (Chapter 9(commencing with Section 7000) af Dlvision 3 ot Ihe Business an0 Professions Cotle) or that he or she is exampt therefrom antl the Desis br ihe elleged ezemption. Any violation ot Section 7031.5 Dy eny epplicent br e Dermit sub�ects tha applicant to a civil penalry ol no� more then five huntlretl tlollers (5500).): ❑ I, es owner of the properry, or my employees with wages as t�elr sole compensation, WILL DO TME WORK, and Ihe siructure is not intentletl or otfered tor sale (Sac. 7044, Busineu and Professions Cotle: The Contractors License Lew does not apply to an owner ol property who 6uiltls or Improves thereon, and who does such work himsell or herself or through his or her own employees, provided ihat such improvements ere noi Intended or ottered tor sale. If, howaver, the building or improvement is soltl within one year ol completion, the owner-builtler will heve �he burden of proving that he or s�e ditl not Duila or improve for purpose of sale.). ' ❑ I, as owner ol the properry. am EXGLUSIVELY CONTRACTNG WRH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Cotle: Tha contractors License Law does not appty ro an owner ot pmperry who 6uiltls or impwves thereon, end who contracts lor such project wii� a contrecmr(s) license pursuant ta tha Contractcrs License Lews.). ❑ I am exempt under 50c. _ Signe�uro: Owner ID ven11BC by tlnvef5license. Vedflcatlon of Ownershlp by (rype ol Business antl Professions Coda for this reason: Ves ❑ Na Drivers License No. nt, i.e. - property tex bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CER7IFICA710N: Date: Expires: ❑ I hereby cenity thet no eacavetion five (5) or more leet In depih In�o which e person is required b descen4 will be metle in connection wlih work authotlzed by Ihis perml4 an� ihat no Duilding structure, scaftolding, falsework, or tlemditlon or tlismantling Ihereof, will be more than thirty-six (38) feet high. (ChaO� 3.2, Grp 2, Art 2, Sec. 341, Tltle 8, Celltomle Atlministretive Cotle). ❑ As owner�builder, I will not emplay anyone to do work whlch would reQuire e pertnit tmm the Divislon ol Intlustnel Sefety, as notetl ebove, unless such person hes e permit to tlo suc� work irom Ne tlivision. Signatura: Dale: DiWsion ol Indusidel Satery Pertnit Number. CERTIFlCATE OF COMPLIANCE AND AUTHORPATIO OF ENTAV: I cenity under penalry of perjury ihat I have read this epplication and state t�at ihe informetlon given is correct. I egree to comply wit� ell stete laws end ciry dinences releting to DuIltling construc�ion, antl au�hodze representetives of the Clry of CaSta Mesa to enter upon Ue ebova-descnbetl properry for insp6c�ion purposes. I ree not to occupy or ellow occupency of eny building eN�orizetl by this permit until final inspection. COpE I, INSYELTIONTYPE Q�¢ � 1616 Fixetl System Finel Fire Prevention 1266 Paol Spa Final 200 Finel Re-Rooi 201 FIneI BIocWRetainlnp Well 202 Final Factory Fire Place 203 Finel Sign 204 Flnel Demolltlon , L�� . : �� ii�° �� COOEI INSPECTIONTYPE 206 Finel Mechenical 208 Finel Plumbing 210 Finel Electrlcal 212 Finel Flre Preventlon 220 Finel Planning Approval 