HomeMy WebLinkAbout230 24TH PL - Building Permits�
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CITY OF COSTA MESA
`0'�pMFq , BlIILDING DIVISION
F�g 77 FAIR DRIVE. COSTA MESA. CA 92626 •(774) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
� FOR INSPECTIONS CALL: (714) 754-5626 '
�°'^°°�°�'' PERMIT NUMBER: B10-00344
PERMIT TYPE B_ROOF2
APN: 11910111
JOB ADDRESS: 230 24TH pL CM
Vicinity: RESIDENCE AND DETACHED GARAGE
Squares: 2800
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
, , ,
Valuation:
\ _ ISSUED
11/15/2010
KJB
$10,000.00
SCOPE OF WORK: TEAR OFF EXISTING ROOF. REPAIR/REPLACE SHEATHING AS NECESSARY. COVER WITH 30 YEAR COMP
SHINGLES. ROOF PITCH 3:12. INCLUDE$ DETACHED GARAGE. 2000 SQ FT RESIDENCE/800 S� FT GARAGE.
OWNER: RANEY,LINDSAYANDJOHN
PHONE: 310-570-2124
APPLICANT: J S L ROOFING INC
PHONE: 949�4Y6-3571 �
CONTRACTOR: J S L ROOFING INC
Address: 2415 MARGARET DRUnit:
City/State/Zip: NEWPORT BEACH, CA 92663
ARCHlTECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
$o.00
$181.25
$0.00
$1.00
Address: 230 24TH PL
City/Stale/Zip: COSTA MESA, CA
Address: 2415 MARGARET DR
City/State2ip: NEWPORT BEACH, CA
License No.
License No.
t
License No. � 747706
PHONE: 949-646-3571 �
CELL: '
PHONE:
PHONE:
Unit:
Unit: :
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3N8/2010 - PER CMMC Sec. 13-279
Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal
New Years DaY. Memonal Dav. Indeoendence Dav. La6or Dav. Thanksoivino Dav anA Christmas f7av
NOTICE: The work authorized by this permit shall comply with 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.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to oblain inspections and fnal approval will result in the expiration of this permit.
CODEp. INSPECTIONTPE OATE IN7ITIALS COOEO INSPEGPONTYPE OATE INTITIA�S
1616 Fixed Sys�em Final Fire Prevention 206 Final Mechaniral
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Elecincal
201 Final Block/Retaining Wall � 212 Final Fire Prevention
202 Final Fac�ory Fire Place ` 220 Final Planning Approval
203 Final Sign Y+--F�—,'-�� 222 Final Site
204 Final Demolition � 250 Final Building/Occupancy
ti �
WORKERS' COMPENSATION DECLARATION:
I hereby aRirm under penalty o! perjury one of the following tleclarations:
❑ I have and will maintain a certificate of consent to self-Insure (or workers'
compensation, as provid@d for by section 3700 of the Latior Code, for the
erto mance of the work for which this permit is issued.
I have and will maintain workers' compensa�ion insurance, as required by
se � n 3700 0( the Labor Code, for the pedormance of lhe work for which ihis
pertnit is issued. My workers' com� tio I�e carrier and policy
numberare: �` I /1
Carrier TI�/l, C.��
(This sec(un nee� nol �e p�p� d fhe permrt is vaJue.(1 af qne hunAretl tlollars (5100) or less )
Policy Number:
❑ I certify tha in [he pe rmance of [he vrork for which this permit is
issued, I shall n employ a person in any manner so as [o become subjec�
to the wor rs' compensa � n laws of Califomia, and agree �hat if I should
become bj to the w ke compensation provisions o( Section 3700 of
�he Lab C , I shal�fo h h comply with t e provisio s.
�v _ �
� b�3lqna �Oe�e' —
WAR �AILURE TO 5ECURE WORKERS' COMPENSATION COVERAGE
IS LA FUL AND SHALL SUBJECT AN EMPLOYER 70 CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION �O THE COST OF COMPENSATION, OAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS OECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of t Business and Professions Code, and
my license is in full force apndP ftec �/f
, .j�.#� V/O S�"��. � /
�
� ,.� . r'SSi Wre �-"�z�e�'
CONSybYUCp16N LENCd1(1G AGENCY:
❑ Il�fieredy affrm that �here is a construc�bn lending agency for [he
perfortnance of the v.ork (p wfiich this pertnit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
Dale
OWNER-BUILDER DECLqRqTIONS:
1 hereby aKrm that under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW (or the following reason (Sec. 7031.5,
Business and Pro/essions Code: Any city or county which requires a permit to
construcl, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires ihe applicant for such permit to fle a signed s�atement
tha[ he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing with Section 7000) o( Division 3 of the
Business antl Professions Cotle) or that he or she is exempt Iherefrom and
the 6asis for the alleged exemptioa Any violation of Section 7031.5 by any
applicant for a permit subjects Ihe applicant to a civil penalry of nol more �han
flve hundretl dollars ($SOQ).):
❑ I, as ovmer of the property, or my employees with vrages as their sole
compensation, WILL DO THE WORK, antl the siructure is not intendetl or
oHered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
[hereon, and who does such vrork himself or herself or through his or her own
employees, provided that such improvements are not intended or oftered for
sale. If, however, the building or improvement is sold within one year of
completion, the owner-builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct Ihe project (Sec. 7044. Business and
Professions Code: The contractors License Law dces not apply to an ovmer of
property who builds or improves lhereon, and who contrac�s for such project with
a contractor(s) license pursuant to the Contractors License Lavrs.).
❑ I am exempt under gec.
Business and Professions Code (or this reason:
305]-06 (3/Ol)
Owner ID verifietl by driv�ense. ❑ Yes ❑ No
Driver'S License No. Expires:
Verification of Ownership by (type o( document, i.e. - propeny tax bill or deeC):
DIVISION OF INDUSTRIAL SAFETY PERMI7 CERTIFICATION: .
❑ I hereby cert'rfy thal no excavation fve (5) or more feet in depth into which a
person is required to descentl, vnll be made in connectbn vnth work authorizetl
by this pertnit, and Iha� no building strucWre, scaffdding, falsework, a demolition
or dismantling ihereof, will be more than Ihirty-six (36) feet high. (Chap. 32, Grp
2, Art 2, Sec. 341, TOe 8, Cali(ornia Administrative Cotle).
❑ As owner-builtler, I will nol employ anyone to do work which would
require a permit from the Division of Industrial Satery, as noted above, unless
such person has a permit to do such work from the tlivision.
Ap0licanfs SgnaWre Date
Division of Industrial Safery Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fuWre builtling occupant neetl [o file antl
certify a Business Plan tor emergency response to release or threalened
release of a hazardous malerial? ❑ Yes ❑ No
(Section 25W5 of the Cali(omia Health and Sa(ety Code requires, with some
ezceptions, �hat a Business Plan be fled with the Costa Mesa Fire
Department by every business which has at any one [ime during a reported
year a quan[ity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas
at standard tempera�ure and pressure).
2. Does or will the applicant or present or fuWre building occupant need to file
a registralion form for acutely hazardous materials? ❑ Yes ❑ No
(Sec�ion 25533 of the Califomia Health and Safety Cotle, with some
exceptions, requires registration vnth the Costa 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 feet of compressed gas at standard
temperatwe and pressure�.
3. Does or will the applicant or present or fuwre builtling occupant neetl to
prepare an RMPP (Risk Management and Prevention Program for acu[ely
hazardous ma[erials�? ❑ Ves ❑ No
(Section 25534 of the California Health and Safety Code provides that the
Costa Mesa Fire Department may require [he preparation, certification and
fling with ihe Fire Depariment of an RMPP by businesses which are required
to register acutely hazardous materials with Ihe Fire Department.
4. If an RMPP is presenlly required, has Section 25534 of the California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or fulure building occupan� require for
the work which is the subject of this application a permit for such consWc[ion
or motlifcation from the South Coast Air Quality Management Disirict or from
any o�her air polWtion contml disMct or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemmenl Code requires that the requested
information 6e fumished on applications fa noo-residential building permits).
6. Will any part o( lhe facility [o be conslructed under this permit be vnthin
1000 feel from the outer boundaries ot a school? ❑ Yes ❑ No
Qt "yes", the facility must meet the requirement of Sections 25534 and 42303
of Ihe California Health antl Safety Code).
7. If a permit From the South Coast Air Qualiry Management District or other
air pollution contml district or a9ency is required for the vrork which is the
subject of this application, have all of the disdosures prescribed by California
Health and Safery Code Section 42303 been made? ❑ Yes ❑ No
8. (I( "yes", attach certificate of compliance from the appropriate air polWtion
control oKcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is correcL I agree to comply with all state laws and
ciry ordinances regarding Hazardous Materials and Emissions. ,
SignaWre oa�e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application antl state lhat
the information given is correct. I agree t comply with all state laws and city
ortlinances relating to building constru n, and aWhonze representatives of
the Ciry of Cos1a Mes ro enter on the above-described property for
inspeclion purp . I' gree not to ccupy or allow occupancy of any building
authorizetl by per it until fin nspection.
r oa�e
�( � �
�. n�r��1
a
Prescriptive Certificate ut' Compliance: Residential
Residentiu! Alterationa�
O Z �f t`' �l,
Climate Zone N /, � N of
2-ALT
] oT 51
� Ooaque SuCCacC Detail5 Ror the lurred pm'tioned of Mass N'alls see Furring Strips Conatruction Table below. �
Assembly Name
No1e.' Far (urred assemblie�.
Framing Thickness,
Material Spacing, U-
and Siu' or Other3 factor'
nY (o�' Cmainuous Insulalion It-vo(ue, see Pa
F I G � H� �,.�, . d il
Values From JA4 Table '
Framed Continuous JA4 ProF
]A4?able Caviry lnsulation Assembly Asse
Number' R-value� R-Value' Cell Valueb U-fe
4-3 ond Equmiw� 4-1. For calculalinp (wv'ed walfr usc !hc Moss nud
1. For Tag/ID indicaie ihe idemifica�ion name rha� maiches �he building p[ans. �
?. lndica�e rhe Assemblr Name or rype: R00%/Ceiling, Wolls, Floors, Slabst Craw/ Space, Doors and em...lndica�e the Frame rype and Size: Fm�
Wood, Metal, Metal Buildings, Mass, en�er ?s4, ?s6, a� etc... see JA4 for oiher possible framc rype ossenblies.
3. Emer iXe �hiclmess (a• mass u� inches ar Spacing Genveen framing members enier; 1 G'a� 24 "OC; or Otherjor� all o�her assem6(p dee�crip�ian
such os Cnnc+'e�e Smidwich Ponel, Spand�el Panel, Logs, Stran� Bale Panel and e�c....
4. Based on ihe Clinmre Zone; enter the Standm�d U fac�or fi�om Table 151-B, C or D fm� each d�%rem assembfp Nome or ry+pe.
5. Enter d�e Table num6er I/m� closelr resemLles Ihe proposed assemblr.
G. L•nter 1he R-valae Ihal ie� Lcing ine�la/led i�v !he woj/ cai�in� or beJween !he fi�m»iirg; al�e�wtse, enter "D ".
7. En�er �he Cantinuous Insidalion R-na(ue,%r (hc proposed assemblp; otherwise, emer "0".
d'. Lnter die ro�� mtd cnlumn aJlhe U•facmr vafue Lased ai Colum�� FTable Number artd en�erlhe Rsaembl�� U-(actor in Column J
). The Proposed Arsen>Lh� U-(ncmr, Column J, n>us� be equa/ �o or less ihmr (he Sfandard U-foclor in Colun:n E/n eomnh+.
Furring Strips Construction Table for Mass W alls Only
A Ii C D C F G H 1 ,1 K L M
Prapused Yruperties uf Muxonn� and Cuncretc Added Inlerior or Exterim� Insulxtiun
VVnlls Trum Reference in Rurring 5pnce from Re(erencc
Juint A eudia Table 4.3.5, 4.3.G. 4.3.7 Joinl A endix 7'ablc 4.3.13
.G
V " .j Y " - U
"• G V A�L �
ASSCI116I)' G^ � � c: � ~� ai`� _ Fin2I
Mass Numc oi .IA4 Tablc '' �= R R o �t :° v e_ "�G ASsemb�y
Thickness' 'I�y c' Numher ��` = ui � u. ii 5 � r �'�` u�i c U-factoi40 CommeN
I
I
Itegi,slralfrni Nwnber: Regi.vtroiion Uaie!lirne: HE/iS Prnvider:
2pOb' Residentiul Crnnplinnc�e Forms �lugu.sl 2009
Residenlinl A[teratinns
Pruiect Name:
Climate Znne
CF-IR-ALT
(Pa�e 3 of' S)
N of Stories
ROOI�ING PR011UCTS (COOL ROOFS) §ISl(n�2
Wheii /hc nren o(rxlerior rnojsrvJace tn be�replaced exceeds' more Ihan 50°/n nj(he erisling roojaren, nr inore lhuu l,000 jr, �vhichever is
less, tLB nem roafiig aren nwsl �ueel tlac ro0f+/�g producl "CoolRoof'requireuients oj§I52(b)IHi, I52(G)IXii, or752(bJlHiii.
Check Pppl�cable al�emnti�c or ecceptiw+ beloir if (he rooJalteration rs ezemp� fi�oni �he roofing producr "Cool Roaf : requirements. Note: /jany
one oJlhe aliernatives or racep�ion below is checked, !he Aged Solar ReJlecmnce a��d Thermol Emitmnce requiremen�s jor roofing produc�s in
§/ /8(i m'e nol applicable. Da no� fil! toble below.
❑ ool Roofs Not Required iu Clima�e Zones 1-12, 14, and 16 with a Low Sloped. Less or 2:12 pitch.
Cool Roofs Not Required in Climate Zones ] through 9 and 16 with a Steep-Sloped Roofs (pitch greater than 2:12) and produci unit weight less
Allernutives to §152(b)IHi and §152(b)Hii, Steep-slope ruof (pitcL > 2:12)
❑ InSulation with a Ihermal resistance of at least 0.85 hr� °F/Bni or at least a 3/4 inch airvspace is added to the roof deck
over en attic; or
❑ Ezisting ducts in the attic are insulated and sealed according to §151(�10; or
❑ ln climate zones 10, ] 2 and 13, with ] ft'. of free ventilation area of attic ventilation for every 150 ft pf atlic Floor erea, and
where al least 30 percent of the free ventiVation area is within 2 feet vertical distance of the roof ridge; or
❑ Building has at least R30 ceiling insulation; or .
O Building has rediant bazrier in the attic meeting the requiremenu of §I51(�2; or
❑ Building has no ducts in the attic; or
❑ 1n climate zones ] 0, ] 1, 13 and 14, R-3 or greater roof deek insulation above vented attic.
�xception to §152(b)1Hiii, Low-slope roof (pitdi <1:12)
❑ Building has no ducts in Ihe attic.
❑ Roofing area covered by building integrated; photovolmic panels and solarthertnal panels are exempt from [he below Cool Roof criteria.
❑ Roof construclions thai have thermal mass over the roof inembrene wi[h at least 25 Ib/ft is exempt from Ihe below Cool Roof criteria.
Note: ff no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach m show compliance, otherwi
CRAC Product ID
below if Exem t from the Roo&n Pn
' Roof Slope
i6er� < 2:12 > 2:12 <
❑ ❑
❑ ❑
0 0
❑ ❑
❑ ❑
'roduct Weight
516/fr� > SIbH
❑ ❑
u
0
�
�
�
0
�
�❑
Product Aged Solar Thennal
T e' Retlectance�'d Emittance
❑Q
❑4
❑Q
SRIS
1. T4e C/�C Producl /D N�unLer cmr Le obminedf'mu U�e Cm/ RoofRaling Caunci/lr RaiedProduc� Olrec/ory o/ w�v�r.cnolroof.r.orn/nroduc�s/seorch nhn
I. lndrea�e iLe tyye oJprndr¢� is Geing �ued.jor dre �'ooJrop, i.c. single-p(p roof, asphal� roof, meml roof, elc.
i. /(Ure AgedHeAec�once is nor avni/oGle i�e�he Cool Ifao(Rming CamC�l'a' Raled Producl Dir'ecroq� lGen use Urc Inilia/ ReJlec/ance valuc fi�om Ilre san�e
direcm�.l' a��d use �he eqimiim� (0.2+pJ(P�ni�ird— ��zl ro nbmin n calculaied aged vuhie. Where p is �he b�iiial Solnr Reflec�nnce.
4. Chcck box i)7he dged ReQeclance ia n caladmed nalne �rsing Ihe eg�mliai aLove.
5. Calcu(a�c /hc SR/ volue l�p using �he S/U- Wa'ka/reei n( In�u://�vwir,enerm•.cn.eov/ii/1e14/ond emer /he msu6ing vaL�e in �6c SR/ Column abo�e anda��och aconi� oj
d�e Slll- Wnr•kshee� m �he CF-]If.
To apply Liquid Pield Applied Cuntings, the coating must be applied across the entire roof surface and meet tl�e dry mil thickness or coverage
�,recommended by tlie coatings manufacturer and mee� minimum performance requirements listed in §118(i)4. Select the applicablecoating:
Aluminum-Pigmented Asphalt Roof Coating �❑ Cement-Based Roof Coating
Regisb'G�ion Nurnber: Regisva�ion Da�e/Time:
2O087iesiden�iai Compliunce Fa�nes �
Other
FIERS Provider:
Augus�2D09
01� Complixnce: Residentiai
n�s��t�,zt«,�,
Yrqjecl 1Jnme:
cr-i
% ui'
� �r �
H�I:S \'�FIFJ CATI O1� SUMA1Aii]' The enforcemerv ngencr shmdd ym� syecml aRemion io Ihe HL1tS hle�u�res specijier! m Ihi.+
checlrhs� belmr fi compl eied nnd si�ned CF-4J( Fm�m Ior nll �hc men.nu�es speciJied shnll Lc suLnritied m tiu• building inspecior before fiunl
v11C1 SCh�IRe & Testine HL/LSneri/iccniou isreguiredJor�Gi.i menazu-e. �
❑ y�S ❑ NO 1'GS�. ln Clima�e Za�es ° and J-1 G, if more ihai� 40 linear feet of new ur replucemem clucts .�re insttilled in unconditioned
space, ihe ducts ure io be sealed per �J52(6)lUii and t6e nee�fy installed ducts are io be insulaied pei §ISI(i110.
❑ EXCEPTIO�: Lxisting duct 51•slems th�t are eztended, �vhich :ve cunstruc[ed, insWated m� set�led with a56estus.
❑ Y�5 ❑ NO 1'i5�. ln Climate'Lones ? and J-7 G, if the existing space-conditimiing system (HVAC equipment and duciingi is replaced, the
ducts are to 6e sealed per § 1 S2(b)] Di. �
Q YES ❑ NO 1'�5�. Jn Climete Zones .�. and 9J G, if die e�:�sting HVAC eqmpment is repluced (including the replacement o1 the ni� hondler,
ouidoor eondensing unii of a splii system: cooling or heating coil, or the furnece lieai exehanger) ths duets are w be
sealedpei §]52(b)]E.
O iaC�PT10N: Duct sYstems that are ducumented tu have been previuuslp sealed conf�rmed thruurli HEi2S
� verification in uccurdance witli prucedures in the Reference Residential Appendiz P.A3.
� ❑�XC�PT10�': Uuct sYstems with less than 4U lineer teet iu uncondiiioned space. �... .
❑ EXCL,PTIO�: L.xisting duct sYs[ems cons[ructed, insulatecl m� sealed wit4� esbestos.
X2efrigerant Charee - Split S,l'stem NERS verrfication is requireci for ihi.s n>easure. . �
❑ 1'LS ❑ NO YLS: ]n Climate Z,ones 2 and E-15, when the existing H VAC equipment is Teplaced (including [he replacement of the air
hatidVer, outdoor condensino unit oT a spltt system AIC or Ueat pump, cooling or heating coil: or the furnace heat
excheneeri a refrieerant cl�aree measummem shall be veriiied per § li2(b)1F.
Central Fan Integrated (CFI) Ventilation System and Fan G��att Drah�
The ventila[ion reauirements of FI SD(o) do not avoVv tn existine residential homes.
Ducted Split Systems - Air Conditioners and Heat Pumps: Airflor�� HERS reriiicario�i is require� ja� �his meoa�irre.
❑ Y�S ❑ NO 1'ES: ln Climare Zones 1 U through ] 5, when the existing space-condiuoning system (H VAC equipment and ducting) is
reolaced. Ihe airflow and fan watt draw sha11 be verified �er � 15216)1 Ci )p meet [he renuireme of Sl� 1(fl7B.
� —T—L
• I
�
�
�h
�
accurate
/� / S •- r/c�
/ lf Hpplicable � CEH or ❑
! (Certification il1:
city�stai�/ / �l / /o' / / `� ` � I rnoiie:
7` L G h
Responsible I3uildine Desi�ner's Declaration Stutement �
° 1 am eligible under Di��isimi ? of the Culiforniu Business uncl Ptofessions Code tn accept responsibility tor the building design identi5ed on
t6is CeniLca�e of Complionce.
• I certify Iha� thc enersy (eaiures and perlormance specificalion;: toi the buildin� desigu identiLed on this Cenificate of Cumpliunce conform
to [he requirements ol'Tillc 2q, P;irt:: 1 enA G of the Calilornia Cndr of IteEulaziuns.
• Thc building design leauves iAentiGed on this CettiLcaie of Complfunce are eonsisiem wiih lhe inlonnmiun 7�rnvided tu document Uii:�.
buildin� design on th: other upplica6le cumplianec lonnc: worl:sheets; culculations, plam and speciLca�ion:. subiniticd w the enforcemeni
JLCOCI' S01 8�)�1f[�\'JI WIIII Illlb I101I(IIII� permii applicution.
N,imc�. Si�nature:
:,�ontpHnl':
Nddress:
Cin:'tiimJ.:ip:
Laie:
License:
FOY lf.1'.59.5'11111CC O!' QtIL'Y110115 l'C�(IP(I[Jt� the Ene�•eI' Suendru•d.ti, cnnl�ecl tltc Enei•er Hotline ut: 1-kUG_772-:i3bll.
1(a�rsvraiian h�umbm" /(egisunrmn Lae/7'nnc
200t: 1( c:; icieiv iul Compl im�cc Fani:;
1-IERS Frm�itier:
/a�gv.si �00%
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, �
CITY OF COSTA MESA �O ��
� �`°"'FQ BI/ILDING D/VISION �
F , � 77 FAIR DRIVE, COSTA MESA, CA 92626 • p14) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us
°. � FOR INSPECTIONS CALL: (714) 754-5626
'`���°"' PERMIT NUMBER: B10-00344
PERMIT TYPE B_ROOF2
APN: 11910111
JOB ADDRESS:�230.24TH•PL-6M-
Vicinily: RESIDENCE AND DETACH�D GARAGE
Squares: 2800
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
Valuation:
FINALED
1 111 512 0 1 0
KJ B
$10,000.00
SCOPE OF WORK: TEAR OFF EXIS'iING ROOF. REPAIR/REPLACE SHEATHING AS NECESSARY. COVER WITH 30 YEAR COMP
SHINGLES. ROOF PITCH 3:12. INCLUDES DETACHED GARAGE. 2000 SQ FT RESIDENCE/800 S� FT GARAGE.
OWNER: RANEY,LINDSAYANDJOHN
PHONE: 310-570-2124
APPLICANT: J S L ROOFING INC
PHONE: 949-6463571 .
CONTRACTOR: J S L ROOFING INC
Address: 2415 MARGARET DRUnit:
City/State2ip: NEWPORT BEACH, CA 92663
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $181.25
Reinspection Fee: $0.00
Bldg Std Admin Fund $1.00
Address: 230 24TH PL
City/State/Zip: COSTA MESA, CA
Address: 2415 MARGARET DR
City/State/Zip: NEWPORT BEACH, CA
License No.
License No.
PHONE:
License No. 747706
949-646-3571
CELL:
PHONE:
PHONE:
Unit:
Unit: :
TOTAL FEES $182.25
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3N8/2070 - PER CMMC Sec. 73-279
Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. ProhibiGed all hours - Sundays and the following Federal
New Years Day, Memori2l Dav. Indeoendence Dav. Labor Dav. Thanksoivina Dav and Christmas Dav
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval musl be obtained. Failure to oblain inspections and fnal approval will resull in the expiration of this permit.
WOE t. INSPECTIONTVPE OATE INTITIr1LS CO�Ep INSPEC110NTYPE OI1TE INTIPALS
1616 Fixed System Final Fire Prevention 206 Final Mechaniral
1266 Pool Spa Final _ �rv� 208 Final Plumbing
200 Final Re-Roof � �-1� ��� ''`� 210 Final Elecirical
201 Final Biock/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign _ 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby aKrm under penalry of perjury one of the following declarations: �
�. r ..
❑ IT[�i`aye antl,l�na`intaima cehifwte o( consent lo selFlnsure for workers'�
compensahon aslpravided�for-�y section 3700 of the Labor Code. for the
performance of tfie work'for which this permil is issued. �
❑ 1 have antl will maintain workers' compensalion insurance, as required by
sectbn 3700 of the Labor Code, for the pedortnance of the vrork for which this
permit is issued. My workers' compensation Insurance carrier and policy
num6er are:
Canier,
(This secton ne20 /ro1 �e Wrtipleletl qthe permR i5 valu¢tl al one huntlietl dJltars (5100) or less )
Policy Number:
❑ I certify tha� in Ihe peAormance of ihe work for which this permit is
issued, t shall not employ any person in any manner so as to become subject
to the workers' compensation laws of Califomia, and agree that if 1 should
become subject lo the workers' compensation provisions of Section 3700 of
Ihe Labor Cotle, I shall torthwilh comply with Ihese provisions.
Applicanl's SignaWre
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
P�hfqLTIES AND CIVIL FfNES UP TO ONE HUNDRED THOUSANO OOLLAftS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
AT70RNEY5 FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions o( Chapter 9(commencing
wilh Section 7000) o/ Division 3 of the Business and Professions Code, and
my license is in full force and eNect.
Lir,. # Class #
Contractor's SignaWre Date
CpNSTRUCTION LENOING AGENCY:
❑ I hereby aHirtn that there is a consWction lending agency for the
peRortnance of the �+vrk (a wfiich this pertnit is issuetl. (Sec. 3097, Civil Code�.
Lender's Name:
Lentler's Address:
OWNER-BUILDER DECLARATIONS:
I hereby affrm that under penalty o( perjury that I am EXEMPT FROM 7HE
CbNTRACTORS LICENSE LAW fo� the following reason (Sec. 7031.5,
BUsiness and Professions Code: Any city or counry which requires a permit to
construct, alter, improve, demolish, o� repair any structure, pdor to its
issuance, also requires Ihe applicant for such permit to fle a signed statement
Ihat he or she is licensed pursuant to the provisions of the Contractore
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Professions Cotle) or that he or she is exempt therefrom and
�he basis for ihe alleged exemption. Any violafion o/ Section 7037.5 by any
applicant for a permit subjects the applicant [o a civil penalty of not more ihan
fivy hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
�ompensation, WILL DO TME WORN, artd the structure is �rot intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law tloes not apply to an owner of property who builtls or improves
thereon, and who does such work himself or herself or ihrough his or her ovm
employees, provided ihat such improvements are not intentletl or oKeretl tor
sale. If, however, the building or improvement is so7d within one year of
cOmpletion, the owner-builder will have the burden of proving that he or she
did no[ build or improve (or purpose of sale.).
[J I, as owner of the property, am EXCLUSIVELY CONTRACTING WI7H
LICENSED CON7RQCTORS to constmct the project (Seu 7044, Business and
Professions Cotle: The conlractors License Law dces not'apply to an owner of
p�operty who 6uilds or improves thereon, and who contracts for such pmject with
a contractor(s) license pursuant tothe Contractors LiCense Laws.).
❑ I am exempt under sec.
B�siness and Professions Code (orlhis reason:
� SignaWrp Date
30A-C6 (3/0])
Owner ID verified by drivers license. ❑ Yes ❑ No
Driver's License No. Expires:
Verifcation o( Ovmership by (type o( documenC i.e. - property tax bill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certrfy that no excavation frve (5) or more feet in depth into which a"
person is required �o descend, will be ma0e in connec�ion with work authorized
by this permit, and that no builtling strucWre, scaffolding, falsevrork, or demoli�ion
or tlismantling ihereo(, will be more than thitly-six (36) (eet high. (Chap. 32, Grp
2, M 2, Sec. 341, Title 8, Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would
require a permit from the DiviSion of Industrial Safety, as noted above, unless
such person has a permit to do such work from the division.
ApphcanYs Signature . Dale
Division of Industrial Safety Permit Numbec
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. will the applicant or present or future building occupant neetl to 51e and
certify a Business Plan (or emergency response to release or threatened
release o1 a hazardous matenal? ❑ Yes ❑ No
(Section 25505 of the Califomia Heaith and Safety Code requires, with some
exceptions, that a Business Plan be filetl with the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a ouantity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature and pressure).
