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Home My WebLink About727 20TH ST - Building Permits' � CITY OF COSTA MESA � � � BY/LDING D/VISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.wsta•mesa.ca.us fOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: BX08-00180 PERMIT TYPE B MISC STATUS: ISSUED APN: 42226202 DATE ISSUED: 06/73/2008 Zoning: , ISSUED BY: JOB ADDRESS: 727 W 20TH ST CM �� Suite/Unit: Vicinity: PrimaryOca ConstType :?? SQ. FT: 0 Valuation: $�,000.00 SCOPE OF WORK: REPLACE 5 WINDOWS IN SAME LOCATION & WITH SAME WIDTH OPENINGS. WINDOWS ARE MANUFACTURED BY PELLA 8 ENERGY STAR RATED. WOftK SUBJECT TO FIELD VERIFICATION - EGRESS HANDOUT GIVEN 8 ATTACHED TO JOB CARD. OWNER: SILVA, JOSE City/State: COSTA MESA, CA' Phone: 714-501-9138 APPLICANT: GUADALUPE SILVA MARTINEZ Ciry/State: Phone: 949 929-9490 CONTRACTOR: Address: City/State: Zip Code: ARCHITECT: Phone ENGINEER: Phone Building Plan Check: Building Permit: Electrical Permit: SMIP Residential SMIP Commercial TOTALFEES Address:: 727 W 20TH ST Zip Code: 92627-3486 Address: Zip Code: License No. Phone License No. License No. FEE SUMMARY $0.00 $38.75 $0.00 $0.00 $0.00 $38.75 Unit Unit: Unih Cell: S V , ..! „r,.t NOTICE: 7he work authorizetl by this permit shall comply vnth all applicable handicap access requirements under Califomia 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. � INSPEC710NS: 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 Flnal approval will result in the expi2tion of this permit. cooe.. ixsvecnoNrrv� � NnLn� 5�� INSPECTIONTVPE � �x�m�� 1878 Fixed System Final Fire Preventlon 206 Final Mechanical 1268 Papl Spa Final 208 Final Plumbing ' 200 Final Re-Roof 210 Final Electrical 201 Final BIacWRetaining Wall 212 Final Fire Preventi0n 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site �� 204 Final Demolition 250 Final BuildinglOcc�paxy WORKERS' COMPENSATIOMDECLARATON. � 1 hereby aKrtn under penalty of peryury one of Ne following Aecta2tions: ❑ I have and will maintain a certificate of wnsent to sel(-Insure for worke�s' compensa[ion, as provided for by section 3700 of the Labor Code, for lhe peAormance of the work for which this pertnit is issued. ❑ I have and will main[ain v.orkers' compensation insu2nce, as required by section 3700 of Ilre Labor Code, for Iha peRortnance of the v.ork fw which t�is permit is issued. My wOrkers' compensation Insurance cartier and policy number are: Carrie[ (T�is secdbn neea ipt Ga mnpeteO Jlne pernit is rdNetl al are nunWM NNars (Ef 00) w Icss.) Policy Number: ❑ I certify thal in the peAormance o( lhe work for which this permit is issued, I shall nol employ any person in any manner so as to become subject to the workers' compensation laws of Califomia, and agree thal il I shoWd become subjecl ro Ihe vrorkers' compensalion provisions of Section 3700 of Ihe Labor Code, I shall lorthwith tomply vrith these provisions. Applipnl's Siprulure WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CAVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED hiOUSAND DOLlAF2S ($100,OW), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND A�ITORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm thal I am licensetl untler provisions ol Chapter 9(commencing with Section 7000) of Division 3 of the Business and Prolessions Code, antl my license is in (ull (orce and eHect. Lic. # Class # Conuacmr's SiBnaWre Da�e CONSTRUCTION LENDING AGENCY: ❑ I hereby affum that there is a construction lending agency tor the peAortnance of the vuAc for which Itus pertnit is issuetl. (Sec. 3097, Civil Code�. Lender's Name: Lender's Address: SgwWre Date OWNER-BUILDER DECLARATIONS: I hereby aKrm that untler penally ot perjury thal I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or counry which reduires a pertnil to wnsWct, alter, improve, tlemolish, or repair any s[r�cture, prior to ils issuance, also requires �he aOPlicant for such pertnit ro file a signetl s�atement thal he or she is IicenseC pursuant to the provisions of the Contractors License law (Chapter 9(wmmenring with Section 7000) of Division 3 0l the Business and Prolessions Code) or that he or she is exempt therelrom antl ihe basis lor the alleged exemplion. Any violation of Seclion 7031.5 by any applicant (or a permit subjects Ihe applicant to a civil penalty of not more than five huntlretl dollars ($500).�: � ❑.-I, as owner ol Ihe propeny, or my employees with �vages as their sole .�compensation, WILL DO THE WORK, and the 51rucNre is not intentletl or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License law does not apply lo an owner of property who builds or improves thereon, antl who does such vrork himself or herself�or through his or her own employees, provided thal such improvements are not intended or offered tor sale. If, however, the buildinq or improvement is sold within one year_of completion, Ihe owner-builder will have the burden of proving thal he or s�e did not build or improve tor purpose of sale.). ❑ I, as owner of the proDeny, am EXCLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS lo con5wtt the prqect (Sec. 7044, Business and Professions Code: The cont2ctas License Law dces not apPty to an ovmer of property who builds or improves thereon, antl who coniracts fw suc� project with a contracta(s) license pursuanl rothe Cont2ctors License Laws.�. ❑ I am exempt under 5ec. Business antl Professions Code !or this reason: ; o� -/3 - oS SIB ure � Daie � 30 <6( rU]) � Owner ID verified by Arie, .cense. ❑ Yes ❑ No � � 1 Driver's License No. Fxpires: Verifiwtion of Ownership by (type o( document, i.e. - property taz bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . �� ❑ I he2by certify that no excavation frve (5) or more (ee� m tlepth into wfiich a person is required to descend, will be made in conneclion with wvrk authorizetl by this permi�, and Ihat no building strucWre, scaffdding, false�wrk, a Oemolilion or tlisman�ling Ihereol, will be more than thirty-si�c (36) fee� high. (Chap. 3.2, Grp 2. M 2, Sec. 3A7, Tlle 8, Califomia Administrative Code). ❑ As ovmer-builder, I will not employ anyone lo do work which vrou10 require a permit from the Division of Industrial Sa(ety, as noted above, unless such person has a permit to do such work from the division. AOW��m's SignaWre Date Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicaN or present or tuture building occupant nee0 ro fle and certily a Business Plan for emergency response to release or threatenetl release of a hazardous material? ❑ Yes ❑ No (Section 25505 0l the Califomia Health and Safety Code requires. with some exceptions, thal a Business Plan be fled vrith the Cosla Mesa Fire Depanment by every business which has at any one time during a reported year a quantily of hazardous materials equal to or greater Ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature antl pressure). 2. Does or will the applirant or presenl or (uWre building occupant need to file a regist2ti0n form (or aculely hazartlous materials? ❑ Yes ❑ No (Section 25533 0l the Califomia Health and Safery Coae, with some exceptions. requires registration wit� the Cos[a Mesa Fire Department by each business vfiich at any one time has on hand a quantity of acutety hazarUous materials equal to or greater �han a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard IemperaNre and pressure). 3. Does or will ihe appliwnl or present or future building occupan� need to prepare an RMPP (Risk Management and Preven[ion Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 0l the Califomia Health and Safery Cotle provides that the Cosla Mesa Fire Departmenl may require lhe preparation, certifcalion and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4. I( an RMPP is presently required, has Section 25534 of the Califomia Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicaN or present or tuture builtling occupant require for Ihe wOrk which is lhe SUDjeCI o( IhiS 20DIiC2�i00 3 P2fR11i (Of SOCh CAf15WC1100 o� mOdi(cati0n from lhe South Coast Air Qualiry Management Dislrict or (rom any other air pollution control districl or agency? ❑ Yes ❑ No (Section 658502 of the Cali(omia Govemmenl Code requires Ihat Ihe requestetl infortnation be (umished on applications for rarnresidential builtlinq pertnits). 6. Will any patl ol Ihe facility to be wnstructetl under Ihis pertnit be within 1000 feel from the ouler boundaries of a school7 ❑ Yes ❑ No Qf'yes", ihe facility must meet the requirement of Sections 25534 anA 42303 of the Calitomia Health and Salety Cotle). 7. I( a permit from the SoNh Coast Air Qualily Management Dislrict or other air polWtion control tlislrict or agency is requiied for the work which is the subjecl ot this application, have all of the disclosures prescnbetl by Califomia Health and Safely Code Seclion 42309 been made? ❑ Yes ❑ No 8. Qf yes', attach cetlificate of compliance from the appropriate air pollution tontrol officer). - CERTIFICATE OF COMPLIANCE: I certi(y that under penalty of perjury the information given above is wrrect. I agree to comply with all sWte Wws antl ciry ordinances re9artlinq HazarOous Materiafs and.Emissions. , , Slgnawre Date CERTIFICATE OF COMPLIANCE AND AUTHORVATION OF ENTRY: I certify under penally of perjury �hat I have read lhis application and sta�e that the information given is correcL I agree to comply with all state lavrs and city ordinances relating to building construction, and authonze�representatives of the Cily of Costa Mesa to enter upon ihe above-descnbed pmperty for inspection purposes. I agree not to occupy or allow xcupancy of any building authonze by this permit until final inspection. Si Nreo(L r�s) � Da1e ' �6' �3 a 4/OfNu111pnZC0 pli 1 D3te I j1 .� -" �i _ �. p�`- r� � �+ .� �` � L)..� r D . /` � I - �. � � � �. 4' _� � � c75� o, �`}'i C? SG �' '' ��-- � .=� ' � �� , `./ � � — _. –r– ---I I f ��, ; , ; ��j �✓ % � �-� � . , � -�a Gi , �,� �r 1�, , ; � �L�l�.- , ; , i ; �---�-------� - -�--- _.._.. . __. . �� -- --.. �tT •�BUILpf�, . <' APp O$��D��`'�`E7 S� li � �� a�� s� a�'�Y pro "�ontr �"�a''han y�� . +�g,�u Nq�k��_pemp�a�p �ole�ry,�,�AIC�T��or +--� ,.�� ,q�a ,�1�,! ---.----. ____... _ _ _U 6 . ` �� I,�� :; �� - .. ,, `�},E� �d I��1'�` ;` ��i,,,�� r� ✓ : ': :��, J�- (7 J / R(G/''�'' ��J in%C rv ��/,/'. , , �,_, �; � ti, ��+'' /" -� S� c w: �i �'� Cj �' ri^ � I a � t C.� n ��r!c,'= -- Il �i. � 1 � (��1 -- � : ------- - - \) � �� , . V �. ., 7'. 1 / � �� i�d' ; '+ � ;. _ . `J�j r',� c.� � � The Pella Advantage Qurclfey ihac im�roves yoxar home. And your iife, Cow=Maintenance • Low•maintenance EnduraClad^ exteriors don't need painting, burablc, suung wnuci frem�s ere Ettocacred hp uur co�h Lnt1u[:�Clxd ;dwninum exmrio[5 �hac rtsist fidin� ;tnd r.hall-ung. EndmaGuard" offers praven resistance t0 water penetrdtion.' 