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HomeMy WebLinkAbout289 23RD ST - Building Permits jtf-' .\ r CITY OF COSTA MESA BUILDING DIVISION F 1 441,—..H1:. I DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER 0. PERMIT OS-01298 " (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cBUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 289 23RD ST Status: ISSUED Suite: Applied: 08/02/2005 Vicinity: Issued: 10/12/2005 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 42608410 Zoning: Applicant: STEVE WARMBIER Address: Phone: 949-389-0481 ISSUED BY: PO Zip: Owner KNIGHT, STEVEN AND SPIDELL, JAMES Address 2593 ELDEN AV APT B Phone: 949-650-2166 COSTA MESA,CA Zip: 92627 Contractor: Address: Phone: Zip: License: Arch : Eng: T D ENGINEERING Address: Address: 23011 LIPTON Phone: Phone: EL TORO,CA Zip: License: 92630 License: 31619 SCOPE OF PERMIT NEW 2591SFD WITH ATTACHED 470SF 2-CAR GARAGE. REF#:B05-00228 FEE SUMMARY Plan Check: $1,195.58 Calc Valuation: $250,829.40 . Permit: $1,839.35 Claim Valuation: $0.00 SMIP Res: $25.08 SMIP Corn: ' $0.00 - Other: $0.00 Inspection: $0.00 Total: $3,060.01 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0.0 Left 0.0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 • Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is susp ded 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)754-5628 2446-8(6N0) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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. 0 I have and will 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 workers'compensation Insurance Garner and policy number are: r r Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) t-_-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 workers' ( compensaNwrlaws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith "comply with these provisions. rr l/)J ApplicantSign'atirMrini, Oppppp ./AA Dat jdAf'/a'S WARNING`FAILURE TO ECURE WORKERS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($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 affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Lic.a Class a Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I 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: Lender's 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 tplicant to a civil penalty of not more than five hundred dollars($500).): 15e--1-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 contractor(s) license pursuant to the Contractors License Laws.). O I am exempt under sec. Business and Professions Code for this reason: Stum. j42.2.1.n 9Cn(ac Owner ID verified by driver's license. es ❑No Driva?s.Licanse'No: _ Fxpl7e�3/•/o q 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,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Ttle 8,California Administrative Code). O 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 Will the applicant or present or future building occupant need to tile and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 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? 0 Yes 0 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 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. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied 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 application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 of the California Govemment 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 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia 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 0 No 8 (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 inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. OM C ture.ORlegel:Owner(s) " Date L.117— And/Or Y—And/Or Authorized Applicant Date CODE I INSPECTION TYPE DATE IIlIIDALS CODE INSPECTION TYPE RAM INTITIAIc 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 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 Factory Fire Place 220 Final Planning Approval 203 Final Signm 222 Final Site { ' 204 Final Demolition .• � 250 Final Building/Occupancy NEWPORT-MESA UNIFIED SCHOOL DISTRICT 1‘12 5633 CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES PURSUANT TO AB 4600 AND AB 181 To: ( ") City of Costa Mesa District Receipt No. ( ) City of Newport Beach _ 12-1 ( ) County of Orange Plan Check No.T2VD DD r• Applicant: C /� Pr cuIQI Address: a g 61 9.3r(•I J�t,t`uF f Telephone Number: (Ci q4) LL o5o- Zl L!q Tract/Parcel and Lot Number(s): "l 2I SJ/ `UT114 it) Location of Project: 9,4M r;3 rc1 6 b-LA , Number of Square Feet of q? COr a! `O3 Residential Space x $1.84 Total --I( 1//1. 11' i (,26q/$ — (0o0 4) Commercial and Industrial Space x $ .30 Total CommerciaVIndustrial Project is: (Check One) _ Warehouse _ Motel _ Preschool R & D _ Bank _ Auto Repair Movie Theater _ Neighborhood Shops __ Hospital Mini-storage Racquet/Health _ Large Office Heavy Industrial _ Hotel _ Office Bldg. Regional Shops _ Medical Office , Restaurant Light Industrial _ Office Park __ Fast Food This project is exempt because This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code sections 53080 and 65995. The Building Perrrits for this square footage in this proposed development may now be issued by your jurisdiction. Checks are to be made payable to Newport-Mesa Unified School District. By ANMriz ^epresentative The above representation as to square footage is true. Applicant agrees that if it is later det: 'nod that such representations are not true,then this certific to shall a omatically terminate and the appropriate, ity/Count s :II be notified. artallivair Date: ICS I2 _art er 4`05 9 CITY OF COSTA MESA _ BUILDING DIVISION >i -,,,. 4r g DEVELOPMENT SERVICES DEPARTMENT PE NUMBER 4. Ys .!! PERMIT R�"'� EDS-01216 gtbe„ GO (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ftt cTRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 289 23RD ST Status: ISSUED Suite No Applied: 11/21/2005 Vicinity: . - Issued: 11/21/2005 • • Parcel Nunmber: 42608410 Applicant: SPIDELL, JAMES .le„� Address: 2593 ELDEN AV i'allir APT B Phone: 949-650-2166 ISSUED BY: COSTA MESA,CA Zip 92627 • • Owner: KNIGHT, STEVEN AND SPIDELL, JAMES . - ' - ;r- - Address 2593 ELDEN AV APT B Phone: 949-650-2166 COSTA MESA,CA - , - Zip:, 92627 - Contractor:, OWNER-BUILDER Address: .. Phone: Zip: License:000000 SCOPE OF PERMIT • .:NEW 2591 SFD WITH.ATTACHED 470SF 2-CAR GARAGE. REF.:B05-01298 `ELECTRICAL TO INCLUDE:2591 S.F.S.F.D.,4 LIGHT FIXTURES,8 OUTLETS,AND 3 SWITCHES. ' FEE SUMMARY -: -r'r-.. -- • Quantity . -• ` • .. . Quantity ' ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 .0 Temp service test . $0.00 Busway/100 ft : $0.00 0 Res.a/c package $0.00 _ _ • Standing Section . ' $0.00 0, New Res(1-2 units) $145.10 2591 Misc Electrical Equipment '- $0.00 0 New Res(34-units) $0.00 '0 Transformers up to 1'kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $4.40 4 up to 50 kva/kw $0.00 0 Recept Outlets $8.80 8 - up to 100 kva/kw $0.00 0 Switches $3.30 3 over 100 kva/kw $0.00 0 • Non Res Appl $0.00 0 _ , Low,Voltage.Equipment_ $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 2000 . $0.00 0 Misc.Conduit. ., $0.00 0 Service to 10000 $0.00 0 ,. Misc.Conductor. ,°$ 0.00 0 Service over 1000a ` $0.00 .0 Circus(gen of ride)" ' ._ ' ' $0.00 0 Motors to 1hp $0.00 0 Circus(mech'ride or lights) $0.00 0 Motors to 10hp .$0.00 , ' .