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Home My WebLink About269 20TH ST - Building Permits / - c 0110 CITY OF COSTA MESA 111111 ' otity.j. BUILDING DIVISION s r->!�. 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754.4856 • www.ci.costa-mesa.ca.us F i .��-- , 4• lin� FOR INSPECTIONS CALL:(714)754-5626 4e4,1.0.660PERMIT NUMBER: BC08-00454 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 10/29/2008 ISSUED BY: RMD JOB ADDRESS: 269 E 20TH ST CM Suite/Uriit: APN: 42628404Zoning: , •Vicinity: Primary Occ: R3 Const Type: VN ' . SQ. FT: 511 Valuation: $100,000.40 SCOPE OF WORK: LEGALIZE 511 SF FAMILY AND BEDROOM ADDITION, INTERIOR REMODEL OF EXISTING HOME (1,763 SF) AND REMODEL EXISTING GARAGE (440 SF)WITH 32 LIGHT FIXT, 37 OUTLETS, 17 SWITHCES, 1 SVC TO 200A, 3 VENT FANS, 1 FAU < 100 K BTU, 1 REPAIR/ALTER COOLING/HEAT,2 SHOWERS, 1 KITCHEN SINK, 3 WASH BASINS,2 WATER CLOSETS, 1 WATER HEATER, 1 WATER-REPIPE, 1 BATHTUB, 1 GAS (1-4 OUTLETS). REF: BX08-00115 FOR INVEST. OF EXIST. CONDITIONS& PERMIT HISTORY OF NON-COMPLIANT CONST. OWNER: STANTON, DAVID AND LISA Address: 269 E 20TH ST • ' Unit: Phone: 949-650-7447 City/State/Zip: COSTA MESA,CA APPLICANT: MEYLING,GEERT Address: _ - Unit: : Phone: 714-731-7417 City/State/zZip: • . CONTRACTOR: GEERT MEYLING CONSTRUCTION • License No. 619089 Phone: 714-731-7417 Address: 1852 HAMPSHIRE RDUnit: Cell: City/State: TUSTIN,CA ' . ZipCode 92780 ARCHITECT: ROBERT STERN ARCHITECT License No.C16865 - PHONE:714-556-2656 ENGINEER: MORTEZA OREIZY-KSI CONSULTING License No.C35229 PHONE:714-282-8770 COMBINATION PERMIT FEE SUMMARY . Building Plan Check: $645.94 - Building Fees: $993.75 . Electrical Fees: - - $137.87 Mechanical Fees: $73.95 t. ,. .,, • Plumbing Fees: $137.45 SMTP Residential: $10.00$ SMTP Commercial: $0.00 TOTAL FEES: $1,998.96 4fd) . **Refer to fee receipts for all fees paid for project • 4iir . . 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. CODER, INSPECfON TYPE ea INIIIIALS CODES INSPECTIONME QAAg INIIUAL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical 2t'7-(13( t K 1266 Pool Spa Final 208 Final Plumbing ,/ Al 200 Final Re-Roof 210 Final Electrical 11/i67[o ir 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site `1723, 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATIO - _ Owner ID verified by dr nse. ❑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 foi 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 - 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 Insurance carrier and policy 0 I hereby certify that no excavation line(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,or demolition Carries or dismantling thereof,will be more than thirty-six(36)feel high.(Chap.3.2,Grp (mi section need not be mnpleted a'the perm 46 valued at one hundred attars($100)ot less.) 2 Art 2Sec.341.The 8,California Administrative Code). Policy uN mber: ❑ As owner-builder, I will not employ anyone to do work which would I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of gpphcant's Signature Date the Labor Code,I shall forthwith comply with these provisions. I n O$ Division of Industrial Safety Permit Number: • . _Date 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,isin full force and effect. YJ a registration form for acutely hazardous materials? 0 Yes 0 No tic"# 4 1 Cl O c\ Class# I 1 (Section 25533 of the Califomia Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by — 16 fl 1- v 2, each business which at any one time has on hand a quantity of acutely Date 1 hazardous materials equal to or greater than a weight of 500 pounds, or a p 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: Lender's Address: ( V (p f hazardous materials)? 0 Yes ❑No I\ f 0 is V 7 C (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. 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 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? ❑Yes 0 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 0 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 ❑ 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 art 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 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. Signature of Legal Owner(s) Date • • Signature Date 3051-46(3/07) 'AAd/or,Authorized Applicant Date ' 0. Ote8 • 01 NEWPORT-MESA UNIFIED SCHOOL DISTRICT 0112�6921� � - CERTIFICATE OF COMPUANCE OF DEVELOPMENT FEES PURSUANT TO AB 1600 AND AB 181 I q trig GI To: ( V) City of Costa Mesa 'strict eceipt No. ( ) City of Newport Beach •i2[y�))yr I ( ) County of Orange tan C eck No.—1 "� L Applicant: lc5ur1� nu 1 ( O `cA • r / T / Address: r• i L& A I TIM MI i Telephone Number: 'J 1 VI / /31- 7 7 Li, J Tract/Parcel and Lot Number(s):I (42.-49‘2. 1jL4' DLj Location of Project: P 1,1 . ozaii .90 • Number of Square Feet of: � 41 U Residential Space :1[40__ v�/p x $1.84 Total / 1I, • ?(.4 Commercial and Industrial Space x $ .30 Total CommerciaUlndustrial Project is: (Check One) _ Warehouse _ Motel _ Preschool _ R & D _ Bank ____ Auto Repair Movie Theater _ Neighborhood Shops _ Hospital Mini-storage _ Racquet/Health _ Large Office Heavy Industrial _ Hotel _ Office Bldg. Regional Shops _ Medical Office _ Restaurant Light Industrial _ Office Park _ Fast Food This project is exempt because This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Govemment Code sections 53080 and 65995. The Building Permits for this square footage in this proposed develop =nt may now be issued by your jurisdiction. Checks are to be made payable to Newport-Mesa Unified School Distri By: Sak Authorized R-. .•live • The above representation as to square footage is true. Applicant agrees that if it is la determined that such representations are not true,then this certificate shall automatically terminate and the appropriate City/County shall be notified. Date: I 0 _Z-cl — °°% Applicant CITY OF COSTA MESA • �r BUILDING DIVISION >• �' �;� 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us tr. irfa FOR INSPECTIONS CALL: (714)754-5626 * PERMIT NUMBER: BC08-00454 PERMIT TYPE: B_COMBO STATUS: FINALED Sub Type: RES_RRIP - DATE ISSUED: 10/29/2008 ISSUED BY: RMD • JOB ADDRESS: 269 E 20TH ST CM Suite/Unit:APN: 42628404 Zoning:• Vicinity: Primary Occ: R3COV1 Const Type: VN SQ. FT: 511 • Valuation: $100,000.40 SCOPE OF WORK: LEGALIZE 511 SF FAMILY AND BEDROOM ADDITION, INTERIOR REMODEL OF EXISTING HOME (1763 SF) AND REMODEL EXISTING GARAGE (440 SF)WITH 32 LIGHT FIXT, 37 OUTLETS, 17 SWITHCES, 1 SVC TO 200A, 3 VENT FANS, 1 FAU < 100 K BTU, 1 REPAIR/ALTER COOLING/HEAT,2 SHOWERS, 1 KITCHEN SINK, 3 WASH BASINS, 2 WATER CLOSETS, 1 WATER HEATER, 1 WATER-REPIPE, 1 BATHTUB, 1 GAS (1-4 OUTLETS).. REF: BX08-00115 FOR INVEST. OF EXIST. CONDITIONS 8 PERMIT HISTORY OF NON-COMPLIANT CONST. OWNER: STANTON, DAVID AND LISA Address: 269 E 20TH ST • Unit: Phone: 949-650-7447 City/State/Zip: COSTA MESA,CA APPLICANT: MEYLING,GEERT Address: Unit: : Phone: 714-731-7417 City/State/zZip: • CONTRACTOR: GEERT MEYLING CONSTRUCTION License No. 619089 • - Phone: 714-731-7417 Address: 1852 HAMPSHIRE RDUnit: Cell: City/State: TUSTIN, CA - . ZipCode 92780 ARCHITECT: ROBERT STERN ARCHITECT License No.C16865 PHONE:714-556-2656 ENGINEER: MORTEZA OREIZY-KSI CONSULTING License No.C35229 • PHONE:714-282-8770 COMBINATION PERMIT FEE SUMMARY Building Plan Check: $645.94 Building Fees: $993.75 Electrical Fees: $137.87 Mechanical Fees: $73.95 Plumbing Fees: $137.45 SMIP Residential: $10.00 • SMIP Commercial: $0.00 Bldg Std Admin Fund ?? TOTAL FEES: • $1,998.96 • "Refer to tee receipts for all fees pain for project • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. C DEL INSPECTION TYPE LG¢, INTmAL$ CODE/ INSPECTION TYPE • �jE 1818 Fixed System Final Fire Prevention 206 Final Mechanical - i �' . 