1'clla' wood pruducc� w•ill E�crform bcaucifuUy fnr ycars wi[h lirde cfkirr — thry're ��rocccteJ ag:vuxr muisturc, �nins wd deuy causcd by muld and mildew, as ��rll as ce�micc damage. FaRory-pretinished White interior on windows and p2tio doors saves finishing time and tosts.1'he paincing hu bccn donc ior ynu wich a durablc faccnry finish chu �vill li�ok oeauriful fnr ycars to come. - 1Lcsisrs ycllowing, ch;dkinG or fadinR whcn exposec! ro tunlighc. - Paint is available in [hz Lowe's paine deparuncnc co cnlor�march in�erior crim «+ che PeOa Wh�rr. - Primed, r�ady-io-paim inatinrs are also availlblc. Beautiful prefinished interior stain opti0ns af2 availa6le on patio doors. Choose fro�� six (aanry-applicd finis6es ro perkedy complemeni ynur hnma. P�imed. rc�dy-�o-paine pario dunn a[c alw avxilablc. 'Energy-Efficient • Lower your energy bills. 1'ell+ winciows and pacio doorc wirh Low-E in.ulacing glass mec[ or axcecd F.NlR( �Y S rA2' gufdclines in all 50 s[aus. , Hclps cut youn c�a[in� and cnoling coscs by up ro 15'W." - You can save s125 _'45� a y�u'. • Better insutation for a more tomfartable home Wond insul�ra 1,800 cimes hcaer rhan alumin�m, so yoii I] enjoy mnrc consiscrn[ rempenm.�s in yuur hnntc ye�r round. - Help eliminate annoying drafts. Ac Pclla, producrs arc resccd in �� scate-of-�he-art facilirics en makc vur� [hey meet or exceed indtuvry �"•'�� ` perEonn;mcc ctanduda, so you c�n resc assurcd YaUa windows and doms will parform &�r ycac> ta eou�e, c . ' � '. In �xaaS <ncd�m+c M:�am mwOMn ua�ulud l.M l-06. ' "Cvmp�at4niWiirnmu m p.diov k� ' W m✓ M P�newi�ibnv�.4r,(cN:.�vm�im:yvary I ` 11(. U�dryTti�l nl fttlyY S.:V\AS C�Iin:llPS bmf'.l M fjt�ylllpn.yi[VjIV,O,�f ft5u111� iM1Wel l,ttry if521W .t Lf.'�iMh n.1'l��yt"iaYp.'l?f3Mi �yY1[ xilc ]iw• JL li ��I nmmir,u�.tna. 9;,s A�� nnA eii��;i air cervlifunle� Evir..iib �Ee �M1^ F.npigy Lumma�v�n Adnimnrnivn': (oC5 m•�qp Wi Vrira; aM vevmr3�i ihuvga :+., � :COfi¢IKp[iq•�u[exMuSk.r.�;�k.xepyym.rynnip.�upplira4itwnl��i��'vliuion<��Kiiim�nAx;WYU�'^dipeaQe.4twi�si �s+no.ery �xi��a�a�,:.�., Ol�7l £l-��=I3��`C �; lIW-69L1 £691-89£-7lL Means Figure 1025-1 Emergency escapc and rescue window � Openable area =57sqR� For SI: I inch = 25.4 mm, I squarc foot � 0.09J mz. �y'/B' r— dear � \`�� . aoie area sq ft wiih full rescue eyuipmeni. By requiring a minimum net clear opening size of at least SJ square feet (0.53 m'), the code cnsures that :m opening of adequatc dimensions is provided. Where the opening occurs at grade level, the opening need only be 5 square feet (0.46 m') because of thc increased ease of access from the ex[erior. 1026.3 Maximum heigh� from floor. In order ro be relatively accessible from the interior of the sleeping room or basement, the emergency escape and rescue opening cannot be located more than 4d inches ( I I 18 mm) above the (loor. The measurement is ro be taken from the iloor to the bottom of the clear opening. 102 fi.4 Operational constraints. As stated in the code, these openings used for emergency escape or rescue must be operational from �he inside of the room. Where windows are utilized, the intent is that they be of the usual double-hung, horizontal sliding or casement windows operated by the turn oi a crank. The building otficial should evaluate special types of windows other ihan those just dcscribed based on the difficultv of operating or removing the windows. If no more effon is required than that required for the three types of windows just enumerated, they could be approved as meeting the intent of the code as long as no keys or tools arc reyuircd. The ever-increasing concern for security, particularly in residential buildings, has created a fairly large demand for securiry devices such as grilles, bars and sreel shutters. Unless properly designed and conswcted, the securiry devices over bedroam windows can complelely defeal the purpose of [he emergency escape and rescue opening. Therefore, the IBC makes provisions for securiry devices, provided the release mechanism has been approved and is operable from the inside without the use of a key, tool or force greater than that which is required for normal operation of the escape and rescue opening. Furthermore, in this case, the code requires that the building be equipped with smoke detectors in accordance with Section 9071.10. Fire deaths have been attributed to the inability of the individual to escape from the building because the securiry bars prevented emergency escape. The very essence of the requirement for emereency escape openings is that a person must be able to effect escape or be rescued in a short period of time because the fire will have spread to the point where all other exit routes are blocked. Thus, time cannot be wasted in figuring out means of opening rescue windows or obtaininL egress through them. Therefore, •rny impediment to escape or rescue caused by security devices, inadequate window size. diFficult operating mechanisms, etc., is not permitted by the code. 1026.5 Window wells. W induw wells in front of emertency escape and rescue openings also have minimum size requirements. These provisions address those emergency escape windows �li ' 4�� 20061BCHandbook • i � CITY OF COSTA MESA BUILD/NG DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax Q14) 754-4856 • www ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 i PERMIT NUMBER: BX08-00137 PERMIT TYPE B MISC STATUS: ISSUED APN: 42226202 DATE ISSUED: 05/12/2008 Zoning: , ISSUED BY: RMD JOB ADDRESS: 727 A W 20TH ST CM Suite/Unit: A Vicinity: UNIT A ROOF - Primary Occ: Const Type :?? SQ. FT: 0 ' Valuation: 52,481.00 � ., SCOPE OF WORK: CHANGE ROOF FRAMING FROM�FLATT0�4:12 PITCH. ADD R-301NSULATION IN ROOF AREA. COVER WITH 30 YEAR COMP SHINGLES. CLASS A ROOFING MATERIAL SRIPLEX UNIT A(DETACHED UNIT) ... OWNER: SIWA, JOSE Address: 727 W 20TH ST � Unit City/State: COSTA MESA, CA '.`' Zip Code: 92627-3486 Phone: 714-501•9138 - APPLICANT: SILVA, JOSE � . City/State: COSTA MESA, CA Phone: 714-501-9138 �� CONTRACTOR: . ' Address: City/State: Zip Code: O' � . � ARCHITECT; , � Phone ENGINEER: . Phone Building Plan Check: Building Permit: � , Electrical Permit: � SMIP Residential SMIP Commercial TOTALFEES Address: 727 W 20TH ST Zip Cade: 92627-3486 License No. Phone Cell: License No. License No. FEE SUMMARY $54.11 $83.25 $0.00 $0.50 $0.00 $137.86 Unit: UniC NOTICE: The work authonzed by this permif shall comply with all appficable handicap access requirements under Califomia sfatutes and retated regulalions. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTION3: 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 8nal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CO�E�. INSPELlIONTYPE 0� IN7I11�L5 4QDF�e INSPEG110NTYPE L INTIn��s 1816 Fixed Sys�¢m Final Fire Prevention 208 Final MechaniCal 1286 Pool Spa Final . 208 Final Plumbing 200 Final Re-Roof � -. 08 � 210 Final Electncal 207 Final Blp�k/Retaining Wall 212 Final Fire Prevention 202 Final Factory Pire Place 220 Final Planning Appmval 203 Final Sign ' 222 Final Site p 204 Final Demoliti0n 250 Final Building/Occupancy LL [ r%� _� WORKERS' COMPENSATION DECLARATION� I h�reby affirm under penalry of peryury one of lhe following decla2tions: ❑ I have and will maintain a certificate of consent to self-Insure tor workers' compensation, as provided for by seclion 3700 of Ihe Labor Code, lor Ihe peAormance of the vrork (or which ihis pertnit is issued. ❑ I have antl will main[ain workers' compensation insurance, as required by section 3700 ot Ihe Labor Code, fa Ihe per(ormance of the v.ork (p which this pertnit is issued. My workers' wmpensation Insurance cartier antl policy number are: Cartier. (iM aattqn rieetl nd Ee mmpiefed Illie permf a v�NeO al ona nunde00pWrslSt0p1 a bss ) Policy Numbec �� certify thal in the performance of the work for which this permit is issuetl, I ehall nol employ any person in any manner so as to become subject to the workers' compensatlon laws of Califomia, and agree that il I should become su0ject ro the wurkers' compensation provisions ot Section 3700 of the Labor Code. I shall forthvrith comply with these provisions. T��-�=-5, (�/t� �/J2 /o � AOW��'s Sgnawre Da�e- - � �__— _` WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrtn lhal I am licensed under provisions o! Chapter 9(wmmencing with Section 7000) of Division 3 0l the Business antl Professions Cotle, and my license is in full force and e((ecl. Lic. # . . Class # LMtIbC10i s Sipndlure CONSTRUCTION LENDING AGENCY: 0 I hereby alfvm that lhere is a cons[mc[bn lentling agency fw the peAormance of the v.ork fa wfiich Ibs permit is issued. (Sec. 3097, Civil CoCe). Lender's Name: Lentlers Adtlress: OWNER-BUILDER DECLARATIONS: I �ereby aKrm that undor penally o( Derjury lhat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sac. 7031.5, Busine55 antl Prole55ion5 CoOe: Any Cily or County which r¢quir85 a pefmit lo wnslmct, alter, improve, demoli5h, or repair any struclure, prior to its issuance, also requires Ihe appliwnt for such permit to fle a signeC sUlement Ihat he or s�e is Iicense0 pursuanl lo lhe provisions of lhe ConUaclors License Law (Chapler 9(wmmencing wi[h Section 7000) of Division 3 of Ne Business antl Professions Cotle) or that he or she is exempt t�erefrom and �he basis for Ihe alleged exemption. Any violalion o( Section 7031.5 by any applicant for a permit subjects the appliwnt to a civil penalty of not more Ihan five hundretl Collars ($500).): �(� I,_as'owner of the pmDertY. or my employees vrith wages as their sole `compensation, WILL DO THE WORK, and the structure is not intenCed or offered for sale (Sec. 7044, Business antl Professions Code: The Conlractors License Law dces not apply to an ovmer of property who builtls or improves thereon, anG who dces such work �imself or herself or through his or her own employees, provided Ihal such improvements are not intenaetl or oKered for sale. If, hovrever, the builtling or improvement is sold within ona year of completion, t�e ovmer-builder vnll have the burden of proving thal he or she did nol build or improve for purpose of sale.). ❑ I, as owner ol tha property. am EXCLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS to conswct the project (Sec. 7044, Business and Prolessions Cotle: The contractas License Law dces nol apply to an ovmer of propeny who builds or improves thereon, antl who contracts for such pmject with a cont2ctor(s) license pursuant m the Coniractors License Lav+s.�. ❑ I am exempt untler sec. � Business and Professions Code for this reason: �k S2- _ S;Lv� $/12/d� �sw�a_ - w�a— � aosnas �w�� (�- —' vwner iu vennea oy am .c. U res LI rvo Driver's�License No, Expires: � 2%l ltm Verificalion of Ovmership by (type of dxument, i.e. - property taz bill or tleed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I �ereby certdy that no excavatbn frve (5) or mwe feet in depth iNo wfiich a persm is requiretl lo descend, will be made in conneclion with work authorizeC by this pertnit, and lhat no buildirg sWclu2, 5t�fdtlirg, false.wrk, or demolition or dismantling thereof, will be more Ihan thitly-siu (36) feet ligh. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Administrative Cotle). ❑ As owner-builtler, I will nol employ anyone lo do work which would require a permit from the Division of Intlustrial Safety, as notetl above, unless such person has a permit to do such vrork from the tlivision. Appliwnfs Si9naWre Date Division of Intluslrial Safety Pertnit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will ihe applicant or present or fuluB building xcupant need to file antl certify a Business Plan for emergency response to release or Ihreatened release ol a hazardous matenal? ❑ Ves ❑ No (Section 25505 of the Cali(omia Health and Safety Code requires, with some ezceptions, Ihat a Business Plan be filed with the Costa Mesa Fire Department by every business which has al any one time during a reported year a quantiry of hazardous materials equal lo or greater than a weight o( 500 pounds, or a volume of 55 gallons, or 200 cuGic feat o( compressetl gas al standard temperaWre antl pressure). 2. Dces or will the applicant or present or fuNre builtling occupaN need to file a registralion (orm for awtely hazartlous materials? ❑ Ves ❑ No (Section 25533 of the Califomia Heallh and Safety Cotle, wilh some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantiry o! acutely hazardous matenals equal to or greater Nan a weighl o( 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature antl pressure�. 3. Does or will lhe applicaN or present or fuWre builtling occupant need to prepare an RMPP (Risk Management and Prevention Program (or acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of [he California Health and Safery Code provides lhal Ihe Costa Mesa Fire Department may require the preparation, certifcation and fling wilh Ihe Fire Department of an RMPP by businesses which are required ro register acutely hazardous materials with the Fire DeOartment. 4. II an RMPP is presently requiretl, has Section 25534 of t�e California Health antl Safety Cotle been fully complied vrith7 ❑ Yes ❑ No 5. Does or will Ihe appliwnt or present or fWure builtling occupaN require for ma work which is Ihe subject of Ihis application a pertnit for such construction or motlification from the South Coast Air �uality Managemenl Dislrict or Irom any olhef aif D011uti0n con[ml di5lritt Or agency? ❑ Ye5 ❑ No (Seclion 658502 Of [he Califomia Govemment Code rcquires that the repuested informatbn be (umished on appliwtions lar ron-residential builtling pertnits�. 6. Will any part of the facility to be wnsWcted under lhis permit be wilhin 1000 teel from the outer boundaries ot a school? ❑ Yes ❑ No p( yes", lhe (acility must meet the requirement of Sections 25534 antl 42303 O( the Califomia Health antl Safety Code). 7. II a pertnit from the South Coas� Air Qualiry Managemenl District or other air polWtion control tlistrict or agency is requiretl for Ihe work which is lhe subject o( this application, have all of the disclosures prescribed by Cali(omia Health and Safery Code Section 42303 been matle? ❑ Yes ❑ No 8. (II "yes", altach certificate of compliance trom the appropnate air pollution conlrol oKcer). CER7IFICATE OF COMPLIANCE: I certify that under penalry ol perjury the information given above is covecL I agree to comply with all state laws antl city ordinances regarding Hazardous Materials antl Emissions. .. SiqnnWre Oa�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury that I have reaC this application and stale that the information given is conecl I agree to comply with all state laws and city ordinances relating to building construction, an0 authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspeclion purposes. I agree not lo occupy or allow occupancy of any building authonzed by this permit until final inspection. 'RSS-i �',Y�a S�/2/a� ��a��a,��,�s� �- ��a_ Mdlw Aulnonze0 App��anl DJIe , �x l� �;��- �U�a�JiLp � C I ��{ I � Y � ,� �-� S `� �� 0 5� v� �-S � �y� �� y�� 12 � V � v oF �ov A Q.e r. APPROVED CITY OF COSTA MESA PLANNING DIVISION SUBlECT TO BLDG. DF.PT. REG. NOTE: ADDITIONS, DELF.TIONS, OR CORRECTIONS SHALL 13E APPROYED BY THB PLANNING DIV. BY: DATE: _��_7__ 2Xg R�� ,�3� R�f z' �` TF,Q � �'°r insa/�(-:o/�. %(o.. � �.�- 5�� ______-- — _ n � /d�sa�� .nt�",- SH�� a ��a��V�,u,s` Jt��,5�`'� �,•,� �� e S�te��'� uoo o� a°�sy,yp exP°� ��u�+eV�" �0� —7 — l6d d�, 5�,� �„��a�� C' �� . 25- �� a��a��. �o�a�a � ',�ao�a,��+ � � CITY OF COSTA MESA - . BUILDING DIVISION F77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.G.costa-mesa.ca.us �.��. FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: BX08-00138 PERMIT TYpE B MISC STATUS: ISSUED APN: 42226202 DATE ISSUED: 05/12/2008 Zoning: , ISSUED BY: RMD JOB ADDR�SS: 727 B W 20TH ST CM Suite/Unit: B Vicinity: UNIT 8 ROOF Primary Occ: Const Type :7? SQ. FT: 0 Valuation: E2,487.00 � SCOPE OF WORK: CHANGE ROOF FRAMING FROM FLAT TO 4:12 PITCH. ADD R30 INSULATION IN ROOF AREA. COVER WITH 30 YEAR COMP SHINGLES. CLASS A ROOFING. TRIPLEX UNIT B(DETACHED UNI'� OWNER: SILVA, JOSE City/Stale: COSTA MESA, CA Phane: 714-501-9138 APPLICANT: SILVA, JOSE City/State: COSTA MESA, CA Phone: 714-501-9138 CONTRACTOR: Address: City/Sta1e: Zip Code: ARCHITECT: Phone ENGINEER: Phone �'� Building Plan Check: Building Permit: Electrical Permit: SMIP Residential SMIP Commercial TOTALFEES Address:: 727 W 20TH ST Zip Code: 92627-3486 Address: 727 W 20TH ST Zip Code: 92627•3486 License No. Phone Cell: License No. License No. FEE SUMMARY $54.11 583.25 $0.00 $0.50 $0.00 $137.86 Unit UniC Unit: NOTICE: The work authorized by this permil shall comply with all applicable handicap access requirements under Califomia statutes and relaled regulations. (Ord. No. 92•28. § 1. 12-21•92) EXPIRAiION: PERMIT EXPIRES 180 DAYS FROM DATE OF 7SSUE OR DA7E OF LAST INSPECiION. INSPECTIONS; In order for the vrork authorizetl under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure lo obtain inspections and final approval vrill result in the expiration of Nis permit. C 0 � INSPEC710NTYPE Q�jF� N RL COUEt I_N$PECTIONTYPE D� INTIlULS 1818 Fixed SyStem Final Fire Prevention 208 Final Mechanical 1288 Pool Spa Final . 208 Final Plumbing 200 Final Re-Roof �� 210 Final Electrical 201 Final Bfo�k/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demoli�ion 250 Final Building/Occupancy `Z— 4-� 8 � WORKER�COMP�SATION DECLARATIOI 1 hereGy affrm under penalty ol perjury one of Ne �ollowinq declaretions: ❑ I have antl will maintafn a certifiwte of wnsenl lo self-Insure for workers' compensation, as provitletl for by section 3700 of ihe Labor Code, for the pertormance o1 the work for which this pertnit is issuetl. ❑ I have and v.ill maintain workers' wmpensation insu2nce, as requiretl by seclion 3700 of the Labor Code, fa lhe performance of ttre wvrk fa which this permit is issued. My workers' compensatlon Insurance wmer and policy number are: Cartier: (T�is secfbn neMipf Ee mmpletM/Ihe permt a rdhied a! ana huMrtH tlolars fff00/ a Mu.) Policy Number: �[��I certify ihat in the Dertortnance of [he vrork for vfiich this permit is issued, I shall not employ any person in any manner so as lo become subject to the vrorkers' compensation laws of Cali(omia, and agree that i! I should become subject to the workers' compensation provisions of Section 3700 of the Labor Cotle, I shall lorthwith comply with Nese provisions. -�S e � �; L �n .T/ r2/o B' npplimm's Sipna Wre ^Dme, i� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAtJD DOLLARS ($700,000), IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CADE, IMEREST, AND AITORNEY'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby affirm that I am licensetl under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Pro(essions Cotle. and my license is in full force and eKecl. Lic. # Class # Canvaaa s SiB^xwre �a�e CONSTRUCTION LENDING AGENCY: ❑ i he2by affvm thal there is a construction ienaing agency (a lhe peAortnance of the work fa which this pertnit is ssueC. (Sec. 3097, Civil Code�. Lender's Name: Lentler'S Address: $iB�ature Dale OWNER-BUILDER DECLARATIONS: I hereby affrm that untler penalry o( perjury Nat I am EXEMPT FROM THE CON7RAC70RS LICENSE LAW for ihe follovring reason (Sec. 7037.5, Business antl Protessions CoCe: My ciry or counry which requires a permit to construct, alter, impmve, demolish, or repair any sWCWre, prior lo its issuance, also requires lhe applicant tor such permit to file a signed statement lhat he ar she is licensetl pursuant to Ne provisions o( the ConVactore License Law (Chapter 9(commencing wilh Section 7000) of Division 3 of tha Business and Pmlessions Code) or Ihat he or she is exempt therefrom and the basis for �he alleged exemption. Any violation of Sec�ion 7031.5 by any applicant !or a permil subjects Ihe applicant to a civil penalry of not more than rve nunaretl tlouars �SSoo).�: ��,—t as ovmer ol lhe property, or my employees with wages as Iheir sole compensation, WILL DO 7HE WORK, and the slrucWre is nol intended or ofleretl (or sale (Sec. 7044. Business and Professions Code: The Contractors License Law dces not apply to an ovmer of property who builds or improves thereon, and who does such work himself ar hersell or throuqh his or her own employees, provided that such improvemen�s are not intended or offered for sale. If, however, the building or improvement is sold within one year of wmpletion, lhe ovmer•Duilder 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 CON7RACTING WITH UCENSED CONTRACTORS to construct the project (Sec. 7044. Business antl Professions Code: T�e conlractors License Law dces not appty to an owner of property who builtls or improves Ihereon, and who cont2ct5 for such projecl with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempl under sec. Business and Protessions Cotle for mis reason: �S� S i �1/{�_ S�/2%� ��SIpNWr<�� T-"'03iG .l 305]<6(3ro1) i�_"_-". ' Owner ID verifed by drive, a lic. ❑ Yes � No r Driver�sLicense No. . �� —� � Expires: �211��d� Verifcalion of Ovmership by (lype of documenl; I:e = pmperty tax Dill or deed): DIVISION OF INDUSTRIAL SAFETY PERMI7 CERTIFICATION: ❑ I hereby certify that no excavation frve (5) w more feet in tlepth into wfiich a person is required lo descend, will be made in connectbn with work authorized by Ihis permit, and that no builtling slrucWre, sc�fddirg, false�wrk, or demolition or dismantling thereo(, will be more Ihan thiAy-six (36) teet high. (Chap. 32, Gry 2, M 2, Sec. 341, Tdle 8, California Administrative Code). ❑ As ownerbuiltler, I will not employ anyone to do work which would require a permit from Ihe Division o( Intluslrial Safery, as noted above, unless such person has a permit to tlo such work from the division. A�d��'s Signalure Dale Division o( Industrial Safery Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 7. Will the applicant or present or future builtling occupant need ro file and certify a Business Plan for emergency response to release or threatened release ol a hazardous malerial? ❑ Yes ❑ No (Seclion 25505 of the Calitomia Heallh and Safery Cotle requires, with some ezceptions, that a Business Plan be filed with the Costa Mesa Fire Department 6y every business which has at any one lime dunng a reported year a quantity o( hazardous materials equal to or greater than a weight o( 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at stantlartl temperature and pressure). 