The URL can be used to link to this page

Home My WebLink About140 20TH ST - Building Permits r CITY OF COSTA MESA 05Ta4'Fs BUILDING DIVISION Orill9 e•i " I g 77 FAIR DRIVE.COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us J FOR INSPECTIONS CALL: (714)754-5626 '`°° °"" PERMIT NUMBER: BC10-00512 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES ALT DATE ISSUED: 01/20/2011 ISSUED BY: RMD JOB ADDRESS: 140 E 20TH ST CM Suite/Unit: APN: 42618122 Zoning: , Vicinity: REAR OF PROPERTY Primary Occ: Const Type: V-B SQ. FT: 144 Valuation: $30,000.00 SCOPE OF WORK: HOUSING REHAB PROJECT FOR A SFD.WORK TO INCLUDE THE LEGALIZATION OF A 144 ST LAUNDRY ROOM WITH (1-4) GAS OUTLETS, WATER LINE, INSULATE ONE EXTERIOR BEDROOM WALL, RE-WIRE ENTIRE HOUSE TO INCLUDE 10 LIGHT FIXTS, 30 OUTELTS, 12 SWITCHES, REMOVE AND REPLACE SHOWER,WASH BASIN, WATER CLOSET IN EXTRA BATHROOM. REF#: MM-11-01 OWNER: PETRO,MELISSA • Address: 140 E 20TH ST Unit: Phone: 949-646-5266 City/State/Zip: COSTA MESA,CA APPLICANT: YAKEL, PAUL Address: Unit: : Phone: 323-841-0725 City/State/zZip: CONTRACTOR: KOONZE ENTERPRISES License No. 922726 Phone: 714-356-2823 Address: 7121 RUTGERS AVEUnit: Cell: City/State: WESTMINSTER,CA ZipCode 92683 ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: COMBINATION PERMIT FEE SUMMARY Building Plan Check: $287.46 Building Fees: $442.25 Electrical Fees: $95.20 Mechanical Fees: $0.00 Plumbing Fees: $93.50 SMIP Residential: $3.00 SMIP Commercial: $0.00 Bldg Std Admin Fund $2.00 TOTAL FEES: $923.41 **Refer to fee receipts for all fees paid for project HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays: New Years Day, Memorial Day, Independence Day,Labor Day,Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE tl INSPECTION TYPE DATE INTITIAI.S CODE# INSPECTION TYPE DATE INTIDALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's licensee ❑Yes El No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. - ' Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance, as required by• DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized �� by this permit,and that no building structure,scaffolding.falsework,cr demolition y� or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp ��1( his senneed not be compele&lithe permit is valued at one hundred&Oars($100)of less) 2,Art 2Sec.341,Title B,California Administrative Code). ci Igllmber: /8 t 66 2. 7- 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code, I shall forthwith comply with these provisions. ��7/ Division of Industrial Safety Permit Number: ^�� rn re ryItQw HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: NG: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? El Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑No i -Ic'8 - • lass:#' „6' (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by /-2 0-1/ each business which at any one time has on hand a quantity of acutely finals> hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard .I - RUCTION LENDING AGENCY: temperature and pressure). 41 I hereby affum that there is a constmction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes IDNo (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct. alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No issuance.also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes ❑ No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes”, the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and El I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project vnth CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ure of Legal Ow ner(s) Date Signature Date ,� __ • / 2.,–// 305]-46(3/0]) �, - ••• • AI>1nvr2eVApphceml Epat Silvia Kennerson FAX#(71t4) 754-5330 CITY OF COSTA MESA Neighborhood Improvement Program Final Work Write Up 9/30/10 Name: Melissa Petro Home Phone: 949-646-5266 Property Address: 140 East 20th Street Work Phone: N/A • All work is to be done per City of Costa Mesa Building, Planning and Public Works Codes. In order to establish standards of quality, the detailed specifications may refer to a certain product by name and/or from a major manufacturer. This procedure is not to be construed as eliminating from competition other products of equal or better quality by other manufacturers. The Contractor shall furnish the list of proposed desired substitutions prior to signing the contract.All items listed on the work description, unless otherwise specified, shall include all patching and finish work, including trim, hardware, patching and finish painting and/or staining. The Contractor is responsible for all permits, fees, City business licenses,plans, etc. City of Costa Mesa Standard Rehabilitation Specifications applies to all items listed on work description. Work Description: Estimate: Lead Based Paint Components: Bathroom 1: Use lead safe work practices when removing and replacing shower, tile floor, curb and wood door frames. Provide and install new acrylic shower surround complete with $4,900 new pan. Provide and install new shower valve. Provide and install new shower door, Sterling brand or equal. Obtain required permits by Building Dept. Laundry Room: Use lead safe work practices to encapsulate and/or remove and replace wood $900 beam,north and west wood walls,door frames, interior/exterior doors and window frames. Exterior Wood/Roof Trim: Assume full responsibility and liability for compliance with all Federal, State and local regulations pertaining to lead in order to provide material and labor, $1,800 coordinate stabilisation of deteriorated exterior roof trim on eaves and rafters along all sides of the property. Using safe lead work practices to remove and replace all painted trim to match existing color and material. Exterior Wood Beams/Columns/Ceilings: Assume full responsibility and liability for compliance with all Federal, State and local regulations pertaining to lead in order to provide material and labor, coordinate stabilization of deteriorated wood beams, columns and ceiling $2,200 located in the carport and porch. Using safe lead work practices to encapsulate and/or remove and replace wood beams, columns and ceilings to match existing color and material. Exterior