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HomeMy WebLinkAbout114 16TH ST - Building Permits . 44 ' . , 4`01"Mf CITY OF COSTA MESA BUILDING DIVISION >: / I WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: El 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 end will maintain workers'compensation insu ance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. er My workers'comp nsu nce carrier a licy numbetrlere: Carrier: pofic Numb`eiP'9' (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 whi h 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, - %agree that' should become subject to the workers'compensation provisions of Section 3700 of the Labor Cod ,I shall forthwith comply with,these provisions. y �IlcenPSlgneture /�2 Y n WARNING:FAILURE TO SECURE •iD RS ..M' NSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMP OVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TQ-ONE HUNDRED THOUSAND DOLLARS(Sim..., TION 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 f Chapter 9(commencing with Section 7000)of Dlvisio f_the Business and Pr.essions Code,and my license is in full Cndl cl lEj »-•••-P i(,n Glass• Contractors-Signature:Signature: Date: 9 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 properly,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.). O I,as owner of the properly,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 em exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,talsework,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 presQnt 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 Li 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 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 U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No 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-described property for inspection purposes.� I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection, Signatural �gal Owner(s) Date Oymay/45 .7 Amazed cant o'-'•.•�?i`:ti.—..» .� • Oate::_-1. CODE. INSPECTION TYPE, gA INTITIALS CODE. INSPECTIONpill6 INTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 206 Final Plumbing 200 Final Re-Roof /-14.—o2 I Ct 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place - r- 220 Final Planning Approval - - . 203 Final Sign 222 Final Site 204 Final Demolition — _ 250 Final Building/Occupancy _ . .- ---S 4`05 F CITY OF COSTA MESA a. BUILDING DIVISION . J 1, DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER J i /s PERMIT01-00468 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT liq Job Address: -448-E 16TH ST Status: ISSUED Suite No Applied: 06/06/2001 Vicinity: SPRAY BOOTH Issued: 06/06/2001 Parcel Nunmber: 42543104 Applicant: YOUNG, TERRY ISSUED BY: `.$,�J Address: 10110 GREEN LEAF AVE Phone: 562-941-5313 SANTA FE SPRINGS, CA Zip: 90670 Owner: SHEEHAN, MICHAEL TR Address 1842 GALAXY DR Phone: NEWPORT BEACH,CA Zip: 92660 Contractor: BRADY ALLEN WILSON GENERAL CONTRACTOR Address: 10110 GREEN LEAF AVE Phone: 562-941-5313 SANTA FE SPRINGS,CA Zip: 90670 License: 561499 SCOPE OF PERMIT 364 SF PAINT SPRAY BOOTH INSIDE AN EXISTING AUTO BODY SHOP. 12 LIGHT FIXTURES,2 MOTORS TO 10HP REF: B01-00284 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 $13.20 -12 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 v 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 S0.00 0 Circus(gen or ride) $0.00 0 Motors to lhp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $24.60 2 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 $0.00 0 TOTAL CALCULATED FEES $61.30 Intermed Pole $0.00 0 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, 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 / - 2448-46 WOO) DECLARATIONS I (MI 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: Carder: Policy Number: (This section need not be completed i/the permit is valued at one hundred dollars($100)or less.) 02CI 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 If I should become subject to the workers'compensation provisions of Se tion 3700 of the Labor Code,I shall forthwith comply with these pr vis ns. / .i Applicant Signature: I) y , Date: G f-�[/I W AND WARNING:FAILURE TO SECURE S'COM ENSATI COVERAGE IS UNLAWFUL D SHALL SUBJECT Ni EMPLOYER TO CRIMINAL ENALTIES AND CIVIL 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(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# Class# Contractors Signature:: Date: (/'4/ir 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 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 Cede: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 en owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,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? 