2. Does or will the applicant or present or fulure Guiltling occupant neetl to fle a registralion form lor aculely hazartlous materials? ❑ Ves ❑ No (Section 25533 0l the Califomia Health antl Safery Code, with some exceptions, requires registration with Ne Costa Mesa Fire Department by each business v+hich at any one time has on hand a quantity of acutey hazardous materials equal lo or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet o( compressed gas at standard temperaNre and pressure). 3. Does or will the applicant or present or fuNre building occupant neetl to prepare an RMPP (Risk Management and Prevention Program !or acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of Ihe Califomia Healih and Safety Code provides that the COsta Mesa Fire Department may require Ihe preparation, certifcation and filing with the Fire Depariment of an RMPP by businesses which are required to register awtely hazardous matenals vrith the Fire DepanmeN. 4. If an RMPP is presenlly requiretl, has Seclion 25534 0l the Califomia HeaIN and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicanl or presenl or (uture builtling occupant require for the vrork wnicn is the subject o( this application a permil for such construction or motlificalion from the Soulh Coast Air Qualiry Management District or (mm any other air pollution conlral district or agency? ❑ Yes ❑ No (SecCon 65850.2 of Iha Califomia Govemment Cotle requires that the requesle0 infortnatwn be fumishetl on applications fv ran-resi0ential building permits). 6. Will any parl ol lhe facility to be consWctetl under Ihis permit �e wi�hin 1000 feet from the ouler bountlaries ol a school? ❑ Ves ❑ No (If'yes", Ihe (acility musl meet the requirement of Sections 25534 an0 42303 o( Ihe Calilornia Health and Safely Cotle). 7. If a permit Irom the South Coas1 Air Qualiry Management DisMct or olher air pollulion coNrol tlistricl or agency is required for tha work which is Ihe subjecl of this application, have all of the disclosures presuibed by Califomia Health and Safety Code Seclion 42303 been matlel ❑ Yes ❑ No 8. Qf yes", attach certificate of compliance fmm the appropriate airpolWtion control oKcer�. CERTIFICATE OF COMPLIANCE: I certify Ihat under penalry o1 perjury Ihe information qiven above is cortect. I agree to comply with all slate lav5 and city ordinances regarding Hazardous Materials and Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certity under penalry of perjury that I have read this application and stale that the information given is cortect. I agree to comply with all slate laws and city ortlinances relating to building construclion, and authorize representatives of the Ciry of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not lo occupy or allow occupancy ol any builtling authorized by this permit until final inspection. [� ,��..�'e � i �V�/ i..5-//2 /�O— —9gnawreo(LepalOwner�s) ��— 'Date Mdlor AutM1w4C0 AppliCdnl 2 �� n �� a� �� r�� -� S � �� ( �05—� ��.s � �' � i ��-� � y � � '�' �' 1 r '� � -- �i1 , , i �1��/7,g t2:pG�_. V OF �pV �e,e � 0 APPROVED CITY OF COSTA MESA PLANNING DIVISION SUBIECT TO BLDG. DEPT. REG. NOTE: ADDITIONS, DELF.TIONS, OR CORRECTIONS SHALL 13E APPROVED BY THE PLANNING DIV. BY: DATE: _%'_7_ . � 2k\��TF� (�,�3e �-F 2 $R ��a,� �� ad�� s"e`,,�� SH�"��d 1�'6� d��+y�` U�:.aM�' �1tD��' d o� �osW �eaR+ �av�� ,r+nst�` o�a"��na�'�"�� 5y1e� �d o` an9 C�o�p�y{fi��9G -7- l6d d,�,..,�s��,��„� � �� .� 25- �O�° oM�A ea�'�a��0 O�d��..;ddQ�b�. � cio � �—�r i►�sa(wJ�:e�'/. ��\ � G' C- `{ �,�! � L� P�� h � ^ � � CITY OF COSTA MESA J � B(lILDING DIVIS/ON 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: BX08-00192 PERMIT TYPE B_MISC STATUS: ISSUED APN: 42226202 DATE ISSUED: 06125/2008 Zoning: , ISSUED BY: RMD JOB ADDRESS: 727 B W 20TH ST CM Suite/Unit: B Vicinity: KITCHEN AND LIVING ROOM Primary Occ: Const Type :?? SQ. FT: 0 Vatuation: E500.Q0 � SCOPE OF WORK: CHqNGE OUT 3(E) WINDOWS LIKE FOR LIKE AT UNIT B ONLY. NO CHANGE IN LOCATION OR SIZE (KITCHEN AND LIVING ROOM). STUCCO WILL BE BROKEN. WINDOWS ARE MANUFACTURED BY PELLA & ENERGY STAR RATED. OWNER: SILVA, JOSE Ciry/State: COSTA MESA, CA Phone: 714-501-9138 APPLICANT: SILVA, JOSE City/State: COSTA MESA, CA Phone: 714•501-9138 CONTRACTOR: Address: City/State: Zip Code: ARCHITECT: Phone ENGINEER: Phone OWNER-BUILDER Building Plan Check: Building Permit Electrical Permit: SMIP Residential SMIP Commercial TOTALFEES y Address:: 727 W 20TH ST Zip Code: 926273486 Address: 727 W 20TH ST Zip Code; 92627-3486 Phone FEE SUMMARY 50.00 523.50 50.00 $0.50 $0.00 $24.00 License No. 000000 License No. License No. C! � ,' ' . Unit Unit: Unit Cell: G � ��. r� \\ �i .� NOTICE: The work aulhorized by this Oertnit shall comply with all applicable handicap access requirements under Califomia statutes anA relatetl regulatlons. (Ortl. No. 92•28. § 1, 12-21•92) EXpIRATION: PERMI7 EXPIRES iB0 DAYS FROM DA7E OF ISSUE OR DATE OF LASi INSPEC710N. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must wmply with all applicable codes, and all required inspections and final approval musl be obtained. Failure lo obtain inspections and final approval will result in the expiration of this pertnit. coo[� ixsr�cnox.rre p�g IN7filALS y.q.p� ixsa�cnoxrrre Q�g x��yg 1818 Fized System Final Fire Prevention 206 Final Mechanical 1288 Pool Spa Final 2�8 Final Plumbing 200 Final Re-Roof 210 Final Electrical � 201 Final Block/Retaining Wall 272 Final Fira Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Dertrolition 250 Final Builtling/Occupancy Z'Q�A �- i �. WORKERS' COMPENSATION OECLARATION: � I hereby affmm untler penalry o( perjury one of the lollowing declarafions: ., ❑ I have antl will maintain a certifiwte of wnsent ro self•Insure foi woFkers' compensation, as providetl for by section 3700 0( the Labor Code, (or the peAormance of lhe wnrk lor which this pertnit is issued. ❑ I have and will maintain v.arkers' compensatbn insurance, as required by section 3700 0l Ne Labor CoAe, (a the peAortnance of the work for which [his pertnit is issued. My workers' compensation Insurance tarrier and policy numher a e: I amer ' usa onn dDemmpelatl epertntbralu afarenimWMcb9ars(S�oo)aiess) Policy Number: �—I ceNfy Ihat in the peRormance of the work for which lhis permit is� issued, I shall not employ any person in any manner so as lo bewme sublect to the vrorkers' wmpensation lavrs o( Califomia, and agree Ihat it I should bewme subject to lhe workers' wmpensation provisions of Section 3700 of the Labor Cotle, I shall forthvnth comply with these provisions. �� 5 ijc/!� ��ZS�U S� AppliwmS Sipnawre --Da�e WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLL4RS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND AITORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrtn that I am licensetl untler provisions of Chapler 9(commencing �with Section 7000) of Division 3 of the Business and Professions Cotle, and my license is in full force and eRect. Lic. # Class # Cant2na's Si8^aiure Date CONSTRUCTION LENDING AGENCY: ❑ I hereby affcm that Ihere is a consWction lending agency fw the peAormance of the Hork (or v.fiich ItriS permit is issued. (Sec. 3097, Civil Cadej. Lendels Name: Lender'S Address: SigriaWre Date OWNER-BUILOER DECLARATIONS: I hereDy aRirtn that untler panalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW (or lhe following reason (Sec. 7031.5, Business and Professions Code: Any cily or county which requires a permit to consWcl, alter, improve, demolish, or repair any slrucWre, prior to its issuance, also requires the applicant for suc� permil to file a signed statement that he or she is licensetl pursuant ro Ihe provisions of �he CoNrectors License Law (Chapter 9(commencing with Section 7000) o! Division 3 of the Business and Profe55iOn5 Cotle) of lha� he Or 5h8 i5 exempt lherefrom antl the basis for the allegeC exemption. Any violation of Section 7031.5 by any applicant lor a pertnit subjects the applicant lo a civil penaliy ol noI more than f,�rve/ hundred dollars ($500�.�: �(y� � l, -as ovmer o1 ihe property, or my employees with vrages as Iheir sole compensation, WILL DO TME WORK, and the sWclure is not intended or o((ered lor sale (Sea 7044. Business and Prolessions Code: The Contraclors License Law tices not apply to an owner of property who builds or improves thereon, antl who does such work himsell or herself or through his or her own employees, provided lhat such improvements are not intended or oflered for sale. If, however, Ihe building or improvement is soltl wilhin one year of completion, the ownerbuilder will have Ihe burtlen of proving that he or she did not build or improve for purpose of sale.). ❑ I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to tm5truct the projecl (Sec. 7044, Business and Professions Code: The cont2ctors License law dces not apply lo an ovmer of property wfio builds or improves thereon, and vfio wntracts for such project with a cont2ctor(s) license pursuant to the Cont2ctors License Laws.). ❑ I am exempt under sec. Business and Pro(essions Coda for lhi5 reasOn: ��1'iv,�-c. S ; �vl� G/�r/�,� v � SiyriaWre vDate 305]<fi(3roJ1 f � i Owner ID verifietl by dm,, .,cens�e+. Yes ❑ No ��Drivers�LicenseNo.�� w.eS:J"2/�a/�O V... ' Verification of Ovmership by (rype of document, i.e. - property tax bill or tleed): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certAy that no excavatbn frve (5) a more feet m depth into wfiich a person is requiretl ro descentl, will be made in connection with v.wk autMrrzed by �his pertnit, and that no building struc�ure, scaf(dding, false�wrk, a demolition or tlismanlling thereol, will be more lhan thirty-sa (36) leet high. (Chap. 3.2, Grp 2, M 2, Sec. 347, Ttle 8, Cali(omia AtlministraWe Code). ❑ As ownervbuilder, I will not employ anyone to tlo work which vroul0 require a permit from Ihe Division of Industrial Salety, as noted above, unless such person has a permil to do such vrork from the division. AppliGlnl'S SignaWre Dale Oivision o( Indusirial Safely Permit Numher: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuWre building occupant need b file and certify a Business Plan lor emergency response lo release or threatened release o( a hazardous matenal7 ❑ Yes ❑ No (Section 25505 of the Calitornia Heallh and Safely Cotle requires, vnth some eaceptions, that a Business Plan De filetl with the Costa Mesa Fire DepaNment by every business which has at any one time tlurinq a reportetl 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 leet of compressetl gas at s�antlartl temperature and pressure). 2. Does or will the applicant or present or luture builtling occupant need to file a regislration form for aculely hazartlous materials? ❑ Yes ❑ No (Section 25533 of Ihe Cali(ornia Health and Sa(ety Code, with some exceptions. requires regislralion with Ihe Costa Mesa Fire Depariment by each business which at any one time has on hand a quantity of acutely hazardous materials equal ro or greater Ihan a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standartl [emperaNre and pressure). 3. Does or will �he applicant or present or future builtling occupant need to prepare an RMPP (Risk Management antl Prevention Program for awtely hazardous materials)? ❑ Yes ❑ No (Seclion 25534 of the California Health antl Satery Cotle provides that the Cos1a Mesa Fire Department may require the preparation, cenification antl filing vrith the Fire Departmenl of an RMPP by businesses v+hich are required to register awtely hazardous materials vnth the Fire Department. 