- 0 Christmas Tree Stand._ -1 $0.00 0 Motors to 50hp ,$0.00 0 . Fireworks Stand,C $0.00 0 Motors to 100hp 80.00 0 -. •- Other Electrical Fee ' $0.00 Motors over 100hp • $0.00- ' - 0 - - - Communication drops $0.00 ,. ,0-- • Investigation Feet- .r, $0.00 Sub panel to 200a $0.00 o , Plan Fee''•'. - $0.00 Pole Light Pkg $0.00' 0 - ' , :. .Reinspection Fee -- - $0.00 Sign Circuits $0.00 - 0 - - Temp Pwr Pole $0.00 o� TOTAL CALCULATED FEES $185.10 Intermed Pole $0.00 COMMENTS /SPECIAL CONDITIONS Tr7r .. Tr I 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 consid'erud iegal, 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,thIcpeimIt. FOR INSPECTIONS CALL: (714)754-5626 2446.46(WOO) Y' DECLARATIONS WORKERS'COMPENSATION DECLARATION: • I hereby affirm under penally of perjury one of the following declarations: ❑ I 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. ❑ I have and will 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 workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: section need not be completed 11 the permit is valued et one hundred dollars($100)or less.) i rY--Lccerti fy 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 laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply_with these provisions. nnn ��� (ApP�gnature:—jig Date: .1 I- /-O 5- WARNING: WARNING:FAILURE TO SE RE WORKERS'COMFMSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($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 affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,end my license Ls in full force and effect.Lis.it Class Si Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I 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). Lenders 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($500).): ( I$- 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. X7044,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 ONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not a••y to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) --- licensapursuant to the Contractors License e .ws.). I am exempt under�sec. � _ Business and Professions Code for this reason: 'Signature: r6 -- /l� Dale:�./ -Jy-OS Owner ID ye ed by drivers license. A Yes 0 No (-Driver's License.No._- - Expues: 3-2-C,7 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 feel 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,falsework,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: I 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? 0 Yes 0 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? 0 Yes 0 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 al 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 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. 4 II an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application akPermlt for such construction or modification from the South Coast Air(Duality Management District or from any other air pollution control district or agency? Yes u No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). U..N.__..._..— 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 a permit tram the South Coast res presrby CaliforniaaiHeai or other airtgold tioncton 4l district3 agency is required for the work which is the subject of this application,have all of the disclosures prescribed by CallloHealth and Safety Code Section 42303 been made? 0 Yes 0 No utio _...._.—_ 8 (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 end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree of to occupy or allow occupancy of any building authorized by this permit until final inspection. 14"1 ff Signet I Legel.Owner(e)-------- Date And/Or Authorized Applicant Date CODE I INSPECTIONTYPF DAB 01TTTIAL5 ;ODE! INSPECTIONTYPE PAM UMW 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical /)-21r.)6 (71r 201 Final Block/Retaining 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 Building/Occupancy „�_' CITY OF COSTA MESA 4 a BUILDING DIVISION f• „„,. i DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER tq rr PERMIT 06-00065 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 289 23RD ST Status: ISSUED Suite No Applied: 02/13/2006 Issued: 02/13/2006 Vicinity: Parcel Number: 42608410 ISSUED Applicant: SPIDELL, JAMES Address: 2593 ELDEN AV APT B Phone: 949-650-2166 COSTA MESA,CA Zip: 92627 Owner: KNIGHT, STEVEN AND SPIDELL, JAMES Address: 2593 ELDEN AV APT B Phone: 949-650-2166 COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: License:000000 SCOPE OF PERMIT NEW 2591 SFD WITH ATTACHED 470SF 2-CAR GARAGE. REF.:B05-01298 MECHANICAL TO INCLUDE: 1 FAU<100K BTU, 1 ALT/REPAIR COOLING/HEAT, 1 HOOD W/MECH EXHAUST,3 VENT FANS,AND 1 COMPRESSOR/ABSORPTION SYSTEM 3 TO 15 HP. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $13.70 1 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $10.65 1 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $21.75 3 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $27.15 1 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $111.55 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 all applicable codes;(and required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiratlo tfns permlt!r- FOR INSPECTIONS CALL: (714)754-5626 2446-46(WO) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have end 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. ❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the perlonnance o1 the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed it the permit is valued et one hundred dollars($100)or less.) 9 ,Oce Ify i n 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 laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith ..l w' Lrese_•revisions. 1 '- 'Appicant gnature ' 'J.moi. 1. - . 4 7r" ` ;.���c -t7li -^ 1' G:FAILURE TO SE+ RE WORMERS'COM' SATION COVERAGE IS UNLAWFUL AND&RAU_SUBJECT AN EMEL i R t NAC1PENALTIES AND GML FINES uP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3709 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commenting with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Lic.# Class M Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I 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: Lender's 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 ��s , ,1,-,3, ssu.u.,by#1''ects the applicant to a civil penalty of not more than five hundred dollars($500).): /y from:, ,I, 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. >z llLIEILI���' 7 44,Business and Professions Code: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 properly who builds or improves thereon,and who contracts for such project with a contractor(s) • •ursuant to the Contractors License Laws.). Q 0® kempt un.:r sec. Business and Professions Code for this reason: Signature ,i_-: • " z Expres, ^.2-el 4 Verification of Ownership by(type of document,i.e.-property tax bill or d=:. "'AA DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereiy 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,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feel 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 10 do such work from the division. Signature: Date: 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? 0 Yes 0 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 0 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)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. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a_permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LI 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? 0 Yes 0 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 prescnbed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No 8 (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 ins ction purposes.1 agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. per_ _ . • - _ 2 nisG1-b_ i nature Of Legal Owners +n Date p'T) And/or Authorized Applicant Date LOPE T INSPECTION TYPE PATE IPWTW,S LODEI INSPECTION TYPE PAM ItfIIDAL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical I[,-Zz-u6 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final BlocklRetaining Walt 212 Final Fire Prevention 202 Final Factory Fire Placa 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy MF 9 CITY OF COSTA MESA 4 BUILDING DIVISION ). :�'nl..4rI DEVELOPMENT SERVICES DEPARTMENT PERM UMBER OPori . PERMIT -_- -__ _ - ___ * ,.4. P05-00874 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,C STA MESA,CA 92626 PLUMBING PERMIT Job Address: 289 23RD ST Status: ISSUED Suite No Applied: 11/21/2005 Issued: 11/21/2005 Vicinity: Parcel Nunmber: 42608410 Applicant: SPIDELL, JAMES ISSUED BY: Address: 2593 ELDEN AV APT B Phone: 949-650-2166, COSTA MESA,CA Zip: 92627 Owner: KNIGHT, STEVEN AND SPIDELL, JAMES Address 2593 ELDEN AV - APT BPhone: 949-650-2166 - COSTA MESA,CA • Zip: 92627 - _ Contractor: OWNER-BUILDER Address: Phone: • .r - . Zip: _ License:...000000 -.-..."--.-r._ .---, - ,.. - - SCOPE OF PERMIT NEW 2591SFD WITH ATTACHED 470SF 2-CAR GARAGE. " - ` REF.:B05-01298 - ' PLUMBING TO INCLUDE:3 BATHTUBS, 1 ICE CONNECTION, 1 DISHWASHER,3 FLOOR DRAINS,1 GAS(1-4 OUTLETS), 1 GAS SERVICE, 1 LAUNDRY TUB/VVASHER,8 P-TRAPS, 1 SEWER ' CONNECTION, 1 SHOWER;1 KITCHEN SINK,5 WASH BASINS, 1.WASTE AND VENT SYSTEM,3 L ' • WATER CLOSETS,-1 WATER HEATER AND 1 WATER SERVICE. ' FEE SUMMARY' - - AMT QTY • . . -AMT ' QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $9.80- 1 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $78.40 ' 8 Trap Primer . $0.00 0 Bathtub , $29.40 3 Pressure Regulator , $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $9.80' 1 ' Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 ' 0 Septic Tank` ' '$0.00 _0 Wash Basin $49.00 5 Dishwasher ' $9.80 ' 1Sewer Cap for,Demo '' ,$0.00 '.;0 Wash Basin Set • $0.00 0 Drain, Floor $29.40 3 ' --, • Sewer Connect , , `.,$24.65' '1 Waste and Vent System $9.80 1 Drain,Rainwater $0.00' 0 ' Sewer Private Line ." $0.00 0 Water Closet(Toilet) $29.40 3 Drain,Roof $0.00 0 ' Shower _ ' $9.80_ 1 _ Water Heater/vent $12.30 1 Drinking Fountain " $0:00 0 ' - Sink,bar -- $0.00'..:_O(.- Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00' 0 Sink;commercial , $0,.00-y-,0 • " Water Re-pipe $0.00 0 Gas Earthquake Valve 50.000 : , Sink,Floor" . "--$0!00" 0 ' ' Water Service" $9.80 1 Gas(1-4 outlets) $6.15- 1 --.Sink,kitchen $9.80, ,1 - -Water:Softener $0.00 0 Gas(Over 4 outlets) $0.00 ' 0 ,Sink,service/mop , $000 0 .: ' OTHER $0.00 Gas Repipe $0.00 0' _ --Spa(private), ' ' $0.00 0. . VIOLATION $0.00 Gas Service $9.80 1 . 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: $360.60 COMMENTS/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 all applicable codes, llnd all required Inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result In the expiration of this pehrnit' FOR INSPECTIONS CALL: (714)754-5626 ---�T9'r '- - - ' ' - LV 2448-48(8/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: . ❑ I have and will maintain a certificate of consent to sell-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. ❑ I have and will 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 workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) t$ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner s0 as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions.�^_� �w-� /� Applicant Signature: c �37Oc4C4V ' Date: /1- 9/-0 5 WARNING:FAILURE TO SE URE WORKERS'COMPENSATION COVERAGE 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 FOP IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and effect.Lis.k Class N Contractor's Signature: _ Date: CONSTRUCTION LENDING AGENCY: ❑ I 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: Lender's 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).): S. 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 contractor(s) license pursuant to the Contractors License Laws.). I am exempt under sec. Business and Professions Code for this reason: Signature: p Date: 1/- 2/-°COwner ID v rifled by driver's license. es ❑No Driver's License No. ! Expires: 7--2-Oq 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,falsework,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: I 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? 0 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? 0 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 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. 4 If an RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied 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 application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes j�No (Section 65850.2 of the Califomia 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 0 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 . ..tr.l . 8 of yes",attach certificate of compliance from the appropriate air pollutionn controlofficer). diceQ. 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 Emissionsi �}� ,�- ei 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 inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sig lure Of Legal Owner(s) Date And/Or Authorized Applicant Dale CODEC INSPECTION TYPE PAIL INITIAL@ CODE! INSPECTION TYPE PATE INi ALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 77 ^, ,(��{ 1266 Pool Spa Final 208 Final Plumbing 1/'..TTC2-UD ( h 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining 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 Building/Occupancy • V2,14/06- (•Q—t. i INSULATION CERT. -CATE • IC-1 Site Address Permit Number Cac ZS9 73(1 St (ossa /0si Number and Street City 4lon5tG County Subdivision Lot Number Description of Installation I. ROOF _ Material fr lu—>//�- Brand Name 117�Jh, /47/1L Thickness (inches) 3 '/2 " Thermal Resistance (R-Value) 2. CEILING • Batt or Blanket Type Brand Name Thickness (inches) Thermal Resistance(R-Value) Loose Fill Type Brand Contractor's min installed weight/ft2 lb Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance(R-Value) 3. EXTERIOR WALL Frame Type JXy AJrr>el A. Cavity Insulation Material Brand Name Thickness(inches) Thermal Resistance (R-Value) B . Exterior Foam Sheathing Material Brand Name Thickness(inches) Thermal Resistance(R-Value) 4. RAISED FLOOR Material Brand Name Thickness (inches) Thermal Resistance (R-Value) 5. SLAB FLOOR/PERIMETER Material Brand Name Thickness(inches) Thermal Resistance (R-Value) Perimeter Insulation Depth (inches) 6. FOUNDATION WALL Material Brand Name Thickness (inches) Thermal Resistance (R-Value) • Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Energy Efficiency Standards for residential buildings(Title 24, Part 6,California Code of Regulations)as indicated on the Certificate of Compliance,where applic le. Item#s Signature, ate InstallingSubc ntracto Co. Name) R General Contractor(Co.Name)OR Owner Item#s Signature, Date Installing Subcontractor(Co. Name)OR General Contractor(Co. Name)OR Owner Item#s Signature, Date Installing Subcontractor(Co. Name)OR • General Contractor(Co. Name)OR Owner Compliance Forms August 2001 A-36 RECEIVED CITY OF COSTA MESA DEVELOPMENT SERVICES DEPA^T+!=NT Memorandum NOV 16 2005 To: Development Services. From: Dusty Bent, Treasury Management Date: November 16, 2005 Re: RETURNED CHECK Payment has been received for the following check: Steven K. Knight/James P. Spidell You may now continue inspections for 289 23"' St. Should you have any questions, please contact me at X5072. • Ctik Memorandum Ji2-6 ° 64 k IV � \ $ S To: Development Services U► 4 From: Dusty Bent, Treasury Management Date: October 31,2005 Re: RETURNED CHECK The following check did not clear the bank: Steven K. Knight/James P. Spidell - $6,237.59 - Amount now due $6,262.59 Please discontinue inspections for 289 23rd St. until payment has been received by this office. Should you have any questions, please contact me at X5072. i0- -2005/C.5 i", . _ V I .. , ' • 001-06152 37 ,. ma pM CITY OF COSTA MESA • `o .See- 4 . .\ P.O.BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92828-1200 °tij .-.-;E".:—.1115k. i r�; V,._,. - p DEVELOPMENT SERVICES DEPARTMENT • Transaction Receipt • . . . ,;y.: . .. : .'.; Date: 10-12-2005 ,, ACTIVITY NUMBER: ' B05-01298 TYPE: New Single Family Res. - • SITE ADDRESS: 289. 23RD ST • Unit/Suite APPLICANT: STEVE WARMBIER CONTR: 949-389-0481 • •1 .• 'OWNER: KNIGHT, STEVEN AND SPIDELL, JAMES STATE LICENSE T• 949-650-2166 CITY LICENSE • TOTAL FEES: .. - $2,039.15 . TRANSACT.AMOUNT: $2,039.15 BALANCE:(PERMIT FEES) $0.00 lj PAYMENT METHOD: Check NOTATION:.:_'. • • • s¢'toi;:•41,1: !;'�, rtrTRANSACTIONRECEIPTDETAIL•INFORMATIONFORTREASURY: RMD 1 ;1 %�1 ,` t•- 'AiYi.hl r '12000 .FIIIrt,«.. lIK/BuildingPermitFee7At0300.c?.$1,838.95 •. .". _ . S �.,• ist s r� ra :1 .1;2005 1 1 ?3r ' Building Plan Check:;1,,0320 cF.Y$150.04 ,7 ' ,:- .:1-• alb'I ^2100, •-+'• ,,Building SMIPFee'r' 03407,,,.::::.$50.16 �'r J t),ii .. - •;'2? rr4 ,( t f�• ./5,s t .Y f if r. F aJSc4 r Vt{'14c"Y•r z1'.p J yS'xr ;4 r[t 31. 1 �+N •�r r � ' > 1 I, I* ;I ,tr �,,p k4„..1 :.:w j'k+ v IL-5 f-7ja1 ,, aR.. r •v )t r `4 t +y2) r }}�� ilk C I IJ-01t•.. 1):t:“.......„,,.,, 11,c ' '1 w(I' 7 , .T 4] - i , 1� 1. • uFl.I It,,' ht t..i: A p171.• > �[y'y - j✓�,{ h+tY-Vo i Y .l s }'.a'i ,I {I kn t i } i i Ir .1 r l.;,r,,,-t•RGS1 s ,, , 1U55° 9'�!q6{(. `1.1e,. .4{it"ysin..s�'l ,, ,y{!c ..r t hili pyr:?:-.,-°..,t, 3h•,, - r 'r t!I 1-. -ilk i.1e}, 'f Wito a Fa liflpiks'rti 4,t rn -S r3 `lilt 1 .f } �.�,.1 G r , A 3�yr�I :? I4 •,F, l t i a. , .- yj ; '14i4Tin e ;w 4 1:.y IE ('MT"i" f OE' {"14'y.11 Jt Ftth 1. :4: Z.N'ii 'I1• 'Pl}�igg.P t I it * f}A� +J•`' a 'u f H 4 t'•J r S ] *r y. R�In .C;fs t- l � �4:4 ,� fy1k yv .147 !1 �W a"* p 7•+a '{rr •••-t:- �i 5 •{' )T d t' ri<7 f a i'tr t•r q:t t t ' a )1 T ,:{ !1 A yqt l )" Jr{l4 r, - - 1^ *I< i-��r�}"f T :;••1 ,1i1•1;11.•:!;‘• } • n 4-r . �{, ��j, >ja'/l+tetra,4 A�i1t��., 41. , *1)1 "tltf fl.{'*1S•isbg; .4I"t I .t}* ii L�ltCife, i 4 t ik ^�ik ! d i 14''. "F ,! '} i' r !- T---1XT-'r -x-y F 74 T ylayt r{Ia f fi . 4 Y-fr t..4.