Wood Wall/Siding: Assume full responsibility and liability for compliance with all Federal, State and local regulations pertaining to lead in order to provide material and labor, coordinate stabilization of deteriorated exterior paint. Ensure all stabilized paint and $3,900 bare wood be painted with applicable encapsulating primer. Paint exterior per owner's color preference. Kitchen: Use lead safe work practices when removing counter top and wall tiles. Provide and install a solid counter top and tile(material not to exceed$6/s.f.)back splash. $3,900 Remove and replace white porcelain sink and faucet. Faucet to be American Standard or equal and faucet not to exceed $150. Obtain required permit by Building Dept. Water Heater: Legalize existing water heater to meet code with pressure relief valve with discharge line, seismic strapping, and new gas line as needed. Also include new $200 water inlet lines as needed and shut-off valves. Obtain required permit from the Building Dept, Electrical Outlets: Evaluate electrical receptacles throughout SFD. Provide arid replace burnt receptacle in bi,droom 3 with new. $200 Rewire house. Remove and replace wainscot panels if required. Provide and install a light $5,500 fixture(material not to exceed$100) in Bedroom 2. Properly dispose of all debris. Obtain all required permits by the Building Dept. Smoke Detectors: Install battery operated smoke detector in front bedroom(1). $150 Laundry Room: Legalize laundry room. Must provide 3 sets of 24"x 36" plans, 3 site plans (24" x 36"), Title 24 requirements and documents, R13 insulation for walls and R19 for �/, ceiling. Must comply with 10' rear and 5' side setback requirements OR obtain a variance 1 �� 'T $9,200 OR minor modification from Planning. Obtain required approval and permits from Planning and Building Departments. Obtain final inspections. Provide and install linoleum flooring. Prep, prime and paint walls, ceiling and trim. Owner to choose color. One paint color for walls and ceiling(bathroom and laundry room). $750 Roof: Tear off existing roof. Install minimum Class B per Code, 2 layers of 15# felt, 30 n �� A year, composition asphalt shingles, replace/repair sheathing as needed. Approximately 4:12 (� LiV 5,400 pitch, approximately 15 squares for single family. Obtain required permit by the Building Department (proof of worker's comp. insurance required). Bathroom I: Remove and replace water closet. Provide and install tile floor. Material not to exceed$6/s.f. Remove and replace water closet,GFCI receptacle and replace shower. Per the 2007 Plumbing Code: Showers shall be a min.of 1024 square inches and be capable $3,400 of encompassing a 30 inch circle. The door needs to provide a 22 inch clear opening.The curb/dam shall be min. 2 inches, max. 9 inches high unless it is an ADA shower. Paint walls,ceiling and trim. Owner to choose one color. One paint color for walls and ceiling (bathroom and laundry room). Obtain all required permits by the Building Dept. Bedrooms I and 2: Provide and install R13insulatioJfor exterior facing walls in both front $1,300 and rear bedrooms(I and 2). Remove existing paneling for Bedroom I only and replace with drywall. Obtain all required permits by the Building Dept. Doors and Window Trim: Paint all doors and window trim throughout the house. Already $1,200 primed. Sub-Total $44,900 Escrow Fees $414 Contingency $4,686 GRAND TOTAL $50,000 I have reviewed the above work description and understand that any changes,additions or deletions shall have prior approval by the City of Costa Mesa Neighborhood Improvement Personnel. Owner's Signature Date Contractor's Signature Date 2 No = ZO`tS 13C l O 003 1Z .11‘. Ft la gifkIk • STRUCTURAL INSPECTION AND TESTING INC. 571-A North El Molino Avenue • Pasadena, CA. 91101-1103 • (626) 487-1488 • Area4lnc@aol.com JOB NO: DATE; 3 -y// PERMIT NO: _ B6 t O O©S(�_ PROJECT: P T �s u. > e ❑CONCRETE,0 POST TENSION,0 MASONRY, 0 OTHER ADDRESS: /12t1 , �C�Cs 4 4 rS— GEN. CONTRACTOR: OWNER: • SUB CONTRACTOR: ARCHITECT: CONCRETE SUPPLIER: ENGINEER: 77 Se A .. tuti2irtil) 0049 REINFORCEMENT SUPPLIER: REINFORCEMENT•INSPECTED BY: , DATE INSPECTED: Locations of Work Inspected,g7Work Rejected, Problems', Lrrn ,,"Progress, Remarks Etc: RiTQar" tni04 .e -SA"'czei rias22 1,t'I9ob rr C, Lc.th '.inti ,o4; S-Kltc j ��!/4e-rit vh 7 a (' 4 t-Ia 1/S': iv ' icor X ,/ grit, 6 4 4.7za L7 i, . l2I,LR Lm G� • • • • • • LOCATION SAMPLED DESIGN STRENGTH MIX DESIGN _CEMENT TYPE TICKET NO. • SLUMP AGE TO BE TESTED: @ 7 DAYS, @28 DAYS, @ DAYS, OTHER: INSPECTOR'S NAME : /Cana.. .a 8 59307 SIGNATURE: j J ze , c��,v/$J TERMS:Al DAYS,ALL REPORTS WELL BE HELD UNRL ACCOUNT IS FWID IN FULL SERVICES BILLED ATF AND 8 HOUR MINIMUMS,WITH A 4 HOUR CHARdaOR CANCELLATIONS AND TWE AND A HALF FOR SATURDAYS SHOULD AREA 41INC.BE REQUIRED TD INSTITUTE LEGAL ACTION FOR THE COLLECTION OF A DEBT WCURRED AS A RESULT OF YOUR ACCEP- TANCE OF THIS REPORT'AREA A INC WILL BE ENTITLED TO ATTORNEY FEES AND COSTS INCURRED W SAID SUIT THIS FIELD REPWTT PRESENTS A SUMMARY OF OBSERVATOWS AND TESTING BY AREA IWC PERSONNEL OUR WORX DOES NOT WCLI.CE SUPERWSION OR DIRECTION OF THE ACTUAL WORK OF THE CONTRACTOR MIS EMPLOYEE4 OR AGENTS THE CONTRACTOR SHOULD BE INFORMED THAT NEITHER THE PRESENCE OF OUR FIELD REPRESENTATIVE NOR THE OBSERVATION AND YE TWG BY OUR FIRM SHALL EXCUSE HIM IN ANY WAY FOR DEFECTS DISCOVERED W HIS WORK IT IS UNDERSTOOD TWIT OUR FIRM WILL NOT BE RESPONSIBLE FOR Joe OR SITE SAFETY ON DC PROJECT NO. OF HOURS REGULAR : OVERTIME: AUTHORIZED BY CITY OF COSTA MESA w" F, BUILDING DIVISION f �t . 