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 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 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? 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 ❑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? 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 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. gnature Of Legal Owner(s) Date t// 4/ And/ A prized Applicant Date CODE I INSPECTION TYPE DAM INRTIALS CODEC INSPECTION TYPE DATE =ELS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical p' 19 .6/ SLL./w�// / 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 011116.. sr •_ - • •fir Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. COSTA MESA CONSTRUCTION PERMIT PE RIv1.LLN ���� TRACT NO. LOT NO: UNIT NO. t' Address /�y -p1� IIIJ�� Sr L 2862 9/10/86 23' �• Applicant's Mailing Address 9 tS 7/ plit-0 C . - TYPE OF CONSTRUCTION ❑ NEW U ADD ALTERATION H REPAIR \� '❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.4 Zone Owner's Name C 2sAcj' ree-.L "P brat Phon I vl,. Cara, - - ---�—�n7 _ DESCRIPTION OF WORK/USE OF BLDG. ifi�e r.✓� Address /151 W' /C `G-si •S Main Building: Accessory Building: Arch/Eng. License No. - TYPE OF PERMIT H GRADING El FOUNDATION 0 STRUCTURAL E Front 0 Address , - e - - �t ❑ TENANT %ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Nam -124- :.t!✓ S AarLd Phon(71/7823 �o 0 OTHER C Ri ht N /� ,/ PROJECT DESCRIPTION SQ. FT. OCCUPANCY g Address(mailing) cf • '� �• ' . • ' j' K G CON ST RUCTION TYPE VALUATION$ _ $ Left - ;R City License No. - ZONE GRADING CU.YDS. - ACRES LICENSED CONTRACTOR DECLARATION ' Ping. Ref.4 - Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: Planning Notes: 0 with section 7000) of Division 3 of the Business and ProfesSjgnj tsantl M my license Is In full foT /rf��.and¢-lfect. JJ f(/C� j1�l•�se3�._ S License .ss •� Cl cense No._. .(ie,L,a _ 1 Date _ r�� - Signature - - . -. - PLUMBING FEES/'•-f WORKERS'COMPENSATION DECLARATI•N a Bar Sink Showers •- rCd/F�-'/ I hereby affirm that I have a certificate of content to self-insu e • a certificate 11 /! ELECTRICAL FEES , - Workers' Compensation Insurance, or a certified copy d ereof (Section Backflow Preventer Service Sink Tr) 1, Lab. C.) - - �`,j' Automatic Washer Transformer 0 15.50 KW ..cy No. Company' ' • Backflow Irrigation Sewer Cap4 1 ❑ 50+KW. 8 Certified copy is hereby furnished. ' Construction Pole Sub. Certified copy is filed with the city Building Division. Bathtubs Sewer Connection 1 LkCooking Unit Meter Ytup to 100 amps • /�y/�1/ Date Applicant ) / I • 5/✓" EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors V3 / / Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred($100) or - •/ less). - Dishwasher Solar PipingDryers ❑Gas ❑Electric Sub Panel I Certify that in the performance of the w•rk for which this permit is issued, I -- shall not �eymplPo�ynsany person in any ,�y� er so s to deco e subject to the - Drinking Fountains Solar Tank Fan t Workers' 7minat flaws of Calif,-, •. . / • • �� - Motors/ 0.1 HP iX-Bea 'S• C Date _ ,O /T AO Signature / .• .. _ I.. r - -- Floor Drains Swimming Pool w/Spa F.A.U. NOTICE:If,after making this declara ion, yo• sh•uld •-come 540r t to theInc.Solar 09-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you my{t orthwithFloor Sinks Urinal comply with such provisions or this permit shall be dee revoked. _-, • Fixtures Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets .Water Closet Boxes Device I hereby affirm that there is a construction tending agency for the performancePole Light of the work for which this permit Is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name - Range Lender's Address Kitchen Sink Water Service - - - OWNER BUILDER DECLARATION Switches ' Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-WashGarba , following reason (Section 7031.5 Business and Professional Code: Any city or ge Disposal