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Home My WebLink About396 LA PERLE LN - Building Permits! (714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us BUILDING PERMIT �ob Address: 396 LA PERLE LN Suite: Vicinity: SOUTH SIDE OF GARAGE Parcel Number: 42531206 Applicant: SKAUG, JIM Address: 250 CLIFF DR LAGUNA BEACH, CA Owner: ROSS, ERIC C TR Address 396 LA PERLE LANE � COSTA MESA, CA� Contrector: OWN ER-BU ILD ER Address: � � Zip: Arch : Address: Zoning: Phone: 949-494-2297 2ip: 92651 Phone: (949) 548-2026 _ Zip: 926273759 Phone: License: , 000000 - Eng: -' Address: 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 04/24/2003 Issued: 04124/2003 . � Phone: , , Phone: Zip: � � License: � � License: � SCOPE OF PERMIT CONSTRUCT TRIANGUTAR 6' WIDE PREFAB OUTDOOR FIREPLACE IN THE PATIO AREA'ON THE SOUTH SIDE OF THE GARAGE. FIRE PLACE IS UL LISTED PER APPLICANT. " �" ' ' � � � � - � � � " " �- � , REF: B02-01145 . Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $54.11 $83.25 $0.50 $0.00 $0.00 $0.00 $137.86�,� ' _ �� .,-.- SETBACKS MAINSTRUCTURE-Front 0-0 ' ACCESSORY Front . 0-0 �� PARKING Existinp: 0 ' ' FEE SUMMARY, " ' . . Calc Valuation: Claim Valuation: ,..f-`.- _ .. Rear 0- 0 Rear 0- 0 . Re uired: 0 PLANNING & ZONING Left 0- 0 LeR 0- 0 - . - Proposed: 0 Right 0- 0 Right - 0- 0 $2,500.00 s2,soo.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-26, § i, 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 orabando en d 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•co�antl all requfred Inapectiona and final approval must be obtained. Failure to obtain inspections and (inal approval will result in Ihe expiiat�on•of this permit. FOR INSPECTIONS CALL: (714) 7545626 zmaae ls�ool WORKERS' COMPENSATION DECLARA710N: . I hereby aHirm under penelty at peryury one of the following declerellons: ' ❑ I have and will melntaln a certificate of consent b self-Insure tor workers' compensation, es provided for by secHon 3700 of Ihe Labor Code, for the pedormance of the work lor which Ihis pertnit is is5ued. . ❑ I have antl will rt�aintain workers' compensation in5urance, as required by section 3700 ot the Lebor Code, for the padortnance of tha work for wNch ihis permil is issued. My wolkers' compehsatlon Insurance carder end policy numbe� are: Cercier. Policy Number: rThis secllon need no� be completetl i( Ihe pelmii is valued at one huntlred doliars ($700) or ieu.) I ceniy thet in the peAo ance�t the work tor which t�is permit is issued, I shall not employ any person in eny manner so as to become subject to the workers' \ compensation laws oi lito i�, gree t�et tl I shoulA become subject to the workers' compensetion proWslons of Sectlon 3700 of the LaDor Cotle, I shall tort�with comply with ihese p si �J - / ,t Appllcant Slpnatura: �Date? LLL �C/ i9 i WARNINO: FAILURE TO CUFE WOqKERS' I A ION COVEMGE IS UNUW FUL AND SW1LL SU91ECi MI EMPLOYER TO CRIMINAL P IES ANO CML FlNES UP TO IXJE HUNORED THIX15rWD DOLLr1RE (�.�1. IN ADDRION T niE T OF COMPENSATION, DAMFGES AS PROVIDED FOR M SECTION 3)OB OF THE UBOR OOOE, INiEqEST, AND ATTORNEI"5 FEES. LICENSED CONTRACTORS DECLARATON: I hereby eNirm ihat I em licensed untler provisions of C�apter 9(commencing with Section 7000) of Division 3 0l the Buslness antl Professions Code, and my license is in tull twce antl eftect. L1c. 9 Ctass q Contrectors SlgnaWrO: Date: CONSTRUCTION LENDING AGENCY: ❑ I �ereby eHirtn that there is a construction lending egency tor Ihe peAormanca of the work for whic� this parmit is issued. (Sec. 