•• t It 3�1r i, ,+ �4`F. .,k;i c1" -GC,,,,,r,...1/40,4,-,:i e ri , .rU. lila v 4E?ISAi:tG +-t cxk+.J1 Y� � �J'.,y 1Y... ic'} r .. r �t t �•ST 1 J , • . B000005873 ,';• - -- -^'"` . .� - " Budding Division(714)754-5273 • Code Enforcement(710)754-5823 • Planning Division(714)754-5245 'i}�'; ";' y FAX(714)754 a856 • TOO(714)754-5244 • vnvw.d.00sla-mesa.ca.us • , +,..,I l • ._ , .,.. USEE:LE- . , • • . . .. .. .. - . . , . - 2 001-00132C37 -- --- 641111 444-4, CITY OF COSTA MESA • •• ifrate.i. P-0• BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 ft - ---rar-,.. -•, . 10 - -Fi-i- i ji, • "I . DEVELOPMENT SERVICES DEPARTMENT . . . • eckiii(iiiii0‘9 • • . ., . . • Transaction Receipt • - . •• . - • . • . • , .. • . • • . - - • . . ... ... , - Date: October 12, 2005 ' . . • • . . . . . . . . . -... . . ACTIVITY NUMBER: PS05-00489 TYPE: Construction Access . • - -.-....- . Ty V SITE ADDRESS: ;289 23RD ST •, . . ...•.Unit/Suite -..- . • . . . -... . , . . „ . . —.v..) , • 'APPLICANT CONTRACTOR . , . KNIGHT, STEVEN AND SPIDELL,JAMES OWNER-BUILDER . . 2593 ELDEN AV - • • . . APT B •. COSTA MESA,CA 92627 - . ' 949-650-2166 bt.1'..-. ,';':,.. . . • . _ . . . 4.,Z4`47, OWNER STATE LICENSE . KNIGHT, STEVEN AND SPIDELL, JAMES 000000 . . 949-650-2166 CITY LICENSE - . TOTAL FEES: $535.00 - TRANSACT.AMOUNT: $535.00 . .. . . . . - ;-TI': '‘:,•;t- . - . . • ' • - $0.06 BALANCE: ' . ., .. . . .. ,........ . . _ , . • • A, i0;:fp;, ,xiiz:sy•rittoi•‘:, •<-?..,••,,•.• - .• ii• ...W.4..:c--,.- '-,:* .,.:;kW 541:71';;CmichtA:L::46Ittiiri144;10-tglijji\C•Viltrli;j: ,:r4P/Ce.i..".. rt.&. :rr P.q0•T}PAYMENT.MErHOD'i atefFr.:Check 7FV,-;.' 4 , ..4',.:^.}4'''40.4131i1;).2?% eS.Igh;.4'arg'4,4.."111/ .'4P-SIrtL..t.:Yittikk,i.VW. • • •i- • .. - . iv ' . 11- i., -:...--'t'rii:-.-.J1;14:1, 44, 12114,F-:?..u.1-; ciagrIS'AlstVlgp: ;;?!, :.t.:;....li ..... .. ,... ., ... ,:,t. ty0,;,,,, . .1A :,-.: ; ;...c. 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FOR INSPECTIONS CALL:(714)7545626 4* • PERMIT NUMBER: P07-00442 PERMIT TYPE PLUM STATUS: ISSUED DATE ISSUED: 07/03/2007 ISSUED BY: RMD JOB ADDRESS: 289 23RD ST CM Suite/Unit: Vicinity: REAR AND FRONT OF PROP SCOPE OF WORK: PLUMBING PERMIT FOR FOR GAS(1-4 OUTLETS)AND GAS PIPING FOR B80 ARE IN REAR AND A GAS FIRE RING AT FRONT OF PROPERTY. OWNER: SPOWART,JIM AND CAROL, - Address: 289 E 23RD ST PHONE: 949-646-1633 City/State/Zip: COSTA MESA,CA APPLICANT: VALERA, ENRIQUE Address: 1282 E SANTA ANA ST : PHONE: 714-624-9667 City/State/zZip: ANAHEIM,CA CONTRACTOR: DETULA CONSTRUCTION License No. 654377 Address: 1282 E SANTA ANA ST PHONE: 714-758-8665 City/State: ANAHEIM,CA ZipCode: 92805 - CELL: PLUMBING PERMIT FEE SUMMARY . PLAN CHECK FEE: $0.00 PERMIT FEE: $39.45 • TOTAL FEES: $39.45 - VOID • DATE: /0115/1 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE# INSPECTION TWE ail INTIM¢ SOU INSPECTION 1-r5 peg L11TIAlL 1618 Fixed System Final Fire Prevention 208 Final Mechanical 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 Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by driv. nse. ❑Yes ❑No I hereby affirm under penalty of perjury one of the foauwing declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for Workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation rance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: � person is required to descend,will be made in connection with work authorized /—+ by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier.—> (�'L or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp (This seam need GI can etedddre is valued atone hundred cblars(3100)or leu) 2,Art 2Sec.341,Title 8,California Administrative Code). Policy Number: t 0 I %---) Ci 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code,I shall orthwith comply with these provisions. Applicant's Signature Dale AL-1 _ U Division of Industrial Safety Permit Number: Alipfieema 6.gnature— - Male—• HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code,and 2. Does or will the applicant or present or future building occupant need to file my licensee/is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No LLic[#=6 S ir( Class#- - (Section 25533 of the California Health and Safety Code, with some � l exceptions, requires registration with the Costa Mesa Fire Department by f'� — each business which at any one time has on hand a quantity of acutely Oontractor's Signature—. Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,CMI Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No 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 (Section 65850.2 of the California Government Code requires that the requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits). Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the properly,or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No. thereon,and who does such work himself or herself or through his or her own 8. (If yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property;-am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: The contractors License Law does not apply to an owner of Signature Dale property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. /Signature of Legal Ovmer(s) Date Signature Date y� , e Ula-Lk 33057-46(3/07) An /or Ao zed Applicant-="'-- — �'� Dale c Ilii 4 CITY OF COSTA MESA BUILDING DIVISION i.A ; 1 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us l.I .:�...'� 1 4. I� . FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: 607-00815 PERMIT TYPE B_MISC STATUS: ISSUED DATE ISSUED: 07/03/2007 ISSUED BY: RMD JOB ADDRESS: 289 23RD ST CM Sui e/Unit: - Vicinity: REAR OF HOUSE Pri ary Occ: 32 - Const Type:?? . SQ. FT: 224 Va' ation: . • $ 200.00 SCOPE OF WORK: CONSTRUCTION OF A 224SF(16'X 14')ATTACH a •TTICE PATIO CO ER W/1 LIGHT FIXT, 2 OUTLETS AND 1 SWITCH BEHIND RESIDENCE. 5 FT. SIDE SETBACK AND 11 FT. REAR SETBACK. ' OWNER: SPOWART,JIM AND CAROL, Address: 89 E 23RD ST nit: PHONE: 949.646-1633 City/State/Zip: COSTA MESA, rA APPLICANT: VALERA, ENRIQUE Address: Unit: PHONE: 714-624-9667 City/State/zZip: • • CONTRACTOR: DETULA CONSTRUCTION • Licen-e N. 654377 Address: 1282 E SANTA ANA STUnit:,-� P •• • : 714-758-8665 City/State: ANAHEIM,CA Zip rode. 92805 C: L: ARCHITECT: License No. _ .. PHONE: ENGINEER: "cense No. PHONE: MISCELLANEOUS PER -IT FE. SUMMAR • ' • Building Plan Check: . , $99.61 Building Permit: $153.25 ' Electrical Permit: , • $27.90 Other Fee: _ -0.0r SMIP Residential , . $0.72 - - SMIP Commercial • , $0.00 t - ". • TOTAL FEES $281.48 O ' DATE: 1 • • 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: PERMIT EXPIRES 160 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODES INSPEC110N Pitt QM INITOAL4 GODES INSPECTION TYPE em �INa11AI4 1818 Fixed System Final Fire Prevention 208 Final Mechanical 1288 Pool Spa Final 208 Final Plumbing 200 Final Re-Root 210 Final Electrical , 201 Final Block/Retaining 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 Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by driv rise. 0 Yes ❑No 1 e_ , 4 I hereby affirm under penalty of perjury one of the f wing declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' ' Verification of Ownership by(type of document.i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: /N (1� /� person is required to descend,will be made in connection with work authorized Carrier:- or�/I {/ tot "l by this permit,and that no building structure,scaffolding,falsework,or demolition fr-- '- Z'1, or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Tins ser nea�ee c>xnderedda�epmMis valued afwre h'"'o'/ry dollars(S100)or less.) 2,M2 Sec.341,Title 8,California Administrative Cale). Policy_-Number: 0 As owner-builder, I will not employ anyone to do work which would O I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of Fgprcanrs Signature Date the Labor Code,I shall forthwith comply with these provisions. 47y L/ - a iZ 7.- Division of Industrial Safety Permit Number: ✓npW� 's'Signature COWHAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds.or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes ❑No (pc:-#.641 l 3 / Class#"� (Section 25533 of the California Health and Safety Code, with some _ _ /"7-6 ,3— - exceptions. requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely ( Conuactorls signature Date_ 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). O I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the Califomia Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the Califomia OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No 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 (Section fie furnished othe onCnliaomia Govemment Code requiresbuilding thnt the requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be applications for non-residential permits). Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑ No, thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature of Legal Owner(s) Date ' Si• ature Date 1 `� O 305]-x6(310]) - - _ 7-3- I -Moiw.A. . •eNicent- -• (—Date-__--y Rafter Header • Header(s) Rafter(s) ■-us ■-m=om111111 DETAIL OPTIONS .—r.r4S Check the ones that appy: . IISMi Lattice Cover: t II ����/� ❑A OA 08 ❑C OlD OE OF ❑D ❑E ❑F III IN / Solid Cover: ■�tiiiimr ■ U vw U-U �..`� ^w^^ . i U misommioreava. ■ asi.iwr ,sn^^^^ � ._ .w. • �■ �a-ts. - . . _ JM/.w.vM Post EXTERIOR WALL OF HOUSE Anchor Post Lattice Cover Solid Floor Cover Roof Covering 6'min 26 Ga. Roof Sheathing " Footing Lattice FRAMING PLAN Flashin\ Depth Roofing J 12" Sheathing \,1 PAD FOOTING A Lattice 0 760#max ,I, perpost Post I, �'i 6'min Rafter d Header _ Rafter Joist Hanger # Joist Hanger Ledger Post Ledger SLAB g ` ` e o o SLAB FOOTING B 2% Slab '- ° m Slab 2% 2x6 Min 2x Joist Slope _ Slope �! F=J to Drain ® to Drain Existingl1 At Anchors - Footing Lattice Solid Roof wall a z'-o 8%0' I roof Cover Cover Max Max Span SECTIONS _ EAVE CONNECTION C CONSTRUCTION MATERIALS I/2'x Ler ' Joist DIVIS • ' • - . Lag s SPECIFY LUMBER: VIDF 0 Redwood 0 Hemfir CITY_OF COSTA MESA ®16 SPECIFY GRADE: si No. 1 ❑ No. 2 APPROVE D CONCRETE: 2500 psi min. @ 28 days _Date CONNECTIONS: ICBG approved or equal By ^ �lo educations MUST be kept on this job al of tunes and d Is u Ledger ,s tofplans,�(dsP p title; LCONNECTION D 1. Roof covering: �. Ku alterationsonsarrewthoawrfllenPe 2. Roof sheathing: L aniiiadSafet .§islttb Deno ns: , , lattice: 2- x .)@ "o.c.: NOT be held to pe mit or totean �w ..n,nit—Lattice The stam Hlfi/p2xm d8pp4fJfdtio it of Costa Mesa Ordinance andlor S J ›.--1—Bolts solid: "CCX plywood or_"lumt (ge vioU'ier2Jl-agy;fc�9is�ns any Y @ j(7Sing(Nysrfil6e ma shah expire by limitation become null and void II the b/ x 3. Rafters: 2 x r� �'o.c. r ced maintained a d ve per UBC§303(d)within 180 days of Dummy Post iL t 4._Header. 9 x tO 21Singlesdt m00.RSf� 4 Beyond 5 Ledger: /. x t0 (2x min) RAFTERIHEADER E 6. Fascia: _x_(2x6 min) 7. Post: r{ x 1) (4x4 min) Raise 1"min above slab surface Roof Sheathing % or LatticeB. Footing: 1 Z x 17. 12"x12' min for up to 66 sf tributary area; 18'x18' min for 67-150 sf tributary area pittorRaner IV "depth(Expansive Soil Zone_ ) Framing u 9. Slab N A "thick (Expansive Soil Zone ) Each Block IA 10. Connections: a. Joist to Ledger -Metal joist hanger Header 2 X Blocking b. Joist to Header -Solid blocking with framing anchor Post Column Cap c. Doubled joist or header to post - (2) 1/2"dia. thru bolts w/washers JOIST/HEADER F d. Joist to Fascia -Metal framing anchors each side (min. capacity =0.5"joist span 'joist spacing' 15) e. Header to Post -Column Cap f. Post to Slab or Footing -Metal Anchor/Post Base g. Roof Sheathing -8 d @ 6"o.c. Edges and 12"o.c. Field 2733<6 back 1991 UBC CITY OF COSTA MESA ) ; 1 BUILDING DIVISION 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.up I-, ::1:..: 1 FOR INSPECTIONS CALL: (714)754.5626 PERMIT NUMBER. BC07-00074 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: POOLSPA DATE ISSUED: 06/28/2007 • ISSUED BY: JOB ADDRESS: 289 23RD ST CM Suite/Unit: Vicinity: REAR OF YARD - Primary Occ: Const Type: - SQ.,FT 50 Valuation: $20,000.00 SCOPE OF WORK: BUILDING PERMIT TO CONSTRUCT A 50 SF IN-GROUND SPA(SW-05-0390), 1 POOUSPA, 1 ELECTRICAL OUTLET FOR BBQ AREA, 1 INST FAU > 100K BTU, 1 GAS OUTLET (1-4 OUTLETS) FOR BBQ AND FIRE PITA/ND 1 PRIVATE SPA. r�� C' - OWNER: g fv{,1xkr* Jim £41Ct la(OI - Address:-.•2�"I — 4 JT' PHONE: 'I-({'1) (eu) 3 City/State/Zip: COSTA MESA,CA IE3 APPLICANT: SCHWARZ,JIM J Address: 3344 TAURUS LANE Unit: PHONE: 714-241.7665 City/State/zZip: SANTA ANA,CA CONTRACTOR: SCNWARZ CUSTOM POOL License No. 770413 Address: • PO BOX 28437Unit: PHONE: 714-241-POOL City/State: SANTA ANA,CA ZipCode:'92799 - CELL: ARCHITECT: - • License No. - PHONE: ENGINEER: TODD L LACHER' License No-67656 PHONE:714-630-6100 COMBINTATION PERMIT FEE SUMMARY Building Plan Check: $208.81 Building Fees: $321.25 Electrical Fees: - $74.10 • Mechanical Fees: • _ -$41.50 Plumbing Fees: $59.90 SMIP Residential: $2:00 - SMIP Commercial: - $0.00 • • TOTAL FEES: • $707.56 "Refer to tee receipts for all fees paid for project • 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. POE t INSPECTION TYPE Deg almaiS COOS/ INSPECTION TYPE • pALP INRMLSS 1616 Fixed System Final Fire Prevention �1 206 Final Mechanical &24-C7? C 1266 Pool Spa Final StF6) • 208 Final Plumbing 8•ti-07 7� 200 Final Re-Roof 210 Final Electrical g‘21-07 (S - 201 Final Block/Retaining 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 Building/Occupancy • • WORKERS'COMPENSATION DECLARATION: Owner ID verified by driv, nse. 0 Yes 0 No I hereby affirm under penalty of perjury one of the w,..,wing declarations: Driver's License No. Expires: 0 I have and ll maintain a certificate of consent to self-Insure for Workers' Verification of Ownership by(type of document.i.e.-propgty tax bio or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 0 I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized 7 by this permit,and that no building sWcture,scaffolding, a falsework, demolition carrier. STLF"(� �(�fJ4-� or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This section need not be completed dere penny avalud at one hundred(*Oars($IOO)or less.) 2,M2 Sec.341,Title 8,California Administrative Code). Policy Number, 2) 330 S 2 t_— 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall fort with comply ori these provisions. Applicant's Signature Date C., 2S , err Division of Industrial Safety Permit Number: inn Signature L Date i y- HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds.or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code,and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. �1 a registration form for acutely hazardous materials? 0 Yes 0 No [Lic.-# ; -7-7 4-( 3 G 'J ass#- . G5 (Section 25533 of the California Health and Safety Code, with some 07 exceptions, requires registration with the Costa Mesa Fire Department by = • each business which at any one time has on hand a quantity of acutely cmrs Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a L volume of 55 gallons. or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure), ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: • 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property,or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044.Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No, (hereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer), completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF.COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date . property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that El I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Le Owners) Date Signature Date � 4 _2-B •V'7 3057-46(3107) And/ AW riled Applicant Date • ` • WIt : . .• ,.. ,.../ - ' ,_,.., iltilpit ; Oj e d ? fe4a & atQI POOL AND SPA REQUIREMENTS The following information is required in a clear and legible manner. All information shall be complete and on the plans. Three sets of plans showing all of the following with measurements shown from property lines, buildings, patio covers or other structures. I. Name, address, phone number of owner. -11 2. Name,address, phone number, type of license of any contractors or subcontractors. 3. Pool and/or spa location. 4. Equipment location. 5. Gas and electrical meter locations. 6. Overhead service lines and serving pole location. 7. Type of gas and electrical conduits to be used. 8. Size of main electrical service (if less than 100 AMP, service is probably inadequate and will have to be upgraded to minimum City requirements.) 9. Rating(horsepower. voltage, amps)of all electrical equipment. 10. BTU rating of gas heater. 11. Distance and size of gas line. 12. All electrical outlets within 15 ft. of pool/spa. 13. Capacity of spa(spas only). 14. Handrails. ladders, slides and diving boards (if any). 15. Location and details of solar panels (if any). 