222 Final Sile 250 FinalBulltlingiOccupanry PAIE ItiI�L$ �� /!rl � �1 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JabAddress: 848 TOWNEST Suite: Viciniry: Parcel Number: 42418111 Applicant: SANDOVAL, EFRAIN Address: Owner: BAR,4JAS, MARTIN Address 848TOWNE ST COSTA MESA, CA Contractor: TOOL TIME Address: � 1118 S BIRCH ST SANTA ANA, CA Zip: 92707 Arch : Address: Zoning: Phone: 714-240-5014 Zip: Phone: 949-548-0652 Zip: 92627 Phone: 714-240-5014 License: 706039 Eng: Address: Phone: ISSUED BY: Status: ISSUED Applied: 10/14/2003 Issued: 10/08/2004 Phone: Zip: License: � License: SCOPE OF PERMIT ADD 352 S.F. TO EXISTING S.F.D. WORK TO INCLUDE: BEDROOM, BATH AND RELOCATE LAUNDRY ROOM. CONVERT EXISTING 3 BEDROOM, 2 BATH S.F.D. TO A 4 BEDROOM, 3 BATH S.F.D. - � Plan Check: Permit: SMIP Res: SMIP Com: Othec: Inspection: Total: $307.16 $472.55 $3.25 $0.00 $0.00 $0.00 $782.96 FEE SUMMARY SETBACKS MAW STRUCTURE Front 22-0 Rear -55-0 ACCESSORY Front 0- 0 , Rear� 0- 0 PARKING Existina: - 4 Required: �4 PLANNING & ZONING Left 5- 0 Left 0- 0 Proposed: . 0� Calc Valuation: Claim Valuation: Right � 5- 0 Right 0- 0 $32,524.80 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilornla statutes and related regulations. (Ord. No. 92-28, § t, 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 inepeetions and final epprovel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545828 / 2448d8 (8�00) . _ WORKERS' COMPENSATION DECLARATION: � ' . � ' I hereby eHirm under penalty ot perjury one ol tha followinq tleclarations: ❑ I heve entl wlll mainteln e certificete ot consent to self-Insure for workers' compensetlon, as provitled tor by section 3700 oi tha Le6or Code, for the peAormance of the work far which l�is pertnit is issuetl. ❑ I have end will maintain workers' compensalion insurance, as �equired by sectlon 3700 of Ihe Labor Code, tor tha peRortnance of the work for which this pertnit is luuetl. My workers' compensation Insurence cerner entl policy number ere: Cerrier: (This s (3700) or less.) Policy Numbar: �cenify that in the pertortnance of th� work br which thi ermit is issued, I shall not employ any person in any manner so es to become subjact to ihe workers' wmpensetlon laws of Gel' mia, end egree ihat it I sh d becom subj ct t he workers' cwnpensation provisions of Section 3700 ot t�e Labor Cale, I shall fonhwit� compy with Ihese pro �� s. / (� / ,/ Applicant 5ignature: Deta: -� �[ O r( 7 � WARNING FAIWRE TO SEC RE KERS' COMPENSA ION COVERAGE IS UNLAWFUL AND SHALL SU8IELT PN EMPLOVEP TO CRIMINAL PENALTIES AND GVIL FlNES UP TOIXJE MUNDRED TFKKISAND OOLLARE (510p,0p0 IN ADDfiION TO THE C06T OF Ct�MPENSqTION, OAM4GE5 AS PROVIOED FOR IN SECTION 31O60F THE LABOR CO�E, IMEFEST, AND ATfORNE1"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby etfirtn that 1 an lorce and ettecL Llc. a, Comractofs SlgneNre: Chapter 9 with Section 7000) ot Division 3 of Ihe Business�r d Prolessians Catle, entl my license is in full � Cless N� '�J Date: � �� CONSTRUC710N LENDING GGENCY: ❑ I hereby eflirtn Ihet ihere is e constructlon lentling egency Por the peAormance ol Ihe work