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HomeMy WebLinkAbout1935 FULLERTON AVE - Building Permits CITY OF COSTA MESA BUILDING DIVISION fARAI 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa- esa.ca.us u. FOR INSPECTIONS CALL: (714)754-5626 A`�w fi PERMIT NUMBER: BX08-00087 PERMIT TYPE B_MISC STATUS: ISSUED APN: 42626313 DATE ISSUED: 03/28/2008 Zoning: , ISSUED BY: JOB ADDRESS: 1935 FULLERTON AV CM Suite/Unit: Vicinity: DETACHED GARAGE. Primary Occ: 32 Const Type :77 SQ. FT: 300 Valuation: $9,500.00 SCOPE OF WORK: 300 SQ FT SOLID ROOF PATIO COVER ATTACHED TO THE DETACHED GARAGE. MISC ELECTRICAL TO INCLUDE 2 GFCI OUTLETS, 1 JUNCTION BOX, 1 SWITCH. OWNER: PERRY,JOAN J JORDAN TR Address:: 1935 FULLERTON AVE Unit City/State: COSTA MESA,CA Zip Code: 92627-2233 Phone: APPLICANT: URIAS,JOHN Address: 1048 IRVINE AVE Unit: SUITE 213 City/State: NEWPORT BEACH, CA Zip Code: 92660 Phone: 949-514-5933 CONTRACTOR: A U BUILDERS - License No. 908644 Address: 1048 IRVINE AVE Unit: SUITE 213 City/State: NEWPORT BEACH, CA Zip Code: 92660 Phone 949-514-5933 Cell: ARCHITECT: License No. Phone ENGINEER: MIRJAHANGIR, FRANK F License No. 20435 •Phone 714-596-5568 FEE SUMMARY Building Plan Check: $117.81 Building Permit: $181.25 Electrical Permit: $27.90 SMIP Residential $0.95 • ,I t SMIP Commercial $0.00 TOTAL FEES $327.91 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. $ODE t, INSPECTION TYPE DATE INTITIALS CODE INSPECTION TYPE DATE INTRIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 6S 08 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site /�[',[gyp /,•�q(�� 204 'Final Demolition _ 250 Final Building/Occupancy A V 2-0 6?t.s WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's licb.._.. ❑Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 0 I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance canier and policy 0 I hereby certify that no excavation five(5)or more feet c1 depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding.falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Thissectionneed nor be competed a the permit is valued of one hundred dollars(S100)d less.) 2,Art2 Sec.341,Tule 8,California Administrative Code). Polls umber: 0 As owner-builder, I will not employ anyone to do work which would I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicants Signature Date Lr Code.I shII forthwith comply with these prOviS• ns. OV Division of Industrial Safety Permit Number: I Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WA NING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be Bled with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons.or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No / /�[ # 0T Class# (Section 25533 of the Califomia Health and Safety Code, with some 1 exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Contractor's signature Ca 7 hazardous materials equal to or greater than a weight of 500 pounds. or a t — volume of 55 gallons, or 200 cubic feet of compressed gas at standard C. STRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the Califomia Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required. has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors (Section 65850.2 of the California Govemment Code requires that the requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits). Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? D Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion. the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property. am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature I Le al Owner(s) ^ Signature Date ^ / ✓^ 3057.46 13/071 And/or Authorized Apdirant / C Date / c, *4,• CITY OF COSTA MESA 4 BUILDING DIVISION >: DECLARATIONS • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: r - . ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the _work for which this permit is issued. -❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. work rs'comp sation I urance carrier and policy number are: / •• p /� /r p (Canier:J �� '� /}� \/}� L—Policy.Number.©0- LCl t5 Q 7 r , o (This section need not be compl ed if the permit Is valued of one hundred dollars($100)or less.) -t ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califon --= :.p:e that it I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro /� - C� Applicant Slgnat aV '9/ (Dat - "� -- Lo` 04 C WARNING:RARURE TO UR' KERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUEUECL AN EMPLOYER TO C NAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED _THOUSAND DOLIARE 100,000),IN• M TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3IW OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed und: . sof •apter 9(commencing with Section 7000)of Division 3 of the Businessand Profen Ions Code,and my license Is in full force.and effect:tie 1f=a Class p � l t 3 4' Contractors Signature:: / Date:. / '��Q "— 0.6 CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the properly,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LLJJ Yes No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given Is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. • Signature Of Legal Owner(s) //�' Date And/Or'Authorized Applicant � /' Date"- /V ti4 0 '.. (Lig et CODE INSPECTION TYPE PAIL !MALI • CODE r INSPECTION TYPF PAIL 1NR➢ELS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing • GS"Final Re-Roof if 9 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention • 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy L .. ADDRESS: 1935 FULLERTON AV UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 070500 OWNER'S : AL n��y—GERCic:lma.•—iia agDRESSREss: /� FG I/E�7��1 406, — PERMIT NO: E 070500 PLAN CHECK NO: N GOVT: N SUPP: Y Ccsin me-SA-/ CA qefi CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE; OTH ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : UPGRADE METER, RE:4E61811 SQ FT: ADDRESS: UNIT: ,J00--.l CLAIM VALUE; CALC-VALUE: GROUP OCC: / PERMITTEE: JORDANFV.gy ( 714 ) 548-6221 ADDRESS: 1935 FULLERTON COMMENTS ; NO OTHER WORK AUTHORIZED BY THIS PERMIT C.M. CA 92627 *************************************************************err**************** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIR EMEN TS 7000)of Division 3 of the Business and Professions Code.and rny,license is in full force and effect. SETBACK S CITY LIC.: STATE LIC.: CLASS: EXP Dale: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FANT: FT IN REAR; FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.CI- LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV; o PARCEL: 42626313 ZNE: REF NO: 7 Certified copy is hereby furnished. El Certified copy is filed with the city Building Division. PLANNING NOTES> > Date: Applicant' ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: 's section need not be completed if the permit is for one hu Bred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of •• ...k for which this r 1 is issued.I shall not employ any rson in any ma er so as to become subject to o.hAsp kers'Comp- sation :cos of Califor ZONING APPROVED BY DATE: Date: .