2. Does or vnil the applicant or present or fuNre buildinq occupaN need to file
a reqistration (orm for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of �he Calitornia Health antl Safety Cotle, with some
exceptions, requires registration with [he Costa Mesa Fire Department by
each business which at any one lime has on hantl a quantily of acutely
hazartlous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet o( compressed gas at standard
femperature antl pressure).
3. Does or will the applicant or present or (uture building occupant need to
prepare an RMPP (Risk Managemeni and Preven�ion Program (or acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Safety Code provitles that the
Costa Mesa Fire Department may require the preparation, certifcation and
(ling with the Fire Department o( an RMPP by businesses which are required
to register acutely hazardous materials wi�h Ihe Fire Department.
4. If an RMPP is presently required, has Section 25534 of the Calitomia
Health and Safety Code been tully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of this application a permit for such construction
or modificalion from the South Coasl Air puality ManagemeM Districl or trom
any other air pollu[ion controt disMct or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Code requires that the requested
information be fumishetl on applications for non-residential building pertnits).
6. Will any part of the facility to be constructetl under Ihis permit be within
1000 (eet (rom the outer boundaries of a school? [] Ves ❑ No
Qf "yes", the facility must meet the requiremenl o( Sections 25534 and 42303
ot Ihe California HeaIN and Safery Cotle).
7. If a permit from the South Coast Air Qualiry Management District or other
air polWtion con(ro! district or agency is requked tor the vrork which is the
subject of this application, have all of the disclosures prescribed 6y Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. pf "yes", attach certificate of compliance from ihe appropriate air pollution
control oKcer). � .
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is correct I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
oate
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state that
the information given is correct I agree to compry with all state laws and ciry
ordinances rela[ing to building consiruction, and authorize representatives of
ihe Ciry of Costa Mesa to enter upon the above-describetl property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until fnal inspection.
SignaWre ot Legal Ovmer(s� Dale
Andlor AWhonzetl AOPlican� Date
PERMIT TYPE
Sub Type:
JOB ADDRESS
APN: 11910111
Vicinity:
Const Type:
�. w
CITY OF COSTA MESA
BIIILDING 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 NUMBER: BC10-00465
B_COMBO
RES_ALT
230 24TH PL CM
Zoning: , ,
SQ. FT: 0
STATUS: ISSUED
DATE ISSUED: 10/13/2010
ISSUED BY: RMD
Suite/Unit:
Primary Occ:
Valuation: $0.00
SCOPE OF WORK: INSPECTION ONLY PERMIT TO FINALIZE PREVIOUSLY EXPIRED/ CLOSED PERMITS. REF:
898-01837-ROOM ADDITION, B99-00550 -POOUSPA, 699-00605 - ALTERATIONS, 699-01040 ADDITION, E99-00097,
E99-00323,E99-00366 - ELECTRICAL WORK. M99-00189, M99-00212, M99-00213 - MECHANICAL WORK. P99-00236, P99-00237,
P99-00263, P99-00237, P99-00497 - PLUMBING WORK.
OWNER: REUTER, MARK L
Phone:
APPLICANT: REUTER, MARK L
Phone:
CONTRACTOR:
Phone:
Cell:
ARCHITECT:
ENGINEER:
COMBINATION PERMIT FEE SUMMARY
Building Plan Check:
Building Fees:
Electrical Fees:
Mechanical Fees:
Plumbing Fees:
SMIP Residential:
SMIP Commercial:
Bldg Std Admin Fund
TOTAL FEES:
Address: 230 24TH PL
City/State/Zip: COSTA MESA, CA
Address: 230 24TH PL
City/State/zZip: COSTA MESA, CA
Address: Unit:
Ciry/State:
LicenSe NO.
License No.
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$658.00
License No.
Unit:
Unit: :
ZipCode
PHONE:
PHONE:
lIVVl�JrVl�liVl\JII�VVIIVI�IIVIIY . L LJ/IV/LVIV� �IV .
Montlay thru Fritlay-7:o0 am thru 7:00 pm. Saturtlays-9:00 am thru 6:00 pm. Prohibited all hours - Sunday5 and the following Fede21 holidays:
NOTICE: The work authorized by this permit shall comply vnlh all applicable handicap access requirements under California statutes and related
regulations. (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 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 will result in the expiration of this permit.
OG pE/, INSPECIIONTYPE U� IN➢nus OD � INSPECPONTYPE DATE IN1111AL5
i676 Fixed System Final Fire Prevention 208 Final Mechanical
1266 Pool SOa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Elecincal � Q• �� �
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site �L �� rn�
204 FinalDemolition 250 FinalBuilding/Occupancy �`���) � uF.�'VI�' QY�
,
WORKERS' COMPENSqTION DECLARATIO :
I hereDy a(frm under penalry o( perjury one of ihe follovnng tleclaralions:
❑ I have antl will maintain a certifcate ol consent to self-Insure (or "v✓orkers'
compensation, as provide0 for by seclion 3700 of the labor Code, for the
peAortnance of Ihe vrork !or which this permil is issuetl.
❑ I have ana will maintain v.orkers' compensation insurance, as required by
section 3700 of the LabOr Cotle, for the pedortnance of the wurk (or which this
pertnit is issued. My workers' compensation Insurance carrier antl policy
number are:
Cartier.
(rnis seaim need rw oe �p¢�¢d nme peim� a vaAiea ai me nu.MrM mparslS10o/ w �ess 1
Poli umber:
( 7 I ceni(y Ihat in Ihe pedormance o/ Ihe vrork (or which this permil is
issuetl, I shall not employ any erso in any anner so as to become subject
to the workers' co ensati la of C mia, and agree that if I should
become suhject e r' mpe ion provisions o( Section 3700 of
the Lab hall 1 compl h t e provisions.
� 3 �u:
� f�ppNom's5' w e ...5
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNIAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($700,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affrm that I arri licensed under provisions of Chapter 9(commencing
with Section 7000) of Oivision 3 0( the Business and Professions Code, and
my license is in �ull force and effect.
Lic. # Class k
GonVactor s SiBnaWre Dale
CONSTRUCTION LENpING AGENCY:
❑ I hereby affrtn that there is a constructbn lending agency for the
per(ormance of the v.ork fa vfiich this permit is issuetl. (Sec. 3097, Civil Cotle).
Lentler's Name:
lender's Address:
Date
OWNER-BUILDER DECLARATIONS:
I hereby affrm that unqer penalty of perjury tha[ I am EXEMP7 FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permit to
consWct, alter, improve, demolish, or repair any sWcWre, prior to its
issuance, also requires the applicant for such permil to fle a signe0 stalement
that he or she is licehsed pursuanl lo Ihe provisions of Ihe Conlractors
License Law (Chapter 9(commencing with Seclion 7000) of Division 3 of the
Business and Pro(essions Code) or that he or she is ezempt therefrom and
Ihe basis tor the allegad exemption. Any violation of Section 7037.5 by any
appliwnt for a pertnit suhjects the applicant lo a civil penalty o( not more than
five hundred tlollars ($5p0).):
❑ I, as owner of ihe property, or my employees with vrages as Iheir sole
compensation, WILL �O THE WORK, and lhe strucWre is not inrended or
offered (or sale (Sec. 7044, Business and Professions Cotle: The Contractors
License Law does not apply to an ovmer of property who builds or improves
thereon, and who does such vrork himsell or herself or through his or her own
employees, provided that such improvements are not intended or oBered for
sale. If, however, the building or improvement is soltl within one year of
completion, Ihe ovmer-builtler will have the burden of proving that he or she
did not build or improve (or purpose ol sale.).
❑ I, as ovmer o( the property, am ERCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS lo construcl Ihe projecl (Sec. 7044, Business and
Professbns Cotle: The contractors License Law dces not apply to an ovmer ot
pmpeM1y wfio builds or improves thereon, antl who contracls (or such project with
a contractor(s) license pursuant to the Cont2clors License Laws.).
❑ I am exempi under sec.
Business and Profes 'ons Cod r t i reaso .
c�wa�' C_ --> �
3051-a6�3/0])
Owner ID venfied by
� F�cpi _ -
-� Veri(cation o( Ownership by (rype of document, i.e. - property tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
� I hereby certify lhat no excavalion Frve (5) or more (eet in depth into wfiich a
person is required to descentl, will be made in connectbn with vrork authorized
by Ihis pertnit, antl ihat no building sWc[ure, scaffofding, falsework, a demolition
or dismantling lhereof, will be more than ihirty-sa (36) feet high. (Chap. 32, Grp
2, M 2, Sec. 341, Tille 8, Cali(omia Adminisi2tive Code�.
❑ As ovmer-builder, I will nol employ anyone to tlo work which vroultl
require a permit trom Ihe Division of Intlustrial Safety, as notetl above, unless
such person has a permit to tlo such work from the division.
AppliWnl'S SignaWre Date
Division of Industrial Safely Permil Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
t Will the applicanl or present oi luNre buddirx� occupant need to (le antl
certify a Business Plan for emergency response to release or threatenetl
release ot a hazardous matenal? ❑ Ves ❑ No
(Sec�ion 25505 0( lhe Calitomia Health and Safe[y Code requires, with some
exceptions, ihat a Business Plan be filetl with Ihe Costa Mesa Fire
Department by every business which has at any one time during 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 feet of compressed gas
at s�an0artl temperaWre and pressure).
2. Does or will the applicant or present or fuWre building occupant neetl to fle
a registration form !or acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 0( the Califomia Heaflh and Safery Code, vnih some
excep�ions, requires registration with the Costa Mesa Fire Depatlment by
each business which at any one time has on hand a quantity of acutely
hazartlous 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 standard
temperature antl pressure).
3. Does or vnll the applicant or present or fuWre builtling occupaM need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous ma[erials)? ❑ Yes ❑ No
(Section 25534 ot the California Health and Safety Code provides that the
Costa Mesa Fire Department may require [he preparation, certi(calion antl
fling with the Fire Departmen[ of an RMPP by businesses which are required
lo register acutely hazardous matenals with [he Fire Department.
4. If an RMPP is presently required, has Section 25534 of lhe California
Health and Safely Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of this application a permit for such construction
or motlification (rom the South Coast Air Qualiry Management District or from
any other air polWtion wntrol tlislrict or agency? ❑ Yes ❑ No
(Sectbn 658502 of the Califomia Govemment Code requires that the requested
informa�ion be fumished on applications for non-residential building permils).
6. Will any part of the (acility to be consWcled under [his permit be within
7000 (eet (rom Ihe outer bountlanes of a school? ❑ Yes ❑ No
Qf yes", the facility must meet the requirement of Seclions 25534 and 42303
of the Califomia Health and Sa(ety Code�.
7. If a permit from the South Coast Air Quality Management DisMct or other
air polWtion wntrol district or agency is required for the work which is the
subject of this application, have all of the tlisclosures prescribed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf "yes", attach certificate of compliance from the appropriate air polWtion
control oKcer).
CERTIFICATE OF COMPLIANCE: I certify thal under penalty of perjury the
infortnation given above is correct I agree to compy with all state laws and
cily,ordinances regarding Hazartlous Materials and Emissions.
Sgnalure oaie
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certi/y under penally of perjury lhat I have read this application and slate tAat
the iniormation given is correct. I agree to comply with all state laws and city
ordinances relating to ilding constructio , and Whorize representatives o(
the Ciry of Costa sa to e er u the ove-described property for
inspectio rpo . I agree to py or ow occupancy o any b ilding
authori i ermit u m pectio � � v
� ew�i���� _.�_.. ���-y-
And/orAulhonzeCA00bcanl Date
n �
\
.f
CITY OF COSTA MESA
�pMFSq BYILDING DIVISION
F�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.wsta-mesa.ca.us
� FOR INSPECTIONS CALI: (714) 754-5626
R°'�^°"`� PERMIT NVMBER: BC10-00461
PERMIT TYPE: B COMBO
Sub Type: RES_ALT
JOB ADDRESS:
APN: 11910111
V'�ciniry:
Const Type: V-9
230 24TH PL CM
STATUS: ISSUED
DATE ISSUED: 10/1�2010
ISSUED BY: � J�
Suite/Unit:
Zoning: , ,
Primary Occ:
SQ. FT: 0 Valuation: $0.00
SCOPE OF WORK: 2 HR INVESTIGATION FEE TO BEGIN PROCEES OF FINALIZING MULTIPLE EXPIRED/CLOSED PERMITS
OWNER: REUTER,MARKL
Phone:
APPLICANT: REUTER, MARK L
Phone: 949-661-1844
CONTRACTOR:
Phone:
Cell:
ARCHITECT:
ENGINEER:
COMBINATION PERMIT FEE SUMMARY
Building Plan Check:
Building Fees:
Electrical Fees:
Mechanical Fees;
Plumbing Fees:
SMIP Residential:
SMIP Commercial:
Bldg Std Admin Fund
TOTAL FEES:
Address: 230 24TH PL
City/Stale/Zip: COSTA MESA, CA
Address: 230 24TH PL
City/State/zZip: COSTA MESA, CA
Address: Unit:
City/SUte:
License No.
License No.
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$94.00
License No.
Unit:
Unit: :
ZipCode
PHONE:
PHONE:
HQURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279
Mo�day in.0 F.�day _�:oo am �nru �:oo pm. Sawraays-s:oo am thru s:oo pm. Prohi6ited all hours - Sundays and the following Federal holidays:
New Years Dav. Memorial Dav. Indeoendence Dav. Labor Dav. Thanksaivina Dav and Christmas Dav
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes antl related
regulations. (Ord. No. 92-28, § i, 72-27-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized underJhis permit to be considered legal, such woik must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure lo obtain inspections and fnal approval will result in the expiration of this permit.
CO�Et INSPEGTIONTYPp � IN7111RL5 WUE� INSPECiIONTYPE DATE IN7I71AL5
1616 Fixed System Final Fire Prevenlion 206 Final MeChanital
1266 Pool Spa Fin.�� 208 Final Plumbing
200 Final Re-Roo( 270 Final Electriwl
201 Final BbcklRetainingWall 272 Fi�l Fire Prevention
202 Final Factory Fire Place 220 Pinal Planning Approval �
203 Final Sign 222 FinalSite v � _ I
204 Final Demolitlon 250 Final BuildinglOccupancy �\ � Q• � Z.' � � 1, �($/
WORKERS' COMPENSATION DECLARATION: �
I hereby affrm under penalty of perjury one of Ihe (ollowing declarations .'
❑ I have and will maintain a certifcale of consent to self-Insure for workers'
compensation, as provided (or by section 3700 0! the Labor Code, (or the
peAormance of the work for which this permit is issued.
❑ I have and will maintain workers' compensation insurance, as required by
section 3700 0( the Labor Code, for ihe peAormance of (he work for which Ihis
permi� is issued. My workers' compensaiion Insurance wrrier and policy
number are:
Cartier:
(This sectbn neetl no( De complelee tlt�e peimtt is valued af one �unOred Collars (8100) or IessJ
Policy Number:
❑ I certify that in the pedortnance 0( Ihe vrork for which lhis permit is
issued, I shall not employ any person in yny manner so as to become subjecl
to the workers' compensation laws o( Califomia, and a9ree thal it I should
become subjecl to !he workers' compensalion provisions of Sec�ion 3700 of
the Labor Cotle, I shall lorthwith comply with Ihese provisions.
AppOcanfs SignaWre Date
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 DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF 7HE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions oi Chapter 9(commencing
with Section 7000) of Division 3 0( the pusiness and Professions Code, and
my license is in full force and eRect.
Lic. # CIa55 #
ConVactor's Signalure Date
CONSTRUC710N LENDING AGENCV:
❑ I hereby aRirtn that there is a ConsWctbn lending agency for Ihe
peAormance of the aork (or vfiich this permil is issued. (Sec. 3097, Civil Code�.
Lentler's Name:
Lender's Adtlress:
SigiuWre Da�e
OWNER-BUILDER DECLARATIONS:
I hereby aHirm that under penalty of pery'ury thal I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW br the following reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permit to
consirucl, alter, improve, demolish, or repair any sWCWre, pnor to its
issuance, also requires lhe applicant for such permit to fle a signed statement
that he or she is licensed pursuant to the provisions of lhe Contracrors
License Law (Chapter 9(commencing with Seclion 7000) o( Division 3 of lhe
Business and Pro/essions Code) or lhal he or she is exempt there(rom and
the basis lor the alleged ezemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant ro a civil penalry of not more than
Me hundred dollars ($500).):
❑ I, as ovmer of the pmperty, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the slruclure is not in[ended or
oflered for sale (Sec. 7044, Business and Prolessions Code: 7he Contractors
License Law does not apply to an owner ot pmperty who builds or improves
Ihereon, and who does such work himself or herself or �hrough his or her ovm
employees, provided Ihat such improvements are not intentled or oKeretl tor
sale. If, however, lhe buil0ing or improvement is sold within one year of
completion, the owner-builder vrill have Ihe burden of proving that he or she
did not build or improve for purpose of sale.).
❑,I, as owner of Ihe property, am EXCLUSIVELY CONTRACTWG WITH
LICENSED CONTRACTORS to construcl the project (Sec. 7044, Business and
Professbns Code: The cont2ctors License Law tices not appry lo an owner ol
property vfio builds or improves thereon, and who contracts for such project wi�h
a contracta(s) license pursuant to the Cont2ctors License Laws.�.
❑ I am exempt under sec.
Business and Professions Code for this reason:
Date
JOS]�a6�J10])
� �
Owner ID veri(ed by driver s iicense. ❑ Ves ❑ No
Driver's License No. Expires:
Venfication of Ownership by (type o( tlocument, i.e. - property [ax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:'
❑ I hereby cert"rfy �hat no excavation (rve (5) or more feet in deplh into wfiich a
person is required to tlescend, vnll be made in conneclbn with v.ork aNFarized
by this pertnit, antl that no building structure, scaffd0ing, falsework, or tlemolition
or dismantling thereo(, will be more than thirty-six (36) feel high. (Chap. 32, Grp
2, M 2, Sec. 341, TOe 8, Califomia Atlminis[rative Cotle).
❑ As ownerbuilder, I will not employ anyone to do work which would
require a permit from ihe �ivision of Induslnal Salety, as noted above, unless
such person has a permit to tlo such work (rom the division.
Appl¢an(s SlgnaWre Dale
Division of Industrial Safety Permit Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous matenal? ❑ Yes ❑ No
(Section 25505 of the California Health and Salery Code requires, with some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
Depahmenl by every business which has at any one time during a reported
year a quaNiry of hazartlous malerials equal to or grea[er Ihan a vreight of
500 pounds, or a volume o� 55 gallons, or 200 cubic feet of compressed gas
at standard �emperature and pressure�.
2. Does or will Ihe applicani or presenl or future building occupant neetl to file
a registration form (or awtely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health antl Safety Code, vrith some
exceptions. requires regisira�ion wilh the Costa Mesa Fire Department by
each business which at any one time has on hantl a quantity o( acutely
hazartlous materials equal to or greater than a weight of 500 pountls, or a
volume o! 55 gallons, or 200 cubic (eet ol compressed gas at standard
temperature and pressure).
3. Does or will Ihe applican[ or present or luWre huilding occupan� need to
prepare an RMPP (Risk Management antl Prevention Program for acutely
hazartlous materials)? ❑ Yes ❑ No
(Section 25534 of the Cali(omia Health and Safety Code provides that �he
Costa Mesa Fire Department may require the preparation, certification and
filing with Ihe Fire Department of an RMPP by businesses which are requiretl
to register acutely hazardous materials vnth the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the California
Healih and Safety Code been (ully complied vrith? ❑ Yes ❑ No
5. Does or will lhe appliwnt ot presenl or Wture huilding occupanl require lor
the vrork which is the subject of Ihis application a pertnit for such construction
or motlifcalion fmm the South Coast Air Quality Management DisMct or (rom
any other air pollution control distnct or agency? ❑ Yes ❑ No
(Section 658502 of ihe Califomia Govemment Code requires Ihat the requesled
information be fumished on applications !or non-residential building permits).
6. Will any part of Ihe taciliry to be constructed under Ihis permit be wilhin
1000 feet from the outer boundaries of a school? ❑ Ves ❑ No
(I('yes", �he (acility must meet the requirement of Sections 25534 antl 42303
of the Cali(omia Health antl Safery Code).
7. If a pertnit from the South Coast Air Quality Managemen[ DisMcl or other
air pollution control district or agency is required for the work which is the
subject of this application, have all of the discbsures prescnbed by California
Health and Safery Code Section 42303 been made? ❑ Yes ❑ No
8. pt yes", attach certificate,of compliance from the appropnate air pollution
control officer).
CERTIFICATE OF COMPLIANCE: I certify thal under penalty of perjury the
infortnation given above is correcL I agree'to comply vnth all state laws antl
ciry ordinances regarding Hazardous Materials and Emissions. -
Dale
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certi/y under penalty o! perjury tAat I have re d tbis application and slate that
the information given is correcL I agr e to mply with all state laws and ciry
ordinances relating t uil ' g co uctio , and authorize representatives of
the City of Cos es e upo the a e-describe pro erty tor
inspectio u s. I r o occ ow occupan of a builtling
autho ' t s pe � nf I ins ction. �O, // �
er(s�
NnC/orAu�honzeCAppliWnl Dale
�
. When recorded mail to:
City of Costa Mesa
Planning Division
P. O. BOX 1200
Costa Mesa CA 92628-1200
Recorded in the County of Orange, California
Gary L. Granville, Clerk/Recorder
���������������������������������������������������������������� 15,00
199905626)6 3; 58pm 01/28/99
005 22056222 22 67
D01�4 6.00 9.00 0.00 0.00 0.00 0.00
FECEIVED
CITY OF COSTA MESA
�FVFI nPAAFNT SFRVICFS DFP�RTAAFNT
NOTICE AND DECLARATION
OF
LAND USE RESTRICTION
OWNERS: MARK L. REUTER AND STEPHANI A. REUTER
auG 0 2 1999
AM pM
71$191inI��i.ni��ni�Id�S'�A
SUBJECT PROPERTY: 230 24T" PLACE, COSTA MESA, ORANGE COUNTY,
CALIFORNIA
LEGAL DESCRIPTION: LOT 25 OF TRACT 1442, IN THE CITY OF COSTA
- MESA, COUNTY OF ORANGE, STATE OF CALIFORNIA,
AS PER MAP RECORDED IN BOOK 48, PAGE 8, OF
MISCELLANEOUS MAPS IN THE OFFICE OF THE
COUNTY RECORDER OF SAID COUNTY
CITY FILE NUMBER: 699-00605
OWNERS declare and says,'' ier penalty of perjury, as follows:
1. OWNERS are the true owners of record of that certain reai property
described herein and referred to as SUBJECT PROPERTY.
2. OWNERS. have applied for and requested of the City of Costa Mesa, a
Municipal corporation, the right to construct, develop and use a toilet and
sink in a room attached to an existing office adjacent to the two-car garage
on SUBJECT PROPERTY within said City in an R1 zone (PROJECT).
3. The City approved said PROJECT but as one of the conditions required
recordation of a Land Use Restriction to inform future property owners that
no part of the existing garage or office shall be converted into a dwellina,
unit.
�
4. OWNERS therefore covenant, agree, and declare that subject property shall
not be used contrary to the above condition, and they shall not permit,
allow, or condone others to so use said property including their tenants,
heirs, assigns, or successors in interest.
�. OWNERS hereby grant permission for appropriate City officials to enter the
premises from time to time for the purposes of determining compliance with
the conditions and restrictions contained herein. Such inspections shall be
conducted during normal working hours and after reasonable notice to the
owner or tenant of the premises.
6. OWNERS intend that this covenant, condition, and restriction shail run with
the land and be binding upon Owners, their heirs, assigns, and successors in
interest for the benefit of the City of Costa Mesa and the adjoining
landowners and users and be a burden on SUBJECT PROPERTY so long as
the toilet and sink exist.
7. This covenant, condition, and restriction may be terminated by recording
with the Office of the Orange County Recorder a Release of Land Use
Restriction duly executed on behalf of the City of Costa Mesa indicating the
restriction is no longer necessary.
8. OWNERS further covenant and agree that they shall execute this restriction
and notify any subseqUent purchasers or tenants of SUBJECT PROPERTY of
this restriction and execute all documents necessary to effectuate the intent
hereof. Any use of SUBJECT PROPERTY inconsistent with this restriction
may be enjoined and abated and the owner of the SUBJECT PROPERTY at
the time of any inconsistent use shail be liable for the expenses to the City
for the enjoining ancl abating, including reasonabie attorney fees.
EXECUTED in the County of Orange, State of California, on this �%��
day of ' 199j
�
FOR THE CITY OF COSTA MESA OWNERS
/
PERRY . VALANTINE
Assis ant Director,
Development Services
�
CALIFORNIA ALL•PURPOSE ACKNOWLEDGMENT
State of �
County of �_
On �DATE �
personally appeared
No.590]
❑ personally known to me - OR �roved to me on the basis of satisfactory evidence
to be the person(s) whose name(s)-isfare
subscribed to the within instrument and ac-
knowledged to me that beFsF�efthey executed
the same in F►isftrer/their authorized
� chear_eneHew�c capacity(ies), and that by k�is�-h-er/their
comm��o�31182626 signature(s) on the instrument the person(s),
� Nof �P„o��-cor,om;o � or the entity upon behalf of which the
onse cAu�ry
tihco�,�,+.�,���,s,zooz person(s) acted, executed the instrument.
WITNESS my hand and official seal.
�, ��� ��.� / -
SIGNATUflE OF NOTAqY
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form. �
CAPACITY CLAIMED BY SIGNER
❑ INDIVIDUAL
❑ CORPORATE OFFICER
nn e�sl
❑ PARTNER(S) � LIMITED
❑ GENERAL
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PEPSON(5) OR ENTtiY(IES)
DESCRIPTION OF ATTACHED DOCUMENT
TITI.E OR TYPE OF DOCUMENT
NUMBER OF PAGES
DATE OF DOCUMENT
SIGNER(S) OTHER THAN NAMED ABOVE
�7993 NATIONAL NOTARY ASSOCIATION • 0236 Remmet Ave., P.O. Boz 718d • Canoqa Park,�CA 97309-7184
�
STATE OF CALIFORNIA
COUNTY OFORANGE
On June 1, 1999, before me, Elaine Steinhardt, a Notary Public,
personally appeared Perry L. Valantine, personally known to me to be the
person whose name is subscribed to the within instrument and
acknowledged to me that he executed the same in his authorized capacity
and that by his signature on the instrument the person or the entity upon
behalf of which the person acted, executed the instrument.
WITNESS my hand and official seal.
/,�
��/ /// � i .i; .-i s
� - - -
• ' • •
(Seal)
�.�,.�._.�,',�� .
����:ii
^`'r' • • .
�' _ .m
� �u1.�
- y��'
; c.;_,;_ �
'�,
(7/4) 754-5273 • Fa�c (714) 754-4856
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
Owner:
Address
Contrador.
Address:
ISSUE FEE
Temp service test
Res. a/c package
New Res (7-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Motors l0 1 hp
Motors to 10hp
Motors to SOhp
Motors to 100hp
Motore over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
230 24TH PL
iis�o�i�
REUTER, MARK L
230 24TH PL
COSTA MESA, CA
REUTER, MARK L
230 24TH PL
COSTA MESA, CA
CITY OF COSTA MESA �
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
ELECTRICAL PERMIT
Phone: 949-645-5824
Zip: 92627
Phone:
Zip: 92627
Phone:
Zip:
License:
SCOPE OF PERMIT
LEGALI2E PORTABLE SPA. 7 OUTLET, I MOTOR AND I CONDUIT.
$22.00
$0.00
$0.00
$0.00
50.00
$0.00
so.ao
$1.00
50.00
$0.00
$4.25
$0.00
$0.00
so.00
$0.00
$0.00
$0.00
so.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
0
t
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
Busway /100 ft
Standing Sedion
Misc Electrical Equipment
Transformers up to 1 kva/kw
................up to 10 kvalkw
.................up to 50 kva/kw
:................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low VOIt Wiring System / Ckt
Misc. Conduit
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
PrE/RMIT NUMBER
i
E99-00323
77 FAIR DRIVE, COSTA MESA, CA 92626
status: ISSUED
Applied: 04/20/1999
Issued: 04/20/1999
ISSUED BY:
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$16.25 1
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
50.00
$0.00
5a.00
TOTAL CALCULATED FEES ¢33.50
COMMENTS / SPECIAL CONDITIONS
��
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or ebandoned
fo� a period of 180 days.
INSPECTIONS� In ordar for the work authorized unde� this permit to be considered legal, such work must camply with all applicable codes, and all
required Inapectlone and final epprovel must be obtained. Failure to obtain inspectlons and tinal approval will result in the axpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
,WORKERS'COMPENSAnON DECLARAnON: - �
I hereby eflirm untler panelty of perjury one of Ihe following decleratlons:
❑ I have antl will mein�aln a ce�ificete of cnnsent to self-Insura far workers' compensetion, as providetl for by section 3700 of Ihe Lebar Cotle, for Ihe peAormance ot Ihe
work lor which ihis pertnit Is issued.
