HomeMy WebLinkAbout332 16TH ST - Building PermitsF
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PERMIT TYPE
CITY OF COSTA MESA --
B1/ILDING DMSION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • ww.v.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
JOB ADDRESS:
vicinity:
PLUM ��
��4�1g1�� L�
DR►Sb,�"'" '
332 E 16TH ST CM
SCOPE OF WORK: WATER REPIPE
OWNER: ESPINOZA, SALVADOR
PHONE: 714-662-5557
APPLICANT: ESPINOZA, SALVADOR
PHONE: 714-662-5557 -
CONTRACTOR: OWNER-BUILDER
Address:
City/State: ZipCode:
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE: $0.00
PERMIT FEE: $33.30
TOTAL FEES: $33.30
PERMIT NUMBER: P07-00502
STATUS:
DATE ISSUED:
ISSUED BY:
SuitelU�it:
ISSUED
0 811 512 0 0 7
CAC
Address: PO BOX 10863
Ciry/State/Zip: COSTA MESA, CA
Address: PO BOX 10863 :
CitylStatelzZipt COSTA MESA, CA
License No. 000000
PHONE:
CEIL:
NOTICE: The worN authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ortl. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF fSSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
OC DEt. INSPECPONTYPE DRTE INTIIIRLS CQ�E/ �NSPECPONTYFE UAT�F IN7IML5
1818 Fized System Fi�al Fire Prevention 208 Final Mechanical
7286 Pool SOa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final BlocklRe�aining 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 BuildinyOccuOancy _'
WORKERS' COMPENSA710N DECLARA710N: r-1 fed by drivei . ,nse. �Yes ❑ N�o � � 1��/'�� ��
I hereby aKrm under penalry o( perjury one of lhe following tleclarations: � Driver's ' nse No. � E/ xoire5�.�7 ' .
❑ 1 have and will maintain a certificate of consent to se141nsure for vrorkers' � �� �
enfication of Ownership by (rype of document, i.e. - propeny taa bill or deetl):
compensation, as provitled for by section.3700 of the Labor Cotle, for Ne _ � �
pedormance of the vrork for which Ihis permit is issuetl. � -
❑ I have and vrill maintain workers' compensation insurance as required by ' �
section 3700 of the Labor Code, for the perfortnance of the �+ork for which this
pertnit is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier:
(This seclun neetl rrot be mmdeted dthe peimG's valuetl at one nunoretl tlollars (St00) a less )
Policy Numher:
[] I certify that in the perfortnance o( ihe work !or which this permit is
igsued, I shall not employ any person in any manner so as to become subject
to the vrorkers' compensation laws of California, and agree that if I should
hecome subject to the workers' compensation provisions of Section 3700 0(
�he Labor Cotle, I shall forlhwith comply with these provisions.
Aoqi�nfs SignaWre Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
15 UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAI
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARS
($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:
� hereby affirm that I am licensed under provisions o( Chapter 9(commencing
with Sec�ion 7000) of Division 3 of �he Business antl Professions Code, and
my license is in full force and eftect.
lic. # _ Class #
ConVactor's SignaWre Date
CONSTRUCTION LENDING AGENCY:
[] I hereby aHirtn �ha[ there is a constructbn lentling agency for Ihe
pedortnance of the work fa which this pertnit is issuetl. (Sec. 3097. Civil Code).
lentler's Name:
Lender's Atldress:
OWNER-BUILDER DECLARATIONS:
I hereby atfirm Ihat under penalry o( Derjury Iha� I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the follovnng reason (Sec. 7031.5,
9usiness and Professions Code: Any ciry or counry which requires a permit lo
Construct, alter, improve, demolish, or repair any structure, prior to its
�ssuance, also requires ihe applicant for such permit to flle a signetl statement
thal he or she is licensed pursuaN to Ihe pmvisions of the ContracPors
License Law (Chapter 9(commencing with Sec[ion 7000) of Division 3 of Ihe
Busfness and Profess(ons CoOe) or Ihat he or she is exempl there(mm and
Ihe basis for the allegea exemption. Any violation of Section 7031.5 by any
epplicant for a permit subjects [he applican[ to a civil penalry of not more than
five huntlred dollars ($500).):
❑ I, as Owner of the propeAy, or my employees with wages as Iheir sole
compensation, WILL DO THE WORK, and the slructure is not intentled or
oHered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builtls or improves
thereon, and who does such wnrk himsel! or herself or through his or her ovm
employees, provided that such improvements are not intendetl or oKeretl for
sale. If, however, the buildinq or improvement is sold vrithin one year of
completion, the ovmer-builder will have the burden of proving that he or she
ditl not build or improve tor purpose o� sale.).
❑ I, as ovmer of lhe property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct lha project (Sec. 7044, Business and
Professbns Code: The contractors License Law dces not apply to an owner of
property who builds or improves thereon, antl wfio contracts �or such project with
a cmtracta(s) license pursuant ro the Contractors License Laws.).
O� I am exempt untler sec. �
Business and Pro(essions Code (or this reason:
������6�5=4-��-r .vf�-:'�ri/
SgnaWre ✓ Da
305]-E6�3/0
DIVISION OF INDUSTRIAI SAFETY PERMIT CERTIFICATION:
❑ I hereby certdy that no excavation frve (5) w more feet m depih inro which a
person is required b descenQ will be made in connectbn with v,ork auttrorized
by thi5 permit, and Ihat no builtling slrucWre, scaHdding, falsework, or demolition
or dismantling Ihereo(, will be more than Ihirty-siz (36) feet high. (Chap. 32, Grp
2. M 2, Sec. 341, 7itle 8, Califpmia Administ2We Code).
� As owner-builder. I will not employ anyone to do work vfiich would
require a permit from the Division of Industrial Safery, as notetl above, unless
such pErson has a pertnit to tlo such vrork (rom the division.
APC�ipnCs Signature
Division of Industnal Sa(ery Permit Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICA710N:
1. Will the applicant or present or fuWre building occupant need to fle and
certify a Business Plan (or emergency response to release or threatened
release of a hazartlous material? ❑ Yes ❑ No
(Section 25505 0( the Califomia Health and Safety Code requires, with some
exceptions, that a Business Plan be filed with [he Costa Mesa Fire
Department by every business which has at any one time dunng a reported
year a quantity of hazartlous matenals equal to or grea[er than a weight of
500 pounds, or a volume o( 55 gallons, or 200 cubic (eet o( compressed gas
at stantlard temperature and pressureJ.
2. Does or will the applicant or presenl or fuNre building occupant need to fle
a registration torm (or acutely hazartlous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Sa(ery Cotle, with some
exceptlons, requires registration vrith the Costa Mesa Fire Depariment 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 feel of compressed gas at standartl
temperature and pressure).
3. Does or will the applicant or present or future building occupan[ need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Ves ❑ No
(Seclion 25534 of the Califomia Health and Safe[y Code provides Ihat Ihe
Costa Mesa Fire Depanment may require the preparation, certifcation antl
fling with the Fire Department o( an RMPP by businesses which are required
to register aculety hazardous materials with the Fire Department.
4. II an RMPP is presently required, has Section 25534 of Ihe California
Health and Safery Cotle 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 subjec� of lhis applicalion a permit for such cons�ruclion
or motlifcation fmm the South Coast Air Oualily Management Disirict or from
any other air pollution conlrol tlistrict or agency? ❑ Yes ❑ No
(Sectbn 658502 0f Ihe Califomia Govemment Code requires that lhe requested
infortnation be fumishetl m applications for rrornresidential building pertnits),
6. Will any part o( the (acility to be constructed under this permit be within
t0001eet from the outer poundaries of a school? ❑ Yes ❑ No
Qf "yes", the faciliry must meel lhe requirement of Sections 25534 and 42303
of the California Health antl Safely Code).
7. If a permit trom the SoWh Coas[ Air Oualily Management Dislnct or other
air polWtion control dislrict or agency is required for the work which is [he
subject of this application, have all of the tlisclosures prescri6ed by Califomia
Health and Safety Code Section 42303 been matle? ❑ Yes ❑ No
8. Qf "yes', attach certificate of wmpliance from the appropriare air pollution
control oKcer�.
CER7IFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is cortecL 1 agree to comply vrith all state laws and
city ortlinances regarding Hazardous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that 1 have read this application and state that
the infortnation given is correct I agree to comply with all state laws and ciry
ordinances relating ro building construqion, and authorize representatives of
the City of Costa Mesa to enter upon the above-described property for
inspeclion purposes. I agree not [o occupy or allow occupancy o( any building
authorized by this permit �til final inspection.
iw.l.Len � /� ' ��
'�B�aWreolLeBalO {e —� Da�e
AnOlor Aul�onzeC AppliWnl
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(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR ORIVE, COSTA MESA, CA 92626
MECHANICAL PERMIT
Job Address: 332 E 16TH ST �
Suite No `
Vicini�y: � �
Parcel Number: 42521117 �
Applicanc MANUEL SANCHEZ .
Address: 668 W 28TH STREET
SAN BERNARDINO, CA
owner: ESPINOZA, SALVADOR
Address: PO BOX 10863
COSTA MESA, CA
Contracror. ALEX CONSTRUCTION
Address: 668 W 28TH STREET
SAN BERNARDINO, CA
Phone: 909-757-2858
Zip: 92405
Phone:
Zip: 92627
Phone: 909-757-2858
2ip: 92405
License: 832016
ISSUED
10I182005
10/18/2005
ADD 1120 SF TO EXIST�NG S.F.D.; 525 SF ATTACHED GARAGE; 25 SF COVERED DECK;
AND, 47 SF FRONT PORCH. WORK TO INCLUDE: CONVERT EXISTING BEDROOM TO A NEW
LIVING ROOM, CONVERT EXISTING BEDROOM TO FAMILY ROOM, REMODEVUPGRADE EXISTING
BATHROOM AND KITCHEN, ADD NEW BEDROOM/BATHROOM AND LAUNDRY ROOM ON 1ST STORY,
ADD 3 NEW BEDROOMS AND 2 NEW BATHROOMS ON NEW 2ND STORY. ADD NEW FIREPLACE IN
EXISTING LIVING ROOM AND NEW WINDOWS THROUGHOUT EXISTING HOUSE. REF.:
BOS-01174 - � �
MECHANICAL TO INCLUDE: 1 FAU < 100K BTU, 7 REPAIR/ALT COOLINGMEAT, t FACTORY
FIREPLACE, 1 HOOD W/MECH EXHAUST, 4 VENT FANS, AND 1 3 TO 15 HP/SOO�K BTU.
ISSUE FEE
Inst FAU <700 k BTU �
Inst FAU >100 k BTU
Repair/Alt CoolingMeal
Inst / Rep. Recess Wall Htr
Re(rig Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech�Exhaust
VAV Box
Venl Fan / Single Duct
Appliance � �
Fire Dampers -
Smoke Dampers
Insl or Relocate Appl Vent
Air Handlers < 10000cfm
AirHandlers> 10000cfm
Floor Furnace
Floor or Suspend Heater
$23.50
$14.80
$0.00
$13.70
$0.00
$0.00
$0.00
$0.00
$10.65
$10.65
$0.00
$29.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
Quantity
1
0
1
0
0
0
0
�
,.
0
4
0
0
0
0
0
0
0
0
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeration Unit
Ventillation�System -
Evaporative Cooler
Commercia l I ncinerato r
Domestic Incineraror
Comoressors / Absomtion Svstems
Uplo3hp/100kBTU
3 To t5 hp / SOO k BTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp I 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilars
Up to 3 hp
3To15hp
15to30hp
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$27.15 1
$0.00 0
$0.00 0
$0.00 0
$0.00
E0.00
$0.00
5129.a5
NOTICE: 1Te vrork authodzed by this pertnit shall compty with all applicab�e handieap access..requirements under Califomia statutes and related
regulations. (Ord. No. 92•28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become vold It work is not commenced within 180 days, or if work is suspended or ebandoned
for a penod 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
requlred Inspeetlons and flnal approvel must be obtalned. Failure to obtain inspections and tinal approval will result in the expiration of this
FOR INSPECTIONS CALL: (714) 754-5626
zaes�+s �sroo�
WORKERS'COMPENSATON DECLARAnON: '
I hereby attirm under penalry ol per�ury one ol ihe following deGarations: , .
❑ I �ave end will maintain a cetliticate ot consent to setl-Insure br workers' compensetlon, es proNded for by saction 3700 of iha LaDor Code, for iha peAormence of the
work for which Ihis permit Is issuetl. . .
❑ I �ave entl will maintaln workers' compensation insurance, es required by section 3700 0l the Labor Cotle, for Ihe pertortnance of Ihe work for which this pgrtnit is issued.
My workers' compensatlan Insurence cerrler and poli�y number are: .
Carder. Poliry Numbec
(This secfion neer/ not be comp/efed i! fhe permi( is veluetl at.one hundred dollers (E 700) or leu.) .
