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Home My WebLink About1960 WALLACE AVE - Building Permits • . l. .. V \ �134079 PAID J**** 3i-��0—S:OOiois 13.00 'COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 \ For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT RECEIVED B DATE RECEIVED DATE ISSUED BUILDING / L.-pc/2-4 �, /.2.s2 Q' //A))DDDRRESS L�IQ�JfpQl fQ,�Lc_t�t_w-€ (2...-.. (�� -z'- —�r �V�/]/ r/ `� o ,1(2�/Ir��Z {dWNi F-R.ec(L) N Free lyni 1 lex. A.P.NO. ,I C- 3 1(`8 I 3R�//TI MAIL 1 BUILDING Z ADDRESS 13?,o Sao (�Lk,LSL�bfT QvC ADDRESS (y(�, O�JAy�Q .e1 �(iri-tel 0-Z CITY ?Laeet, TCC- I CQ Lu ui L i °' TRACT LOQ LOT a. BLOCKF Z < CONSTRUCTION , NEW ADD I ALTER REPAIR I MOVING DFMOI ISH Oto LENDER / am JD BRANCH �C,.}//�, n ., �/ J In OWNER! /U ...... -6L-CI (/ D Q W ADDRESS mQ ARCHITECT yEr:',../ atae TEL-•,.-yy 2r e) S VALUE 3 / t ' to OR ENGINEER/ Ce J sOc-- • NO. / ti)-36, Z Q 1440 Th IP. Co(tete gL • AI•l L •ZONE •YPE GROUP \ W c ADDRESS a Ly APPROVE, W Z CONTRACTOR RI-ed LI(J Vim pt aT' BY 44 DATE A—ed J Q coZ (/J Jcc ADDRESS 133o Sao PQ(1L(, Ave //"'� W W ' •�• ZONE NO.OF 1 USE OF NEWT t11_-[/ ZH CITY PLeLe,-r `ti' &J�1'NOL. R PLANS O BUILDING//((JJ�� W O STATE CITY YARDS APPROVED YARDSAPPROVED cn X LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING _0 512E NO.OF BLOCS. (FROMC/LS�)TREET) /', ` d OF LOT NOW ON LOT Ci _E?ONT U FT. i (1l eL�l.•[FCt—c-e_--- USE OF —_ I // ,/( EXISTING BLDG. R.SIDE a5 FT. (O FT. I•' SIZE OF NO. OF Q NEW BLDG. ROOMS STORIES __ L.SIDE 0 FT. �j FT. EXTROOF V COVERRIOR ING WALL COVERING REAR �7 FT. /�/ r FT. - J USE OFUILD NG AND WORK TO BE PERFORMED yp DISTANCE BET. BET.MAIN& •.] , 1 4r Q� DISTANCE -- 21 xp _ MAIN BLOCS. [/ ACCESS. BLDGS. r� 7 oDATE _ CUP#�E-2�—o D APPROVED/24/7( I-y 'RAPPRgWj•/'L eav/IATF Q-—7-7 T - o MOLD FOR SPEta REQUIREMENTS UI hereby acknowledge that I have read this application and state op (/ D that the above information is correct and agree to comply with (,),2-- A •O -��" ' -� cc all laws regulating building construction, and I shall not employ i_ any person in violation of the workman's compensation laws of 11/ N the State of California. /�/J F I m ZI hereby certify that I am properly licensed as a contractor under / i SO. FT. o the State of California Business and Professions Code, Dlvisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business CC VALUATION and Professions Code,Division 3,Chapter 9. tO N PERMIT FEE $ O Signature of 2 m Permitteeg a v , t , '`1 $3 /DD by PLAN CHECK $ /./r E Authorized Agent / I• 't/sI TOTAL FEE $ 9-& !VA/J_'Y/y n ? /.0 79 OCT 25 77-PAIB001103 ****32.28 'COSTA MESA BUILDING-SAFETY DEPARTMENT tnsa P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIV. 8 DATE RECEIVED BUILDING ADDRESS , o ,/ - "— d ," /_�/ P.R T NO OWNER i_ �� / A.P.NO. f' BUILD1ADDRNG7i O fr .e MAIL ADDRE Z ADDRESS 1 U CITY NO. TRACT LOT BLOCK Z Q CONSTRUCTION N_ EW,1 ADD[ALTER I REPAIR 1MOVINflamLENDER �/� J BRANCH ' (� J /�rIZ.