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: BC10-00512 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES ALT DATE ISSUED: 01/20/2011 ISSUED BY: RMD JOB ADDRESS: 1 40-EL20TH-ST GM Suite/Unit: APN: 42618122 • Zoning: , Vicinity: REAR OF PROPERTY Primary Occ: Const Type: V-B SQ. FT: 144 Valuation: $30,000.00 SCOPE OF WORK: REVISION TO PERMIT ON 03/01/11 TO INCLUD THE LEGALIZATION OF WATER HEATER LOCATED AT SIDE OF HOUSE. HOUSING REHAB PROJECT FOR A SFD. WORK TO INCLUDE THE LEGALIZATION OF A 144 ST LAUNDRY ROOM WITH (1-4) GAS OUTLETS, WATER LINE, INSULATE ONE EXTERIOR BEDROOM WALL, RE-WIRE ENTIRE HOUSE TO INCLUDE 10 LIGHT FIXTS, 30 OUTELTS, 12 SWITCHES, REMOVE AND REPLACE SHOWER, WASH BASIN, WATER CLOSET IN EXTRA BATHROOM. REF#: MM-11-01 OWNER: PETRO,MELISSA Address: 140 E 20TH ST Unit: Phone: 949-646-5266 City/State/Zip: COSTA MESA,CA APPLICANT: YAKEL, PAUL Address: Unit: : Phone: 323-841-0725 City/State/zZip: CONTRACTOR: KOONZE ENTERPRISES License No. 922726 Phone: 714-356-2823 Address: 7121 RUTGERS AVEUnit: Cell: City/State: WESTMINSTER, CA ZipCode 92683 ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: COMBINATION PERMIT FEE SUMMARY Building Plan Check: $287.46 Building Fees: $442.25 Electrical Fees: $95.20 - Mechanical Fees: $0.00 ��• \\` \\� Plumbing Fees: $103.30 SMIP Residential: $3.00 SMIP Commercial: $0.00 Bldg Std Admin Fund $2.00 TOTAL FEES: $933.21 "Refer to fee receipts for all fee1paid for project HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010- PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays: New Years Day,Memorial Day,Independence Day,Labor Day,Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE It INSPECTION TYPE DATE INTITIALS CODE 4 INSPECTION TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical ,t( S' L— I' b 1266 Pool Spa Final 208 Final Plumbing X c "b .I I PLt- I 200 Final Re-Roof 210 Final Electrical M? by 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy ,. S -I. t( WO) FTS. rr.� WORKERS'COMPENSATION DECLARATION: • Owner ID verified by drive._,,cense. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. O I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code, for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Ins ranee carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: � person is required to descend,will be made in connection with work authorized rs-y r�� by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier. � l' V 1Z or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Thuon sed not be cnmpeteddthepenn s af�alone hundred dalars(5100)wleu.) olfd (Jl�Yn (((q///¢¢_(((///yyy2,Art 2,Sec 341,Title 8,California Administ2l a Code). ylNumber: ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Dale the Labor e,I shall forthwith comply y with these provisions. Division of Industrial Safety Permit Number: prpenl's Signature '-`-- HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes ❑No � a. `72_� y CI ssw (Section 25533 of the California Health and Safety Code, with some —7 exceptions, requires registration with the Costa Mesa Fire Department by 7�/ " 1( each business which at any one time has on hand a quantity of acutely tlbrTSignature dieate' hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Dale 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑ No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑ No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑ No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and 0 I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Mate als and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractors)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature of legal Owner(s) Dale Signature Date 3057-46(3I07) N• uthorizw APphwnt le ( CITY OF COSTA MESA s. BUILDING DIVISION 4$1.0-91 .� �A I I R 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: B10-00349 PERMIT TYPE B ROOF2 STATUS: JSSUED • APN: 42618122 DATE ISSUED: 11/19/2010 _ ISSUED BY: KJB — — JOB ADDRESS:0140-E 20TH CM Suite/Unit: Vicinity: Squares: 1500 Valuation': $5,000.00 SCOPE OF WORK: HOUSING REHAB PROJECT.TEAR OFF EXISTING ROOF.INSTALL MINIMUM CLASS B ROOF.APPROX 1500 SQ. FT.RE-ROOF WITH COMP SHINGLES. ROOF PITCH IS 4:12 OWNER: PETRO,MELISSA Address: 140 E 20TH ST Unit: PHONE: 949-646-5266 City/State/Zip: COSTA MESA,CA APPLICANT: CHARLIE KOONZE Address: Unit: : PHONE: 714-356-2823 City/State/Zip: CONTRACTOR: KOONZE ENTERPRISES License No. 922726 Address: 7121 RUTGERS AVEUnit: PHONE: , , 714-356-2823 City/State/Zip: WESTMINSTER,CA 92683 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: • FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $111.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $112.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010-PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays New Years Day, Memorial Day,Independence Day, Labor Day,Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE O. INSPECTION TYPE DATE INTITIALS CODES INSPECTION TYPE DATE INIITIAl. 1616 Fixed System Final Fire Prevention �/ / 206 Final Mechanical 200126 Spa 8 Final Plumbing 6 Finall Re-Roof- / y•N1•II L SU 2110 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivr. ...ens,,. '❑Yes ❑No I hereby aff am undel i enalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the erformance of the work for which this permit is issued. • - ave an will maintain workers'compensation insurance, as required by s tion 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My rkers' compensation Insyr�nce carrier and policy IDI hereby certify that no excavation five(5)or more feet in depth into which a number are: C—Cart eco ✓`^ / I person is required to descend,will be made in connection with work authorized �`7 —'t by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This sectonn not be romo9kga ecermrtrsval�-cr one nuneree dollars(SI oo)axss.l 2,Ant Sec.341 Title 8,Califomia Administrative Code). (Policy'Number: LP ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California. and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date the Laborat,I shall forthwith co with these provisio, V Division of Industrial Safety Permit Number: ca 's Signature I �-oata HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my licenseelc)11.,fol and effect. a registration form for acutely hazardous materials? ❑Yes 0 No Lb-CT-72 �4'LS(b t—Class#' (Section 25533 of the California Health and Safety Code, with some Mr exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely o ornractor,'s Signature hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued. (Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption.Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044.Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by Califomia License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑ No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for control officer). sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I. as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date • property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city .ordinances,relating to building construction, and authorize representatives of Business and Professions Code for this reason: ' the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Si natal Owner(s) ( / Signature J 0 Signare Date �> / 305746(3/07) r rerarAuhort2edApplteant to Prescriptive Certificate of C. tri'`liance: Residential - CF-1R-ALT • Residential Alterations 'Page 1'of 5) • PFS `' Climate Zone W / 14 of Stories if) EA)T Mt � . 1�/Jl &O—OO f' 1 General Information SltcAf'°'Id:...,,"-j,qQ e40-.).044% -rte, Enforcement Agency: Date: /r^//i / 0 uiklin rT iT in le Family 0 Multi Family Circle the Front Orientation:N,E,S,W,or degrees_ 1_ 1 n Qr Area -eFA): foo S5 'f1. Project Type: ❑ Alterations 0 Envelope O Fenestratio . ',roof ❑ HVAC t C -- _ Replacement or Change Out ❑Duct Replacement ❑Water Heater NOTE: This form in not to he used for Newly Constructed Buildings or Additions • Insulation Values For Opaque Surfaces(for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration 0 Opening of framed cavity alone-Alterations that involve the opening of the framed cavity ofer wall,ceiling. orfioor must install the mandatory minimum insulation value per§150 for the altered assembly.Fill in Columns A-C and enter mandatory insulation value in Column H. 0 Replacement of entire assembly-Replacement of an entire wall, ceiling,or floor assembly requires the installation of Component Package-D insulation values in Table 15)-C. Fill in Columns A-J. • Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. .A A C D E • F G .1 H ' . •I• • 1 J Proposed s"No" Standard Values From 1A4 Table ' Framing Thickness, i Framed Continuous JA4 Proposed Tag/ Assembly Name Material Spacing,, Uum -values - JA4 Table Cavity Insulation Assembly Assembly Size or ID' or Type' and Other' factor' - Numbers Rlue' - R-Value' Cell Value° U-factor9 Note:For.furred assemblies.accounting for Continuous Insulation R-value,see Page JA4-3 and Equation 4-1. For calculating furred walls use the Mass and ;Furring Consultation table below. I.For Tag/ID indicate the identification name that matches the building plans. 2.Indicate the Assembly Name or type:Roof/Ceiling, Walls,Floors,Slabs, Crawl Space,Doors and etc...lndicate the Frame type and Size:For Wood, Metal, Metal Buildings,Mass, enter 2s4, 2x6, or etc...see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24"OC;or Other for all other assembly description such as Concrete Sandwich Panel,Spandrel Panel,Logs,Straw Bale Panel and etc.... 4.Based on the Climate Zone;enter the Standard Ufa mor front Table 151-B, C or D for each different assembly Name or type. 5.Enter the Table number that closely resembles the proposed assembly. 6. Enter the B-value that ix being installed in the wall cavity or between the framing; otherwise, enter "0". 7. Enter the Continuous Insulation R-value for the proposed assembly;otherwise, enter "0". 8.Enter the row and column of the U-factor value based on Column F Table Number and enter the Assembly U factor in Colunnt J 9.The Proposed Assembly U-famor, Column J. must be equal to or less than the Standard U-factor in Column E to comply. Fun ing Strips Construction Table for Mass Walls Only A 1 A 1 C DIE F G H I .1 1 K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Walls From Reference in Furring Space from Reference Joint Appendix Table 4.3.5,4.3.6.4.3.7 Joint Appendix Table 4.3.13 li U V '_ .0 Y n I r U �: 1 ° - . Assembly -I- j c 9. F' H c a,'s. z.' Final Mass Name or JA4 Table `o = R R m a 't v = " n Assembly y Thickness' Type' Number' < 2 v 3-1 = `, aLL 3 a' r d i m C U-facto ' Comment — It - - t F I I I I 1 Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms August 2009 Prescriptive Certificate of Compliance: F ential CF-1R-ALT Residential Alterations - (Page 3 of 5) Project Name: Climate Zone# i #of Stories • iOOFING PRODUCTS(COOL ROOFS)§151W12 When the area of exterior roof surface to be'replaced exceeds more than 50%of the existing roof area, or more than 1,000 fir, whichever is ess, the nein roofing area must meet the roofing product"Cool Roof'requirements of§152(b)IHi, 152(b)1Hii, or 152(b)1Hiii. heck applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof'.requirements.Note.-If any ne of the alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in 118(0 are not applicable.Do not fi/I table below. , Cool Roofs Not Required in Climate Zones 1-12, 14,and 16 with a Low Sloped. Less or 2:]2 pitch. Cool Roofs Not Required in Climate Zones 1 through)and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less han 51b/ft2. Alternatives to§152(b)IHi and§152(b)Hii,Steep-slope roof(pitch>2:12) ❑ Insulation with a thermal resistance of at least 0.85 hr•ft2'°F/Btu or at least a 3/4 inch air-space is added to the roof deck over an attic;or ❑ Existing ducts in the attic are insulated and sealed according to§151(f)10;or ❑ In climate zones 10,12 and 13,with 1,112.of free ventilation area of attic ventilation for every 150 ft2 of attic floor area,and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or ❑ Building has at least R-30 ceiling insulation;or ❑ Building has radiant barrier in the attic meeting the requirements of§15](f)2;or 0 Building has no ducts in the attic;or .\ .. 0 In climate zones 10,11, 13 and 14,R-3 or greater roof deck insulation above vented attic. Exception to§152(b)1Hiii,Low-slope roof(pitch 52:12) 0 Building has no ducts in the attic. Other Exceptions . 0 Roofing area covered by building integrated;photovoltaic panels and solar-thermal panels are exempt from the below Cool Roof criteria. ND Roof constructions that have thermal mass over the roof membrane with at least 25 lb/fir is exempt from the below Cool Roof criteria. - 'Note:If no CRRC-I label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise, Check the applicable box below if Exempt from the Roofinj Products"Cool Roof"Requirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Number' < 2:12 >2:12 < 51b/ft2 > 51b/ft2 Type2 Reflectance3'4 Emittance SRI5 ❑ ❑ 0 0 ❑4 ❑ ❑ 0 0 ❑4 ❑ ❑ 0 0 ❑4 • ❑ 0 0 0 ❑4 0 0 0 0 ❑4 I. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolr'aofs.ore/products/search.phn 2. /ndicate the type ofproduct is being used for the rooftop,i.e.single-ply roof asphalt roof metal roof etc. 3. If the Aged Reflectance is not available in.the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value front the sante directory and use the equation(0.2+0.7(Pmum—0.2)to obtain a calculated aged value. Where p ii the Initial Solar Reflectance. 4. Check box if the Aged Reflectance is a calculated value using the equation above. 5.Calculate the SRI value hr using the SRI- Worksheet a/hltp://www.energy.ce.gov/til/e24/and enter the resulting value in I/re SRI Column above and attach acapy of the SRI- Worksheet to the CF-Ik. To apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in§I I 8(i)4. Select the applicable coating: 0 Aluminum-Pigmented Asphalt Roof Coating 0 Cement-Based Roof Coating 0 Other Registration Number: Registration Date/Time: HERS Provider 2008 Residential Compliance Forms - August 2009 ▪ Prescriptive Certificate of t- .pliance: Residential CF-IR-ALT Residential Alterations (Page S of 5) • 1'rujecl Na pie: Climate Zone t/ Sof Stories -HERS VERIFI CATION SUMMARY The enforcement agener should par special aaemiar to the HERS Measures specified in this checklist below A completed and signed CF-4R Form for all the measurer specified shall be subrnured rn the building inspector before final inspecnon Duct Sealing & Testing HERS verification is reg[nred for this oteasure. ❑YES ❑ NO 1'ES:In Climate Zones 2 and 9-16,if more than 40 linear feel of new of replacement ducts are installed in unconditioned space,the ducts are to be sealed per§152(b)lDil and the newly installed ducts arc to be insulated pet §)51(It)0. O EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. ❑YES ❑ NO YES:In Climate Zones 2 and 9-16, if the existing space-conditioning system (HVAC equipment and ducting)is replaced,the ducts are to be sealed per t 152(b)1Di. ❑ YES D NO YES:hi Climate Zones 2 and 9-16,if the existing HVAC equipment is replaced(including the replacement of the nit handler, outdoor condensing unit of a spilt system,cooling or heating coil,or the furnace heat exchanger)the ducts are to be sealed per §l52(b)lE. ❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS • verification in accordance with procedures in the Reference Residential Appendix RA3. D L7:CEPTION:Duct systems with less than 40 linear feet in unconditioned space.• .... O EXCEPTION: Existing duel systems constructed,insulated or sealed with asbestos. Refrigerant Charge - Split System HERS verification is required for this measure. ❑ YES 0 NO YES:In Climate Zones 2 and 8-15,when the existing HVAC equipment is replaced(including the replacement of the air handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil,or the furnace heat exchanger)a refrigerant charge measurement shall be verified per§152(b)1F. Central Fan Integrated (CFI)Ventilation System and Fan Watt Draw The ventilation requirements of§150(0)do not apply to existing residential homes. Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. - 0 YES 0 NO YES:In Climate Zones 10 through 15.when the existing space-conditioning system(HVAC equipment and ducting)is replaced.the airflow and fan watt draw shall be verified per*152(6)1C1 to meet the renuirements of§151(f17B. • Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete. 1112M111(, A fctaffrr ,.,4�>-P� Wit_ tet/ -lb- io d roes . t': if Applicable 0 CEA or 0 CEPE r 7/ l ' Cc- (Certification 41): Cit /S i Phon`e: Wraffi+it '� s r ,r'l/ 5S6 z83 Responsible Building Designer's Declaration Statement • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • 1 certify that the energy features and performance specification::lot the building design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts 1 and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance arc consistent with the information provided to document this building design on the other applicable compliance forms, worksheets,calculations,plans and specification::submitted to the enforcement agency lot approval with this building permit application. Name: Signature: Company: Date: Address. License: Cay/State/Zip: • I Phone: For assistance or question:. regarding the Energy Standards, contact the Energy Hotline at: 1-8(10-772-5300. Iteg strut on liontber• l(eprspntmn bate/Trmc HERS Provider: 200/:Itest[iential Compliance Forms August 2009 • ,'t CITY OF COSTA MESA BUILDING DIVISION >`:/ AI DEVELOPMENT SERVICES DEPARTMENT PERMIT BER Tel nm*� PERMIT 2-00797 (714)754-5273' • Fax(714)754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 140 E 20TH ST Status: ISSUED Suite No Applied: 08/26/2002 • Vicinity: KITCHEN AND BATHROOM Issued: 08/26/2002 Parcel Nunmber: 42618122 Applicant: CLARKE, MATT ISSUED BY: Q✓� Address: 8422 HILLHEAD CL Phone: 714-969-4927 HUNTINGTON BEACH,CA Zip: 92646 Owner: PETRO, MELISSA Address 140 E 20TH ST Phone: COSTA MESA,CA Zip: 92627-2202 Contractor: M C ELECTRIC Address: 8422 HILLHEAD CL Phone: 714-9694927 HUNTINGTON BEACH,CA Zip: 92646 License: 786408 SCOPE OF PERMIT ELECTRICAL TO INCLUDE: 1 LIGHTING FIXTURE,7 OUTLETS, 1 SWITCH AND 1 MISC.CONDUIT (40'). FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $1.10 1 up to 50 kva/kw $0.00 0 Recept Outlets $7.70 7 up to 100 kva/kw $0.00 0 Switches $1.10 1 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $18.20 1 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 . Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $51.60 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1,12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days,or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2448-46(Nilo) DECLARATIONSI WORKERS'COMPENSATION DECLARATION: ' I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation insurance carrier and policy number are: Carrier: Policy Number: (This ction need not be completed if the permit Is valued at one hundred dollars($100)or less.) j 1 certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' v compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with rhes_... islon, $ ry -1 Appl—Team Signature A -ie...._. .. .. <Date: ) S. (� l .g – U 2– WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S1OO,O0D),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm.that I am lice s dm proolslons of Chapter 9(commencing with Section 7000)of Division 3 of the Business end Professions Code,and my license is in full force and.effect.Lie.