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PERMIT TYPE
Sub Type:
� CITY OF COSTA MESA �
BU/LDING DIVISION
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77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
6_COMBO
RES_ALT
JOB ADDRESS: 888 W WILSON ST CM
APN: 42235379 Zoning: . , ,
Vicinity: ATTIC AR�A
ConstType: V-B
SQ. FT: 0
PERMIT NUMBER: BC09-00105
STATUS: ISSUED
DATE ISSUED: 04/07/2009
ISSUED BY: RMD
Suite/Unit:
Primary Occ:� R-3
Valuation: $5,000.00
SCOPE OF WORK: HOUSING PROJECT: FRAME, INSULATE AND DRYWALL PORTION OF ATiIC ACCESS FROM INSIDE
GARAGE, REMOVE 2(E) WALL HEATERS, CAP t GAS OUTLET, REPLACE WI7H 1 FAU < 100 K BTU IN ATTIC SPACE,
REPAIR/REPLACE DUCT SYST WITH 1 LIGHT FIXT, 1 OUTLET AND 1 SWITCH.
OWNER: MELENDEZ, SALVADOR
Phone: 949-548-7702
APPLICANT: LEYVA, ROBERT
Phone: 714323-$820
Address: � 898 W WILSON ST
City/StatelZip: COSTA MESA, CA
Address: 953 UNION AV
City/State/zZip: COSTA MESA, CA
CONTRACTOR: ROBERT LEYVA CONSTRUCTION � Licen"se No. 825124
Phone: 714323-5820 Address: 953 UNION AVUnit:
Cell: CitylState: COSTA MESA, CA
ARCHITECT:
ENGINEER:
COMBINATION PERMIT FEE SUMMARY
Building Plan Check:
Building Fees:
Electrical Fees:
Mechanical Fees:
Plumbing Fees:
SMIP Residential:
SMIP Commercial:
Bldg Std Admin Fund
TOTAL FEES:
^'Refer to fee receipts for all fees paitl for project
License No.
License No.
$0.00
$111.25
$26.80
$5220
$24.60
$0.50
$0.00
$1.00
$216.35
Unit:
Unit .
ZipCode 92627
PHONE:
PHONE:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia staWtes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit lo be considered legal, such work must comply with all applicable codes, and all
required inspections and fnal approval must be obtained. Failure to obtain inspections and final appmval will result in the expiration of this permit.
CODEt. INSPEC➢ONTYPE OATE INTITIALS COOE% INSPEC➢ONTYGE p E IN�
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Elec�rical ��
201
202
203
204
Final BIocWRetaining Wall
Final Factory Fire Place
Final Sign
Final Demolition
212 Final Fire Prevention
220 FinalPlanningApproval
222 Final Site
250 FinalBuilding/OccuDancy
�
WORKERS' COMPENSATION DECLARAT
I hereby aKrtn untler penalty of perjury one of the following declara�ions:
❑ I have and will maintain a certifcale of consent to self-Insure for workers'
compensation, as provided (or 6y section 3700 of the LaDor Code, for the
pedormance o/ the work (or which this permit is issuetl.
❑ I have and will mainfain workers' compensation insurance, as required by
sectbn 3700 of the Labor Code, for the perfortnance of the vrork for which [his
pertnit is issuetl. My workers' compensation Insurance carrier and policy
number are:
Cartier.
� �(Thi55eIXi�nnee�nofbemmplefediltheperm�isvalueda(onehuntlretldollars(3f00)orlessJ
Policy Number
�I certify ihat in �he pedormance of the work (or which Ihis permit is
is eQ I shall not employ any person in any manner so as to become subject
to the workers' compensation laws o( California, and agree Ihat if I should
become subject to the vrorkers' compensation pmvisions of Section 3700 of
the Labor C I sha �I fort with comply vnth these provisions.