�IGD -J CO OWNER LLdI�U I/ co J ADDRESS VALUE J CO ARCHITECT TEL. USE $ J Q OR ENGINEER NO /� U to FIRE Z Q ZONE /PE ROUPW D: ADDRESS �APPROVERO7mZ CONTRACTORBY DAT tt O �6/ 7� Z ttt /// Jfr ADDRESS W uJZONE NO.OF USE OF NEW 0= CITY NOL PLANS BUILDING Z H STATE CITY YARDS APPROVED YARDS APPROVED NCL LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING D 0 SIZE INO.OFBLDGS. (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R.SIDE FT. FT. _ I— SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES LSIDE FT. FT. oEXTERIOR WALL I ROOF _ COVERING COVERING REAR FT. FT. .1 USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0' a GSMAIN BLOCS. ACCESS.BLD . QVAR.# DATE O C.U.P.# APPROVED CO 13\ APPROVED / O o __ ' SATE Oby I hereby acknowledge that I have read this application and state d�C� that the above information is correct and agree to comply with s D (' , all laws regulating building construction, and I shall not employ �- soz 11111 fr OPP ll F any person in violation of the workman's compensation laws of C/3 the State of California. m ZI hereby certify that I am properly licensed as a contractor under SQ. FT. o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR s Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a fC am exempt from the provisions of the State of California Business and Professions Code,Division 3,Chapter 9. VALUATION _ O N PERMIT FEE $ Signature of co • Permittee $ r��/��/J PLAN CHECK $ Mq E Authorized Agent Ca / (/ per TOTAL FEE $ ��+++JJJrrrr ` . L� t .� • / O fp • AI OCT 25-72001102* ***3143.90 ii. C COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 PP 1 AT/ON FOR BUILDING PERMIT For Applicant to Fill in Completely p 1 Mit, R EI BV DATJE RCEC�EJIVED p/qTE I-STSUED ADDRBUILDESS G ' /� 0 GJRLy�� •#v' N L� /B /-✓�( /C� �/"s-7� LY OWNER DF3A- FREDL.IN Ptee>/>P-JPr/ES. BUILDING /� - �I 39 / � • MAIL ill laZ // ADDRESS /f ,�QO t'aLt,LO Ale . ADDRESS /9�D G(i1t//d C� _Ave TRACT LOT BLOCK FF--Z CITY Plate/41/i ` L4• NO.TE Z C CONSTRUCTION NEW (ADD(ALTER(REPAIR (MOVING f1FMOLlSH d cn LENDER J D BRANCH �/�j r}� / 1' e'f b�y� J to OWNER f kg.t)i-/�Y Pnofrel i C J w ADDRESS R /' CPT: REEL• VALUE -CO ARCHITECT U a OR ENGINEER P/ gc.n G3B TEL. 7; �s FIRE' v �X�D= $/1 �� W¢ ADDRESS /4C�Q Sh,•4p C.LI 1/eja. (4id• ZONE TYPE GROUP -,-„ Q.w ` APPROVED wZ CONTRACTOR i 2 / i' e• a eV DATE 0 �� /L m- Z J Cr ADDRESS w W TEL. ZONE NO.OF USE OF NEW ZCITY NO. PLANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED en CC LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING DO SIZE NO.OFBLDGS. (FROM C/L STREET/ OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R.SIDE FT. FT. SIZE OF NO.OF ZNEW BLDG. ROOMS STORIES L.SIDE FT. FT. Z < EXTERIOR WALL ROOF COVERING COVERING REAR FT. FT. -I USE OF BUILDING AND WORK TOB PERFORMED DISTANCE BET, BET.MAIN& 0. 9 0AI t T A-Pr- L-IbXY, cpr, MAIN BLDGS. ACCESS.BLDGS. Q VAR.# DATE QCAid>-ea.S pee---...c2/en C.U.P.# APPROVED I- APPROVED // 0 lit D�ATf{❑IJx�- /l/-E '_ /! t~.I I hereby acknowledge that I have read this application and state �r' D D that the above information is correct and agree to comply with - we- ccall laws regulating building construction, and I shall not employ 1" any person in violation of the workman's compensation laws of l N the State of California. m ZI hereby certify that I am properly licensed as a contractor under - SQ. FT. O the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In lull force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: II am exempt from the provisions of the State of California Business VALUATION OQ.,')o and Professions Code,Division 3,Chapter 9. 