1266 Pool Spa Final 208 Final Plumbing /(a��7 �5f 200 Final Re-Roof 210 Final Electrical /(Y� 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver,.„cense. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: 0 I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-properly 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 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 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,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp (This section need ME bemmpleted A the permit is valued at one hundred dollars WOO)or less) 2 Art 2,5cc 341,Title B,Califomia Administrative Code). Policy Number: 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 is.! ✓t employ any person in any manner so as to become subject such person has a permit to do such work from the division. to t CVl*,:, tion laws of Califomia, and agree that if I should be,.' '±:) mpensation provisions of Section 3700 of Applicant's Signature Date a s• ' . th& -.bar Co.f.t ;r 'Si v h nply with these provisions. J Division of Industrial Safety Permit Number: Applicant's Signa Date 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 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? 0 Yes ❑No Lic.# Class# _ _ (Section 25533 of the California Health and Safely 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 Contractor's Signature Date 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). O 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)? 0 Yes ❑No (Section 25534 of the Califomia 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 Califomia OWNER•BUILDER DECLARATIONS: Health and Safely Code been fully complied with? 0 Yes 0 No 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? 0 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 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? 0 Yes 0 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). O 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 0 No (hereon,and who does such work himself or herself or through his or her own • 8. (If yes',attach certificatecompliancefrom theriate air pollution employees, provided that such improvements are not intended or offered for of appropriate 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 city ordinances regarding Hazardous Materials and Emissions. ❑ 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 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. Signature or Legal Owner(s) Date Signature Date 3057-46(3/07) And/or Authorized Applicant Date / w a CITY OF COSTA MESA J BUILDING DIVISION F' '• 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us O- rigs • FOR INSPECTIONS CALL: (714)754-5626 • PERMIT NUMBE E08-00379 PERMIT TYPE ELEC STATUS: ISSUED . APN: 42628404 DATE ISSUED: 10/02/2008 - ISSUED BY: RMD JOB ADDRESS: 269 A E 20TH ST CM Suite/Unit: ' • A • Vicinity: - - -- SCOPE OF WORK: ELECTRICAL PERMIT FOR TEMPORARY POWER POLE IN PREPERATION LEGALIZATION WORK. NO CONSTRUCTION AUTHORIZED UNDER THIS PERMIT. OWNER: FURDUI, LAURA A Address: 269 E 20TH ST Unit: PHONE: 949-631-4313' ' . - - City/State/Zip:, COSTA MESA,CA . - � , APPLICANT: MEYLING;GEE_ RT .;` I • Address: 1852-HAMPSHIRE lftD, Unit:, • PHONE: 714-731-7417 - City/State/zZip: TUSTIN,CA CONTRACTOR: GEERT MEYLING CONSTRUCTION License No. 619089 • Address: 1852 HAMPSHIRE RDUnit: - 'PHONE: 714-731-7417 City/State: TUSTIN, CA ZipCode: 92780 CELL: ELECTRICAL PERMIT FEES . Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $47.00 Reinspection Fee - $0.00 TOTAL FEES • $47.00 Ratio 4 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in.the expiration of this permit. CODE I. INSEECTIONTYFE DATE INTITIAL$ COOP if INSPECTION TYPE PATE !APPALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ' D - L 200 Final Re-Roof 210 Final Electrical PSR- Wr 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 • . a. Or WORKERS'COMPENSATION DECLARATION: Owner ID verified by di1 ,cense. ❑Yes ❑No I hereby affirm under penalty 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 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: -. permit is issued. My workers' compensation Insurance carrier and policy ❑ 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,or demolition CCarrier or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp (This sedan need not be completed I the permit is valued at one hundred dollars($100)or less.) 2,Art 2,Sec,341,Tale 6,California Administrative Code). Policy.Number: i. ❑ As owner-builder, I will not employ anyone to do work which would -XfII 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 A p;;canI Signature Date the Labo Code,I shall forthwith comply with these provisions. 1 6 ^2 ^O % Division of Industrial Safety Permit Number: tiwnt's Signature :Date' 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 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? 0 Yes 0 No 'Lic.#" - &' I Cf O $ CIDss'#- (Section 25533 of the California Health and Safety Code, with some I exceptions, requires registration with the Costa Mesa Fire Department by I CD.—Z-2._ —O each business which at any one time has on hand a quantity of acutely r-\ •• - • Ignature c-Date 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)? 0 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 Califomia 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,tor repair any structure, prion to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file,a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested that he or she is licensed pursuant to the provisions;bf the'Contractors information be furnished on applications for non-residential buildingits. License Law(Chapter 9(commencing with Section 7000)'of Division 3'of the perm ) 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 0 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 0 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 ❑ 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 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.• - - 1Ovmegs) Date Signature Dateeiir �j 3057'46(3107) t• a— "� _ U Cj - i.ri Ted Applicant ter Dale `p c • CITY OF CCSSTA MESA 4 BUILDING DIVISION 0,fes _ F • : ohl 6 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT• B06-01158 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ERRLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 269 E 20TH ST Status: ISSUED Suite: Applied: 07/12/2006 Vicinity: FRONT ROOF ONLY Issued: 07/12/2006 Primary Occ: R3 Type of Construction: V-N Parcel Number: 42628404 Zoning: Applicant: FURDUI, LAURA A Address: 269 E 20TH ST Phone: 949-6314313 ISSUED BY: _ COSTA MESA,CA Zip: 92627 Owner: FURDUI, LAURA A Address 269 E 20TH ST Phone: 949-631-4313 COSTA MESA,CA Zip: 92627. I EXPRED Contractor: OWNER-BUILDER jYyiJLL Address: D ,---�•� Phone: Zip: License: 000000 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REVISION TO PERMIT ON 11/07/06 IN ORDER TO REPAIR AND REPLACE RAFTERS LIKE FOR LIKE DUE TO TERMITE DAMAGE AND DRY ROUG PARTIAL REROOF OF HOUSE ONLY(FRONT ONLY,REAR PORTION NON INCLUDED).TEAR OFF(E)ROOF MATERIALS,INSTALL 1 LAYER OF 30#FELT AND REROOF W/30 YEAR COMP SHINGLES ON HOUSE ONLY,APPROX 1,890SF.REPAIR AND REPLACE SHEATHING AS NEEDED. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $3,000.00 Permit: $83.25 Claim Valuation: $3,000.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $83.75 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0.0 Left 0-0 Right 0-0 PARKING Existinq: 0 Required: 0 Proposed: 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 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(800) • DECLARATIONS I "" 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 sell-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carder and policy number are: Carder: Policy Number: (This section need not be completed it the permit is valued et one hundred dollars($100)or less.) C _ I certify that In the•= ormanco 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' California,an gree 1 at If hshould become subject to the workers'compensation provisions of Se lion 3700 of the Labor Code,I shall forthwith comply with lhes p; i si�o�j ia) _Applicant Signature: 0 A/'Wl f Dete:-1t 06 WARNING:FAILURE TO SECURE WORKERS' ENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRI ENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE(St @,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commenting with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force end effect.tic.4 Class 0 Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of penury 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 acts the applicant to a civil penalty of not more than five hundred dollars($500).): T I.as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license p suant to the Contractors License haws.). ❑ I am axe t under sec. Business and Professions Code for this reason: Sig t rung ruae:: __ ... . Date: k 1t I O G Owner ID ve' by driver's license. ❑Yes ❑No Drivers License No. � �._ Epires: 'Q•I O S 1 1 O Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,talsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or 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? ❑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 ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the-applicantor present or future building Occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and Tiling with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑Yes U No (Section 65850.2 of the California Govemment Code requires that the requested Information be furnished on applications for nonresidential building permits). 6 Wit 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). ._ ._.or...oher l_ —__d..fo_..t_.____ 7 If a patrohav tae South Coast res prescri edManagement biHeal or Sr air pollution ooncontrol district3 agency is required far the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 Of yes",attach certificate of compliance fmm 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 end Emissions. Signature: Date: CERTIFIC TE 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 ree to comply with all state laws and city ordinances relating to building construction,and authorize representativ¢5 of the City of Costa Mesa to enter upon the above- a bed property for' pection pu sea.I agree not to occupy or allow occupancy of any building authoriI l ypthis p�rmit untiljlnal inspection. a l Iof(o nature Or'Leg ner(s) ! Date -- - And/Or Authorized Applicant Date CODE I IfISPECIION TYPE 181E KEW CODEC INSPECTION Mg ) g& It4AL$ 1616 FlxedSystem Final Fire Prevention 206 Final Mechanical iii//// - 1268 Pool Spa Final A) k • 1)C1 ' 208 (FInetPlu bing� i" P,1"/V\ I /1 200 1 Final Re-Roof ..z.,,,,-: t 0 Nom- ' I/1/ 11 1 2io Final eeempal � --- ) II // i\ f II 201 I /Final Block/Retaininq�( 'i`& d _ • 1 - li/I II I A2' Final Fire Prevention J V - 202 Final Factory Fire Place @ ) 220 Final Planning Approval 203 Final Sign 222 Final Site • 204 Final Demolition 250 Final Building/Occupancy z • CITY OF COSTA MESA - BUILDING DIVISION >4 f _ ,� DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER F t `iiSi' PERMIT °. B06-01158 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.r$.nLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 269 E 20TH ST Status: ISSUED Suite: Applied: 07/12/2006 Vicinity: FRONT ROOF ONLY Issued: 07/12/2006 Primary 0cc: R3 Type of Construction: V-N Parcel Number: 42628404 Zoning: Applicant: FURDUI, LAURA A Address: 269 E 20TH ST Phone: 949-631-4313 ISSUED BY: COSTA MESA,CA Zip: 92627 Owner FURDUI, LAURA A Address 269 E 20TH ST Phone: 949-631-4313 COSTA MESA,CA Zip: 92627' Contractor: OWNER-BUILDER Address: Phone: Zip: License: 000000 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT PARTIAL REROOF OF HOUSE ONLY(FRONT ONLY,REAR PORTION NON INCLUDED).TEAR OFF(E)ROOF MATERIALS,INSTALL 1 LAYER OF 30#FELT AND REROOF W/30 YEAR COMP SHINGLES ON HOUSE ONLY,APPROX 1,890SF.REPAIR AND REPLACE SHEATHING AS NEEDED. FEE SUMMARY Plan Check: $0.00 • Calc Valuation: $3,000.00 Permit: $83.25 Claim Valuation: $3,000.00 SMIP Res: $0.50 . SMIP Corn: $0.00 Other: $0.00 ' Inspection: $0.00 Total: $83.75 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 ' Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days,or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754.582$ 2448-46 WOO) WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carder and policy number are: Cartier. Policy Number: (Thi section need not be completed if the permit is valued et one hundred dollars($100)or less.) r; 1'certify that(/'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 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 thus p visions. IRQ (trSgtinatufe: _ Aril) A .;Date: 7/-1.2/1cc 1..' LWARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRI NAL PENALTIES AND CML RNES UP TO ONE HUNDRED THOUSAND DOLIARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE.INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.UC.M Class 0 Contractors Signature: _-, Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit (stri ct, ihS applicant to a civil penalty of not more than five hundred dollars($500).): LJ_ I —t.ams owner of the property,or my employees with wages as their sole compensation.WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am x pt under sec. / Business and Professions Code for this reason: Signatd?. loft) fl d °--f-' / l DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec, 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of industrial Safety Permit Number: • HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions.that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No� (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes No (Section 25534 of the California Health and Safely 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 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? [5 Yes 0 No (If'yes".the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). y Management District ._ _ _._ ____.____..___._ 7 a permit fromn the South Coast res Quality ed al or dhSr air pollution 4l district3 agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Californiaia Health and Safety Code Section 42303 been made? 0 Yes 0 No _._ at.._.._..._..