��a�///�/�% 0
Apo���nl'sSignaW ' oal
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) o( Division 3 of the Business and Professions Code, and
my license is in full force and eHect. n
Lic.#� �� ^� /�Z� Class# // ����rZ�
i.sil' /�J�lf �
—�° �Conl aclor's Sig aWre e� �
CONSTRUCTION LENDING AGENCY:
❑ I hereby affrm that [here is a consWction lending agency for the
performance of the work fa which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
oate
OWNER-BUILDER DECLARATIONS:
I hereby aKrm that under penalry of perjury that I am EXEMPT FROM THE
CON7RACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Busine5s and Pro(essions Cotle: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any structure, prior lo its
issuance, also requires the applicant for such permit to fle a signed statement
that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing with Seclion 7000) of Division 3 0( lhe
Business and Professions Code) or thal he or she is exemp[ therefrom antl
the basis for the alleged exemption. Any violation of Section 703L5 by any
applicant for a permit subjects the applicant lo 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 struclure is not intended or
oRered for sale (Sec. 7044, Business and Professions Code: The Contracrors
License Law does not apply to an owner of pmperty who builds or improves
thereon, and who does such work himself or herself or through his or her own
employees, provided that such impmvements are not intended or oRered for
sale. If, however, the building or improvement is sold within one year o(
completion, the ownei-builder wilt have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of ihe property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS lo consWct Ihe project (Sec. 7044, Business and
Professions Code: The contractors License Law dces not apply lo an owner of
property who builds or improves thereon, and who contracts for such project vnth
a contractor(s) license pursuant rothe Contractors License taws.�.
❑ I am exempt under sec.
Business and Professions Code tor this reason:
Signalure Oate
905�-46�3/0])
w�
Ovmer ID ven(ed by driver s license. ❑ Ves ❑ No
Driver's License No. Expires:
Verification o( Ownership by (rype of document, i.e. - pmperty taz bill or tleed):
DIVISION OF INDUS7RIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation fve (5) or more feet in depth into wfiich a
person is required �o descend, will he made in connection with work authonzetl
by Ihis permit, and that no huiltling structure, scaHdding, falsework, or tlemolition
or disman0ing ihereof, will be more than lhirty-six (36) feet high. (Chap. 3.2, Grp
2, Ari 2, Sec. 341, Ttle S, Califomia Administra[ive Code).
❑ As owner-builtler, I will not employ anyone to do work which woutd
require a permit from the Division of IndusViai Safety, as notetl above, unless
such person has a permit to do such vrork from the tlivision.
np0licam's SlqnaWre oa�e
Division ot Industrial Safety Permit Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
7. Will lhe applicant or present or future building occupan[ need lo fle antl
cehify a Business Plan (or emergency response to release or threatened
release ot a hazardous matenal? ❑ Yes ❑ No
(Section 25505 of the California Health and Sa(ety 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 dunng a reported
year a quantity o! hazardous materials equal to or grea[er ihan a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature antl pressure).
2. Does or will Ihe applicant or present or Wture building occupanl need to fle
a registration form for acutely hazardous matenals? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some
excep�ions, requires registration with Ihe Costa Mesa Fire Department by
each business which a[ 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
temperaWre antl pressure).
3. Does or will the applicant or presen� or future building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutety
hazardous ma[erials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the
Costa Mesa Fire Department may require the preparation, ceAifcation and
fling vrith the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials wi�h Ihe Fire Depariment.
4. If an RMPP is presently required, has Section 25534 of lhe California
Healih and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or vnll the applicant or present or fuWre builtling occupant require for
the work which is Ihe subject of this application a pertnit for such construction
or modifcation from the South Coast Air Quality Management Disirict or from
any other air polWtion control distric[ or agency? ❑ Yes ❑ NO
(Sectbn 658502 ot the Califomia Govemment Code requires that Ihe requested
infortnation be fumishetl on applications fa non-residential builtling pertnits).
6. Will any part of the facility lo be consiructetl untler this permit be within
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
Qf "yes", the facility must meet the requirement of Sections 25534 and 42303
of the Califomia Health and Safety Code).
7. If a permi[ from the South Coast Air Quality Management Distric[ or other
air pollution control distric[ or agency is required for the vuork which is Ihe
subject o( this application, have all of the disclosures prescribed by Cali(omia
Health and Safety Code Section 42303 heen made? ❑ Yes ❑ No
8. Qf'yes", attach certificate of compliance fmm the appmpriate air pollution
contml oKcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is cortect I agree to comply with all state laws and
city ordinances regarding Hazardous Matenals and Emissions.
Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state that
lhe information given is correcL I agree to compty vn[h all state laws and city
ordinances relating to building conshuction, and authorize representatives of
the Ciry of Costa Mesa to enter upon the above-described property for
inspection purposes. 1 agree not to occupy or allow occupancy of any 6uilding
authorized by this permit until fnal inspection.
S��reo Legal er(s) � � ate
/
MQ/ r AulM1onzeC App� Dale �
:.. • , J . .
CITY OF COSTA D4ESA
iVeighborhood Improvement Program
Final Work Write Up 03/27/09
Name: Salvador & Maria Melendez Home Phone: 949-548-7702 Spanish
Pronertv Address: 898 W. Wilson Street
All work is to be done per City of Costa Mesa Duilding, Planning and Public Works Codcs. In order to es�ablish smndards of
quality, the detailed specifications may refer [o a certain product by name and/or from a major manufacwrer. "I'his procedure is
not to be construed as eliminating from competition other products o( equal or better qualiry by other manufacturers. 7'hc
Contractor shall furnish the list of proposed desired substimtions prior to signing the contract All items listed on the work
description, unlcss otherwise specified, shall include all patching and finish work, induding vim, hardwure, patching and finish
painting and/or staining. The Contractor is responsible for all permits, fees, City business licenses, plans, etc.
City of Costa Mesa Standard Rehabilitation Specificalions applies to all i[ems listed on work description.
�Vurk Descri tion: Estimate:
l. Smoke Detectors: Provide and install battery opera[ed smoke detectors in each
bedroom and hallway (4). $125
2. Drywall: Close attic access from inside of garage. Frame, insulate, comply
with occupancy separation of a 1 hour modified wall (dryv✓al]), prep, p�ime and
pain[ wall [o match existing. Comply with curren[ Building Code requiremen[s.
Obtain re uired crmits from lhe Buildin Dc L � �800
3. Furnace: Remove existing wall heaters (2). Cap gas, patch, prep, prime and pain[
walls. Provide and install 80,000 BTU FAU, 3 ton unit or better, Energy Star, with
new duc[ sys[em, vents, and all associa[ed framing/electrical work [hroughout the $4200
house. Remove 2 existing wall heaters. Cap gas, drywall pa[ch, prime and paint to
match existing wall. Obtain required pernuts from thc Building Dept.
4. Termite Damage: Evaluate possible termite damage in attached garage. Provide full
[enni[e treatrnent (tenting) including subtertanean. $ I500
5. Closet Doors: Provide and install microred, sliding closet doors for middle bedroom to
fit existin � framin . 5700
TOTAL $7,325
1 havc rcvicwetl Ihe above work tlescnp[ion antl untlerstantl Iha[ any changes, addihons or delenons shall have prior approval by
the City of Costa Mesa Neighborhood Improvement Personnel.
$ignamre of Property Owner
Date
Signamrc of Contractor Date
• �• � CITY OF COSTA MESA • ; _ . �
T""'Fs,, BlIILD/NG DIVISION
it�� 77 FAIR DRNE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • www.ci.costa-mesa.ra.us
f
° ` FOR INSPECTIONS CALL: (774) 754•5626
�`�un� `�
PERMIT NUMBER: E09-00068
PERMIT TYPE ELEC
APN: 42235319
JOB ADDRESS: 898 W WILSON ST CM
Vicinity: KITCHEN AND GARAGE
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
ISSUED
03/10/2009
RMD
SCOPE OF WORK: HOUSING REHAB PROJECT. ELECTRICAL PERMIT TO UPGR4DE SERVIE PANEL TO t00A ADD 7 NEW CIRCUITS IN
KITCHEN AND GARAGE.