2 PERMIT FEE $ Signature of 4frea.'SC -- S-2-1/21:1". 7 1}( 1m Permittee �y PLA�N7 CHECK-f$ �^ E Authorized Agent ��..5 220 TOTAL EE$ tS5 co u . IP a Saggr3408.0 '')' 31-7+ °oo1O19 d***118.75 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely jn� �/—lays- Ui Gr RECEI 8../V)�{�- DATE RECEIVED DATE ISSUED BUILDING SS /0&'o oil mI -Lt. J'`! ".. 7 2S, $ Hie L-1 t1-1 Ito petTtL 7 I.xc• A.P.NO. S-3 tri PERMIT NO. OWNER MAIL ••77••�� s� 1 ss�1 BUILDING 0 I —/ T d/AlJ/-�QS Z ADDRESS 17,Js/ Sao I/G1iU aut.() H1IC• ADDRESS f�//1� 1 atL„(y�()'/L��• o_0 CITY 1?LQCerST1� ( CQL. NOTEL TRACT (Q(,�- LOT $ SLOE Z < CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOI ISH O-0 LENDER v Il m J D BRANCH ' J N OWNER 0—&_�[, ,() —2(...1_4-11-2-C-0 03 J ADDRESS vt' �/ VALUE f/--) J Q OR ENGINEER•c0 ARCHITECT � A53 K..•aO JL NOLy l'�7(, D US= S "O UN A C_ / Aq&!aQlkkkes /W�s FIRE w W ADDRESS 1440 TaTe (cLLe1t 31.`¢1_ ZONE 'APPROVES PE GROUP 1t' / W Z CONTRACTOR %,e(1 L 1 • • e.• t BY / A ' DATE J Q m /e s ' JCC ADDRESS I 0 • O ao LO 1 e y . ' W W ZO• E NO.OF USE OF NE C• • 0= FLAG `�•v /�-•1 TEL / ']•] _= � PLANS / BUILDINtJJ •r6cc. Z F CITY P1.-•at.�C N 1)Q ea - NO./Q�J.J • .' Rl • 0 STATE l CITY YARDS APPROVED 9" 8." to K LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY B ILDING D OSIZE NOW ON LOT (FROM C/L STREET) OF LOT 63n l��s1 x 270 NO.OF S FRONT a 7 FT. f (a)at eiGe ) USE OF I o • EXISTING BLDG. �� B,SIDE SJ FT. FT. F" SIZE OF NO.OF '7 ZZ NEW BLDG. ROOMS STORIES Z L.SIDE %0 FT. - FT. EXTERIOR WALL.,...--,-, y ROOF G I L -V COVERING \InCO COVERING -muss REAR QFT. O � — �E�� x J USE F BU LDING AMID WOFt$TO BEP FO1R,ME DISTANCE BET. BET.MAIN& Rn ULT, I-d the L V 9 V 1- S MAIN BLDGS. ACCESS.SLOGS. Q 1 1 _ VAR.# DATE Q La OM at yea1 . T CL11Likzfj C.U.Pp.rW,s�,y�AE n�8'C APPROVE+D� 1>N., 141 7I zeec . Jlvze0. 4 HVP/A YEO / 6� r DATE a`� / —72- O i n: r • 1 : .• s U I hereby acknowledge that I have read this application and state S•P ' .-62 €.40—..../_.---A ,-t p _ � / 'fl-- g�uL�Yl�y(�.-+�•I�r r that the above information is correct and agree to comply with /V�i�C�A--a.1 CC all laws regulating building construction, and I shall not employ F„ any person In violation of the workman's compensation laws of N the State of California. 730 ter, co ig 0 I hereby certify that I em properly licensed as a contractor under SO. FT. o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UND VALUATION IS FOR a Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHI A PERMIT FEE ONLY: cc am exempt from the provisions of the State of California Business VALUATION and Professions Coda, Division 3,Chapter 9. co CS , PERMIT FEE $ CS Signature of Permittee $ Raw m Authorized Agent ��4y/ nall� 42• TOTAL FEE $ e u. CA VL'ALLLUU, vSLIWSJ "' JOB ADDRESS 1960 Wallace Ave. BUILDING PERMIT NO. 35688 GENERAL CONTRACTOR Owner Builder DESCRIPTION of WORK Block Wall AP , 115-346-39 LOT TRACT FIRE ZONE . VALUE $ 1100.00 IN. .CTIONS