❑ I certity that in the peAormen ork for which this permit is issueQ I shell not employ any person in any manner so as to become sub�ect to Ihe workeB'
compensation laws c i omi d�e that if I shoultl become sub�act lo the workers' campensatlon pmvisions of Section 3700 of Ihe Lebor Code, I shell torthwith
camply with Ihese prow, �
Applicant Signatur Date: %Ci " %� � G�
WARNINO: FAILURE TO $ RS' fAMPENSATION CAVERA�E IS UNLAWFUL AND SHALL SUBJEGT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVI� FINES UP TOONE HUNDRED
THOUSANDDOLLARE� OO,OOO�,INA�DITIONTOTHECOSTOFCAMPENSATIIXJ,OAMAGESASPROVIDEOFORINSECTION3]OBOFTHELABOFCODE,It�REPEST,ANDATTOqNEV'SFEES.
LICENSED CONTRACTORS DECCAHATION: ` -�
I hereby aHirm ihat I em licensed u er.piovisjo s ot Cha [er 9(commencing with Sectian 7000) of Division 3 of the Business and Profeu�s Code, end my license is in full
torce and eflecL Lic. A l� � �. �C�ass p
ContrectofsSlgnetura: � nJ�rDate: !U – /� —d�
CONSTflUCT10N LENDING AGENCY: ' `��
❑ I hereby eHirtn thet t�ere is e construction lentling egency for the peAormance ot the work for whic� this permit is issued. (Sec. 3097, Civil Catle).
Lenders Neme: Lendefs Atltlress:
Signa�ure:
OWNER-BUILDER DECLAFiAT10NS: '
Date:
I hereby aflirm Ihet under.penalry ol perjury ihat I�em EXEMP7 FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Busineu and Protesslons
Code: Any ciry or county whic� require5 e pOrmil to construct, alter, impmve, demolish, or repair any bWcture, prior to its Issuance, also requires l�e applicant for suc� permit
to lile e signetl stetement thet he or she is Iicensad pursuant to Ihe provisions of the Conirectors License Lew (Chapter 9(wmmendng with Sectlon 7000) ol DlWsion 3 01 the
Business entl Pmfessions Cotle) or thet he or she is exampt t�eretrom end the besis for the elleged exemption. Any Nolation of Sectlon 7031.5 Dy any epplicant far e pertnit
suD�ects tha epplicant to a civiPpanelty of not more Ihen five hundred dollars ($500).):
❑ I, es owner ot the propeny, or my employees with wages es Iheir sole compensation, WILL DO THE WORK, antl ihe structure is not intentle0 or otlered tor sale (Sec.
7044, Business and Prolessions Code: The Contractors License Lew does nol apply to en owner ot property who builds or improves thereon, end who does such work
himseN or herseN or through his or her own employees, provitled that such impmvemems ere not intended or otteretl for sale. If, however, Iha builtlinp or improvement Is
sold within one year of completion, ihe owneo-builder will have the 6urtlen of proving that he or she tlid not build or improve tor puryose of sale.). •
❑ I, es owner oi the property, em E%CLUSIVELY CONTRACTING WITH LICENSEO CONTRACTORS lo constmct the project (SecJ044, Business and Prafessions
Code: The contractors Licensa Law does not apply to en owner of property who builds or Improves t�ereon, end who contracts for such pmlect wlth a contreaor(s)
license pursuant to ihe Contrectors License Lews.).
❑ I em exempt under sec. Business entl Professi0n5 COdo for this reason:
Signatura: Date:
Owner ID verllletl by dnvefs license. ❑ Yes ❑ No Orivefs Licensa No.
Verification ol Ownership by (type ol document, i.e. - properry tax bill or tleetl):
Ezpires:
DIVISION OF INDUS7RIAL SAFE7Y PERMI7 CERTFICATION:
❑ I hereby certify thet no excevation five (5) or more feet in tlep�h into which e person is requiretl to tlescend, wlll be made in connection with work euthorizetl by ihis
permit, enC that no Duilding sirudura, scaHolding, falsework, or tlemolition or tlismantling Ihereof, will be more than thirty-six (36) teet high. (ChaO� 3.2, Grp 2, Art 2, Sec.
341, Ttle 8, Calilomia Atlministraiive Cotle).
❑ As ownar-builder, I will not employ enyone to tlo work whic� woultl require e Dermit Irom Iha Division ot Indusirial Safery, es noted ebove, unless such pereon hes a
pertnit ta do such work irom Ihe tlivision.
Signature: Date:
Division ot Industrial Sefery Permit Number:
CER7IFICA7E OF COMPLIANCE AND AUiHOR1ZA710N OF EMAV: I cenity under penalty of perjury thet I heve read this application end state that Ihe Informetlon given is
correct. I agree to comply with ell stete laws entl ci�y ordinances relating to building consirucllon, end euthodze representatives ot ihe Ciry of Costa Mesa to enter upon Ihe
above-descnbed property lor inspection purposes. I egree not to occupy or ellow occupency ot eny building euthorized by this permit until tinel inspectian.
COpE I. AHSPECfI0N7YVE � �¢
1618 Pixed System Final Fire Prevention
12fi6
200
201
202
203
204
Pool Spa Finel
Final Re-Rool
Finel BIocWReteining Wall
Final Fectory Fire Place
Finel Sign
Finel Demolitian -
Date
�Q��� �U�
Date
CODE� INSPECTIONTYPE �
206 Finel Mechaniwl
20B Final Plumbing
210 Final Electricel
212 Final Fira Prevention
220 � Final Planning Apprwal
222 Final Sile -
250 Finel Builtling/Occupency
��
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address: 332 E 16TH ST
Suile No
Viciniry:
Parcel Nunmber: 42521117
Applicant MANUEL SANCHEZ
Address: 668 W 287H STREET
SAN BERNARDINO,�CA
owner: ESPINOZA, SALVADOR
Address PO BOX 10863
COSTA MESA, CA ,
Contracror. ALEX CONSTRUCTION
Address: 668 W 28TH STREET
SAN BERNARDINO, CA
ISSUE KEE
Temp service test
Res. a/c package
New Res (i-2 units)
New Res (3+units)
Pool I Spa
Lighting Fixis
Recept Outlets
Switche5
Non Res Appl
Res Appl
Service l0 200a
Service to 7000a
Service over 1000a
Motors lo thp
Motors l0 10hp
Motors to 50hp
Motors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
�
�
��
►
- Phone. 909-757-2858
Zip -" 92405 -
Phone:
Zip: 92627
Phone: 909-757-2858
Zip: 92405- _.� .
License: 832016
Stams: ISSUED
Applied: 1 0/1 820 05
Issued: 10118/2005
ADD 1120 SF TO EXISTING S.F.D.; 525 SF ATTACHED GARAGE; 25 SF COVERED DECK; AND, 47
SF FRONT PORCH. WORK TO INCLUDE: CONVERT EXISTING BEDROOM TO A NEW LIVING ROOM,
CONVERT�EXISTING�BEDROOM TO FAMILY ROOM, REMODEWPGRADE EXISTING BATHROOM AND
KITCHEN, ADD NEW BEDROOM/BATHROOM AND LAUNDRY ROOM ON 1ST STORY, ADD 3 NEW BEDROOMS
AND 2 NEW BATHROOMS ON NEW 2ND STORY. ADD NEW FIREPCACE IN EXISTINGLIVING ROOM AND
NEW WINDOWS THROUGHOUT EXISTING HOUSE. REF.: BOS-01174 -
ELECTRICAL TO INCLUDE: 1 RES A/C PACKAGE, 18 LIGHT F�XTURES, 54 OUTLETS, 21
SWITCHES, AND 7 SERVICE TO 200 AMPS. ,-
� � ' Quentiry
823.50
$0.00
$54.50
50.00
$0.00
$0.00
3� 9.80
546.82
$2273
$0.00
$0.00
330.50
$0.00
50.00
$0.00
$0.00
$0.00
$D.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
0
0
0
18
54
21
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
Temp Dist System / Lighting
Busway /100 ft
Standing Section
Misc EleIXrical Equipment
Transformers up to 1 kva/kw
................up l0 10 kvalkw
.................uP to 50 kva/kw
.................up to 700 kvalkw
..................over 100 kva/kw
Low Voltage Equipment
Law Volt Wiring System / Ckt
Misc. Conduit � �
Misc. Condudor
Circus ( 9en or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks_Stand
Other Eledrical Fee T � �
Investigation Fee ,
Plan Check Fee � ,
Reinspeclion Fee
�uantity
$0.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
E0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES E197.85
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this pertnit shall compty wlih all applicable handitap access requirements under Califomia statutes and related
regulaUona (Ord. No. 92-28, § 7, 12•21-92)
EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 1 BO days, or if work is suspended or abandoned
tor a period of 180 days.
INSPECTIONS: In order tor the work authorized under this permit to be considered-legal, such work must comply with all applicable codes, and all
requlred inspectlona end final epprovel must be obtalnad. Failure to obtain inspections and final approval will result in the expiration ot this.permit,
FOR INSPECTIONS CALL: (714) 7545826 �,
zwa+e �ww�
WORKERS'COMPENSAnON DECLARAnON: • ' � '
1 hereGy aflirm under penalry of perjury one of the following tleclarations:
❑ I heve end will maintein e cenificate ol consent to self-Insure br workers' compensatlon, es proNtletl for by sectian 3700 of ihe Lebor Code, for the peAormence of the
work tor which this permit is i5suetl.
❑ I heve antl will maintain workere' compensation Insurence, es raquirad by section 3700 ol the Lebor Coda, for Ihe peAortnance of ihe work fa which Ihis pertnit is issuetl.
My workars' compensatlon Insurance carrier end policy number ere:
Cerrier: Pplicy Number:
(Thls secNon need not 6e campleted I! the pe�' is velued at one huntlred dollers ($700) ar less.) . . ,
Q' I certlTy that in tha peAorm ��f! or which Ihis permit Is issued, I shall not employ any person in any manner so as to become sublect to the workers' �
�� compensatlon laws of Rat il I shoul� become subiect to tha workers' compensetion provislons ot Section 37 of the Lebar Catle, I ahall forthwith
comply with the
� ��o
Applicem Signeture: Date: � � �
WARNINO: FAILURE TO R E0.5' COMP�ISATION COVERAGE IS UNLAW NL AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES M1D CNIL FlNES UP TO ONE HUNDRED
hKK1SANDDOLURE($ , ),IN �fiIONTO7HEC0$TOFCOMPENS/TION,OAMAGESASPROVIOEDFORINSECTION31OBOFTHEIABORCODE,IMEREST,ANDATTORNEY'SFEES.
LICENSED CONTRACTORS DECLAIiAT10N:
I hereby aHirm Ihat I am IlcenSed un �rpyiSia
lorce and eHect. LJc. N �i
Contractofs SignaWre: fi
�
9(commencing with Section 7000) of Dlvision 3 oi the Business antl P��ons Catle, end my license Is In full
Clau M ��
�'� � Date: /O — / Si" ^ O
�'�' , .'.
CONSTRUCTION LENDING AGENCY: . "
❑ I hereby eHirtn ihat there is a constmction lentling egency tor Ihe pertortnance of the work lor which ihis pertnit is issued. (Sec. 3097, Civil Code).
Lenders Neme: , Lentler's Address:
Siqneture: ' � � Date:
OWNER-BUILDER DECLARATIONS:
I hereby eMirtn thet under penalry ot perjury IMa� 1 am EXEMPT FROM 7HE CONTHACTOFiS LICENSE LAW for ihe following reason (Sec. 7031.5, Business end Professions
Code: Any ciy or county whiU requires e pem��t to construct, elter, Improve, tlemolish, or repeir eny structure, pnor to its Issuance, also requiras t�e epplicant for such pertnil
ro lile e signeA statement that ha or she is licensed pursuent to the pmWsions of the Contraaors LJcense Lew (C�epter 9(commencing with Sectlon 7000) 01 DlWslon 3 ot t�e
Business end Professions Code) or that he or she is azempt therelrom entl the basis for the ellegetl exemption. Any Wolation at Saqion 7031.5 by eny epplicant tor e pertnit
su�jects ihe epplicant to e civil penalry oi not more than five �untlretl tlollars (5500).):
[] 1, as owner of tha pmperty, or my employees wiih wages as thair sole compensation, WILL DO h1E W ORK, entl the slrucW re is not intended or oHeretl tor sale (Sac.
7044, Business and Professions Code:'T1�e Conirectors License Law dces not apply to an owner of property who builds or improves thereon, end who tloes such work
himsalt ar herself or through his or her Own employeas, provided Ihet such improvements ere not Intended or otteretl lor sale. It, howevar, ihe bullding or improvement is
sold within one year oi completion, t�e 0�'�er-builder will heve the burden o� proving that he or she ditl not Duiltl or improve for purpase of sale.). •
❑ I, as awner of lhe property, em E%CLUS��ELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Protessions
Code: The contrectors License Law tloes not apply to en owner oi property who builtls ar Improves Iherean, end who conirects for such project with a contrector(5)
license pursuant to ihe Coniractors Licensa Laws.).
❑ I am exempt untler sec. Business entl Pmfessions Code br this reason:
Signature: Date:
Owner ID venfied by tlnveYs license. ❑ Yes ❑ No Dnvers License No. Expires:
VenllcaUon af Ownership by (type oi tlocume0�. ��e. - property tea bill or deed):
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTiFICATON:
❑ I hereby certity Ihat no excavation five (5) or more feet in depth into which a person is required Io tlescend, will be made in wnnection with work eulhorized by Ihis
permit, end that no building strucWre, sCeNo�tling, lalsework, or demolition or tlismantling ihereof, will ba more ihan thirty-siz (36) feet hiqh. (Chep. 32, Grp 2, Art 2, Sec.