# i s6 ,Crass R1 –/8 Hie ____ .Contractors Signature: /. P .?Date: `:' �j–]-4– U 2– CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business end Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(typo of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(38)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, _or 200 cubic feet of compressed gas at standard temperature and pressure). _ __ _ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑ eo ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required.has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 No (Section 65850.2 of the California Govemment Code requires that the requested information be fumished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescnbed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. S' Wre gal ner(s) A Date ‘ cd/Or Authodzed-App cant `Date_._ .? CODE I INSPECTION TYPE PAIL MALI CODES INSPECTION TYPE DAIS DEALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 20 Final Plumbing k I 200 Final Re-Roof ElectricalII0 Final t 201 Final Block/Retaining Wall 212 • Final Fire Prevention 202 Final Factory Fire Place • 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition _ _ 250 Final Building/Occupancy ADDRESS OF BUILDING: 140 E 20TH ST u"r' CITY OF COSTA MESA — BUILDING PERMIT I awNERS NAMEIp IDi0ylN: MACRES HARRY. ' PERM NO; P 078213 ' ADDRES9t 140 E MACRES, ST .- ' COSTA MESA,CA 92627 PERMIT NO; P 078213 PLAN CHECK NO: N GOVT: N SUPP: N ),PPL.YAWNS AODRE59: 7 2 2—1 3 4 7 CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH 1 ARCHITECT OR ENGINEER: UC,NO.: JOB DESCRIPTION : GAS REPIPE SQ FT: ARCH.OR ENG.'S ADDRESS: OMT: CONfRACTOR's NAME: CLAIM VALUE: CALC—VALUE: GROUP OCC: / CONTRACTORS MAIUNG COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT ADDRESS: UC NO: *#dEdE*1EdE1E1E1E1E1E*1E****1E****1Eif1E1E**RE1E1E1EiE1E141E******1E1E*SE*1414**1E**1EdE*14*1E1E1E#**1E****1E9E*1EdE*** DIST' ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penaty of perjury that I am licensed under provisions of Chapter 9 SE TB ACK S (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. CRT LIC.NO.: LIC.CLASS: UC.NO.: EXP ; MAIN BUILDING ACCESSORY BUILDING Dae: Contractor: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury That I am exempt from the Contractors License Lew for the 4 following reason(Section 7031.5 Business end Professions Code:Any city or county which requires a permit to construct,eller,improve, PARKING REQ: demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed satement that he or she Q: P ROV: PARCEL: 42618122 Z N E: REF NO is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Sedan 7000)of Division 3 of the PLANNING NOTES> Business end Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Sedan L..---- 7031.5 by any applicant tore permit subjects the applicant taecivil penalty of not more than five hundred dollars l$500]). **,*,*,*,*,*,***,***,*****,*** ,* ,***,*,***,*******,***********x,lklEiEiEiEiE1E#1EiE1E1E1E1E1E1kiE141F1F1FiE1E1E1E1E*** ❑ I,as owner of the property or my employees with wages as their ale compensation,will do the work,and the structure is not intended Or offered for sale(Section 7044,Business end Professions Cede:The Contractors License law does not apply to an Owner of property DEVELOPMENT S ER V I C E S , REQUIREMENTS who builds«improves thereon.end who does such work Nmself or herself or through his or her own employees,provided that such . •y r � }j., ori areilhae�hel Nmofp�'n«ip'!mat'eo„'ahowever. btu Nm«mmpwef«hepurpoaeoalw'laele)�'y�d completion.'tom ZONING APPROVED BY ` DATE: L I,as owner of the property,am exclusively contracting with licensed contractions to coasted the project(Section 7044.Business and �l Professions Code:The Contractors License Law does not apply m an owner d property who builds orimproves thereon and who BUILDING APPROVED BY : • /' / h DATE: contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). 7 n pp Dale:❑ IemaxemqurdSed B.6 Per:.t 'I APPLICATION ISSUED BY: DATE: — /0 -(b/under — �i Owner: SS C."21141-7—A71.7 1f 1E 1E 1E 1E 111E 1E 1E 141E 1E 1E 1f 1E 1F 1f 1E if iE 1E 1f 1f 1f 1F 1f if 1E 1E iE 1E iE iE 1F 141E 1E 1k 1F 141E 1E 1E 1E 1E 1E 1E 1f 1F 1E if if 1F 1E 1f 1E 1E1Fif******* 1E***4E4E#** I do hereby certify that I am awared end understand the requirements of is Health and Safety Code Sections 25505,25533,end LEGALIZAT ION:N F E E S UMMARY STRUCTURAL SEGMENT:N 25534,and that I or any future Wilding o«upant will/will not(circle one)need to comply with said stale codes end the requirements for i i" District. applications BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING Provisions. PERMIT 8 . 75 Date: Applicant: 25% U SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: PLAN ' , ElI have and wit maintain a certificated consent ean to setVinare for workers'compensation.as provided for by Sectd ion 3700 the Lebo ISSUE FEE 22 , 00 PA Code.fr the pedmencealtheworkforwhchthispermiisissued, « BUILDING—DIV—> PERMIT ISSUE PLAN CHECK TOTAL PAID DUE o Ihave and wit maintain workers'mnpensetioninsurance,as required bySection 3700of the Labor Code,for the performance dthe TOTALS----> 8 . 75 22 . 00 0 .00 30 . 75 30 . 75 .00 work for which this peanut is issued.My workers'compensation insurance tether end policy number are: T\J • Carrier: REVENUE DIVISION TOTALS--> COLLECTED: 30 . 75 OVER/SHORT: .00 Policy BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need not be completed I the permit is for one hundred dollars($1001 or kiss) 30 . 