❑ I have and will meintaln workers' compensetlon Insurence, as required by section 3700 of the Lebor Cotle, for the perfortnance of tha work for which this pertnit is issue0.
My workers' compensetion Insurence cerner enC policy number ere:
Cartier: . Policy Num6er:
(Thls sectlon need nof be comp/etetl i/ the permit Is veluetl et one Auntlretl tlallers ($100) or /ess.)
❑ I certlfy thet in the padormanca of ihe work for which this permit is iuued, I shall not employ any person In any mannar so as to Decome subject to the workers'
campensetlon laws a� Calitomia, end agree that tl I should bacome sub�ect to iha workers' compensation provislons oF Section 3700 a� the Leho� Cotle, I shall forthwith
comply with thesa provisions.
Applicant Slgnature: Date:
WARNINO: FAILURE TO SECURE WORKERS' WMPENSATION COVEfiAGE IS UNIAW FUL AND SHALL SU9IECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNpRED
THWSAND DOLLARE (5100.000). IN AD�ITION TO THE COST OF COMPENSATIIXJ, DAMAGES AS Pi70VIDED WR IN SEC�IIXJ 3]O6 OF THE LABOR ODDE, IMEREST, AND ATTORNEI^5 FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eftirm that I am Iicensed under provisions of Chepter 9(commancing wfth Section 7000) oi Division 3 ot the Business entl Professions Code, antl my Ilcense is in tull
fome entl ettecL Lic. x qass M
Contractor's SiBnawre: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby ettirtn thet there is a construction lentling egency tor the pertortnance ol ihe work for which this permit Is issued. (Sec. 3097, Civil Code).
Lentler'S Neme: Lentlefs Atltlress:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eflirm �hat under penalry of per�ury Ihat I am EXEMP7 FROM 7HE CONTRAC70RS LICENSE LAW for Me following reason (Sec. 7031.5, Business and Protessions
Code: Any ciry or county which requires e pertnit to consWct, alter, improve, Cemolish, or repair any structure, pnor to its issuenca, also requires Ihe flpplicaM tor such permit
to tile e signed statement t�et he or she Is licensed pursuant m the provislans of the Contradors License Lew (Chepter 9(wmmencing with Sectlon 7000) oi Division 3 of ihe
Business end Professions Code) or Ihet he or she Is ezempt Iherefrom end ihe hasis for ihe alleged exemptlon. Any Nolation oi Sectlon 7031.5 by eny epplicent for e permit
su6�ecis the applicant ro e Gvll penalry ot not more then tive huntlretl tlollars ($500)J:
❑ I, es owner oi ihe property. or my employees with weges as their sole compensetion, WILL DO THE WORK, end the structure is not IntentleC or oNeretl for sale (Sec.
704d, Business enU Professions Cotle: iTe Contractors License Lew does not apply to an owner of properry who builds or improves ihereon, antl who does such work
himself or herselt or thwugh �is or her own employees, Drovitled thet such improvements are not intendetl or oNared for sale. If, however, ihe building or improvement is
sold within one year oi completlon, the owner;builtler will hava Ihe burden oi proving that he or she did not build or improva for purpose oi sele.).
�I, as owner of t�e pro� em �EL�ONTRACTING WITH LICENSED CONTRACTORS to construb the pwlect (Sec. 7044, Business and Professions
Cotle: The conirectors ns e not y ta an owner oi property who builds or ImO�oves Ihereon, end who comrects for such pro�ect with e contrector(s)
license pureuay.;a I onl cl0 nse La s � / _
end Professions Code for ihis reason:
ifs licensq/ es `� No
by (type ot document, ..- property �av bill
DIVISION OF INDUSTRIAL SAFETV PEHMIT CER7IFICA710N:
❑ I hereby cenity Ihet no excavetlon ilve (5) or more feet in �epth into which e person is requlred to descend, will be made in connection with work aut�onzed by this
permit, entl that no building siructure, scattolding, felsework, or tlemolition or dismantling Ihereof, will be more thfln thlrty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Califamie Adminlstretive CoCe).
❑ As owner-builder, I will not employ enyone to tlo work which would require a permli irom the Division of Intlustnal Safery, as notad aDove, unless such person has a
permit to da such work Irom ihe division.
Signature: Date:
Division ot IndusMal Satety Pertnit Numbar.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATON:
1 WIII ihe applicant or Oresent or tuture building occupent need to tila and certiry a Business Plan for emergency response to release or threatenetl release oi a hazarUous
mateAal7 ❑ Yes ❑ No
(Section 25505 of ihe Califomia Health end Sefery Code requires, wi�h some exceptions, that e Business Plan be filed with the Casta Mesa Fire Department by every
business which has et any ona time during e repartetl year e puentiry ol hazartlous matenals equal to or greater than a weight ot 500 pounds, or e volume ot 55 gallons,
or 200 cubic feet of compressetl gas el standard temperature and pressure�.
2 Does or will the epplicent or present or fuNre builtling occupam need ta file e registration form br eately hezerdous matedals7 ❑ Ves ❑ No
(Section 25533 of the Califomia Healih end Satery Cotle, with some ezceptions, requires registre�lon with the Coste Masa Fire Department hy each business which at any
one time has on hentl a quan�ity ol ecutety hazerdous materlels equal to or greater than e welght oi 500 pounQs, or e vdume of 55 gallons, or 200 cubic feet oi
compressatl gas at stentlard temperature antl pressure).
3 Does or will the epplicant or Dresen� or future bullding occupant neetl to preDare an RMPP (Risk Menagemem antl Prevention Program tor ecutely hazardous matenals)?
ves ❑ No
3ction 25534 ot the Califomla Heelth and SeteN Code pro�
Dariment of en FMPP �y businesses whic� are required to
II an
Ihat the Coste Mesa Fire Department mey r
ler acutely harartlous matedals with lhe Fire
iie Healt� antl Safetv Code been futiv comDlii
ihe
with7 IJ Yes
certlfltation antl filing with ihe Fire
No
5 Daes or will the applicant or presen� or NWre bulltling occupent repulre for Ine worK wmcn is ma suD�ecl or IniS 8 puca�wn a BRIII[ fOf SULO fAfIS[NCIIOfI Of
irOm �he South Coast Air Ouelity Menegement Dlsidc� or trom any othar eir pollutlon conVol tlistdct or agency7 � Ves - No
(Section 65850.2 af the Celifomie Govamment Code requires thet the raquestatl iniortnetion be fumishetl on applications tor nomresidential building permits).
e Will any patl oi tha feciliry to be wnsirucred under ��is pertnil be within 1000 teet from the outer boundades oi a school7 ❑ Ves ❑ No
(If yes', the tadllry must meet lhe requirement ol Sections 25534 entl 42303 of the Califomia Health end Satery Code).
7 It e permit irom Ihe South Coast Air Oualiry Manegement Oistdct or other air pollution contml disMct or egency is reQuired for ihe woM which is the si
aoolice�ion. have all of the disclosures orescribed bv Celifomie Health and Safery Cotle Section 42303 been made? ❑ Ves ❑ No
B Qf yes , attech cenificate ot compliance trom the eppropriate elr polWtion conirol otlicer).
GERTIFICATE OF COMPLIANCE: I certify ihat under penalry oi perjury the iniormatlon given above is correct. I egree to compy with ell stete laws and ciry ordinances
regarding Hazardous Metenals end Emissions.
SlgnaNre: �_�!� Date:
CERTFlCA7E OF C M CE l7THOR ON O E : I certi 'ury that I heve read this appli etion and state that Ihe information given is
conect I agree wit s e laws an �y o' an s r ting t uildi g construction, e rize representativ of the ot Costa Mesa to enter upon the
above-tlesc' r t ns i purp . I egr ro y o Ilow upancy of any hulltling authodzed b t'�s C in n e tion.
i
ignature 0 w er Date
And/Or Authorized Applicant � Date
cooe r.
1616 Fixed Svst m Final Fire�Prevention
1266 Pool Spa Finel
200 Finel Ra-Roof
201 FInaI BIocWReteining Wall
202 Finel Fettory Fire Place
203
204
2466d6
Final Sign
Finel Demolition
PAIE
0
�
COOE� INSVECTIONTYPE
206 Final Mechanical
20B Final Plumbing
210 Final Eleciricel
212 Final Fira Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
D�
H7//17 % /
a�
I y `'
CITY OF COSTA MESA ��
,` _ � BUILpING DIYISION
F DEVELOPMENT SERVICES DEPARTMENT
� .
�� PERMIT PERMIT NUMBER
698-01837
(714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 230 24TH PL
Suite:
Vicinity:
Parcel Nunmber: 11910111
Applirant: REUTER, STEPHANIE
Address:
Owner: REUTER; MARK L
Address REUTER; STEPHANIE A
COSTA MESA,CA
230,24TH PL � �
BUILDING PERMIT
Zoning:
Phone: �949-645-5533
Zip:
Phone: . �
Zip: 92627 '. .
Status: ISSUED � (�
Applied: 10/09/7998
Issued: 02/11/1999
Contrador: ' �
Address:
" . � ", Phone: ' � � �
� Zip: , � License� . .
v
Arch : ' . .� . . . . En9 . . , � `-
Address: - , � Address: , . �
� Phone: - Phone:
Zip: License: . License:
� � SCOPE OF PERMIT� , � '
� .-ADD 182SF BDRM, 350 SF COVERED PATIO 8 UPGRADE INTERIOR OF EX SF RESIDENCE: KITCHEN: MINOR �
, MODIFICATIONS, REMOVE 7/2 OF A NON-BEARING WALL TO CREATE A BAR TOP AND ADD 1/2 OF A NON-BEARING ' �
WAIL TO OPEN KITCHEN AND LAUNDRY AREA. ADD A NEW SKYLIGHT IN THE KITCHEN IC80 #. POSSIBLE REMODEL
� OF EXISTING BATHROOM, H/O WILI LET INSPECTOR KNOW PRIOR,TO INSPECTION.
- , ,�, � �
� _ FEE SUMMARY �� .
Plan Check: $227.34 '
Permit: $349.75
SMIP Res: $2.45
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $579.54
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existinq: z
NOTES:
Calc Valuation. $za,a�s.00
-___.. . Claim Valuation: `$o.00
_ �
� , PLANNING & ZONING
Rear 10-0 Left 29-0 . , Right
Rear 0- 0 Left 0- 0
Required: 2 Pr000sed: 2
Right
o- o
0- 0
EXPIRATION: This permit shall automatirally expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work aulhorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspeetlons and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 �
WORKERS' COMPENSATION DECLARATION: �
I hereby affirm under penalty of perjury one of the tollowing tleclarations:
❑ I heva entl will meintain e certificete of consent to setl-Insure for workers' compensation, es provided tor by section 3700 ot ihe Labor Code, tor the performence ot the
work for which ihis permi� is Issued.
❑ I heve antl will meintain workers' compensation insurence, as required by section 3700 of the Lebor Cotle, tor the peAortnence oi ihe work tor which this pertnit is issuetl.
My workers' compensation Insurance cartier antl policy number are:
Carner: Policy Numbar:
(TirlS sectlon need not be cromp/etetl il the pe�mit is valued et one hundretl tlollars ($100) or Iess.J
❑ 1 certity that in Ihe pertortnance of the work for which this permit is issued, I shell not employ any person in eny menner so es to become sublect to ihe workers'
compensetion laws of Celitornie, antl egree ihet Ii I should bacome subject to ihe workers' compensation provislons of Section 3700 ot lhe Lebor Code, I shell fort�with
comply with these provisions. '
Applicant Signeture: Date:
WARNING: FAIIURE TO SECURE WOFKEPS' COMPENSATION COVERACaE IS UNL4WFUL AND SMALL SU6IEGT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITIQV TO TME C0.5T OF COMPENSATION, DAM4GES AS PROVIDED WF IN SECTION 31060f THE LABOF CODE, IMEFEST, AND ATTOHNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eAirm thet I em licensed untlar provisions ot Chapter 9(commencing with Section 7000) ot Division 3 of ihe Business entl Professions Catle, entl my license is In full
torce end eHecL Lic. p Class p
Contrector's Signature: Dete:
CONSTHUCTION LENDING AGENCY:
❑ I hereby atfirtn thet th�eare is a conSWction lending agency for the performance oF the work for whic� Ihis permit is issued. (Sec. 3097, Civil Code).
LantleYs Name: /l 7N'ir:_ Lendefs Address:
Signature:
Date:
OWNER-BUILDER DECL'AHATIONS L' � r "
I hereby aHirtn Ihat under penelty of perjury thet I�em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reeson (Sec. 7031.5, Business end Protessions
Code: Any ciry or counry which requires a permit to construct, alter, improva, tlemolish, or repair any stmcture, pnor to its issuenca, also requires iha applicant for such parmit
to tile e signed statement ihat ha or she is Ilcensed pursuent to Ihe provislons of the Contrectore License Law (Ghapter 9(commencing with Section 7000) of �ivislon 3 oi Ihe
Business and Protessions Code) or that he or sFie is exempt ihereirom end the basis for the elleged examption. Any violation ot Section 7031.5 by any applicant tor a pertnit
su IacLs ihe'applicant to a civil penalry of not more t�en five hundred dollars �$500).):
es owner of ihe properry, or my employees with wages as their sole compensation, WILL DO THE WORK, end the siructure is not intended or oHered for sale (Sec.
7044, Business end Protessions Code: The Contractors License Lew does not apply to en owner oi property who builds or improves thereon, end who does such work
himself ar herself or through his or her own employees, provltled [hat such improvements ere not intended or ottered for sale. H, however, the building or improvement is
sold within one year of completion, Ihe owner-builder will have the burden oi proving that he or she tlitl not builtl or improve for purpose of sale.).
� I, es owner of ihe property, em E7(CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business end Protessions
Code: The contrectors License Law tloes not apply to an owner of property who builtls or improves thereon, and who cronirecis for such prqect with a coniracbr(s)
license pursuant to the COMractors License Lews.).
❑ lam
Owner ID veri
Venfication of
Business end Protessions Code for Ihis reason:
_�-- �Da�e:
Yes ❑ No Dnver's License No. Expires:
of document, i.e. - property lav biil or tleetl):
DIVISION OF INDUS7RIAL SAPETY PERMR CERTIFICATION:
❑ I hereby certity that no ezcavetion five (5) or more teet in depth Into which e person is required to descend, wlll be mede in connection with work euthorized by this
pertnit, entl that no building structure, scaftoltling, falsework, or demolition or dismantling ihereof, will be more ihen thirry-six (36) feet high. (Chep. 32, Grp 2, Atl 2, Sec.
341, Title B, Calitornia AEministretive Cotle).
❑ As owner-builder, I will not employ anyone to tlo work which would require e permit irom the Division of Industnal Sefery, es noted above, unless such person has e
pertnit to do such work irom the division.
SignaNre: Date:
Division of Intlustrial Safery Permit Number:
CERTIFlCATE OF COMPLIANLE AND AUiHORIZA710N OF ENiFiY: I certify untler penalry of perjury that I have read ihis application antl state thet the intortnetion given is
correct. egree to com I with all state laws and clry ordinances relating to building consWction, and euthorize representetives of the Ciry of Cosla Mese to enter upon Ihe
eb property c � rpos I egree not to occupy or allow occupancy ot any 6uilding authorized by ih�is perm/�t until �ne?l inspection.
C � ��U �� `7�
'gne ure f gel Owner(s) -T' Date
.�'
�
Antl/OrAuthonzedApplicant ' Date
�d7�'�I;69lind97Y� 17 i
1616
1266
200
201
202
203
204
244848
Fixed System Final Fire Prevention
Paol Spe Finel
Fnel Re-Root
Final BIocWRetaining Well
Finel Fflctory Fire Plece
Final Sign
Final Demolition
QAg UQIDALS
�QpEj INSPECTIONTYPE
206 Final Mechanicel
20B Finel Plum6ing
210 Finel Eledncal
212 Finel Fire Prevention
220 Finel Plenning Approval
222
250
Final Site
Final Building/Occupancy
� 1��
(774) �54-5273 • Fan (�ia) �sa-aess 77 FAIFi �FiNE, COSTA MESA, GA 92626
Job nddress: 230 24TH PL
Suite:
Viciniry:
ParcelNunmber: 11910111
BUILDING PERMIT
Applicant: REUTER, MARK L
Address: 230 24TH PL
COSTA MESA, CA
owner: REUTER, MARK L
Address 23024THPL
COSTA MESA, CA
Contrector.
Address:
Zip:
Arch :
Address:
Zip
LEGALIZE PORTABLE SPA.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$40.46
$62.25
$0.50
$0.00
$0.00
$0.00
$103.21
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0- 0
PARKING Ex�stinq: o
NOTES:
Phone:
License:
Rear 0- 0
Rear 0- 0
Reauired: 0
Zoning:
Phone: 949-645-5824
Zip: 92627
Phone:
Zip: 92627
Phone:
License:
Eng:
Address:
Zip:
SCOPE OF PERMIT
FEE SUMMARY
PLANNING 8 ZONING
Left 0- 0
LeR 0- 0
Proposed: 0
Status: ISSUED
Applied: 04/20/1999
Issued: 04/20/1999
ISSUED BY: �
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
Phone:
License:
si.sss.00
st,sss.00
NOTICE: The vrork authorized by this permit shall compty with all appiicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the vrork authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inepeetlone end final approvel must be obtained. Feilure to obtain inspections and finel approval will result in ihe expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545828
WORKERS'COMPENSATON DECLARAnON: �
1 here0y aHirm unAer penelry o! perj�ry one of Ihe following decfaratfons: ' ' '
❑ I �eve end wlll melnlain e certtlicete ot consent to setl-Insure tor workers' compensatlon, es provitled tor by secllon 3700 ot the Lebor CaOe, for Ihe pertortnence ot the
work far whiCh (hl9 pertnit I9 issuetl.
❑ I have entl will melnWin workers' compensatlon insurance, es required by seclion 3700 ot the Labor Coda, for the peAortnance of Ihe work br which ihis pertnll is issuetl.
My workers' compensation Insurance carder entl policy number are:
Casri�r: - Pollcy Number.
(This secfion need not be completetl il fhe permlf fs vslued ef ane huntlretl0ollers ($100) or less.)
❑ I certity Ihat I� lhe peAortnence at Ihe work for wNch Ihis pertnit is issued, I shall not employ eny person in eny manner so es to beCome subject to the workere'
compensation lews of Calitornle, and egree Ihet if I should become su6ject to the workers' compenseiion provisians of Sectlon 3700 of the Lebor Code, I shall forihwith
compty with Ihese provisions.
AppliCanlSignature: Dale:
WARNING: FAILURE Tp SECURE WORKERS' COMPENSATIIXJ ODVERpGc IS UMAWFUL AND SHALL SUBJECT AN EMPLOYER Tp CRIMINFL PBNqLTIES !WD dVIL FlNES UP TO ONE HUNDRED
T}KMI6AND DOl1ARE (5100.000),IN AD�fiION TO THE ODST OF COMPEN3ATION, DAMNGES AS PflOVIDED FOR IN SECf10N 37060F THE UBOq CODE, IMEREST, ANO ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I her9by aNirtn Ihet I am Iicensetl under pmvisions of Chapter 9(commencing with Section 7000) of Division 3 of the eusinass entl Protesslons Cotla, and my license is in tull
force entl ettect. Lic, p Class q
Contrectors Signawre: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby aHirtn thet Ihere is e construction lentlin9 egency tor Ihe pedormence ot the work tor which this permit Is Issued. (Sec. 3097, Civll Code).
Lendars Neme: Lendefs Address:
Signatura: Dete:
OWNER-BUILDER DECLARATIONS:
I her�by aHirm ihat Under penalry,ot perJury ihat I em EXEMPT FROM TNE CONTRAC70RS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business end Professions
Code; Any ciry or counry which requires a permil to constmct, elter, improve, demolish, or repair any structure, prior lo its issuence, also requlres the epplicant for such permit
ta file a signed stetemem thet he or she Is Iicensetl pureuent to the provisions ot the Contredors Llcense Lew (Chepter 9(commencing with SeIXlon 7000) of Divislon 3 ot Ihe
Business and Professions Cotl �,or Ihat he or slie,ls,exempt ihereirom and the basis for the elleged examptlon. Any vloletion ol Section 7031.5 by any applicant for a Dermit
subjecls the appllcent to a Gvil�elry o� not more tlun tive bundred dWlars ($500).):
/���+
❑ I, es owner of ihe property, or m}qy{�p ees with wages as Iheir sole compensation, WILL DO THE WORK, end the structure I5 not IntenEad or oHeretl for sale (Sac.
7044, Business end Professlons COTle�liontrectore License Lew does not apply to en owner af property who bulltls or Improves t�areon, antl w�o tloes such work
himselt ar hersell or Ihrough his or her dnploy proN ed that such improvements ere not inlentletl or oMered for sele. It, however, the bullding or improvement is
sold within ona year of compl n, the er�bu er III h ihe burden of proving Ihat he or she did not huiltl or Improve for purpwe of sale.).
� I, as owner oi Ihe prope EX L IVE C NTR TING WITH LICENSED CONTRACTORS to construct tha pro�ed (Sec. 7044, Business antl Prafessions
Cotle: The contrecto ^ c_ se �es n ap y to e wnar of�r peqy�who builds or improves thereon, end who contrects for suc� project wtt� a conirecior(s)
end Professions
license. `'Tj`,�es ❑ No
Venfi�tion o( Ownar/fifp by (type of daumenf, i.e. - properry fas 6ill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATON:
❑ I hereby certily ihet no excavatlon five (5) or more tee� In tlepth into which e person is requlred to descend wlll be metle in connection with work euihonzetl by this
permit, antl that no hulltling strucWre, scefloltling, felsework, ar demditlon or dismantling theraof, will be more then thlrty-six (38) teet high. (Chep. 32, Grp 2, A� 2, Sec.
341, Title 8, Celitomla AtlminlsUeOve Code).
❑ As owner-builder, I will not employ enyone to tlo work which woultl require a permii irom the Division of Indusirlal Salery, ea noteA ebava, unless such Dersan has a
permit to do such wark irom the tlivision.
SignBture: Da�e:
Divislon ol Industriel Sefety Permit Number:
CEqT1FlCATE OF CO�EiCJN�10E AN ORI7Ailyf�l� Y: I certity under penalry ot per�ury �ha� I heve read this applicatlon entl stata thet Ihe intormation given is
corract. I egr o 6mp�with ell lews eq� !y ordin s relatin t ' sWction, end authodze represemativ ol the iry oi Coste Mesa to enter upon the
above-de rop forinsp ionpurp d.I gr pyorallowoccupencyoferrybulltlirgauthonzed t is ermitun tt Ilnspecfion.
� nature er( ) a
AnNOr Authonzed Aoolicant Date
CQOfi �. INSGECTIONTYPE
1616 Fixed System Final Fira PrevenUon
7266 Pool Spe Final
200
201
202
203
204
]dA6 d6
Finel Ra-qoot
Final BIacWRetalnln8 Wall „
Final Fectory Fire Pleca
Final Sign
Final Demolition ,
o"re IN.�leLB
COOE I INSPECTION TYVE
206 Final Mechanical
208 Final Plumbing
210 Final ElecMcal
212 Final Pire Prevemlon
220 . Final Plenning Approvel
222 Finel Site
250 Final Builtling/Occupancy
�
� u, �
.:
By
This seI ct plaris 2nC sp
make en�f clar,ges ur a0.e
ar�d SateTy, City eS Cosa
�
�1n'�C7 C!✓5 �p Z3G'� c�r�y �r�rc1 3{11 �� ����:0 �+?1 r+i soH�nl
iv qt'-�liTi�:�U�4;�F�i�Y:��:-,,�� a�; -;;:,,�_. ' =`%i,'�^G �;�; �,{�'ry� �
T!' 4F +:OSTq`(AESA V f � �
.4�'�`6t��TED -
�-�. oa,� �.1 � 1 �Q
%�m MUST �e x�pi on this jot a1 an iimes and'A is unla�iul t�
cn s��*; �ti+t;r�l vrtitt2n peani�sbn tr�m the Diwisiun ot Eu�din;
-� ���_ Qo S�9
Thestafnpuigofthispfan specificatio:tisSHALLNOTboheWtoperm8orrobeanapprovei
oi the violation ol nny pr sions oi 2ny Ci!y of Cos'a b"esa Ordlnance anNor Stxte la�v. __ ._
.. .. _...
Thae plar,s and psnl s I ezpiro Cy fmilal�on and Gsmme null and wid it ihe bu0d'mg or /� ~
�rak is nc>. wmmer��d e.�,�;�Z;aKRd acliva per UBC §3U3 (� wBhin 18� days af issuznce. •
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�
CITY OF COSTA MESA
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
(774)754-5273 • Fax(714)754-4856
Job Address: 230 24TH PL
Suite:
Viciniry:
Parcel Nunmber: 11910111
Applicant: STEPHANI REUTER
Address:
owner: REUTER, MARK L
Address 23024THPL
COSTA MESA, CA
Contractor:
Address:
Zip:
Arch :
Address:
Phone:
BUILDING PERMIT
Zonin9:
Phone: 949-645-5533
Zip:
PERMIT NUMBER
� B99-00605
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: OSI04/1999
Issued: 05/04/1999
ISSUED BY: � ��
Phone: ���
Zip: 92627 ��
,�,E
04
Phone:
License:
Eng:
Address:
Zip License: Zip:
SCOPE OF PERMIT
CONSTRUCT WALL IN GARAGE TO CREATE POWDER RPOOM.
FEE SUMMARY
Pian Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$13.65
$21.00
$0.50
$0.00
$0.00
$0.00
$35.15
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existinq: o
NOTES:
�
Rear 0- 0
Rear 0- 0
Required: 0
PLANNING 8 ZONING
Left 0- 0
Left 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
Phone:
License:
$500.00
5500.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12•21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for e panod of 180 deys. •
INSPECTIONS: In oidar for the work authorizad undar this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inepectiona entl flnel epprovel must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WOViKERS' COMPENSATION DECLAHATON: �
I hereby aHirtn unOer penalry ot pe�jury one af the lallowing declaratlons:
❑ I �eve end will melntain e certificete o1 cansent to selt-Insure tor workers' compensetlon, as provided for by section 3700 of the Lebor Code, br Ihe pertormence of tha
work tor which Ihis permit Is issued.
❑ I have and wlll maintaln workere' canp�nsetion Insurance, es requiretl by section 3700 oi Ihe Labor Cotle, for Ihe perfortnance of the work tor which this permit Is issuetl.
My wOAcere' campensetlon Insurflnce cerrier entl policy numDer are:
Carrier: Policy Number.
(This secNon need not be can0/eted U the pe�it is veluetl ef one �undred dollar3 ($700) or less.)
❑ I certity that in lhe pertortnence ol the work for which Ihis permit is Issued, I shell not employ eny person in any manner so es to become sub�ect to lhe workers'
compensetlon laws ot Celitomia, entl agrea Ihat N I should becrome sub�ect to ihe workers' compensation provisions of Section 3700 at the Lebor Cotle, I shell lort�wit�
compy with these provisions.
Applicam Signature: Date:
WARNIN(3: FAILURE TO SECURE WORKERS' WMPENSATION COVERAOc IS UNL4WFUL AND SNALL SUBIEGT AN EMPLOVER TO CfiIMINAL PENFLTES AND GVIL FINES UP TOONE HUNDRED
THOUSANO DOLI.ARE (5100.000�, IN ADDfiIIXJ TO TryE WST OF COMPENSATION, OAMAGES AS PROVIOEO FOR IN SECfIIXJ 3]O60F THE LABOR ODDE, IMEREST, AND ATTORNEYS FEES.
LICENSED CONTRAC70RS DECLARATION:
. I hereby eHirtn ihat I em licensed under provisions of Chepter 9(commencing with Sectian 7000) of Division 3 oi the Business and Protessions Cotle, antl my Ilcense is in full
�'� force antl eHact tic. N Class M
' Contractofs Signeture: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby eHirtn thet ihere Is e consiruction lending agency tor Ihe peAortnance ot the work tor which this pertnit is issued. (Sec. 3097, Civll Cotle).
Lender's Neme: Lentler's Atltlress:
Signelure:
Date:
OWNER•BUILDER DECLARA710NS:
�v_ �� i.
I hareby altirtn the� under penelry of.per�ury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor �he following reason (SecJ031.5, Business entl Professions
Code: Any ciry or cdunry whic� requires e permil b construct, elter, improve, demolish, or repair any strucWre, pnor to its issuance, also requlres the epplicant tor such permit
ta file a signed statement theUhe or she Is Ilcensetl pursuant to ihe provisions of the Contrectars License Lew (Chepier 9(commencing wit� Sectlon 7000) oi Dlvisian 3 af the
Business and Professions CoCe) or,ih�t he�or�she'Is exempt therefrom and the basis for the alleged eaemption. Any violallon ol Section 7037.5 by eny eDPllcant tor e permlt
sub�ects the applicent to e civll peneltyyot not more than flve hundred dollers ($500).):
❑ I, as owner ot the property, or my empbyees w7th weges es their sole compensatlon, W7LL DO THE WORK, arM the structure Is not Intentletl or ottered lor sale (Sec.