Signature Date GROUP J TYPE II ZONE R4—CP SOIL SUBCONTRACTOR PERMITS ISS�IED GAS Date Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER 0 ROUGH WIRING Heating and Vent. TRENCHES FORMS Li STEEL REINF. a-AKt-r/—J/•7y FLOOR SYSTEM 2 BOND BEAM n STEEL REINFORCE I�/%�h C//_77_72, SHEATHING FRAME AND FLASHING LATHING - IN n OUT n PLASTER, BROWN COAT Si 'URAL, FINAL Electric Hew..HG, VENT.. REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL Ain/'. BUILDING. FINAL /,iatt- y' -?r SPECIAL REQUIREMENTS (((III 3563.3 PAIB "OV 14-72C1.1;:UO 519* ****16.58 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 • PP C ION OR BUILDING PERMIT For Applicant to Fill in Completely RE / • • • - : EIVED DT ISSU ADDRESS I7 0 �,� ,Set-4VG Yr_ / / - - /q/, - / - ,� 7/7 ArernPERM • OWNER d4/$ J3 Y'GRRIC0 A.P. NO. / �L.,-, MAIL �^ J/ BUILDING y/�/ LL.4Cp �s. gr Z . ADDRESS /930 Sop ( oto fr� ADDRESS // O �� f 0-U CITY een C/Lm/V t //q. NO.1 29' in... TRACT �j��•- LOT BLOCKF ZQ CONSTRU ON -�J� /� �; �/., NEW _ADD ALTER REPAIR MOVING DE^AOI LSH O- N LEN DE R'`?u cj�/r2It ex?4- FARcrAONAK• f.// a m J D BRANCH NUN /1) �// 'Q//1 J en OWNER 72a41OD 14a/ C0 �/ m J ADDRESS �" VALUE (' ' — -m ARCHITECT TEL. US �-�/4 j ) V $ /41 J Q OR ENGINEER NO. - / w Q FIRE Z 2 ADDRESS ZONE LPEO.-- GROUPaw LU Z APPROVED ////[/,� Z J O CONTRACTOR BY DATE //" s� mZ TEA / J m ADDRESS W Lu TEL NO.OF �y USE OF NEW 6e4c. . Z -. CITY NO. 7C CP PLANS �j�9UILDING ��A�� Z H E/ LU 0 STATE CITY YARDS APPROVED YARDS APPROVED rn IT LIC. NO. LIC.NO. MAIN BUILDING SSORY BUILDING ' (FROM CREET) /SIZE OF LOT I NNO.WOONBLLOT5. FRONT /IT. P1t- 3 OFT. /- USE OF G/�. EXISTING BLD4 '^ FT:. O FT, G. LES /C..tJ/�/+G— R SII? IJ-� I- SIZE OF NO.OF //JJ�I� Z NEW BLDG. ROOMS STORIES L.SIDE 3 FT. /(J T7. Q EXTERIOR WALL ROOF � ,r .t V_ COVERING COVERING REAR 30 FT. 3r Z om. _ J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& a MAIN BLDGS. ACCESS.BLOCS. Q J/�� 1Q� • rr VCA.URP.#. e/ W.0 DATE APPROVED VED NO yl �LDC % (VYnLL. RYPROVEZ164 ,77 DATE // /0°1-..- 2 0 F Olq U I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with EC all laws regulating building construction, and I shall not employ F any person in violation of the workman's compensation laws of N the State of California. To 2 I hereby certify that I am properly licensed as a contractor under SO.FT. TAX o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATI IS FOR. Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT ITY: • LE am exempt from the provisions of the St to of California Business (/ and Professions Code,Division ,Chapt- 9. VALUATION m PERMIT FEE $ w � D Signature of /ij` , /��i� !/ m Permittee .t/ .// $//D� PLAN CHECK $ E ar S o Authorized Agent ))) u_ / TOTAL FEE $ ...:, i. .._.... . - ' &4- - CITY OF COSTA MESA BUILDING DIVISION VISION Aill•i7a DEVELOPMENT SERVICES DEPARTMENT NT PER NUMBER t. Prga ) PERMIT P07-00117 • • "kblatonsase (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesaRtJsJMBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 • Job Address: 1960 WALLACE AV Status: ISSUED Suite No • Applied: 02/26/2007 Issued: 02/26/2007 Vicinity: DRIVEWAY • Parcel Nunmber: 42226210 Applicant: BANGERT, BILL Address: PO BOX 12 . . _,- - _,_ -_- -__. .,, ISSUED BY: _,------ ..