__..mheropria_ __.o _ 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 penally of perjury that I have read this application and state that the information given is correct. 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- scribed1 ,^DLO-- fo�(Jr/�Lppecctllo�n wampum I agree not to occupy or allow occupancy of any building authorized by thispeit un' final inspection.insp A/�� i gpature-Of L4 Ovmer(s) "/ (-Dawe �` And/Or Authorized Applicant Date ;ODE• INSPECTION TYPE tCODE! INSPECTION TYPE Rdff UMW 1616 Fixed System Final Fire Prevention 206 Fin echanical 1266 Pool Spa Final 'S 08 al Plumbing 200 Final Re-Roof 210 Fin I.Electrical 201 Final Block/Retaining Wall 212 Fi I Fire tion / 202 Final Factory Fire Place _ 220 Final Planning pproval- 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy CITY OF COSTA MESA BUILDING DIVISION --"4 Y • r.,,,,.,,,,,,,. DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT B06-01160 41%(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.CBtLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 269 E 20TH ST Status: ISSUED Suite: Applied: 07/122006 Vicinity: FRONT OF HOUSE Issued: 07/12/2006 Primary Occ: R3 Type of Construction: V-N Parcel Number: 42628404 Zoning: Applicant: FURDUI, LAURA A Address: 269 E 20TH ST Phone: 949-631-4313 ISSUED BY: COSTA MESA,CA Zip: 92627 Owner: FURDUI, LAURA A Address 269 E 20TH ST Phone: 949-631-4313 _ ��t1T • COSTA MESA,CA Zip: 92627tiV �j,,,�1Jr D Contractor: OWNER-BUILDER Address: DATE Phone: Zip: License: 000000 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT CHANGE OUT 6(E)WINDOWS;LIKE FOR LIKE IN BEDROOM,LIVING ROOM AND DINING ROOM.NO CHANGE IN SIZE OR HEADER.WINDOWS SHALL MEET 1997 UBC EGRESS REQUIREMENTS. FEE SUMMARY Plan Check: $45.01 Calc Valuation: $2,000.00 Permit: $69.25 Claim Valuation: $2,000.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $114.76 PLANNING &ZONING SETBACKS - MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 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 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)754-5826 2446-4e(dee) DECLARATIONS j 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 action need not be completed if the permit is valued at one hundred dollars($100)or less.) certify-thaLin the performance of the work for which this permit Is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pr visions. (j • r AApplicant.Signature: kJAILQ- R.- P .. iDete-1v `LL C CJARNING:.FAILURETo S URE WORKERS'COMPEN$A'-ION COVERAGE IS UNLAWFUL MID SHALL SUBJECT AN EMPLOYER TO CRIM NAL P LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND COLLARE(5100,0001,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 licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lk.4 Class x Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Busin s 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 sub' is NJ applicant to a civil penalty of not more than five hundred dollars($500).): i 7 4 ,as/Owner of the oo ode:The sone wagesrsas their sole compensation,notply WILL DO THE WORK,and the structureroves intended offeredod for sale(Sec. L�-h0 s Businessrsand ProfessionsiCode:The plryeLicense Law doesuch not aovely ta isaowner of enwfe builfo or improves a thereon,, and who does ove 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 exp t under sec. Business and Professions Code for this reason: Signature: WtQi('I`'- 11 .LA— rDate: (f.t./(J(2 Owns Ir D verified by driver's license. ❑Yes 0 No r dver.'s Licen e No. - LExp ri es� Verification of Ownership by(type of document.i.e.-property tax bill or deet.-- 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,wit be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous materiel? 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 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this implication 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 Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). _. .� o......which__ the.._ubec.__his 7 If a permit from the South isclst s Qualityced Management District or other air pollution ooncontrol district3 agency is required for the work which is the subject of this application,have all of the disclosures prescribed by CaliforniaCelifoHealth and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes-,attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. gree to comply with all state laws end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the abov -d(�crib�e�d/prroperty{1o�ins' tion pu s.Oagree not to occupy or allow occupancy of any building authorized by this permit�u7ntiill final inspection.ns+ Win Y'\ * .�.I+� T/s'� /GWYT Si. cure Of Legal Owner(s� L' , And/Or Authorized Applicant Date CODE I BISPECTION TYPE gait 11ITmAL5 PDF INSPECTION TYPE PATE ISL$ 1816 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 Well 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 q� CITY OF COSTA MESA 4 BUILDING DIVISION > 4, i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4• In • PERMIT 4be•Ong ,,A E06-01258 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us CAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 269 E 20TH ST Status: ISSUED Suite No Applied: 11/06/2006 Vicinity: DINING AREA AND BEDROOMS: Issued: 11/07/2006 Parcel Nunmber: 42628404 Applicant: FURDUI, LAURA A � � Address: 269 E 20TH ST ISSUED BY: Phone: 949-631-4313 COSTA MESA,CA Zip 92627 Yp Owner: FURDUI, LAURA A _ ESi�+ MED Address 269 E 20TH ST Phone: 949-631-4313 OMB-----------"-- - , COSTA A 's-- COSTA MESA,CA Zip: 92627 , Contractor OWNER-BUILDER al P ' I Fr, 2ICo �ast Phone: Zip: , License:000000 SCOPE OF PERMIT 3 NEW ELECTRICAL FIXTURES IN DINING AREA,2 BEDROOMS A SFD. NO OTHER EL WORK AUTHORIZED UNDER THIS PERMIT.NO EL WORK SHALL BE DONE IN THE REAR BEDROOM ADDITION AT THIS TIME. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway 1100 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 $3.30 3 up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 - up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 .- Misc.Conduit $0.00 0 Service to 10006- $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 $26.80 Intermed Pole $0.00 0 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS U (U 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 carver and policy number are: Cartier: Policy Number: (This` section need not be completed it the permit is valued at one hundred dollars($100)or less.) .l — , is1 certify that in the pe rmance 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 tjallfomla,and-g ,e that If I ouldbecome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these si Irl -Applicant Signature; - Y}��I!MAD t (Date: `` �--jo 6j 1WARNING:FAILURE TO CURE WORKERS'•6 �e1• TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TOCRIMI PE TIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5106.0001,IN ADDfTION TO • T OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Lic.k Class A Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business end Professions Code)or that he Or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ` <I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. _.-- 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: :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 p)rsuant to the Co rectors License Laws.). ❑ I am"-.