HomeMy WebLinkAbout396 20TH ST - Building Permitsp M6
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CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
(714) 754-5273 • Fax (714) 754-4856
Job Address:
Suite No
Vicinity:
396 E 20TH ST
Parcel Nunmber: 42623'I7'I
nppucant: BANGERT, RUSS
Address:
Owner: THORLEY, JOHN P
Address: 396 E 20TH ST
COSTA MESA,CA
Contrector: A.B.C. HEATWG 8 A/C
Address: 2951 GRACE LN
COSTA MESA, CA
ArchlEng:
Address:
ISSUE FEE
Inst FAU <700 k BTU
Inst FAU >100 k BTU
Repair/Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refng Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single DuIX
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
Air Handlers > t0000dm
Floor Furnace
Floor or Suspend Heater
MECHANICAL PERMIT
REPLACE 7 WALL HEATER.'
$22.00
$0.00
$0.00
$0.00
$7325
30.00
$0.00
E0.00
so.00
$0.00
so.00
$0.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
Phone:
Zip:
Phone:
Zip: 92627
Phone:
Zip: 92626
License: 133298
Phone:
Zip:
License:
SCOPE OF PERMIT
FEE SUMMARY
1
PER TNUMBER/
M98-00502�/
77 FAIR ORIVE, COSTA MESA, CA 92626
Repair / Alt Absorbtion Unit
Repair I Alt Refrigeration Unit
Ventillation System
Evaporative Cooler
Commercial I n ci nerator
Domestic Incineretor
Compressors / Absorption SVstems
Upto3hp/100kBTU
3 To 15 hp / 500 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
Boilers
Upto3hp
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
Status: ISSUED
Applied: 10I30l7998
Issued: t013017998
Quantity
$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
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
535.25
EXPIRATION: This permit shall automatically expire and becoma void if work is not commenced within 180 days, or ii work is suspended or abandoned
tor a period of 180 days. .
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicabla codes, and all
required inapeetlona and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of �his permit.
FOR INSPECTIONS CALL: (714) 7545826
WORKERS' COMPENSATION DECLARATION: �
I hereby aRrtn untler penalry of perjury one ot the idlowing tledaretions:
❑ I have and will meintein a cenifiwte of consent to self-Insure lar workers' compensetlon, es provided for by section 3700 ot the Labar Code, for the peAortnance of the
��Q w"""ork tor which Ihis permil is iuued.
�,p� have and will maintain workers' canpensation insurance, es required by section 3700 of Ne LeOor Cpde, for the peAortnance of tha work for whic� Nis pemut is iswed.
�M wo com ns on Insurence canfe/reud� li numbar ere: (� n /'7�f �
Cartier:Y� y / /�rr�.i PolicyNumb�7�J/��a//
(Thls section need n e complefetl il Ne pe � s va/u f one �untl�ied tlallea (5700) or Iess.J /�—
❑ I certify that'Ifi thp petlortnence of t�e
compansation la�4s of C,alifomfe, and e�
LICENSED CONTRACTOR$ DECLARATION:
CONredor's
CONS7RUCTION L�NDING qGENCY:
br whicti this portnit is issued, I s0all not orr ploy-eny-p on in eny menner so as to Cecome subject to t�e workers'
et ff I shoultl becom ubject fo lhe workers' compensetiqn.pr ' ns ol Seclton 3700 of �he Lebor Code, I shell forthwith
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COVERAGE IS UNUW FUL AND SMALL SU61EGf EMPLOYEH TO C INAL PENALTIES M1D CML FlNES UP TO ONE HUNDRED
T OF COMPENSATON, OAMAGES AS PROVIDED FOq IN S THE IABOR COOE, INTEREST, AND ATfORNEI"S FEES.
Section 7000) of Divislon 3 0l tho
De�e:
❑ I hereCy aHirtn thet there is e wnstruction lendinq egenq far Iha peAormence ot iha work lor which t�is pertnit Is Issued. (Sec. 3097, Civll Cotle).