4. If an RMPP is presently required, has Section 25534 of Ihe Califomia Health and Safery Code been fully complied with7 ❑ Yes ❑ No 5. Dces or will the applicant or present or fWure building occupant require lor Ihe work which is the subject of Ni5 applicali0n a permi� for 5uch wnSWClion or modificalion fmm lhe South Coasl Air Qualily Management District or (mm any other air pollution coNml dislrict or agency7 ❑ Yes ❑ No (Section 65850.2 0( lhe Califamia Govemment Code requires Ihat Uie requestetl informatbn be fumished on applicalbns ta rao-residential builtliry pertnits�. 6. Will any part of the facility to be wnstructed under lhis pertnit be within 1000 feet from the outer boundaries of a school7 � Yes ❑ No (If yes". lhe lacility musl meet the requirement of Sections 25534 and 42303 o( the Calilomia Health and Salely Code). • 7. If a permit lrom the South Coast Air Quality Management Dislrict or other air polWtion control district or agency is required !or tha xroB vmich is Ihe subject ol this application, have all of Ihe disclosures prescnbed by Calitomia Health and Sa(ety Code Section 42303 been madel ❑ Yes ❑ No 8. Qt "yes", aUach-cerlifcate o( compliance from Ihe appropriate air pollution control officer). ' � � ' CERTIFICATE OF COMPLIANCE: I certify �hat untler penalry ol perjurythe infortnation given a6ove is correcl. I agree to comply with all state laws antl ciry ordinances regarding Hazardous Materials and Emissions. '� Signalure Da�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read Ihis ap0lication antl state t�at the information given is correcl I agree to comply with all stale tavrs and city ortlinances relating to building construction, and aWhorize �epresenutives of the City of Costa Mesa to enter upon the above-descriDetl property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permil until final inspection. , SignaWre of Legal O.mer(s) �Ud�e - �jS�r� �C j �v� _ 6�25�0 � � Authonze0 Ap canl pale CITY OF COSTA MESA � BIIILpIN6 DIVISION _ +�+� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT TYPE APN: 42226202 Zoning: , JOB ADDRESS: Vicinity: SQ. Ff: 0 B_MISC 727 C W 20TH ST CM PERMIT NUMBER: BX08-00187 STATUS: ISSUED DATE ISSUED: 06/20/2008 ISSUED BY: yh � . , . Suite/Unit: C PrimaryOcc: � �� ConstType :7? Valuation: 51,000.00 -' SCOPE OF WORK: REPLACE 5 WINDOWS IN SAME LOCATION & WITH SAME WIDTH OPENINGS'. WINDOWS ARE MANUFACTURED BY PELLA 8 ENERGY STAR RATED. • WORK SUBJECT TO FIELD VERIFICATION - EGRESS HANDOUT GIVEN & ATTACHED TO JOB CARD. OWNER: SILVA, JOSE CitylState: COSTA MESA, CA Phone: 714-501-9138 APPLICANT: GUADALUPE SILVA MARTINEZ City/State: Phone: 949 929-9490 CONTRACTOR: Address: City/State: Zip Code: ARCHITECT: Phone ENGINEER: Phone Building Plan Check: Building Permit: Electrical permit: SMIP Residential SMIP Commercial TOTALFEES � Address:: 727 W 20TH ST , Zip Code: 92627-3486 Address: Zip Code: ... � License No. Phone Cell: FEE SUMMARY $0.00 _ $38.75 . � $0.00 �, . $0.00 $0.00 $38.75 License No. License No. Unit Unit: Unit: �� + � � � � � �� ; �, ., NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statules 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. INSPEC710NS: In order for the worlc authorizad 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 fnal approval will result in the expiratlon of this permit. �� CO�Et. INSPECTIONTYPE o� iNs�� rjQp� ixsvecnoxttve � o� ixmu�s 1618 Fized System Final Pire Prevention 206 Final Mechanical 1268 Pool Spa Final � 208 Final Piumbing 200 Final Re-Roof � 270 Final Electncal 201 Pinal Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 FinalSite 9 204 Final Demolition 250 Final Building/OccuOancy L' —� � WORKERS' COMPENSATION DECLARATIO� I hereby affirtn untler penalty of perjury one o( th ng decla2tions: ❑ I have and will �i[a�n a certificale ol wnsen� to 5e1(-InSure for workers' compensation, as providea br by section 3700 of the Labor Code, for Ihe pedormance of lhe work for which this pertnit is issued. ❑ I have and will maintain V,arkers' compensation insurance, as required by section 3700 of the Labor Cotle, (w the peAwmance of the work (w wfiich this permit is issued. My workers' compensation Insurance wrner and policy numher are: Carner. (T�rs sedon nee0 �rol �e mmple�p� d t�e pe�mrt u rohre0 af are huntlrcd tlollars (f10p) a less ) Policy Numher: ❑ I cerlity Ihat in the performance ol the vrork for which this Dermit is issued, I shall not employ any person in any manner so as to become subject b the workers' compensation lavrs o( Calilomia, and agree that if I shoultl become subjecl to the workers' wmpensation provisions of Seclion 3700 of Ihe Labor Code. I shall forthvrith comply vnth these provisions. Applionts SignaWre Da�e WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CAVERAGE IS UNIAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HLINDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECT70N 3706 OF TNE LABOR COOE. IFfTEREST, AND AITORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensetl under provisions of Chapter 9(commencing vrith Section 7000) o( Division 3 of Ne Business and Professions Code, and my license is in full force and eHect. Lic. # Class # ConVador's Signature Da�e CONSTRUCTION LENDING AGENCY: ❑ I hereby af(vm that there is a wnstructbn lending agency for the peAamance o/ the work for which ihis permit is issued. (Sec_ 3097, Civil Cotle). Lender's Name: Lentler's Address: Dare OW NER-BUILDER DECLARATIONS: I heraby affrm thal under penalty of peryury that I am EXEMPT FROM THE CONTRACTORS LICENSE LqW for t�e following reason (Sec. 7031.5, Business antl Professions Code: Any ciry or counry which requires a permit to construct, alter, improve, demoli5h, or repair any structure, pnor to i�s issuance, also requires the applicant for such permit to fle a signed slatement thal he or she is licensetl pursuant to the provisions of Ne ContractoB License Law (Chapler 9(corr�mencing with Section 7000) of Division 3 of the Business and Prolessions Cbde) or that he or sha is exempt Nerefrom and Ihe Dasis lor Ihe alleged exgmption. Any violation of Section 7031.5 by any applicant tor a permil subjects Ihe applicant to a civil penalry of not more than five huntlred dollars (5500).): ❑ I, as ovmer of the property, or my employees with vrdges as their sole compensation, WILL DO THE WORK, and the structure is not intended or oflered lor sale (Sec. 7044, Qusiness and Professions Code: The Contractors Licensa Law does not apply to an owner ol property who builds or improves thereon, and who does such work himself or herself or through his or her ovm employees, provided ihat suth impiovements are not intended or oHered for sale. If, hovrever, 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 pvrpose of sale.). ❑ I, as owner o� the property, am EXCLUSIVELY CON7RAC71NG WITH LICENSED CONTRACTORS to conswct tne projecl (Sec. 7044. Business and Professions Cotle: The coniractas License Law dces not appy lo an amer of property who builds or improvps thereon, and who contracts for suc� project with a cmtractar�s) license pursuant ro the Cont2ctors License Laws.�. ❑ I am exempt under sec. Business antl Protessions Code (or this reason: Owner ID verifietl by driv�se. ❑ Yes ❑ No Driver's License No. Ezpires: w Venlication o( Ownership by (�ype o( document, i.e. - propeny tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFlCATION: ❑ I hereby certify that no excavalion frve (5) w more feet in tlepth into wfiich a person is required to descend, will be matle in wnnec[bn with work authorized by Ihis permit, and that no building slrucWre, scaf(dding, lalsewprk, or tlemolition or dismantling thereo(, will be more than thirty-sa (36) feet high. (Chap. 3.2, Gry 2, Ari 2, Sec. 341, Ttle 8, Califomia Administrative Code). ❑ As owner-builder, I will nol employ anyone to do work which would require a permit from the Division of Industrial Safery, as noted above, unless such person has a permit to do such vrork Irom the divisi0n. Apdicanl's SiB�alure DiviSion o( InduStrial Safe�y Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicanc or presant or future building occupant need to Ne antl certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 0( the California Health and Safely CoCe requires, wilh some exceptions, that a Business Plan be Poed with tha Costa Mesa Fire Departmenl by every husiness which has a1 any one Ume tlunng a reported year a quantity of hazardous matenals equal to or greater lhan a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standard temperature and pressure). 2. Does or wiu the applicaN or present or tuture building occupam need to file a registration form for acutely hazardous matenals? ❑ Yes ❑ No (Section 25533 of the Califomia Health antl Sa(ety Cotle, with some axceptions, requires registralion wilh the Costa Mesa Fire Department by each business which at any one time has on hand a quantiry of acutely hazardous matenals equal to or greater than a weight ot 500 pounds, or a volume o! 55 gallons, or 200 cubic feet of compressetl gas at standard IemperaNre and pressure). 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management antl Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safety Code provides Nat the CosW Mesa Fire Depanment may require the preparation, certificadon antl filing with tha Fire DepaAment of an RMPP by businesses which are required to register awtety hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 0l the Calilomia Health and Safery Code been fully complied vrith? ❑ Ves ❑ No 5. Ooes or will Ihe applicant or present or fuWre building otcupant require !or the vrork which is tha subject of this applicalion a permitlor such conslruction or motliTlcalion from Ihe South CoaSt Air Qualily Management Di5lfiCl of (fOm any other air polWtion con[rol district or agency9 ❑ Yes ❑ No (Section 658502 of the Califomia Govemment Code requires that the requested infortnation be fumished on aDPlications (or non-residential buildirg permits�. 6. Will any part o( tha lacility lo be constructed under Ihis permit be within 1000 leet from ihe outer boundanes o! a school7 ❑ Yes ❑ No (If'yes", the (acility musl meet the requirement ol Sections 25534 and 42303 of the Califomia Health and Safety Code). 7. If a pertnit from the Soulh Coast Air Qualiry Management District or other air pollNion contml disirict or agancy is required for the work which i5 Ihe subjecl of this application, have all ol lhe disclosures prescribed by Califomia Health and Safety Code Seclion 42303 baen maCe7 ❑ Yes ❑ No _ 8. Qf 'yes", attach ceni(wte of compliance from the appropriate air pollution control oKcer). CERTIFICATE OF COMPLIANCE: I �ertify thal under, penalty of perjury the in(ormation given above is correct. I agree to comply vrith all slate laws and city ordinances regaiding Hazartlous Materials and Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRY: I certify under penalty of perjury that I have read this appliwtion and state that the information given is correcl I agree to comply with all state lavrs and city ordinances relating to building conswction, and authonze represenUtives of the City ot Costa Mesa ro enter upon the above-descnbed property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ti� 6+� �j�� j _/ k . Si9naWre o! Legal Owner(s� Oa�e r c CV� <' Signalure pdtE J 305]<6 (10]/ �S�"�� -�l��i! �� . AnOlorAuthon e AppliLtnt Da�E � '� r�i.