for which this permit is issued. (Sec. 3097. Civil Cotle). Lenders Name: SignaNre: _ OWNER•BUILDER DECLARATIONS: Lender's Address: Dete: I hereby ettlrm ihat untler penel�y ol perjury Ihet I am EXEMPT FROM THE CONTFiACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business end Professlons Code: Any ciry or county w�ic� requires e permit to consiruct, alter, improve, demolish, or repair any stmcture, prior to its issuance, elso requires the epplicant for such permit to file e signed stetement �het he or she is Ilcensed pursuent to the provisions oi �he Contradors Llcense Lew (CheO�er 9(commencing wi�h Sectlon 7000) oi Divlsion 3 of ihe Business and ProfesSions Code) or ihat �e or she is exempt Iherefrom entl the besis lor the alleged e:emption. Any violation ot Sectlon 7031.5 by any applicent tor e permit suhjects tha eppllcent to a civil penelry oi not more ihan five hundred dollers ($500).): ❑ I, as owner of Ihe property, or my employees with weges es iheir sole compensation, WILL DO 7ME WORK, and the simcture is not imended or oHered lor sele (Sec. 7044, Business end Professlons Code: The Contracbrs License Law does not appry to en owner of property who bullds or impmves Ihereon, and who does such work himself or herself or ihrough his or her own employees, provided Ihat such improvemenis are not intentlad or oNered tor sale. If, however, ihe building or improvement is sold withln one year ol completion, the owner-builder will have the burtlen of proving ihat he or she did nol build or imDrove for purpose of sele.). � ❑ 1, as owner ol tha property, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business and Professlons Code: The conlrectors Llcense Lew does not epply to en owner of property who Duiltls or Improves thereon, and who conirecls lor such project wlih a conlrector(s) license pursuant to ihe Conlractors License Lews.). ❑ I am exempt under sec. Signature: Business and Professions Code br ihis reeson: Date: Owner ID veriiletl by dnver's license. �Ves ❑ No Dnvers License No. Expires: Verification of Ownership by (rype ol document, i.e. - property tas hill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity that no excavation tive (5) or more feet in tlep�h into which a person is required to descend, will be matle in connection with woAc authorized by this permit, end ihat no building siructure, scaHolding, felsework, or tlemolition or dismantling thereof, will be more ihan �hirty-six (38) leet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ttle 8, Galifomie Administretiva Cade). ❑ As owner-builder, 1 will not employ enyone to tlo work which would require e permit from Ne Division ol Indusinel Sefery, as noted ebove, unless such person has a permit to tlo suc� work Irom Ihe division. Signature: Dele: Divisian of Industnal Sefery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUTMORIZATION OF ENTRY: I certily under penalry of perjury �hat I have reatl this epplication end state iha� the informa�ion given is correcL I egree to comply with ell state I s and ciry ortlinances relating to building consiruction, end authonze represemetives ot ihe Ciry at Costa Mese to enter upon Ihe ebove-descnbed O�Perty lor inspectio�rposes. I egree not to occupy or allow acupancy of any Cuilding authorized by ihis permit until finel inspection. 