OWNER: MELENDEZ, SALVADOR
PHONE: 949-548-7702
APPLICANT: SULLIVAN,�RICKY
PHONE: 949-933-2749
CONTRACTOR: 1 SUPERIOR ELECTRIC INC
Address: 10481RVINEAVUnit: UNIT408
CitylState: NEWPORT BEACH, CA ZipCode: 92660
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: $0.00
Electrical Permit Fee: $61.70
Reinspection Fee $0.00
TOTAL FEES $61.70
Address: 898 W WILSON ST Unit:
Ciry/State/Zip: COSTA MESA, CA
Address: 10481RVINEAV Unit:UN1T408
City/State/zZip: NEWPORT BEACH, CA
License No. 883400
• PHONE: 949-933-2749
CELL:
NOTICE: The work authorized by this permit shall wmply with all appliwble handicap access requirements under Calitomia statutes and related
regulations. (Ord. No. 92-28, § t, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for lhe work authonzed under this permit to be considered legal, such vrork must comply vrith all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
CODEf, INSPEC770NflPE
1816 Fized System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final Block/Retaining Wall
202 Pinal Faclory Fire Place
203 FinalSign
204 . Pinal Demolilion
OATE NTII TIALS C� INSPECTION ME
208 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 FinalBuiltling/OccuOancy
oa�r ix1i11RL5
.
-WO�ii KERS' COMPENSATION DECLARATION:
I hereby aRirm under penalty of perjury one of the following declarations:
❑ I have antl vnll maintain a ceAifcate of consent lo selbinsure for vrorkers'
compensation, as provided for by sectipn 3700 of Ihe Labor Code, lor the
per(ormance of Ihe work for which Ihis permit is issue0.
❑ I have and will maintain v.arkers' compensation insurance, as required by
sectbn 3700 0! the Labor Code, fa �he peAortnance ol the �+vrk (w wfiich this
pertnit is issued. My workers' compensation Insurance carner and policy
numberare: �� ( , �
Carrier: c�.� N
�_(Thrs Seclbn nred irof be comWefetl �If�e pe�mtt is valuee af one huntl�ed Collars (5100/ a less )
Policy Number. I��7 R' Z� f( Z�O O$
r���:�
❑ I cerii/y that in Ihe peRormance 0f [he work for which this permit is
issued, I shall not employ any person in goy manner so as to become subject
to the workers' compensation laws of California, antl agree that if I should
become subject �he workers' compensation provisions of Section 3700 of
the Labor Code, s i I forthwith comply with these provisions.
.3-lv-v�
C3M5'Signalure ( D"a�e,:y
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDREO THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF 7HE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm thal I am licensed under provisions of Chapter 9(commencing
with Sec[ion 7000) of Oivision 3 0( ihe 9usiness and Professions Code, antl
my license is in tull force and eflect.
���J:,:. i�3 r�v ���#� c_.-� �
--�.-:-,-� 3-to -o ^L
Cy ' tSgnaWre o,OalBi"
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn tha� there is a Constructbn lentling agency !or the
performance o! the �+ork fa which ihis permit is issued. (Sec. 3097, Civil Cqde�.
Lender's Name:
Lender's Adtlress:
OWNER-BUILDER DECLARATIONS:
I hereby aHirm Ihat under penalty of Oery'ury that I am EXEMP7 FROM THE
CONTRACTORS UCENSE LAW for the following reason (Sec. 7031.5,
Business and Pro(essions Cotle: Any ciry or counry which requires a permil to
construct, alter, improve. demolish, or repair any slrucWre, D�or to its
issuance, also requires the applicant for such permit to file a signed statement
Ihat he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing with Section 7000) o( Division 3 of Ihe
Business and Professions Code) or that he or she is exempt therefrom and
lhe basis for the allegetl exemption. Any violation of Seclion 7031.5 by any
applican[ for a permit subjects the applicant [o a civil penalry of not more than
five huntlred dollars ($500).):
❑ I, as ovmer of the property, or my employees with wages as their sole
wmpensation, WILL DO THE WORK, and the stmcWre is nol intended or
oRered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply ro an owner of property who builds or improves
thereon, and who does such work himself or hersel( or through his or her own
employees, provided ihat such improvements are nol intentletl 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 provinq 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 construq the pmject (Sec. 7044, Business and
Professions Code: 7he cont2ctas Lirense Law dces not apply to an owner of
property who builds or impmves thereon, and who contrects for such prqect vrith
a cont2cfa(s) license pursuant to the Contractors License Laws.).
❑ I am exempt untler sec.