341, Tltle 8, Calitomia Atlmini5lratNe COde).
❑ As owner-builder, I will not employ enyone to tlo work which would require a permil trom the Division ol Intlustriel Sefery, as noted above, unleu such person has e
pertnit to do such work trom the tlivision.
Signature:
Division of Indusirial Sefety Permit Number:
Date:
W ill Iha applicant or present or future bullding occupant neetl to file en0 certiry a Business Plen for emergency response to releese or threatenetl releese oi e hezerdous
materlel? ❑ Yes ❑ No
(Section 25505 ot the Califomie Health antl Safery Cotle requires, with some exceptions, thet e Business Plan be filed with the Costa Mesa Fire Depanment by every
busineu which has at any one time durin9 a reponed yeer a quantiry of hazartlous matenels equal to or greater than e weighi o1500 pounds, or e volUme ot 55 gellons,
or 200 cubic feet ot compressetl gas at slantlartl temperaWre antl pressure).
...........__ .......................................................__...._..........—._..........................__................._....__........................_._.................._._..........................._........_.._.._.. _..._...._.... ............._._........._._.............._
Does or will the applicant or present or fu�ure builtling accupant neeA to file a regisiretion lortn lor acutety harartlous material57 ❑ Yes ❑�No
(Sectlon 25533 of the Califomia Haelih ePtl Safery Cotle, wit� some excep[ions, requires reglstratlan wiN the Costa Mesa Fire Department by eac� business which at any
one Nme has on hantl e quantiry oi acutety hazerdous metedels equal to or greater Ihan e wei9ht ol 500 pounds, or e volume of 55 gallons, or 200 cubic feet of
compressed gas et standertl temoereture end pressure).
es or wm ma appuwn� or present or
Ves ❑ No
prepare an RMPP (Risk Manegement end Prevention Program
(Section 25534 of the Califomia Health end Safery Code pmvides ihat Ihe Costa Mesa Fire Department may require the preDaration, certification antl liling with the Fire
Depehment ot an RMPP by businesses which are required lo register ecutely hazartlous metedals with the Fire Depenment.
......................................................................................... ................................................................................................................................................................................................................ _.............................................................. _
II en RMPP is presently requiretl, has Section 25534 of the Califomia Heelth and Safety Code been lully complieA with? ❑ Ves ❑ No
..........................................................................................................................._.................................._.........................__.........................................................................................................._._................................._.........._...............
Daes or will Ihe applicent or present or fU�ure building occupant reQuire for �he work whic� Is iha subject ol this e�ppliration e partnit far such consiruction or modification
Irom the South Coest Alr �uelity Menegement Disidc� or trom eny other eir pollution control dlstdct or egencyt �J Yes �.J No
(Section 650502 ot ihe Calitomia Goverr�ment Code requires iha� the requested informetion ba turnishetl on applica�lons tor non-residentlel bullding pormlis).
.............................................................................................................................................................................................................................................................................................................................................................................
Will any pah of the faclliry to he consWctetl unCer Ihis permlt be within 7000 feet irom ihe outer boundaries of e school7 ❑ Yes ❑ No
Qt yes", the tacility mus� maet t�e requir9ment of Sectlons 25534 antl 42303 ot the Calitomia Heelth and Safety Code).
.__ ....................................................................._........... . .......................... ......................................................................................................................_..................................................................
If e permit irom the South Coast Air ��aliry Menegemenl Distdct or other air pollution control distnct or egency is required br the work which Is the suDject of Ihis
aoolicatlon. heve ell of the tlisclosures or6scribea by Celifornla Health and Safety Code Saction 42303 6aen made7 ❑ Ves ❑ No
CERTIFICATE OF C
regartling Hazartlous
Signeture: �
n the eppropnete eir pallution wntrol otticeQ.
that under penelty of perjury the intormation given above is correct. I egree to comply with all state lews end ciry ortlinances
Date:
CERTIFlCATE OF C�MPLIANCE I ON OF EMRY: I certify under penalry of perjury ihat I hava read ihis epplication and stata Ihet the Inlortnation given is
correct. I agree to c ply wjX ell t� en i ordinences relating to building construction, antl euthonze representa0ves of the Ciry of Coste Mesa to enter upon the
ebove-described property forTa . agree no��(o occupy or ellow occupancy of eny building au�horized by ihi �� it 'ntil f�aCl�s�ti��
a
a O egelOwner(s) � Date
COOE �. INSPECTIONTIPE
1618 Fi:etl System Final Fire Prevention
1266 Pool Spe Finel
200 Finel Re-Root
201 Flnel BIocWRelaining Well
�202 Finel Factory Fire Place
203 Final Sign
204 Final Demolition
Q�¢ INTRIALS
,�
:.%f /'�
COOE I INSPECTON TYPE
206 Final Mechanical
20B Finel PlumDing
210 Final ElecMcal
2�2 Flnal Fire Preventlon
220 Final Planning Approval
222 Flnal Site
250 Finel Builtling�Occupancy
Oate
P� IIiI��L4
Owner: ESPINOZA, SALVADOR
Address 332 E 1fiTH ST ,
COSTA MESA, Cq ,
Contractor ALEX CONSTRUCTION
Address: � 668 W 28TH STRpET �-
t
Phone:� 714-662-5557 �
Zip: 92627 � -�..
Phone: 909-757-2858 --��"
, � SAN BERNARDINO, CA __._
Zip: , 92405 License: 832016 �-'�` ���
Arch : MICHAEC J MURPHEY Eng:
Address: 2601 N DEL ROSA AV Address: � �
- � � SUITE��220 ' Phone: 909-888-0459 �� Phone:---: -�
�� � SAN BERNARDINO, CA.: . : . ' - ,
. . 2ip: 92404� � License: -C16304 �, . License: - �
SCOPE OF PERMIT
�. � ADD:1120 SF TO EXISTING S:F.D.; 525 SF ATTACHED GARAGE; 25 SF COVERED DECK; AND; 47.SF��FRONT PORGH�_.VJORK TO INCLUDE:
'� CONVERT EXISTINGBEDROOM TO„A.NEW LIVING ROOM, CONVERT EXISTING BEDROOM TO FAMILY ROOM REMODEVUPGRADE EXISTING
=� }BATHROOM AND KITCHEN ADD !��^,`` ��"•�= � � � .. . =: � ., r � . . .. - � '�. -
--- NEW BEDROOM/BATHROOM AND;LAUNDRY ROOM ON�1ST STORY, ADD 3 NEW ��BEDROOMS AND 2 NEW BATNROOMS ON NEW 2ND STORY.
�� ADD NEW PIREPCACE IN�EXISTING LIVING ROOM AND NEW WINDOWS THROUGHOUT�,EXISTWG HOUSE. ---
.\ CONVERT 4 BEDROOM"1�.'�BATH S.F,D. TO 4 BEDROOMS, 4 BATH S�F.D. � � . .-. -�
, .. . ., . ... . .
" FEE SUMMARY "
Plan Check �$857.06 '' � Galc' Valuation: 8is�,asa.�a
Permit:��` ,$1,318.55 , � Claim Valuatiorr:'� � So.00
SMIP Res: ` $15.78 "
SMIP Com: $0.00
Othec $0.00
Inspection: $0.00
Total: $2,197.39
SETBACKS_� ,
MAIN STRUCTURE�.Front 18- 3
ACCESSORY Fmnt- .0-0
PARKING Existin : o
Rear ' 61-0
Rear 0-0
- Reauired: 4
PLANNING & ZONING
" . left -' 5- 0 �- --. � � Right' " '13- 0
Left 0-0 � Right..- - 0-0
� �Pr000sed: 4
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-26, § 1, 12-21-92)
EXPIRATION: This pertnit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work euthorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
requlred inepeetlons and final epproval must be obtainetl. Failure to ob[ain inspections and final approval will result in ihe expiration of this permit.��
FOR INSPECTIONS CALL: (714) 7545826 �
2M&48 (&00)
WORKERS' COMPENSATION DECLARATION: � - � ' - � �
I hereby aHirm untler penalty of periury one of the following declarations:" � � " --
❑ I have and will maimain a certificate ot consent to selt-Insure tor workers' compensation, as provided tor by section 3700 oi ihe Labor CoUe, for the pertormance of the
work for which this permit is issuetl. '
❑ I have antl will maintain woAcers' compensation insurance, as reQuired by section 3700 of Ihe Labor Cotle, For Ihe pedortnance of the work for which this pertnit is issued.
My workers' compensatlon Insurence carrier and policy number are: _ _
Carrier
(This section need not be
Policy Number:
oNess.) .
I cetlity ihat in the pertormanc of the ork toi which this permit is issueQ I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of C if 'f � sho�ld become subject ro the workers' compensation provisions ot Section 37 0 of the Labor Code, I shall torthwith
comply with Ihese pr ' �e� ' �
:anYSignatu`ra:'-�-�. � � �Date:-`?^�-%� ��/G�
'lIY3?FAktlRE'-i0'SECU E S' CAMPENSATION CpVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLO�YE�A'TQ'GAIMINAL PENALTIES A D CIVIL FWES UP TOIXJE HUNORED
iANDDOLLARE($1W �,INADDITIONTOTHECOSTOFCAMPENSATION,DAMAGESASPiiOVIDEDFOqINSECTION3lO60FTHELABORCAOE,INTEREST,FNDATTORNEV'SFEES.
i
LICENSED CONTRAC70RS DECLARATION:
with Section 7000) ot Division 3 of the Business
e�
Code, and my license is in full
CONSTRUCTION LEN6ING AGENCY: i6"'� � —
❑ I hereby aHirm that there is a consimction lending agency for the pertormance of the work tor which Ihis permit is issuetl. (Sec. 3097, Civil Cotle).
Lentler's Name: Lender's Atldress:
SignaWre: � _ Date:
OWNEfl-BUILDER DECLARATIONS:� �
I hereby aflirtn that untler penalty of perjury thet I am EXEMP7 FROM THE CONTRACTORS IICENSE LAW tor the following reason (Sec. 7031.5, Business and Professlons
Code: Any city or wunry which requires a permit to consimct, alter, improve, demolish, or repair any stmcwre, prior to its issuance, also requires the applicant for such permit
to file a signed statement ihat he or she is licensetl pursuant to the provisions ot ihe Contredors License Law (Chapter 9(commencing with Section 7000) of Division 3 of ihe
Business antl Professions Code) or ihat he or she is exempt thereirom and the basis for the alleged exemption. Any violation o� Section �031.5 by any applicant for a pertnit
subjects the applicant to a civil penalry ot not more than five hundred doliars ($500).):
❑ I, as ownar of ihe property, or my employees with wages as lheir sole compensation, WILL DO THE WOflK, antl the stmcture Is not intentletl 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 thareon, and who does such work
himself or herself or ihrough his or her own employees, provided that such improvements are not intendetl or oNered for sale. If, however, the 6uilding or improvement is
sold within one year of completion, the owner-buiitlei wiil have ihe burden of proving ihat he or she did nol build or improve tor purpwe ot sale.). •
❑ I, as owner of ihe property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Cotle: The contrectors Licensa Law tloes not apply to an owner of property who builds or Improves Ihereon, antl who coniraqs Por such project with a contracror(s)
license pursuant to ihe Coniractors License Laws.).
❑ I am exempt under sec. Business and Pmfessions Code for ihis reason:
Signature: Date:
Owner ID verified by driver's license. ❑ Ves ❑ No Driver's License No. Expires:
Venfication of Ownership by (rype of tlocument, i.e. - property ta: hili or deed):
DIVISION OF INDUSTRIAL SAFETY PEIiM1T CERTIFICATION:
❑ I hereby certify ihat no excavation five (5) or more feet in depth into which a person is required to dascend, will be matle in connection with work authonzed by ihis
permit, and ihat no building s�mcture, scalloltling, falsework, or demolition or dismantling thereof, will be more ihen ihitly-six (36) feet high. (Chap. 32, Gry 2, An 2, Sec.
341, Title 8, California Administrative Code).
❑ As ownar-builtler, I will not employ anyone to do work which would requira a permit irom ihe Division of Industrial Safety, as notetl above, unless such person hes e
permit to do such work irom the division.
SignaNre: Date:
Division of Industrial Safery Pertnit Num6er:
CERTiFICATE OF COMPLIANCE AND AUiHORVA710N OF ENTRY: I certify under penalry of perjury that I have read ihis application and state ihat the information given is
correct. I agree to comply with II nd city ordinances relating to builtling construction, and authonze representatives of ihe Ciry of Gosta Mesa to enter upon ihe
above-describetl prop r pection urp s. I aqree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
I iv - i�/�s
COOE N. INSPECTIONTYPE
1616 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final Block/Retaining Well
202 Final Fadory Fire Place -
Dr1TE INT� 4QQjN . INSPECTONiYPE
206 Finel MeChanical
zaa
210
212
220
Final Plumbing ,
Final Electncal
Final Fire Prevention
Final Planning Approval
203 Final Sign 222 Finai Site
204 Final Demolition � � � 250 � Final Building/Occupancy�
To:
Applicant:
Address:
Telephone
TracUParcel and Lot mt
Locadon of Project:
Number of Square Feet oi:
Residential Space
Commercial and
Industrial Space
J
NEWPORT-MESA UNIFIED SCHOOL DISTRICT
CERTIFICATE OF COMPLIANCE OF DEVEIOPMENT FEES
PURSUANT TO AB 1600 AND AB 181
N� _ 5638
(�) City of Costa Mesa District Receipt No.