� �� X ��- i� 0 �� -= 2() � �Y.�-�`�C � � r.. � �.. . CITY OF COSTA MESA BIIILDING DIVISION F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa.ca.us °. � FOR INSPECTIONS CALL: (714) 754-5626 }��.' PERMIT NUMBER: BX08-00139 PERMIT TYpE B MISC STATUS: ISSUED APN: 42226202 DATE ISSUED: 05/12/2008 Zoning: , ISSUED BY: RMD JOB ADDRESS: 727 C W 20TH ST CM Suite/Unit: C Vicinity: UNIT C ROOF Primary Occ: � Const Type :?? SQ. FT: 0 Valuation: E2.487.00 SCOPE OF WORK: CHANGE ROOF FRAMING FROM FLAT TO 4:12 PITCH. ADD R-30 INSULATION IN ROOF AREA, COVER WITH 30 YEAR COMP SHINGLES. GLASS A ROOFING MATERIAL. TRIPLEX UNIT C. (DETACHED UNIT) OWNER: SILVA, JOSE Ciry/Stale: COSTA MESA, CA Phone: 714-501•9138 APPIICANT: SILVA, JOSE Ciry/State: COSTA MESA, CA Phone: 714-501-9138 CONTRACTOR: Address: 'J � City/State: `� Zip Code: ARCHITECT: Phone ENGINEER: Phane Building Plan Check: Building Permit: Eleclrical Permit SMIP Residential SMIP Commercial TOTAL FEES Address:: 727 W 20TH ST Zip Code: 926273486 Address: 727 W 20TH ST - Zip Codei 92627-3486 License No. ' Phone ' Cell: � License�No. � License No. FEE SUMMARY $54.11 583.25 $0.00 $0.50 $0.00 St 37.86 Unit Unit: Unil: NOTICE: 7he vrork authorized by this pertnit shall comply with all applicable handicap access requiremenls under Califomia sfatutes and related regulations. (Ortl. No. 92-28, § 1. 12-21-92) EXPIRA710N: PERMI7 EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAS7INSPECTION. INSPECTIONS; In order for the work authorized under this permit to be considered legal, such work must comply vrith all applipble oodes, and all required inspeeHons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expirafion of ihis permit. CODE/. �xsaecnoxTrve o� �xmu�s r,,op�E� �xsaecnoNTrre oR�TF IN71ML5 1818 Fiaed SyStem Final Fire Preventian 206 Final MeChanical 1288 Pool $pa Final . 208 Final Plumbing 200 Pinal Re-Roof Z � � � 210 Final Electrical 207 Final BIo�IdReWining Wall 272 Final Fire Prevention 202 Final Fattory Fire Place 220 Pinal Planning Approval 203 Final Sign 222 Final Site 204 Final Demplition 250 Final Building/Occupancy l2—Y—e(p � WORKERS' COMPENSATIO�OECLARATIO� 1 hereby affirm under penalty of perjury one ot the tollowing deGaraUons: ❑ 1 have and will maintain a certificate of consent to self-Insure for workers' wmpensation, as provided for by section 3700 of Ne Labor Cotle, tor the peRormance of the work tor vfiich ihis Dermit is issuetl. ❑ I have antl will maintain v.orkers' compensation insurance, as requiretl by section 3700 of the Labor Code, fa the performar�ce of Ne work tor which this pertnit is issued. My wnrkers' compensaUon insu2nce cartier and policy number are: Cartier. (Tlra serfnn rreM nd Oa canplefetll Na perma 6 valuetl af ine �uMiM cbRars (St00) a iess.) PoliCy Numhec ��.—I-certify ihat in the peAortnance o( lhe wvrk lor which this permit is Issued; I shall not employ any person in any manner so as to become suhjecl to the vrorkere' compensation laws of Califomia, and agree that if I should become subject lo Ihe vrorkers' compensalion provisions of Section 3700 ot lhe Labor Code, I 5hall forthwith compty with Ihese prOvisions. '�QS-e-- . S � Lyk �/l2/.OSI LAppirenfs SlgnaWra 4b—� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNL4WFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED 7HOUSAND DOLLARS ($100,000�, IN ADDRION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LA80R CODE, INTEREST, AND ATTORNEY'S FEES. UCENSED CONTRACTORS DECIARATION: I hereby aKrtn lhat I am licensed under provisions o( Chapter 9(commencing with Seclion 7000) ol Division 3 of the Business and Protessions Code, and my license is in full force and e(fect. Lic. # Class # CanVaclor's SipnaNre CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrm that ihere is a constmctbn lending agency for the perfortnance of lhe uork for v.tiich this pertnit is issued. (Sec. 3097, Civil Code�. Lender's Name: Lentler's Atltlress: OWNER-BUILDER DECLARATIONS: I hereby aKrm ihat untler penalty o( perjury tha� I am EXEMPT FROM THE CONTRACTORS LICENSE lAW lor the follawing reason (Sec. 7031.5, Business antl Pro(essions Code: My city or counry which requires a permit to construct, alter, improve, demolish, or repair any shucture, pnor to its issuance, also requires Ihe appliwnt for such permi� to file a signed statement that he or she is licensad pursuanl lo lhe provisions of lhe CAntrattors License Law (Chapter 9(wmmencing with Seclion 7000) of Division 3 0l the Business antl Prolessions Cotle) or thal he or she is ezempt therefrom and ihe basis for the alleged exemption. Any violation of Section 7037.5 by any applicant for a permit subjects the applicant to a civii penalty of not more Ihan five hundred dollars ($500)J:. ��I�,-as ovmer of the properry, or my employees vrith wages as Iheir sole moensation, WILL DO 7HE WORK, antl the structure is not imendetl or oflered !or sale (Sec. 7044. Business and Professions Code: The Contrectors License Law does not apply to an ovmer of property who builtls or improves thereon, antl who does such vrork himself or hereelf or Ihrough his or her ovm employees, provided I�at such improvements are not intended or offeretl tor sale. If, hovrever, the building or improvemenl is sold within one year of completion, the ownervbuilder will have the burden ot proving that he or she ditl not build or improve for purpose of sale.). ❑ I, as owner of the property, am EJ(CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law dces rrot apply to an wmer of property v.ho builds or improves thereon, antl who conVacts for such project with a cont2ctor(s) license pursuam m the Contractors License Laws.). ❑ 1 am exempl under sec. Business and Pro(essions Cotle (or this reason: r �nc , s; l �/t� S i2/o� - SignaWr� �Dale. . 3�A<6 �3IOJ) �� Owner ID verifietl by dn ic� ❑ Yes ❑ No , Drivar's�l:icense No. Ezy`Res �(�� Verification of Ownershi b V p y(rype ot Cocumenl, i.e. - property tax 6ill or tleed): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certi(y lhat no excavation (rve (5) or more feet m depih into wfiich a person is required to descend, will be made in conneCtion with �+ork authorized by this pertnit, and Ihat no buildirg sWcture, sca((dEiig, false�wrk, a demdifion or dismantling thereof, will be more than thirty-sa (36) leet �igh. (Chap. 3.2, Grp 2. M 2, Sec. 341. Ttle 8. Califomia Atlministrative Cotle). ❑ As ownerbuiltler, I will nol employ anyone to da work whic� woultl require a permit from ihe Division o! Industrial Sa(ety, as notetl above, unless such person has a permit to tlo such work �rom the division. Applicanl'S Signature Division ol Industrial Sa(ety Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. will the applicant or present or fuWre building occupant neeC to file and certify a Business Plan for emergency response lo release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of Ihe California Health and Safey Code requires, wit0 some exceptions, that a Business Plan be filed with lhe Cosla Mesa Fire Department by every business which has at any one time during a reportetl year a quantily of hazartlous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons. or 200 cubic teet ol wmpressetl gas at stanCard temperawre and pressure). 2. Does or will the applicant or preseM or future Euiltling occupant need to file a registralion form for acutely hazartlous materials? ❑ Yes ❑ No (Section 25533 0! the Cali(ornia Health antl Safery CoCe, with some exceplions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazartlous materials equal to or greater ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at slantlard remperaNre antl pressure). 3. Does or vnll ihe applicanl or present or fu[ure building occupant neetl to prepare an RMPP (Risk Management ana Prevention Program (or acutely hazar0ous matenals)? ❑ Yes ❑ No (Section 25534 of lhe Califomia Health and Safery Code provides [hat the Costa Mesa Fire Department may require the preparation, certification and filing vnth the Fire Department of an RMPP by businesses which are requirad to register acutely hazartlous materials with Ihe Fire Department. 4. If an RMPP is presently require4 has Section 25534 of I�e Calitomia Health and Safely Code been fully complietl vrith'1 � Ye5 � No 5. Dces or will Ihe applicant or preseN or IUWre builtling occupant require for the vrork which is the subject o( this application a pertnit (or such wnsWction o� motlifcation from lhe South Coast Air Ouality Management District or (rom any other air Oollution control districl or agency? ❑ Yes ❑ No (Section 658502 of the Califomia GovemmeN Cotle requires that ttre requestetl inlormalbn be fumished on applications lor ron-residential building pertnits). 6. Will any part Of the lacilily lo be constructed under this pertnil be vnthin t0001ee1 from the outer boundanes of a 5chool7 ❑ Ve5 ❑ No (If "yes", the facility must meel the requirement of Sections 25534 antl 42303 ol lhe Calilornia Health and Safety Code). 7. If a pertnit Irom the Soulh Coast Air Quality Management Dislrict or ot�er air pollulion control district or agency is required for the work which is Ihe subject ol this application, have all of the disclosures prescribed by Califomia Health antl Safety Code Section 42303 been made? ❑ Yes � No 8. (If'yes". attach certifcale of wmpliance from Ihe appropriate air pollution control oKcer). � . CERTIFICATE OF COMPLIANCE: I certi(y thal under penalry of perjury the information given above is correct. I agree to comply vrith all slate laws antl city ordinances re9artling Hazardous Materials anC Emissions. SignaWre Daie CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cenify untler penalty of perjury that I have read this application and sWte thal the infortnalion given is cortect. 1 agree to wmpty with all stale laws and ciry ordinances relaling to building construction, and authorize represenWtives of the City of Cosla Mesa lo enrer upon the above-described property for inspection purposes. I agree not to occupy or allow xcupancy of any building authori�d by this permit until fnal inspection. .L1/3�2�- <iLirA _ .S�/210 �- ��Slgnalure ol Legal Ovmer�s) - (-Oale, � AntllorAUl�OnzeE AppLcxnl Dab 2�`� (� ��pG� : �� aL �� 3 � (�� I - , � � �� S �� oS� � �S °` �`�% %�� `�� t y r 7 _ - - `�� __J ". — :�_.+ , , /i � �l/�/7� �lpF RpV Ae,e r, APPROVED C1TY OF COSTA MESA PLANNING DIVISION SUBIECI' TO BLDG. DF.PT. REG. NOTE: ADDITIONS, DELF.TIONS, OR CORRECI'IONS SHALL BE APPROVED BY THE PLANNING DIV. `„` BY: DATE: _i�_ 2Xg R��\ �,�se j'�-F �z• %'�',P �- _�r inswfa-J�;e✓�- %(o �. G -� C _,.�r . . _ . ��.,� r�+s�;`;;`��"w� - � SHa"�S b ��•o'y`��5;.