16. Location of doors and windows within 5 ft. of pool/spa. 17. The type of construction—gunite, poured concrete, prefabricated fiberglass or other. 18. The pool dimensions, including the depth and adequate cross-sections drawn to scale. 19. Computations, stress diagrams and other data sufficient to show the correctness of plans; including reinforcing steel schedule and details. 20. A statement by the applicant concerning the anticipated nature of the soil under and around the pool structure (expansive, moderately expansive, non-expansive). (A soils report may be required by Building Division prior to permit issuance.) 21. The Engineer's wet ink signature is required on pool plans and calculations. 22. All semi-private pools and spas shall conform to California Administrative Code Title 24 handicapped requirements(hotels, motels, recreation areas for lease to public or publicly funded projects). 23. Where a permanently installed pool is constructed, at least one 120 volt receptacle shall be installed a minimum of 10 feet and not more than 15 feet from the'inside wall of the pool and shall be protected by a ground fault circuit interrupter. 24. Indoor installation of spas and hot tubs, receptacles shall not be closer than five (5) feet to spa/tub. 25. Receptacles located within twenty(20) feet of a spa or hot tub shall be G.F.C.I. 26. Receptacles for spa/hot tub motors shall be G.F.C.I. protected. 27. Comply with Costa Mesa City ordinance 93-12 requiring protective barriers, fencing and/or enclosures. 1039-46 (REV.7/98) . GENERAL REQUIREMENTS 1. If capacity is 750 gal. Or more, backwash and P-Trap shall be installed. 2. All P-Traps shall tie in at lower terminus of house drain. 3. If permanent fill line is not installed, nearest hose bib shall have an anti-siphon valve. 4. All PVC shall be 18 inches underground. 5. PVC gas lines shall be tested at 60 P.S.I. 6. Pressure test required on entire system (35 P.S.I. air test or water fill) prior to back fill. TYPICAL SETBACK REQUIREMENTS Equipment: 4 ft. from property line 4 ft. from doors/windows 4 ft. from attic vents 18 inches from house/garage Pools/Spas: Above-ground pools and spas shall not be located in the required front yard setback from a public street and are subject to 5-foot side and 10-foot rear yard setbacks for main structures. Any deck that is raised higher than 6 inches above grade will also be subject to the 5-foot side and 10-foot rear yard setbacks for main structures. all-be-Iocated-51 t from any ppuperty line. Please consult with the Planning Division re:ardin_• any in-ground pool and/or spa that are proposed to n e ront yard. • . . . . .. . . . • . -tore. 1. Overhead Edison drops shall be installed per NEC 680-8 (see attachment). 2. It shall be unlawful for any person to install, remove, alter, repair or replace any plumbing. gas or drainage piping or any fixture, swimming pool heater or treating equipment in a building or premises without first obtaining a permit to do such work from the City Building Division. 3. Clarification or additional information may be obtained by telephone: (714) 754-5273, between 8:00 a.m. and 4:30 p.m. FENCE AND GATE REQUIREMENTS (see attached) 1039.46 (REV.v96) CHAP.31B,DIV.II •3150B 2001 CALIFORNIA BUILDING CODE 7154.18 L C Division Ii—PRIVATE SWIMMING POOLS(STATEWIDE) L A LC NOTE:These regulations are subject to local government modification.The applicable local government requirements at the time of application for a building L A permit should be verified. LC NOTE:These standards become applicable commencing.anuary I,1998,to a private,single-family home for which a construction permit for a newswimming L c pool has been issued on or after January 1,1998. L A L C L A SECTION 315013—DEFINITIONS toafford protection that isequal toorgreater than that ajfordedby A L L C any of the devices set forth in Items 1-4,inclusive. A L L c As used in this division, the following terms have the following C L L c meanings: Reference:Health and Safety Code Section 115912 A L L A Authority:Health and Safety Code Section 18942(6) A L L L c APPROVED SAFETY POOL COVER means a manually or AB 3305,Statutes 1996,C.925 A L L power-operated safety pool cover that meets all of the perfor- A L I. mance standards of the American Society for Testing andMateri- C L LC als(ASTM),in compliance with Standard F 1346-91. ON 31528—ENCLOSURE; ' OUIRED C L L C —'CHARACTERISTICS L a ENCLOSURE means a fence, wall or other barrier that iso- AC L L A lutes a swimming pool from access to the home. 3152B.I An enclosureshal i• a l of the following characteris- c L L C A L L c EXIT ALARMS means devices that make audible,continuo tics' C L L C alarm sounds when any door or window that permits access from 1. Any access gates through the enclosure open away from the c L LL C the residence to the pool area, that is without any intervening en- swimming pool and are self-closing with a self-latching device c L L c closure,is opened or is left ajar.Exit alarms may be battery oper- placed no lower than 60 inches(1524 mm)above the ground A i L c ated or may be connected to the electrical wiring of the building. 2. A minimum height of 60 inches(1524 mm). c L L c PUBLIC SWIMMING POOL means a swimming pool aper- 3. A maximum vertical clearance from the ground to the bottom A L L c ated for the use of the general public with or without charge,or for of the enclosure oft inches(51 mm). A L L c the use of the members and guests of a private club.Public swim- C L L cing pool does not include a swimming pool located on the 4. Gaps or voids,if any,do not allow passage of a sphere equal c L L A to or greater than 4 inches(102 mm)in diameter. L C grounds of a private single-family home. A L L c 5. An outside surface free of protrusions, cavities or other c I. L A SWIMMING POOL or POOL means any structure intended A L L A for swimming or recreational bathing that contains water over physical characteristics that would serve as handholds or foot- A L c 18 inches(457 mm)deep. "Swimmingpool"includes in-ground holds that could enable a child below the age offtveyears to climb C L L A g A L L A and above-ground structures and includes, but is not limited to, over. C L L C hot tubs,spas,portable spas and nonportable wading pools. Reference:Health and Safety Code Section 115923 C L L A A L L CAuthority:Health and Safety Code Section 18942(6) A L L c Reference:Health and Safety Code Section 115921 AB 3305,Statutes 1996, C.925 C L L c Authority:Health and Safety Code Section 18942(6) A L L c AB 3305,Statutes 1996,C.925 A L L A SECTION 31538—AGREEMENTS TO BUILD;NOTICE c L LL A OF PROVISIONS A L L c SECTION 31518—CONSTRUCTION PERMIT; A L Any person entering into an agreement to build a swimming pool A L L c SAFETYFEATURE$REQUIRED shall give the consumer notice of the requirements of this article. C L A L L A Commencing January 1, 1998, except as provided in Section Reference:Health and Safety Code Section 115924 A L L A 3154B,whenever a construction permit is issued for construction Authority:Health and Safety Code Section 18942(6) A L L A of a new swimming pool at a private,single-family home,it shall AB 3305,Statutes 1996,C.925 L A CA rhe equipped with at least one of the following safety features: C L L A The pool shall be isolated from access too home by an enclo- A L L C SECTION 3154B—EXEMPT FACILITIES • C L L A flai that meets the requirements of Section 3152B. A L L A 3154.18 The requirements of this article shall not apply to any of A L L c 2. The pool shall be equipped with an approved safety poolC L L Athe following: A L L C cover. C L L A 1. Public swimming pools. A L C L L c The residence shall be equipped with exit alarms on those 2. Hot tubs or spas with locking safety covers that comply with c L L A s providing direct access to the pool. A L L C �l the American Society for Testing Materials—Emergency Perfor- A L L A jt All doors providingdirect access from the home tothe swim- mance Specification(ASTM-ES 13-89). C L L c ming pool shall be equipped with a self-closing,self-latching de- 3. Any pool within the jurisdiction of any political subdivision Al L A vice with a release mechanism placed no lower than 54 inchesA L L c that adopts an ordinance for swimming pool safety that includes c L L A (1372 mm)above the floor. A L L C requirements that are at least as stringent as this division. C L t. n • 5. Other means of protection, if the degree of protection af- t. 4. An apartment complex or any residential settingother than a c L L c forded is equal to or greater than that afforded by any of the de- single-family home. c L L c vices set forth in Items 1-4, inclusive, as determined by the A L L c building official of the jurisdiction issuing the applicablebuilding Reference:Health and Safety Code Section 115925 A L L c permit.Any ordinance governing child access to pools adopted by Authority:Health and Safety Code Section 18942(b) A L L A a political subdivision on or before January 1,1997,is presumed AB 3305,Statutes 1996,C.925 A L 1-294.16 2001 CALIFORNIA BUILDING CODE CHAP.318,DN.I FIGURE 31B-4 FIGURE 318-5 C L A L C A L C A L C L A L C A L C L L A L C A L C L A L 111111114'I 4'ndn. C L 9,D mn _4 A �i�/�11111111111 C L Ground A L _ ■MM811''j'/ n, C L IIIIIIIIIIIIII YID'mN. A L 1,j;II il rfli . A L 1 LLL A L C L C L A L C L A L C L A L C L A L C L A L C L C L C L A L FIGURE 31B-4—PERPENDICULAR FENCING DIMENSIONS ON SLOPING GROUND C L C L A L C L A L C L A L C L A L C L A L C L A L C L A L C L A L C L A L C L ' A L INSIDE OUTSIDE • CA L A L C C L Fencing deer A L space A L A L C L A L .t-i/.