1616 1268 200 201 202 203 INSPECTION TYPE Fi:ed System Final Fire Prevemion Pool Spa Final Final Re-Roof Final Block/Retaining Well , Final Factory Fire Place Final Sign 20a Final Demolitlon Qejf, INLITIRLS /O� � � � ua�e ) -� Date " CODE� INSPECTIONTYPE 206 Final Mechanical 20B . Final Plumbing 210 Final Elecirical 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Site � 250 FinalBuilding/OccupenCy P�IE It�A48 CITY OF COSTA MESA PF�[2M�N� CONSTRUCTION PERMIT �j Address �,� � Arch/Eng. License No. Address - ' ' '� within �eavy-EorCer lines an0 sign all apD�opriate Eeclai ( TRACT NO. LOT NO. �BLDG � TVPE OF CONSTRUCTION ❑ NEW ❑ AOD ❑ ALTERATION ❑ REPAIR ❑ ONVERSION ❑D M( ❑ OTHER � DESCR,PTIp'N OF WO�iK n. I �ereby a(flrm that I am Ilce�seA untler provizlons ot Charter 9(cOm- mencing wltM1'sectlon 7000) of Divlslon 3 0! tne Buslness antl Professlons Code, antl iy Ilcenze Iz In full force antl e(fect. Litense Class � lyicense � Dat,�e A-�N—� S�9nature WORKERS' COMPENSATION DECL RATION I hereby affirm that I hava a ttrtificate of consent to ulLinsure or a certificale of Workers' Compensation Insurance, or a cerlNiea coOY thereo( (Section 3800, Lab. C.). � Policy No. Company ❑ Certi(Ie0 CoOY IS hereby (urqgh¢tl. ❑ CertifieC copy I5 tlleE with the <Ity Builtling Divislon. EXEMPTION FROM WORKEqS'COMPENSATION DECLARATION (This settion neeU not be coer�pleteC ii the permit is tor. one �untlretl or less). cert ty t�at In tha.p¢r(orTarl�¢ p} th¢ wo�k fo� whic� t�ls pe�mit Is ISsuetl, I Shall nol emFlloy dny p¢r5on In any fNnn<f 50 d5 [o b¢cOm¢ iubject to the, /Workers Compe�satlon w t Calito nia. Date��^��7 �& Z Si9nature �� NOTICE�I( after makinq this tlecta tion, you shoultl become subject to the Workers' CompensaUon provislons ot the Labor Cotle, you must fOrthwith comply wlth suth prOvisions or thls pe�mi[ s�all be Geerpetl revoketl. . CONSTRUCTION LENDING qGENCV i h¢reby aHi�nl that [hCre is a�p�it�uGtion IenOing agency to� t�e pe�- formance of the work for wh��h this permit is i55uetl (Section 3097 Civ. CJ. . . . L¢ntler'S Ndme L.enEer's Atltlr�ss —' � OWNER BUILDER DEClARA7�ON ' ' � hereby a(Hrm tbal I am exemp� (rom.the Contracmr•s Licenze Law for t�e following reason (Section 7031.5 Business antl Professions Cotle: Any city or county wbich require5 a permi[ t0 <onstruct, alteq antl Prdessions Cotle)�or any appllwnt (or a pBrmit sUbjecls•the applicant to a civll penalty Of nOt mo�e than five nuntlretl Eollars ($500�. ❑ 1-as owner ot tbe pwperty, or my emploYees with wagei as t�eir sol¢ com0¢nsstlon, will tlo the �vprk, antl th¢ slructure Is not Intentletl Of offeretl for ule. (Se<tlon 7qqy, Business dOd PIOfC55�0O5 COd2: ThC Contratt0/'s LIC¢nse Law tloe5 not appty to an Owner ot a prop¢rty wh0 buIICS or Imp�oves thereOn, antl who tlOes such wO�k hlmseH or throU9b his Own employee5, provitletl that sucn improveme0t5 a�e pot Int¢ntletl Or offer¢tl for