7044, Business antl Professions Code; Tha Conlrectors License Law does not appty to an owner of properry who builds or improves t�ereon, end who does such work
himself or herself or ihrough his or her own employees, provided Ihet such improvements are not Inientled or oNered for sele. If, however, ihe bullding or improvement is
soltl within one year of com0�etion, the owner-builtler will heve the burden of proving ihat he or she ditl not builtl oi improve for purpose of sele.).
t] I, as owner of the property, am EXC�USIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Buslness antl Protesslons
\ Cotle: The contractors Llcanse Lew tloas not epply to en owner of property who builds or Improves ihereon, and who conirects for such proJect with e contractoqs)
license pursuant to the Gontractars Licgnse Laws.).
❑ 1 em eLc�mpi�mder sec. eusiness entl Professions Code tor this reass:- i
Owner ID veniied bydlivelS.Acensa? ❑ Ves� ❑ No Dnvefs License No. / l ' Expires:
Venficetion of Ownership by (rype ot daumen�, i.e. - proparty tex blll or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTFICATION:
❑ I �ereby cenity that no axcavatlon Ilve (5) ar more feet in tlepth into which a pereon is requlred to descend, wlll be mede in connectlon with work euthodzed by this
permit, end that no builtling strudure, sceNoltling, felsework, or demolition or dismantling ihereof, wlll be more Ihan thirty-six (36) feet hlgh. (Chep. 32, Grp 2, ArI 2, Sec.
341, Ttle B, Callfomia Administretive Cotle).
� As owner-bullder, I will not employ anybne to do work which would require a permit trom iha Division of Intlustrial Safery, es noted ebove, unless such person has a
pertnit to do such work trom the diNsion.
Signeture: Date:
Division oF Industriel Sefey Pertnii Number:
CERIIFlCATE OF COMPLIANCE AND AUTHORVA710N OF ENfRY: I certify under penalry of perjury that I have read this application antl state that the intortnetion given is
c . I�gr e lo co y Ith ell state lawa and ciry ortlinances relating to building construdion, entl euthonze representatives of the Ciry f Cwte Mesa to enter upon the
a e descnb tl perry �pe�cti n purposes. I agree not to occupy or ellow occupency ol any 6ulltling euthodzed by this permit un II flne Ins ect
^� g etur . 9ga .e�
i \ , � �J
_ And/ uthorized Aoolirant De�e
COOE �. INSPECTON TYPE
1616 Fivetl System Flnel Flre Preventlon
1266 Paol Spe Final
200 Final Re-Rooi
201 Finel BIaWRetaining Well
202
203
204
2d4&d6
Final Fectory Fire Place
Final Sipn
Finel Demolitlon
J�iF� IMtMLS
CODE� IXSPECTIONME
206 Final Mechanicel
200 Final Plumbing
210 Finel Eleclrical
212 Final Fire Preventlon
220 Final Planning Approvel
222 Final Site
250 Final Building/OccuOency
�
I�!.$
(714) 754-5273 • Fex (�ia� �sa-aess
Job Address: 230 24TH PL
Suite:
Vicinity: SIDE OF HOUSE
Parcel Nunmber: 11910111
Applicant: REUTER, MARK L
Address: 230 24TH PL
CITY OF COSTA MESA /, l
svuo�N� �nr�s�oN
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
�
COSTA MESA, CA -
Owner: REUTER,.MARK L �
Address 230 24TH PL, � _ �
� j �
/ COSTA MESA, CA �
Contractor. ��, %";;! „-,�
�Address: , '=�!�-�
BUILDING PERMIT
Zoning:
Phone.
' Zip: 92627
Phone: �- �' '� �.
Zip: 92627
� - , � Phone: ,
- Zip: - " Llcense:
Arch : , , � - . % �
Atldress: ' � - � �- -�
'-, r�
, - . � Phone: �
-`.
PERMIT NUMBER
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 07/07/1999
Issued: 08/18/1999
ISSUED BY: '!�+'!
� �Y
����c � U�� \ \ ;
'1F'�3���,
�� ��
Eng:
Address:
.. . Zip: r � � � � License:
� ' SCOPE OF PERMIT
;� 80 SQ. FT. BEDROOM EXTENSION ON StDE OF EXISTING SINGLE FAMILY DWELLING.
A MINIMUM 6' CLEARANCE
WILL BE PROVIDED BETWEEN THE NEW CONSTRUCTION AND THE EXISTING DETACHED GARAGE.
� � � �
Phone:
License:
� , �= FEE SUMMARY
Plan Check: $81.09 • � �% Calc Valuation:
Permit: $12475 _ • Claim Valuation: .
. SMIP Res: $0.68 - - .
SMIP Com'. $0.00
Other., $0.00 . �
Inspection: $0.00 '
Total: $206.52
SETBACKS
MAIN STRUCTURE Front 43- 0
ACCESSORY Front 0- 0
PARKING Existinv: 0
NOTES:
Rear 0-0
Rear 0- 0
Required: 0
PLANNING 8 ZONING
Left 25- 0
left 0- 0
Pr000sed: 0
Right 0-0
Right 0. 0
$s,aao.00
ss,aao.00
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a penod of 1 BO days.
INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply wi�h all applicable codes, and all
requlred Inapectlona and final approvel must be obtained. Failure to obtain inspections and final approval will resufl in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLARAnON:
I hereby eHirm under penelry ol pe�ury one ot �he (ollowing detlaralions:
❑ I heve antl will melntain e certiticate ot congent ro selt-Insure tor workers' compensation, es provitletl for by section 3700 of tha Lebor Cotle, for the petlormence of the
work for which ihis pertnit is issued.
❑ I have antl will maintain workers' compensation insurence, as requlred by section 3700 of the Labor Coda, for iha peAortnance ot Ihe work�for which Ihis pertnit is issued.
My workars' compensation Insurance wrriar and pollcy number ere:
Cerder. Policy Number.
(�Th/is secflon need nat be camp/eretl i/ the permi( is veluetl et on undr dWlars ($ f00) oNess.)
L7 I ceniry that In the peRormance of wo r wh' is pe t is Issuetl, I shall not employ any person in any manner so as to become subject to ihe workers'
compen58�ion law5 of C' ia egree ai if ultl be e subject Io Ihe worker5' compensation provisions of ectl n 3700 of the LaDOr CoCe, 1 shell fohhwith
comply with these pr si j� y G
Applicant SigneWre: Date: U� U l G�
WARNINO: FAILURE TO SEC RE WO ERS' WMPENS ION CAVEPA�E IS UNLAWFUL ANO SHALL SU&IECT AN EMPLOVER TO CPIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN�RED
TIN)USANDDOLLARE�5100.00p),IN ITIQVTOTHE�p$TOF�MPENSATION,DAh41GESA5PqOVIOEDFORIN5ECT10N3]O6pFTHELAOpRCODE.INTEREST.ANDATTORNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm thet I am licensed under provisions ot Chepter 9(commencing wlth Section 7000) of Division 3 of the Business and Protessions Code, and my license is in tull
force end eRect. Lic. x Class x
Contrac�ors Slgna�ure: Date:
CONSTRUCTION LENDING AGENCY:
❑ I heraby eMirm that there is a construction landing agency for tha pertormance ol the work tor which Ihis permit Is issued. (Sec. 3097, Civil Code).
Lender5 Neme: Lentlefs Atltlress:
SignaWre:
Date:
OWNER-BUILDER DECLARA710NS:�( ��/i�
I hereby ettirm that under penalry ot perjury thai I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions
Cotle: Any ciry or counry which reqmres a pertnit to constNct, alter, impmve, demolish, or repair eny sirucNre, prior to its issuance, elso requires the appliwnt for such permit
lo fila e signed stetement ihat he or she is licensed pursuent;to Ihe prodsions of Iha Contractors License Law (Chapter 9(commencing with Secilon 7000) of Division 3 of ihe
Business antl Prolessions Cotle) or that he or she is exempCtherefrom and �he basis for the allegetl exemption. My violation of Section 7031.5 by eny appllcant for a permit
sub�gots the applicant to e civil penalry W not morp than five'huntlretl tlollars ($500).):
� I, as owner ot the property, or my employeBs with wages as their sole compensetion, WILL DO TME WORK, and the structure is not intentletl ar oHeretl for sale (Sec.
7044, Business entl Protessions Code: The Contrectors License Lew tloes not epply to en owner of properry who huilds or improve5 thereon, end who does such work
himself or herself or through his or her own employees, provided thet such Improvements ere not Intended or oHered far sale. If, howevar, the builtling or improvement is
soltl within one year of completion, Ihe ownqr-bullder will have the burtlen of proving t�at he or sha did not build or improve for purpose of sale.).
❑ I, as owner ot the pmperty, am EXCLU$ I�VELY CQNTHACTING WITM LICENSED CONTRACTORS to constmct the pro�ect (Sec. 7044, Business an0 Professions
Cotle: lTe contrecrors License Ww dp�s�ot app�J to an owner of propeny w�o builds or improves thareon, end who conirects for such pro�ect with a coniractor(s)
license pursuant to ihe Contr�tors Li94n Lawsy�
❑ I em exemp e�c. Business end Professions Code tor this reason:
Signeture: Date: �i �
Owner ID verifietl by tln er's license. ❑ Ves ❑ No Driver's License No. � �� Ezpires: a�
Venfication of Ownership by (type ot tlocument, i.a. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT C�RTIFICATION:
❑ I herehy cenify that no excavation five (5) or more teet in tlepih into which e person is requiretl to tlescen4 will be made in connection with work euthorized by this
permit, antl Ihat no building sWCWre, scatiqltling, falsework, or tlemolition or dismanlling t�ereot, will be more than thirty-siz (36) feet hig�. (Chap. 32, Grp 2, An 2, Sec.
341, Ttle B, Calitornia Atlministra6ve Code),
❑ As owner-builder, I will not employ anyona to do work which would requlre a pertnit irom the Division of Industrial Safery, as noted ebove, unless such person has a
permit ta do such work from the division.
Signature: Date:
Division ot Indusirial SafeN Pertnit Number:
COOE t. INSGECTIONTYiE
1616 Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-Foof
201 Final BIocWRetaining Wall
202 Finel Fectory Fire Plece
203 Final Sign
20d Final Demolition
2aaBde
PAL� INTRIRLS
CODEY INSPECTIONTYGE
206 Final Mechanical
208 Final Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Final Plenning Approval
222 Final Site
250 Final Building/Occupancy
QAjE I pL
CITY OF COSTA MESA �--
BUILpING p1VISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
�
PERMIT NUMBER
E99-00097
(714) 754•5273 • F2�c (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
Owner:
Address
ContraCtor:
Address:
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 7000a
Motors to 1hp
Motors to 70hp
Motors to SOhp
Motors to 100hp
Molors over 100hp
CJ�'!i1H:GILo11C.'. d(ONS
S•;�;pr�:r� lo ?OOa
P,.!q 1 �q,hi�Pi�9
�IQI I�It��L.IS
:�mpF::r°•.,
230 24TH PL
11910111
STEPHANIE REUTER
REUTER, MARK L
REUTER, STEPHANIE A
COSTA MESA,CA
230 24TH PL
EIECTRICAL PERMIT
Phone: 949-645-5533
Zip:
Phone:
Zip: 92627
Phone:
Zip:
License:
SCOPE OF PERMIT
install 2 fxtures, 4 outlets, 2 switches and 1 subpanel for residential addition,
re:b98-01837.
$22.00
$0.00
$0.00
$0.00
$0.00
$0.00
$2.00
$4.00
$2.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
P/� (1!1
:c,o
:0.CU
quantity
FEE SUMMARY
Temp Dist Sys[em / Lighting
Busway/700 R
Standing Section
Misc Eleciriwl Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System ! Ckt
Misc. Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stantl
Other Electrical Fee
investi�a!ion Fe�
;%10n Cj:�ci�?c_
Rair.specvc+: rce
Status: ISSUED
Applied: 02/12/1999
Issued: 02/12/1999
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 D
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
SO.CU
se.cc
5aqc
707n� r,a_::�.{;.ATED FE�S GL'.2p
EXPIRATION: This pertnit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In �order for the workrautharized under this permit to be consitlered legal, such work must comply with all applicable codes, and all
requlred inapeetlona end flnel approvel must be obtained. Failure to obtain inspections and final approval will result in the expiretion of ihis permit.
FOR INSPECTIONS CALL: (714) 7545828
WORKERS' COMPENSATION DECLARATION:
I �ereDy ettirtn untler penelly of perjury ona of the tollowing declerelions:
❑ 1 have entl wlll meintaln e certificale of cansent to self-Insure for workers' wmpensatlon, es provided tor by seclion 3700 at the Lebor Cotle, for the peAortnance oi ihe
work for which Ihis pertnii is issued. '
❑ I have end will maintein workers' compensation insurance, es require0 Dy section 3700 of the Lebor Cotle, tor the pertormance of Ihe work for which this pertnit is issuetl.
My warkere' compensatlon Insurance cartier end policy num6er ere:
Cartier. Pdicy Number.
(Thfs secfion need not be completetl l/ Me peimit is valued et one hundred dollers ($100) or /eu.J
� I certily Ihat In the pertortnance ol Ihe work for which this pertnit is issuetl, I shall not employ any pereon In any menner so es to become su6�ect lo Ihe workers'
compensetlon lews ol Celiforngi .� aC-e ree ihet tl I shoulA become sub�xt to the workers' compensation proWsions of Section 3700 of [he Lebor Code, I shell fort�with
comply with th pr is o�
ApplicenlSigneWre:� � — �. Data:
WARNINO: FAILURE TOSECURE W RI ' C`,OM�NSATIO CAVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINA� PENALTIES AND GVIL FINES UP TO ONE HUNDRED
THOUSANDDOLIARE(E100.OW), ADDIiIONTOTHE OFCOMPENSATIIXJ,DAMAGESASPROVI�EDFORINSECfION3lO60fTHELABORCODE,IFREREST,ANDATTORNEY'SFEES.
LICENSED CONTRACTOfl3 DECLARATION:
I hereby efllrtn Ihet I em licensed under pmvisions of Chaptar 9(commencing with Sectlon 7000) ot Division 3 ot Ihe Buslness end Professlons Coda, and my Ilcense is in full
farce end eHecL Lia a Class k
Contracrors SigneWre: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby effirtn thet there is a consiruction Ien0in9 agency for Ihe paAortnance of the work for w�lch this permit is issuad. (Sec. 3097, Civil Code).
Lentle�s Name: Lentlers Address:
Signature:
Date:
OWNER•BUILDER DECLARATIONS:
I hereby eHirtn thal untler penalty oi per�ury ihet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, Busineu entl Professions
CoOe: Any dry or counry which requires e pertnit to conswct, atler, imprave, tlemolish, or re0alr any siructure, prior ro its issuance, also reqWres the a0711cant for such parmit
ro tile e signetl statement t�at he or she is licensed pursuent to Ihe provislons at the Contrectors License law (Chapter 9(commencing with Section 7000) of DlNslon 3 of the
Business end Protessions Cotla) or thet he or.she is exempt ihereirom and iha Oesis tor ihe alleged ezemption. Any violation of Sectlon 7031.5 by any epplicent for a permit
sublects ihe epD��cent to e civll penelty of not more Ihen Me hundred dollare ($500).):
❑ I, es owner oi ��e properry, or my employees with wages es their sole wmpensetlon, WILL DO THE WORK, and tha structure is not intentleO or oftered far sale (Sec.
7044, Business and Professions Cade: The Contrectore License Law tloes not epply to en owner of property who builtls or improves Ihereon, end who Aoes such work
himself or herealt or through hls or her own amployees. Provided thet such Improvements are not Intentled or otteretl tor sele. It, however, the bulltling or Improvement Is
sold withln one year ol campletion, the owner-builder will heva the burtlen of proving Ihat he or she did nol build or imprave for purpose oi seleJ.
❑ I, es owner ol the properly, em EXCLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to consiruct ihe praject (Sec. 7044, Business end Protessions
Cade: The contractors Llcense Lew does nat epply to en owner ot property who bulltls or Improves therean, and who contrects for such pro�ect wlth e coniractar(s)
Ilcense pursuent to the Contrectors License Laws.).
❑ 1 am mpt under Businass end Professlons Code tor this reason:
_ 3 Slgnetu�1y°°µ�#� , . �
Owner v s lic se. Ves ❑ No Oriver's LJcense No. ��
Vedflcetlon oi Ownership 6y (rype of tlocument, i.e. - property ta¢ 6111 or Oeetl):
�
DIVISION OF INDUSTRIAL SAFETY VERMR CERTIFICATON:
❑ I here6y certity that no e:cavation live (5) or mora feet in depth into whic� e person Is requlretl to descend, will be made in connection with work aut�oAzed by this
permit, entl t�at no builtling strudure, scaftolding, telsework, or demolitlon or dismentling Ihereol, will be more than thirry-six (3fi) feet hlgh. (C�ep. 3.2, Grp 2, Art 2, Sec.
341, Ttle 8, Celifamle Adminlstretive Cotle).
❑ As owner-builder, I will not employ anyone to do work which would requlre e pertnit frwn the DMsion of IntlusMal Safery, es noted above, unless such person hes a
pertnit to do such work trom ihe division.
SigneWre: Date:
DiNsion of IndusMel Safery Permil Number:
CERTIFlCATE OF COMPLIANCE AND AUfHORVATON OF EMRY: I certity under penelry ot perjury thet I heve reed this epplicetion and state ihat the informetion given is
correct. I egree to comply with ell state lews end ciry ordinences relating to building construction, end authorize representatives ot lhe City of Coste Mese to enter upon the
ebove-tle nbed p perty-fortnspecliorypurpq;e¢, I agree not to occupy or ellow occupency of eny bullding euthorized 6y this permjt until tinel�Inspection.
fAOE /. IxSVECTONTYPE PA¢ Iti�lL4
1618 Fixetl System Finel Fire Prevention
1268
200
201
202
203
Pool Spe Final
Flnal Re-Roof
Final BIacWRetelning Wall
Finel Fectory Fire Place
Flnal Slgn
204 Final Demolition
26a&a8
COOE I INSPECl10N TYPE
206 Finel Mechenical
20B Final Plumbing
210 Flnal ElecMcel
212 Final Fira Preventlon
220 Final Planning Approval
222 Final Site
250 Finel Building/Occupancy
(714) 754-5273 • Fax (714) 754-4856
Job Address: 230 24TH PL
Suite No
Vitinity:
Parcel Nunmber: 11910111
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Applicant: STEPHANI REUTER
Address:
Owner: REUTER, MARK L
Address 23024THPL
COSTA MESA, CA
Contraclor:
Address:
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 7000a
Motors to 1 hp
Motors to 10hp
Motors to SOhp
Motors to 100hp
Motors over 100hp
Communicalion drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
ELECTRICAL PERMIT
Phone: 949-645-5533
Zip:
Phone:
Zip: 92627
Phone:
Zip:
License:
PERMIT NUMBER
� E99-00366
77 FAIR DRIVE, COSTA MESA, CA 92626
SWtus: ISSUED
Applied: 05/04/1999
Issued: 05/04/7999
ISSUED BY:
SCOPE OF PERMIT
CONSTRUCT WALL IN GARAGE TO CREATE POWDER RPOOM. BATHROOM FAN, RE:899•00605.
$22.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$4.25
$0.00
50.00
50.00
$0.00
$0.00
so.00
$0.00
so.00
$0.00
50.00
so.00
$0.00
50.00
$0.00
Quantity
FEE SUMMARY
Temp Dist System / Lighting
Busway /100 ft
Standing Section
Misc Electrical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kvalkw
..................over 700 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTALCALCULATEDFEES
COMMENTS / SPECIAL CONDITIONS
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00
$0.00
so.00
$0.00
526.25
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia stetutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a penod of 1 BO days.
INSPECTIONS: In order (or ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inepectlone end Iinel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545828
�
WORKERS'COMPENSAnON DECLARArON: '
1 herehy atlirtn under penalry of perjury one oi tha tollowing tleclarations:
❑ I heve end will meinteln a certiticete of consent to self-Insura far workers' compensatlon, as provided tor by section 3700 of the Lebar Code, tor ihe perlortnence oi Ihe
work tor which ihis permit Is issued.
❑ I hava and will mainteln workers campensatlon Insurance, es required by section 3700 oi the Lebor Code, tor Ne peAormence ot Na work fw which this perml� Is issuetl.
My workere' campensetion Insurence cerner and policy num6er ere:
Cartier. Policy Number.
(This sectlon neetl nof be comp/etetl i/ the peimit is velued ef one huntlred tlollers ($ f00) ar less.)
❑ I certity ihet In the peAormence of Ihe work for which this permit Is issued, I shall not employ eny person in any manner so es to 6ecrome subject to the workers'
� compensation lews oi Celitomia, end agree thet ii I should becoma subject to Ihe workers' compensetion provlslons of Sectlon 3700 of the Labor Cotle, I shall forthwith
comply with ihese provisions.
AppliwN Signeture: Date:
WARNING FAILUPE TO SECURE WORKERS' WMPENSATIIXJ ODVERAGE IS UNLAWPU�lWD SHALL SUflIECf AIJ EMPLOVER TO CRIMINAL PENALTES AND CNIL FlNES UP TO IXJE HUNDRED
THOUSAND DOLURE (5100.000�, IN ADDRION TO TME C0570F COMPENSATION, DAMAGES AS PROVIDEO FOF IN SECfION 3]O60F THE IABOF CODE. IPREREST, AND ATTORNEY'S iEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirm that I am licensed under provislons oi Chepter 9(commencing wlth Section 7000) oi Division 3 oi the eusiness end Professions Code, and my license is In full
force and eHed. lic. p Class a
Contractofs Signatura: Date:
CONSTRUCTON LENUING AGENCV:
❑ I hereby aKrtn that there is e constniction lentling agency tor the peAortnence ot the work tor which this permit is issued. (Sec. 3097, Civil Cotle).
LendeYs Name: Lendefs Address:
SignaNre: Date:
OWNER-BUILDER DECLARA710NS:
n <,
I here6y aHirtn t�at unCer penalry of perjury that I em E%EMPT FROM THE CONTBACTORS LICENSE LAW tor the tollowing reawn (Sec. 7031.5, Business and Professions
Catle: Any ciry or counry which reqwres e pertnit to consiruct, elter, improve, demalish, or repeir eny strucWre, pnor ta its Issuance, elso requlres Ihe epplicant far such permit
to file e signed statemenYthHt he or-she is licensed pursuent to tha provisions of ihe Comreaors LJcense Lew (Chepcer 9(commencing with Sectlon 7000) ot Divislon 3 oi the
Busineu antl Professions Cude) or ihet he or she Is exempt theretrom antl the basis for t�e elleged e:emption. Any Woletlon of Section 7031.5 �y eny epP�lcent for a permit
subJects the appliwnt to a ciNl penalry of not more than live hunAretl Oollars (5500).):
�
❑ I, es owner ot ihe Droperry, or my employees wlth weges as their sole compensatlon, WILL DO THE WORK, entl the siructure Is not intentled or oHeretl tor sale (Sec.
7044, Business antl Professions Cotla:'Tha Contrectors License Law does not epply to en owner af property who bullds or improves Ihereon, antl who does such work
himself or hereelf or Ihrough his or her own employees, pravitled Ihat such Improvemenis ere not intended or otterad tor sale. It, however, t�e builtling or improvement is
�soltl within one year ot complelion, ihe owner-builtler will heve the burden oi proving thet he or she tliA not builtl or Improve tor purpase ot sale.).
I, as owner of t�e property. am EXCIUSIVELY CONTRACTING WITH LICENSED COMRACTORS to construct the project (Sec. 7044, Business entl Professlans
Cotle: The contreciors License Lew does not epply to en owner of property who builtls or Improves thareon, antl who conirec�s for such project with a contractor(s)
liceryte-bu(suant to Ihe Conirectors License Laws.).
❑�
Owner IBven
Venfication ot
Busineu end Prof8551on5 Cotle tor Ihis
Yes ❑ No
by (type of tlocument, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Dnvefs Licanse
Dete:
Explres:
❑ I hereby certity Ihet no excavatlon five (5) or more feet In depth iNo whlch a person Is requlred to descen4 will be made In connecUon with work authodzed by this
permit, entl ihat no building structure, sceHolding, felsework, or tlemolitlon or dismantlinq thereoi, wlll be more t�en thirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Title 8, Celitomia AdminlstratNe Code).
❑ As owner-builtler, I will not employ anyone to tlo work whlch would require a permli irom the Divisian ot Industrlel Sefery, es noted ebove, unless such person has a
pertnit ta do such work from the division.
Signature: Date:
Division oi Industrial SefeN Pertnit Number:
ICEHTiFlCATE OF COMPLIANCE AND AUTHORQA710N OF EMRV: I certity under penalry of per�ury ihai 1 heva reed this epplication entl state that the intortnation given is I
correct� , grae wmply with all state laws and ciry ordinences relating to bulltling constmction, end euthorize representatives ot the Ciry of Costa Mesa to enter upon the
aboveboCScnbed D� or ipn.purpases. I agree not to acupy or allow occupancy of eny building authodzetl by t�is pertpit un(I tinel inspection.
COUE I. INSGECTIONTYPE
1616 Fixetl System Final Fire Preven[ion
1266 Pool Spa Final
200 Final Fie-Root
201 Final BIocWRetaining Well
202 Final Factory Fire Place
203 Final Sign
204 Final Damolition
26G6dfi
[I� f�$ S,QQE� INSPECl10NTYPE
206 Finel Mechanical
208 Final Plumbing
210 Final Elecirlcal
212 Finel Fire Prevention
220 Finel Plenning Approval
222 Finel Site
250 Final BuilCing/Occupancy
Q�¢ INniIALS
(714) 754-5273 • Fex (714) 754-4856
Job Address: 230 24TH PL
SWte No
Vlcinity:
ParcelNumber: ��9�0���
Appl�cant: REUTER, MARK L
Address: 23024TH PL
COSTA MESA, CA
Owner: REUTER, MARK L
Address: 230 24TH PL
COSTA MESA, CA
Contractor:
Address:
ArchlEng:
Address:
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
MECHANICAL PERMIT
Phone: 949-645-5824
Zip: 92627
Phone:
Zip: 92627
Phone:
Zip:
License:
Phone:
Zip:
License:
SCOPE OF PERMIT
LEGALIZE PORTABLE SPA. REF 899-00550. I MISCELLANEOUS ITEM.
ISSUE FEE
Inst FAU <100 k BTU
Insl FAU >700 k BTU
Repair/Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >700 k BTU
Gas Piping
Faaory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Dud
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < t0000cfm
Air Handlers > 70000cfm
Floor Furnace
Floor or Suspend Heater
$22.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
50.00
$0.00
50.00
$0.00
$0.00
$9.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
FEE SUMMARY
PERMIT NUMBER
M99-00189
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 04/20/1999
Issued: 04/20I1999
ISSUED BY: C�
Repair I Alt Absorbtion Unit
Repair I Alt Refrigeretion Unit
Ventillation System
Evaporetive Cooler
Commercial I ncinerator
Domestic Incineretor
Compressors / Absorption Svstems
Up to 3 hp I 100 k BTU
3To15hp/SOOkBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
3To15hp
15 to 30 hp
30 l0 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
Quantity
50.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
50.00
$0.00
E31.50
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Celifornie statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 deys.
INSPECTIONS: In order for the work authorized undar this permit to be considered legal, such work must comply with ell applicable codes, and all
required Inspectiona entl flnal epproval must be obtained. Feilure to obtain inspections and tinel approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnbNDECLARATON: - � .
1 hereby ettirm under penalry of peQury one of the tollowing tleclarations: '
❑ I heve antl wlll maintaih e certilicate ot consent to self-Insure for workers' compensetion, es providetl for by section 3700 of ihe Lebor Cade, for ihe peAortnence of the
wark for which Ihis peRnit is Issued.
❑ I hava antl will maintan workers' compensation insurance, as required by seclion 3700 of Ne Labor Cotle, tor Me pertormance of ihe woilc for which this permit is issued.
My workers' compensatlon Insurence certier and poliq number are:
Carrier: Policy Number:
(This section need not be completed I! fhe permit is velued et one huntlred tloPers ($100) or Iess.J
❑ I certify Ihet in the peNormence of ihe work for which this permit is issuetl, I shell not employ eny pereon in any menner so es to Decoma subject to the workers'
compensetiort laws ot Califomia, and agree that I! I should become subject to the workers' wmpensation provisions of Section 3700 of the Labor Code, 1 shell forthwith
comply with thesa provisions.
Applicant Signeture: Date:
WARNINO: PAILURE TO SECUR� WORKERS' COMPENSATION COVERAdc IS UNLAW FUL AND SHALL SUBJEGT AN EMPLOYER TO C(iIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED
THOUSAND OOLURE (E100.000), IN ADDITION TO THE COST OF CAMPENSATION, DAM4GE5 AS PROVIDED FOR IN SECTION 3]W OF THE IABOR CODE, IMERESi, AND ATTORNEY'S PEES.