��A �1vt3�'�AV°1�'Os� �nv �Sa1e,ti ,�a �;,��*;+� "� �s �� a „mna{`°� � --� _ ( 6d d� ,:,,,W��n,`,� e��' w �' � ►1� �N fl p�6cd 25= � � r , • CITY OF COSTA MESA * BI/ILDING DIVIS/ON 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • v.v+w.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT TYPE B_ROOF2 ApN: 42226202 PERMIT NUMBER: B08-00189 STATUS: ISSUED DATE ISSUED: 06I2712008 ISSUED BY: CAC JOB ADDRESS: 727 W 20TH ST CM Suite/Unit: Vicinity: , . Squares: 0 Valuation: $2,500.00 SCOPE OF WORK: TEAR OFF EXISTING BUR CAHNGE PLYWOOD AND INSTALL BUR. ONLY ON GARAGES OWNER: SILVA, JOSE PHONE: 714•501-9138 APPLICANT: SILVA, JOSE PHONE: 714501-9738 CONTRACTOR: OW NER-BUILDER Address: Unit: City/State2ip: . ARCHITECT: E��' GINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: TOTALFEES $0.00 $83.25 $0.00 583.25 Address: 727 W 20TH ST City/State/Zip: COSTA MESA, CA Address: 727 W 20TH ST City/State/Zip: COSTA MESA, CA License No. License No. License No. 000000 PHONE: CELL: PHONE: PHONE: Unit: Unit: : NOTICE: The work authonzed by this permit shall comply with afl appticable handicap access requirements under Califomia statutes and retated rsgulalions. (Ord. No. 92-28, § 7, 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 consideretl legal, such work must comply with all applicable codes, and all �equired inspections and final approval must be obtained. Failure to obtain inspections and Mal approval will resuft in the ezpira6on of this permit. 0 1 INSPECTIONTYPE Q�TE INT�I/45 �Z INSPEL710NTYPE . j1�TF� IN7fML5 1816 Fized System Pinal Fire Prevention 206 Final Mechanical � 7Z68 Pool Spa Final .t �� 208 Final Plumbing 20p Final Re-Roof 1-' [� �'�i�— 210 FinalEtectncal 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fi�e Place 220 Final Plannirtg Approva! 203 Final Sign 222 Final Sife G 2p6 Final Demolition 250 Final Builtling/Occupanty /Z— L�vA �� WORKERS' COMPENSATION DECLARATION� . . I hereby atfirm undar penalty o( perjury one ot the o lowing declarations: ❑ I have and will maintain a certificate o( consent to sel(-Insura for workers' compensation, as provided for by section 3700 of the Labor Code, for the pertormance of the vrork for which this permit is issued. ❑ I have and will mainlain workers' canpensa�ion insurance, as required by sectbn 3700 of the Labor Code, Iw the performance of the aork for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Carrier (This seaian neetl rot be cnmdeted elhe ce� �s ✓�M1� al one nunorz.d ddlars (St00) a less) Policy Number: ❑ I ceAi(y ihat in Ihe peAormance of lhe 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 Califomia, and agree thal if I should become suhject to the vrorkers' compensation provisions of Section 3700 0( the Labor Code, 1 shall IoMwith comply vrith these provisions. AOG�i�nfs Si8^aWre Date WARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SNALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE CAST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm ihat I am licensed under provisions of Chapter 9(wmmencing wilh Section 7000) of Division 3 of the Business and Professions Code, and my license is in (ull force and eftect. Lic. # Class # Contrac�ar's SignaWre �ale CONSTRUCTION LENDING AGENCY: ❑ I hereby affvm that there is a wnstruction lending agency for the pertortnance of the v.ork fa wfiich this pertnit is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: OWNER-BUILDER DECLARATIONS: 1 hereby affrm that under penalty of perjury lhat I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for t�e following reason (Sec. 7031.5, Business antl Professions Code: Any city or county which requires a permit to conslruct, alter, improve, demolish, or repair any sWCWre, prior to its i55uance, also requires the applicant for such permit to file a signed slatement �hat he or she is licensed pursuanl to the provisions of the Contractors License Law (Chapter 9(commencing with Section 7000) o( Division 3 of the Business and Professions Code) or ihat he or she is ezempt therefrom and the basis (or the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the appliwN [o a civil penalty of not more than frve huntlretl dollars ($500).): ❑ I, as owner of the property, or my employees with vrages as their sole compensation, WILL 00 THE WORK, antl ihe struclure is not intended or offered for sale (Sec. 7044, Business and Professions Code: 7he Contractors License Law does not apply to an owner ot property who builds or improves thereon, and who dces such work himself or herself or through his or her ovm employees, provided that such improvements are not intended or otfered for sale. I(, however, lhe building or improvement is sold vnthin one year of completion, Ihe ovmer-Duilder vrill have the burEen of proving thal he or sAe did not build or improve for purpose ol sale.). , ❑ I, as ovmer of lhe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec 7044, Business and Professbns Code: The contractors License Law dces �not apply lo an ovmer of property who builds or improves �hereon, and who wntracts for such project with a c/9�tractor�s) license pursuant to the Contractors License Laws.). /-� I am exempt under sec. _�-�� V—� Business and Professions Code tor this reason: "�n �-�� b� Signature �ate 305)-a6�3/01) . , 1Z//a��° Owner n ie dnvi cens .�'es ❑ N S, D' er's License . � a Expi s: � erifcati Ownership by (type of document, i.e. operty tax bill or deetl�: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � I hereby certify that no excavation fve (5) or more feet in depth inro wfiich a person is required to tlescentl, will be made in connectbn with work authonzed by this permit, antl ihat no building sirucWre, scaffdding, falsework, a demolition or dismantling Ihereof, will be more than thitly-six (36) feet high. (Chap. 32, Gry 2, M 2, Sec. 341, TUe 8, Cali(omia Administ2�ive Code). ❑ As owner-builtler, I will not employ anyone lo do work which would require a permit from ihe Division of Intlustrial Safety, as noted above, unless such person has a permit to do such vrork (mm Ihe division. Appliram's Signature Division of Indusirial Satety Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fWure building occupant need to file and cenity a Business Plan for emergency response to release or threatened release of a hazartlous matenal? ❑ Yes � No (Section 25505 of the Califomia Health and Safery Code requires, vnth some exceptions, that a Business Plan be fled with the Cosla Mesa Fire Department by every business which has at any one time during a reportetl year a quantity of hazartlous matenals equal lo or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standard tempereNre and pressure). 2. Does or will the applicant or present or fuWre building occupant neetl to (le a registralion form for aculely hazartlous materials? ❑ Yes ❑ No (Section 25533 of Ihe Califomia Health antl Sa(ery Cotle, with some exceptions, requires reqistration with the Cos[a Mesa Fire Department by each business which at any one time has on hand a quantiry of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume o( 55 gallons, or 200 cubic teet of compressed gas at standara temperature and pressure). 3. Does or will [he applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevenlion Program tor acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Calitornia Heallh and Safery Cotle pmvides 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 �o register acutely hazardous ma[erials with Ihe Fire Department. 4. I( an RMPP is presently required, has Sec[ion 25534 o( the Cali(omia Health an0 Safery Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or fWure building occupant require tor the vrork which is Ihe subjact of this applicalion a permil (or such consiruclion or modification from Ihe South Coasl Air Quality Management District or fmm any o�her air polWtion coNrol tlistrict or agency? ❑ Ves ❑ No (Sectbn 65850.2 of Ihe Califomia Govemment Code requires thal the requestea information be (umishetl on applications far rron-residential building permits). 6. Will any parl of the (acility to be consiructed under this pertnit be within 1000 feel from the outer boundaries o( a school? ❑ Yes ❑ No Qf'yes", the facility must meet the requirement of Sections 25534 antl 42303 of ihe Califomia Health and Salery Code). 7. If a permit from ihe South Coast Air Quality Management DisMct or other air pollution control disUict or agency is required for Ihe work which is the subjecl ot this application, have all of the disclosures prescribed by Cali�omia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf "yes", attach certificate ol compliance,from tFie�appmpnate air polWtion controloKcer). � '� � '" CERTIFICATE'OF COMPLIANCE: I certify'thafu'nder'penalty of perjury t8e infortnation given above is correcL I agree to comply_with all slale laws and ciry ordinances regarding Hazardous Matenals and;Emjssions. . SiqnaWre Date - y �. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cenify untler penalry ot perjury Ihat I have read this application and state that Ihe information given is correcL I agree to comply vrith all state laws and city ordinances relating ro building construclion, and authorize representatives of the City o( Cos[a Mesa to en[er upon the above�described pmperty for inspection purposes. I agree not to ocwpy or allow occupancy of any builtling authorizetl by this peFmit until final inspec[ion. $ na olLegal 0�er(s ate O AnG/o�AUNonzetlAOClit�anl pate � (714) 754-5273 • Faz (714) 754-4856 • wv+w.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 727 W 20TH ST Suite: Vicinity. SIDE PROPERTY LWES Parcel Number: 42226202 Zoning: Applicant GILMORE, ANTHONY Address: 727 W 20TH ST - UNITC � Phone: (949)631-6962 COSTA MESA, CA Zip: 92627 Owner: GILMORE, ANTHONY & KIMBERLY Address 727 W 20'fH ST UNIT C Phone: (949) 631-6962 COSTA MESA, CA Zip: 92627 Contractor: OW N E R-B U I LDE R Address: Phone: Zip: License: 0 Arch : Eng: Address: � Address: Phone: Status: ISSUED Applied: 10/08I2001 Issued: t0/08I2001 ISSUED BY: � Phone: Zip: � License: License: SCOPE OF PERMIT 205 L.F. TOTAL OF 6 FT. HIGH BLOCK WALL. 102.5 l.F. ON LEFT SIDE OF PROPERTY AND 702.5 L.F. ON THE RIGHT SIDE. � Plan Check: $72.31 Permit: $111.25 SMIP Res: $0.00 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $183.56 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Lek 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 sa,ioo.00 so.