=/ C L A L C L C L A L C L A L C L A L C L A L C L A L C L A L C L A L C L A L C L A L FIGURE 318-5—EFFECTIVE FENCING HEIGHT AL 1-294.15 MF CITY OF COSTA MESA 4BUILDING DIVISION .ye•ri j,,,, i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER F 1T.i PERMIT lit4bomit## E05-00085 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 289 23RD ST Status: ISSUED Suite No Applied: 02/07/2005 Vicinity: REAR OF LOT Issued: 02/07/2005 Parcel Nunmber: 42608410 Applicant: SPIDELL, JAMES ISSUED BY: Address: 2593 ELDEN AV APT B Phone: 949-650-2166 COSTA MESA,CA Zip 92627 Owner: KNIGHT, STEVEN AND SPIDELL, JAMES Address 2593 ELDEN AV APT B Phone: 949-650-2166 COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: License:000000 SCOPE OF PERMIT INSTALL TEMPORARY POWER POLE. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c 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 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $23.50 1 TOTAL CALCULATED FEES $47.00 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 . 2446-48(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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. ❑ I have and will 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 workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit/s valued at one hundred dollars($100)or less.) .; :'01 edify 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 laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall fdrthwlth comply with these provisions. ,/ Applicant nature: Q�-rv�92 4ten'i./// Darer"..-2/7/0 c W NINO:FAILURE TO SE RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS(5100,000),IN ADDRION 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 affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and effect.Lic.0 _ _ Class x Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I 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: Lender's 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 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 soldwithin 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.). • tri,,_,owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Cade: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: rt S rE :...�°t - =B`1 3 0 ars Owner ID v 'tied by driver's license. *Wes 0 No Driver's i tnie'No. , mart,'+ ] O C. Verification of Ownership by(type of document,cei.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,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. ' 341,Title B,Califomla 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 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? 0 Yes 0 No (Section 25505 of the California Health end 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? 0 Yes 0 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 Califomia 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. 4 If an RMPP is presently required,has Section 25534-OTthe California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this implication aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes 0 No (Section 65850.2 of the Califomia Govemment 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? 0 Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 01 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? 0 Yes 0 No B (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-describedcproperty for inspection pu ses.I agree not to occupy or allow occupancy of any building authorized bybythis�/�permit final inspection. 09744-4124 � � 1 na 01111egarCfwner(s) Dat ligir And/Or Authorized Applicant Date you}, IBSPEC11ON TYPE PA TF INTDIALS CODES INSPECTION TYPE 1♦�E' INImeLS ^I 1616 Fixed System Final Fire Prevention 206 Final Mechanical 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 Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy • CITY OF COSTA MESA ►9@ BUILDING DIVISION F••' ..�� DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER • PERMIT eF B05-00045 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 289 23RD ST Status: ISSUED Suite: Applied: 01/12/2005 Vicinity: DETACHED GARAGE Issued: 01/12/2005 Parcel Number: 42608410 Zoning: di/ ISSUED BY: Applicant: SPIDELL, JAMES Address: 2593 ELDEN AV APT B Phone: 949-650-2166 COSTA MESA,CA Zip: 92627 Owner: KNIGHT, STEVEN AND SPIDELL, JAMES Address 2593 ELDEN AV APT B Phone: 949-650-2166 COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 000000 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT DEMOLISH EXISTING 400 S.F.DETACHED GARAGE. APPLICANT WILL CONTACT A.Q.M.D.PRIOR TO DEMOLITION. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $1,000.00 Permit: $38.75 Claim Valuation: $1,000.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $39.25 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all 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 2446.48(GM - DECLARATIONS ' ) - WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,es provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. ❑ I have and will 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 workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit Is valued at one hundred dollars($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 workers' compensation laws of California.and agree that It I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. / ,., J. — / r Applicant Signature: .4,21�- t i .� Date: 0 7 WARNING:FAILURE TO S RE WORKERS'COMP TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLIARE($103,000),IN ADOmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Llo.a Class it Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I 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). Lenders Name: _ Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:My 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 Ucense 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(5500).): ❑ 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 contractor(s) license pursuant to the Contractors Ucense Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: 1-ii Date: l -/2 - 0 41 Owner ID ve ted by drivers license. Yes 0 No Drivers Ucense No. Expires: .7-.7-07 Verification of Ownership by(type of d 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,falsework,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 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? 0 Yes 0 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 0 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). __...._ ._ _ __.. __..r —...._._...._t__.)_._ 3 Does�r will Ih❑e applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Flre 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 en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied 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,application aPernit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? U Yes 0 No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). 8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 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? 