LICENSED CONTRAC70R$ DECLARATION:
I hereby affirtn ihat I am licensetl under provislons of Chapter 9(commencing with Section 7000) of Divislon 3 of ihe Business end Protessions Cotle, antl my license is in full
force entl ettect Lia M Class N
Coniractors Signature: Date:
CONSTRUCTION LENDINq qGENCV:
❑ I hereby ettirtn thet Ihe�e is a construction lendinq aqency for tha pertortnance ot the work for which this permit is issued. (Sec. 3097, Civil Cale).
Lenders Nama: Lendels Address:
Signatura: Date:
OWNER•BUILDER DECLAqAT10NS:
I here6y aHirm Ihat under penalry of perjury ihet I am EXEMPT FROM TliE CONTRACTORS LICENSE LAW for ihe following reeson (Sec. 7031.5, Business and Protessions
Code: Any city or counry which requires a pertnit to consWct alter, improve, demolish, or repair any strucNre, pnor to Its issuance, also requires Ihe flpplicant tor such permit
to file e signad statemem ihat he or s�e is licensed pursuent ro Ihe provisions of Ihe Gontrectors Llcense Lew (Chapter 9(commencing with Section 7000) of Divislon 3 of the
Business and Professions C�e) or that he or she is exempt iheretrom and Ihe basis for Ihe elleged ezemptlon. Any vlolatlon oi Sectlon 7031.5 by eny epplicent tor e permit
subjects the applicant tB e ciyll penalry of not more Ihan fve hundretl tlollars (E500).):
�n
❑ I, es ownarPi ihe property, or my employees with waBes es their sole compensatlon, WILL DO THE WORK, end the structure is not Intentletl or oHeretl For sale (Sec.
7044, eusiness end Professions Cotle: The Contractors License Lew does not apply to an owner of property who builtls or improves thereon, end who tloes such work
himself or hersetl o;through his or her own employees, provitled that such improvements are not intendetl or oHeretl tor sale. If, however, Me 6uiltling or Improvement is
sold within one year of compleflon; the owner-b r will heve ihe burtlen of provirtg that he or she ditl not buiM or improve for puryose ot sala.).
�I, as ow�ner of ihe� E%C � IV V' ON ACTING WITH LICENSED CONTRACTORS to construcl Ihe Projecl (50C. 7044. BuSinesS and Professions
Cotle: The contr rs ' n La d s ot pply n owner of properry who builtls or improves Ihereon, end who comrects for such project with a comractor(s)
license ursu h on ctor L' en s..
rl �rrexe u r ec. /% Business end Professions Code for Ihis reason: �1 .// /
�er ID venil4d by
Venficetion of Ownei
DIVISION OF
properly taz blil
SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that nq excavation five (5) or more feet in depth inlo which a person is required to descend, wlll be matle in connection with work authorizetl hy this
permit, and Ihat no building slrucWre, scaflolding, falsework, or demolition or tlismentling Ihereot, will be more then thirry-six (36) feet hlgh. (C�ep. 32, Grp 2, Art 2, Sec.
341, Titla 8, Celifomia Administrative Code).
❑ As ownerbuilder, I will not employ anyone m tlo work which would require a permit from the Division of IndusMal Safety, es noted above, unless such person has a
permit to tlo such work from the division.
Signature: Date:
Division of Industnal Satery Permit Number:
COOE �, INSPECTIONTVPE
1616 Fi:ed System Final Fire Prevention
1266
200
201
202
203
204
2446 a6
Pool Spa Final
Final Re-Roof
Final BIocWRetaining Well
Finel Factory Fire Place
Final Sign
Final Demolition
�g �NTRIpLS
CODEN INSPECTIONTYPE
206 Final Mechanical
20B Final Plumbing
210 Final Electricel
212 Final Fire Preventlon
220 Final Plenning Approvel
222 Final Site
250 Final Building/Occupancy
PAIE INTRIALS
�� �1�:1•/y.
. q-���..� �
i •.:.�::: I
�. .
(714) 754-5273 • Fax (714) 754A856
�ob Address: 230 24TH PL
Sulte No
Vlcinity:
Parcel Number: 1�910111
npp�icant: REUTER, MARK L
Address: 230 24TH PL
COSTA MESA, CA
Owner: REUTER, MARK L
Address: 230 24TH PL
COSTA MESA, CA
Contractor:
Address:
ArchlEng:
Address:
Au . .a
CITY OF COSTA MESA
BI/ILDING p1VIS10N
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
MECHANICAL PERMIT
�Phone: 645-5824
Zip: 92627
Phone:
Zip: 92627
Phone:
Zip:
License: ��
Phone:
Zip:
License:
SCOPE OF PERMIT
ALTER DUCT SYSTEM REF 698-01837
ISSUE FEE
Inst FAU <700 k BTU
Inst FAU >100 k BTU
RepairlAlt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >700 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfrn
Air Handlers > 10000cfm
Floor Furnace
Floor or Suspend Heater
$22.00
$0.00
$0.00
$1225
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
so.ao
Quantity
FEESUMMARY'
PERMIT NUMBER
M99-00212
77 FAIR ORIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 05/03/1999
Issued: 05/03/1999
ISSUED BY: ��
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeration Unit
Ventillation System
Evaporative Cooler
. Commerciallncinerator
Domestic Incinerator
Compresso�s / Absorption SYstems
� Up to 3 hp�/ 700 k BTU
� 3 To 15 hp / 500 k BTU -
15 To 30 hp / 1,000 k BTU "
�30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
' � � Boilers
Upto3hp
3To15hp
15to30hp
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investi9ation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
Quantlty
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00
$0.00
$0.00
534.25
NOTICE: The work authorized by this permit shall comply with all applicable handicap eccess requirements under Califomia statutes and related I
regulations. (Ord. No. 92-28, § 7, 1241-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned
for a period of 180 deys.
INSPECTIONS: In order for the work authonzed under this parmit to be considered legal, such work must compiy with all applicable codes, and all I,
requlred Inepectlone end final approvel must be ob�ained. Failure to obtain inspections and final approval will result in the axpiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
• - �
WORKERS'COMPENSAnONDECLARAnON:
I hareby eHirtn under penelty ot per�ury one of Ihe lollowing deGeretlons: '
❑ I have erid will mainteln a certlticate of consent to setl-Insure for workers' compensation, es proNdetl far by sectlon 3700 of the Labor CoOe, for the pertormance ot the
work for which this pertnit is issued.
❑ I have flntl wN melntaln wakers' compensatlon insurance. as requiretl by seclim 3700 of ihe Labor Coda. fa tha peAortnance oi the work for which MLs pertnit is issued.
My workers' campensetlon Insurance certier entl policy number are:
Carner. Policy Number.
(This section need nat be camp/eted U(he permitls veluetl ef one hundred dollars ($700) or Iess.J
❑ I certify that in the pertormance of the work for which Ihis Dermit is issued, I shell not employ eny person in any manner so es to become sub�ect to the workers'
wmpensetlon laws ot Celltomia, enA egree thet if I should become subject to the workers' campensetian provisions oi Sectlon 3700 of the Lebor COCe, I shall fonhwith
comply wlth these provislons.
Applicant Signelure: Dete:
WARNIN(3: FAILURE TO SECURE WORNERS' COMPENSATION COVEMGE IS UNUWFUL AND SW1LL SUBJEGT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FlNES UP TOIXJE HUNDRED
THOUSAND DOLLAFE (5100,000), IN ADDITIIXJ TO THE COST OF CAMPENSATIqJ, DAh1AGE$ AS PROVIDED FOP IN SECTION 3]O60F THE LABOR CODE, IPfrEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I herehy ettirtn that I am Iicensetl under provisions ot Chapter 9(commencing with Sectlon 7000) of Division 3 of ihe Buslness antl Prolessions Coda, antl my license is in full
force antl eflect. Lic. M Cless N
Contraclols Signature: Date:
CONSTRUCTON LENDING AGENCY:
❑ I hereby eRirtn t�at Ihere Is a consVuc�lon lending agency tor the peAormance of the work for which Ihis pertnit is Issuad. (Sea 3097, Gidl Code).
Lenders Name: Lenders Address:
Signatura: Date:
OWNER•BUILDER DECLAHATIONS:
I hereby aNirm that under penelry oi perfury that I em EXEMPT FROM 7HE CON7RACTORS LICENSE LAW tor the following reeson (Sec. 7031.5, Busineu antl Professions
Cotle: My ciry or counry whic� requires a pertnit to consWct, alter, improve, demolish, or repair any strudure, O�or to its Issuence, also requires the epplicant for such pertnit
to file e signetl stetement �het �e or she is Ilcensed pursuent ro the provisions oi the Contreclors Llcense Lew (Chapter B(wmmenGng with Sedian 7000) oi Division 3 of Ihe
Business end Professlons Codej or ihat he or she Is exempt theretrom and ihe basis for the elleged exemption. My Wdation oi Sectlon 7037.5 by eny epplicant tor a permit
sub�ects �he appllwnt ro e�Gv\II penelry o1 not more then five hundred dollars ($500)J:
❑ I, es owner of the O�aPerry, or my employees with weges as thair sole compensation, WILL DO THE WORK, end Ihe strudure is not Intentletl or ottered 1or sale (Sec.
7044, Business end Proleulons Cotle: The Contractors License Lew tloes not apply ta en owner of pmperry who builtls ar improves thereon, end who does such work
�Imselt ar hersetl or ihrough his or her own employees, pravided thet such impravements ere not intended or oXered for sele. If, hawever, tha builtling or Improvement is
sold within one year ol completion; the ownervbuilder will have the burtlen of proving that he or she did not build or Improve for purpa5e of sale.).
❑ I, es owner at Ihe properry, em E7(CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Buslneu and Professions
Code: The crontrectors License Law does.not appty to en owner oi property who builds or imprwes t�ereon, end w�o contracis for such project with a coniractor(s)
license pureuanl lo ihe Contreclors License Lews.).
❑ I em exempt under sec. Business antl Professions Code for this reason:
Signa�ura: Da�6:
Owner ID verHied by driver911cense. ❑ Ves ❑ No Orivels License No. Expires:
Verificetion of Ownership by (type of daument, i.e. - properry tax bill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certlty thet no excevatlon flve (5) or more teet in de0�h Into which a person is requlred to descend, wlll be mede in connectlon with work authonzetl by this
permil, end thet no bullding structure, scaflol0ing, talsework, or tlemolition or tlismentling �hereof, wlll 6e mora then thirry-six (36) feet �Ig�. (Chep. 3.2, Grp 2, Art 2, Sec.
347, Title e, Cellfomia Administretive Code).
❑ As owner-builtler, I will not employ anyone to tlo work which woultl require a pertnit from the DiNslon ot InAustrlel Sefery, es notetl ebove, unless such person has a
permit to do such wark from Ihe tlivision.
Signature: Date:
Division ot Industnel SefBry Pertnit Number:
CERTFICATE OF COMPLIANCE IWD AUTHORVATION OF ENTRY: I certity under penelty of perjury that I have read Ihis epplicatlon antl stete �het the infortnation given is
correct. I agree to comply with all state laws and ciry ortlinances relating to 6uilding conslrucilon, end euthorize representetives of �he City ot Coste Mesa to enter upon Ihe
ebovadescdbetl praperry for Inspection purposes. I egree not to occupy or ellow occupanq ol eny Cullding euthodzed by Uis permit untll tinal inspeaion.
Signeture Of Legal Owner(s)
_ AnNOr Authonzed Applicanl
CODE 1. INSPELTIONTVVE
1616 Fizetl System Final Fire Prevention
1266
200
207
202
203
Pool Spa Finel
Final RaRoot
Final BIxWRetalning Well
Finel Feclory Flre Place
Flnel Sign
jll�g INTRLILS �QpE� INSPECTIONTYVE
206 Finel Mechenical
20B Finel Plumbing
270 Finfll Electrical
212 Finel Fire Pravention
220 Final Plenning Aoprovel
222 Finel Slta
250 Finel Building/Occupancy
Q�jf, INTITIALS
�u1!-,
. q�'�..�
i �.:.�::� ; :
' �. ,
(714) 754-5273 • Fax (714) 754-4856
Date: OS/03/1999
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Transaction Receipt
ACTIVITY NUMBER: M99-00212 TYPE:
SITE ADDRESS: 230 24TH PL
Unit I Suite
APPLICANT: REUTER, MARK L
230 24TH PL
COSTA MESA, CA
92627
645-5824
OWNER: REUTER, MARK L
CONTR:
STATE LICENSE
CITY LICENSE
TOTAL FEES: $34.25
TRANSACT. AMOUNT: $34.25
BALANCE:(PERMITFEES) $0.00 � � ' �
- :
PAYMENT METHOD: Check 693
NOTATI ON: _
TRANSACTION RECEIPT DETAIL INFORMATION FOR TREASURY:
2015 Mechanical Fee 0270 $3425
B000006657
PERMIT NUMBER
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
CAC
c
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremants under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or it work is suspended or abandoned
for a period of 180 deys.
INSPECTIONS: In order for the work euthorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapeetlone and finel epproval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
'
. �
WORKERS'COMPENSAnON DECLARATON:
I here6y ettirm under penelry oi perlury one of t�e following tleclaretions:
❑ I have entl will meintein e cenificete oi cronsent to setl-Insure for workers' compensatlan, es provitle0 tor by sectian 3700 oi the LaDor Code, tor the pertortnence of the
work for which lhis pertnit Is issued.
❑ I �eve entl wlll maintain workers' compensetion insurance, es requlred by section 3700 oi Ihe Lebor CoOe, for I�e perfortnence of ihe work for which thls permit Is issued.
My workers' crompensetlon Insurence carrler end policy number ere:
Cerrier: Policy Number:
(Thls section need nat be complefed /l the perm/t!s velued et one hundred dollers ($100J ar less.)
❑ I certify that In lhe pertormance oi Ihe work for which ihis permll is issuetl, I shell not employ eny person In eny menner so es to become su6�ect to the workers'
compenseilon laws of Celifomia, end egree thai if I shauld become subJed to Ihe workers' compensation proWsions of Section 3700 of the Lebor Code, I shall forthwith
comply with these provisians.
Applicant Slgneture: Date:
WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJEC( AN EMPLOVEP TO CRIMINAL PENALTES AND GVIL FlNES UP TO ONE HUNDRED
TIIOUSAND OOIIARE (§100,000), IN AD�RION TO THE COST OF COMPENSATION, OAMACaES AS PRONDED FOR IN SECfIIXJ 3]Ofi OF TME LABOR CODE, INfERE5T, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirtn thet I am Ilcense0 under pmvisions of Chapter 9(wmmencing wlth Sectlon 7000) of Divislon 3 ot Iha eusiness and Professlons Code, and my Ilcense Is In tull
torce end ettect. LJc. # Cless p
Contrattor'SSigneWre: Dete: �
CONSTRUCTON LENDING AGENCV:
❑ I hereby ettirtn ihet there is a consVuctlon IenAinq egency tor the peAormance at Ihe work for which Ihis permit is issued. (Sec. 3097, Clvil Code).
Lendefs Name: Lenders Address:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby attirm thet under penalry of per�ury Ihet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions
Code: Any ciry or counry which requires e pertnit to consiruct, alter, improve, Aemollsh, or repair any structure, prior to its Issuence, elso requires Ihe applicam tor such pertnit
to flle e signed stetement thet he or she Is licensed pursuant to ihe proNsions ot Ihe Contrectors License Lew (C�aD�er 9(commencing wl�h Seclion 7000) of �ivision 3 of Ihe
Business antl Professions Code) or thet he or she Is exempt t�eretrom enC t�e basis for the alleged exemption. My violatlon ot Sectlon 7031.5 by eny applicent for e pertnit
sub�ecls ihe eppllcant to e Gvll penelry of not more ihan five huntlretl Oollars ($500).):
❑ I, as owner o1 the properry, or my employees with wages as their sole compensation, WILL DO THE WORK, entl the struclure is not Intentled or oHered for sale (Sec.
7044 Business entl ProFessions Cotle: The Camractore license Lew does not apply to en owner of property who builds or improves t�ereon, entl who tloes such work
elf or hersetl or thmugh his or her own employees, proNded t�et such impmvemenis ere not Intended or oMered br sale. It, however, Ihe bullding or improvement is
sold within ane year oi completion, the owner-builder will have ihe burden of proving thet he or she Oitl not build or improve far purpose of sele.).
I, es owner of Ihe properry, em EXCLUSIV C�ACTNG WITH LICENSED CONTRACTORS to construct the proJect (Sec. 7044, Business antl Protessions
ode: The contractors LlcQpse LsiA,�loe apply en owner of property who 6uiltls or Improves ihereon, and who contrects for such project wilh a contrector(s)
license oursuant �u theji6tfrecto/sXic s wsJ
Vediicatlon
license ❑ Wo
(rype of doc nt, i.e. - property lex blll or
entl Profe55ion5 Code fOr thl5 reeson:
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIPICATION:
❑ I hereby certify Ihet no excevetion five (5) or more feet In de0�h Into which e person Is requlretl to tlescend, will be mede In connectlon wlth work authanzetl by �his
permit, end t�at no builtling structure, sceflolding, talsework, or tlemolitlon or dismentling Ihereot, wlll be more then thirty-six (38) feet hlph. (C�ep. 32, Grp 2, An 2, Sec.
341, Title B, Celifornia Administretive Code).
❑ As owner-bulltler, I will not employ anyana to do work which woultl require e permit from the Divislon of Inaustrial Sefety, es noted ebove, unless such person hes a
pertnit to do such work from the tlivision.
Signature:
Division of Industrial Safery Pertnit Number:
5
Da�6:
WIII Ihe applican� or present or future bullding occupant nead lo file and cenify a Business Plan for emergency response to release or Ihreatenetl release of a hazardous
matenel? ❑ Yes ❑ No
(Section 25505 ot Ihe Celifprnla Health end Safery Code requlres, wlt� some exceptions, that a Business Plan be filetl wl�h Ihe Coste Mesa Fire Department by every
business which has et eny one time during e reported year a quantiry ot hezardous meterials equal to or greater ihan e weight ot 500 pountls, or e volume of 55 gellons,
or 200 cubic leet of compressed gas at standard temperature entl pressure).
Does or will the apD�icant or present or future building occupaN naed m tila a registration fortn for acutely hazardous matenals? ❑ Ves ❑ No
(Section 25533 of ihe Celitomia Heelth end Safery Cotle, wi�h some ezceptions, requires registretion with the Costa Mesa Fire Deperiment by eech business which at eny
one time has on hentl e quantiry oi ecutery hazardous meterials equel to or greater then a welght of 500 pounds, or e volume ot 55 gallons, or 200 cubic feet of
cnmpressed ges at stenAartl tempereWre end pressure).
Daes or will the applicant or present or future building occupent neetl to prepare an RMPP (Risk Menegemem end Preventlon Progrem for ecutely hazardous matedels)7
an
25534 of the Celifomie Healih
ent ot en RMPP by businesses
or
ihat the
25534 of the Celitomle Healt� antl
Flre Depariment may reduire ihe
meteAals wlth the Fire Departme
�ode been tunv wmofied w�m?
certitication antl tiling wit� t�e Fire
Ves ❑ No
or
>m ihe Sou�h Coast Alr Ouallry Menagement District or tmm eny other alr polWtion control tllattict ar egencyt �J Ves �J No
'�action BSB502 oi Ihe Calltornle Government Code requlres that ihe requested informetlon be furniahad on epplicelions br nomresidentlal bulltling permits).
'ill any pan of Ihe faciliry to be consWcted under t�is pertnit be within 1000 teet from Ihe outer bountletles oi a school7 ❑ Ves � No
yes', the faciliry must meet ihe requlrement of Sections 25534 antl 42303 of t�e Celitomia Health end Safely Cotle).
a pertnit from the South Coast Air Oualiry Management Distdct or other eir polWtion conlrW district or egenq Is require0 tor I�e work which is Ihe si
�olication, heve ell of the disGwures D�escribetl by Califomia Heelih end Safery Cotle Section 42303 been mede7 ❑ Ves ❑ No
CERTIFICATE OF COMPLIANCE: 1 certiy t�at under penalry ot per�ury tha infortnation gNen ebove is correct. I egrae to compty with ell state laws antl ciry ortlinances
regartling Hazardous Materials antl Emissions.
SigneWre: ' _ Date:
CERTFICATE OF
carrecL 1 agree i?
cooe �.
tfi16
1268
200
207
202
203
• 204
Fixed System Final Fire Prevention
Pool Spe Finel
Final Re-Rool
Finel BIocWRetalning Well
Finel Feclory Fire Placa
Finel Sign
Finel Demalition
2� Bd8 �
under penalty of per�ury ihat I heve read this applicatlon entl state thet Ihe information given is
uilding constructlon, en0 euthodze representaNves ol th CIIy� Costa Mesa to enter upon iha
w-escupancy ol eny bullding authonzad by t�is t tll fin (§p tion.
Date
Date
COOE I INSPELTION TYPE
208 Finel Mechenical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevenlion
220 Finel Planning ApProval
222 Finel SIIe
250 Final Building/Oaupancy
P�E It�ll4S
Pp &
j� .
i:1.`��.
. y��
i :�.a::: ; ;
�;
pia� �sa-s2�s • Fex (»a) �sa-aess
Job Address: 230 24TH PL
Suite No
Vicinity:
Parcel Number: 1 � 9101 �'I
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Applicant: STEPHANI REUTER
Address:
Owner: REUTER, MARK L
Address: 230 24TH PL
COSTA MESA, CA
Contractor:
Address:
ArchlEng:
Address:
MECHANICAL PERMIT
Phone: 949-645-5533
Zip:
PERMIT NUMBER
M99-00213
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 05/04/1999
Issued: OSI04/1999
ISSUED BY: � C 1 �
Phone: ^
Zip: 92627 � oA
����0
��c�0
Phone: �
Zip: 0�.�
License:
Phone:
Zip:
License:
SCOPE OF PERMIT
CONSTRUCT WALL IN GARAGE TO CREATE POWDER RPOOM. BATHROOM FAN, RE:899-00605.
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >700 k BTU
Repair/Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refng Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Boz
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Insl or Relocate Appl Vent
Air Handlers < 10000cfin
Air Handlers � t0000cfm
Floor Furnace
Floor or Suspend Heater
$22.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
$0.00
$6.50
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
so.00
Quanlity
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeration Unit
Ventillation System
Evaporative Cooler
Commercia l I ncine rator
Domestic Incinerator
Compressors / Absomtion SVstems
Upto3hplt00kBTU
3To15hp/500kBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
3Tot5hp
i5to30hp
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
50.00 0
50.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
528.50
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or ebandoned
for a period of 180 days.
INSPECTIONS: In order for ihe work authorized untler this permit to be considered legal, such work must comply with all epplicable codes, and all
required Inapectiona and flnel approvel must be obteined. Failure to obtain inspections and final approval will result in the ezpiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626 �
WORKERS' COMPENSATION DECLAqp7�ON:
I herehy attirtn untler penalry oi perjury one ot Ihe following decleretians:
❑ I �eve entl wlll melntain e cetlificate of consent �o setl-Insure for workers' compensation, es provlAetl for by sectlon 3700 of the Lebor Code, for the peAormance of the
work for which thi9 permit Is issuetl.
❑ I liave end wlll malntein wwkers' compensation Insurence, as requiretl Dy section 3700 01 the Labor Cotle, tor Ne pertormance of Ihe work lor which Ihis pertnit is issued.
My workers' compensation Insurance carrier and poliry number are:
Carder: � Policy Number.
(lhls section need nat �e campleted i! fhe perm/t fs ve/ued ef one hundred ddlars (5100) or /ess.)
❑ I certily that in the pertortnence oi the work lor which this pertnll is issued, I shall not employ eny person in any manner so es to becoma sub�ect to the workers'
compensetlon laws ot Calitomia, Sntl egrae Ihet it I shoultl hecome subject to Ihe workers' compensetion provisions of Section 3700 0l Ihe Lebor Cotle, I shall forthwith
comply wlih thesa provisians. _
Applicent Signeture: Date:
WARNING FAILURE TO SECURE WORKERS' (;pMPENSATION COVERAGE IS UNIAWFUT AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSMIO DOI.LriAE (SI00.000j, IN ADORION TO THE WSiOF OOM1iPENSATIQV, OAMAGES AS PfiOVI0E0 FOF IN $ECTIIXJ J�(IB OF THE LABOR WOE, INTEFEST, AND ATfORNEV'S FEES.
LICENSED CONTRACTORS DECLARqTION:
I hereby affirm thel I am Iicensetl under provlsions of Chapter 9(commencinq with Section 7000) oi Divislon 3 oi ihe Businass antl Professlona Code, antl my license is in full
IOrtB antl efleci. LiC. N Class N
Contrectofs Slgnature: Date:
CONSTRUCTION LENDING AGENCY:
�❑ I hereby eHirtn that Ihere is a consWctlon lendlnq agancy lar tha pertortnance oi the work lor which Ihis permit is issuetl. (Sec. 3097, Civil Code).
i Lendefs Name: Lentlers Atltlress:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eHirm ihat untler penalty of perjury Ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, 8usiness and Professions
Code: Any city or county which requires a permi� to constmct, elte4 improve, demolish, or repair any simcNre, prior to its issuance, also requires the appllcaM tor such permit
to file e signetl statemenf thai he or she fs Iicensed pureuem to ihe provfstons of ihe Comreclors Lfcensa Lew (Chepfer 9(commencfng with Sectlon 7000) of Didsion 3 ot ihe
Business end Protessions Code)pr that he or sha Is exempt t�eretrom end the basls tor the alleged exemption. Any violatlon ot Sectlon 7031.5 by any epplicem for a permlt
sub�ecis ihe apP�icant to e civll penalN,a� �ot more then live hundred dollers ($500).):
� i_c�i,
❑ I, as owner oi ihe proPerry, or.my employees wlth wages as iheir sole compensation, WILL DO THE WORK, and ihe siructure Is not Intentlad or otlered for sale (Sec.
7044, Busineu end Professions C6tle: The Contrectors License Lew does not apply to an owner al proparty who builds or improves t�ereon, end who tloes such wark
himsell or hersell or Ihmugti his or her own employees, provided ihet such impmvemenis ere not in�ended or ottered for sale. It, however, the builtling or impmvement is
�soltl within one year oi completion, ihe owneo-builder will heve the burtlen ot proving thet he or she ditl no� 6uiltl or improve for purpose oi sele.).
I, as owner of ihe properry, am QXCLUSIVELV CONTRACTING WI7H IICENSED CONTRAGTORS to construct ihe pro�ect (Sec. 7044, Business antl Professlons
Coda: 7Te� ntrectors License Law does not eppry m en owner of property who bullds or Improves thereon, and who conirflcts for such project with a contrectoqs)
license n'�cuent lo the Coniractorg License Lews.1.
Business and Pmfeuions Cotle for t�is reason:
OwneiiBBverHied�6y riv�1'Slicense. �Yes ❑ No nvars License
Vetlfication of OvSnership by (type of doCument, i.e. - property tex bill or deed):
DIVISION OF INDUSTRIAL SAFETV PEpM1T CERTIFICATION:
❑ I hereby certity that no excevetian live (5) or more feet In depth in�o whic� e persan Is requlred to descend, will be mede in connectlon with work authorizatl by this
percniC antl that no building structure, scetfolding, felsewark, or demolition or tllsmantling thereot, w711 be more than thtrty-siz (38) teet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Ttle 8, CalHomia AdmlNs�retive Coda).
❑ As owner-builder, I will not employ anyone to tlo work which would require a pertnit from the Divlslon of Industrlal Safary, as notetl e6ove, unless such person has a
pefmit to tlo such work from the division.
Signeture: Date:
DiWsion af Industrial Safery Pertnit Number.
CERTI ATE-(jF�COMPIUWCE AND qUTHORVA710N OF ENTHY: I cerlify under penalry of perjury that I heve read this application end stela Iha� the intormation given is
correct�egree to LQmply with all state laws and ciry ordinences relating to builtling conswction, end euthotlze represen�atives of th Ciry of Casta Mesa to enter upon the
ebove-b S atl ro Q(or i Bcti n p oses. I e8ree not to oaupy or ellow occupancy ol eny building authorizetl by thls De� u�t�ir�l Inspection.
�-- ' IQr1
Si Seture OI L gal Owner(s)_ ��
CODE �. INSiELTIONTYPE
1616 Fixad System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Root
201 FInaI8locWReteining Wall
202 Finel Fedory Fire Place
203 FinelSign
204 Finel Demolition
2466<6
Q�g
�NiRIALS
COOE I INSPECTIONTYVE
206 Final Mechenical
20B Final Plumbing
210 Final Electrical
212 Flnal Fire Prevention
220 Final Plenning Approval
222 Final Site
250 Final BuildinglOccupency
Pd1E INTRIALS
(774) 754-5273 • Fax (714) 754-4856
Job Address: 230 24TH PL
Suite No
Vicinity:
Parcel Nunmber: 11910111
Applicant: REUTER, MARK L
Address: 230 24TH PL
COSTA MESA,CA
owner: REUTER, MARK L
Address 230 24TH PL
COSTA MESA, CA
Contractor.