Standing Sections county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays Generator❑0.5 KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor . to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000)of Division 3'of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section . '.5 by any applicant for a permit subjects the applicant to a civil ity of not more than five hundred dollars($500). as owner of the Property or my employees with wages as their sole Reinspection Fee. I $15 Issue Fee $ 3 _ compensation, will do the work,and the structure is not Intended or offered Reinspection Fee I $15 Issue Fee $ 3 for sale (Section e Business and Prf a property Code: The Contractor'smproveMECHANICAL FEES ern Law does notapply to o owner f a orwho builds or improves thereon, andwho does such work ovehimself/herselfntsarot through his or her own - DEVELOPMENT SERVICES REQUIREMENTS: employees,'il, tnat such r poe are not Intendedwihiooffered com- Boiler Hood or Type I 0 • sale. If, however,wthe building improvementfro i sold within one year of rem- Canopy Type II 0 Zoning Approved By Date prove for the owner will have the burden of proving he/she did not build or im- Duct-Under Ground pBuilding Approved By /� Date p-ID*0 I, the purpose the pf ope). '�/lY) / ID-b'f� ❑ t rs owner of the a project am tu lively sinesscontracting with licensedioncon- Duct-Structural' Refrigeration System Application Issued By nate hetors tactorsconstruct the project (Sections 7044, tos Business and Prof property Code: The Contractor's License Law does not gra t to ans owner je pro ithta who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU builds or improves thereon, and who contracts for such projects with a con- SUMMARY OF FEES tractor(s) license pursuant to the Contractor's License Law). I am aware thatExhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $' SMIP $ proof of their Worker's'-Compensation Insurance should be provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG 4 Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ -ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BTI, aI4-CO GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives is city "ter on the above-mentioned pro erty for inspect]. ••ses. _ MECHANICAL $ �,r� TOTAL FEE $ t ....1-4:90 .--p4y� ��� Date _ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' License or 'It• �' CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting;Goldenrod - Assessor — — , I CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1:Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55.'Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57;APPROV-AL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd..Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring' t I c7 o.."r.y.o.n- L 67. Fencing &Access Approval' 17. Rough Wiring Sign 68. APPROVED FOR P.,LASTERING fb 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE-DEPT. REQUIREMENT 20, Rough Factory Fireplace APPROVALS -,Permit# t _ 21, Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT.REQUIREMENT 31. Plaster Brown Coat • 79. FINAL INSPECTION - 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric - Notes/0-j,- c` I .e ssor. Gin nos 34. Final Heating & Air Conditioning // b3J-s Ir.. rLaa.F a toe rt. 4,r . e Art>>rl 35. Final Gas Pipe-Test 17b5 682 a, ngra/rts2 c✓e za 36. Hood or Canopy ,i0G-ll-k Co SS n vi , - 11/411, , 37. Final Factory Fireplace b.,in"-co Oa P.°rt..it- 0.,. 0.3 n rr 38. Final Plumbing O �1 / J ry �Q�/ V a + Co. /a -4.0.I As of 1, ;sr'Yn?r.'lV.%. 39. Water Service-Final 3-/c-e? per _ / Q, Sc e,�'j C/� !7 ! I �Y�ccr C{�-e� 40. Gas Service-Final on the Ac4-e Shp Store 41. Solar Domestic-Final ?regent owner cird K ' 42. Backflow Preventer • iA..,1.