Lentlefs Name:
Signeture: _
OWNER•BUILDER DECLAqpTIONS:
Lentlefs Atldress:
Date:
entl my Iicense is in full
I hereby eNirtn Ihet under penalry at perjury that I em E%EMPT FROM THE CONTRACTORS LICENSE LAW lor the following raeson (Sec. 7031.5, Business antl Prafessions
Cotle: Any ciry or counry whlCh requires a permlt to consiruct, altar, Improve, tlemolish, or repalr eny stmcWre, pdar to Its issuance, elso requires the eppliceN tor such permit
to file e signed statemenl ihe( he or she Is licensed pureuent ro t�e provl5ions of �he Contrectors Licensa Lew (Chapter 9(commencing wit� Sectlan 7000) oi Divlsion 3 0l the
Business end Pmfessions Cpde) or that he or she is exempt therefrom entl the basis tor the elleged exemptlon. Any vlolatlon of Section 7031.5 by any applicant tor a permit
sublects the epplicant to e civA penalry oi not more then Me hundred dollare ($500).):
❑ I, es owner of the properry, ar my emD�%'ees with weges es t�elr sola compensatlon, WILL DO THE WORK, entl the strucWre Is not inientled or oflared for sele (Sec.
7044, eusiness end Profeuions Cotle: The Contractors Llcense Lew does not epply to en owner of property who builds or imOroves thoreon, end who does such work
himseN or herseli or t�rough his or �er awn employees, proNdetl that such improvements are not intenEetl or oHeretl for sala. If, however, Ihe bullding or Improvement is
sold within ane year of completion, Ihe ownervbuiltler will �eve the burden of proving thet he or she dltl not bufltl or improve for purpose o1 sale.).
❑ I, as owner of iha property, am EXCLUSIVELY CONTRACTNG WITF1 LICENSED CONTRACTOqS to consiruct ihe project (Sec. 7044, Business and Professions
Code: The wntractors Licensa Lew does not apply to en owner of property who builds or improves ihereon, entl who con�rects tor such pwject wlth e con�ractor(s)
licensa pursuanc m Ihe CONractors License Lews.).
❑ I am ezempt untler sec.
SignaNre:
Owner ID verified by driver'Slicense. ❑ Yes ❑ No
Busineu and Prolessions Code tor this reason:
Venficetion oi Ownership by (type ol dacument, i.e. - pmperty tex bill or deed):
Drivars License No.
Dete:
ExpireS:
DIVISION OF INDUSTRIAL 6AFETY PERMR CERTIFICA710N:
� I hareby certity t�et no e:cavatlon tive (5) or more leet in Oepth into which e person I5 requlretl ta tlescenQ wlll be mede In connectlon with work aut�orizetl by this
pertnit, and t�el na building structure, scaHoltling, lalsework, or tlemolillon or di5mentling thereot, wlll be moro then ihirry-Six (38) feet �igh. (Chep. 32, Grp 2, Art 2, Sec.
347, Tii7e 8, Calltomla 4pminlstrethre Code).
❑ As owner-builder, I wlll not employ anyone to do work which would require e pertnll trom the Divislon of Intlusirlal Safery, es notetl eDove, unless such persan hes a
permit to Co such work Irom t�e tliNsion.
Slgneiure: Da�e:
Dlvision ol Indusirial Sefery Permll Number:
CERTi CAlE OF COMPLIANCE AND AIJIHORRA710N OF EMAY: I certily untler penalty of perjury �he� I have read this epplicaiion end stete ihat ihe information given is
corte I egree to�wm Iy�with ell stet ews end ciry ordinance elatlng to building consiruction, end euthodze represe tetives ofJ� Ciry ot Costa Mesa to enter upon the
eb -described pro /Aies� � purposes. I agree no occu or ellow occupancy ol eny builtling au ed '�K9Ftil fln�gp�e�
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Rlnnmimn�f.N narlsl Da�9
LODE �. INSVECTIONTYVE Qe¢ I�IS
1618 Fixetl System Finel Fira Prevention
126fi Pool Spe Final
200 Final Re-Rool
201 Finel BIocWRetaining Well
202 Final Fectory Flre Place
203 Final Sign
20d FinalOemolition
26a8d6
COUE 1 INSPECTION TYPE
206 Finql Mechenicel
208 Finql Plumbing
210 Final Electdcal
212 Final Fire Prevention
220 Flnel Planning ApO�a�al
222 Final Sita
250 Finel BuIINng/Ocapency
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