Shce. Ii, however, [h¢ bulltling o� Improvement is Soltl wltM1in one yea� o� comp�etion, lhe owntr will hdve Ih¢ burtlen Of proving he tlitl not builtl or Improve to� tne purpo5a ot sale). ❑ I, a5 Owner of the pro0erty, am GxCluslvely conl�acting wlih Iicensetl conVactors to constr�<t the project (Section 1044, Business antl Professions Cotle: Tne Co��ractor's Licenu Law tloes not apply (o an owner of Oroperty who byiltls or improves thereon, antl who con- trdcts from Sllch ptojects with a contractOf(5) IlctSn¢tl pur5uant to the ConVac[or'S License Law). Q 1 am ezempt untler Sectio B, d P. Q �or [�is reason /' Date �n � � r—�Owner I h¢v¢by certity thdt 1 hav¢ r¢atl Ih 5 application antl Stale that the a00ve info�mation is co�rect. I agrep [o comply with all City antl munty ortlinanC¢5 antl stale IawS relatiqg to construGtlon, antl hereDy authmlEe r¢pre5entalive5 Of this city to en[er upon Ihe above mentionetl property fo in ectlon purpo s. Signature ��0— � oate ^,/n /y �2' Drivers' License or 55 � CMF 0865-46 White-Builtlinq; �ynary-Applitant; Pink-Accounting; G NO. SH TYPEOF PERMIT! ❑ GRADING ❑' FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL OPLUMBING ❑MECHAI ❑ OTHER PROJECT DESCRIPTI^ON SQ.F7. -�� oC�� . . OCCUPANCY��T�ICTION TVPE VALVATION ZONE GRADING CU. VDS. ACRES PLUMBING LAVATORIES 'KIT. SINKS SERVICE SINKS FLOOR SINKS � DRINKING FOVNTAINS 'INTERCEPTORS- � SWIMMING POOL WATER SERV ICE GASSERVICE '� WATER HEATERS� SEWERCONNECTIONS PLAN CHECK SHOWERS URINALS - DOUBLE LAVS DISHWASHERS SUMPS ' FLOOR DRAINS CLARIFIERS � � � P TRAP ALTERATION OVTLETS � BTUOUTPVT � COLLECTORS SOLAR PIPING SVS. ' ISSUE FEE MECHANICAL PLAN CHECK HEATING SYSTEM 0-300,000 BTV _ AND DUCTING 100,000 + BTU _ REFRIGERATION 0-300,000 BTU_ SVSTEM 100,000+BTU_ BOILERS ' BTU' SVSTEM REPAIR,ALTERATION EXHAUSTSVSTEM MULTIPLE ISSVE FEE .XJ � r,"� 4r.. n . , ZONE � V � -,� �, �G REGULATIONS � PLNTGp.RgUEF�.p� • � �PRO PE�RT Vrl REAR YARO (TO P/L) -PKG. SPACE REp. - STREET WIDTH ' ZONINGAPPROVEDBV . SPECIALCONDITIONS: � �� FROVIDED PqRK FEE E DATE , ELECTRICAL �- vLArv CHECK � ❑wF[L"fR[��—GARRI, �� GENERATOR _ 0-I KW_ 1-10 KW _ TRANSFORMER APPLIANCE 30-50 KW=50 + KW _ MOTORS " 0-1 HP_1-10 HP'_ (ING. SOLAR) 30-50 HP 50�* HP _ FI%TURES.. OUTLETS SWITCHES GAS TUBE SIGNS _ - _. POLE LIGHTS. - ' . ' PANELS . MAIN ' SVB SERVICE AMP•� � ISSUE FEE - APPLICATION APPROVED BV � S MARV OF FEES, PE0.M1T G • DO SMIP _ S i SO � PLAN CHECK E PERMIT � . ISSUANCE 5 PLVMBING $ . GRADING E PLAN CHECK S ELECTRICAL S f �PLAN CHECI( S � MICROFILM E MECHANICAL S TOTAL FEE 5 PLANCHECK E VAN EPC b FINAL FEE •S O .' ' �r .. . . �I� .. .�•i. - -- -POOL.&SPA + CONSTRUCTION AND PLANNING � �• , � • - APPROVALS Permit# ' / 0 Date �-Inspector qppROVALS -. r� , �Permit# � � '" " � '•Date �-. _ Inspector .. . .-----' - - � - - � 1. Temporary Electrical Service or Pole � 43. � Pool & Equipment Lowtion -- - - � - � � - = -� �- • � - - - �-- - i_ ipe- n rgrn �•� - � . Steel Reinforcement -� - � - , 3. _ Iectrical.ConduitUtility-Undrgm_ _ � � .. 