� / 'a �r - //!AJ ./ {G • BUILDING APPROVED BY NOTI ,after making tidaration,you should ome subject to the Worke Compensation visions of a Labor DATE: Cod: au must forthwith ply with such provisio or this permit shall be de ed revoked. CONST•••CTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: rr DATE: �q U which this permit is issued(Section 3097.Civ.C). ****************************************** 341E******************** - • •• . * LENDER: ******************************************************************************* ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT;N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9 , 0 0 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 0 SM I P/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE 4 ,50 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Iii structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 9 . 00 4 , 50 0 . 00 13 . 50 13 , 50 , 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.II,however the building or REVENUE DIVISION TOTALS--> COLLECTED:1 13. 50 OVER/SHORT: ,00 improvement sale). one year of completion.the owner will have the burden of proving he/she did not build or improve for Mepurpose BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/TOT GRADING PLAN-CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business _ 13 . 50 ❑ and Professions Code: The Contractors'Stale License Law does not apply to an owner of properly who builds or improves thereon ,. and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *****e!************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: / B.8 P.C. • thisrea . : / TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST / Owner: /�/' 7 r ELE 10 RECEPT/OUTLET 1 ST 20 EA. . 75 7 . 50 / rebycenlfyle•amawareofandunderslandlherequiremenliforniaHeallh d5afetyCodeSections25g5,25533,and ELE 2 RECEPT/SWITCH 1 ST 20 EA, . 75 1 . 50 4 and roar or y future building occupant wi=Vwill not(circle one)need to comply with said state codes and the requirements fora • rmit for construe ion or modification from the Air Duality Management District.Residential construction applications are exempt from END OF FEES hese provisions. E PIRED Date: Applicant. I. 4 •' If'iL' on- I hereby certify that I have read this application an.state that the above i. .illation is correct agree to comp) ith all city and county ��� //�! �•' ordinances and slate laws rel.'•iio buildingco : ction and hereby .rue re resentative his ci to enter oe the above-mentioned T/ • //1 V orogen inspection p s. '�' /',, G 7 / fr ' n / n y Dal . . — — mater /el 1 K 7 y XJ 01 001739::7-G01739;'7 To-r •;.- 1' Dri/License or Si/Security x: DATE= 12/22/74 irr=: 13;58 16•..46 White—Bwlding:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor • CONSTRUCTION AND PLANNING 200E SPA APPROVALS Permit# Date Inspector APPROVALS Permit # - - Date Inspector. 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2.,1 Soil Pipe-Undrgrnd,r 53. Steel Reinforcement :e� .;vctrical Contd3rl, tility-Undrgrnd. 54. Forms �.;'4:-tElectrical Conduit•Undrgrnd. 55. Electrical Bonding , tyT G' `i _1-;'C'steel Reinforc?7it ni t 56. Rough Plumbing & Pressure Test •, dl '-.t6:EEctrical UFEfi"Grnd. 57. APPROVAL TO COVER-GUNITE n:n,0 ^ •t'ItL2Pdotings to 58. Electrical Conduit-Undrgrnd. 6 v •a I it't„aroundation 59. Gas Pipe, 0 Undrgrnd., Test o 4.3Nater Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. o, 1KJI. Structural Floor System 61. APPROVAL TO DECK 11, 11Q3perty Sewer Lirier& House Connection 62. Backwash & Receptor-Final 1/411a 12. Sayer Cap o, 63. Heater & Vent-Final • 13. Roof Drains t) n 64. Plumbing System - Final 14. Rough Plumbing " .. • 65. Electrical-Final 15. Rough Electrie -Conduit 66. Solar System-Final - • I 16. Rough ElectridY°t•Viring 67. Fencing & Access Approval - 17. Rough Wiring Stign 68. APPROVED FOR PLASTERING 18. Rough ElectriSJ-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT im 20Jn2ot h Facto^y t}tAPlace ! til -1 * r2 =) c' ' * a PPRMVA'14::)'-Per Y it # ` " '-t•' tl, m f 1 5: ' Ga-: F H lT* t. 1H F- _ 1 21 -Duc:s,istStrgcttci , ! •• 2: 0 '- * 70. tfndergi56htt-'Hy_tiro 1 L, 1) c ti t t n .. k F. .