Business and Pro(essions Code for this reason:
](IAd6(3/0])
Owner ID venfetl by tl r5license. ❑ Ves ❑ No .. .�
Dnver's License No. Expires:
Verification of Ovmership by (type of tlocument, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby certHy that no excavation frve (5) a more feet in depth into wfiich a
person is required to tlescend, will be matle in connectbn with work authonzed
by this pertnil, antl that no building structure, scaffolding, falsework, a demolition
or dismantling �hereo(, will be more �han thirty-siz (36) feel high. (Chap. 32, Grp
2, Art 2, Sec. 341, Ttle 8, California Administrative Code).
❑ As ovmer-builder, I will not employ anyone [o do work which would
require a permit from ihe Division o( Intlustrial Safety, as noted above, unless
such person has a permit to tlo such work from the tlivision.
Applicanfs Signalure Date
Division of IndusMal Sa(ery Permit Number _
H/1ZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
7. Will the applicant or present or fWure building occupam need ro fle and
certify a Business Plan !or emergency response ro release or threatened
release of a hazardous ma�erial? ❑ Yes ❑ No
(Section 25505 of ihe Califomia Health and Safery Code requires, with some
exceptions, lhat a Business Plan be fled with the Costa Mesa Pire
Depariment by every business which has at any one time during a reportetl
year a quantity of hazardous materials equal b or greater than a weight ot
500 pounds, or a volume of 55 gallons, or 200 cubic feel of compressed gas
at standard lemperatura and pressure).
2. Does or will the applicant or present or (uWre building occupant neetl to file
a registration fOrm (or aCutely hazarCous material5? ❑ Ve5 ❑ NO
(Section 25533 0( the Cali(omia Health and Safety Code. with some
ezceptions, requires registration vnth the Costa Mesa Fire Department by
each business which at any one time has on hantl a quantity of acutely
hazardous matenals equal to or greater ihan a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at stantlartl
temperature and pressure).
3. Does or will the applicant or present or future building occupanl need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazartlous malerials)? ❑ Yes ❑ No
(Section 25534 of Ihe Calilornia Health and Safey Code provides that the
Costa Mesa Fire Department may require [he preparation, certificalion and
filing with the Fire Department of an RMPP by businesses which are required
to register awtety hazardous materials with the Fire Department.
4. If an RMPP is presentty required, has Section 25534 of the Califomia
Health and Safety Code Deen fully complied with? ❑ Yes ❑ No
5. Does or will the applicanl or presenl or future building oCcupant require for
the work which is the subject of this application a permit for such construction
or modification from Ihe SoWh Coasl Air Quality Management District or fmm
any olher air polWtion control district or agency? ❑ Yes ❑ No
(Sec�bn 658502 of the Califomia Govemment Cotle reQuires that the requested
in(wmation 6e fumi5hed on applicalions (a rwmresidenf�al building pertnits).
6. Will any part of the facility ro be constructed under this permil be vnthin
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
Qf "yes", the faciliry must meet Ihe requirement of Sections 25534 and 42303
of Ihe Califomia Health and Safery Code).
7. If a permit from the South Coast Air Qualiry Management District or other
air pollulion control disUict or aqency is required !or lhe work which is the
subject of this applicalion, have all of the disclosures prescribetl by Califomia
Health and Safety Code Section 42303 been matle? ❑ Yes ❑ No
8. Qf "yes". attach cerlifcate o( compliance from Ihe appropriate air pollution
conhol oKcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury the
intortnation given above is correct I agree ro comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
SiB�aWre Oale
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify untler penalry of perjury lhat I have read this application and state t�at
the information given is correct I agree to comply with all state laws and ciy
ortlinances relating to buil�ing construction, and authorize representatives of
the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not ro occupy or allow occupancy of any building
au[horized by this permit until final inspection.