---:"---Phone: 94965 9304 --..,, .... ... TUSTIN,CA --,..------ „.-; Zip: • 92781 , -t -• -,- :,--...., /‘ \ • ', -,----!...:-.-c• •'' - 7,12:7-1..-"±-„, \ --Th ! ' • Owner: LIOO;',EQUITIES GROUP LLC' , 7 _. ___-- Address /218-N CANON DR \ 6-;.....? ,.L.:_, 4_2.. .:. „,..„ \ , , /Q2\ \\„.)2,,..-2-',;;;;;.,---,_ '.:----:-Phone: /1/Y7/7/BEVERLY HILtS:ICA4---.-.- Zip: 90210-5302 , .: •, 'A ' -.- ,-,/•11r-7- /;:',7 '`,._ 7,,//,?.> . •\ -:. „\., ..,. -:.-....\ : ,> ContractoF: M8TIBANOERT INC ' - \ , . . i , / i \ -' \ . i tAddress7.7 PO BOX/2 . PP-7 , Phone: -714-838-0937 :\!,.:A\ I TUSTIN CA i Zip: -92781 -' ' ' - : ' • ' - ' °'°• •"..°• i ' I ::::•-. fic527.------ - ...-----';\: ,- 'iLicense:: 752497 00° ,7\`‘-, .:-. 1.-- --. . 1 y/ ( - /Tic I, / ' . ,,,, /u -2-,... .. : . . . /7 , . ‘"'•,\,,`, '. „.. , . • • - 1 ri I >V ' ' 'afe4..-- .------ d I,,,f is ,./.. c,.,' -:',....-•- SCOPE OF PERMIT - - , , ,, \ - . • „ ;119-13LUMBING•PERMIT FOR A SEWER REPAIR LOCATED IN DRIVEWAY FOR APARTMENT BUILDING. : \' . • 17 L 1' - c"'-', . , \ , , • , :‘ \--- r C.WORK TO INCLUDE: 1 PRIVATE SEWER LINE. -, . . , ‘ , „ . • - N . , - . '.... ; ../ i ,t.) - , 7 (1' 7.irt'y c)FEE SUMMARY / , ,• ', '' -' ..• , ,I •-• s ..,,..t. I. .1 ' , ... - ... - , ), ,t - AMT QTY ISSUE-FEE .. {, ' $23.50. \ Laundry Tub/Washer $0.00 ••0!!:"-! , Sump Pump . $0.00 - -0 Backflow irrigation •• 0!, $0.00.1. 0 • Landscape Irrigation moo ,o7- ! Swimming Pool $0.00 .0 _ . Backflow Preventer $0.00 0 !,-„-t5-<..:0;TMply-!-..„-‘,-. 7.--,7 •„; !' r..$000 10 ..., ._ Trap Primer 7 •. _ •$0.00 . 0 Bathtub\ t \ .!!, \ 1 $0.00 0 ' -----r_-r_-_-iPressure:Regulatort -- z-2. ' . $0.60,i 0:1 rri:1 - - ,i 1; Urinal $0.00 • ! 0 .____ Ctarifier System-\ , \t,:10- $0.00 0 k..`" Process Piping(per 101) _ .$6.00 ,./0 - 1! Vacuum Brkr Bkflp(e(1-4)-- - $0.00 ' 0 , Connect Oce,Socleeicj-,,! $0.00 0 • I Receptors $0.00 If 0 I Vacuum Brkr BkflOw(5+)„1. , $0.00,,' :0 Dental Units- ‘,\` ., $0.00 0,-/• Septic Tank -sem/ 0 1....W /ash Basin ,/,', - • "- $0.00 • 0 Dishwasher- <\ \\\\\$0.00 Oi Sewer Cap for Demo c„$0.60"}, 0 Wash Basin Set/' ,1!..,,,- $0.00 0 \ , , Drain,Floor. • ' • -,10.00 0: Sewer Connect $0.00- 0 Waste and Vent System :-- $0.00 .• 0 Drain,Rainwater - • ',$0.00 0 Sewer Private.Line•!-,z, $24.65 1 Water Closet(toilet) -• . $0.00 0 . _ Drain,Roof, ‘, ,,-- '42.00 a, Shower,i. ii:1, • .'.4.,$0.00 0 Water Heate0 vent- ! $0.00 0 DrinkinC•Fountain \ $0'.00.. 0 Sink,bar* -!--1- '• Water Piping(Inst or Rep.) ,-.$0.00 0 Expansion Tank <-01 -r $0.60k:\ 0' .Sinktommercial- ' :.- : $0.00 .•.•0Water Re-Cipe . 7- '.$0.00 0 Gas Earthquaker'yalve $0.60 --t0:(,!,-. ;Sink,..Floor,.! c1i7 V 6 . . ; $0.002 -•;,*0'.; '7:4`":"-±•F WaielService i -1 ; $0.00 0 Gas(1-4 ouilels)\ $0.00 \\,>'0* ; '7!Sink,kitchen,i,,. `:: •$0.00 0 - . -Water:Softener .7 $0.00 0 Gas(Over 4 outlets) /7/$000 '0:'-'-,-::\ i!.Sink,seridce(rhap, --: 't2 $0 00 - 0 .<,-,2-0THER,-,- --. 'N; 7 $0.00 Gas Repipe -\\••:\:°<$0.062,_ 0 N'-.:`"-c-,..-„ tS,f3a:-(Private)f : '-„, / $0.00 ' •0 ,- -7;: ;12 VIOLATION(); ,,-(!/ $0.00 Gas Service :`,,t\---N- $0.00-7 --1-0! Spa(public) ' 1!5' ,t!. • $0.00 . -0 2.