- ' t 22. uas, V nt9tin '* =� * n 4 x t r°7 <P 1 Pr.. Ftfctiipg tGSs IQlOil 23.:Gas ipe=Rough & test , MS * m & •c• 0* .l '-02. Undergroimd Flush-: * - r: -i ^t- .7,9_-.‘ C7 S. . ,.. -y� �. 24DRoci Framing •�a i '11 * -' j u ,_,x ' -73�iUndergrnq Stor%eriank LJ Gas 0011'1 i 25. Rory.Sheathing F t < •, t = n * -.74?,O .H verheadydr'o._ • ': - • * IP p 514 t I -I * - r:a u:tr; 26.i -eat Ceiling (Stn dturall &al ...•-• at . J ). n * 752Ary •Chemical ,._, t 11 C7~ * :a s s F- rr: IJ . ? `r. 1'1 . . 27 .frame an`d Flashi;'tg, _ttrcr, it el >I 11 t 76. Dry Standpipe :to* t -_ :*1!n -• •-S.-Lathing:& Siding�:* c') '7-.^,IA 1M177�"FIXED Y$lE,�.1jelNAL2 ri F'E" . "19. Insulatigh iD •• •• . to i ,■ 78rFIRE PREY. FINA-L * . �a^s - co J ti30. Drywallyailing Ff o =IN= r~ VIE,ALTH'DEPT*R'EQbtRF.,�AENT ? %'1 1 S - k . t S)> 1 -. _ r31. Plaster liinwn;Coyt;; g 1 .r LI' r I ■ na9.' FINAL I 1 P.ECTR7N.i * H.r. r<32.s1ElectricSKPoNer Metef'%F;nal ! a 780l00D CERTIFICAI`B ISK. DH .c33.`Fini Elggtrid, ;-i x - i G I a p -ZQ•, /7'r * '1V4es. - 9''r.i n '+ O t* ^/ n84.r'Find{Heatingi& AiriConeition[Agr. ci •- - * Cr. •r.1 (1'.1: * '3 I/ r. t. - ri 4_n, el r 1 I l e :U 1-430 r.1 1 ;..✓ L ..... i35.�1 i. L a 17 •• • la t r)0 '-. :i( 1 .TJ'=. . ri, inal'Gas1Pipe-Test., ., * �, i ; ? _, ,;p -1,., :,•1n- tri i u36. Hood or'Canopyrut ^-1 t 'T"1 * i1 I 1t t 2: 1 no - ^ n I c f,l ' : r :h ':J rr •..1...1)1 _ -1 1 :r' ,v * m i z �, r) • _te l_ .•, D :37. Fina`t,Faciory Fir ��ace M 1 F,;_, I* * ;: '1 :38. FinatiPlumbing _* _•C') I ' 1 ''1. 3. = - L-• * to 39. Watei Service-Firi81: .- "' "* a' I . is s n -.,-n .•'7l ?40. Gas Service-Final s n: n' , m I i. _ - . rr 1. Solar Domestic-Find -• z. * I I I* 4. ,o, _ 0 , IP `42.-Backflow Preventers r ,:is i I I; . tti :.F. , ri _ 43. Backflow Irrigations or„"" a ;a * s -;• r,r- * , l 144. Landscape Irrigation Systemw-;io c: '1: -'1 "1 2: + r:• Ili ,1 r.r• r ,.iro (13-i.1••t• '71 e .t t'• t . 'r rir '-1 `. r r S - `45. Sound Atteriliatio "'Cf.. t„ r -. H H: a r-. Cw 1;a-: r i-• i . r '- .:. - i-i . i • r*16. Handicap•Regulatio's ' s r7 * , , tr; 0 .. . -r I It d ci.o t 47..-FINAL STRUCTURE & BUIkDING i I* ; •-1 n1 t, 48. INeL PLANNING* 1 t-k- • . 1 I< + m ni • X19. Electtic Release to Edison i ( 1 I• I u; y v. •50. ,Gas Release to Southern CaliforniaGas Co a ' r . :- ^ • to ii , 51. CERTIFICATE OF OCCUPANCY ., � r+ - C - No. _ Date /1► • ,k ':. 00 d► 1 T35 Pct t 1 e tkoi1 . , , . I ______ . 769 1 I I : 4 . mie.N t ;., .., ts , .g. is . 57 4. 1 1 1 B t tor (.) / 11A e • _ 4 4 0. ..„____Jsi______ .. • (; d • ,'t i 147 , c 1 ..,,„\.. w• ,• .. ?•• :1.. I - . . • . . . . . . . . Ii- PROJECT ADDRESS: 1935•TULL"GRTON AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 061811 OWNER'S NAME: PEASLEY GERALD W TR ADOREss: 632 BEACHCOMBER DR PERMIT NO: E 061811 PLAN CHECK NO; N GOVT: N SUPP; N SEAL BEACH, CA 90740 CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH ARCM/ENGINEER: REG.NO.: JOB DESCRIPTION : UPGRADE METER SQFT: ADDRESS: ) UNIT: -4:114) 302-0.4)) Feely CLAIM VALUE: CALL—VALUE; GROUP OCC; / PERMITTEE: t.-.