Slgnalureo Le alOwner(s) oaie p
�'—'I( D _� l
� �ArMbr u zCCFppIRan�' "pal�"' e —
Silvia Kennerson FAX#: 714-754-5330
CITY OF COSTA MESA
Neighborhood Improvement Program
Emergency Grant Work Write Up
Name: Salvador & Maria Melendez
Propertv Address: 898 W. Wilson Street
�
Home Phone: 949-548-7702
Work Phone: N/A
All work is to be done per City of Costa Mesa Building, Planning and Public Works Codes. In order to establish
standards of qualiry, the detailed specifica[ions may refer to a certain product by name and/or from a major
manufacturec This procedure is not to be construed as eliminating from competition o[her products of equal or
be[ter quality by other manufacturers. The Contrac[or shall furnish Ihe list of proposed desired substi[u[ions prior [o
signing the contract. All items listed on the work description, unless otherwise specified, shall include all patching
and finish work, including trim, hardware, patching and finish painting and/or staining. The Contrac[or is
responsible for all permi[s, fees, City business licenses, plans, e[c.
Cit}' of Costa Mesa Standard Rchabilitation Specifications applies to all items listed on work description.
Estimate:
Electrical Servicr. Replace 100 amp service panel, stucco repairs and paint, provide
and install 7 new circuits, remove exposed Romex garage, pipe and wire; and
repaidrewire kitchen li�hdswi[ch to meet curzent electrical code requirements. Obtain
all required permits from the Buildin2 Department.
TOTAL
$2,265
$2,265
I have reviewed the above work description and understand [hat any changes, additions or deletions shall have prior
approval by the City of Costa Mesa Neighborhood Improvement Personnel.
Signature of Property Owner
Date
Signature of Contractor Da[e
, -
CITY OF COSTA MESA
� avno►N� �nr►s�oN �� '
� _ � DEVELOPMENT SERVICES DEPARTMENT
� PERMIT P RMITNUMBER
�� d0'
B98-01483
(714) 754-5273 • Fa�c (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 898 W WILSON ST
Suite:
Vicinity:
Parcel Nunmber: 42235319
Applicant: MELENDEZ, SALVADOR
Address: 898 W WILSON ST
COSTA MESA,CA � �
owner: MELENDEZ, SALVADOR
Address 898 W WICSON ST
, COSTA MESA,CA
Contrector: � - -
Addressi � � � ,,��� �
BUILDING PERMIT
Zoning:
Phone:. 949-548-7700
Zip: 92627
Phone:
Zip: 92627 ` � .
Status: ISSUED
Applied: 08/19/1998
Issued: OB/19/1998
' ' , Phone: � .
ZiP .
. ' � � License��
Arch / Eng : - �'� , � - • , �
Address: � � ' .
. .. �� ' Phone: � � , � . . - .
' . � � ZiP: - - . .
� License: - � � �
SCOPE OF PERMIT
,TEAR OFF & REROOF WITH 30 YEAR COMP. SHINGLES. - .
Plan Check: $0.00
Permit: $56.75
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
, FEE SUMMARY
- -_ � �
. /
�
Total: $57.25
� PLANNING & ZONING '
SETBACKS
MAIN STRUCTURE Front
ACCESSORY Front
0-0 Rear 0-0
0- 0 Rear 0- 0
PARKING Existina: o
NOTES:
Required: 0
Calc Valuation: s�,eoo.00
Claim Valuation: E�,aoo.00
Left - 0. 0 Right
Left 0-0 Right
Pr000sed: 0
0- 0
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
requlred inapectiona and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
WORKERS' COMPENSATION DECLARATION:
I hereby eHirtn under penelry of pe�ury one of the tollowing declaretions:
❑ I have end will maintain e certificate ot consent to self-Insure for workers' compensetion, es provitletl tor by sectlon 3700 of the Labor Code, for the pertormance of the
work for which this permit is issued.
❑ I heve and will maintain workers' compensation in5urence, as required by sedion 3700 ot Ihe Lebor Code, for iha peAortnence ot ihe work for which this pertnit is issued.
My workers' compensatlon Insurence cartier entl policy number are:
Carrier: - Policy Number:
(Thls secNon need nat be crompleted i/ fbe permif is valuetl et one hundred dollars ($100) or /ess.)
❑ I certity that in the pertormance of the work for which this permit is issued, I shell nm employ any pereon In any manner so es to becoma sub�ect to the workers'
compensation laws of Cali(omie, and agree ihat if I should become subject to t�e workers' compensation provisions of Section 3700 oi the Lebor Code, I shell forthwith
comply wiM these provisions.