3097, Civil Code). Lendefs Neme: Lentlers Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: 1 herehy aHirtn [hat under penalry of perjury that 1 em EXEMP7 FROM THE CONTRACTORS UCENSE LAW iw the tWlowiag reasop (Sec. 7031.5, Busi�ss afW ProSesstons Cotle: Any ciry or counry which requires e parmit to construct, alter, Improve, demolish, or repair any structura, pdor to ils issuance, also requires the applicant for such pertnit to tile e signed statement Ihet he or she is licensed pursuent to Ihe proNsions of Ihe Coniraqors License Lew (Chapter 9(commencinq with Sactlon 7000) of Dlvlsion 3 0l the Business entl Profess�ons Code) or that he or she is exempt iherelrom entl the basis lor the alleged exemption. Any violetion ol Section 7031.5 by any applicant lor e pertnit sub� the epplicant to e civil penalry of nol more than five hundred dollars ($500)J; I, as owner ot t�e property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the siructure is not intended or oHered lor sele (Sec. 7044, Business end Professions Coda: The Coniractors License Lew aoes not epply to an owner of properiy who builds or Improves thereon, end who does such work himself or herself or ihrough his or her own employees, provided that such improvemenis are not Intendetl or ofle�ed for sale. If, however, the builtling or improvement Is soltl wlihin one year ol completion, the owner-bullder will have ihe 6urtlen of proving that he or she did not build or improve for purpose oi sala.). � ❑ I, as owner ot the proparty, am EXCLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS to consimct Ihe project (Sac. 7044, Business end Professions Cotle: The coniractors license Lew tlaes not eppry to en owner ol property who builds or impmves Iherean, entl who contrects lor such prolect with e comractar(s) license puryuapj �o the Coniractors License Lews.). ❑ I am axep�(pt,�iGJ�pBc. 8usiness and Protessions Code for this reason: Da�e: Owner ID v dfied by d��ers lic � Yes � No Ddvefs Licensa No. ��/./�.�� Expir¢s;�� Veriflcati ot Ownership by e i tlaument, i.e. - property tart blll or tleetl): DIVISION OF INDUSYAIAIL SAFETY PERMIT CERTIFICATION: ❑ I hereDy certify tda� no exwvation Tive (5) or more leet in tlepih Into which a parson is required to descentl, will be mede In connection with work authodzed by this pertnii, end that no building structure, scatfolding, lalsework, or tlemolition or dismantling ihereof, will be more than Ihirry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Cali�omia Administralive Cotle). ❑ As owner-builde�, I will not employ enyone to tlo work which would require a permit from ihe Division ol Industnel Setety, es noted above, unless 5uch person has e permit to do sucP work irom the diNsion. Signature: Date: Division of Intlustnal Safety Permit Number: CERTFlCATE OF COMPLIANCE AND AllTTfORVA710N OF ENiRY: I certify untler penalry of perjury thet I have read this appliwtion and state that ihe informatlon given is correct. I egree to comply with ell state laws end ciry ordlnances relating to building conswction, entl auihorize representatives of Ihe Ciry ol Costa Mesa to enter upon ihe ebove-descnbed properiy ior inspedion purposes. I egrae not to occupy or ellow occupancy ot arry building eNhorized by ihis permit uMil final inspaction. Signature OI Legal m��cuunF. 