-!----->: PLAN CHECK ,i/5,2 $0.00 ,7-:--,-‘ - i( . . Interceptors(Grease/Oil)c.\.$0:00 0' Z\--, ----...T=-- -:::**-07'.•-.7",/,---t.c.„ .7 - --/--:' -.,•1*---- • .. •REINSPEOTION7., ,'" $0.00 0 - , - - Interceptors(Sand AutO)\ .$0.007-C ,0.7 : !-: - - _ ... _ _ - . _ . . t i _, c.-- '\--..../ --, ." Ty -\ ,,.._ -,,- . \ TOTAL CALCULATED FEES: $48.15 COMMENTS/SPECIAL CONDITIONS -12/'-'"---' -- --.... ... - . .. . ., NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) • • • DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: 0 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. CMy works co npe/nation/Insurance carrier and policy number are: -Cartier:-- Stine— /rr'pvff� Policy Number: -Mrs section need not be completed if the permit is valued at one hundred dollars($100)or less.) I ❑ 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 Califomlg,4nd agree that if I should become subject to the workers'compensation provisions of Sect on 3700 of the Labor Code,I shall forthwith comply with these pr visions. / / n Applicant Signature: /1�/ ,1 ��//��/ _ Date: WA9 / 1O/0 / WARNING:FAILURE TO SE URE WORKERS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND CIVIL FINES LIP TO ONE HUNDRED THOUSAND DO&LARE(miaow).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST!AND ATTORNEYS FEES. I LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of.the Business„and Professions Code,and my license is in full force ne effect..Lic:'a 9 d ' _ Class-g -i c- 3 C. I Contractors Signature:/A n R Detect__ -a I Z?o/d 7 I CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: I Signature: Date: I OWNER-BUILDER DECLARATIONS: I 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).8I ❑ 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: I Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): I 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: I 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes 0 No I (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,ora 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 I 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Flre 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). I 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 I (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. I 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 apPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 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 0 No I 8 (If'yes",attach certificate of compliance from tho appropriate air pollution control officer). I 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 property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final int pection. /� A /� (Lc Slgn_ a Ot Legal Owner(s) et;le I/Jv o er .7/ZGb/d� n Or.Authorized Applicant__ _i----_ ate' sour INSPECTION TYPE PATE III I& CODES INSPECTION TYPE I PAIS INTITIALE 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing a/a t/07• M 6 200 Final Re-Roof 210 Final Electrical 1 r 201 Final Block/Retaining Wall 212 Final Fire Prevention I 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site I 204 Final Demolition 250 , Final Building/Occupancy I