`O„{" MO.0r(s)W0,5__ a.c/c/ d ran • 43. Backf low Irrigation 19$3 eve rthc nut tookecI oK 44. Landscape Irrigation System arepS4.64 res we r no vt AiCes-1 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date t I 4` F CITY OF COSTA MESA • , .. BUILDING DIVISION F I •w�,� � DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT 4. irLik /,• B01-00284 cRpTio d (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 IN- Job Address: 1dF8 E 16TH ST Status: ISSUED Suite: Applied: 03/05/2001 Vicinity: .)94 y fer'Hi Issued: 06/06/2001 Parcel Number: 42543104 Zoning: Applicant: YOUNG, TERRY ISSUED BY: #_____ Address: Phone: 562-941-5313 Zip: Owner: SHEEHAN, MICHAEL TR Address 1842 GALAXY DR Phone: NEWPORT BEACH,CA / Zip: /92660 Contractor: 3.t 5 4�//les /) l,S n 4 877 Cron ,', '6&'< Address: /t)lk/d 6reeh leaft e: Sia Fe tit, C 5-e2 - 9 y/ 5-3/3 Zip. 1,0670 License: S/ / 4179 Arch : (� Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT • ADD ONE 364 SO. FT PAINT SPRAY BOOTH INSIDE AN EXISITNG AUTO BODY SHOP. FEE SUMMARY Plan Check: $254.31 . . _ . Calc Valuation: $25,000.00 Permit: $391.25 Claim Valuation: $25,000.00 SMIP Res: $0.00 • SMIP Corn: $5.25 Other: $0.00 • Inspection: $0.00 Total: $650.81 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 PARKINGExisting: 0 Required: 0 Proposed: _0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No. 92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) 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 et 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 if I should become subject to the workers'compensation provisions of S ctlo 3700 of the Labor Code,I shall forthwith comply with these•r- 'sion / ) Applicant Signature: . Date:a� 41 Date: b �! WARNING:FAILURE TO SECURE •RKERS'CO -EN'�ION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRI INAL ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION T. "ST 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.q Class N /��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). Lenders 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 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: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,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 ❑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)? ❑Yes 0 N (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? Yes IJ No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for nonresidential 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 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 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) sate _ as I / Aridd)/:utho ed Applicant Date CODE# INSPECTION TYPE / our IMmAL$ COD€s INSPECTION TYPE DAA INTMALS 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 L7� / ' MF • CITY OF COSTA MESA 41111 BUILDING DIVISION F .�i DEVELOPMENT SERVICES DEPARTMENT RMIT NUMBER PERMIT P01-00048 (714)754-5273 • Fax(714)754-4656 • www.ci.coste-nyf sbPRESSION PERMIT ' 77 FAIR DRIVE,COSTA MESA,CA 92626 LI Job Address: 1.146 E 16TH ST Status: ISSUED Suite: Applied: 03/12/2001 Vicinity: NEW SPRAY.BOOTH " Issued: 06/11/2001 Parcel Number: 42543104 Zoning: ISSUED BY: Applicant: FIMBREZ, FRANK Address: Phone: Zip: Owner: SHEEHAN, MICHAEL TR Address 1842 GALAXY DR Phone: NEWPORT BEACH,CA Zip: 92660 Contractor: RIGOLI FIRE EQUIPMENT CO Address: 2526 N LOMA AVE Phone: (626)579-9830 S. EL MONTE,CA Zip: 91733 License: 524249 SCOPE OF PERMIT INSTALL FIRE SUPPRESSION SYSTEM IN NEW SPRAY BOOTH FOR"SOUTHERN AUTO BODY". REF:B01-00284 FEE SUMMARY Plan Check: $54.11 Calc Valuation: 52,500.00 Permit: $83.25 Claimed Valuation: 52,500.00 Other: $0.00 Total: $137.36 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 2446-46(6/O0) DECLARATIONS %T WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O 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. 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 orkers'compensation Insurance carrier and policy number are: Cartier: }7.47 Policy Number: /.5.7 /Ir Cl/ (This section need not be completed If the permit is valued at one hundred dollars(5100)or less.) ❑ I certify that in the performance of the work for which this mil Is Issued,I shall not employ any person In any manner so as to become subject to the workers' compensation laws of Car ,and agree that If become subject to the workers'compensation provisions of Section 3700 yyy the Labor Code,I shall forthwith comply with these pres /i/0 / Applicant Signature: G - Date: / WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAC�ISUNLAW FUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL 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 ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under9 vi omens f Chin er• .