1616 Fixed Sysiem Final Fire Praventlon 1266 Pod Spe Final 200 Final Re-Roof 201 Final BIocWRo�aining Wall 202 Final Factory Fire Place 203 FinelSign 204 Fin01 DBmoliliP� � ��.!liio , Date CODE� INSPECTIONTYPE � 206 Flnal Mechanical 208 Finel Plumbing 210 Finel Electncal 272 Finel Fire Prevention 220 Final Planning Approval 222 250 Final Site Final Builtling/Occupancy P� ItIIIDeLi � • t�1j Job Address: Suite No Vicinity: 396 LA PERLE LN SOUTH SIDE OF GARAGE Parcel Number: 42531206 Applicant SKAUG, JIM Address: 250 CLIFF DR LAGUNA BEACH, CA Owner: ROSS, ERIC C TR Address: 396 LA PERLE LANE COSTA MESA, CA Contractor. O W N E R-B U I LD E R Address: MECHANICAL PERMIT ISSUED BY: Phone: 949-494-2297 Zip: 92651 Phone: (949)548-2026 Zip: 92627-3759 Phone: Zip: License: 000000 Status: ISSUED Applied: 04/24/2003 Issued: 04/24/2003 SCOPE OF PERMIT MECH PERMIT IN CONJUNCTION WITH CONSTRUCTION OF A TRIANGULAR 6' WIDE PREFAB OUTDOOR FIREPLACE IN THE PATIO AREA ON,THE SOUTH SIDE OF THE GARAGE. FIRE PLACE IS UL LISTED PER APPLICANT.� � - � � � , 1 FACTORY FIREPLACE, 1 GAS PIPING - - �- � �� REF: B03-00679 AND 802-01145 - ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 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 Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfrn Air Handlers > t0000cfm Floor Furnace Floor or Suspend Heater $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 �$6.15 $10.65 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Commercial I ncinerator Domeslic Incinerator Compressors / Absorption Svstems Upto3hp/100kBTU 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 Uplo3hp 3To15hp 15 to 30 hp - . , 30 to 50 hp � . Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee �uantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 so.oa o $0.00 0 so.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 $0.00 NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspende� bandoned for a penod of 180 days. / INSPECTIONS: In order for ihe work authorized undar ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inapeetions and tlnal approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this pertnit. FOR INSPECTIONS CALL: (714) 754-5626 U Ei:.�� I�1 WORKERS'COMpENSAnON DECLARAnON: I hereby aHirm untl9� penalty ol perjury one of ihe following declarations: ❑ I heve entl wll� maintein a cenificate oi consent m selbinsure for workers' compensetion, es providetl for by section 3700 ot the Labor Cotle, tor ihe pertormence of ihe work tor whicn Ihis pertnit is issued. ❑ I �eve end will maintain workers' compensation insurence, es raquired by section 3700 of Ihe Lebor Cotle, for the peAortnance of the work tor whic� ihis pertnit is Issuetl. My workers' compensetlan Insurance carner antl policy number ere: Carner: policy Number: (Thls secHon need not be comp/etetl i! the permif is ve/ued ef one hundred dollers ($ f00) or less.) �I certify that in ihe perto an of e work for whic� this pertnit is issued, I shall not employ eny peroon in eny menner so es to become subjact to the warkers' compensation lews ot alii ia gree tbat II I shoultl Eecome subjact to the workers' compensetion provlslons ot Sectlon 3700 ot Ne Labor Catle, 1 shell forihwlth wmply,with tbese i ' s. ,/ Applicant Signature; �{�` Date: � ��F �/l/! � WAfiNINO: FAILURE TO CURE WORKERS' CO PENSA ION COVERAOE IS UNL4WFUL Ml� SHALL SUBJECT AN EMPLOYER TO CRIhUNAL PENAL ES AND CML FlNES UP TO ONE HUNDRED T}IOUSAND DOl1ARE 00.000). IN ADDRION TO E T OF COMPENSATION, DAMAGE$ AS PROVIDED WR IN SEGfION 3%OB OF THE LABOR CODE, INiFAEST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: 1 heraby attlrm Ihat I am licensetl untler provisions of Chapter 9(commencing with Section 7000) ot Division 3 01 the Business and Professions