( ) City of NewpoA Beach
( ) Counly of Orange Plan Check No.�7�j
3 3Z �� I(� r++ � 5 i C�S-rp n� �S.a
CommerciaVlndustrial Projed is: (Check One)
_ Warehouse
_ R8D
_ Movie Theater
_ Mini-storage
_ Heavy Industrial
_ Regional Shops
_ Light Industrial
_ This project is exempt because
�x a�.aa
x S .30
_ Motel
Bank
_ Neighbofiood Shops
_ RacqueUHealth
_ Hotel
Medical Offiee
O�ice Park
c-� � �1 Z 6 2�-
�' ��
,. � � �
Total
_ Preschool
_ Auto Repair
_ Hosqtal
_ Large Office
_ Ofice Bldg.
_ Restaurant
_ Fast Food
This certifies that the above-named Developer/Applicant has paid school faa6ty fees in comptiance with Government Code sections
53080 and 65995. The Building Pemits for this square footage in this proposed development may now be issued by your jurisdicBon.
Checks are to be made payable to NewpoA-Mesa Unified School Disfict.
By: �
AWwrizad RapreseMaWe
The above representation as to square tootage is We. Appticant agrees
true, then this cerfificate shall automatically terminate and the appr '<
Date: � �
later detemined that such representatians are not
unry shall be notifled.
r
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
,lob Address: 332 E 16TH ST
Suite No
Vicinity:
Parcel Nunmber: 42521117
Applicant: MANUEL SANCHEZ
Address: 668 W 28TH STREET -
SAN BERNARDINO, CA
Owner. ESpINOZA, SALVADOR
Address, � POBOX10863,- ��
, COSTA MESA, CA
Comraaor. ALEX CONSTRUCTION
�
Address: 668 W 26TH STREET
SAIV BERNARDINO, CA
PLUMBING PERMIT
z•L; "
N.
.1
G't ,T� •�•
Phone:
Zip: 92627
Phone: �909-757-2858
Zip: 92405 . �
License: 832016
Status: ISSUED
Applied: 10/18/2005
Issued: 10/18/2005
:�. ADp 1120 SF,TO EXISTING S.F.D.; 525 SF ATTACHED GARAGE; 25 SF COVERED�DECK; AND�, 47 ��
�' SF KRONT PORCH. N/0RK TO INCLUDE: CONVERT EXISTING BEDROOM TO A NEW LIVING ROOM�,
, CONVERT EXISTING BEDROOM TO FAMILY ROOM;'REMODEWPGRADE EXISTING BATHROOM AND
KITCHEN;?ADD NEW BEDROOM/BATHROOM AND-LAUNDRY ROOM ON 1ST STORY, ADD 3 NEW BEDROOMS
ANp 2 NEW B,4THROOMS ON NEW 2ND STORY. ADD NEW FIREPLACE IN EXISTING LIVING ROOM AND
NEW WINDOWS THROUGHOUT EXISTING HOUSE.-REF.: BOS-01174� �-
,, ' PLUMBING TO INCLUDE: 1 BACKFLOW PREVENTER, 4 BATHTUBS, 1 DISHWASHER, 1 GAS (1-4 �
OUTLETS),'I`KITCHEN SINK, 4 WASH BASINS, 4 WATER CLOSETS, 1 WATER HEATER AND 1 WATER
,"PIPWG -._ -, .. _ . _ - -
ISSUE FEE
Backflowirrigation , '
Backflow Preventer
Bathtub � .,
Clarifier System
Connect (Ice,Soda,etc)
Dental Units �
Dishwasher �
Drain, Floor
Drain, Rainwater � -
Drain, Roof "
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (1-4 outlets)
Gas (Over 4 ouHets)
Gas Repipe
Gas Service
Interceptors (Grease, Oil)
Interceptors (Sand Auto )
� AMT QTY
$23.50
$s.ao a°,.` o
$0.00�;'::.:�.r , t-.
$3920 .- � 4
$0.00---� �`�0
$0.00 -0 ' . -
$0.00 --'-0
$9.80 - 1._- .
$0.00 0
$0.00 "'0
$0.00.,_.. 0
$0.00 0
$0.00 0
$0.00 -' 0
$6.15 , 1.:.
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
FEE SUMMARY ,
AMT �
Laundry Tub / Washer $0.00 0
Landscapelrrigation �:, $0.00 0
P-Trap, „ �� $0.00 0
Pressure Regulator � $0.00- 0
Process Piping (per 10 N) . �• $0.00 � -0
Recep�ors - � $0.00 0
Seplic?ank _ - r � $0.00 0
- Sewer Cap for Demo. =,n -' $0.00 �-' 0
Sewer Connect : E0.00 � 0 �
Sewer Private Line � � -- $0.00 . 0 -
Shower ' � --�- $0.00�., 0 -
Sink, bar � � $0.00 0
Sink, commercial $0.00 0
Sink, Floor � � ` $0.00 0
Sink, kitchen � _ $9.80 1
Sink, 5ervice/mop . $0.00, 0
, Spa (private) � $0.00,,, 0 �
Spa (public), • $0.00 0
COMMENTS / SPECIAL CONDITIONS
SumpPump
Swimming�Pool �
Trap Prlmer �
Urinal
Vacuum Brkr Bkflow(1-4)
� � Vacuum Brkr Bkflow(5+)
Wash Basin
� � �Wash Basin Set
Waste and Vent System
�Water Closet (Toilet)
Waler Heater I vent
Water Piping Qnst or Rep J
Water Re-pipe
Water Service
Water Softener
OTHER
�� VIOLATION
PLAN CHECK
REINSPECTION
TOTAL CALCULATED FEES:
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$3920
$0.00
$0.00
$3920
$12.30
$9.80
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$196.75
gN
0
0
0
0
0
0
4
0
0
4
1
1
0
0
0
C
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 92-28, g 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it 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 Inapectlons antl final approval must be obtained. Failure to obtaln Inspections and final approval will result in the expiration of this perm't!'`
FOR tNSPECTIONS CALL: (714) 7545626
zaaa�ae �aroo�
WORKERS'COMPENSAnON DECLAHAnON: � � '
1 hereby aHirtn under penalry of perjury one of tha following declarations: � �
❑ I have and will maintain e certificate ot consent to self-Insure tor workers' compensation, as pmvitletl for by section 3700 of the Lebor Code, tor ihe pertortnance ot ihe
work tor which this parmit is issued. ' .
❑ I have and will maintain workers' compensation insurance, as reQuiretl Dy section 3700 oi ihe Lsbor Cotle, tor Iha perfortnance of Ihe work for w�ich Nis pertnit is issued.
My workers' compensation Insurance carner antl policy number ere:
Carrier: Policy Number:
(This section need nof be comp/eted il the pertnit is valuetl a( one hundred dollars ($100J or less.)
❑ I certify ihet in ihe pertormance of ihe ork tor which this permit is issueQ I shall not employ any person in any manner so as to become sublect to the workers'
compensatlon laws oi CeJjfnuHareA g that if I shoultl become sub�ect to the workers' compensation provislons of Saction 3700 of ihe Labor Code, I shall forthwith
comply with these provisio f'r �
Applicant Signeture: Dete: i � —�� � G S
WARNING: FAILURE TO SECU S' COMPENSATION COVERAGE IS UNLAWFUL FND SHALL SUBIECT AN EMPLOYER TO CRIM�NAL PENALTIES AND CNIL FlNES UP TOONE HUNORED
THOUSANDDOLLARE�5100, ),INADDITIqJTOTHECOSTOFCOMPENSATION,DAMAGESASPROVIDEDf-0RINSECTION3]O60FTHELABORCADE,IMEREST,ANDATTORNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am
force and eflect Lic. A_
Contrador's Signeture:
of Chapter 9(commencing with Section 7000) of Division 3 of the Businass antl ProJsssions Coda, and my license is in full
Class k LY
� ' Date: /O —/8 "GS
CONSTRUCTION LENDING AGENCY: �
❑ I hereby aHirm ihat Ihere is a consiruction leniJiriq agency_tor the peAormance of ihe work for which ihis permit is issued. (Sec. 3097, Civil Code).
Lendefs Name: Lentler's Address: •�
Signature:
Dare:
OWNER-BUILDER DECLARATIONS: `
I hereby afflrtn thet under penalty of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Protessions
Code: Any city or county which requires a permit m conslmcL alter, improve, tlemolish, or repair any stmcture, pnor to its issuanca, also requires the applicant tor such permit
to file a signatl stetement that he or she is licensed pursuant to the provislons of the Contrecmrs License Law (Chepter 9(commencing with Sadlon 7000) of Division 3 of t�e
Business end Professions�Cotle) or that he or she is exempt therefrom end the besis for the allegetl exemption. Any violetion of Section 7031.5 by eny applicaN for a pertnit
subjects the epplicent to e civil penalty ot not more ihan tive hundred dollers ($500).):
❑ I, es owner ot ihe property, or my employees with wagas as �heir 5oie compensation, WILL DO THE WORK, antl the structure Is not intentletl or offered for sele (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of properry who builds or improves Ihereon, and who tloes such work
himself or herseN or �hrou9h his or her own employees, provided that such imDrovemenis are nat intended or oNered for sele. If, however, Ihe building or improvement is
sold within one year of completion, �he owner-builder will have the burden of proving Ihat he or she did not build or Improve tor purpose of sele.). '
❑ I, as owner oi Ihe property, am EXCLUSIVELY CONTRACTNG WITM LICENSED CONTRACTORS to construct the projett (Sec. 7044, 8usiness and Professions
Cotle: The coniractors License Lew does not epply to en awner of pmpeny who builds or Improves ihereon, end who contrects for such pmject wiih a contractar(s)
license pursuant to the Coniractors License Laws.).
❑ I am e:empt under sec. eusiness end Protessions Code for this reason:
SignaWre: Date:
Owner ID venfietl by drivers licen5e. ❑ Yes ❑ No Dnvefs License No.
Verification of Ownership by (type of dwument, i.e. - property tex bill or tleetl):
Ezpires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify ihat no excavation tive (5) or more feet in tlepth into which a person is required to descenQ will be matle in connection with work authorized by this
permit, and that no building simcNre, scaHolding, falsework, or demolition or dismantling thereot, will be more then ihirry-si: (36) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Calitornia Atlministrative Cotle). �
❑ As owneo-builtler, I will not employ anyone to tlo work which would require e permit irom the Division oi Industriel Sefety, es notetl above, unless such person hes e
permit to tlo such work irom Ihe division.
Signature: Date:
Division of Intlustrial Sefery Permit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTAY: I certi(y under penalry of perjury ihat I have read ihis application end state that the information given is
correct. I agree to comply with ell state laws and city ordinances relating to 6uiltling construction, and euthonze representatives ot ihe Ciry ot Costa Mesa to enter upon the
ebove-descnbed property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until finel inspection.
COOE I,
Fixed System Final Fire Prevention
7266 Paol Spa Final
200 Final Re-Root
201 Finel Block/Retaining Wall
202
203
204
Final Factory Fire Place
Final Sign
Final Demolition
Date
/U -/b'.-oS
Date
Q�g �$ �CQOF� INSPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final ElecMcal
212 Final Fire Prevention
� 220 Final Planning Approval
222 Final Sile
- 250 Final Building/Occupency
. 111. '
� ,/�
[=1� ./''�
N
IVIVf(CNV VHLLC 1 � l.A
Owner: ESPINOZA, SALVADOR
Address PO BOX10863 - .
COSTA MESA, CA
Contrector. ESTRELLA CONSTRUCTION
Address: 12410 LOEZ DR
MORENO VALLEY, CA
Zip: 92557
Arch :
Address:
Phone:
Zip:
License:
<I�l. JGD'J/
Phone:
Zip: 92627
Phone: 951-489-8800
License: 869312
Eng:
Address:
Phone:
License:
SCOPE OF PERMIT
ADD 1120 SF TO EXISTING S.F.D.; 525 SF ATTACHED GARAGE; 25 SF COVERED DECK; AND, 47 SF FRONT PORCH. WORK TO INCLUDE:
CONVERT EXISTING BEDROOM TO A NEW LIVING ROOM, CONVERT EXISTING BEDROOM TO FAMILY ROOM, REMODEL/UPGRADE EXISTING
BATHROOM AND KITCHEN, ADD
NEW BEDROOMIBqTHROOM AND LAUNDRY ROOM ON 1ST STORY, ADD 3 NEW BEDROOMS AND 2 NEW BATHROOMS ON NEW 2ND STORY.
ADD NEW FIREPLACE IN EXISTING LIVING ROOM AND NEW WINDOWS THROUGHOUT EXISTING HOUSE.