ApPlicant Signature: Date:
WARNING FAIIURE TO SECURE WORKERS' WMPENSATION COVERAC+E IS UNLAWFUL AND SHALL SU&IECi PN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE NUNDRED
TFIOUSAND Dd1ARE (E100,OW), IN AD�RIIXJ TO THE WST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 310fi OF THE L�BOR CA�E, IMEREST, AND ATiORNEV'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby eflirm Ihat I em licensed under provisions of Chapter 9(commencing with Saction 7000) of Division 3 of ihe Business entl Professions Cade, antl my license is in full
force Bntl eBecl. Lia u� Gass 8
Contrectofs Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby eifirtn Ihat Ihere is e construction lending agency for the perfortnance of Ihe work For which ihis pertnit is issued. (Sec. 3097, Civil Code).
LentlaYs Name: Lentlar's Adtlress:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby ettirtn ihat under penalty ot perjury Ihat I am EXEMPT FpOM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business end Professions
Code: Any ciry or counry which requires a pertnit ro construct, elter, improve, demolish, or repeir any structura, pnor to its Issuance, elso requires the applicant tor such permlt
to iile a signetl statement ihat he or she is licensed pureuent to the provislons of the Contrectors License Lew (Chapter 9(wmmencing with Section 7000) ot Division 3 of ihe
Business antl Professions Coae) or Ihat he or she is exempt Iheretrom end the hasis for the elleged axemption. Any violatlon oi Section 7031.5 by eny applican� for a pertnit
subjecls the applicant to a civil penelry oi not more than frve 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 oMeretl for sale (Sec.
7044, Business and Professlons Cotle: The Contrectors License Law does not apply to en owner ot proparty who builds or improves thereon, and who does such work
hlmself or hersetl or through his or her own employees, provitletl Ihat such improvements ere not intentletl or ottered for sale. tl, however, ihe bulltling or Improvement is
sold within one yeer ot completion, the owner-buildar will have the burden of proving thet he or she did not build or improve tor purpose of sale.).
❑ I, es owner af ihe property, am EXCLUSIVELV CONTpACTING WITH LICENSED CON7RACTORS to canstruct ihe project (Sec. 7044, Business and Professions
Code: The contractors License Lew tloes not apply to en owner ot properry who builtls or Impmves ihereon, and who coNracis for such project with e contractor(s)
license pureuant to ihe Coniractors License LawsJ.
❑ I am exempt under sec.
Signeture:
Owner ID verifietl by dnvefs license. ❑ Ves ❑ No
Business antl Pmtessions Code for ihis reason:
Vetlfica0on oi Ownarship by (rype of documen�, i.e. - property tex blll or deed):
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICA710N:
Drivers License No.
Date:
Ezpires:
❑ I hereby certily thet no excavetlon flva (5) or more feet in depth Into which a person Is required to descend, wlll be mede in connection with work authonzed by this
pertnit, end that no building stmcNre, scaHolding, felsework, or demalition or tlismentlinq thereof, will be more then thirry-si: (36) feet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Title e, Califomia Administrative Cade).
❑ As owner-builder, I wlll not employ anyone to do work which would require a pertnit irom the Division of Indusinal Sefery, es notetl above, unless such pereon has a
pertnit to do such work fram the division.
Signature: Date:
Division of Industnal Safery Permlt Number:
CERi1FlCATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certity under penalty of perjury that I have read this epplication and state thet the informetion given is
correct. I agree to comply with ell stete laws end ciry ordinences relating to building construction, and authorize representetives of �he City of Costa Mese to enter upon Ihe
above-described property tor Inspeclion puryoses. l agree oot to occopy or altow ocwpancy of any h�ilding authorizad by Mis permH uMil final inspadion.