•mmencing with Section 7000)of Division 3 of the Business and Prof ssjpns ode,and my license Is In full C force andteffect.Lie.e /l`7` Classat : a Cr (7 ContractoYs Signature: � / _ Date: /j /(-)/ 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 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.). O I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,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 ono time has on hand a quantity of acutely hazardous materials equal to or greeter 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? 0 Yes 0 No ._ _—._._. __._ ___. .i_building oorwillbuildingis or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? �Yes LJ No (Section 65650.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan of the facility to be constructed under this peril 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 fromn the South Coast s Quality crri ed Management la Iricf or other epollution controloon3agency? is required for the work which is the subject of [his application,have all of the disclosures prescribed by California stir and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air lution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of pe'try 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.1 agree not to occupy or allow occupancy of any building authorized/bey,this permit until final inspection. Y/ SI ILegal or(s) //i/D Yate And/Or Authorized ' nt / Dale ;ODE r INSPECTION TYPE PEE INTITIAL$ ;ODE E INSPECTION TYPE USE INTRIALS 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 q–/0'O1 '').14 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy `5MF CITY OF COSTA MESA t501 (�) BUILDING DIVISION f • r_l DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT M01-00296 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT IN- Job Address: -9111 E 16TH ST Status: ISSUED Suite No Applied: 06/06/2001 Issued: 06/06/2001 Vicinity: SPRAY BOOTH Parcel Number: 42543104 ISSUED BY: n. Applicant: YOUNG, TERRY Address: 10110 GREEN LEAF AVE _ Phone: 562-941-5313 SANTA FE SPRINGS,CA Zip: 90670 Owner SHEEHAN, MICHAEL TR Address: 1842 GALAXY DR Phone: NEWPORT BEACH,CA Zip: 92660 Contractor: BRADY ALLEN WILSON GENERAL CONTRACTOR Address: 10110 GREEN LEAF AVE Phone: 562-941-5313 SANTA FE SPRINGS,CA Zip: 90670 License:561499 SCOPE OF PERMIT 364 SF PAINT SPRAY BOOTH INSIDE AN EXISTING AUTO BODY SHOP. 1 VENTILATION SYSTEM REF: B01-00284 FEE SUMMARY Quantity - Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $0.00 0 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $10.65 1 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Ref rig 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 $0.00 0 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 \ $0.00 0 Over 50 hp/Over 1,750 BTU i $0.00 0 Appliance $0.00 - 0>v Boilers. - . Fire Dampers $0.00 0 Up to 3 hp - - - $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 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 $34.15 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, 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 2446-46(6/001 V DECLARATIONS I fI 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 carder and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued et 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 if I should become subject to the workers'compensation provisions of Section 3 00 of the Labor Code,I shall forthwith comply with these provislo s. / Applicant Signature: "/.tel (! Date: f7 6 ) WARNING:FAILURE TO SECURE WORKERS' P SATION COVERAGE IS UNLAWFUL AND SHALL suBJECT AN EMPLOYER TO GRIM NAL P TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITI 0 THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION axe 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.Lic.x Dlass Contractors Signature: Date: � 2 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 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 end Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of properly who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,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 e,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? 