CONVERT 4 BEDROOM, 1 BATH S.F.D. TO 4 BEDROOMS, 4 BATH S.F.D
• FEE SUMMARY
Plan Check: $857.06
Permit: $1,318.55
SMIP Res: $15.78
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $2,191.39 -�
PLANNING & ZONING
SETBACKS �
MAIN STRUCTURE Fronl 0- 0
ACCESSORY Front 0- 0
PARKING Existina: o
l V �
Rear
Rear
Reauired:
Calc Valuation: gte�,s3a.�a
Claim Valuation: S�s�,asa.�a
0- 0 Left 0- 0 Right 0- 0
0- 0 Lek 0- 0 Right 0- 0
0 Pr000sed: 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced wlthin 180 days, or if work is suspended or abandoned
tor a pariod of 1 BO days. � �
INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes; and�all
requlred Inspectlona ahd final approval must be obtained. Failure to obtain inspections antl (inal approval will result in the expiration of /thi�s�pertnit.
FOR INSPECTIONS CALL: (714) 754-5626 /�
�
244&48 (fl�00) '
WORKERS' COMPENSATION DECIAHATION: � . , �
I hereby aflirm under penalry oi perjury one of Ihe following declarations: � . � � ',
❑ I ave antl will melntain a certiticate ol consent to self-Insure for workers' compensation, es provided tor by section 3700 of lha Labor Cotla, for the pertortnence of the
ork tor which thls permit is issue0.
� ve antl will maintain workers' cwnpensation Insurance, as requiretl by section 3700 of the La6or Cotle, for the pertortnance of the work lor which Ihis pertnit is issuetl.
My workers' compensat�on suranc carrieer and policy number are: Q
'.�_ «������ OL/�lei/Oi�f( �:PoiicyNumbsr: /Zt/'i�% �!t
7Triis secfion ed not be complefeU il fhe permit is valued ef one huntlred dollars ($ f00) or /essJ Q L�/��f"�
❑ �I certify that in the perf mance oi the work tor which ihis pertnit is issued, I s�ell not employ any person in any manner so as to become subject to ihe workers'
compensation laws o � elifornia, and e ra ihat If I should become subjed to the workers' compensation provisions ot Section 3700 of the Labor Cotle, I shell forthwith
comply with ihese p v ions. /
�n ic �,�g,gneture:— ' _ _ �—. , o,ate" ��.9��D—��O !o
NG FAILURE O ECURE WORKERS' CAMPENSATION CAVERAGE IS UNIAWFUL M1D SHALL SUBJECT AN EMPLOVER TO CFIAyNAL PENALTIES AND CIVIL FWES UP TOONE HUNDRED
THOUSANDOOLLA 10D,000),INADOITIIXJTOTHECOSTOFCOMPENSATION,DAMAGESASPROVIDEDFORINSECTION3]O60FTY(EL40pRCADE,IMEREST,ANDATTORNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
of Chapter 9(commencing with Section 7000) of Division 3 o_i the.Busina�nd Professions Code, and my license is in full
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that ihere is e consimction lending agency for ihe peAormance of the work for which this permi� is issued. (Sec. 3097, Civil Code).
Lentler's Neme: Lentler's Atltlress:
Signature:
OWNER-BUILDER DECLAFiAT10N5:
Date:
I hereby aflirm that untler penalry of perjury ihal I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for lhe following reason (Sec. 7031.5, Business and Protessions
Code: Any city or counry which requires a permit to constmci, alter, imOrove, demolish, or repair any stmcture, prior to its issuance, also requires Ihe applicant tor such permit
to tile a signed statement ihat he or she Is licensed Oursuant b Ihe provisions of the Coniractors License Lew (Chapter 9(commencing with Sectlon 7000) ot Divislon 3 ot ihe
Business end Professlons Code) or ihat he or she is ezempt therefmm and the basis for the alleged exemption. Any violetion of Section 7031.5 by eny applicant tor a pertnit
su6jeqs the applicant to a civil penalty of not more then five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as iheir sole compensation, WILL DO TME WORK, antl the structure is not intended or oHered for sale (Sec.
7044, Business and Professions Code: The Con�ractors License Law does no� apply to an owner ot proDerty who builds or improves ihereon, and who does such work
himself or herself or thmugh his or her own employees, providetl that such impmvements are not Intended or oHered for sale. If, however, Ihe building or improvement is
soltl within one year of comp�etion, the owner-builder will have the burden of pwving that he or she did not builtl or improve tor purpose of sale.). -
❑ I, as owner ot Ihe property, am EXCLUSNELY CONTRACTING WITH LICENSED CONTRACTORS lo constmct ihe project (Sec. 7044, Business antl Protesslons
Code: The wmractors License Law does not apply to an ownar of property who builds or Improves ihereon, and who contracis tor such project with a contrector(s)
license pursuant to the Contractors Licensa Laws.).
❑ I am ezempt under sec. Business and Protessions Code for thi5 reeson:
Signature: Date:
Owner ID veniietl by OnveYs license. ❑ Yes ❑ No Drivels License No.
Verification oi Ownership by (type ot tlocument, i.e. - propeny tex bill or deadj:
DIVISION OF INDUSTRIAL SAFETV PERMR CER7IFICATION:
Expires:
❑ I hereby certify that no excavation five (5) or more feet in tlepth imo which a person is required to descend, will be mede in connection with work amhorizad by this
permil, and that no building siruciure, scaHolding, falsework, or demolition or dismantling thereof, will 6e more than thirry-six (36) feet �igh. (Chap. 32, Gry 2, Art 2, Sec.
341, Title B, Califomia Atlministrative Code).
❑ As owner-builder, I will not employ enyone to do work which would require a permit irom Ne Division of Intlustrial Safety, as noted ebove, unless such person has e
permit to tlo such work from �he division.
Signature: Date:
Division of Indusinal Setety Permit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATON OF ENTRV: I certity under penal�y oi perjury ihat I have read this epplication and state that the informa�ion given is
correct. I agree to comply with all state laws antl ciry ordinances relating to building construction, and authonza representatives of ihe City of Costa Mesa to enter upon the
a6ove-tlescnbetl proyerty for inspection puryoses. I agrea not to occupy or allow xcupancy ol eny building authorized by ihis permit until final inspection.
o� �NTRIALS
1616 � Fixetl Sys�em Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Rool
207 Final Block/Retaining W ell
202 • Final Factory Fire Place
203 Final Sign
204 Final Domolition
COpEt INSPECTIONTYiE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final BuiltlinryOccupancy
o�h INfiilALS
7,7 c�- �
, (760)757-0556
Cell: (949) 370-7922
Fax:(760)757-1064
MIDGET
A Prafessronnllnspeclion Service
365 Mainsail Road, Oceanside, CA 92054
❑ REINFORCED CONCRETE
REGISTERED INSPECTOR'S �pRE-STRESSED CONCRETE
REPORT OF: �
� REINFORCED MASONRY
nooaEss
4� ,� /l'�Sr,. �<�� �j-�� !',�:
JER Ofl PFOJ T NAME � � �
�L✓�� �sn.ti.zA
Cf}IBE MATERIAL (MI%DESIG , R�BAR GFA�E 8 MFNUFACTURER, WELD-ROD. ETC:
Si,x�n��u ,Sv��2 t�,�.a-s ��lf'/%r/�
❑ STRUCTSTEELASSEMBLV dOTHER t lXl'
❑ HIGH-STRENGTH BOLTING r� �C�� I�5
❑RE-BAR WLDING ❑SHOP ❑FIELD
_�
INSP�N. LOCATIONS OF WORK INSPECTED, TEST SAMPlES TAKEN, WORK REJECTED, JOB PROBLEMS, PROGRESS, REMARKS, ETG.
INCLUDES INFORMATION ABOUT AMOUNTS OF MATERIAL PLACED OR WORK PERFORME� NUMBER TVPE 8 IDENTIFICATION NUMBER'S OF TEST
DATE SAMPLES TAKEN, STRUCT CONNECTIONS, WELDS MADE. H T BOLTS TOP�UED, CHECKED, ETC.
� D�v V�'P�� /F P�(<t.t, � ��OIv.UG/�.�� /�° /G�l�S/7! /�ChYS �.G' '/�' /'
�.i,...,tti . %I/' �N�,1 ( o? �tiCl `5/Si // /3 5 rn//J..!lc.P�,(i
�l�'s . �� �s �, �1�� <<,, � � �; � - > s�,� L7 ,�a -, �
�-
,� �
Jc�'/� l;,v— P�G�' U� r4 t L � /. s ,N �/;/� ,;r �_
/t'i /.L�IN/JL�/7IL1✓.Iif �Y.�fiV/17/7 i.tl �G.{I//1L/� �(�I _•1/ir�..
I HEREBV CERTIFY THAT I HAVE INSPECTED ALL OF 7HE ABOVE REPORTED WORK, UNLESS OTHERWISE NOTED, AND TO THE BEST OF
MV ABILITY, 1 HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SP�CIFICATIONS„8 APPUCABLE BUILDING LAWS.
REGISTERE�
OFREPORT
��
r
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR ORIVE, COSTA MESA, CA 92626
��.` �
�, i .
\ ,,`.
,lob Address: 332 E 16TH ST
Suite No
Vicinity:
Parcel Number: 42521117
App�icant: JOHN ESTRELLA
Address: 12470 LOEZ DR
MORENO VALLEY, CA
MECHANICAL PERMIT
Owner: ESPINOZA, SAIVADOR
Address: PO BOX 10863
COSTA MESA, CA
Contrecroc ESTRELLA CONSTRUCTION
Address: 12410 LOEZ DR
MORENO VALLEY.CA
Phone: 951-489-8800
Zip: 92557
I
� t •
� �
fi#^r ,x
Phone: 951-489-8800
Zip: 92557
License: 869312
ISSUED BY:
k
- �
Slatus: ISSUED
Applied: 09/07I2006
Issued: 09/07/2006
SCOPE OF PERMIT
ADD 1120 SF TO EXISTING S.F.D.; 525 SF ATTACHED GARAGE; 25 SF COVERED DECK;
AND, 47 SF FRONT PORCH. WORK TO INCLUDE: CONVERT EXISTING BEDROOM TO A NEW
LIVING ROOM, CONVERT EXISTING BEDROOM TO FAMILY ROOM, REMODEL/UPGRADE EXISTING
BATHROOM AND KITCHEN, ADD NEW BEDROOM/BATHROOM AND LAUNDRY ROOM ON 1ST STORY,
ADD 3 NEW BEDROOMS AND 2 NEW BATHROOMS ON NEW 2ND STORY. ADD NEW FIREPLACE IN
EXISTING LIVING ROOM ANO NEW WINDOWS THROUGHOUT EXISTING HOUSE. REF.:
606-07488
MECHANICAL TO INCLUDE: 1 FAU�< 100K BTU, 1 REPAIR/ALT COOUNG/HEA7, 1 FACTORY
FIREPLACE, 1 HOOD W/MECH EXHAUST, 4 VENT FANS AND 1 3 TO 15 HPISOOK BTU.
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k BTU
Repair/AIi Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <700 k BTU
Refrig Sys >700 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV 8oz
Vent Fan / Sinqle Duc�
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocale Appl Vent
Air Handlers < 10000ctm
AirHandlers> 10000c(m
Floor Furnace
Floor or Suspend Heater
523.50
$14.80
$0.00
Si3.7o
50.00
50.00
$0.00
$0.00
510.65
870.65
$0.00
529.00
50.00
50.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
. � .
Quantity
FEE SUMMARY
Repair I Alt Absorbtion Unit
Repair I AI� Refrigeralion Unit
Ventillation System
Evaporetive Cooler
Com me rcia l I ncinerator
Domestic Incinerator
Comoressors / Absorotion Svslems
Up to 3 hp I 100 k BTU
3 To 15 hp / 500 k BTU
15 TO 30 hp I 1,000 k BTU
30 To 50 hp I 1,750 k BTU
Over 50 hp / Over 1,750 8TU
Boilers
Up to 3 hp
3To15hp
15to30hp
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investi9ation Fea
Plan Check Fee
Reinspection Fee
TOTAL CALCUTATED FEES
COMMENTS / SPECIAL CONDITIONS
�uanlity
50.00 0
$0.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
50.00 0
$0.00 0
$27.15 1
$0.00 0
$0.00 0
$0.00 0
50.00
$0.00
$0.00
E129.45
. ��.
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 7, 1241-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced wilhin 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all appli '�s, and all
requlred inspectlona and final approvel must be obtained. Failure to obtain inspections and final approval will result in tha ex ' n of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2a4&68 (B�W)
WORKERS' COMPENSATION DECLARATION: �' ��
I hereby affirm under penalty ol perjury one oi Ihe following declaietions. -, - ,
❑ I antl will meintain e cenificate ot consent m selt-Insure tor workere' compensatlon, es pmvitletl for by section 3700 of the Wbor Cotle, for t�e peAormance of the
ork for whlch this permit is issuetl.
I have and will meintain workery'�ompensation insurance, as required by section 3700 of ihe Lebor Cotle, for the peAormance of Ihe work for which Ihis pertnit Is issued.