• t -ram. Business and Professions Code for this reason: + Signature:fel ate:-- I 1 O C Owner ID willed by driver's lice . 0 Ye 0 No Driver's'Llcense No. " - 1 Expires:.QK) S i (..0 Verification of Ownership by(type of document,i.e.-property tax bill or deed): It --- DIVISION DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). _ _ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 if an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication apermit 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 Califomia Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 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 perjurythe information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CE FlCATE OF COMPLIANCE AND AUR{ORIZATION OF ENTRY:I certifyunder penaltyof perjurythat I have read this application and state that the Information given is c61.e I agree to comity with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the a v ascribed prope b '•r inspec on purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until fi al ins a ion. Llllr(, i t "t \�� 0[„ ignature Of Ogal Owner(s) Lim And/Or Authorized Applicant L-DDate CODE r INSPECTION TYPE . aim DMIIALE CODE6 INSPECTIONTYPE DATE IKTITIAIa 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 il204 Final Demolition 250 Final Building/Occupancy p �f• CITY OF COSTA MESA r � BUILDING DIVISION > l .. • : DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER fr Ste..: I : • 7 PERMIT � 11® P06-00906 (714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.ca.usNG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBIJob Address: 269 E 20TH ST Status: ISSUED Suite No Applied: 11/06/2006 Issued: 11/07/2006 Vicinity: Parcel Nunmber: 42628404 \.. tr"-.> Applicant: FURDUI, LAURA A ISSUED BY: Address: 269 E 20TH ST Phone: 949-631-4313 COSTA MESA,CA Zip: 92627 Owner FURDUI, LAURA A Address 269 E 20TH ST Phone: 949-631-431321 w. COSTA MESA,CA Zip: 92627 Ili 4•, 4l; - f}, w 4111. Contractor OWNER-BUILDER �' 4k. Address: Phone: lap License: 000000 EXP th r .,, DATE __----- SCOPE OF PERMIT PLUMBING PERMIT TO CHANGE OUT 1 BATHTUB AND 2 WATER CLOSETS. NO OTHER WORK AUTHORIZED UNDER THIS PERMIT. FEE SUMMARY AMT QTY AMT Qfl AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $9.80 1 Pressure Regulator $0.00 0 . Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $19.60 2 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $52.90 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 246-46(WOO) DECLARATIONS 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: Cartier: Policy Number: (This- -don need not be completed if the permit is valued et one hundred dollars($100)or less.) r 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 California,end agree that III should become subject to the workers'compensation provisions recti n 3700 of the Labor Code,I shall forthwith comply with thesep visions. Applicant Ol_jlp_/,t'-N'r\hS Applicant Signature:— ALA. Ilk, rDete:- It- / (/6 WARNosa FAILURE TO 9F RE WORKERS'COMP SATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO ORM! P NALTIES AND CML RNES UP TO ONE HUNDRED THOUSAND DOLLARE(5I00,003),IN ADDrt1ON TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commenting with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full force and effect.Uc.N Class N Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: 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(5500).): 1,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. c -7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpnce 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 purse91 1 to the Contractors License Laws.). ❑ I am exe t p der sec. Business and Professions Code for this reason: - ,S eture: »ff �_.. res (O Verification of Ownership by(type of document,i.e.-property tax bill or deed): - - DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file end certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). _ _ -- 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑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 end pressure). __...._..—.._._.._ ._ _.._..._—._ _ ._.._ ____._..__ _ 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. _______ —_ __________ _.......... ..._e_ co .. 4 If an RMPP is presently required,has Section 25534 of the Celifomia Health end Safety Code been fullylly complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification Irom the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). _—_ _ _.._w_ _.._.._. _.._a__ . 7 If a permit from the South Coast res Duality Management Heal or dhSr airtPollution ooncontrol district3 agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Co0e 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 penally 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 ree 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-o a nbed property' r inspec ion purposes.I agree not to occupy or allow occupancy of any building authorized by this permit til fin inspec 1�t1U1� Atejilt— 11 1 0 �LSigaatureLegal Owner(s)—— - -- �( lea And/Or Authorized Applicant Date ;ODE I INSPECTION TYPE PAIS Pmw.s T,ODEI INSPECTION TYPE. PMIS ecmiAAI/ 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 LI 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign222 Final Site 204 Final Demolition 250 Final Building/Occupancy CITY OF COSTA MESA A �w, P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 i' . . iiiRic'inadaria• et DEVELOPMENT SERVICES DEPARTMENT : BUILDING DIVISION September 6, 2007 Christina Mazzei 870 Governor St Costa Mesa CA 92627 Re: Your letter of August 27, 2007 concerning 269 E. 20th St Permit numbers: B06-01158, B06-01160, E06-01258, P06-00906 It has been determined by Ed Petros, Chief of Inspections, that due to the confusion on this job it will require investigation before any extension can be considered. We would need to charge for two hours of time for each permit for the investigation. Fee payments can be made at the Building counter. Once the fees have been paid, the investigation can begin. In addition to the permits referenced above, there is also a legalization for a bedroom, B06-01156, that was allowed to expire in plan check, . If you have any questions, please contact the Building Division at 714-754-5273, between 8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. We appreciate your working with us to resolve this matter. Sincerely, �I7 5 / I/ I M-rryy Jane Weidenkeller Office Specialist II Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754.5245 FAX(714)754-4856 • TDD(714)754.5244 • wwv.ci,cosla-mesa.ca.us ' _ \/ • Christina Mazzei 870 Governor St, Costa Mesa , CA, 92627 Date : Monday , 271h August , 2007 Re : 269 E 20th St, Costa Mesa, CA, 92627 Plan Check and Permits Renewal Att. Ed Petros City of Costa Mesa , Chief Building Inspector Dear Mr Petros, I am writing with regards to the property located on 269 E 20th St, Cost mesa, ca, 92627. As you are familiar I have been working on this property for quite sometime. A few months ago we were forced to stop the works due to lack of funds and unforeseen problems related to the pre existing conditions of the property. I am in the process of selling the property AS IS and I would appreciate your assistance in allowing me to renew the plan Checkynd the original Permits that I applied for 006-0118,06-01160,E06-01258,P06-00906 ) in order to resume the Plan check process and allow my buyer to resume the work and complete the house. • Your assistance in this matter is greatly appreciated and any advice is very welcome. Best Regards, \\6U , 5 03" ig a / az,ci It ,\` i if ill i I p ;Li r .