-- — _-- ( 714 ) 548-6221 ADDREss: 1935 FULLERTON COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT • C'M, CA 92627 ***�E*�E�E�Ex*+L+E�E�L�E***#�F********�E+E�E�EtE�E�E*�E*�E********* ¢*�F�6*�E*�F********* ****�E*�r�E�r**** f LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSOR BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent o self-insure or a certificate of Workers' FRNT: FT IN REAR- FT IN FRNT: FT IA REAR; FT IN Compensation Insurance,or a certified copy thereof(Section 3800, Lab.C). LEFT: FT IN RG : FT IN EFT: FT N RGHT- FT IN POLICY NO.: EXP. DATE: COMPANY: PARKING REQ• PROV; PARCEL: 4 626313 ZNE: / REF NO: 0 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division, PLANNING NOTES> > fate' Applicant: ******************************************** **********Y*********************** EXEMPTION FROM WORKERS'COMPENnON DECLARATION: (This secti d not be co.. the permit is for one hundred(5100)or less). DEVELOPMENT 5 E, R VICE R E Q ' IR EMEN T S I certify that in the perf ante al e wont tor-,tihich this permit is is ed shall no 'mploy a person in any manner so as to become r subject to the Worker?jinn lion Laws of California, / /� 1 �/ r?jl� ZONING APPROVED BY ----I—SATE: Date: 7 7� Signature: /.7 _ NOTICE:If,after making this declaration,you should beco bject to the W. er Compensation provisions of the Labor BUILDING APPROVED BY . DATE: Code,you must forthwith comply with such provisions or permit shall be ree 'd revoked. 7 CONSTRUCTION LENDING AGENCY: I hereby affirm that thefts a construction e .ng agency for the performance of the work fpr APPLICATION ISSUED B Y: • DATE; 99�/``I CC�a which this permit is issued(Section 3097.Civ.C). **********************x • it sr tt• 7 - - .. • • **********SxCiru:!/At** LENDER: *********************************i(,*************. ******************************* ADDRESS: LEGALIZATION:N F E E S .' M M A - Y STRUCTURAL SEGMENT:N / OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from theContractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHA IC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 1850 , repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 0% SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15 ,00 I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ;Q structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 18 . 50 15, 00 0. 00 33 . 50 33 . 50 • 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If.however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED • 33, 50 OVER/SHORT; 00 for the purposeof sale). BLDG PMT PLUMBING ELECTRIC MECHAN C FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner al the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 33. 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ******************************** ********************************************* that proof of their Worker' Compensation insurance should be provided to me. I am exempt order Sect' n: B.&P.C. INDIVID A L F E E BREAKDOWN 1 Elr • mr this ra ,n: TYPE QTY DESCRIPTION UNIT COST TOTAL COST Dale: / Owner: ii' ' Ida hereby cer ily that I a r aware of and understand the requirements of Cali.mi ealth and Sal y ode Sections 25505.25533,and ELE 1 SERVICES BELOW 600 V S BELOW 201 AMP 18 , 50 18 . 50 25534 and that I or any future building occupant wilgwill not(cirde one)neer o mply with said •codes and the requirements for a END OF FEES permit for construction or modification from the Air Quality Management D.tm.Residential cons uction applications are exempt from these provisions. Date: Applicant' I hereby certify that I have read t is application and state that the ab. •' ormation is corn . agree r comply with all city and county ordinances and stat laws elan to building construction and her•.author'e representa' '5 of this city ti enter upon the above-mentioned property for msp ,lion purp es. / Date'.1t �� _� Slgnalure'. - /tn-i. / _.�A. — Ul 00137532-00137532 TOT 33,50 Drivers ic se or Soci Security#: DATES 04/20/93 TIME: 16:42 1 1641-46 white—Building;Green—Code Enforcement:Ca ///• y—Applicant;Pink—Rev.n :Goldenrod—Assessor IIIIr 1 CONSTRUCTION AND PLANNING POOL A . •-i Datn Inspector Date iIn>pectnr APPROVALS Permit•;.