My workers' compensatlon �urence arner enj� policy number ere:
Canier. .5�� �� e.{'/�1t/t0/JiCP PolicyNumoer���+ CQh/�
(This section nead nat be comp/eted il Bie permif is valuetl et one hundred dollers ($ f00) ar less.) � 2 7L`��
J JJ
❑ I certity thet in the perto�qience of ihe work for which this permit is issued, I shell not employ any person in eny manner so es to hecome subject to the workers'
compensation laws of�Cylllfomla, entl egr at it I should become subject to the workers' compensetion provisions ol Section 3700 of Ihe Lebor Cotle, I shall forthwlth
comply with Ihese p 6(sions.
Applicant Signature: Dete: e� g/O %���
WARNING: FAILUR ECURE WORKERS' CAMPENSATIIXJ COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CPIMI PENAL ES AND CIVIL FWES UP TOONE HUNDREO
THOUSAND (S10D,000),INADDIiIONTOTHECOSTOFCOMPENSATION,OAMAGESASPROVIOEDFORINSECTION3]OBOFTNEL480RWOE,INTEREST,ANDATTORNEY'SFEES.
LICENSEO CONTRAC70R5 DECLARATION:
I here6y aHirm that I em lic ed un rov' 'o of ��er 9(wmmencing with Section 7000) of Division 3 of the Busin�d Professians Code, end my license is in full
forca and ettect. Lic. M � Class a
Conirectofs Signature: Date: �
CONSTRUCTION NDING AGENCY:
❑ I hereby aflirtn thet thare is a consiruction lending agency for the pertortnance of the work for which Ihis pertnit is issued. (Sec. 3097, Civil Cotle).
Lentler's Name: Lendefs Address:
Siqneture: _
Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business entl Professlons
Cotle: Any ciry or counry which requires e permit to construct, alter, improve, demolish, or repair any structure, pnor to its issuance. also raquires the epplicant for such pertnit
to file e signetl stetement Ihet he ar she I5 Iicensed pursuant to ihe proNsions ol the Cantrectors License Lew (Chepter 9(commencing with Section 7000) af Dlvlsion 3 ai the
Buslness and Professlons Code) or thet he or she is exempt therefrom and the basis tor Ihe alleged exemption. Any violetion ol Section 7031.5 by eny epplicant for e permll
subjects the epplicent lo a civll penelty of nol more then tive hundred dollars ($500).):
❑ I, es owner of the Oroperty, or my employees wi�h weges es Iheir sole compensetlon, WILL DO THE WORK, entl the strucWre is not intended or ottered for sale (Sec.
7044, Business and Pmfessions Cotle: The Contractors License Law does no� apply to en owner of property who builds or improves thereon, and who does such work
himselt or harself or ihrough his or her own employees, provitlad ihat such impmvemems ere not Imentle0 or oNeretl br sele. If, however, Ihe building or improvement is
soltl within one year of completion, the owneo-builder will have Ihe burtlen of proving that he or she did not builtl or improva for purpose of sale.).
❑ I, es ownet of the property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business end Prolessions
Cotle: The contractors License Law tloes not apply to an owner ol property who 6uilds or Impmves thereon, enA who wntracts for such pmlect wlth a comracbr(s)
license pursuant to ihe Cantractars License LewsJ.
❑ 1 am examp� under sec.
Signature:
Ownar ID venfietl by tlrivar's Ilcensa. ❑ Yes ❑ No
Business and Professions Code br this reason:
Venfication oi Ownership by (type of 4ocumenL i.e. � property tae bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Dnvefs Ucense No.
Date:
Expires:
❑ I hereby certity Ihat no eacavation five (5) or mora teet in deplh into which a person Is required to dascend, will be made in wnnection vn�h work euthodzed by Ihis
permit, antl t�a� no building strucWre, scattolding, falsework, or tlemoli�ion or tlismentling theraol, will �a more Ihan �hirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Calitomie Administrative Code).
❑ As owner-builder, I will not employ enyone to do work which would require e permit from the Division of Intlustnal Safery, as noted ebove, unless such pereon �fls e
permit to do suc� work trom the tlivision.
Signature: Date:
Division of Industnal Sefety Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUTTIORIZATON OF ENTRY: I cenity under penalty of perjury ihat I have read this application antl state that the intormetion given Is
correct. I egree to comply with ell state laws and city ordinances relating lo bullding constmction, antl authorize representatives of the City of Coste Mesa to enter upon the
above-tlescribe� property lor insDection puryoses. I agree not to occupy or allow occupency ol eny building authorized by Ihis permit un�il finel inspecNon.
INSPECTION TYVE
tfi Fixetl System Finel Fire Prevention
1266 Pool Spa Final
200 Final Re-Rooi
201 Final Block/Retaining Wall
202 Final Fectory F*re Place
203 Final Sign ��
204 Final Domolition ,
PA� �5
COOEI INSPECTIONTYPE
206 ' Finel Mechanical
20B Finel PlumDing
210 Flnal ElecMcal
212 Final Fire Prevention
220 Final Planning Approval �
222 Final Site
250 FinalBuilding/Occupancy
���
�
(714) 754-5273 • Fax (714) 754-4856 • v+ww.ci.costa-mesa,Gd,iI�TRICAL PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
tLt
�
dobAddress: 332 E^16TH ST Status: ISSUED
Suite No Applied: 09/07/2006
� Vicinity: Issued: 09/072006
Parcel Nunmber:
ApplicanC
Address
Owner:
Address
42521117
JOHN ESTRELLA
12410 LOE2 DR
MORENO VALLEY, CA
ESPINOZA, SALVADOR
PO BOX 10863
COSTA MESA, CA
Phone: 951-489-8800
Zip 92557
Phone:
Zip: 92627
. .i
� ISSUED BY: � /__ 1��
�
Contractor. ESTRELLA CONSTRUCTION
Address: 12410 LOEZ DR
Phone: 957-489-
MORENO VALLEY, CA Zip: 92557
- License: 869312
ISSUE FEE
Temp service test
Res. a/c package
New Res (Y2 units)
New Res (3+uniis)
Pool / Spa
Li9htin9 Fixis
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 7000a
Molors to 1 hp
Motors to 10hp
Motors to 50hp
Motors l0 100hp
Molors over t00hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
SCOPE OF PERMIT
ADD 1120 SF TO EXISTING S.F.D.; 525 SF ATTACHED GARAGE; 25 SF COVERED DECK; AND, 47
SF FRONT PORCH. WORK TO INCLUDE: CONVERT EXISTING BEDROOM TO A NEW LIVING ROOM,
CONVERT EXISTING BEDROOM TO FAMILY ROOM, REMODEUUPGRADE EXISTING BATHROOM AND
KITCHEN, ADD NEW BEDROOMIBATHROOM AND LAUNDRY ROOM ON 1ST STORY, ADD 3 NEW BEDROOMS
AND 2 NEW BATHROOMS ON NEW 2ND STORY. ADD NEW FIREPLACE IN EXISTING LIVING ROOM AND
NEW WINDOWS THROUGHOUT EXISTING HOUSE.
CONVERT 4 BEDROOM, 1 BATH S.F.D. TO 4 BEDROOMS, 4 BATH S.F.D
ELECTRICAL TO INCLUDE: 7 RESIDENTIAL PACKAGE, 18 LIGHT FIXTURES, 54 OUTLETS, 21
SWITCHES AND t SERVICE TO 200 AMPS.
523.50
50.00
554.50
50.00
50.00
50.00
519.80
546.82
522.73
50.00
50.00
$30.50
$0.00
$0.00
50.00
50.00
50.00
$0.00
$0.00
$0.00
50.00
50.00
$0.00
50.00
50.00
Quantity
0
0
0
78
54
21
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
Busway I100 ft
Standing Section
Misc Electrical Equipment
Transformers up to 1 kvalkw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misc. Conductor
Circus ( gen or ride)
Cirws (mech ride or IigMs)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
Quantiry
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
50.00 0
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES E197.85
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by Yhis permit shall comply with all applicable handicap access requiremenis under California statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or If work is suspanded or abandoned
for a period of 180 days. �
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inapeetiona end finel approval must be obtained. Failure to obtain inspections and final approval will result in the ezD�ration ot th(s permit.
FOR INSPECTIONS CALL: (714) 7545626
zue-ae Iarool _ V �
WORKERS'COMPENSAnON DECLARATON:
I hereby 'rtn under penalty of perjury one ot the following tleclaretions: '� �_ � .,
❑. eve entl will meintein e certificate at consent to self-Insure for workere' compensetlon, es provitletl for by section 3700 of the Lebor Cotle, for the pertortnance of the
work lor which this pertnit is iuuetl.
I have antl will maintain wo ers' com��4ensetion insurance, as requiretl by section 3700 of the Lebor Cotle, lor the pertortnance ol Ihe work for which Nis permit is issuetl.
My workers' co�m `�satl sure-n�` cerner �en�° licy num�er ere: '/
Carner: ST /� /K!' l..T"/��$U/?i/X e Policy Number �= '� � I�'h!�
(This section need not be cwnO�etetl il the pertnif /s valued et one hundred dollers ($100) or /ess.)
❑ I certity that iri ihe peAormance ol ihe work lor which t�is partnit is issued, I shall not employ eny person in any manner so as to become subject to the workers'
compensation laws ol ifomia, entl e th t if I should bewme subject to the workers' compensation provisions oi Section 3700 of the Labor Cotle, I shall forthwith
comply with ihese pr i s. 9/Q �/O�
Applicant Signeture: w� Dete:
WARNING FAIWRE T CURE WORKERS' COMPENSATIqJ COVEMGE IS UNLAWFUL M1D SHALL SUBIECT AN EMPLOVER TO CRIMj1 AL PENAL ES AND dVIL FlNES UP TOONE HUNDPED
Ti%%ISNJD OOLLA 100,000�, IN ADDIT10NT0 THE COST OF COMPENSATIqJ, DAMAGES MS PROVIOED FOH IN SECiION J]OB OF THE UBOR ODDE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aNirm that I am lic ed er p vi 'ons of C�epter 9(commencing with Section 7000) of Division 3 oi Ihe Busine nd Professions Cotla, and my license is in full
force antl eHect. Lic. A �% Class q
Contractofs Signature: Date: O
CONSTRUCTION DING AGENCY:
❑ I hereby aHirm Ihat there is a construction lentling egency tor Ihe peAortnance ot iha work for which ihis pertnit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lentlers Atltlress:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby eflirtn that under penalry ot perjury that I am EXEMP7 FROM 7HE COMRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business antl Professions
Code: Any ciry or counry which requires e pertnit to canstruct, elter, imprave, tlemolis�, or repair any structura, prior ro its issuance, also requires the applicant tor such permit
�o file a signed statemant the� he or she Is Ilcensed pursuent to the O�ovisions ot Ihe Comraciors License Ww (C�epter 9(commencing with Section 7000) of Division 3 of the
Business and Protessions Cotle) or that he or she is ezempt thereirom end the 6asis lor Ihe ellegetl ezemption. Any violation ot Section 7031.5 by any applicent for a pertnit
sublecis �he aDP�itant to e civil penalty ol not more ihen live hundred dollars (5500).):
❑ I, as owner of the pmperty, or my employees wit� wa9es as their sWe compensetlon, WILL DO TME WORK, entl t�e structure Is not intendetl or oHeretl tor sale (Sec.
7044, Business and Professions Code: The Coniractors License Law tices not apply to an owner of properry who builds or improves thereon, and who does such work
himselt ar hersell or t�rough his or her own emplayees, pravitled thet such improvements are not Iniended or oHered lor sale. It, however, the building or improvement is
sold within one year ot completion, lhe owner-builder will heve the burden of proving that he or she tlitl not builtl or improve for purpose of sale.).
❑ I, es owner ot the pmperty, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTR11C70RS to construct the prqect (Sac. 7040, Business and Protessions
Code: The cromrectors License Lew does not epply to en owner ol property who �uilds or Improves ihereon, and who contracis for such pmjeci wit� a con�ractor(s)
licanse pursuant to ihe Contractors License Lews.).
❑ I am exempt under sec. Business and Prolessions Code lor Ihis reason:
Signatura: Date:
Owner ID verified by drivefs license. ❑ Ves ❑ No Driver's License No.
Venfication ot Owners�ip Dy (type ot tlocument, i.e. - pmperry tax blll or deed):
DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIFICATION:
Expires:
❑ I hereby cehify ihat no eacava�lon flve (5) or more feet In depih Into which a person Is required to tlescend, wlll be matle in connection with work euthodzed by ihis
permit, entl that no builtling stmcWre. scalloltling, lalsawork, or demolition or tlismantling ihereoi, will be more then thirty-sia (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Titla 8, Calilomia AdministratNe Code).
❑ As owner-builder, I will not employ anyone to tlo work which would require e perml� from the Division of Indusirial Salety, es note0 above, unless such person has e
permit to tlo such work irom the division.
SignaWre: Date:
Division of Indus�rial Sefery Permi� Number:
CER7IFlCATE OF COMPLIANCE ANO AUTHORIZA710N OF ENTRV: I certity untler penalry ot perjury that I have read this appliwtion antl state that the inlormation qiven is
wrtecc I egree to wmpty with ell stete laws end ciry artlinances relatlng to building construction, end authorize representatives of Ihe Giry ol Costa Mesa to emer upon the
above-tlescnbed property for inspection purposes. I e9ree not to occupy or allow occupency ot any building authonzed by this pertnit until final inspeciion.