- I r 1 ADDRESS- QIGc5- ^+"Q.Lk cT TRACT /1 a' _-_. PMT. gip.); 4t1=,-% q?-! Ib:N�� DIST-n[4-.0- C--i."___ n'E ;'.}a ._ -_ • LOT I L� DATE Iz's L-c' H-cl /2q_I((7.��?L�I OWNER' _ 4444 _. _ BLOCK _ _ ._ AMT. 10000 '�i ^(L,0 /,E4Y ROOF BUILT-INS ROOM AND FINISH DETAIL UN S _ -NI ILIk.IM- 7./"0__ X - __ el A Y26X28q�UY FLAT _ de ,FLOORS ROOK FINISH _ _ INTERIOR FINISH 1 -wfiE 4111 Krt. FAN' ._-ROOMS B 1 2 iArtuu it wuis CEILINGS__,REMARKS 44 SHEET .T OF _ -, _ .___- __ _ _ 4444 HIP Moo° ALL SHED RANGE 1444. _. . SS Z.E.ODATE WT.VF OV - - - 4 BOA EAVES GARB OISP GT TIMI N USE COOS PYPE __ ---__. .. __ 4114-..______.__.__.__ _ 1111 "aMINGLC - - DIa1TWA)NLR-'- -LIVING _ _ _ 4444__ __ _ __ _ 4444 - - '- --- '-•'- SHAKE REPRIOtAAr DINING - fx °if TINCT--- COMPO SHINGLE - FOOD COEUR MINN r"- I E 14� Al TRACT NO. ^/1� COYIO ROTI INTEIKOY .---- _ -_ -4414_ -1441 / N'._ TAII•GSAVEL" - - BREAM.BAR----11 .1)E!l ,.I _.. _ _ _ _ _ _ N CONST.DATE TU VK CIIIAN ° 3 ... - ----.- '--5- e0Nat Tl"- vittEAp ' e[u 10 DEBIDN TYPE OI 1111 �._ _ _ _... _ .. 1444_ ROCK____ _ _ /1 W[TIFF 4411_. ._-_. __. �1. BTRUCT.WALL _ - _. _.3b_._.._ tE nrtrnv�rnR 'FRAME _.- ._ MITRE, ! E - - jL«µ. __.. HEAT KIT,CM. META1 OP Hw I O� WALL CAB FT. n DEPRECIATION TAUS in I1.1_1. "BRICK - 'CENT. _DR.00.A EAE.TOP TILE •I I MICA I lIMOl SPLASH)__ !.]E cAsa IT, j� FUNCTIONAL PLAN 1 O x❑I ADoac • a AV� BATH DETAIL El IT.!--.._ ___ .,,KMY. _. ---- . .. _ -_.—. 1] CONDITION"" _ 102030 FIG EXTERIOR • C DEED. _in NO. FlNISM FIXTURES -}i WORKMANSHIP 1OP❑]O ' MOOR! WALLS RC LA TOB ti 01 FINISH GRADE PULLMAN! THENM: ''T.' - ____ CO.. •— ___ _._ • SHEATHING ECOMO l.. _ -PL_ I I I _ . NOTAL ROOMS p 'SIDIHO L T .Ar •C .. _ - _ 1 to LIVING RMS _L_ SHINGLE COOLING _ ._, -- .-I-.-- ”AR-Alit-- . . _GLM. - _. _ .._ --- Ef DINING ma AaBUTOa -' _ EVAP. WALL __ __. .. T I -T_ "11-4 [NDIHit ECD11D- l_ I l T I IAYILY Art 1 ALUMINUAi _ , MISCELLANEOUS STRUCTURES BI ax BMC.YEN - -- FIXTURES A ----'— .. . 4 S -YEWpm PAIR fTRUCT. FMO. CON. EXT. 40011 FL INPNT - UNIT .-- SIZE cosy • NO.Or BED RM] AVO. ' AVIA. OAR e T' - . 4 4U NO.OF BATH RMS WINDOWS L 4444___-- nit" . DH - w0°G-i6 - EN 1444-rots, - s--4 GTIYC 3k __ t Yy —. — w Drnu Wi '- - 13Lo X17---- FOUNDATON -Fw - --"" y�D •fir (r1-j3�j - n arilAAL I�ur TES El la�. iviro- TIM coNarrel ifiS - --- 1441-_-..__._._..__---- SB CENT.COOLING Tis No If A 0 -taNSTE BB — . . . -__--- ❑ 'ELIO OL DOORGLA S CONCRtTrIkoCF K _. .. .___ COY A COST LEVEL BABE at 441_ .. . . _.._.... .___ COST FACTORS -.--_ _- , r N' - 52 L� -_ - _- )1.7,7; ._.iktiti_ is QUALITY CLASS D 5.1, R •+• . . i -_- G FOR MOD. Ana I : - . . I I I ' . err IN FLA MLA _ J� / _ apti . . �.-.�...�_. . . . : . 7 4- i :_ __ Q_AraM rut MG >S�J_ _- . . .. __.___. 1111, - 011/ 4444_ lms rut FACTOR I.r-I . • I . ._ }. I- - . .- . . . . _ . . . ._ . 91 )r!!lR AREA . • I .. _. . . IL : I ff ATTIC AREA'-- . .• : i . . I El ATTIC FACTOR I : I 1 111 ..--..-1 ...: .._ - i i_ . . 1 x .. . . IS .0 i 91 FIN taYT AREA i1 4 I - . • /.\ I t vB f14 BUM FACTOR ._ . . I,' L SI G I V .,1$. __. . _ . . . _. . . . ., M Until. SEPT MG 77 L tI100 UNIIN B]MT FACTOR 1 101 MDTTIOM _ CT. .._i.._._ . . . . �...,._. .._._ I 1 )M� 1 103 PORCH TOTAL COST //� �. . . Til . . . . I . . .: . _. COV PATIO coax -�,.t . TOS UNCOV PATIO COST I 11I 1iS BV Y 1+] I . . 104 IP COST 3.512 Q .4411.. . m1 K coar ' _.___._ . . - ... 4411: _.._....._ ._. .. _. . ._:. _._. I r i I . .�•_.. l . . TOS m FLAG FAST 11 1 1_1. , - . : _. .... ...._. _ . ..I ... 4.40 ` I M. . . ._ 1 110 GCLASS ori 4 . . U ! ; .-: : :-1 I ' -. i l : I i s I j . 1 . . 4.--111: III GAR cuss ATT• I II GAO ARG 4 140 COMPUTATIONS APPR. DATE _ in /w ARIA---- ._ .. _.4144 __.. ._. . _ _ 2 itpS (Bilge 1334 SEEM FACT. N°"o. inirr COST ii. VW CURT //� ISI ii.,R l 2rl FL-f '' RG. _ — - — —115 MCI CCfT _/i,.0 -IIB ma 16 $16= 356 16X 16 -7-56 -- 117 POOL COST - M� IIS POOL DATE - P _ .__ _._...._. 119 DOCK IMPS COST 1411._ 4411__ _._4144_ITO DOCK IMM DATE ------- --- --- 'in OVGREO SAINT VOa no ___ _ xn • _— - RCN RES _ -- spy, • -_ % RCLNO_ Ii'F5-- •—_-_ _- - RES Peel . - TH .�3�� /��fi�SFS _.__ DATE U.14 r. TOTAL 327 ." i_ 'Y . ORANGE COUNTY ASSESSOR . - 4 a RES- -NTIAL UNIT APPRAISAL RECORD A.P.No. 426 _j4•.04 : '--- ---- _ SHEET / OF 2 LAND VALUE COMPUTATIONS LAND OR UNIT ATTRIBUTES YEAR UNIT VALUE FRONT FT. VALUE SITE VALUEVALUE I WIDTH 6,0,03 .__.- _ 9 o[rtN -'TION --- __. - .. --_ _ I 2_,_:_U. ------..- ---- TIN_-_----- __..._ - - 4 ACRE[ - . . SUMMARY 4 IROU4V •• KVEY❑NO g ASSESSMENT YEAR - __7 CGI OE-SAC YES❑NO® APPRAISER .__ , 9-alive". 0 NO 10 DATE MONTH YEAR-- __.. - • __.--__- -_. 7TLLEr..._ --- - rH-�rioa- R.C.N. _- - -, ` . 111 VIEW I 0 a❑ )O . -_MLA.NDD IV.ALUE -_ TI _ II Maya. AT."SORT 'MS '�-��-'----_--- -i0 ctI❑❑NGO)® _ TITIN. S.__MTIDN TINNI..T.DR ON - .-TIN -__ + VMIT COMPoRY. 1❑ I❑ a❑ INDICATED SALES PRICE LISTED PRICE-- . 10 ...__.._— _ _— _— _.1I urian[$ . ._ . -_—_. 1❑ I 10 TITIN. .__ .. - _. IS LANDIY'a,---- 1❑ I❑ S❑ TOTAL PROPERTY VALUE _--a LOT UTILITY 10 i D I D LAND VALUETION_ - - _- -.__ U WATG FRONT _--_- vki❑ Iq❑ IMP.VALUE _ _- DOCKING RIGHTS IGHTS "S «T PERSONAL PROPERTY VALUE . ❑ ❑ 20 ZONING CONIORY, "SO m°0 REMARKS 21 LAND uui❑ F❑ )❑ - -- u MISPLACED IMP. ------ YaS❑ NO❑, ---- -- - 22THE UNIT ------- 1❑ 2❑ I 0 FORMERLY - -. 24 MINERAL RIOHti-.._ ..__...- la NG❑ 116-134.16 -------- - - - - --46 _ _ _ Ea EXCESSIVE TRunC TEl❑ NO 'dS A'-.- Ac 40a(' 4r) 2v. -+ . C4v Foa 4.nI. 34 -M 1-!5& C4:FV2- _ _ ....--f._ rS4✓aAooelaoX. De/r Te .ldprY.o!P.e.ees!_'. L�.f.EE6cai.�Slo4-f6z.zi - TITIN_--_--__.-- -- _ ------- -----` ------r - 1 -- --- - - - -- --- NEIGHBORHOOD ATTRIBUTES - n -111-all FAY. USK YES 0 wD 0 u MULTI IAM. USE tab moo'- -- _ n CLUSTER TYPE all❑ NG❑ .. . u rRCND _NOON-_ I 20 )O u ZONING CONPO.W. YES0 NO0 IS DESIRASIUTY -. .-- - I❑- I❑ )❑ _ -_ . _.. __-_.. _ -_ 1❑ 1❑ S❑ _- - T DATE or IMPS. .- ----- _- .. . - _ TITIN' M AVAIL PINANCINO __0.__ O I❑ E❑ ------- ' - - -- IS PSEDOM OWNER OCCUPIED TES ❑ NO❑ - _..._._.. TITIN - 40 SOCIAL UMW 1❑ I 0 E 0 _--_- 41 PUBLIC EEAVICES1❑ 2❑ 10 _.TION. ..... .- . - . .. ... -_ _- . I) .TION . _.._ _ ... -__ _TITIN_ M TIN --..-__- -._._ _- _ IS __ - TI .44 - _ _ - __- a .. _ _ - - - . .__ .__. .. . 411 - CONCLUSION +.-_ __ ___.___ -_-TITIN TITIN= 11 TOTAL PINY.YAWS .. ...__—. - - PP -_ TITIN--.-_NOON-TION_._. fo LAND VALUE 9 .TITIN .. . . -- --.. e + . .. ._ _ fl Mr.YALUC 12 PERE.PROP.VALUE ••.• sip M Doc.Tree.Number o TITIN.__ �._ .. _- UN ru TTT _ -_—.NOON-__.._---..__.._. ._ ~ lV a 0 -. Si TITIN.___ ..... EO ..APPR. DATE 0 S BPS TION.' -_---_ SI - I 1°4152 0 4 8 8 y- - — ----' 2 6.14 4C L ) ----' 1; 1 "-tea. - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CIT'�OF COSTA MESA CONSTRU ION PERMIT PERMIT NO. TRACT NO. LOT4). UNIT NO. Project Address ��Q &- 2_O S♦♦rf vC••os7 fl--, A �� (0512-- U� � Z-�/ 1��/Tl 3568 12/06/84 51342 TI. Applicant's Mailing Address 2/9/ /J0M343 eS/'riS AJ. TYPE OF CONSTRUCTION NEW ADD U ALTERATION U REPAIR - p ❑ CONVERSION ❑ DEMOLISH 0 OTHER 42 f _ �„ �s C/ L.. O LJ. Owner's Name l✓,arca- 4--- rJ� Phone'Y8 4 i C �/( r A.P.91`- ��C �-d'[ 1 Zone DEis 'fu tJI.pF WORK/USE OF BLDG. -J Address 5'9-� _ p� (JK/L.