Signeture OI Legal Owner(s) Date
AnNOr Aulhonzed Applicant
COOE I INSPECTON TYPE
161fi Fixed System Finel Fire Prevention
j288 Pool Spe Final
200 Final Re-Root
201 Final BIocWRetaining Well
202 Finel Fectory Fire Plece
203 Final Sign
204 Final Demolitian
204Gd8
p� �{,5 SppE1 ixsvecnoxTrre
208 Final Mechenicel
20B Final Plumbing
210 Finel ElecMcel
212 Final Fire Preventian
220 Finel Planning Approval
222 FinalSite
250 Final Building/Occupancy
�dff U�AlS
'L+c�i`-Y ✓.��Zs�'
OWNER �j�jppV TI]V83tiR8ri't-COIRD3IIV� DATE 11-1&—{6 .
JOBADDRES3 898 West. Wilson,Street BUILDINGPERMIT,N0.2798
GENERALCONTRACTOR $.�r.Nunsaker VALUE s 8,�56.i�
� z5 s�ocK raacr 2873 Single Res. w/att gar
GROUP I Sc J TVpE V � ZONE RLL FIRE DISTRICT Z6�.S
PERMITSISSUED
INSPECTIONS � DATE I SUBCONTRACTOR I
�� /��" DATE NUMBER
Footina Trenr.h /� lJ i�. 1 i=�
Foundation Forms and Grade to
Rough Frgming j �
Plumbing� Rough to Slal��y,
Plumbing, Rough Compl�
Temporary pole
Wiring, Rough
Heating, Rough
a 'ng in 1 _ �
� ew i, us d' Sewer, S
Se^'�eTanko Cesspool"'j��'
L .ig, �n Out L
Plastering /�j�
Plumbing, Finai, Fixtures Co�'.
Plumbing, Final Gas Test ( 3
Wirinq. Final
�2.
�
/ Icl I'O '
�
�
Dccupancy /y�/j �� V/; 31,5 _�, I
FOFM210 JM �0.55 �� � O� R�`1 J V /�r /�l� r SdQ����
. - Costa Mesa Bailding Department
i� � P. O. Box 3!7
COSTA MESA, CALIFORNIA
FOR APPLICANT TO 1�'ILL IN
s���a��9 � �f/, u//GSa�J ST
Address ,
Costa. Mesa, California
c� sssc. /%lo,t/�GY//�9 A�✓�
APPLICATION FOR PERMIT
2615 BUILDING �
FOR OFFICE USE ONLY
I ReceiptNo. Per�i� o.
7 D
Received by Date Rec'd. Date Issued
�,.�/ l,�-i.� -a ��/g��'
Owner U/�/� / v�.57'�f,Eg�r Cp Address
Mail p /�� y ,ur Costa Mesa, California
Address /�i���0 E LT3 /�ivi7� d�. Nearest
s �� � Te� . �y Cross St.
o�t,,y""EmFG6. ��r,.Y No` %/��5� Zone No.of Type ./
Arohitector ' Lic. I Plans I /�
Engineer No. Approved
„ b D:
_Address a.'. /� -:_ . .�,M1 . ., � ,�.,i:... ----wiv���—
�'..i•.V f�2�/✓i�'�'�/�CitY Lic.
�f�arfn� wi.. . �.v. ��. �. n 11t'1 S�
I �, ' LOt
Hon No.
Metes and
ljse of .• /.
Existing Bldg: ��
Setback Lineirom rr/
No. of Bldgs O
Now on Lot
No.of 1 I No.ot
New IN Alteretion I I nddition I
Repair I I Moving I I Demolish I
Building „No.of /
Size �Q � 7" Raoms Storiey
=r�o9wa�STL. GGO I Roof '`/�� r—
erin � Covering �/1Q�✓��
Build�na�WS/A/li LE �.�i/17/GY • j
I hereby acknowledge that I have
and state that the above is correcl
with all Clty Ordinances and S1
building rnnstructton �vql+r �
3ignatureof
Pefmittee
this Application
3gree t0 Comply
APPROVALS
Foundation Location Inspector
Forms, Materials,
Under-Pinning
Frame: Fire Stops,
Bracing, Bolts
Lath.lnt.
Lath. Ext.
Plaster. Int
Authorized Agt. J ' ` � Plaster, Ext
Valuatlon Permit Fea $ aa .� O Masonry ReinTorced
�J�� Plan Check $ / I�� Bond Beam
$ � Total
� Fee 3 3. ° �I FINAL
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PLOT PLAN
Show locatlon and distances from
property Iine and between buiidinps
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