1616
1266
200
201
202
203
Of Legal
INSFECTIONTYPE
Fixed'Sysiem Final Fire Prevention
Pool Spa Finel
Finel Re-Rool
Finel BIocWReteining Wall
Final Factory Fira Place
Final Sign
204 Final Domalitian
`
PAIE - lt{INEIfl
�'/O �/O� ate
Date
cooer iNsvecnoxnve �
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Builtling/Occupancy
D�re L�LS
�� �
(714) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
,lob nddress: 332 E 16TH ST
Suite No
Vicinity:
ParcelNunmber: 42521117, -� \'•.,
Applicanl: JOHN ESTRELLA
Address: 12410 LOEZ DR
MORENO VALLEY, CA
Owner: ESPINOZA, SALVADOR
Address PO BOX 10863
COSTA MESA, CA
Comractor. ESTRELLA CONSTRUCTION
Address: 12410LOEZ DR
MDRENO VALLEY, CA
ISSUED BY:
Phone: 957-489-8800
!, `
,;
- _ + I �;
.;��a`�' a� f
� �
P.
Phone: 951-089-8800
Zip: 92557
License: 869312
Slatus: ISSUED
Applied: 09/07/2006
Issued: 09/07/2006
� i�
SCOPE OF PERMIT
ADD 1120 SF TO EXISTING S.F.D.; 525 SF ATTACHED GAR4GE; 25 SF COVERED DECK; AND, 47
S� FRONT PORCH. WORK TO INCLUDE: CONVERT EXISTING-BEDROOM TO A NEW LIVING ROOM,
CONVERT EXISTING BEDROOM TO FAMILY ROOM, REMODEUUPGRADE EXISTING BATHROOM AND
KITCHEN, ADD NEW BEDROOM/BATHROOM AND LAUNDRY ROOM ON 1ST STORY, ADD 3 NEW BEDROOMS
AND 2 NEW BATHROOMS ON NEW 2ND STORY. ADD NEW FIREPLACE IN EXISTING LIVING ROOM AND
NEW WINDOWS THROUGHOUT EXISTING HOUSE. REF.: B06-01488
PLUMBING TO INCLUDE: 1 BACKFLOW PREVENTER, 4 BATHTUBS, 1 DISHWASHER, 1 GAS (1-4
OUTLETS), 1 KITCHEN SINK, 4 WASH BASINS, 4 WATER CLOSETS, 1 WATER HEATER AND 1 WATER
PIPING.
AMT (
ISSUE FEE $23.50
Backflow irrigation $0.00
Backflow Preventer $9.80 i
Bathtub $39.20
Clarifier System $0.00
Conned Qce,Soda,etc) $0.00 �
Dental Unils � $0.00 i
Dishwasher � ' S9.80 ,
Drain, Floor 50.00
Drain, Rainwater 30.00
Drain, Roof � $0.00
Drinking Fountain ' $0:00
Expansion Tank $0.00
Gas Earthquake Valve $0.00
Gas (1-4 outlets) $6.15
Gas (Over 4 outlets) $0.00
Gas Repipe $0.00
Gas Service $0.00
Interceptors (Grease, Oil) $0.00
Interceptors (Sand Aulo ) $0.00 �
FEE SUMMARY
ITY AMT �TY AMT QTY
Laundry Tub / Washer $0.00 0 Sump Pump $0.00 0
� Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
1 P-Trap , $0.00 0 Trep Primer $0.00 0
{ Pressure Regulator $0.00 0 Urinal $0.00 0
I - Process Piping (per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
1 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
1 „ SepticTank $0.00 0 WashBasin $3920 4
�� . Sewer Cap for Demo $0.00 0 � Wash Basin Set $0.00 0
1 Sewer Connecl $0.00 0 Waste and Vent Syslem $0.00 �0
1 Sewer Private Line $0:00 0 Water Closet (Toilet) $3920 4
) Shower � $0.00 0 WaterHeater/vent $12.30 1
1 �- Sink, bar $0.00 0 Water Piping Qnst or Rep.) $9.80 1
) Sink, commercial $0.00 0 Water Re-pipe 50.00 0
1 ' Sink, Floor $0.00 0 Water Service $0.00 0
Sink, kitchen $9.80 1 Water Sokener $0.00 0
1 Sink, service/mop $0.00 0 OTHER $0.00
) Spa (private) - � $0.00 0 VIOLATION $0.00
1 Spa (public) $0.00 0 PLAN CHECK 50.00
1 REINSPECTION 50.00 0
COMMENTS / SPECIAL CONDITIONS
TOTAL CALCULATED FEES: 5198.75
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 780 days, or it work is suspended or abendoned
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 appli I'. odes, and all
requlred Inapectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expir f this permit.
FOR INSPECTIONS CAL�; (714) 7545626
Lya.r:fl:lbll
WORKERS'COMPENSAnON DECLARAnON: t� ��
I hereby ettirm undar penalty of perjury one ol ihe following tleclarelions: .� � • � ,
❑ I heve end will melntaln a certiliceta of consant to selFlnsure br workers' compensetion, es provided for by section 3700 of the Lebor Catle, for Ihe peAortnance ot i�e
w r which this permit is Issued.
I have entl will malntaln workers' compensetlon Insurence, as required by section 3700 oi the lebor Code, for the pertortnance of the work for which this permi[ is IssueO.
My worker ' wmpensatlon rence errler and pf� icy number are:
Carrier: ��i�'� /�X.� 0I'�9.uYn NP PolicyNumDer..2i�9 � Q o l//'t> �
(This section need no! be completetl i/ the pertnit is velued et one hundr�tla Ier�00) oi /eu.J oo �y 3 s rI
❑ I certity thel in t�e pertorm ce ol ihe work for which this permit is Issued, I shall not employ eny person in any manner so as to become subject to Ihe workers'
compensetlon laws oi C�mia, entl egree th il 5 uld bacome subject to t�e workers' compensetion provisians of Section 3700 ot the Labor Cotle, I shall forthwlth
camply wit� t�ese prov ns. /�, /`
Applicent Signature: Dete: C� �� / �%
WAFWING: FAILURE TO RE WORKERS' COMPENSATION COVERAGE IS UNUWFUL rWD SHA�L SUfl1ECT PN EMPIOYER TO CRIM�PENALTIES D CML FlNES UP TO ONE MUNORED
THOUSANDDOl1ARE ,OOO�,INADOITIONTOTHECOSTOFCOMPENSATION,DMMGESASPROVIDEDFORINSECTION310GOFTHEIABORCODE,INTERESt,ANDATTORNEY'SFEES.
LICENSED CONTRACTOHS DECLARATION:
1 hereby aHirm t�at I em licen untl ero 'sions f pter 9(commencing with Saction 7000) ot DiNsion 3 0l Ihe Business aa�}professions Code, antl my license is in tull
lorce entl eNecL Lic. p 6 Class a ���
ContractaYs Signeture: Date:
CONSTRUCTION DING AGENCV:
❑ I here�y aHirtn that there I5 a construction lending agenty for Ihe peAormance ot the work tor which ihis permi� is issued. (Sec. 3097, Civil Cotle).
Lender's Name:
Signature: _
OWNER-BUILDER DECLARATIONS:
Lenders Address:
Date:
I hereby eMirtn Ihat under penelty of perjury Ihet I am EXEMPT FHOM THE CON7RACTORS LICENSE LAW far ihe tollowing reason (Sec. 7031.5, Business and Prafessions
Code: Any ciry or wunry whic� requlres a permit to consiruct, alter, improve, demdish, or repair eny strucWre, pnor to its issuance, also requires the applicant for such pertnit
ta tile e signetl siatement thet he or s�e Is Iicensatl pursuent to the proNsions of ihe Contrectors License Law (Chapter 9(cammencing with Seclion 7000) of Divislon 3 oi the
Business antl Pmfesslons Cotle) or Ihet he or she Is exempl therelrom end lhe besis tor tha allege0 exemption. Any violetion of Section 7031.5 by any applicant for a pertnit
subjects the epplicant to a cfvil penelty of not more than tive hundred dollers (3500).):
❑ I, es owner of Ihe propeny, or my employees wlth weges es their sole compensation, WILL DO 7HE WORK, antl Ihe siructure Is not intentletl or oHeretl tor sale (Sec.
7044, Business and Prolessions Code: The Contractors License Lew does not apply to an owner ot propeny who builds or impmves Ihereon, and who does such work
himsatl or harsell or �hrough his or her own employees, provided Ihet such improvements are not intentletl or oHerea for ule. If, however, Ne building ar improvement is
soltl wit�in one year of completlon, the owner-huilder will have Ne burtlen ol proving ihat he or she did not build or improve tor purposa of sale.).
❑ I, as owner ol tha property, am EXCLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to construct the projacl (Sec. 7044, Business antl Protessions
Cotle: Tlie contractors License Lew tloes not epply to en owner ol propeny w�o builtls or improves Ihereon, end who contreds lor such pmject with a contracbr(s)
license pursuant to ihe Conirectors License Lews.).
❑ I am ex0mp� under se[. BuSineu end ProlOssion5 Code �or IhiS reason:
Signature: Date:
Owner ID verilied by drivers license. ❑ Ves ❑ No Driver's License No. Expires:
Verification ol Ownership by (type oi daumen6 I.e. - property �ax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATON:
❑ I hereby cartity that no excavetlon tive (5) or more fee� in dep�h Into which e person is required to descend, wiil be made In connection wi�h work euthonzed by ihis
permit, antl Iha� no buil0ing sirucWre, scaHolding, falsework, or tlemolitlon or tlismantling t�ereof, will be more ihan ihirry�six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tule B, Calitomia Atlminisiretiva Code).
❑ As owner-builder, I will nol employ enyone to do work which would require a Dermll irom ihe Division of Industnel Sefery, as noted ebove, unless such person hes e
permit to do such work from ihe division.
Signature: Data:
�ivision ot Intlustnal Sefary Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF EMRV: I certity untler penalry of perjury that I have read this ap0�ication antl state that the infortnation given is
correct. I agree to compty with all stete laws antl ciry ordinences relating to building conswction, antl authonza representatives of Ihe Ciry of Cos�a Mesa to enter upon tha
ebove-described properry lor insDection purpases. I agrea not to occupY or allow occupancy of eny building authorized by ihis Dermit until final inspection.
cooe �.
1616
7266
Fixed System Final Fire Pravention
Pool Spa Final
200 Final RaRool
207 Final BIocWRetaining Wall
202 Final Fadory Fire Place
203 Final Sign
204 Final Dom
f7.u�r,i�iu��y
COUE I INSPECTION TYPE
206 Final Mechanical
20B Finel Plumbing
210 Final Elecincal
212 Flnel Fire Prevention
220 Final Planning Approval
222 Final Site
250 Finel BuildlnWOccupan�
�.i un.
� ►�Y
June 25, 2006
Salvador Espinoza
332 E i 6'� Street
Costa Mesa, CA 92627
Attention: Inspector
To Whom It May Concern:
,a-��- �r� ��
CD �- ola9�
MOS-oo�oG
i'n 5-c�o�g9
"I7uis letter is to request an extension to finish construction on the above address property. There
were pmblems with the original contractor, Alex Construction. Alex Construction has
abandoned the project and I will be hiring a new contractor to finish the construction project.
Feel free to contact me if you have any questions.
Thank you,
S�-ad°�ri �is-�'`2�.,�v��
s�t��ao� E��o�
714.662-5557
October 17, 2005
TO:
FROM:
RE:
!
CITY OF COSTA MESA
P.O. BOX 7200 • 77 PAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMENT SERVICES DEPARTMENT
OFFICIAL PUBLIC NOTICE
OF ZONING APPROVAL
Distribution List
Claire L. Flynn, AICP, Senior Planner
ZONING APPROVAL (B05-01174)
332 E. 16`h Street
�
�Q -���'.�'
The Planning Division has completed its review of the above-referenced project. The
application has been approved based on the following project description.
PROJECT DESCRIPTION:
The proposed project involves a 1,649 sq.ft. addition to an existing single-family
residence. The proposed construction includes the following: 397 sq.ft. addition to the
first floor and 1,252 sq.ft. addition to the second floor. The proposed project also
includes a new concrete tile roof. The new 3,716 sq.ft., two-story residence will be
approximately 24'9" in height. The addition will feature a variety of architectural
elements, including a decorative belly band, stucco border around windows in a
contrasting color, and a decorative firepiace stack. In terms of massing and scale, the
ratio of the second-story versus the first-story floor area is 51 percent. The proposed
project will convert the existing 3-bedroom, 2-bath residence into a 5-bedroom, 3-bath
residence (includes rooms for office and playroom purposes). The proposed second-
story addition complies with the City's Residential Design Guidelines and Development
Standards. Minor modifications will be approved to allow a 7'6" block wall with pilaster
ball caps and minor encroachment of the second-story master bathroom into the rear
setback (16'8" proposed, 20' required).
APPEAL PERIOD:
The zoning approval will become final at 5 p.m. on Mondav, October 24, 2005, unless
appealed by an affected paRy (including filing of the necessary application and payment
of the $700 appeal fee) or by a member of the Planning Commission or City Council.
If you have any questions regarding this notice, please contact me at 714-754-5278. If
you are interested, you may also call to arrange an appointment to review the building
plans.