( s S Main Building: Accessory Building: Arch/Eng. •ill• OLPC License No.` �`7I IG TYPE OF PERMIT U GRADING U FOUNDATION LetISTRUCTURAL E Front ' p Address ❑O TENANT ❑ ELECTRICAL 0 PLUMBING 0 MECHANICAL BA Rear iZs_ 1 1� N. THER Contractor's Name�.��nNC�•'-�1 h c p /P�hon� PROJECT DESCRIPTION SQ. F •� OCCUPA Y �.3 C Right ( 5/",�- f r Address(mailing) 11-9q E • -LLQ ' lr. ( . rn . K - / t( C ON ST RUCTION TYPVALUATION$ s Left '1 R City License No. ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION �+r� n Ping. Ref.# 1. Parking Req./Provided E 0 I hereby affirm that I am licensed oder provisions of Charter 9 (commencing Remarks: �[-' FEE 0 /22, S 2 fir, 7/Z/Q�i Planning Notes: ail'Li� L t�i-� i1 _ Ni with section 7000) of Divisi 3 f the Business and Professions Code,and ! !! _t [-�L'a--� my license is in full force an of c Q c 155'_e/e S - T S. License Class License No. f "J T • Date - Signature PLUMBING FEES WORKERS'COMPENSATION DE LARATION Bar Sink Showers I,hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink .800, Lab. C.) Automatic Washer - Transformer El15-50KW Policy No. Company - Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW A Certified copy is hereby furnished.hcit Certified copy is flied with the city t3uilding Dlvii Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps (This section need not be completed if the permit is for one hundred($100)or . less). - Dishwasher Solar Piping - Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which th s permit is Issued,I . shall not employ any person in.any manner so as aa.D esu t to th Drinking Fountains Solar Tank Fan ' Workers' o pensation Laws of Californ Motors 00-1 HP 01%-8 --?C., Date I . Signature Floor Drains SwimmingPool w/S a NOTICE: If,atter making this declaration,-you shourd bee e subject to the - p F.A.U. Inc-Solar❑9-15 HP❑16-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a'constructlon lending agency for the performance Pole Light . of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name Ran ge Lender's Address Kitchen Sink Water Service Switches Sign I OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories GarbageDisposal following reason (Section 7031.5 Business and Professional Code: Any city or P Standing Sections county which requires a permit to construct,alter,Improve,demolish or repair P—TrapGenerator ❑O-5 KW❑5.15 KW any structure, prior to its issuance, also requires the applicant for such permit - Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9,(commencing with Section 7000)of • ...Division 3 of the Business and Professions Code) or that he/she is exempt iserefrom and the basis for the alleged exemption. Any violation of Section • J31.5 by any applicant for a permit subjects the applicant to a civil > enalty of not more than five hundred dollars($500). • - ❑❑ 1, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered - — - Reinspection Fee I $15 Issue Foe - $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own - — - •---- - -' ` DEVELOPMENT SERVICES REQUIREME - )� �(� employees, provided that such Improvements aro not intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of cons- - Canopy Type II ❑ Zoning Approved By �. I�`-f LJ Date c,- r_� r• proven, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground _ _ Building Approved By s ,. ^. X Date 2'� • 4 0 rove for the purpsale). I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat (2_- i — tractors to construct the project (Section 7044,Business and Professions Code: - buil Contractor's License Law does nottraapply to an owner je is with property who Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU SUp'l�ARV of FEES builds or improves thereon,and so oys for such projects with yeon- —UM Y OF tractor(s) license pursuant to the•Contractor's License Law). I am aware thatBUILDING PERMIT $ $MIP $ 2,-00 of Exhaust System ❑ Multiple 0 System Repair/Alteration PLAN CHECK $ 12' ski PERMIT proof their Worker's Compensation insurance should be provided to me. 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ PERMIT ISSUANCE - $ Date /2 '�f owner Heating System& Ducting - PLAN CHECK 25% $ ENERGY P.C. $ 1 hereby certify that I have read this application and state that the above ❑0.100,000 BTU 0100,000 BT ELECTRICAL GRADING $ - - information is correct. I agree to comply with all city and county ordinances $ _ - - and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of this city to nter upon the above-mentioned property for i nspectionnnrr y +�yeeses. • Signature V.-6-n? Date/2-6-i�/ MECHANICAL $ TOTAL FEE $ 3i3 •�Z /\ Drivers' License or SS yr Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor I •' . jl CONSTRUCTION AND PLANNING POOL .,PA APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4..Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement Vs/ Ss- - /t- -'-,( 56. Rough Plumbing & Pressure Test • 6. Electrical UFER Grnd. f/tecl r67 57. APPROVAL TO COVER-GUNITE 7. Footings //silts- -r.--z 58. Electrical Conduit-Undrgrnd. 8. Foundation /e/Ar-ien7 59. Gas Pipe, El Undrgrnd.,Test 9, Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System t' i 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection �'_ 1 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 FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# • 21. Ducts, in Structure • 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0Oil 23. Gas Pipe-Rough & Test / 72. Underground Flush 24. Roof Framing tbiskr G7d7t-V j 73. Undergrnd.Storage Tank OGas OOil 25. Roof Sheathing g//q/P�`f�j^� / 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical . 27. Frame and Flashing z77z3- Q7 l276. Dry Standpipe 28. Lathing& Siding �/,�ss 11127 4141 77. FIXED SYSTEM FINAL 29. Insulation ,(!4� vV1/ 78. FIRE PR EV. FINAL 30. Drywall Nai-ling (cif?fir- &iei r HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat -�-' QQ 1]�/asp 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 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. Special Requirements Completed Vld OC - I g' U.8(j B7' 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. UNIT NO. , CIT OF COSTA MESA CONSTRUCT N PERMIT T NO �' 6376 1 /24/85 1L1] TL I Project Adcflss ��9 H' �z�bb I ' ....-- Applicant's Mailing Address S�{yiC TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION U REPAIR 'l /�-x ` ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Owner's Name 1+C Z ' ayi P ondQ%�-(o i3 A.P.`N• - 12onD �J�/Z/L'� DESCRIPTION OF WORK/USE OF•B LDG. Address S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT Li GRADING U FOUNDATION ❑ STRUCTURAL T Front 0 Address , ❑ TENANT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL B Rear N Contractor's Name 060-4S 'Phone ❑ OTHER - C Right N PROJECT DESCRIPTION SQ. FT. OCCUPANCYK • G Address(mailing) CONSTRUCTION TYPE VALUATIONS S Left R City License No. ZONE - GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION �y! Ping. Ref.