Address:
ArchlEng:
Address:
CITY OF COSTA MESA �
BUILpING DIYISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
LEGALIZE PORTABLE SPA.
ISSUE FEE
Backflow irrigation
Backflow Preventer
Bathtub
Clarifier System
Connect (Ice,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwaler
Drain, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (14 outlets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptors (Grease, Oil)
Interceptors (Sand Auto )
AMT
$22.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
QTY
PLUMBING PERMIT
Phone: 949-645-5824
Zip: 92627
Phone:
Zip: 92627
Phone:
Zip:
License:
Phone:
Zip:
License:
SCOPE OF PERMIT
FEE SUMMARY
AMT
Laundry Tub / Washer $0.00
Landscape Irrigation $0.00
P-Trap $0.00
Pressure Regulator $0.00
Process Piping (per 10 fl) $0.00
Receptors - $0.00
Septic Tank $0.00
Sewer Cap for Demo $0.00
SewerConnect $0.00
Sewer Private Line $0.00
Shower $0.00
Sink, bar $0.00
Sink, commercial $0.00
Sink, Floar $0.00
Sink, kitchen $0.00
Sink, service/mop $0.00
Spa (private) $27.00
Spa (public) $0.00
nrv
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
PERMIT NUMBER
P99-00236
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 04/20/1999
Issued: 04/20/1999
ISSUED BY: �/ V �-
Sump Pump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr Bkflow(1-0)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
Water Service
Water Softener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTALCALCULATEDFEES: $49.00
COMMENTS / SPECIAL CONDITIONS ` � � ' -
- _ r _ .. �� .t . � ,. .�,
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapections and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSATONDECLARATON: - -
I hereby aflirm untler penalry ot perjury one of tha tollowing tleclaretions: � -
❑ I have and will maintein a certlticete of consant to seN-Insure for workers' compensation, es provided for by section 3700 of the Labor Code, for the performence of the
work for which Ihis pertnit is issued.
❑ I have and will meintain workero' compensation insurance, es required by seclion 3700 of the Labor Code, for the peAormance of the work for which this pertnit is issuetl.
My workers' cnmpensation Insurence carrier end policy number are:
Carrier: � Policy Number:
(This section need nat be comp/eted il the perm/f Is velued ef one hundretl tlollars ($100) ar /essJ
❑ I certity that in the perlormence of the work for which this pertnit is issued, I shall not employ eny person in any manner so as to become subjed to the workers'
compensation laws of Califomla, end agree that If I should become subject ro Ihe workers' compensation provisions of Section 3700 of the LaDor Cotle, I shell forthwith
camply with Ihese provisions.
Applicam Signature: Dete:
WARNING: FNILURE TO SECURE WORKERS' WMPENSATION CqVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND QVIL FWES UP TO ONE HUNDRED
iHOUSAND DOLLARE (5100,000). IN ADDITION TO THE COST OF COMPENSATION, OAMHGES AS PROVIDED FOq IN SECTION 37060F THE LABOR CODE, INrEREST, AND ATTORNEV'S FEES.
LICENSED CON7RACTORS DECLARATION:
I hereby aHirm ihat I am licensed untler provislons of Chapter 9(commencing with Sectlon 7000) oi Division 3 of the Business and Professions Code, antl my license is In full
force and eNect. Lic. # Class q
Conirecmr's Signeture: Date:
CONSTRUC710N LENDING AGENCV:
❑ I hereby aflirm that there is a construction lending egency for ihe pertormance of ihe work for which this permit is issuetl. (Sec. 3097, Civil Coae).
Lender's Name: Lender's Address:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aflirtn Ihet untler penalty of perjury that I em EXEMPT FROM 7ME CON7RACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions
Code: Any city or counry which requires e permit to construct, alter, improve, demolish, or repair any sWCNre, prior to its issuanca, also requires the applicant tor such permit
to file a signed statement Ihet ha or she is Ilcensetl pursuem to Ihe provislons of the Contrecrore License Lew (Ghapter 9(commencing with Sec�ion 7000) of DlNsion 3 oi the
Business antl Professions Cotle) or Ihat he or she is exempt therefrom end the basis for the alleged exemption. Any Nolation of Section 7031.5 by any eDPlicant for a permit
sub�ects ihe epplicent to e ciNl penelry ot not mora then five huntlretl tlollers ($500).):
❑ I, as owner of the property, oi my employees with wages as their sola compensation, WILL DO THE WORK, antl ihe structure is not interWed or oHeretl for sele (Sec.
7044, Business antl Professions Code: The Conirectors License Lew tloes not apply to an owner of properry who builds or improves theraon, end who does such work
himself or hereelf oi,ihrough his or her own employees, provided thet such improvemems are not intentled or oHered for sale. tl, however, tha building or improvement is
sold within one year of completion, tha owner-b r will have the �urtlen of proving Ihat he or she tlitl not build or improve tor purpose oF sale.).
❑ I, as owner of the prope �em E SIV CO ACTING WITH LICENSED CONTRAC70R5 to construct the projeq (Sec. 7044, Business antl Professlons
Coda: The con ctois nse w s o pply en ow -of properry who builtls or improves thereon, and who cnniracts for such pmject with a contrector(s)
license pure to nira ors ' e e ws.).
❑ I am exe t d 5. Business antl Professions Cotle tor this reason: '
SignaWre:
� xpir :
Venfication of Owna hip by (type of d ment, i.e. - proparty lax blll or deed):
DIVISION OF INQUSTRIAL SAFETY PENMIT CERTIFICATION:
❑ I hereby certiry that no excevation Ilve (5) or more feet In tlepth into which a person is required to descend, will be made in connection wlth work authonzed by this
permit, antl that no building structura, scaHol0ing, talsework, or demolition or dismentling Ihereof, will be more ihan thirty-six (36) feat high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tlla 8, Califomia Atlministrative Code).
❑ As owner-builder, I will not employ anyona to do work which woultl require a pertnit trom Ihe Division of Industnal Safery, as notetl abova, unleu such person has a
permit to da such work from the divisian.
Signature:
Division of Intlustnel Sefety Permit Number:
2
5
Date:
W ill the epplicant or present or fuMe builtling xcupant need to file end certity e Business Plan tor emergency response to release or ihreatened release of a hezardous
matedal? ❑ Yes ❑ No
(Section 25505 of �ha Calitomia Healt� and Satety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire �epartment by every
business which has et eny one time during a reported yeer e quennry of hazerdous materials equal to or greater ihan a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic Feet ot compressed gas al stantlarA lemperetura and pressure).
"""""__""""'._...."'_""""""....__"""'...__.__""'__—_"""""_'_"""...""___.._..'_" '_"__
Does or will ihe epplicenl or present or future building occupent neetl to file a reqistration form tor acutely hazardous materials? ❑ Ves ❑ No
(Section 25533 of the CalHornle Heal�h and Setety Code, wlth some exceptlons, requires registretion with ihe Costa Mesa Fire Deperiment by each business which at any
one time hes on hantl a quantlty of ecutely �ezartlous meterials equal to or greater than a welgM oi 500 pounds, or a volume of 55 gallons, or 200 cu61c feet oi
compressetl gas et stenderd tempereture and pressure).
.......... . .. .......... _ ....... ... ... .................. ._ .... ....
Does or will the epplicant or presant or tuture building occupant need to prepare an RMPP (Risk Management antl Prevention Pmgram for ecutely hazartlous materials)7
(Sec�ion 25534 of �he Californla Haalth and Satery Code provides ihat ihe Caste Mesa Fire Depanment may require ihe preparation, cenification antl tiling with the Fire
Department of an RMPP by businesses which are raquired to register aately hazartlous matenais with the Fire Dapartment.
........ ...... . .... .. ............ .......... .............. ,_..,.
If an RMPP is presently required has Section 25534 of ihe Cehfomie Healt� and Safety Code been fully comphed with7 ❑ Ves ❑ No
...._--..__.._._._.—__.'..._.__....__._.........._..._............___._.__..
Does or wlll the applicant or present or future huilding occupent repulre for the work which is the sublect oi this a plication a germit tor such constmctlon oi motliticatlon
From lhe South Coas� Alr Oualiry Menegemen� Dls�tici or from eny other alr polWtion contwl tlistrict or agenc�? � Ves u No
(Section 658502 ot t0e Calilornie Government Code requires that the requested information be furnishad on epplications for non-residential building permits).
Will eny part o� ihe tecllity to be consimcted under �his permit ba within 1000 feet from ihe outer bountlaries of e school? ❑ Ves ❑ No
(It'yes", the faciliry must meet ihe requirement of Sections 25534 end 42303 ot ihe CaliFornia Health and Safery Code).
tl a permit from the Soulh Coast Air Ouality Manegament District or othar eir pollution contml disirid or agency is required for Ihe work which is the subjact ot Ihis
epplication, heve ell of the disclosures prescribetl by Californie Health antl Safery Code Section 42303 been made? ❑ Yes ❑ No_ __ __
pf yes", ettech certiticate ot compliance from the appropriate eir pollution control oHicer).
CERTIFICATE OF COMPLIANCE: I certity thet under penelty of perjury the informatlon given above is correct. I egree to comply with all state laws antl city ordinances
regartling Hezardous Matenals end Emissions.
Signature: � Date:
CERTFICA7E OF COM CE Dp IZA �N OF ENTRY: I certity under penalry oF perjury that I have read this application antl state �hat t�e information given is
cortecL 1 a o c� with I s}a( end ci ordinances relating to buiiding construction, and authonze representylves of t e Ciry of Coste Mese to enter upon the
ebove-de � 6p for � p�cti ryoses. gree not to upy or allow occupancy of any building authorized b (s permi ntil final inspection.
�
Sign r Legal neqs) ate
And/n. Ainnnvnd Annlirant Date
CODE t.
1616 Fi:etl System Final Fira Prevention
1266 Pool Spa Final
Final Re-Roof
Finel BIocWRetaining Well
Finel Fettory Fire Plece ,
Finel Sign
r` Final �emolition .,
200
201
204
24a8-48
�. I u7d�9
CODEt INSPECTIONTYPE
20fi Final Mechanicel
208 Final Plumbing
210 � Final ElecMcal
212 Final Fire Prevenlion
220 Final Planning Approvel
222 Final Site �
250 ._ Final Building/Occupancy
QSIf. It1�L5
`L' �:�.
l�� �
i •.: _�:: I '
�,
(714)754-5273 • Fa�c(714)754-4856
Job Address: 230 24TH PL
Suite No
Vicinity:
Parcel Nunmber: 11910111
npplicant: REUTER, MARK L
Address: 230 24TH PL
COSTA MESA, CA
Owner: REUTER, MARK L
Address 230 24TH PL
COSTA MESA, CA
Contractor:
Address:
ArchlEng:
Address:
CITY OF COSTA MESA ,
evno�N� onr�s�oN
�DEVELOPMENT SERVICES DEPARTMENT
PEiiMIT
PLUMBING PERMIT
PERMIT NUMBER
P99-00237
T7 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
_ ; ; . - .
,Phone: 949-645-5824 / � - �
Zip: 92827 i�/ . ; -
/ �
, . - -� _ ._ , � - - . .
... `\:��� ' '.
Phone:
Zlp: 92627 A:��`.
/'
. "� .
� .
, •�Phqne: �
� �� � Zip_ � ,
License: �
Phone: '� ' � �, '-
.. _ ;ZiP: . "� .
License:
' � �SCOPEOF PERMIT'; �,� '' �
1 SHOWER, 1 WASH BASIN�AND 1 TOILET. REF B99-01837/ /
ISSUE FEE
BackFlow irngation
BackFlow Preventer
Bathtub
Clarifer System
Connect (Ice,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drein, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (i-4 outlets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptors (Grease, Oip
Interceptors (Sand Auto )
AMT
$22.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Qn
FEE SUMMARY__'
• ... . AMT 'QTY
Laundry Tub / Washer $0.00 0
LandscapeJr�igation ' $0.00 0
P-Trap' � ' " $0.00 0
Pressure Reyulator �;. � $0.00- 0_
Process Piping (per 10 ft) �- $0.00 0
Receptors � . � $0.00 0 .
Seplic Tank . � � `" $0.00 � 0,
Sewer Cap for Demo '�$0.00 .� 0:
SewerConnect".. ` �� $0.00 � �0 '
Sewer Private Gine -� � ' $0.00 - 0 -
Shower - $875 1
Sink, bar , $0.00 � � 0
Sink, commeicial ' " � � $0.00 ' 0 �
Sink, Floor � $0.00 0
Sink, kitchen' - '� � � � $0.00 0
Sink, service/mop $0.00 � 0 �
Spa(private)- � � - y$0.00.� 0
Spa (public) $0.00 0
COMMENTS / SPECIAL CONDITIONS
Status: ISSUED
Applied: 04/20/1999
Issued: 04/20/1999
,w'�C ♦Y
����y y�"
�r`'�/p/���/�l
O /"
i
SumpPump
Swimming Pool
Trap Primer
Urinal
� Vacuum Brkr BkFlow(1-4)
Vacuum Brkr BkFlow(5+)
,Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
� Water Heater I vent
Water Piping (Inst or Rep.)
Water Re-pipe
Water Service
Water Softener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$8.75
$0.00
$0.00
$8.75
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES: $48.25
QTY
0
0
0
0
0
0
t
0
0
1
0
0
0
0
0
0
NOTICE: The.work authorized by this permit shall comply with. all applicable handicap access requiremants under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire end become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to-be considered legal, such work must comply with all applicable codes; and all
required Inapeetlons and final approval musf be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permi4.� �
FOR INSPECTIONS CALL: (714) 7545626 : �. ,
WORKERS' COMPENSA710N DECLARATION: � —
I here6y aflirtn under penalry o1 perjury one of the following declaretions:
❑ I heve end will melntain e �ertificate of consent to self-Insure for workers' compensetlon, es providetl tor by sectlon 3700 of the Lebor Cotle, for the pertortnance of the
work for which �his permil is issued.
❑ I have and will melntaln workeB' compensatlon insurence, as required by section 3700 of the Le�or Cotle, for ihe pertormence of tha work for which Nis pertnit is issuetl.
My workers' compensetion Insurence carrier end policy number are:
Cerrier: poiiq Number:
(TM1Is secHon need not be cnmpleted i/ the permlt is ve/ued at one hundred dollars ($700) or /ess.)
❑ I cartity that In the pertonnance of the work for which Ihis pertnit is issued, I shell not employ eny person in any manner so as to become subject to the workers'
compensation laws of Califomia, end agree Ihat if I shoultl become subject to ihe workers' compensatlon provislons oi Sectlon 3700 of ihe Labor Code, I shall forihwith
comply wl�h ihese provisions.
Applicent Slgneture: Date:
WARNINO: FAIIURE TO SECURE WORKERS' WMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES FNO CIVIL FINES UP TOONE HUNDRED
TNOUSAND Dd1FRE ($100.000�, IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIDEO FOR IN SEGTIIXJ 3]O60F THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CON7RACTORS DECLARATON:
I hereby aXirtn Ihat I am IicensBtl under provislons of Chapter 9(commencing wit� Sectlon 7000) of Division 3 of ihe Business and Professions Cotle, and my license is In full
force entl eRect Lla x Class #
' Contradofs SlgnaNre: Date:
CONS7RUCT10N LENDING AGENCY:
❑ I hereby eftirm that there is a constructlon lending egency for the pertormanca of ihe work for which this permit is Issued. (Sec. 3097, Civil Code).
Lender's Neme: Lender's Address:
�'. SlgnaNre: Dete:
OWNER-BUILDER DECLARA710NS:
I hereby atfirtn ihet under penalry o� parjury that I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for the following reason (Sec. 7037.5, eusiness antl Professions
Cotle: Any city or counry which requires a pertnit lo consiruct, elter, improve, demolish, or repair any strucWre, pnor to its issuence, elso requires the applicant tor such pertnit
to file a signed stetement ihet ha ar she is Iicense0 pursuent to ihe provisions of the Contractors License Lew (Chapter 9(commencing wi�h Section 7000) of DiNsion 3 ot the
Busineu antl Professions Cod9) or thet he or she Is esempt therefrom and Ihe basis for t�e alleged exemption. My Nolatlon oi Sectlon 7037.5 by any epplicant for e permit
sub�ects tha appllcant to e civll penalry of not more than five huntlretl tlollare ($500).):
❑ I, es owner oi iha praperty. or my employees with weges es iheir sole compensetlon, WILL DO 7HE WORK, end the struclure is not intended or ofrered for sele (Sec.
7044, Business entl Profess�ons Code: The Contractors License Law tloes not epply to en owner of property who builtls or improves thereon, antl who does such work
himsetl or herself or throu9h his or her own employees, provitled ihat such improvaments are not intentletl or ottered for sale. If, however, the building or Improvement is
sold within one year of completion, the owner-builder will heva the burden ol proving Ihat he a she did not build or improve for puryose of sale.).
1/ ���
� I, as owner of ihe properlYr am LUSIV C RA ING WITH �ICENSED CONTRACTORS to consWct Ihe pra�ect (Sac. 7044, Busine54 antl Professions
Lode: The contract LiCe _ _ w doe�e aAp�l�en �vnar of property who builds or improves thereon, end who contrects for sych project with a coniractor(s)
license pureue J
❑ I am exe n9p/';
Venfication of Ownarshjdby (typa at
property tau bill or deed):
ProiB551on9 Codeforihis rea5on:
DIVISION OF INDUS'fR1AL SAFETY PERMR CERTFICATION:
❑ I hereby certify that no e%�e�ation Irve (5) or mora feet in tlepth into which a parson Is reduired to descend, will be mede in connectlon with work authonzed by this
permit, end that no buildin9 structure, scafloltling, falsework, or tlemolitlon or dismantling t�ereof, will be more than ihirry-six (38) feet hlgh. (Chap. 3.2, Gry 2, Art 2, Sec.
341, Title B, Celifornia Atlministrative Code). .
❑ As owner-buildar, I will no� amploy anyone to do work which would require e permlt from �he Division ot Industrial Safery, es notetl ebove, unless such person has a
permit to do such work from ihe division.
Signature: Date�.
Division of Intlustnal Sefary Permit Number:
1 W ill the epplicam or presen� or fuWre 6ulltling occu0ant neetl to file and certify e Business Plan for emergency response to release or threatenetl release of a hazartlous
material7 ❑ Yes ❑ No
(Section 25505 of the Califomia Healih end Safery Code requires, with some exceptions, thaf a Business Plen be filed with the Costa Mesa Fire Department by every
busineu which hes at eny one time tlurinB a reported year a quantiry of harertlous materiels eQual to or grea�er ihen a weight ot 500 pounds, or a valume oi 55 gallans,
or 200 cubic taet of compreued ges et slandard temperature and pressure).
2 Does or will Ihe applicant of present or future building occupant need to file a registration form for acutely hazardous metenals7 ❑ Yes ❑ No
(Section 25533 of ihe CalifOrnia Healih end Satety Code, with some exceptions, requires reglstratlon with the Costa Mesa Fire Depertment by each business which et any
one tlme hes on hand a tluantiry o1 acutely hezertlous materials equal to or greeter then e weight of 500 pounds, or e volume of 55 gellons, or 200 cubic teet of
compressetl gas et stentlard tempereture entl pressure). �
.._—.......__._.......__..._.___—'—,_._._....._.._' ...................__.__....._......................................'...__._.'__.____._.......�.........._..._.......__.........—...__.'_.� .__..
3 Does or wlll the epplicant o� P�esent or fuWre bulltling occupant neetl to prepare en RMPP (Risk Management and Preventlon Pmgrem for acutey hazartlous meterials)?
❑ Yas ❑ No
(Section 25534 of the Califomia Health antl Safery Code provides ihet the Costa Mese Fire Depariment may require the preparetlon, cenification and flling with ihe Fire
DeOariment of en RMPP by businesses which ere requiretl to register acutely hezerdous matenals with [he Fire Depertment.
4 Ii en RMPP is presently required, has Section 25534 at the Califomia Health antl Safery Code been fully complied wit�? ❑ Ves ❑ No
5 Does or will ihe applicant a� p�esent or future Culltling occupent requlre for the work which is the subjed of this a pllcation e permit far such consWction or motliFlcation
irom ihe South Coas� Air �ueliry Menegemani Dislnci or trom eny other air pollution control distnct or agenc� � Ves �J No
(Sectlon 658502 of the Cal��omia Govemment Code requires that ihe requested informetlon be fumishad on epplications for non-residential building pettnits).
6 Will any part of ihe faciliry to ba constructetl untler Ihls permit be wit�in 1000 feet from Ihe outer bounderies of e schooll ❑ Ves ❑ No
(Ii yes", the tecility must maet the requirement ot Sections 25534 antl 42303 of the Calitomia Health and Safery Coda).
7 II a permit irom Ihe South Coest Air �uelity Management Dis[rict or ot�er eir polWtlon conirol disMct or agency is requlretl for the work which is ihe subject of this
aoolication. heve all of the disclosures Drescribed bv Califomia Heelih and SeteN Coda Sedion 42303 been matle7 ❑ Yes ❑ No
��� yo� � o„o,.�� ,.o„���,.o,a ,.. __......_..__ .._......_ _r.._r.._._ _.. ,._.._.._.. __...._. _...__.,.
CERTIFICATE OF COMPLIANCE: I cenlfy t�et untler penalry oi perjury t�a Iniormetlon given above is correct. I egree to comply with all state laws end ciry ortlinances
regerding Hezerdous Mate�als end Emisslons.
Slgnature: ' Date:
CER7IFlCATE OF CO �C ���n0 ( F ENfAY: I certify untler penelry of perjury ihat I have read this eppliwtion and state ihat the infortnation given is
corred. I ey� to y wit all a a entl ci ' aucccsakting-1e�building wnsiruction, antl authorize represe latives ot the Ciry of Costa Mesa ro enter upon the
ebove- Sc 6e ro rty for � ec = ses. gr e not to occupy or allow occupancy of any building euthon e his pe I�yqtll Inal inspaction.
_ _ _� ���/ G� 1
�sv / -i�
� i a iLegel-Owner(s) Date�
AnNOr Authorized Aoolicant — Date
COOE �, �14bi1PE .
1616 Fixed System Final Fire Prevention
1266 Pool Spa Finel
200 Final Re-Roof
201 Final BIocWRetaining Well
202 Finel Fectary Fire Place
203 Finel Sign
204 Finel Demolition
244&48
PAIF. INTRIALS
CODE1
206
20B
210
272
220
222
250
INSPEC710N TYVE
Final Mechanical
Final Plumbing
Final Electriwl
Final Fire Prevention
Final Planning Approvel
Final Site
.Final Building/Occupency
IiAIE INTRIALS
�
(714) 754-5273 • Fax (714) 754-4856
Job Address: 230 24TH PL
Suite No
Vicinity:
Parcel Nunmber: 11910117
CITY OF COSTA MESA �
9UILpING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
App�icant: STEPHANI REUTER
Address:
Owner: REUTER, MARK L
Address 230 24TH PL
COSTA MESA, CA
Contrector:
Address:
ArchlEng:
Address:
PLUMBING PERMIT
Phone: 949-6455533
Zip:
Phone:
Zip: 92627
Phone:
Zip:
License:
Phone:
Zip:
License:
PERMIT NUMBER
P99-00263
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: OSI04/1999
Issued: 05/04/1999
ISSUED BY: =
SCOPE OF PERMIT
CONSTRUCT WALL IN GARAGE TO CREATE POWDER RPOOM. TOILET & SINK, RE:B99-00605.
ISSUE FEE
Backflow irrigation
Backflow Preventer
Baihtub
Clarifer System
Connect (Ice,Soda,etc)
Dental Units
Dishwasher
Drein, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (1-4 outlets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptoro (Grease, Oil)
Interceptors (Sand Aulo )
AMT
$22.00
$0.00
$0.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$o.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
$0.00
nrr
FEE SUMMARY
AMT
Laundry Tub / Washer $8.75
Landscape Irrigation $0.00
P-Trap $0.00
Pressure Regulator $0.00
Process Piping (per 70 ft) $0.00
Receptors $0.00
SepticTank $0.00
Sewer Cap tor Demo � $0.00
Sewer Connect $0.00
Sewer Private Line $0.00
Shower $0.00
Sink, bar $0.00
Sink, wmmercial $0.00
Sink, Floor $0.00
Sink, kitchen $0.00
Sink, service/mop $0.00
Spa (pnvate) 50.00.
Spa (public) 50.00
QTY
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
COMMENTS / SPECIAL CONDITIONS
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr BkFlow(1-4)
Vacuum Brkr BkFlow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater / venl
Water Piping (Inst or Rep.)
Water Re-pipe
water Service
Water Softener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
TOTAL CALCULATED FEES:
AMT
$0.00
$0.00
ao.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$8.75
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
50.00
$0.00
$39.50
QTY
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
NOTICE: 7he work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 780 days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legel, such work must comply with all applicable codes, and�all
requlred Inepectlone end Iinal approvel must be obtained. Feilure to obtain Inspections end final approval will result in the expiration of lhis permit:
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLApATON: �
I hereby ettirm untler penelry af perjury one of the following declflretlons:
❑ I heve end will mfllntein e certilica[e of cansent Io setl-Insure for workers' compensetion, as proviaetl far by section 3700 of Ihe labor Code, for Ihe peAormance ot the
work tor which this pertnit is issuec�.
❑ I hava end will malntein wo'Icers' compensatlon insuranca, es required by section 3700 of the Lebor Code, for ihe pertortnance ot Ne work tor which this pertnit is issued.
My workers' compensation Insure�ce carrier en0 policy number ere:
Cartier: Policy Number:
(This sectlon neetl not be cromplefed!! the pertnit Is velueC et one huntlretl tlollers ($100) or less.)
❑ 1 certify Ihat in Iha pertormance qt the work for which this pertnit is issued, I shall not employ eny person in eny manner so as to hecome subject to the workers'
compensation laws of Califomla, qnd egree that Il l should become subject to lhe workers' compensation proNsions of Section 3700 oi the Labor Cotle, I shall forthwith
comply with ihese provisions.
Applicent Signeture: Date:
WARNIN(3: FAILURE TO SEWRE WORKERS' �pMPEN5r1TIIXJ WVERAOE IS UNUW FUL rWU SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENFLTIES AND GYIL FlNES UP TO ONE HUNDRED
TY/OUSANO OOLLAHE (5100,000). IN ADOfTiIXJ 7p THE COSiOF COMPENSAT7IXJ, OAA4iGE5 A$ PHOVIOEO PoR IN SEGTION 31060F THE LF90fi WOE, INiEFESf, AND ATTORNE`/'S FEES.
LICENSED CONTRACTORS DECLARqT10N:
I hereby attirm that I em Ilcensed under provisions ot Chepter 9(commencing with Section 7000) of Divislon 3 of Ihe Business and Professions Code, and my Ilcense is In tull
torce end ettecL Lic. q Class x
Contracbr's Signature: Date:
CONSTRUC710N LENDING AGENCV: ,
❑ I heraby ettirtn ihet there is a consWction Iending egency tor the pedortnence ot the work tor which Ihis pertnit is issued. (Sec. 3097, Civll Cade).
Lenders Name: Lenders Address:
Signeture: Date:
OWNER-BUILDER DECLARA710NS:
I �ereby affirtn that under penelry of per�ury that I em EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW tor Ihe tollowing reason (Sec. 7031.5, Business end Professions
Code: Any city or county which requires e permit to consWcL alter, improve, demollsh, or repair eny structure, pnor to its issuance, elso requires ihe eppllcant for such permit
to file a s(gnatl s�etemenf Ihef ha or she Is Ocensed pursuent �o the provfslons of ihe Coniractors License Lew (Chapter 9(commenctng with Section 7000) of DlNslon 3 oi the
Business antl Pmfessians Cotle) or thet he or she Is exempt Ihereirom entl the besis for tha alleged exemption. Any vlolatian of Saclion 7031.5 by eny appllcent tor a permit
sub�ects the epplicant to e civil penelry of not more then tive hundred dollers ($500).):
❑ I, as owner of the properry. or my employees with wages es thelr sole campensation, WILL DO THE WORK, end the structure is not intentlad or offered tor sale (Sec.
70a4, Business antl Professlons Cotle: The Contrectors License Lew tloes not epply to en awner of property who builtls or improves t�ereon, end who does such work
himself or herself or.through his or her own employees, provided ihat such improvemenis are not Intended or ottered for sale. If, however, the building or improvement is
sold within one yesEaf completion, Ihe awner-bullder will heve the burtlen af proving Ihet he or sha did not build or improve for puryase ai sale.).
1 Av/ ..i�
� I, as owner,of tl�e propeM; am �XCLUSIVELY CONTiiACT1NG WITH LICENSED CONTiiACTORS to construct the proJect (Sec. 7p44, Business entl Pmfesslons
� e contrecrore License:L4w does not epply to en owner ot properry who builds or improves ihereon, and who contrects tor sVch pro�ect with a contractor(s)
lice �suant to Ih ontrectoB License ws.).