CotlB, and my license is In tull lorce entl ettect. Lic. b Class a Contrector's SlgnaNre: Date: CONS7RUCTION LENDING AGENCY: ', ❑ I hereby aHirm that there is e construction lending agency for t�e pertormance of ihe work for which Ihis pertnit is issued. (Sac. 3097, Civil Cotle). � Lender's Name: Lentlefs Address: Slgnature: Dete: OWNER-BUILDER DECLARATONS: I hereby eHirtn that under penelry ot perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7037.5, Business entl Professlons CoGe: Any ciry or counry which requires a permit to construct, elter, improve, demolish, or re0air eny strucWre, O�or m its issuance, also requires the aDDlicant far such permit to Ille e slgnetl slatement Ihet he or sha is licensed pursuent to the proNsions of iha Contredors License Lew (Chapter 9(commendng with Sec6on 7000) of DMsion 3 of Ne Business entl ProfeSslonS Gode) or that he or she is exempt iherelrom entl the Gasis for Ihe ellegetl exemption. Any violetion of Section 7031.5 by eny epplicant for e permit �u �ects tha applican� �o e civil penalry of not more than five �untlretl dollars (5500).): � I, as owner of the property, or my employaes with wages es their sole compensation, WILL DO THE WORK, antl the siructure is not intendetl or offered tor sele (Sec. 1� 7044, Business antl Professions Code: Tha Contractors Licensa Law does not apply to an owner ot property who 6uilds or improves Ihereon, antl who does such work himself or �erseN or �hrough his or her own employees, provided that such improvemenis are not In�entled or oHeretl for sale. N, however, the bullding or Improvement is sold within one year of completion, the owner-buildor will have ihe burden of proving that he or she did not builtl or imp�ove for purpose of saleJ. � ❑ I, as owner ot the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Professions Catle: The con��ectors Llcense Law does not apply ta en owner ol property who bullds or Improves ihereon, and who coniracts tor such pro�ecl wllh e conirector(sj license pur,qtianf�lo jhe Contractors License Laws.). ❑ lem Busine55 end Protessions Cotle lor ihis reason: Date: Owner �D rified by tlriver's Vedlicati n at Ov.•nership by a. �yes ❑ No Driver's License No. oi tlocument, i.e. • property tex blll or tleed): DIVISION OF INDUSTRIAl SAFETV PERMI7 CER7IFICATION: ❑ I hereby certify ihat no excevation five (5) or more leet in depih into which e person is requiretl to descend, will be made in canneciion with work euthorized by Ihis permit, and th0� no building siructure, scaHoltling, ialsework, or demolition or dismantling t�ereoi, will be more than t�irry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Celitornia Administretive Catle). ❑ As owner-huilder. 1 will not employ enyone to do work whic� would require a pertnit trom the Division at Industrial Salery, as noted ebove, unleu such person hes a permit to do su�h work Irom the divisian. Signe�ure: Dete: Divislon oi Intlustnal Safety Permit Numbar: CERTIFlCATE OF COMPLJANCE AND AUiHORIZA'f10N OF ENTRY: I cenify untler penalry of perjury t�at I have r0ad this epplication and state ihat ihe Infortnatlon given is correct I agree to ctlmD�Y w��h all stete laws end ciry ordinences relating to Guilding construc�ion, end authonze representallves of Ihe Ciry of Cwta Mesa to enter upon ihe ebove-descri6ed pmperty for inspection puryoses. I agree not to acupy or allow acupancy of eny building authorized by this permit until final inspection. j�jE INTRIAlS 7616 1266 zoo 201 202 203 Fi:ed System Final Fire Prevention Paol Spa Final Final Ra-Root Finel BIocWPetaining Well Final Factory Ptra Place Final Sign 204 Final DemdRion CpDE� INSPECTONTYiE � Q�]E � 206 FinalMechanical �-3�.