75 ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'compensation laws of California,end agree that g should become abed to the workers' **************************************'***************************************** compensation provisions of Section 3700 of the Labor Coda,1 shall lathwnh comply with those provisions. Date: Applicant: I N D I V I D U A L-I ',F E E BREAKDOWN Warning:Failure to secure workers'compensation coverage Is unlawful,and shall subject en employer to criminal penalties end TYPE QTY . DESCRIPTION,--, UNIT COST TOTAL COST civil lines up to one hundred thousand dollars(5100,000),In addition to the cost of compensation,damages as provided ler In Section 3706 of the Labor Code,Interest,and attorney's lees. 1 / n PLU 1 GAS RE—PIPE '" ' ,� 8 , 75 8 . 75 • CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is a construction lending agency for the r performance of the work for which this permit is issued(Section 3097,Cy.C). END . FEES i LENDER'S NAME: -1 /t LENDER'S ADDRESS: . I certify that 1 have read this application and stale that the above information is correct.I agree to comply with ell city and county ordinances �- and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property .4 for inspection purposes. HARRY MACRES / nmpName 9/ - - __ .---77 Date:1j�/eg-/ 's/ 1") Si are of Owner/AgentrApplicenVConiredor n ' (5151-46.WP) While-Building A Safety;Green-Rte:Canary-Appkrant;Pink-Revenue;Goldenrod-Assessor 1 CONSTRUCTION AND PLANNING I v POG . SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe•Undrgrnd. - 53. Steel Reinforcement -8.5Electrical Conduit Utility-Undrgrnd. 54. Forms r 3"Ppytrical Conduit-Undrgrnd. 55. Electrical Bonding Sc Stee] Reinforcement 56. Rough Plumbing & Pressure Test _ ..r...-.. C ',-6.--Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE -- _ 7,,jiootings 58. Electrical Conduit-Undrgrnd. -- ti 8• . Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9.'Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Boor System 61. APPROVAL TO DECK 11. Poperty Sewer Line & House Connection -- 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - , 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING . 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning m « _ .mow -t c_FIgkE gr. REQUIREMENT 20. t 3ug :FaE_toryfir Oce :;t-., ,`7. r r �' C.: = tPPCV4%°_, Pettiibit # c s. - -. za ^"2 - cCy3-5 F? r 21. D,sctsrin Struaurec't `-" y y :70. Dhdereo Hero v 22. Q�ctS�,Ve�tlila ng�I:. •Jr . r- C F ,. y cre' ping Upp is •71. Produ CSOiI 23. Gas Fipe-Enough.&Test m,S « ,r. - _ CY' 72. Undergrodnb Ftts' * t- - - CT- crs X �•T /; r-1 V K >. 24. Roof Fra r Ing^ "� .{. > ? t; r,, ..73mUndergrnt&.StorpggTank a Gas 0 Oil 25. Roof$heathing r' Q , . *m C - 0/i �74(:Overhead Hydrt�a. t 26. 713V-ceiling (Struacirall & Nco$o at Y- t 0 m k 7 T ` " '' _ 1; G ;r r,x 75SDry Chergical E.p .4, r; 27. Frame an4;Flashing;t 0,XcC, r 7 :. I7T 76. Dry Stant "pe k-ZC * _ _ _, . -Ire '- -, I-, • t o -28. Lathing&Siding ^' '• 2,`,.., C . < 1 774 FIXED c-YSTElyj,r-6AL ., L., m '29. Insulation•• ¢* s •• t ! 1 1. 788FIRE PR EV. FINa m %' - ': -30. Drywall tiling t.4.: - T I ii, - ; .;'Ar LTHrpEPcRtOUIR'EMENT - ,r, w r I r'31. Plaster Brown,Qoatr, s I ,r!rs t ^79. FINAL IISPECTION t 732. E ectrical Pow Mlel- t;inaal -Y (."`Ja J � '802FOOD CERTIFICATE ISSUED,-, _ i. •1 0* 1 tr. t Cr] ? - -t. �33. Fsnal lectnc a t:, ; ¢ s ' - Notes: // '[ ......•- 4. RinallReating &'Aii''Cond'rionin¢l I t 35. att.'- a .. )-'2-/44// ;-•- C CC -• OH T l - ' 6. Hood-or Canopy t't' I rr� n R ri t * z rIo fi r f T , t R;m i' 'x i +: m T.c T Ili it 37. hinal Factory Firegl oe 1 p H _ g, * r y. 1. nI -38. Final Plumbing ~x �cu a 1 �I� ;y 3: L C '-39. Water=Service•Finah;` 1 � ��; * ` ..t,, L I ._ ... Q 1 I I. „ ., r, • T •40. Gas Service-Final * of <r"r" S •k tr. ' ('t, t--co * r I--“- rr: * 1 F . r.,-; . 741. Solar Domestic-Final," S f.r.1 •' ry It it �n 7 Yt . t-, Ct r <- •_42. Backflow Preventer * CO I' v �fm - - r . • r . r-.1--i r-; * -- v m .r~ * C �$S A. r. •.-.:- T V 43. Backflow 1(69'6-ion . ,. * tc T -,; T. _ 44. Landscape-lrrtgation System y?'t:r G Y m c C r-:z t7 m r. ..r. * - .- C. C fc.:; m t , - •-r. dx - - _. :tea = F H cc tt• lm t z- I-. 'i 7 -..."t F-1 E- - • (Z. Sand AgenUation , e r- m 7 • .• m * - FcC < • 1 T 4. 4 ndicap Regulations �- r x x c( = Cru •• * S f* G, r 0 CJ t • 41. FiNPi1 STRUCTURI& BUILDING r F Cu Y. --r Y 48. F,tNA%L PLANNING r t-•i- * "1j i` 'n m 41: t. F t•.• * 1 - ,x � O CO S T 4 19'. eT cute Release to E4 son ii * to C 50. Gas Release to Southern California.GasCo e I ht r `+ ('!'t * C • F. i t r 3'. _ _7.2 CI 51.. CERTIFICATE OF OCCUPANCY c .. '� :TIM- No Date drrssociawm 140 E 20TH ST WIT: CITY OF COSTA MESA - BUILDING PERMIT wmENSN.MEI mat MACRE& HARRY PERM NO: E 080159 . re amass140 E 20TH ST ' COSTA MESA,CA 92627 PERMIT NO: E 080159 PLAN CHECK NO: N GOVT: N SUPP: N 722-1347 APDL.MAILING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH • ARCHITECT ORENILIEER: lit NO.: JOB DESCRIPTION : SERVICE UPGRADE, ONE OUTLET SQ FT: ARCH.OR ENG.'S ADDRESS: WIT: CLAIM VALUE: CALC-VALUE: GROUP OCC: / conmAcrarsNAME: WRIGHT ELECTRIC/L . WRIGHT ( 909 ) 622-3958 CONTRACTOW$MMLDIO 237 SHERWOOD RD COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT ADDRESS: POMONA CA ueIC.: 611878 *******MESE******************HESE*******************SE*********sESE*iE************+t**** 91768 UNT: Z ON ING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby edlim under penally et perjury Nat I am licensed under provisions d Chapter 9 SETBACKS (commencing with Section 7000)of(Wake Sc'the Business and Professions Code.and my license is in fug force and eded. CrTYuc.No.:056325 uc.cuss: C 10 LIc.No.: 611878 cXP: 05/93 MAIN BUILDING ACCESSORY BUILDING L/J� � FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: /u— � d/'S4 Conrad«: 9727 / LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under parWy of perjury tawing from th5 C«mraoes License Law for the followiq reason(Region7031.5 Business and Professors Code:Any ray or countywhkh reaves a permittoaonsad,alar.improve, PARKING RE : PROV: PARCEL: 42618122 ZNE: REF NO: demolish,«raper any structure.prior to eis seance.eeo requires the apgimd t« Wee e to file a signed"nee Chet he or the PLANNING NOTES> S licensed pursuant to the provisions of the Contractors License Law(Chapter 9(c«mnenen0 with Section 7000)d Division 3 of the