��1 °M � ntle Business enA Professions Code tor this reason:
Sig irta u e: `' Date:
er I ' ie riv 's license. Yes ❑ No D' xpires: �
Veritiwtion of Owri9rship by (rype oi tloCum _i.a. - property tan DIII or deetl): �
DIVISION OF INDUSTRIAL SAFETY VEqM1T CER7IFICATON:
❑ I hereby certify thet no exwvation Ilve (5) or more feet In depth Into whlch e person is requiretl to descend, will be mede in connection with work aut�orizeC by ihls
pertnit, entl thet rro buiMtng structure, scaltolding, tfllsework, or demolition or dlsmentllrg Nereat, w711 be rtrore then thirty-s�z (36) teet high. (C�ap. 32, Grp 2, Art 2, Sec.
341, Title 8, Celitomia Administretive Code).
❑ As owner-builder, I wlll not employ enyone to tlo work which waultl require e pertnit Irom the Division oF Industrial Satety, as notetl above, unless such person has a
permit to tlo such work trom the division.
SignaNre: Date:
Division ot Intlusinal Sefary Pertnit Numygc
COpE �. INSPEGTIONTYPE
1616 FIxeO System Finel Fire Preventlon
1266 Pool Spa Finel
200 Final Re-Rool
201 Final BIocWRetelning Wall
202 Final Fecrory Flra Plece �
203 Flnal Sign
204 Finel Demolitlon
2aa&ae
QSjF INfIfULS y�pf,j INSPECTIONTYPE
206 Final Mechaniwl
200 Final Plumbing
210 Final Electrical
272 Final Fire Preventlon
220 Final Planning Approval
222 Final Sife
250 Final BuildingiOccupancy
PAg 1t�AL5
(714) 754-5273 • Fax (714) 754-4856
Job Address: 230 24TH PL
Suite No
Vicinity: KITCHEN
Parcel Nunmber: 11970171
/ �
CITY OF COSTA MESA �
B{/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Applicant: REUTER, MARK L
Address: 230 24TH PL , '
„
CA •
COSTA MESA ' , , .
Ownec ` REUTER', MARK�L
, � .
Address � 230 24TH PL- .-,-. --
„ CA . /
�:
� COSTA MESA:%�
.Contractori /�A � �
Address:
�/�..��v
ArchlEng:�
� Address:, -
0
PLUMBING PERMIT
Phone: (949)845-5824,�
Zip: 92627 ,
Phone: (949)645-5824
Zip: 92627
l.
Phone:
Zip:
License:
Phone:
Zip:
License:
\
PERMIT NUMBER
� P99-00497
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 0 82 411 9 9 9
Issued: 0812 4 /1 9 99
ISSUED BY:
� _ ,A
� � ,'
I ��
: ���`�'� ,
� 4�� �
� �� �
�p,
SCOPE OF PERMIT �
SUPPLEMENTAL PLUMBING PERMIT FOR 1-GAS LINE, 1-LAUNDRY TUBNVASHER, 1-KITCHEN SINK, &
1-WATER HEATER. -
- REF: P99-00237-
AMT QN
ISSUE FEE . � $7.25 .
Backflow irrigation $0.00 � � � 0
Backflow Preventer $0.00 0.
Bathtub � ' $0.00 � 0
ClarifierSystem $0.00� 0 �
Connect (Ice,Soda,etc) $0.00 0
Dental Units ' $0.00 0
Dishwasher � � $0.00 �0
Drein, Floor $0.00 0
Drain, Rainwater $0.00 0
Drain, Roof $0.00 0
Drinking Fountain $0.00 0
Expansion Tank $0.00 0
Gas Earthquake Valve $0.00 0
Gas (1-0 outlets) $6.15 1
Gas (Over 4 outlets) $0.00 0
Gas Repipe $0.00 0
Gas Service $0.00 0
Interceptors (Grease, Oiq $0.00 0
Interceptors (Sand Auto ) $0.00 0
FEE SUMMARY
AMT
Laundry Tub I Washer $9.80
Landscape Irrigation $0.00
P•Trap � $0.00
Pressure Regulator $0.00
Process Piping (per 10 ft) $0.00
Receptore $0.00
Septic Tank � $0.00
Sewer Cap for Demo $0.00
Sewer Connect $0.00
Sewer Private Line $0.00
Shower $0.00
Sink, bar $0.00
Sink, commercial $0.00
Sink, Floor . $0.00
Sink, kitchen $9.80
Sink, service/mop $0.00
Spa (pnvate) $0.00
Spa (public) $0.00
Qn
1 .
0
0
0
0
0
0
0
0
0
0
0
0.
0
1
0
0
0
COMMENTS I SPECIAL CONDITIONS
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr BkFlow(1-4)
Vacuum Brkr BkFlow(5+)
Wash Basin
Wash Basin Set
Wasta and Vent System
Water Closet (Toilet)
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
Water Service
Water Softener
OTHER
VIOLATION
PL4N CHECK
REINSPECTION
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$12.30
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
50.00
TOTAL CALCULATED FEES: $45.30
.
0
�N
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inepectfona end flnal epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION: '
I hareby eitirtn under penalry of perjury one oF the following declaretions:
❑ I have and will maintain a certificeta ot consem to selt-Insure for workers' compensation, es providetl for by sectlon 3700 of the Labor Cotle, for the pertortnance ot Iha
work for which ihis permit is iuued.
❑ I have and will maintain workere' compensation insurence, as requiretl 6y section 3700 ot the Labor Code, tor ihe pedortnance of the work lor which Ihis pertnit is issued.
My workers' compensatlon Insurance carner end policy number ere:
Carner: Policy Numbar:
(Th/s secfion need nof be comp/eted il fhe permit is velued af one hundred dallers ($100J or less.)
❑ I certity that in the peAormence of ihe work for which this pertnit is issueQ I shall not employ eny person in eny manner so as to Decome subject to the workere'
compensation laws ot Calitomia, and agree that if I shaultl 6ecnme sublect to Ihe workers' compensation proNsions af Section 3700 of Ihe Lebor CoCe. I shall forthwith
compy with these provisions.
Applicant Signature: Da�e:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SMALL SUflIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRE�
THOUSAND OOLLARE (5100,Op0), IN ADDITIQV TO THE COST OF COMPENSATION, OAMAGES PS PqOVIpED FOR IN SEGTIIXJ 3]OB OF THE IABOR CODE, INTEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aNirm �hat I am licensed undar provisions ot Chapter 9(commencing with Section 7000) of Division 3 of t�e Business end Professions Cotle, and my license is in full
force antl eHect. Lic. a Cless a
Contrecrofs Signature:. Data:
CONSTRUCTION LENDING AGENCY: .
❑ I hereby aHirtn that there is a construciion lending agency lor the pertortnance of the work for which this pertnit Is issued. (Sec. 3097, Civil Catle).
Lenders Name: Lendefs Address:
Signefure: Dete:
OWNER-BUILDER DECLARATIONS:
I hereby aHirtn that under penalry of perjury ihat I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Professions
Code: Any c' or county which requires a permit to construc6 elter, impmve, demolish, or repeir any struciura, prior to its Issuance, also requires the applicant for such permii
to fila e etl statemeN that he or she is licensed pursuam to Ihe provisions oF Ihe CONractors Licensa Law (Chapter 9(rnmmencing with Section 7000) of Division 3 of ihe
Busin s and Professions Cotla) or thet he or s�e is e:empt Iherefrom antl the basis for the elleged ezemption. Any Naletlon of Sedion 7031.5 by eny eppllcant for a pertnit
su ' cts the appliwnt to e ciWl penelry ol not more than tive huntlred dollars (5500).):
1, as owner of ihe property, or my employees with wages es iheir sole compensation, WILL DO THE WORK, and Ihe structure is not intended or oHeretl for sale (Sec.
7044, Business and Professions Code: The Contractors License Lew does not apPly to en owner of pmperty w�o bulltls or improves thereon, antl who does such work
himself or herseN or thraugh his or her own employee providad Ihat such improvements are not Intended or oflered for sale. If, however, Ihe building or improvemem is
sold within one year ol completion, the owner-builtl ill have the burden ot praving that �e or she did not 6uild or improve far purpose oi sele.).
❑ I, as owner of the pmperry EXCLU El NTR 71NG WI7H LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business antl Professions
Cotle: The contractors ' en law-d no a ly to e owner of property who Duiltls or impmves theraon, and who contracts tor such pmject with a contrectoQs)
license pursu to th o actors L' e s.).
❑ I am exe tle ec. Business antl Professions Cotle for this reason:
Signature: Date:
Owner fie y driv ls license. es ❑ No Drivers License No. �� Expires� G
Venfication of Owner ip Dy (type of document, i.e. - property tax bill or tleetl):
DIVISION OF INDUSiROQ SAFETV PERMIT CERTIFICATION:
❑ I hereby ceRify that no excave�lon tive (5) or more teet in tlepth into which e person is requiretl to descen0, will be matle in connection with work authorizetl by this
permit, and that no building stmcture, scattolding, talsework, or tlemolition or tlismantling thereoi, will be more Ihan thirty-six (36) teet high. (Chap. 3.2, Grp 2, An 2, Sec.
341, Title e, Califomia Administretive Code). �
❑ As owner-builder, I will not employ anyone to do work which would raquire a pertnit from the Division of Intlus�rial Safery, as noted above, unleu such person has a
permit to do such work Irom ihe division.
Signatura: Data:
Division ol Industnal Satety Permit Num6er:
COpE �, INSPECTIONTVPE QAj� INTIiIRLS
7676 Flzetl System Final Fire Prevention
1266
200
201
202
203
Pool Spa Final
Final Re-Rooi
Final Block/Reteining Wall
Final Factory Fire Plece
Final Sign
204 Final Demolition
2aaB a6
CODE� INSPELTIONTYVE
206 Final Mechenical
20B Final Plumbing
210 Finel Eleciricel
212 Final Fire Prevention
220 FinelPlanning Approvel
222 FinalSite
250 Final Building/Otcupency
E97E INTRIRLS
r
PflOJECT POOflESS: � j J � Q TH P L
OWNEB'SNAME: g�;j'iER, [,ARK L
nooxEss: „�,JiGR, STEPAAivIE A
<.0 24TH FL
Wb"iA ;�ESA,CA 926"l'0
'J1ti) 72i-39D5
AHLNIENGINEEN: flEG.NO.:
AOOflESS:
UNIT:
UNIT:
PEHMITiEE: HEUTERS 3EN CUNTRACT2NC ( 71 � 1 2 i 1—U 1 L? 1
aooeess: � 79 J 1 M! TCHELL SOU'PH 11 U
IRVINE l".1 9271�i
LICENSEO CONTBAC70fl OECNRaTION: I nere�y aifirm ihat I am licensed unaer omvisions of Cnapter 9 �commencing witn Sectian
7000) a� Div��sion 3 0� �he Business antl Pmiessions Cotle, antl my license is in lull force antl eitect.
/ciTy�luc.: C543�d TaTeuc.:589336 c�ass: E' P: 09/99
' py�¢: �/� 3 SignaWre'�� _
�REBS' COMPENSRTION DECUIBATION: I here�y aHirm l�at l have a cetlificate of consent ro f�insure ar a certilica�e 0i Worker5'
mpensation Insurance or a cenifieA copy thereol (Seciion 3800, lab. C�.
POLICYNO.: SLUO/U:S''j4 E%P.DPTE: U%/OlI�iS
I comraxr. STATE FUND
7 Cehified cavY is hereby lurnishee. � Cenifietl copy is file0 wit� ihe ci Builtli Divisio
'T '7 ADPlican(� � /
ExEMPTIONFHOMWOXREflS'COMPENSFTIONOECL�7flPTI0N: QhissedionneetlnotbecompleteOilthepermitisloronehunUreU�5100)orless).
I cetlity Ihal in Ihe petlormance of Ihe work �ar which t�is permi� is issueq I shall no� em0loy any person in any manner so as to �ecome
su�leq lo ��e Warkers' Compensation Laws ol California.
Daie: SignaWre:
NOTICE: I�, a�ier making ihis tleclaralion, you shoultl �ecome subject to �he Workers' Compensation provisions of Ihe Labor
Cotle. yau musl �orthwi�� compty with such pmvisions or Ihis permit shall �e tleemetl revaked.
CONSTBOCTION LENDING pGENCY: I herehy af�irm Iha� �here is a conStNc�ian lending agency for the pedormance o� �he work for
which ihis permil is i<sued (Sectian 3W7. Civ. C).
LENOEN:
RODflE55:
OWNEB BIIILDEfl OECIANAT10N: I here6y allirm t�at I am exempt irom the Contracmrs' State License Law for the followinA reason
(Sectian 7031.5 Business and Pmfessional Catle: Any ciry of coumy which requires a permi� to con5imc�, alter, improve, demolish, or
repau any stmcture. Orior b i�s issuance. also re0uire5 the apPlicanl for SucA permii Io �ile a signea s�a�ement tha� he/she is licensee
'� pursuam to Ihe pmvisians ol lhe Coniracrors' Sia�e License Law (CM1ap�er 9(commencinq wi�h Section 7000� ot DHision 3 0� Ihe Business
I and Pmtessions Code� or I�al �e/she is exem0� Iheretmm an0 Ihe Uasis br ��e alleAeA exemption. Any violation ol Sec�ion 7031.5 by
any apPlicanl for a permi� Subleci5 ��e applicanl to a civil penalry of not mare lhan live huntlretl dollars (5500�.
I, as owner o� �he D�opehy or my emplayees with wages as �hei� sole compensation, will tlo �he work, and Ihe
❑ stmcNre is not intentleJ or oHeretl for sale (Section 70d4, Business and Pmiessional Cotle: The Contracrors' State License Law
does nol aDDly to an owner oi a pmperty who builtls or improves ��ereon, anE who Aoes such woB �imseli/herself or t�roug�
�is or her own employees. pmvideA t�at such impmvemenls are not intentled or oflere0 lor sale. If, however the huil�ing or
impmvemenl is 5oltl wiihin one year Oi tom0lelioq the owner vnll have ��e buraen af D�OvinA �e/She Uitl noi �uilJ or improve
lor the purpose of sale).
I, as ownerof �he pmper�y, am excWsively conUac�ing wi�h licensed conVactors to cons�mc� �he prolect (Section 7044, Business
❑ and Prolessions Code'. The Coniractors' Slaie License Law does not apply �o an owner o� pmpeny who huilds or improves thereon
an� who conttacts lor such D�ojects wi�� a conirac�or(5) license purSuaN to Ihe Contrac�ors' S�ate License Law�. I am aware
Ihal O�ool ol thelr Worker's Compensation insurance s�oultl be pmvi0etl Ia me. �
� I am exempt under Sec�ion: B. 8 P. C.
lor �his reason'.
Da�e'. Ownec
I do hereby cetli�y �na� I am aware o� ana unAerstand the requiremenis ol Calitomia Hea1N and Safely CoOe Sec�ions 25505, 25533, antl
25534 ana I�ai lorany Wlure building occupanlwilVwillnot(circle one�need to compiy wi�� sai0 s�ate cotles and�he reQuiremen�sfor a
permit for conslmction or motlilicalion �mm Ihe Air Oualily Management OisMci. flesiaential cons�mc�ion applica�ions are ezemp� from
I�ese pmvisions.
Daie: ApPlicanC
I nereoy cerlily ihat I have reatl Inis application an0 slate iha� Ihe a6ove information is correcL I agree to comgggply with all city ane county
ordinances an0 5�aielaw5 relatingto builUing consimclion ana hereGy aut� ative5 0l 'S ciryto e��ove-menlionetl
pmpeny lor inspection lpurposes. �
D� �/�� �'T � Signal '
river�ense ar Saiai 5ecuri�y q:
1641-a6 Whi�e—Bmltling', Green—Cotle Enbrcemen�; Canary—Applican�: Pink—Revenue; GalEanmtl—Assessor
CiTY UF CGST1 ";ESA — HJ�iDIiVG PER:�,IT FER:: i�0: �: 'vt,bJb9
PERMIT NO; i�l 068069 PLAN CHECi: NO: N GOVT; N�UEP; ;i
CONSTkUCTIOi] TYPE; V—N PERMIT TYPE: '•iEC PURFOSE: O'7A
JOS UESCRIPTION . LUS:aLL NEW H.C�,A,C U:JIT Sy� FT:
CLA�M VAiUE; CALC—VALuE: GROOP OCC; R-3 !
COMMENTS: X
k� i. f:, i:� iC• #� i( K�X- K� # ie 1h 3: �: if �.'c ii #� i'� iE K#} K� %� Y� �Y #� i� iF'..- i.� # i` # k i:� i:. 3i # iF i:� a%t:� IF K� # i�- iF i(� �% i. i: # iF # i'� #� i� Y� 3� i�� i. #- ic iF if #}. i.� 3c i:.:. {c �.- i, it� ::
Z O N I N G R E Q U I R E;•� E N T S
S�: T b A C K S
----------- ;6AlN BUILDING ---------- --------- ACCESSORY &UILDING --------
FRNT: FT IN REAR: FT IU FRNT: FT iN kEAR: FT ��d
LEFT; FT IN RGH'I': FT IN LEFT; FT iiV RGHT; FT :N
PARKING AEQ� PROV: PARCEL: 1i910111 ZNE; REF NO:
PLANNING NOTES>
7
X�#iEiF#kiEiEiciFifit#K�####'#itiE3E3,'-k�##r.-###iE#if##9E#Y�##itiE###*ir#it##ic####1af.�Y.�Y%%3Ft:it##it#iEi:-X�%�#iF#�Y.�itiF�
D E V E L O P M E N T S E R V I C E S R E Q U I R E f4 E N T 5 �
ZONING APPROVED 2Y __ DATE:
BUILDING APPROVED BY : L�ATE; �y'
APPLICATION ISSUED BY: / /�-"� PATE; �_I J/��y�
*w�*#+*�-��**�i���*w�#���x�w����r��r*-z�i �c�u :r.�i.# �rt+r##�x�x-�x-�#��-�x���:��**��#�.���x�+���sl� ,+i� <.*�:1
'N # iE jF IE k- %il� # iF i( 141F 9E iF # 1E iF ##'lE'lElE %# # ie 1Elf # if # iF # iE'R iF # ItlFlE jf iE iP ## i! 3E iE-It ##!5 ## iM1 i! iF fF # K� ## 1} # i! iF fE �� �1F d, k- 1� #� �## 7F #
LEGALIZP.TION:N F E E S U M M A R Y STRJCT[IRAL SEGt9L•'Ui:N
BLDG PMT PLUMBING GLECTRIC MECHANIC FIRE SMZP/AES GRADING
PERMIT 12.00
25� SMIP/NON—RES
PLAN '.
IS5UE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID Di;E
TOTALS----> 12,Q0 L5.00 0,00 '7,00 27,00 .00
REVENUE DIVISION TOTALS--> COLLECTED: '',�r0 OVER/SHORT: 00
BLDG PMT PLUMHING ELECTRIC t�1ECHANIC FIR dMIP/TOT CRADING PLAN—CHECY.
27.00 �
�:#r.�x���*ec*#z�#� �*#��+��x�*x���u���r���t�e �; � ��x-x�:��z x�����r�*�r:�#�crt#r���#*#�:it� 3�#�r:������it����ix��a��:�::;:
Z N D I V I D U A L E E E B R E A K D O W N
TYPE QTY P E S C R I F T I O N
MEC 1 INST FORC—AIR/GRAV FURN := 100 K BTU
MEC 1 GAS PIPING SYS 1— 4 OOTLETS
END OF FEES
EXPIRED
1 omplete lnspedion�
�YC ��—" l-� S�8 "r—y�
U
UNIT COST TOTAL COST
9.00 9,00
3.00 3,00
G1 �0164�53—�0164�53 T CtT 27.Q0
DATE� 07/i4/94 7LCIEc 16:40
.�
�
CONSTRUCTION AN6 PLANNlNG PO(. . SPA
APPROVA�S Permit #�' Date Inspector APPROVAIS Permit # Date Inspector
t. 7emporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soii Pipe�Undrgrnd. 53. Steel Reinforcement
3. Electrical Cond�it Utility-Undrgrnd. 54. Forms '
4. Eiectrical Conduit•Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcemenc 56. Rou�h Plumbing & Pressure Tzst I
6. Electricai UFER Grnd. 57. APPROVAL TO C04ER-GUNITE
7. Footings � 5&. Electricai Conduit�Undrgmd.
8. Foundation � 59. Gas Pipe, l7 Undrgrnd., Test
9. Wacer Pipe-Undrgmd. 60. Backwash Lines, RTrap, O Undrgrnd. �
10. Structural PSaor Systerrf 61. APPROVAL TO DECK
11. Property Sewer �ine & House Conneaion 62. Backwash & Recepter�Pinal .
72. Sewer Cap - 63. Heater & Vent�Finai
13. Roof Drains 64. Plumbiny System � F+nal .
14. Rough Plumbing 65. Electrical-Final
15. Rouyh Elecvicai�Conduit 66. Solar Svsiem�Final
76. Rough Electric Wiring 67. Fencing & Access Approval
77. Raugh Wiring Sigrt 68. APPROVED FOR PLASTERING
18. Rough Electricai�T Bar Ceiling 69. POOL/SPA SYSTEi`�,i5 FINAL '
79. Rough Heating & Air Condi[ioning FIRE DEPT. REQUIREMENT �
20, Rough Factory Fireplac= APPROVALS Permit � �
21. C�c.s, in Structure 70. Underground Hyclro
22. Ducts, Ventiiacing 71. Product Piping � Gas ❑ Oii
23. Gas Pipe�Rou3h & Tes. 72. Underground fiush
24. Roof Framin9 73. Undergrnd. Storaye Tank � Gas ❑ Oil
25. RooT Sheath(ng 74. Overhead HYdro '
26. �T�Bar Cefling (Structura[: & Monocoat 75. Dry Chemical :. I
27. Frame and Plashing 76. Dry Standpipe ��
28. Lathing & Siding - 77. FIXED SYSTEM FINAL �
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUtREMENT �'� �
31. Piaster Brown Coat 79. FINAL INSPECTION .' �
32. Elecvical Power MeterFinai SQ. FOOD CERTIFICATc ISSUED �
33. Final Elec:ric Notes:
34. finai He34ing & Air ConditiOning
35. Final Gas P�Pe-Test �
36. Hood or Car.opy �
37. Final FacWry Fireplace
38. Pinal PIur�6ing
39. V!ater Servica-Final
40. Gas ServiGe-Final
41. Solar pomestic-Final
42. Backfiow Preventer i
43. Backflow irrigation
44. Landscape Irrigation Sys:em
45. Sound Attenuation
46. Handicap Regulations
47. FINAL SrRUCTURE & BUILDING �
48. FINAL PLANNING -'"`
49. Eiectric Release to Edison F
50. Gas Release to Southern California Gas Co -
51. CERTIFICATE OF OCCUPANCY `
No. Da:a
PHOJECT POUPESS: 1 j O 2 4 i H P L
OWNEP'S NAME: REU 1 ER � i�i2.RF: L
. aoosEss: REU'i�:H, SiEPiiAN1L•' ee
230 24TH YL
COSTA i1ESA,CA 92626
'i14) 72i-39f15
AHCNIENGINEEN: NEG.NO.:
nooecss:
uxrt:
uxir:
PEPMITTEE: REUTER� GEN CONTRACTING (714 ) 251-0181
aooness: i7991 MITCHELL SOUTH 110
IR�'INE CA 927i4
IICEN5E0 CONTHFCTON OECIAXATION: I hereUy alfirm thal I am Iicense0 untler D�ovisions ol C�apter 9(commencing wit� Sec�ion
7000) of �iNsion 3 ot the Business and Pmiessions Co4e, antl my license is in full lorce an0 effect.
��c.�:..(/�59�68 sTaTeuc.:58N83F cuss: �fn E%P: 09/99
Dai .—! { �� �� Signature:�`{/7�✓i
KEHS'COMPENSPTIONUECLABATION: I�erebyaffumt�all�aveaterti�icaleoi on5enitosetl-inSurearaCertifita�eOiWOrkers'
Compensaiion Insurance, or a cenifietl copy Ihereol (Section 3800. Lab. q.
voucrwo.: 1200708-99 E%P.OATE: U%IOS�9J
comraxv: 5TATE FUND
�Ceriih¢d CaUY is hereby lumishetl. �. C¢rlilie0 copy i5 �iletl wilh �Ae ciry /BuJilOinp Oivi � n.
�at . � � AODiican�: ��%�/'�r`���
PTION FNOM WONKEPS' COMPENSATION DECNfiATION: Q�is section neetl not be completetl if ihe permit is forone hundretl �$100) aNess�.
I cetliry Ihai in ihe petlormance oi Ihe work �or which �his permi� is issuetl, I shall not employ any person in any manne� so as to become
sublec� to Ihe Warkers' Compensa�ion Laws oi Calilomia.
Daie: SignaWre:
NOTICE: If. a�ter making Ihis tleclara�ion, yau 5houl4 �ecome SUDIe�� �o Ihe Workers' Compensation D�ovisions o� the LaGar
Cotle, yau musi forthwilh compry with suc� pmvisions or ��is permi� shall be deemetl revoke0.
CONSTFUCTION LENUING pGENCY: I hereby allrtm Ihat ��ere is a con5lNc�ian IenOing agency tor �he pedormance o� �he work for
which ihis permil is i<suetl (Sec�ion 3W7. Crv. C�.
LENOEX:
AOOflE55:
OWNEB BOILDEfl OECLABBTIDN: I here6y alfirm thatl am exemplimm ihe Conirac�ori' S1ate License Lawtor�he following reason
(Section 7031.5 Business antl Prolessional Cotle: Any ci�y o� coumy which requires a permit to constmc6 al�er, impmve, demolis0. or
reoair any stmcWre. Wior lo iB issuance. also reQuires the aDPlicant br such permit to lile a signea statement ihat ne/she is Iicense0
pursuam Io Ihe O�ovisions o� t�e Caniracmrs' Slaie License Law (Chapter 9(commencing with Sec�ion 7000� of Division 3 oi Ihe Business
anA PmIe55ion5 Catle) or Ihal �¢/She is ezemp� Iher¢Imm anA I�e �asis lor ��e allegetl exemption. Any violaii0n of Settion 7031.5 by
any apPl¢ant �ar a Dermit su�le��s �he aD�licanl ta a civil penalty of not more than five huntlretl do�lars (5500).
I, as owner of ihe pmpetly or my employees wi�h waAes as �hei� sole compensa�ioq will tlo �he work, and �he
❑ stmcture is no� in�en0etl or oflered for sale (Section 704a, Business and Pm�essional Code: The ConUactors' Slale License Law
Ooes noi apply m an owner o� a pmperty who builds or improves thereon, anJ who Ooes such work himsel�/herself or Urough
his or ner own emDloyees. O�ovitled ihat such imo�ovemenis are not inteneea or oflere0 for sale. II, however ine �uiltling or
imD�ovement is sold within one year o� completioq the owner will have the burden of pmving he/she Aitl no� builJ o� improve
lor ��e purpose o� sale�.
I, as owner of ��e pmpeny. am exclusively contrac�ing wi�h licensea contrac�ors Io wnstmct the pmlec� (Section 7044, 9usiness
❑ antl Pwfessions Cotle: The Coniractors' State License Law tloes not appty to an owner of OmDeny who builOs or improves thereon
anU who conVacls �or such pmjec�s with a conirac�oqs) license pursuant to the Conirac�ors' $�ate License Law�. I am aware
Ihai proo� of their Warker'S Compensa�ion insurance 5hou10 be D�oNdetl ta me.