� 208 Final Plumbing 210 212 220 Final Electrical finel Fire Preventlon Final Planning Apprwal 222 Final Site 250 Finel Building/Occupency � `-� , . -� ^`� -- � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT �ob nddress: 396 LA PERCE LN Suite: Viciniry: DETACHED GARAGE Parcel Number: 42531206 Applicant: ROSS, ERIC C TR Address: 396 LA PERLE LANE COSTA MESA, CA� � . i,i ., Owner: ROSS, ERIC�C TR Address �396 LA PERLE LANE , � i� ��/i� - . . ' . - ' � COSTA MESA, CA- . " . � Cont`racror. O W N E R=BU I LD E R �� _ Address: � � , � - _ 2ip: Arch : Address: w Zoning: issueo av: Phbne: (949) 548-2026 Zip: 92627-3759 . Phbne: (949) 548-2026 .� . ' Zip: 92627-3759 - . . . Phone: License: 0 Eng: /I Address: Status: ISSUED Applied: 07/01/2002 Issued: 07/01/2002 , ' , . � . � � Phone: _ , Phone: � . Zip: � License: License: , SCOPE OF PERMIT _ _ � DEMO PERMIT TO REMOVE THE ROOF AND WEST WALL OF THE EXISTING DETACHED GARAGE. PLANS ARE IN PLAN CHECK FOR A GARAGE ADDITION. REF: 802-00749 �� - - - ' Plan Check: $0.00 Permit: $23.50 SMIP Res: . $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 � �Total: $24.00_ � , � � � � i_ SETBACKS , , MAINSTRUCTURE Front 0-0 ACCESSORY Front� 0-0 PARKING Existinq: o NOTES: � FEE SUMMARY - Calc Valuation: Claim Valuation: Rear 0- 0 Rear 0- 0 Reauired: 0 PLANNING & ZONING Left 0-0 Right 0-0 Left 0-�0 . Right 0-0 . , Pro osed: 0 $500.00 $500.00 NOTICE: The work authorized by this permit shall comply with all appiicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-g2) EXPIRATION: 7his 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 vnth all applicable codes,.an�ll required Inspectiona end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis perrtiit. FOR INSPECTIONS CALL: (714) 7545626 V cao�ao �dw� WORKERS' COMPENSATION DECLARATION: I heraby aNirm under penalry of perjury one of the tollowing tleclaratlons: ❑ I have end will maintain a ceNficate ot wnseni �o self-Insure tor workers' compenselion, as provitled for by sedion 3700 of the Lebor Code, far the pertormance ot the work for which Ihis permit is issuetl. . ❑ I have flntl wi11 malntain workers' compensation insurenca, as requlretl by section 3700 of �he lebor Cotle, for ihe peAortnance of Ihe work for which this pertnit is issuetl. My workerg' compensation Insurence carrier entl policy number ere: Cartier. � Policy Number. (7his section need not be completed i! fhe permit /s veluetl a! one hundred dW/ars ($100) or /ess.) . � I cenify thdt in the peAortnance of the work for which Ihis pertnit Is issued, I shell not employ any person in eny menner so es to become suD�ect to t�e workers' wmpensetion laws of Calitomia, end egrea thet If I ahould become subJect to the workerg' compensatlon provislons of Sactlon 3700 oi the Labor Coae, 1 shell forthwith comply with these provisions. Applicant SignatUre: Date: WARNING: FAILUqE TO SEWRE WOHKERS' COMPENSATION COVERAGE IS UNLAW FUL M1D SNALL SUBJECT Ml EMPLOYER TO CRIMINAL PEWILTIES PN� CML FlNES UP TO ONE MUNORED T}IOUSAN� DOLLARE (5100.000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGE$ AS PROVIDED FOfi IN SEC(ION 3108OF THE LABOq COOE, It�trEREST, M1D ATTORNEV'$ FEES. LICENSED CONTRAGTORS DECLARATION: I hereby eftlrm Ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) of D'Msion 3 oi Ihe Business and Protessions CoOe, antl my license is in full torce and eHecL Lic. p Cless N Contractors