45.. Forms,. �• - ' � � 4. _ Electrical Conduit•Undrgrn _ � 46. _ Elec[rical Bondin - - -- � - - tee e�n orce � ' , 47. Rou h Plumbin �& Pressure Test'= -� �-" �_e ..6.._Electrical UFER Grn ' ' 48. APPROVA'LTO COVER-GUNITE - 7. ootings ' � - 49. Electrical Conduit-Undr rn' � � '� ' �' � � �.8. Foundation_ . � 50. . Gas Pipe ❑ Undr m, Test � � - 9._ Water Pipe,Undrgrn __ - .51. Backi'vash Lines P-Tra � rrdr � - - - - - ,10. Structural Floor System _ . . _ 52. APPROVALSO DECK -- - ' ` �_11.. Aoperty Sewer Line & House Connection - -� 53. Backwash & Rece torFinal ' ' . . ... ... . ' . �2. .Street Sewec Connection ' 54..- Heater & Vent-Final� " 3. Rough Plumbing _ ---- - - - � . - - - � -- - - � - ' �� ; 14. Rough ElectricConduit - - - - - - <56. Electrical•Final � � � A 15. Roa h Elecfric-Wiring" ' � - ' � - -- " ' � -- - - � - - -- � -57. -Solar-System-Final _ " ', ' ' " "' °-' -' � - � - � "_"- '• 7 '�-16. Rough Heating�& Air Conditioning- = = � -a . _ -_ . � . � . • - _ encing;&;Access Approval � � -^�•��-� � �77. Ducts in Structure. �'�. ' � - :` • APPROVED FOR�PLASTERING - � ' " ' � _�. -- -- -- - . . .. . -18. - Ducts: Ventilating ' . ' . - - ' ` � - _ ----- - -_. _. . . 79J GasPipe-Rough&Test� _: _ __ "��• FOOUSPASYSTEMS,FINAL -� , � � � f-20.. Roof.Framing' . ' - " "' � ' ��• � �� ' ' 21.. Roof Sheathi ' --- - -- � fl�(S - . -. � - . - . . .��r• . . 22. Freme and Flashin ' NOTES: • ' ' ' 23.� Insulation - -- - -- - - � �� 24. Lathin & Siding . - - - - - , ' . . "- - - -- - - . � . 25. Orywall Nailing - - , - i -- - -- � N - -- --- -- - - - . -, � - � . -. , 26. Plaster Brown Coat- . -- - - - - -. .- . . . � ' . . �27. Electrical Power MeterFinal . ' ' � � - ' '� ' � � ` � � � : 28. Final Electric- ' - - - ' - - - - - -- - . � -- - � .�,,,��1 - Final Heating & Air Conditioning ._ ' ' � , "' . . .,,.. , . .. . . . 3 `�� ;5'., - - � � - - - -... - , . . . . . . . .i;�. Final Gas Rpe•Test . �� I " , ��r� � � �� + 31.,- Final Plumbing --- - - - � -- - - - -. .' •. ` ., .. '. . ". . ., . . . ' � 32. Water Service•Final - ' . -- - , - . . � �'" . . . . , '* - -33:�.--GasService-Fina� - . �. - - _.. - - - - - • , '� 34. Solar pomesiic-Final � - � ' � - - - - ' . . . .•- . ' • . . - , . . . . , . . - ' 35.� Landsca S rinklin S stem �' - ' ' . • '� � 36. Sound Attenuation ' _ ' � � ` - � � � n 37. Handicap Regulations � - - ' � � • � 38. FINALSTRUCTURE&BUILDING � -� - � � � -� - 39. Special Requirements Completed ' � � - ' -� "' - -' � � � . 40. Electric Release to Edison ' ' � ' - " " � "' -' ' ' - - ' ' � 41. Gas Release to Southern California Gas Co. � � � �� - - � 42. CERTIFICATEOFOCCUPANCY _. _- ___ . - � -. . ,. , . . I No `� ' Date - ---� - - . . - - - � � - - � - -- _ - -- _ .� _ _ -_ --- , . May 7, 2004. CITY OF COSTA MESA BUILDING DNISION 77 Fair Drive, 2od Floor Costa Mesa, Ca 92628 SILVIA KENNERSON: MRS. KENNERSON, PD LIKE TO REQUEST AN EXTENSION FOR MY PROJECT CONSTRUCCION CASE # B03-01780. S[TE JOB; 848 S. TOWNE COSTA MESA, CA 92627 OWNER; MARTIN BARAJAS I COULDN'T STARTED FOR FINANCIAL APRECIATE YOUR CONSIDERATION. THANK YOU VERY MUCH. �'��fl � �Q �� TIN BARA AS PROBLEMS. I'M VERY � IJ P \� � . 1, . � � � , � i � y i ' /� i � I