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 0N (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? f�Yes ❑No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (II"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 end 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. Ignature Of Le al ner(s) Dat ,r /9 -_ n Or Aut ze pplicant `///Da/te CODE I INSPECTION TYPE gait IIITmAL4 CODE I INSPECTION TYPE PATE f(�AL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1 o-9-0( L4<�rwtI 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 E CITY OF COSTA MESA 44, 9 BUILDING DIVISION ).:J L DEVELOPMENT SERVICES DEPARTMENT PERMI UMBER 1IIP. 1 PERMIT o � b.°Aq,r. Vi`,o P01-00351 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT 114 Job Address: '44$'E 16TH ST Status: ISSUED Suite No Applied: 06/06/2001 Issued: 06/06/2001 Vicinity: SPRAY BOOTH Parcel Nunmber: 42543104 ISSUED BY: Applicant: YOUNG, TERRY Address: 10110 GREEN LEAF AVE - Phone: 562-941-5313 SANTA FE SPRINGS,CA Zip: 90670 Owner: SHEEHAN, MICHAEL TR Address 1842 GALAXY DR Phone: NEWPORT BEACH,CA Zip: 92660 Contractor: BRADY ALLEN WILSON GENERAL CONTRACTOR Address: 10110 GREEN LEAF AVE Phone: 562-941-5313 SANTA FE SPRINGS,CA Zip: 90670 License: 561499 Arch / Eng: Address: ' Phone: - Zip: -- License: SCOPE OF PERMIT 364 SF PAINT SPRAY BOOTH INSIDE AN EXISTING AUTO BODY SHOP. 1 GAS OUTLET(1-4) REF: B01-00284 , • FEE SUMMARY AMT QTY:. AMT -QTY - AMT QTY ISSUE FEE • .$23.50 � _ ; Laundry Tub/Washer $0.00 0 =Sump Pump $0.00 0 Backflow irrigation $0.00 , 0; Landscape Irrigation ,- $0.00 0 r - - Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 P Trap Primer $0.00 0 Bathtub $0.00 0. 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) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 -0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 - Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $6.15 1 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 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: $29.65 c9A.u4IENT3 r SrtCIAL CuNur 1 mina 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 • i • v 244646(6/00) DECLARATIONS ( r-, 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 Cale,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 if I should become subject to the workers'compensation provisions of Se tion 3700 of the Labor Code,I shall forthwith comply with these prov'sions. ) G /£4/ Applicant Signature: ✓f/1�, Date: / WARNING:FAILURE TO SECURE WORKERS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDM THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under 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.M Class# Contractors Signature: Date: ?/r CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a constru tion 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 I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I em exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,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? 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 0 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 apermit 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 California Government Code requires that the requested information be fumished 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 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 MID 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. /Sonature Of Legal Owner(s) ��///� / Date / ' And/dr •.�morfz(d`¢pplicant Date CODE F INSPECTION TYPE PATE WEALS CODE! INSPECTIONTYPF PATE INTLTIAL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical ,� 1266 Pool Spa Final 208 Final Plumbing )o" —0( 1 .01 200 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 CIT'-'1F COSTA MESA, BUILDING SAFE- 7IVISION : 4 es N ' • POST IN CuNSPICUOUS PLACE ON THE JOB NOTICE Schedule inspection one workday in advance. To schedule inspections, call (714) 754-5626. Provide the following information: 1) Permit number, ob address, 3) Inspection item number, 4) Day and date you need the inspection. _ e TA— Building . Building Address: �5 /4 '`_11-5-7- // Owner: )22_t. �.fin.-Lee...,..„.J'-' e GL _ _riPermitp:,9/9,21'/ Electrical Permit#:/4C7 01/4' T7 Contractor: ate, A),e).„--,43-,-, Mechanical Permit It Q/4�/(O Plumbing Permit# 1)J-1�•3S/ Job Descriplion !!! Type: Group: I Plan Check No. • Issue Date: 6/‘/O N/O / - -��/(//'�/-C�� L /�,�"jr / J NEW ADD - ALTER REPAIR MOVING DEMOLISH "►`! ���Q,�Q -Y `i D PERMITS EXPIRE 180 DAYS (6 MONTHS)IFROM ISSUE OR �LASyITC1I`N-S ECTION S11 n�Y r ljUi u}�1"yr1(' r.hlr, .y'. ;i,! 5 "�,,a. -..... . . . .