SignaNre: Dete: CONSTRUCTON LENDING AGENCY: � ❑ I hereby aftirtn that there is a consiruction lentling agency br ihe Dedortnance ot the work for which this pertnit is issued. (Sea 3097, Civil Code). Lendafs Name: Lendefs Address: Signature: Da�e: OWNEH-BUILDER DECLARATIONS: I hereby affirtn Ihat untler penelry of perjury that I em EXEMPT FROM 7ME CONTRACTORS LICENSE LAW for Iha following reason (Sec. 7031.5, Business anA Protessions Code: My ciy or counry which requires a permit to cauWet, alter, imp'ove, demWish, or repai� any swcmre, pdor Io Its Issuance, also requires the �pplicant �or such permit to fila e signetl statement ihat he or she is Iicensed pursuant to Ihe provisions ot the Contrectors License Lew (Chepter 8(commenUng wit� Sectlon 7000) oi Dlvislon 3 of the Business antl Prpfessians Cotle) or Ihat he or she is exempt Uereirom and Ihe basis for t�e alleged exemption. Any vidation oi Sectlon 7031.5 by eny applicant tor a pertnit �sub'ec4s ihe applicant to a cWil penalry oi not more ihen five hundred tlollars ($500).): 1, es owne� ot Iha property, or my employees wlt� weges as their sole compenselion, WILL DO THE WORK, antl the structure Is not intendetl or oNered tor sele (Sec. 7044, Business and Protessions Catle: The Coniractors License Law does not epply to an owner of property who builds or Improves �heraon, entl who tloes such work himselt or herself or through his or her own employees, providetl thet such improvements ere nol Intendetl or oNered tor sale. II, however, Ihe building or improvement is sold within one year ot wmpletion, the owner-6uilder will have Ihe burden oi proWng ihat he or she Oitl noi build ar Improve for purpose of sale.). ❑ 1, as owner of the pr perty, am EXCLUSIVELV CONTRAC7ING WITH LICENSED CON7RACTORS to conslruct tha project (Sec. 70d4, Business and Protessions Code: The conirectof3JJeensetew tloes not epply to en owner ot Droperry w�o bullds or Improves Ihereon, and who contracis for such pro�ect with a cantractor(s) license oursuao4t6�e Contracfars license Lews.l. ❑ lami Signature: Owner ID v Veritication Business end Professions Code tor this reeson: license. ❑ Ves ❑ No by (type ot documeni, i.e. - property tax blll Or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATON: Date: � Drivers LJcense No. _ /✓ ' ❑ I hereby cgrtify thet no excavetion Nve (5) or more leat in tlepth Into which a person is required lo descend, will be made in connection wilh work euthadzed by Ihis permit, anp that rro building structure, scafloldirg, talsework, or demolition or dismantling theieol, will be mae than thirty-sIx (36) �eet high. (Chep. 3.2, Grp 2, Art 2. Sec. 347, Tltle B, Califomia Administrative Code). ❑ As owner-builder, 1 will not employ anyone to do work which would require a permit from the DiWsion oi Industnel Safery, es notetl above, unleu such person hes a permit to do such wark trom the division. Signature: Date: Division ot Industnal Satery Permit Num6er: CERTIFlCATE 6F COMPLIANGE AN lI�fHO iION OF EMRY: I ceriify under penalty of perjury thet I heve read Ihis epplicalion and state Ihat the infortnetion given is correct. I agree b comply with all stat laws ^ tl city ortl s releting to Guilding construction, end eNhorize representatives uf Ihe Ciry ot Cosla btesa o enter upon the above-describetl praperry far inspecii p oses. not to acupy or ellow occupancy oi eny building autharized by Ihis permit uniil finel inspec'6n. � � Z �i � ure Of Legal Owner(s) - � Date � n n�nr ninnndmd Annlicant Date LOpE �. INSPELTONTYPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spe Final . 