Business and Professions Code]or that he or she is exempt therefrom and the bees for the alleged exemption.MY vidal on of Section > .v• 7031.5 by any applicanl for a perm)subjects the applicant to a del penalty of nal more than fire hundred dolls MOOD. ******************************************************************************* ❑ I,eaowneroftheproperlyormyampbyeeswihwagesastheirsolecomprsaiian,willdothework,endtheStreeturewndintended DEVELOPMENT S' E. R V I C E S REQUIREMENTS or offered for sale(Section 7044,Business and Professions Code:The Contractors Licensed law does nol apply to en owner properly t-, who lsuch ids a improves thereon,and who does auwork himsel or hexed Cf through his or her own employees.provided that such de:improvement nal landeda se orafired le.B.however,the l'ttlinga)npeoverned Jessie within ns d l eyarcompon,the ZONING APPROVED BY - DATE: owner-builder vial have the burden of proving he or she did not build or improve for the purpose of sale). ❑ Ias°umerdthe(nasal'am exckntwy cataract jig wail"awl cenaedcrsb eemNd the rain(sectian Toa,Boahrs rad BUILDING APPROVED BY : DATE: Professions Code:The Contractors License Law does rice apply to en owner of properly who builds or improves thereon and who contracts for such projects with a contractor(s)licensed pursuant to the Contractors license Law). p Elm Iaexempt under Section: B.AP.o..for this reason: APPLICATION ISSUED BY: DATE: tQ--, �,YA� 11� — CLL ********************************************** * ******#********************** Dale: Owner: erne LEGALIZATION: N F E E1 SUMMARY STRUCTURAL SEGMENT:N I do hereby candy that I am aware el and understand the requirements or California Health and Safety Code Sections 25505.25533,and 25534,and that I or any haus building compass will/wg not orr)need to comply with mid etre codes and themstwernwsbr BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a peon)for ecsWction or modificationfrom the Air Outlay Management District Residential aonrrudbn appicai«e mexenW from these prodabns. PERMIT 28 . 25 Date: applicant: 50% SMIP/NON-RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations; ISSUE FEE 2200 , ❑ I have and wilmeimaio a certificate of consent to sett-insure tor workers'oompersation,as provided for byswion 37Wd the Labor BUILDING—DIV—> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Cade for the pedororcedthe work for welch this permit eIssued. TOTALS----> 28 . 25 22 . 00 0 . 00 50 , 25 50 . 25 . 00 . .3 I have and wit ma'vaaii workers'compensation insurance.as required by Section 3700 d the Labor Code.for the performance d the , work for which this prow is issued.My workers'compasatbn banana center and poly number are: Gamer: REVENUE DIVISION TOTALS--> COLLECTED: 50 . 25 OVER/SHORT: , 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (This section need not be completed I the panel is b one hundred dollars(S IX)or Jest) 50 . 25 ' ❑ I eerily that in the performance of the work for which this perm)Is®ued.I shag not employ any person it any rummer so ea to become subject to the workers'compensation laws d California,and ern tel 11 should become subject to the workers' **********************************!f******************************************** comperaaipm provisions d Section 3700 d the Labor Code.I shell t •h comp*,,/who/those provisions.y/ IND IV IDUAL F E E BREAKDO 14 N / Daeria :J0 — .Y -S 6 Applicant K 5 c Warning:Failure to mecum workrsconpruadon contrive le unlnrNLa h subject aneAphotwr toatSnef penalties end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST dM fines up baa hundred thousand dollars($104000),N ddlrbn to the coat of compensation.damages es Provided for In Secton3706ofthe L.aborCode,IMt, reaandattomey''ees. ELE 1 RECEPT/OUTLET 1 ST 20 EA. 1 .00 1 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjay that thele is a canstndimn lending agency for the ELE 1 SERVICES BELOW 600 , V & BELOW 201 AMP 27 . 25 27 . 25 performance of the work for which this permit i,issued(Salton 3097.Cie C). END OF FEES LENDER'S NAME: _ LENDER'S ADDRESS: , I certify that I have read this application and gate that the above information is coned.I epee to comply with an thy and ooaay ordinances and state Laws relating to boldly construction and hereby authorize representatives el this dtyb enter upon the above-mentioned property for inspection purpesss.LARRY WRIGHT 01 00217836-00217836 TOT 50.25 DATES 10/24/95 TIME: 11:47 ��b�,�.��, Print Name ...,L G/Ly`1 of jaws mat.// Date: i�,1 Y 6 ue d c. N/Appicanttiantred« (5151-48.WP) White-Sugdig&SaletY:Oreen-Fueco...^—anne'ant:`k-Revenue:Goldenrod-Assessor '-. CONSTRUCTION AND PLANNI,.., Date Inspector ,IOL & SPA ''y APPROVALS Permit# • APPROVALS Permit # Date Inspector -= Temporary Electrical Service or Pdle • 52. Pool & Equipment Location } 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement t 3. Electrical Conduit Utility-Undrgrhd. 54. Forms 4. Electrical Conduit-Undrgrnd. -. 55. Electrical Bonding i 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVE R-GUNITE V 7. Footings 58, Electrical Conduit-Undrgrnd. ' 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test ' 9. Water Pipe-Undrgfnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK ' 1 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 1 63. Heater & Vent-Final 1 13. Roof Drains ) 64. Plumbing System - Final I 14. Rough Plumbing } 65. Electrical-Final 1• , 15. Rough Electrical-Conduit '� 66. Solar System-Final 16. Rough Electric Wiring67. Fencing& Access Approval • 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace . APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating , 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test - 72. Underground Flush 24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation • 78. FIRE PREV. FINAL 30. Drywall Nailing _ HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final . / 80. FOOD CERTIFICATE ISSUED,/ / D,,( 33. Final Electric S1 /p % Notes: s�L-97 coW' , O 4o o' i 34. Final Heating& Air Conditioning ((( (((��""" C.✓ 'ids 35. Final Gas Pipe-Test 36. Hood or Canopy • 37. Final Factory Fireplace 38. Final Plumbing . • 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date