� A'1-7 .-wit.Je �". ,Cant r 1 j '14:- ♦.4l itinh Sfli.i*a12F�:' I[a'n„`�lu'�..Gad, .vdxr2''2,1 :11 ..(.;' .'^rr' COWSTRUCTIONAPPROVALSA':/;.a` .r'w.r:r`,V5t;;e1 ,.+�I'rx a $0.1ht Item U STRUCTURAL Date Inspector Item U POOL&SPA . Date Inspector 4 Footings 94 Pool&Equipment Location 6 Slab 96 Steel Reinforcement — 8 Structural Floor 100 Electrical Bonding 11 Pre-Inspect Roof 102 Rough Plumb&Pressure Test 12 Roof Sheathing 104 Approval to Cover•Gunite 14 T-Bar Ceiling-Structural 106 Elec Conduit-Underground 16 Shear Panel 108 Gas Pipe/Underground Test 18 Frame&Flashing 110 Backwash Lines,P-Trap, ' 20 Lathing&Siding Underground 22 Insulation 112 Approval to Deck 24 Drywall Nailing 116 Pool Plumbing System-Final •26 Raster Brown Coat 118 Pool Electrical-Final 30 Pre-Grout 122 Fencing/Access/Alarms Approval 33 Disabled Access 124 Approval for Plastering 126 Pool/Spa Systems-Final 1 z;1ii.kiir,k.Ar,, F,IR,E;DEPARTMENtAPPROVAL»i•f'; s,,, 1610 Overhd Hydro/Overhd Rough 1612 Dry Chemical 1614 Dry Standpipe ELECTRICAL 1616 Final-Fixed System 36 Ufer Ground — S * :ASP v_o'<---- 38 Elec Conduit-Underground _ hly;1; d .J ,FINAI±;INSPECIFIONS I a y` „``'ig.fa 44 Rough Dec•Wiring 4' /f B/ or . Jr -Call(714)754.5626 for the following: Date Inspector 46 Rough Elec. Conduit 200 Final Re-Roof 48 Elec T-Bar Ceiling 201 Final Block/Retaining Wall 50 Elec Power Final 203 Final Sign 51 Temp Power Final 204 Final Demolition 206 Final Mechanical 208 Final Plumbing ,J,/J/�� 210 Final Electrical gl y/o1 y( v(.G_. PLUMBING&MECHANICAL Call(714)327-7400 for the following: Date Inspector 52 Soil Pipe-Underground 212 Final Fire Prevention 54 Water Pipe-Underground Call (714)754-5335 for the following: Date Inspector 55 Underground Gas 214 Final Transportation Svs. 62 Rough Plumbing Call(714)754-5671 for the following: Date Inspector 64 Rough Mechanical 216 Final Engineering Approval 66 Rough-Factory Fireplace Call(714)754-5307 for the following: Date Inspector 66 Sewer System 218 Final CMS!)Approval 7.2 Gas Pipe-Rough Test 5 fil Cr_ 9-let-p( VS11 Call (714)754-5245 for the following: Date Inspector 90 Gas Pipe Test-Final N oYL 220 Final Planning Approval 92 Water Service-Final Call(714)754-5626 for the following: Date Inspector 222 Final Site NOTES: SEE REVERSE 250 Final Building/Occupancy 055946 (rev.05/15) ' Costa Mesa Building Department /APPLICATION FOR PERMIT 111 EAST 20th STREET 1" 3BUILDING - COSTA MESA, CALIFORNIA • FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN • Receipt No. Permit No. Building ! J -� Address /7 r ! /6 .GL i) Costa Mesa, California Received by Date Recd. FDDate Issued Nearest scree...,a/` '-�6 -dl` a' ....j/ -1 Cross St. Building '/ Address / / S" - /c- Owner -Owner Zo.-en z 5'p;tt, Costa Mesa, California Mail Address 2V& Ocean j' -d Nearest Tel. c u Cross St. City Na'p*• j-ffs, No.L4 g:y Zoo No.of Typ� � Group Architect or Lia E Plans I �Syf� Cay • Engineer Act/ Ia y nd No. (r&V 7? Approved Address /G7</ 4 Marry 5, A• by Date l'',, City Lie. CORRECTIONS .tractor $4v.. 4'�9/erchitr No. 277d Address 16/f /Y, Main SA Legal I 'Not / I Bloc#4.p, Pt/ffi1 Tract • Description No. .p (Attach Metes and Bounds) ARAy/17-c7/-/- • No.of Bldgs, �p Size of Lot /81.q lx /'73` Now on Lot - Z- �} t7 Use of �• No.of No.of Existing Bldg. illeq . I Families I Rooms - - •.. g Setback Line from Rear Yard 'J '— G .0 _ • _ Center of Street ��''s' y 1." ''Side Yard r, n Z DESCRIPTION OF WORK • .41-nL- b 1J j � New Alteration I I Addition ICITY OF ®STA MESA Repair I I Moving I I Demolish I Building No.of Size *'7") ( /x'4-'7"Rooms ' Stories / F ',rior Wall Ioof -- ring C .2-i-1-/-on€, Covering rr /`9` APPROVALS. b.c of New Building M?* - /gee tie 6" ,A '/e Foundation Location Inspector Date �flrr�tt Forms,Materials, re �Gntwj' 6. Under-Pinning Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath.Int. with all City Ordinances and State Laws regulating building construction. CO;/ f, ` Lath.Ext. Signature of W-L • Permittee P- Plaster, Int. Authorized Mt. a -Plaster,Ext. Valuation Permit,Fee $ T 7 0�. Masonry Reinforced i, '1�� OO Plan Check$ / .S..---- Bond Beam $ ze R,:ce Feeal $ (�: Yam FINAL __ N • • CD Ct d • !WC , COSTA 1-r a - -'h:Y d:,"rOj{in a` WC 6-5''rIni sa Street • PLOT PLAN • •- Show location and distances from - , Property line and between buildings.