= APPROVALS Pcrrnit - - 1. Temporary Eleetr ca; Sere c!or Pc!u • 52. pool & Eq u'; mint Location - i _- 2. SooRpe•Undrgrrd. 53. SNuI Rai fora -nem( e 3 ElcctrIcal Cond.Jt Utihty•Urorgn•.J. • . 54. Form: 4. Electrical Conduit Undrg-od. T 55. Electrical Bonn nn IF 5. Steel Reinforcement 56. Rough Pius-hirq& 'r"sure Test i I r a 6. Electrical OF ER Gind I 57. APPROVAL In CC VFti rli^ F'iTi 1 7 Footings I53. Electric-al Curnu•t l,rd,_ino � j B. 'ou^dation --- _ _-59. Ga; P.pe, �r -_ -d --- -•- -- - O. ..ater P.pe.U.^.drgrr.o. CO. S,.c4;a%li I. ' •. P •ap. L..-..:-.;.- I -r 7C. St•..ct.ral F1ocr System _-.1.... _F � 61. AP?ROL' _ t L .".t - - 11. Property Sewer Line 8: :Trust: Concretion I 62. Back.ac-t & {.ca • . F. Lir 12. Server Cap I 63. 1i2.•stei C Vert F:,-:., II I 3Reof Dra!ns - r 64. Piumbirq Sym m F gel i 1 _ 14. Po..gh Piumbing 65. Electrical F.r:i I r ---------- -- - 15. Rough Eiectri al-Conduit 66. Solar SysterdI . 'in.. 16. Rough Electric Wiring , 67 Fencing & Act its 1n cs,I : - 17. Rough Wring Sign ---_- --� _68. A'?AOVCO 02 'U�S�ERI:G i._- _-- -- --- -i-- - - r - - - I 18 Rough Electrical-T Bar Cee'!.-.o 69. PCOL'S S"ST -3 FILA: 19. Rough Heating & Ar Cor.dIt er,r.q I FIRE L'CPT. RrnUIRE1•7'-:T ' 20. Rourrh F„ctory F rep:ee, - -- -I ----I ---i APPRCtr.`-,:.5 . , ..1, . ..- --- j 21. D.,ct.. '• Str_cr re 70. U ,na.rC. ,: r ' .... ., y 22. 0,r;. Vc-t sting --_ --t I 71. nru.�i ct -• 1'.,. - -. • a' -__�-_ 23. Gss ° ac Rou;i, & Tst - -- - -i---- - -- - ----- - --- -I---72. Lnct:-,r r - -',7. ; -- - I--- _t_ 24 Roo` am:rg -1- _ - _ 73. Und.rmnu. c , _ - _ _ -J- __ _ • 2h. Root Sheathing --.--_ _ _- --. 74 OurilteuiI Hyr:i. -_ -- _f I 26. .'13ar Ceiling (Structural; & iionoco.t _ ---I-- 15. f_ Dry Chemical i r 27. Frame ar.d Flashing i 76. Dry Stu idu:u, • 26 :atn.gg2: Sdrg --_ -- - -- 77. FIXED SVS ::"..!Al 29 InsF-- - -- - .uI4o.. --- � I - 78. =1F : PRL"- --- - - - ---I-- L _ 'J D. rg r HEAL Tom' DPT. REOL'IHE":'r:CT 3' ^-.wt:- 3.2'.n Coat I 172 ..?' 1" - -.. .- I 32 E ectncal Po•'.er 'Ate -F.nai 1- 130. FOOD C. ' •- , 'c ` :"C'` 4- I_33. F.ra' Electrc iL_ _ S//,42__, �gotc:: _ - . I 34. Fire:. Heat,ng & Au CrtuGI- . -- I -- - 35. Final Gas Pipe•Test --- --- - 1- -- ----I---- -- - - - - -- - - - - -- 36. Hoed or Canopy 37, F`hal Factory Frep'ace 38. Fi.^.ti Plumbing _ I3939. Water Service Final -----_- - - - - - -- -- - _- -- ---_- --_ - - 40. Gas Serica-F,nal 41. Solon Domcst of r:. --- - .12. 3eccLo Pracenter - - 43. Baci f'ov: Irrigation - ---1---! - - - - --_-- r--- --- ------II_ - - - -- -- -- -- - - -- -- 44 ".ed,rapc l r.daticn Syst;•' --�-_ 45. Sound Attenuation 46. Handicap Regulations I - -- - -- - --- - -_ ___ - - -- 47. FINAL STRUCTURE & BUILDING - 48. FINAL PLANNING -�-- 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date . - I _ - - I • LIMITED STATEMENT OF RESPONSIBILITY Bldg. Permit # TO WHOM IT MAY CONCERN: This Permit # Street Address AP Number I, Sc�✓tLt7 h A , as Owner in Title of the above referenced property,/ do hereby authorize: c� J0 ✓ Ll 0&,A/ 7 /y fYw - G 1-2.--1 Name Telephone No. r Street Address CJ% Z�JA /1 ( Z L 1-7 City State Zip to obtain permits in my behalf, as owner/builder, for C R4,/6C L- c zTS��tn� at the above referenced property. Should 4pv persnn become an emptnyee engaged in the improvement of the property, I shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per- son, company or corporation. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties. • Printed Name / Dat (/ Sig °` + STEVE A.FINGERHUT l comm.#955966 JO NOTARIZATION Ncrest NOTARY PUBLIC-CALIFORNIA N ���Fil�7����e, Los Angeles County t T �� My Comm.Expires Feb.9,1996 REQUIRED 4 If OA 077946,rev,6/67 /6 . �.