0 Yes 0 No 8 (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 COMPUANCE 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 inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. atvnb -d,de.C1 i -4-05 l nature Of Legal Owner(s) Date And/Or Authorizod Applicant Date CODE r INSPECTION TYPE PATE INTITIAL5 gODEt INSPECTION TYPE PAIL REALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site r �L,,,,� 204 Final Demolition 250 Final Building/Occupancy S[V '77 1� <DPip2gv+m6 Cccr•, .: / "AIG ONINNVid 21-11 A8 G ?3AO1ddV 38 '11VHS SNOI.LDHNNOD NO `SNOI.LH"IHG `SNOLLIGGV :H.LON 'D31I '.Ld3G 'D018 O.L.LD3I8fIS NOISIAIQ ONINNV1d A VS31AIVISODDdO AID A U3LAOHJJA 4 2i ,x1 i a ,i z Q ' ma rarp. 0.0 i W W � Tf7- �%`I 0 _'1 '1� i i O N i �` �I�,`�i. J- Cu W RUCK OWNS m . ouc an.¢ /1 i V I—� at o N Z CM DRAM TRU W N 0' m Wv. ILP z r. A•0.0 SITE PLAN m,v-rte 1:11!*r CITY OF COSTA MESA • BUILDING DIVISION f • �) DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER J• SPCA 05-01835 �� (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cSWJILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 289 23RD ST Status: ISSUED Suite: Applied: 10/12/2005 Vicinity: HOUSE Issued: 10/12/2005 Primary Occ: R3 Type of Construction: V-N Parcel Number: 42608410 Zoning: Applicant: KNIGHT, STEVEN AND SPIDELL, JAMES Address: 2593 ELDEN AV APT B Phone: 949-650-2166 ISSUED BY: COSTA MESA,CA Zip: 92627 Owner: KNIGHT, STEVEN AND SPIDELL, JAMES Address 2593 ELDEN AV APT B Phone: 949-650-2166 COSTA MESA,CA Zip: 92627 Contractor: Address: Phone: Zip: License: Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT LEGALIZE DEMO OF EXISTING(APPROX)600SF SFD. FEE SUMMARY Plan Check: $0.00 Calc uation: 55,000.00 Permit: $111.25 aim Valuation: 55.000.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $111.75 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void II 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 end final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(&00) I DECLARATIONS WORKERS'COMPENSATION DECLARATION: • • I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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. / J ❑ I have and will 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 workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) ly:ttat In the performance of the work for which this permit is issued,I shell not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that It 1 should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Appik.curti .ete. / _--/ tDaty/-0//110 WARNING:FAILURE TO-ECURE WORKERS'•i'ENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S100p0tl).IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of tho Business and Professions Code,and my license is In full for0e and effect.Us.0 Class 0 Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I 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). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 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 to a civil penalty of not more than five hundred dollars($500).): �75—zits 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 contractor(s) license pursuant to the Contractors Ucens ws.). ❑ I am exempt under sec. Business and Professions Code for this reason: atom: ��//J`'��n4,44 GErires`s?7.7/09 Verification of Ownership by(type of document,I.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIVERTIFICATION: ❑ I hereby certify that no excavation fly pore 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, ing,fatsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,The 8,California Administrative lath." ❑ As owner-builder, I will not employ an a to do Work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has e permit to do such work from the division. Signature: /u Date: Division of Industrial Safety Permit Number: 1- HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Wit the applicant or present or future building occupant need to file ' a usiness Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with xceptions,that a Business Plan be filed with the Costa Mesa Fire Department by eve business which has at any one time during a reported year a quantity of ha dous 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? 0 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 ono 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 end 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 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. 4 if an RMPP is presently required,has Section 25534 of the Celifomia Health end Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes LJ 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 an _.......rool? y pan of the facility to be constructed under this permit be within 1000 feat from the outer boundaries of a scdhool? ❑Yes 0 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? 0 Yes 0 No 8 (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 Coate Mesa to enter upon the above-described properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. eA.T4 r y" 'J.4:-e-e-al.owaegs)�—�-- - 'Q//'/p o te_� r And/Or Authorized Applicant Date CODE 6 I/JDFTLT10N TYPE . PATE IK®ALE CODE( INSPECTION TYPE PAIS MALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 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 Factory Fire Place 220 Final Planning Approval • 203 Final Sign z ( 222 Final Site . 204 Final Demolition • -Io-«_c 250' Final Building/Occupancy • ,.i GAR AG (: •PemGDF-4c) Demolished 4305-vim45 w 6 gire House APPROVED CITY OF COSTA MESA PLANNING DIVISION SUBJECT TO BLDG. DEPT. REG. NOTE:ADDITIONS, DELETIONS, OR CORRECTIONS SHALL BE APPROVED BY THE PLANNING DIV. BY: it DATE:1440S T>txrtdi �xLc iha 5Ff 4-n hU&, new Sfe- 605-bla0g) d 2 6 . 23& 5t OWNER RITTER, Blanche DATE 5-1-72 JOB ADDRESS 289 East 23rd Street BUILDING PERMIT NO. 34627 GENERAL CONTRACTOR Doyle ED 'Smith DESCRIPTION of WORK Reside Residence 0118-164-0$ LOT TRACT FIRE ZONE VALUE $ 1.395.00 INSPECTIONS Signature Date GROUP TYPE ZONE R-1 SOIL PERMITS ISSUED GAS SUBCONTRACTOR Date I Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE El NOOSE CON. 9 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER 9 ROUGH WIRING Heating and Vent. TRENCHES d FORMS 9 STEEL REINF. 9 FLOOR SYSTEM BOND BEAM n STEEL REINFORCE in SHEATHING FRAME AND FLASHING LATHING - IN n OUT n P' -TER, BROWN COAT :TURAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL - _ A s 11 n _f --ri ff ---- PAID 34627 " -j-7i�—`.00 003* **te*1 4.10 COSTA MESA BUILDING-SAFETY DEPARTMENT . P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely /�J��j9 p{I R REC,F/y[VE 23V Dlq��j($A_EC IVED DA ISSUED BUILDING .'/5J I t' 3 RA () .�r t p4.� /P- CY / i/r-7 '.� ADDRESS}��r /r J� ny yfSj' / �{ �yy PERMIT NO. OWNER L Lc% �I 4 l' f' H+, A.P. NO. //F/6 rlO / MAIL 9 BUILDINGDRS 79 ( 3 /�f� �/ Z ADDRESS SA-An,� ADDRESS / ` .--- .'/^ Z CITY '1w Lli C T S' NO.TEr�J L T g BLOCK -�s /L a / Z Q cn CONSTRUCTION /\f�MLP NEW ADD I ALTER PAIR (MOVING DEMO(CH O LENDER J J BRANCH J CO OWNER • m -1 LU ADDRESS VALUE -I<03 ARCHITECT TEL. USF $ OR ENGINEER NO. U FIRE SE 573/4- W Z ADDRESS ZONE TV eE DATE 71/ JO CONTRACTORDep D J s C+1 t`{_4 BYPROV ED flOJ�/ ' W W ADDRESS 7, 0,1,A1� ia,cy3„, Dyi, ZON�gB NO.OF USE OF NEW Q= ��• TEL. qG K- PLANS BUILDING Z H CITY W, 5 la rn�ca ND fcDO /C / O STATE(- q CITY YARDS APPROVED YARDS APPROVED rwn LIC. NO. €' 77, LIC.NO. MAIN BUILDING ACCESSORY BUILDING D O / (FROM C/L STREET) SIZE NO.OF BLDGS. OF LOT // (' I NOW ON LOT FRONT FT. FT. USE EXISTING •©N r/' tpii ` EXISTING BLDG. � � ��, ���i,y(� q SIDE FT. FT. I-' SIZE OF NO.OF J Z NEW BLDG. ROOMS STORIES / L.SIDE FT. FT. ✓ ( EXTERIOR WALL ROOF ; _ COVERING COVERING _REAR FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& D_ o_ MAIN BLOCS. ACCESS BLOCS. 0It ' /� O fj�DS id ON../A4 AA IF-I J)fh`/AI (s C.U.P.# APPROVED I- J APPROVED (n -cid cid SIJ/�)5 ----ELY DATE Z 0 VI hereby acknowledge that I have read this application and state STTT\ D that the above information is correct and agree to comply with G \`4 all laws regulating building construction, and I shall not employ �� F any person in violation of the workman's compensation laws of CO the State of California. oil 0 ZI hereby certify that I am properly licensed as a contractor under SO. FT. TA , o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATI OR i Chapter 9, and that s licenses are in f and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 0 it am exempt fro th p ovisions of the Sta .'fornia Business / /t'C end Professions o e, ivision 3 Chapter • VALVATION S/�/ pl Q CL_ PERMIT FEE $ N _ B Signature of / j/ (`1 �--. at Permittee / { $ / 3! O PLAN CHECK $ E • g tP0 7 Authorized Agen SG '-'— TOTAL FEE $