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for �he work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspections and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 24C6661N00) WORKERS'COMPENSAnON DECLARAnON: ' ' I hereby attirm under penalry of perjury one of the toilowing tleclarations: ❑ I have and will maintain e certificate of consent to self-Insure for workers' compensation, as provitletl tor by section 3700 of the Labor Code, for ihe pertormance ot the work for which this permit is issued. ❑ I have and will mainiain workars' compensation insurance, as requiratl by section 3700 of Ihe Labor Cade, for the pedortnance of the work for which this pertnl� Is Issuetl. My workers' compensa�ion Insurence carner and palicy number ere: Carriar: Policy Number: (This section neetl no( be cromple(etl i! the permit is valued e( one hundred dollers ($100) or less.) ❑ I certify ihat in ihe peAortnance of the work for which this pertnit is issued, I shall not employ eny person in any menner so as to become subject to the workers' compensatlon lews of Calilornle, end egree that il I should become sublect to the workers' compensation provisions oi Sectlon 3700 0l the Labor Cotle, I shell fotlhwith comply with ihese provisions. Applican� Signeture: Dete: WARNING: FAILURE TO SECURE WOFKERS' COMPENSATION COVEMGE IS UNLAWFUL PND SHALL SU&IECT AN EMPLOYEii TO CRIMINAL PENALTIES AND CIVIL FMES UP TOONE HUNDRED TTIOUSAND DOLURE (5100,000�, IN AODITION TO THE COST OF COMPENSATION, DPh41GE5 AS PROVIDED FOR IN SECTION �O6 OF THE IABOR COOE, IMEREST, ANO ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm ihat I em licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business antl Professions Code, and my license is in full force and eRecL Lic. N Cless N Contrectors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm thal there is a consimction lending agency for ihe peAormance of the work for which Ihis permit is issued. (Sac. 3097, Civil Code). Lentlets Name: Lender's Address: Signatura: Date: OWNER-BUILDER DECLARA710NS: I hereby afllrtn Ihet under penaity ot perjury ihat I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for ihe following reason (SecJ031.5, Buslness end Professlons Code: Any city or county which requires a permit to consimct, elter, improve, demolish, or repair eny siructure, prior to its issuance, also requires Ihe applicant for such permit to file a siqnea statement that he or she Is licensed pursuant to the provisions of the Coniractors License Ww (Chapter 9(commencing wlth Sectlon 7000) of Division 3 ot the Busineu and Professions Code) or thet he or she is exempt tharefrom and the besis for ihe allegetl ezamption. Any violetion of Section 7031.5 by any applicant tor e pem+' subjects the apP�icant to a civil penalry of not more than five hundred dollars ($500).): ❑ I, as owner of the pmperty, or my employees wl�h wa9es es Iheir sole compensation, WILL DO THE WORK, and Ihe simcture is not Intended or ofterad lor sala (Sec. 7044, eusiness and Protessions Code: The Contrectors License Law does not apply to an owner of properly who builds or improves thereon, and w�o tloes such work himself or hersalf or through his or her own employees, provitled ihat such improvements are not intended or oHeretl for sale. If, however, ihe building or improvement is �d within one year ot completion, ihe owner-6uiltler will have the burden ot proving ihat he or she did not build oi improve for purpose of sale.). s owner ot the property, am E%CWSIVELV CON7RAC71NG WITH LICENSED CONTRAC70RS to constmct the prolect (SecJ044, Business and Protessions Code: The contractors License Lew does not apply to en owner of property who builds or Improves Ihereon, end who contracts for such project with e coniractor(s) license pursuant to the Contractors License Laws.)./� ❑ I am exemptypder sgr. ) / 1 Business antl Professions Code for Ihis reason: Ownar ID verifieAtSy dnver's IicensC/ `�[J Ves - LJ No - Venfication of Ownership by (type ot document, i.e. - property tar bill DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I here6y cenity that no eacavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by Ihis permit, and ihat no Duilding stmcture, scaHolding, falsework, or tlemolition or tlismantling thereoi, will be more then ihirry-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title e, Califomia Adminlstretive Code). ❑ As ownervDuiltler, I will not employ anyone to tlo work which would requira a permit irom the Division ot Industriel Safety, as notetl ebove, unless such person has a pertnit to do such work irom the divisian. Signature: Date: Division ot Intlusirial Satety Permit Number: CER7IPICATE OF COMPLIANCE AND AUTHORIZA710N F ENTHY: I cerlify under penalry of perjury that I hava read this application and state that ihe iniormation given is wrrect. I agree ro comp �� lh all stete lews antl ciry or i ances relating to huilding constmdion, entl authorize representatives ot ihe Ciry of Costa Mesa to enter upon tha ebove-descnbe : e inspection puryoses. agr not to acupy or ellow wcupancy ot any building authorized by ihis permit until tinel inspection. � r I -�� n reOt�ls)�' �e��-"' 1 d/Or Authorized Appticant Date COUE �. INSPECTIONTYPE 1616 Fi:etl System Final Fire Prevention 1266 200 201 202 203 204 Pool Spa Finel Final Re-Root Final BIocWRetaining Well Final Factory Fire Place Final Sign Final Demolition pdj� INTIiIA�S CODE� INSVECTIONTYPE 206 Final Mechaniwl 20B Final Plumbing 210 Finel Electrical Inl� � 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy PATE INTRULS OWNER KORNW�EL� THEO DATE ��_� _ JOB ADDRESS 729 (Rear) 20th� St. BUILDING PERMIT NO. $�Q� �2�}j� �QNTI$�EipR Romar Builders, Inc, vaLUE ; 1.500.00 fiou` LOT TRACT F[RE ZONE DESCRIPT[ON OP WORK ThrPr? v+.all g�,no�^ GROLIP J TYPE V ZONE R.�i PLAN NO. A79c ECTIONS I DATE I SUBCONTRACTOR I __ PERMITSI , , ' 8"'l�� COSTA MESA BUILDING DEPARTMENT P. O. BOk 3 I � COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN nooRess �� /1c�o�P a.m--tY1' SY COSTA MESA. CALIFORNIA OWNER MAIL ADDRE55 ARCHITECT OR ENGINEER LIC. NO. CONTRAcRiSri�'�AR BUIIDERS, IN(`.'T`' No: COST� M3 >. CAUF. rE�. nooAess •,.. : No. LEGnL LOT / OESCAiP1ioH NO. �'%r� B40CK /- TRACT A.P. NO. / S— � — � SIZE ,�( �N /a �"� NO.OF BLDGS. OF LOT ��J V� NOw Ov LOT USE OF E%ISTING BLDG. SET�tCN LINE FPOM � CErviER OF SiREET '�i� ��L. REAR YAR� RIGHT DESCRIPTION OF WORK NEW AITERATION I ADDITION REPAIR I �MOVING DEMOLISH BUILDING � �% Np,OF SIZE O� O RqOMS STORIES EXTERIOR WAII R40F COVERING COVERING USE OF NEW '/ �a�.� BUILDING %JH�/rLY �vNII R _ � _ _ � �-i�[� �_-.��9��i� 31�Isr �I� FINII�+CE DEPT. r�Tv qF (:p.CTA f,7Es� APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIVlO BY OM1TE RECEIVE� D /7� .� �o�' �5 , �i IL�ING �� 'f' DRE55 COSTA MESA. CALIFORNIA CORRECTIONS ! SUBJECT TO O PLAN TtCH. DEPT. REG. a _- 2 $TATEcTHRT TNEvNBOVE I$ CORRECTnqNO^�GREE TO COMP�Y WITX �LL purpose of es�a6lishing a permit fee on(y. CITV ORDINANCES FND STFTE LAWS FEGVL/�iING BUILOING CONSTPVC� nOrv. VALl1ATION SIGNATURE OF PERMIT FEE S �� PERMITTEE - p�'� "� y} �V PLAN CHECK � � 5 �'% � �� 70TAL FEE $ � -� �°'�� AUTHORRED AGENT � OWNER IOB ADDRFSS St, DATE BiIILDING PERLvIIT NO. ' NTRACTOR ROIR32' Builders IriC. VALUE $%�fa,Q$�OQ AP. o. LOT TRACT FQtE ZONE DESCRIPTION OF WORK Acci Acnnn GROUP I ECTIONS caat Gas F�' ' Gas TCst ( :uction Pc V ZONE DATE I SUBCONTRACTOR PLAN NO. PERMITSISSUED l l � L3"7� COSTA MESA BUILDING DEPARTMENT P.O.BOX 31� COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN eui�oiNc ADDRE55 MAIL QTV / APp ARCHITECT ADDRE55 �%a'rrf' sP'. COSTA MESA. CALIFORNIA O � TEL. NO. LIC. NO. q�M AF2 BUILDERS, Iry�ITY LIC. CONTRACTOR' NO. ADORE55 COSTA ME�A. CALIF. TNo. [SCniPnOru NO. J'�'� BLOCK ` TRACT�� A.P. NO. � — � SIZE �y�./I � /��A NO.OF BLDGS. � OF LOT /�� Mow on �oi USE OF E%ISTING BLDG. SET9ACN LINE FROM -4 �I ��—S4 CENTER OF STFEET v7 O REAR YARD �� SIDEYARO RIGHT � LEFT ��j, � DESCRIPTION OF WORK NEW ALTERATION � AODITION REPAIR_ _1_�MOVING I DEMOLISH BUILOING l2' NO.OF 512E )�O ROOMS � STORIES EXTERIOR WALL ROOF COVERING COVERING qSE OFnN,Eyy�� e i i . ✓ . _ /.� � . �„ �m .� �... � �. /ia ��: ��'�� ' /a-/s y V 4, FIiV�4NCE DEPT. APPL��C�ATI ONSTFO^R�PERM IT BUILDING FOR OFFICE USE ONLY RECEIPT NO. PERMIT NO 6UILDING -� Z / ZO �/^�� ADDRESS F COSTA MESA. CALIFORNIA FIRE ZONF ZONE 3 CORRECTIONS CtTY oF C'_ ;Ta n4HSn ."`�•�:v�:��. , c=f— SUeJECf TO 6 G. UEFT. REG. i / / I HEREBY ACNNOWLEOGE TMiT I HqVE PE1O THIS SPPLIC>TION /.NO --- ST>TE THAT THE ABOVE I$ CORPECT ANO AGREE TO COMGLV WITM RLl purpose of eslabiishing a permit fee anly. CITY OROINPNCE$ hNO STRTE LLWS REGUL4TING BUIIOING CONSTRUC� ' riorv. , VALUATION SIGNATURE OF PERMIT FEE S � O'� PERMITTEE � O Qj g7� �� PLAN CHECN S �D � niiTNoaizEo nc,ENr TOTAL FEE S fQ — v°"'r �r. OWNER KORNWEIBELi THEO DATE 3-3-54 JOB ADDRESS� %2% °B° 20bh S'b, B[IILDING PERIviIT NO. $%Q j GENERAL CONTRACTOR Rom2.r Builders. Inc. � VALUE S 7.Lt08.00 AY: N'o�- " LOT TRACT FII2E ZONE 3 DESCRIPTION OF WORR GR011P I TYPE 0 ZONE �l PLAN ECTIONS � DA7E I SUBCONTRACTOR coat Gas PERMITS IS$UED ��`�`7 COSTA MESA BUILDING DEPARTMENT P. O. BO% 31] COSTA MESA, CALIFORNIA FOR APALICANT TO FILL IN BUILDING — - � Q � � ADDRE55� S m' COSTA MESA. CALIFORNIA OWNER MAIL AODRE55 CITY� ARCHITECT OR ENGINEER NO. LIC. NO. UILDERS, IPf�.aTv uc. NO. P RT BLV . ME'd/+. C4UF. TE^. LEGnt DESCPIPTION N�Tr�-�' A.P. NO. �/ S '— SIZE OF lOT 'z' f`� USE OF E%ISTING BLDG. SETawCll LIrvE FNOM CENTER OF STREET � � N� DESCRIPTION OI NEW ALTERP.TION REPAIR MOVING BUILDING � NO.OF SIZE �OO q� ROOMS E%TERIOR WALL ROOF O REAR VARD � LEFT � WORK, PDOITION DEMOLISH � STORIES � ..� � ��...: �. � 31a Is � � `� Ft��:',N�E ��'T• u117 0` C'�^,Tn !`,qESA APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIPT NO. I �p�BMIT N� O � Z ECEIVk:O BY DATE NECEIV=D� D� IS EO �L�' 3-7�-� / � 3 s ; _DING �7 �'7 RE55 / 4 �� _ COSTA MESA, CALIFORNIA � nJ1 �'Y DATE CORRECTIONS �it tlr � r' i `L1' `� :_• �� GITY OF ( !S'-T-.-A[�_ .P.�!ESd l' tlVl'.}"� y/:.,!-i_ SUBJEC! TO L G. DEPT. REi r - w H_ 0-U \ STwTECTMRT THEVnBOVE 181CORNECT�wNDryAGREE TO COMPLV WITH 4LL purpose o( esiablishing a permit fee oniy. CITY OHDINRNCES /�ND STRTE L�W$ REGVLPTING BVILOING CONSTRUC- nOrv. . VALUATION �J n SIGNATURE OF � // PERMiT FEE S pc (/ � PERMITTEE ��•� $'7�/08� PLANCHECK 5 /D � / �` AUTHORIZED AGENT TOTAL FEE 8 J O ,�� A 20th LOT 1'RACT FIRE ZONE � DESCRIPTION OF WORK Re 'ECTIONS I DATE _I BUBCONTRACTOR I DATE VNUMBER _ / coat y ,.' i�� COSTA MESA BUILDING DEPARTMENT a. o. eox 3 n COSTA MESA. GALIFORNIA FOR APPLICANT TO FILL IN �a 7 '� -ao -� � COSTA MESA. CALIFORNIA MAIL ADDRE55 � cir ,c ARCHITECT OR ENGINEER LEGAL ILOT OESCNIPTION N0. A.P. NO, t � SIZE — .' OF LOT � USE OF E%ISTING BLDG. SETBRCM LINE FROM CENTER OF STHEET t .� I/G � � �. NO. LIC. NO. BUILDERS, INCcirr �ic. EWPmcrBt�E1i NO. \ MESA. CAL�P. TEL Q NO.OF BLOG6. /,3 �A REAR VAR� � � SIDE YARD RIGHT /� LEFT � DESCRIPTION F WORK NEW ALTEftATION I AODITION REPAIR MOVINC � DEMOLISH BUILDWG p a NO.OF �f SIZE �JO� ROOMS �J STORIES / EXTERIOR WALL ROOF COVERING COVERING BUELOFNGEW / U/O ��'�YJ.�On�J N i/�n � � .C. _ _ _ �� i � /..�/�� /. . � „•. � ��-,'� . d 1 �__ � � _-. � 3�als`� J� FINANCE DEPT. CITY 0` '%�ST� R9F_$i, APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY pECEIPT NO. PERMJT NO aui�o�%Z 7 � �Q i ADDRE55 COSTA MESA. CALIFORNIA FIRE �L BY..._.- �al�(� I1DATE b CORRECTIONS � ii11 .. :� � li 8 i•.� v tJ 1 VY � � �i iai:.�1 . EPT. HUOJ�Cf l0 lL)G. JEPT. RE( PLAN TcCH.�1 " " The Amount shown under valuation is for the I HEPEBV �CRNOWLEOGE TN�T 1 M�VE RE�O THIS �PPLIC�TION /.NO purposz of eslablishing a permit fee only. $TPTE THnT TME �BOVE IS CORN6CT /.ND AGXEE TO COMPLY WITH wLL CITY OROINwNCES wN0 STATE L�WS REGUL/.TING BUILOING CONSTRUC� T�o�. VALUATION SIGNATURE OF l;' �� PERM�T FEE S aO � PERMITTEE < < ' S�� PLAN CHEGK S � D � AUTHORIZED AGENT TOTAL FEE $ �O � '��