Buiiding Divisian p14) 754-5273 • Code Enforcement (714) 754-5623 • Planning Oivision (714) 754-5245
FAX (714) 754-4856 • iD0 (714) 754-5244 • wuav.ci.cosla-mesa.ca.us
a
Location
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PLANNING ZONING REVIEW SUMMARY
226 Loyola Road Plan Check/DR
Number:
Request: �,�52 sq.ft. second-story addition to existing single-family residence
SUBJECT PROPERTY:
SURROUNDING PROPERTY:
Zone: R1 zone North: Single-Family Residential
General Plan: Low Density Residential South: Single-Family Residential
Lot Dimensions: irregular East: Single-Family Residential
Lot Area: approx. 8,426 sf West: Single-Family Residential
Existing Development: sinqle family residence
DEVELOPMENT STANDARD COMPARISON
604-01436
Development Standard City Requirement Proposed/Provided
` Residential Design Guideline;
CEQA Status Exempt- Gass 3, Section 15303
Final Action Planning Division
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Distribution; Mr. Mathieson (Ownerj
226 Loyola Road
Costa Mesa, CA 92626
Mr. Matzuy fAgent)
901 Amber Lane
Lake �Isinore, CA 92530
Miller Trust
2371 LiUleton Circle
Costa Mesa, CA 92626
Percival Tolentino
224 Loyola Road
Costa Mesa, CA 92626
Marles Crow
2365 Littleton Circte
Costa Mesa, CA g2626
�'�i
� � CITY OF COSTA MESA �,
; _ BUILDIN6 DIVISION ,
� _ � DEVELOPMENT SERVICES DEPARTMENT ____C�
J. -. '
` � � PERMIT PERMIT NUMBER
`�aienN
B98-01569
(714) 754-5273 • Fax (714) 754•4856 77 FAIR ORIVE, COSTA MESA, CA 92626
JobAddress: 332 E 16TH ST
Suite:
Vicinity:
Parcel Nunmber: 42521117
Applicant: ESPINOZA, SALVADOR
Address: PO BOX 10863
Owner:
Address
Contractor.
Address:
COSTA MESA,CA � � -
ES PI NOZA;. SALVADOR
PO BOX 70863 �. �
� � � �,�.� .-
COSTA MESA,CA _
� :
BUILDING PERMIT
Status: ISSUED
Applied: OB/31I1998
Issued: 08/31/1998
Zoning:
- Phone:" 714-662-5557 _
Zip: 92627 �.
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-Phone: -� - - _ - _ , \\ �
� ,.
Zip: 92627 `. A . � ��
���' yn �
£ .�
Phone:, pA't
Zip:
� � . License:�� �
Arch/En9� " . ... , .... �.
i
Address: . , = - - .
, ,"Phone:� �� - �
� Zip: - _
, .
- � � ' License: ,
SCOPE OF PERMIT
� � .27 LF OF 2'6" HIGH BLOCK WALL ALONG LEFf SIDE P/L, 60NNECTING FROM EX WOOD FENCE TO
� ,FRONTP/L. , � , � - �
Plan Check: $15.44
Permit: $23J5
SMIP Res: $0.50
SMIP Com: $0.00
Otlier: $0:00
Inspection: $0.00
Total: $39.69
� � �.
SETBACKS
MAINSTRUCTURE Front 0-0 �
ACCESSORY Front 0.0
PARKING Existinq: o
NOTES:
, FEE SUMMARY ; �
_ ��/ i
- -� /
Rear 0- 0
Rear 0- 0
Reouired: 0
PLANNING�& ZONING
Left 0- 0
Left 0.1
Pr000sed: 0
Calc Valuation: Seoo.00
Claim Valuation: So.00
Ri9ht
Right
0- 0
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EXPIRATION: This pertnit shall automatically expire and become vold if work is not commenced within 180 days, or if work is suspended or abandonad
for a period of 1 BO days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlretl Inapeetlone and final approvel must be obtained. Failure to obtain Inspections and final approval will resutt in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
1`�
WORKERS' COMPENSATION DECLARAT�ON: "
I hereby atfirtn untler penalry of pe�ury one o� �he following decleretians:
❑ I heve end will melntain e certificate ol �nsent to seli-Insure for workers' compensetion, es provided for �y sectlon 3700 0l Ihe Lebar Catle, tor Ihe pertortnence of ihe
work for which lhis pertnll is issued.
0 I have and will melntain workers' compensellon insurance, as required by seqion 3700 of the lebor Code, tor the pedortnance of ihe work tor which ihis pemiit Is issueG.
My workers' campensetion Insurence Cerrier enA policy number ere:
CaMer. Policy Number:
(ih/s sectlar neetl not be completed U Ne pB��t !s valuetl et one hundred dollers ($ f 00) oi less.)
❑ I certily that in the peAortnance ot thb work for which this pertnil is issued, I shell not empla/ eny pereon in any manner so es to bacome sub�ect to the workers'
compensatlon laws ot Celifomla, end 6gree Ihet If I should become su6Ject to I�e workers' campensetlon proNsions ot Sectlon 3700 of the Lebor Code, I shall torthwith
comply wIM Ihese provisions.
Applicant Signeture: Deta:
WARNINO: FAILURE TO SEWRE WORKER5 WMPENSATION COVERAGE IS UNL4WFUL AND SNALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES M!D CML FlNES UP TO IXJE HUNDRED
TFIOUSAND DOLLARE (5100,OW), IN ADDRION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE IABOF COOE, INiEHEST, AND ATiORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby ettirtn that I am licensed undar proWsions ot C�apter 9(commencing with Sectlon 7000) of D'Msian 3 ot the Business end Professions Code, end my license is in full
torce entl eNed. LJc. x Class a
Conireclors Signature: Dete:
CONSTRUCTION LENDING AGENCY:
❑ I hereby amrtn Nat there is e constmctlon lentling egenq lor the peAortnence of the work tor which this permit is iuuatl. (Sec. 3097, Civil Cotle).
Lendefs Neme: . _ Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eHirtn thet untlar penalry oi par�ury tdat I em EXEMPT FROM THE CON7RACTORS LICENSE LAW lar the following reeson (SecJ031.5, Business end Professions
Cotle: Any ciry or counry which reqmres a pe�nit to consiruct, eltar, Improve, demolish, or repelr eny siructure, prior to its Issuance, also requires Ihe applicant tor such permit
ro file e signetl statement that he or she is Ilcensed pursuant to iha provisions of Iha Gontrectars License Lew (Chaptar 9(commencing with Section 7000) ot Division 3 oi the
Business end Professions Code) ar tha� he o� she Is eaempt Iherefrom end ihe basis for the ellaged esemptlon. Any violatlon of Sectian 7031.5 by eny appliwnt for a permit
sub)ecis the epplicant to e civll penalry of not mora Ihan tive hundred dollars ($500).):
❑ I, as owner oi Ihe D�operry, or my emp�oyees with weges es Iheir sole compensation, WILL DO THE WORK, end Ihe structure Is not intentle0 or ofrered for sale (Sec.
7044, BuSiness end Pmfessians Cotle; ThB Contrectors License Lew does not epply to an owner oi pmperty who builtl5 or Improves thereon, antl who tloe5 such work
himself or herself or t�rough his or her Qwn emplayees, proNtled Ihet such Improvements ere not intended or aHeretl lor sale. If, hawever, the bulltling or improvement is
soltl within one yeer of completlon, t�e owner-bullder will heve Ihe 6urden ot proving thet he or she dltl not Dulld ar improve for purpose ol sele.).
❑ I, es owner of Ihe praperry, em EXCLUSIVELY CONTRACTING WITH LICENSED COMRACTORS to consiruct the projed (Sec. 7044, Business and Professions
Code: The conirectors License Lew tloes not eppty to en owner of properry who bulltls or improves ihereon, end who contreds for such project wlth a contrector(s)
Ilcense pursuent to the Conirectors lJcanse Lews.).
Dete:
Venfication of Ov+nershlp by (rype of document, i.e. - property taa bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMfi CERTIFICATION:
Expires:
❑ I hereby certity thel no eacavetlon ilve (5) or more taet In depih Into which e person Is requlretl to descend, wlll be metle In connection with work authorized by ihis
permit, anC thet no buildinp structure, s�eRoltling, felsework, or demolitlon or tlismantling ihereoi, wlll De more then thirry-siz (36) feet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Tllle 8, Celifomle AtlmIn15VBIlve Code).
❑ As owner-6uilder, I will not employ eny0�e to do work which woultl requlre a pertnit irom the DlNsion of Indusirial Safery, as noted ebove, unless such person has a
permit to do such work from ihe division.
Signature: Date:
Division of Industrial Salery Partnit Number:
CERTIFlCATE OF COMPLIOJdCE AND AUTHORVJITION OF ENTAY: I certify unCer penalry oi perjury thet I heve read this application antl state that the infortnation given is
conect. I agree to comply with ell stata lews and ciry ordinances releting to Dullding construction, and euthorize represenlatives of Ihe Ciry of Costa Meu to enter upon tha
ebove-Gescnbed properly tor inspec6on OurpOses. I egree not to occupY or allow occupan�y o ny building authorized by this pertnil until final inspection.
S y C � ,�
Signeture Of Legel Owner(s) ' Date
And/Or Authodzed Applicent
CQQE �. INEpECTONTYPE QAiE U�ALS
1616 Fixed System Final Fire Preventian
1288 Pool Spe Final
200 Finel Re-Raof
201 Finel Block/Retelnin9 Wall
202 Finel Fectory Fire Place
203 Finel Sign
206 Finel Demoli�ion
2at8-46
COOEI INSPECTONTYPE
206 Final Met�enical
20B Finel Plumbing
210 Finel Electncal
212 Finel Fire Preventlon
220 Finel Plenning Approvel
222 Final Site
250 Finel BuilCing/Occupancy
��
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OWNER ��� �L M• DATE �G 2 8 1963
JOB ADDRESS 332 E. lEth St. BUILDING PERMIT NO. 20474
SUBCONTItACTOR
/
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� COSTA MESA BUILDING-SAFETY DEPARTMENT F E E R E.fC/� E�I'V E D
P.O.BO%Dl] COBTAMlHA.CALIRORNIA pUG ,.`�. B� IJB�
t
For Applicant fo Fill In Completely ARHI�I��HI`�J,� PERMR
TYPE OR PRINT C.'ty nra�j;��e�y
BUILDIN6 �� C,S � rti ��mf E�n�
ADDRES9 F-�7
q[CHI�T NO. PC MIT NO..
COSTA MESA. CALIFORNIA l
�;��, 2 H �a 63
OWNER e
MAIL L BUILDING • � 7Z /
ApDR65S 3 Z /�d -� �1DDR859 � E>
FIRE /
TEL. ZONE GROUP J
CITY NO -
APPROVE � ��!� : .
ARCHITECT —� TEL. BY �ATE !S
OR ENGINEER N .
ZONIN6
ADDRE55
NO. OF � 118E OP N
�' �. � �urvn em�oirv0.. ?
CONTRACTOR� ` �
�eo.� yo- (� �..,�:T:
AODRE98 [Qy�L� , Deecaimox . -2
7 ' .c' �.,�0 T
A. P. NO. I� �V `�� � ��. n
CITV r
NOTE: NO EAVE OVERHAN6 SH�LL BE LESSTFi �
6TATE TEL. 90' TO SIDE 8 REAR P. L. • +
LIQ NO. �� NO. � i� � �
EAVES �
SIZE I no. op eLnOe. ALLOWED ,''.� N. B. C. REQUIREMENTI u
OF LOT How oN LaT
YARO9 MPROVED YAROSAPPROVED �
U6EOF MAINBUII.DING ACCESSORYBUILDIN6
EXISTINO BLD6.
( FROM GL STREET)
BETBACK LINE FROM FRONT FT. FT.
CENiEHOF6TRER REAR YARO
SIDE YARD LEFf I RIGHT R. SIDB FT. FT.
DESCRIPTION OF WORK L.SIDE �� -
\
NEW _ ALTERATION _ AODITION
REAR FT.
OISTANCE BET. ET. M �
MAIN BLO09. AGGE . B 9.
REPAIR MOVIN6 DEMOLISH
BUILDINO NO.OP VAR.7F DAT �� -
SIZE ROOMB STOR169 C.U.P. APPROVEO
EXTERIOR WALL ROOF APPRO �
COVERING COVERIN6 BY DATE �
U8E OF UILDIfi6 D W K TO B FORMED '
t t .-
1
n
6Q. Ff. �
I HEHEBY ACKNOWLEDOB THAT 1 NAVB R6AD THI9 APPLICATION THE AMOUNT BHOWN UNUEN VALUATION I6 FOq THE F'
•NO BTNTE THAT TH6 ABOV6 IS CORHECT AND AOREG TO COM- PUHPO56 OF f6TABL18HIN0 A PEflMIT FEE ONLY. 0
PLY WITH wLL CITY ORDINANC[Y ANO BTATi LAW6 RBOULATING ypLUATION BC% q
BOIL�INO CONSTR ION. ' q h
SIGNATURE OF /� PERMIT FEE $ N j
PERMITTE OL m
� $/�/ PLAN GHECK $ Q
AUTHORIZED AGEfJT �i � °'
TOTAL PEE /�� �'