# Parking Req./Provided E I hereby m affirm that I alicensed under provi Ons of Charter 9 (commencing Remarks: 6 /j Planning Notes: 0 with section 7000) of Division 3 of the si es nd Professions Code,and �NS I my license is in full force and effect. Il/J\1 T License Class L No. S date Signature PLUMBING N. I FEES WORKERS' COMPENSATION DECLARATION • N..,„ f I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL FEES bf Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 1800, Lab. C.) Automatic Washer Transformer 0 15-50 KW Policy No. - Company Backflow Irrigation Sewer CapN 0 50+KW e Certified copy is hereby furnished. - Construction Pole Sub. , • Certified copy Is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit 1 Meter (Duo to 100 amps 5 tx. Date _Applicant - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors _ (This section need not be completed if the permit is for one hundred($100)or • — Dishwasher .Meter (Dover 1D0 amps- . • less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel 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 bee me subject to the Drinking Fountains Solar Tank Fan • Motors 00.1 HP 01%-8 Workers Cprnpensyt}pp taws of Calif070n • ,Date"/�•L y—rts _Signature ' /LE•e/, Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09.15 HP 016-15+ 'NOTICE:If,after making this declaration you sho d ecome Su jest to the Workers' Compensation provisions of the Labor ode, you,mut forthwith Floor Sinks Urinal • ' • comply with such provisions or this permit shall' be deem d revoked. Fixtures Miflpwave •• CONSTRUCTION LENDING AGENCY . Gas Service Outlets Water Closet Ste' I hereby affirm that there IS a construction lending agency for the performance Device Boxes Pole Light - Interceptors • Water of the work for which this permit is issued (Section 3097 Civ. C.) Heater Lender's Name Outlets I D Range 'r Z to Lender's Address • Kitchen Sink . • Water Service <rn' __ OWNER BUILDER DECLARATION Switches 3 Sign _ /„n I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal f following reason (Section 7031.5 Business and Professional Code: Any city or 9 P ,Standing Sections county which requires a permit to construct,alter,improve,demolish or repair ' P-Trap Laundry Trays Generator ❑0.5 KW❑5-15 KW Trash Coli• actor any structure, prior to its issuance, also requires the applicant for such permit P to file a signed Statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt _ - therefrom and the basis for the alleged exemption. Any violation of Section - 31.5 by any applicant for a permit subjects the applicant to a clvii _ ' aaity of not more than five hundred dollars($500). p I, as owner of the.property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not Intended or offered Reinspection Fee I $15 Issue Fee ' $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES - License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her ownDEVELOPMENT SERVICES REQUIREMENTS: employees,emploees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of corn- Canopy Type II ❑ Zoning Approved By • Date _ plelion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By Date prove for the purpose of Sale). ,I�'1 ❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By ---�L'=d4+ Date I a- tractors to construct the project(Section 7044,Business and Professions Code: / The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,00(IBTU ❑100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration Cr BUIWING PERMIT $ SMIP $ • Proof of their worker's Compensation insurance should be provided to me. E X P I R E D PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers 1i1 PLUMBING $ ISSUANCE $ �,! ccmp:etc hupvl,thins ^� Date �� ' i72FI Owner Heating System& Ducting Registers ENERGY P.C. $ z PLAN CHECK 25% $ I hereby Certify that I nave.read th s appli tion and ate that the above 00-100,000 BTU 0100,000 BTI. GRADING $ information is correct. I agree to comply with all City a d county ordinances Date SI ELECTRICAL $ In.Op and state laws relating to t builds g construction,and hereby authorize repre- F' =-'-TLAN CHECK 50% $ 3 .Q j MICROFILM '$ sentatives of this city to enter upon the above-mentioned property for inspection p . 14.4 O Signature ftDate /—.2-944:5 MECHANICAL $ TOTAL FEE 3 - CMF 0865-46,rev,10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL .. SPA i Date Inspector Date ctnr e InsP" ' APPROVALS Permit# APPROVALS Permit # i 41 1 -1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location . i2.-Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test - 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final •12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 04/1:0 �r�^_ 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 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 33. Final Electric Notes: 34. Final Heating & Air Conditioning 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 EXPIRED 45. Sound Attenuation • Incomplete Inspections 46. Handicap RegulationsA Date _77)-4 ! /Sig Pet ._ 47. FINAL STRUCTURE & BUILDING 48.,Special Requirements Completed 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date OWNER ILLUS;--MARSHALL SEP 2 4 1957 - DATE h-3-57 _ JOB ADDRESS 269 20th- Street BUILDING PERMIT NO. #1.1795 GENERAL CONTRACTOR OWI1Br Bldr. VALUE $ 960.00 AP118-134-16 14 BLOCK TRACT 7121Den & Bath Add. GROUP I TYPE V ZONE R4 FIRE DISTRICT 11826 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR �/� I DATE NUMBER Footing Trench 77 2 Foundation Forms and Grade to Garage / _ Rough Framing •' : ,OQ 71 Plumbing,Rough to Slab , .. t :f S 7 t.,,_s Pte_„ in,..) -v-41 -3-7 ny/ y Plumbing, Rough Complete,..J.,“a i y jt'../s.4q �/ Temporary Pole I-- Wiring, Wiring, Rough APR 1 5 1951 VC[ - _ -r- ye ya 1 V Heating, Rough ✓MATLi-r 6-P.4t (�� ^" .. _/0-- - t-- 4/' 9-S7 t 9 ✓ a-' '. Heating, Final 444MC S•r{-s/ V¢� ` Sewer, House Sewer,St. (I . �� etar -s A' C// 3,_, Septic Tank or Cesspool ,/ 09 ._..... . L ig, In ",Out I' 11 14/64�} PL.a[ering Y/ 1-2,547 Plumbing,Final,Fixtures Complete)r,5i C-2-57 Plumbing,Final Gas Test/7 /t)41'c 5-3-n" Wiring,Final „t ZT 7 -49 _ ; 1 Occupancy G¢AP✓ / FORM 210 3M 10.53 4795 .n 4826 FEE RECEIVED COSTA MESA BUILDING DEPARTMENCIINSCIDEPTAI C7-4P.O. BOX 317AL COSTA MESA. CALIFORNIA ((!!��yy FF rpp��T� FOR APPLICANT TO FILL IN APPLRCR'T'I'Of4EobR PERMIT ADD BUILDING Di. 6 y 20 A BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY �I --1.4...,-t--43 RECEIPT NO. PERMIT NO. OWNER rnGr/ ��`1[ �EI 9S MAIL J� \ - RECEIVED�,BV/ DATE RECEIVED TE ISSUED ADDRESS oL 6 7 0 /y.yj�/ 3Gs / ie-3 'S 7' TEL. BUILDING CITY 0. Vt/LS-A LL. NO. ADDRESS ARACHITECT LIC. OR F 'NEER NO. COSTA MESA. CALIFORNIA FIRE ADDRESS ZONE pp�� 1.0.3.--VCITY LIC. ZONES f pOP 105 TYPE V GROUP, CONTRACTOR 6/�-E..1 NO. p TEL. APPROVED A DRESS - 0—ne`--'42--. NO. BY DATE L LOT /� 7�• CORRECTIONS BER1PnoN NO.(/ BLOCK TRACT '1 APPROVED D . A.P.N O. / •I /� _ / u i/ SIZE / Z NO.OF BLOCS. CITY OF COSTA MESA 6 6 % OF LOT I 7 NOW ON LOT PLUSE OF y A _ i SUBJECT c DEPT. EXISTING BLDG. 7�-�(�W SUBJECT TOB . DEPT. REG. ETBCCN LINE FROM 7 / CENTER of STREET ,S Q REAR YA D (� /o�; L :TV � +-� •I / i BY-0.1ii J� DATE i 6 V SIDE YARD RIGHT Sr) /LEFT 1$. G< PLAN TcCH(/i/y DESCRIPTION OF WORK ;3V re7.--", ,e e.y/ NEW ALTERATION ADDITION U REPAIr 'tY MOVING DEMOLISH SIZE BUILDING x iy�� ROOMS NO.OF /(�'�AS�TORIES �7// EXTERIOR.COVERING WALLV �^ r�O COVERING Olaf ?Li USE OF NEWT} call___ • BUILDING 0----4- li ' A C :�I—,—.. 44 1EREBY ACKNOWLE E THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUE TON. r. f VALUATION �'u+ , ewV '& N �II 11 PERMIT FEE 5 — AUTHORIZED AGENT SIGNATURE OF V V PERMITTEE /�/_ (p PLAN CHECK g 94....,, S� S 6/ /l/ TOTAL FEE S — W` C.l