� I am exemp� untler Seclion: B. 8 P. C.
lor Inis reason:
Dale'. Ownec
I ao here0y [etlity ihat I am aware oi and unAerSiand the requiremenis of Calilomia Health anA Safery Coae $ec�ions 2550.5, 25533, anA
2553a and �hal I ar any IUWre �uiltling occupan� wilVwill not (drele one� nee0 io comOfY with said s�ate coaes an� �he requirements tor a
permit lor constmctian or motlificatmn imm Ihe Nir �ualiry Management �isirict. Fesiaential constmction apvlications are exempt imm
I�ese pmvisions
Daie: Applicanc
I �ere�y ceriily Ihal I have reatl I�is application anC 9ale �Aat t�e above inio�ma�ion is wrrecL I agree Io compty with ali ciry and coun�y
ordinances and staielaws relatingto builtling con9mclion antl �ereby authorize represenlativesof�his cilyto enteruDan�he above�men�ionetl
rOperty lOr in5 et�ian purpose5. // �
Dai ' " Signalure'. �' ' / � /
i�er's �icense or Sociai Securiiy +:
16aF46 Whue—Builtling', Green—Cotle Enlorcement: Canary—ApplicanC Pink—Revenue'. GolEenroE—Assessor
CITY Or' COSTA ,ESA — BUTLDING dERMIT
PERMIT iEO: � 06U070 Pi.AN CHECK NO: N
CONSTRUCTION TYPE: V—N PEAHTT TYPE: ELE
JOB DESCRIPTION : INSTALL NEW H.V.A.0 UNIT
CLAIN VALUE:
CALC—VALUE:
FERM NO: E 06f107C
GOVT: N SUPP: AJ
PUAPOSE: OTfi
Sc,� FT:
GROGP OCC: R-3 /
COMMENTS: X
�c�w�-�r��tt: �x�x�+�x��r�:��*s:�-�#��*#��:-�:�*x�r��, #i: i�-t *#�r�r���t*#*�:�*�*���:�i�*�-**�����-x��u-�r�-�i%�tt� aaa>z r���v�t:�i: �:
Z O N I N G R E Q❑ I R E FI E N T S
S E T B A C K S
------------ �IAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR• FT 1N FRNT• FT IN REAR: FT Ii�
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT ii�
PARKING P,EQ: PROV; PARCEL; 11910111 ZNE: REF NO;
PLANNING NOTES>
>
iElFilfEiF�1E�ltifiEiE,i°?E1f�1EiFiElE##%�1flEiE#if###iEiElF!l�N�1h1Fif%MIl1E#1E#1EA`#lEiE1F###k Ik1F#fE!`Y.�l.�##1Ca(-iFi.'#iffEitiFk`##'T-YK�Y�#
U E V E L O P A1 E N i S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVEP BY DATE:
BUILDING APPROVED BY : DATE; _
APPLICATION ISSUED BY: �,�+��� p DATE� � �
IEiS"IFN"H'IF'K'Y")%'X'fI')FIt3P'I�'#'N'ih'IE'IFi'r9E3l�f"SF3F�F�]cYlTFTtlYil'�i'riY)�'li'] R RT"Ic3('3FiFio-�'cF'ti'i�"Ir�iF'tr'�3F'IE'IF'M"IEY.`iF'M'ih'N"N' i1X' (n 1F 'F'
iF#1EiEi:iEiFiFie3E#iF9FiE3'9(-�kit�K�iEiEiEiE�7EiEit#iciEiF#i(�3E#9E#Yc##lEiEiE###ihiEifiE#i:##iF1F�k-iF�W#�K•#iE###iE#� Y.�##Y.•#��1'��-'F3t'.2
LEGALIZATION:N F E E S U M•M A R Y STRUCTURAL SEGIr1ENT:N
BLDG PMT PLUMBING .ELECTRIC YMECHANIC FIRE SMIP/AES GRAL7iNG
PERMIT 29.50 � "
502 � SMIP/NON—RES
YLAN _
ISSUE FEE 15.00
BUILDING—L�ZV—> PERMIT ISSUE PLAN—CAEC,K ' TOTAL PAID UUE
TOTALS----> 29,50 15.00 : 0.00 ' 44.50 �4,50 ,00
1
REVENUE DIVISIOP] TOTALS--> COLLECTED: .� �4A.50 OVER/SHORT: .00
BLUG PMT PLUMHING ELECTRIC MECHANIC •FIRFi SNIP/TOT GRADING PLAN—CAECK
44.50 � •
�
iE#iEitit#iF?EiE3E!!###it#iE#iEiF##3h##itiE3E##k�iFiE?C###K�##iEjFr:�Mi?K�#iF#Y.�iE#f.'lJ�1E##iP##'rF#t:#%#iEiEiE7Et.�%�#%###�%Y.
I N D I V I L1 U A L F E�£ _ B R E A K D O W N
TYPE QTY L� E S C R I P T I O N `�;` ;� UNIT COST TOT£aL COST
ELE 1 SERVICES BELOW 600 V 6 BELOW�,201 AMP 18.50 1&.50
ELE 1 SOB—PANEL 11,00 11,00
EXPIRED END OF ��ES
I+zcornplete lnsp�ctianc -
� qj 1/�.. ' � 01 60164054—�01640`4 T� T 44.50
���te��� /� $ig � DpTE: 07f14/94 TIME: 16:42
y . �
; `
CONSTRUCT�ON AND PLT:NNING
APPROVALS Permit#
t. TemPorary Electrical Serviceor Pole
2. Soil Pipe-Undrgmd.
3. EieUrical Conduit Utility-Undrgrnd.
4. E?ectrical Conduit-Undrgrnd.
5. Sceel Reinforcement
6. Electrical UFER Grnd.
7. Footings
8. FoundaT�On
9. Wate� P�Pe-Undrgrnd.
10. Sz�uctural Fioor System �
�
11. Property Sew=r �ine & House Connection
12. Sewsr Cap
73. Roo4 Dreins .
14. Rough Plumbing
15. Rouyh Electrica6Condu�t
16. Rough Electric Wiring
77. Rough Wiring Sign
18. Rough Electrical-T Bar Ceiling
19. Rough Heating & Air Conditioning
20. Rouyh Factory Fireplace
21. Duccs, in Structure
22. Ducts, Ventiiating
23. Gas PiAe�Rough & Test
24. Roof Framing
25. Rooi Sheathing
26. T�Bar Ceilin9 (Structura,) & Monocoat
27. Frame and Flashing
28. Lath�ng & Sidin9
29. Insuiation
30. Drywali Nailing
31. P�aster Broevn Coat
32. Ekecu�cal Powzr Meter-Final
33. �ina� Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Faciory Fireplace
38. Final Plumbing
39. Water Service�Final
40. Gas 5ervice-Final
41. So1ar pomestirFinel
42. Backflow Preventer
43. 6ackflow Irrigation
44. Landscape Irripation SVstem
45. Sound Aitenuation
46. Hand�cap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Eiectric Relsase to Edison
50. Gas Release to Southern California Gas Q
51. CERTIFICATE OF OCCUPANCY
Dace
i
Date
POG SPA �
inspector APPROVAI.S Permit #
52. Pool & Equipmenc Location �
53. Steel Reinfo�cement
54. Forms
55. Electrical8onding
56. Rough Pium6ing & Pressure Test
57. APPROVA� TO COVER�GUNITE
58. Electrical Conduit�Undrymd.
� 59. Gas Pipe, (� Undryrcd., Test A
6Q. Backwash Lines, P-Trap, O Undrgmd.
61. APPROVALTO DcCK
62. Backwash & Recepmr-Final
63. Heater & Vent-Final
6�. Plumbiny Systcm � Fir.al
65. Electrical-Finai
66. Solar SYstem-Pinal
67. Fencing & Access Approval
68. APPROVEDFORPLASTERING
69. POOUSPASYSTEP,15FINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
� 70. Underground Hydro
77. Product Piping O Gas � Oii
72. Undergror.;nd Flush
73. Undergr�d. Storage Tar.k O Gas ❑ 0��
74. Overhead HVdro
75. Dry Chemical
76. Dry Standpipe
� 77. FIXED SYSTEM FINAL
76. FIRE PREV. FINAL
HEALTN DEPT. REQUIREN7ENT
79. FINAL INSP[CTION �
80. FOOD CERTIPICATc ISSUED
Notes: I D � 1 G. l.f�•� A yl 1 I A M(�0
Oate � inspector
�-
%
PflOJECT pU0HES5: 2 j O 2 9 TH PL
OWNEN'$ NpME: C , HU•�LH
aooxess:SAME A5 ABOVE
714/650-8161
PflLNIENGINEEP:
ADONE$$:
flEG.NO.:
UNIT:
PEPMITTEE: NOCK PI,UMBING ( 714 ) 895-1246
aooxess:11610 SEAHOARD CIR
STANTON CA 90680
LICENSEU CONTPAC70B OECNNRTION: I hereby atli�m �hat I am licensea untler pwvisions of ChaD�er 9(commencing wi�� Section
7000) af Oivision 3 oi Ihe Business an0 Pmlessions Cotle, antl my license is in full brce and eliec�.
ciTvuc.:050386 p�STPTELIC.:511971 u55.C-36
. Daie: �n— 3O � LO Signature:_ _ _ _ _ _ —
I WORRENS'COMPENSpTIONDECtANA7fON: Ih¢re�ydffhmMatihaveatertilitateofconSentfoSClf-io5uremacerti�itateolWOB¢rs'
ComOensalion Insurance. ar a cerlilie0 copy Ihereo� (Seciion 3800. LaG. C�.
voucvxo.:116799290 E%P.DATE:O3IO1�iS
COMPANY: S TAT E
� C¢Nb¢0 Co�Y is �ereby lumi5�e4. � Cenihea �apy is filea w�th t�e cily BuilOing OiviSion. /J
�a�e: �� � .7D ' l CJ Applicant; "(���Y
E%EMPTIONFBOMWOflHEPS'COMPENSRTIONDECUBA710N: Qhi55ec1ionneeOnolbecom0letcdi�l�epumAi5loronehuntlretl�511p�orle55�.
I cetlily Ihai in ihe Dedormance ot Ihe woek for whic� ��is permit is issued, I shall nol empl0y any Oersan in any mann¢r 50 as lo become
su�leoi io I�e Workers' Compensalian Laws o� Califorqia.
Daie: Signamrg:
NOTILE: II, af�er making @is Ueclaration. you s�opld 6ecome suElect to ihe Warkers' CompenSation Dmvivons oi Ih¢ laDor
Code. y0u musl fonhvnih comply mt� suc� 0�o'�.4ion5 ot �N5 permit sAall �e Aeemetl tetrokeG. �
CONSTflOCTION LENUING RGENLY: I �ere�y affi�m t�u� t�ere is a cansiruction IenGinA aA��Y �or l�e peAormance ot IAe woA lor
wNCA t�is permil fs issuea (Sxiion 309L Gv. C�.
IENOEfl:
FODNESS:
OWNEN BUILOEN DECIABpiION: I nere0y allirm inal I am exempi Imm Ne Contracbrs' State License Law for �he lollowinp reason
�Seclwn 7031.5 Business anA Pmlessional COEe: Any �i1y ol coumy which reQuires a pe�mit lo conSlmci, alier, imDmve, Oemolis4 or
repai� any simcmre. onor m i�s issuance, alm reavires ihe aOD���ant for such permi� �o file a signe0 statement tfut nels�e is Iicense0
Oursuanl lo I�e pmvisions ol Ihe ConVactOrs' S�ale License Law �C�apler 9 �commencing vn�� Sectian 7000) ai Oivisian 3 al ��e Business
and Pmlessions Cotle) or ihat he/sne is exemo� ��ecefrom and �ne basis for �ne allepea eKemption. Any violation of Sec�ion 70.31.5 Uy
any apDliwnt for a permil su�lecis the apD�iwn� 10 a Civil Denal�y ol noi mOr¢ IAan tive hunCreO tlWlars (5500�.
I, as owner oi ihe pmpeny or rtry employees with wages as t�eir sole tAmpensation, will Eo t�e wark, anA ihe
❑ slruclure is noi imenGea ar o�ferea far ule (Sec�ion 70aa, Buvness anA Professional Code: The Coniraclors' State License Law
does na� apPN ia an owner ol a pmDeny wtq builOs otimproves iherean, antl who OoeS sucA waik himsell/�erself ori�rough
his or �er own employees. pmviaed Ihai such imprwemenis are nol intenaetl ar ollered br sale. Ii, �owever t�e Ouilding or
. improvemen� is solA wil�in one year ol [om0le�ion, Ihe owner vnll have Ihe Uuraen of pwving he/s0e diU no� Uuil� or im0�ove
br the purpose of sale�.
I, as awne� ol me pmpeny. am erclusively com�acting with Iicense0 conlractors io consimcl lhe O�ohct (Sectian 704a, Business
❑ anU Pmfessians Coae: The Comraclors' Stale License Law Joes nol apDly lo an owner o� pmpeM �o �uAOs or imprpves 1Aereon
and who toniratls iar SUc� pmle��5 wi�h a wqVacior(s) license pur5uanl lo Ihe ConiractoR' $Iaie Litens¢ law�. I am aware
Ihal prool ol Iheir Work¢r'S Campensa�ion inSUrance sMWE �e D�a�ded la me.
� 1 am exempt under Section: 8. 8 P. C.
lo� Ihis reason:
Oate: Owner.
I ao �ereCy cenify that i am aware oi antl untlerstanU �he requiremenis ol Calilomia Nealt� antl Safety Coae Sections 25505, 25533, an0
25534 anU Ina� I or any fuWre building occupanl willlwil no� (circle one) neetl to comply wiN said s�a�e cotles antl I�e repuir¢ments br a
permil lor consimclion or modilicalion imm IM1e Air Ouahry Managemenl Dis�ricl. Residenlial consimclion aOPlicalion5 are exemp� �rom
�he5e provi5ions.
Oa�e: Applican�;
I hereby [etlify Ihal l �ave rea4 ihi5 apDliCalion antl Slal¢ ��al Ihe abOve inlormali0n is correCl. I aA�¢e �o Comply wit� all [iiy anA t0unty
ordinances antl slaie Iaws relaling lo bUiltlmg wn5lmtiioq ana nereDy aulhorrze repr¢Sen�alives oi ihi5 Ciry lo enier upon ��e aboVe�menlbnetl
pro0eny forinspection Ourposesp. .
�a�e� %�- ,�!� - L'2 Signalure��
oriver's License or Sona� Security a:
�641�46 W�ile—Builtling; Green—Coda Enlorcem@nl: Canary—Np0licantl Pink—Revenue: Goltlenrotl—Assessor
CITY OF COSTA MESA — bUILDING PERMIT PERM NO: P 049637
PERMIT NO: P 049637 PLAN CHECK NO: N GOVT: N SU P:
t_iF)f:j�jT#tjr'lT�`rC� T�fE3 Y$F<.MIT TYNEi Pt,t) PURPOSE: OTH
JOB DESCRIPTION ; PISHWASHER REPLACEMENT SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: /
COMMENTS; NO STRUCTURAL WORK BEING DONE
x�*-��*****�t*+�-����***���***�*x�*�*�*�**�r***�*�t**���r***�x�*�**�+t�t-*****x�****�*x�at�*�t+t*x�
Z O N I N G R E Q U I R E M E N'C S
S E T B A C K S
------------ MAIN HUILDING ---------- `------- ACCESSORY bUILLING ---------
FkNT: FT IN 1tGAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEL'T: FT IN RGHT: FT IN
PARItING REQ: PROV: PARCEL; 43918136 ZNE: REF NO:
PLANNING NOTES>
>
iE iE �E if i4 if if it if if 1E iE iE iE iE it ik if it if 7E iE if iE iE IE 1f if jk iE fk ik ik iE it iE jE iF iE iF iE if iE if # 1E X�%IE if �f if �E if M if %jf 3! if jE iE iF iE',E iF � if Jt �k k If K iE iE dk iF 1F if
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
BUILDING APPROVED HY :
APPLICATION ISSUED BY: �
it K 1E if if iFif if if it if if iE ih 3f if�lE ififif k iE�k�� iE�i�ik iF i� 1�i�� iE 3E
iF iE jf 1i 1F iE iElf df if iElf aE iF iE 1f dF 1F it 1E iE iE iE jf 1E �E it �f if �f !k fE %�E )E if if 1F if if if iE if lE �f �� 7E 3E iE �1f
LEGALIZATION;N F E E 5 U M M A R Y
BLDG PMT
PERMIT
PLAN
ISSUE FEE
PLUMBING ELECTRIC MECHANIC
2,��
25$
3.00
DATE:
DATE:
DATE:
jf if aE � kaf�lf IfiF3Eif�h lE 3f 1f if � kaE iF�F�Ejf iE i4af
STRUCTURAL SEGMENT:N
FIRE SMIP/RB; GRADING
SMIP/NON—RES
HUILDING—DIV—> PERMIT ISSUE PLAN—CAECK TOTAL PAID DUE
TOTALS----> 2.00 3,00 0.00 5.00 5.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 5.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHEC3{
5.00
if !F if iF 1f 16 �f �lf iE iE 3f ik iE if if if if dE it �if K if if 1! iE if if iF iF if %af iE if iE iE iE iE jE 9f �E if iE iE �!f %� iF iE iE jf iElE if � lE if iE it )E 3E jF aE iF iE 3f 9f # IE lE 3E iF?f �F ik �f jE dE
Z N D I V I D U A L F E E B R E A K D O W N
TYPE QTY
yLU 1
D E 5 C R I P T I O N
DISHWASHER
END OF FEES
tINIT COST TOTAL COST
z.00 i.00
01 �G073214—�J007321; T CoT �,�p
�ATE� 10/31ISD TIFlE: 12:0;
CONSTRUCTION AND PLANNING P� 6 SPA
APPROVALS Permit # Date Inspector qpPROVALS Permit # Date Inspecto�
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. '' 53. Steel Reinforcemen[ �
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. ' � 55. Electricai Bonding �
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor System ' " 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection � 62. Backwash & Receptor�Final
12. Sewer Cap ' �
63. Heater & Vent-Final
13. Roof Droins ' 64. Plumbing System - Final '-
14. Rough Plumb�ng ' 65. Electrical-Final �'
15. Rough Elec[rical-Conduit , 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access ApP�oval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rou�h Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � � ��. � •. � � 'APPROVALS Permit # �
21. Ducts, in Structure �• ' '�70. Underground Hydro �
22. DuMs, Ventilating ' , � _, 71. Product �Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test ��� �,n •- r �� 7y, Undergrou�d Flush �
24. Roof Framing '' '�, :� - ;,, , � 73. Undergrnd. Storage Tank O Gas ❑ Oil �
25. Roof Sheathing � ' �• � i 74. Overhead Hydro �
26. T-Bar Ceiling (Structuraq &-Monocoat ' � , ' 75. Dry Chemical � �
27. Frame and Flashing -�� � .��� � 76. Dry Standpipe �
28. Lathing & Siding . ' � • • �'� '� � 77, , FIXED SYSTEM FINAL .
29. Insulation - , i ' �� 78.:FIRE PREV. PINAL �
30. Drywall Nailing �� .'„ HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � '� 79. FINAL INSPECTION �
-32. Electrical'Power Meter�Final � �80. FOOD CERTIFICATE ISSUED
33. Final Electrit � � �Notes: � � � � �
�
34. Final Heating�& Air Conditioning � : ' '
35. Final Gas Pipe-Test .. , � . � '
� 36. Hood or Canopy ' ' � . ' � � �
. , � , • .. .. ,
37. Final Faaory Fireplace , ' ;
38. Final Plumbing � � ( Zy '� � � '
39. WateF Service-Final , ; �.,'�'�, '
40. Gas Service-Final . , � �:� �
41. Solar pomesiicFinal ;, � . , ,
42. Backflow Preventer �
43. Backflow Irrigation " ' ,
..44. Landscape Irripation System ' ^ ' � '� � � � • '
45. Sound Attenuation ' ,', : . .
46. Handicap Regulations .
47. FINAL STRUCTURE & BULLDING ' �• .
46. FINAL PLANNING . � ' ' �
49. Electric Release to Edison j� ,�
50. Gas Release to Southern California Gas Co . � i • �
57. CERTIFICATE OF OCCUPANCY � '
No Date `'
COUNTY OF ORANGE
BUILDING DEPT.
636 No. Bmadway
Santa Ana, CaGfornia
P6one: KI 2b211
1. OWNER'S NAME.._F.H.
hpplication for Building Permi. , �
AND FOR A
CertiFicate of Use and Occupancy
Permit No..���-�--; p--_
3ept. 22� 1952
PHONE �acon6749 J _.,,_,.
256 Santa Ieabel 9L._....----------------------------------------------------- CITY-----_Coata_6Sesa
MAILING ADDRESS- -----------�-�---.._--�--�-- �------- - - � . ................�------•
Owr18T --' "-'---"--'-----'_-"'-'----...""_"-"-'--'•-" IQame Ov+ri9T
Name _......----`-------------' ---------"-'---......-'-----'-'-------'------...-----------'-"-----------"--------"----
� (Archirect or Engineer) (Contractor)
'; Address _.-----'--"------"----------'......_-"------'...-----'-----"-----'--.... Address '------.........----'-'-'----"--'---'-----------------'------'-'---'---'--------
.
City.........--------...-----....--------""-"-'-.------------------'-"...--`-"--..... City "'-'------...----'-----...........................-----'--'-'-'--......-'-'---'------"'."
State State
Lic. No.-------------------------'----. Phone....-----._ .............----"----. Lic. No...----------"---------------------..... Phone....._.----...-----...-----.........
PROPOSED USE: ------------�----llqve�.1�48.....�.Fld...c�_Y..LB.4k.@Sl...gAd[a�-------- -- ------------------- --�- .......................................
230 - 24th Place Coata Lfesa
2. JOB LOCATION--- ........... .........-- ............------------......__...---......-------- -----...-- ---.........-------- --- - . . ...---.............---�--..._........_-
(I-Iouse No.) (Name oE Stree[) (Town or School District)
NAME OF AND DIRECTION FROM NEAREST CROSS STREET....._�.�eetminieter Plaoe A:aet
.. . .. . ............. -�- - ......................---- -�- �
3. LEGAL DESCRIPTION: I,ot------?.-5----.......------....-----------...Block ------------------
(Metes and Bounds Description—Use rcverse side o( form)
4. CORNER LOT ( ) INTERIOR LOT ( x ) THROUGH LOT (
1442
) SLOPE OF LOT ( )
i. SIZE OF BLDG.:---.---.-35x---41.---.----AREA:---.-_9.OII.._-_------_..SIZE OF LOT:-----•---_aT...z.13A.....AREA:.7200------------------•--
6. HEIGHT OF BLDG.:.._.._12-_---------------_--........CEILING HEIGHT:.....-8.'4---........._....---.NO. OF STORIES....-_1--....._------_._.--
1 lOs 12 ---. -- ._. Size of Kitchen.....9-6 x.li
7. NO. FAMILIES---------------_--.-------__._---_.Size of Smallest Bedroom:---_-------_---..- --.-------....
8. EXTERIOR WALL CONSTRUCTION:_..._8tucoo INTERIOR WALL COVERING...$l�eter __...____.__..___��
(Frame, Stucco, Etc.) (Plaster•Drywall, Etc.)
/
ROOFING COVERING --ComPosltio�5- - ...... - �-- -- ......- � ----� ...................- - -- ---. ...... !
R STATE HOW MANY BUILDINGS NOW ON LOT AND GIVE USE OF EACH.._none
10. SETBACKS: Front Yard From Center Line of S[reet--'_...-------50.�.-D..^ ................................................:.�.........................................-.--
Nearest Side Yard.18-� .............Rear Yard..._34-0 Distance in Feet Between Bldgs. on Same Lot.,... none._...___._...__„__.,._.,,.
(Propecty Line) (Proper[y Line) ' -
11. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
12.
13.
14.
��
(a) Footing: Width------"---4--..........--'--"---Depth in Ground-----------'-- ��-'-'-----...Width of Wall..._bn...------'-'--`-----
(b) Size of Stitds:._2x4.---------------Spacing.---.-----.16--------�CC Iviaterial of Floor.-----wooi......_ ......................
2x8 16 ' ,.
(c) Size of Floor Joists:.....___.....--------------------------- Pacing..-------------:
--- ---------�� ----.... �
(d) Size of Rafters:..._....2s6 ..............--�---- -----.Spacing ��: �: ---�4.... ---....-----....:'CC
VALUATION OF 6300 OSED WORK: I�n.�cl�v g all labor, plumbi�g, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $------------�-------�--�-�n�fl
I HEREBY CERTIFY THAT TU THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
Ti3E�COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
�^ i � i �'l0 /1
Signed:----"�--r..-� ~--`-----'-u- ---a"�c±C�t-'-`-`."�--.....-'-----'---------------------------"
SEP __2 4 _1952 (o1V1eC>
PlansFiled:---------------- ' --...----.....---------� ..................
BY°----....-�-'-----------------'-�------------...---`-------`--�----......................------�---'-----....
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY
Bldg. Permit
Plan Check
Total • -
Receipt No.
Paid to •
PEES:
$------- � �_� � ---�---
$.....�.-� --o Q - -....----
$------------ -�-�-------- -
SEP 2 4 1952
DATE ..... .............-� --- --------•----
s000--�-s�
G R O U P----� ---=s .--......
TYPE------ �-�--------.........
DIST.
MAP-----L---- /�`/-----.......
SHEET NO.--}�--------------- -
�
APPLICATION.7u'i�f..'�. HEALTH ............................
ZONING-_-.-----.-(�-----.-. FIRE
PLANS AND � MARSHAL ........................
SPEC'S- --- ------.........----- STATE-----------.....---•- ........
CORRECTIONS ENGINEER
VERIFIED------� - -----._.. CAL .......... .....------�--.........
�UI7�L10.VYJ�FIUE�OUh p B70R IN
C
� L
3�36�.
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 817 COBTA MHBA. GALIPORNIA
For Applicanf +o Fill In Complefely
TYPE OR PRINT
BUILDING �
AD�RESS
GOSTA MESA, CALIFORNIA
, '�� ' ��� ���
� ��� �DEC 7 1980
�" ,=1VHtiCc �J_".
cr��: n� �os�A �:��-�,
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
NCCH�PT NO. V[RMIT N(
� NQLlN6D CY I DAlB RECCIVED DAT
_ �� % 07 - �'% /��
TEL. �) " �, BUILDING
NO. ADDRE6S
7E^. COSTA MESA. CALIFORNIA
� BIZE .: •Y . .—. � _ . . _ � I C , I no. oP eLDo9.
� 9HT9ACN LINH INOM
DESCRIPTION OF
WORK TO BE
i HBNHBY AC%NOWL8D68 TXAT 1 NAYB q6AD T1118 AALIWTON
ANO 6TATE THAT TH8 I�BOV! IB LORH6GT ANO AQR88 TO CAY-
PLY WITM ALL GITY ONDINANCE9 PNO 9TATE IJ�W9 R80UlATINO
BUIlDINO CqN}6TIiUCT10N. n ,A/ /� oa ////j
BIGNATURE OPh� //. // !/i /I�...�. /N
� AUTHORIZED
ZON!•
�
LHOAL
/I%Q r�' � � DATE
ZONING
NO. OR �J �I UBI Op l.
rLANO (/ BUILO�N6
"�/��Z
%�%—��/—/,
YARDS EVE6
APPROVED
ICHNT6P LIN[ BT.1
/
0
G J
TX8 AMOUM BXOWN UNOlR VALUATION IB IOq TNe
PURP096 OF ¢STABLI8HIN0 A PlHMIT IeH ONLY.
VALVATION C
�� �j PERMIT FEE S Q '
i //
S � J � PLAN CHECK $ % ~
_ / 7 .�
i
' ,�.
' 3�� 3G'�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 C08TA MEBA. CALIPORNIA
For Applicant +o Fill In Complefely
TYPE OR PRINT
nooaess � �l� �
COSTA MESA. CALIFORNIA
OWNER
MAII. , /
A�DRESS Y-
TEL.
CITY P NO.
ARGHITECT TEL.
-J ,
.�,, .
_�,� pEc 7 ,�°-
��
!'�!'�Ill'.l�L Ji_ '
APPLICATION �FOR�PERMIT' ���`'�
BUILDING
For Office Use Only
NHCHIPT NO. PCPMIT NO.
pY DATH RECCIVEO ./I�, DwTE 160U�p
- �a���(�K� /.�- /%-(0[7
..10"�0 �.3�'� � �
ZONe NO. OI U86 OF N6 �
CITY ��LANB �I BIIILOINO �
LIC.TNO. NO. L[aA� -l��j /(/_ � L /� % yJ
O68CRIVTION � �� T"
8RE r� ( No. oI e�n�e.
OF LOT I X� ^X /. � xoW oN LOT I p. p, NO. U'/
USE OF YARDS EYES
EXISTING BLOG APPROVEO ALLOWED
96T9ACK LINB PROM /� <CCHTeR LIN[ 6T.1 r/� �,(� � �/J
cedieR or arnssr t REAR YARD FRONT `F �'L-""�`--6`�N.
�/� � � f
61DE YARO LEFT.?� G RIGHT � R.SIDE � FT. IN.
DESCRIPTION OF WORK 3 S � FT. �� r�:x1,N.
SIOE
NEW I II ALTERATION I II ADD1710N I REAR � �`� FT. � IN.
REPAIR I IIMOVING I IIDEMOLISH I APPR E �, p7E �—Y�O
6Y
BUILOIN / A /NO. OF . /
81ZE ROOMS 6TORIES
EXTERIOR W LL ROOF �
COVERING COVERING � E�� �
USE OF B LD G�+ND WORK TO BE PERFQRMED
/� /
� � � - 7
� H8H8BY ACNNOWL8Dp6 TXAT � HAVB RGD THIB APPLIWTION Tryg AMOUM 6MOWN UNDCR VALUATION IB POR TH6
•ND BTATE TNAT TMQ ABOVH IB CORHECT AND AOREB TO'CON- pURP098 OP �eBTAlLIBHIN6 A PlRMIT P!H ONIY.
PLY WITH AL CITY ORDINMICE9 ANO IAWB qBpU{aTNO
euumwo Cbx ucnow. _ VALUATION (r. —
SIGNATURE
�� PERMIT FEE S A/
PERMITfE - � 9 s�' � � �
� S � PLAN CHECK $
AUTHORIZED AGEN7 /� � o
70TAL FEE y