200 Final Ra-Fioot 201 Finel 61ock/Retaining Well 202 Final Factory Fire Place 203 Flnal $ign 204 Final pemolition QAIE It�LS � COOE I IMSPECTION TYPE 206 Finel MBchenicel 208 Finel Plumbing 210 Finel EleciriCel 212 Final Fire Prevention 220 Final Plenning Approval 222 Final Site 250 Final Building�Occupsrwy �g � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-meSa.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626 ELECTRICAL PERMIT JobAddress: 396 LA PERLE LN Status: ISSUED Suite No Vicinily: Parcel Nunmber: 42531206 ApplicanC ROSS, ERIC C TR _- - _ Address: 396 LA PERLE LANE % -,�%-'.� - � �� ', � � -- i . o! ��, �- � Phone: (949) 54&202,6 i „�'� �'" COSTA MESA; CA i�, = , � ' Zip:- 926273759 /�/ � � ',\. � �' . , , , - . /�� A Owner:/. ROSS, ERIC C TR � - Address' i 396 IA PERLE LANE , � �, '' � / Phone: (949) 54&202 - ' COSTA MESA� CA Zip: 92827-3759 i Applied: OB/OS/2002 Issued: 08/OS/2002 ISSUED BY: \ �� ' . �� .�,� ..\ _ . -- �� .��,.�. .��` �� C � � � � - u �� __ �� .�; �� \\.� � �� /,'� �. 8 � ��• �� : , ` .';'�,\ . , ' . �: � � `_ �\ ; Convacror. � OWNER BUILDER • • � `�� ' : j:�, ,o � �� ' ��-`. i ' nddress: � �, - - � = �. ; . , � �/�= ; -i.. - �� , . � ; �, , i , , \ � �Phone: � '+; ..� i� , �. _ . , . . . . . . . . ' ' , - Zip: _ ... , - � , . ,. _ - , - . ��' . � � .� . � .i _ � , � �" License: 000000 ' � \.�� , . / / �, ADD 396 SF TO KITCHEN; NEW�BATHROOM,-AND FRONT HALL: REPLACE EXIST WINDOWS WITH SAME SIZE. WTERIOR WORK TO EXIST BATHROOM-AND REPLACE 4 EXIST �DOORS . , � REF: 802-00749. ELECTRICAL TO INCLUDE:-12 L�GHT FIXTURES, 30 OUTLETS, 14 SWITCHES, 1 -' " SERVICE UPGRADE TO 200 AMP, 2 RESIDENTIAL APPLICANCES TO W LCUDE A DISHWASHER AND ' � MICROWAVE. . - � ' �-'-- _ - . . - . ' , ri �L . , . -� . _ ' ... . . _ . _ . , /� � �� ' _ ' _ ' . � _ _ _ � � ' - ' � Quantity � ' � Quantity ISSUE FEE �- �. $23.50 Temp Disl System I Lighting $0.00 0 Temp service tesL ' � 50.00 •- � `:�Busway /100 ft $0.00 .� 0 ' Res.a/cpackage ,\�°, �$0.00 =^�}'"r�' StandingSection $0.00 �� 0 New Res,(1-2 uniLs) � ��;$0.00 � 0 ''� � Misc Electrical�Eqwpment 50.00/� �0 New Res (3+units) �� a \$0.00 . 0 „ � Transformers up,to�1 kva/kw�..� , $0.00 � 0 � , • . " , -... . � ., . Pool / Spa �. �� $0.00� � � - 0`` � � - - � ....... ...up to 10 kva/kw �� $0.00� 0 � Lighting Fixis�� , �� %� $13.20`� , � 12 , � . _ , ....up to 50 kva/kw : $0.00 i � 0 , . :...... . Recept Outlets� � � �� $29.30 `� � �'�30 �� - " � .................up to 100 kva/kw � $0.00��% 0- �. i, Switches � �, _ � ' $15.40 - � �-��t4'�-�. __, � ..................over 100 kva/kav - ' � $0.00 -�,'( 0 Non Res Appl � �$0.00 ��- 0 . � ' � � .. � Low Voltage Equipmenb " - .$0.00-� , 0% Res Appl � ��-�� 59.50; �,� � . .2 - , _ � Low Volt Wiring System / Ckt•,�, � $0.00- � ,- 0, Service to 200a � $30.50 � , � � 1 � Misc. Conduit � � . � � -$18.20 ,' j i. � Serviceto t000a �� $0.00 �, ' �:0 . . , Misa Conductor • � �$0.00'� /0 Service over 7000a 30.00 '- � 0' - � �Circus ( gen or ride)� .$0.00/ 0 Motors to 1 hp $0. W; - �. 0�- � "Circus (mech ride or lights) �, L- $0.00 0 Motors to 10hp $0.00 � - �--0�- �� Christmas Tree Stan4, -" � �--� $0.00 0 Motors to 50hp $0.00 �� 0. ' . ,. : - � Fireworks Stand '- . - � $0.00 0 Motors to 100hp $0.00 0 - - . ' ^ � Other Electrical Fee- � $0.00 Motors Over 100hp $0.00 0 Communication drops $0.00 0 Investlgation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 . Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $139.60 Intermed Pole $0.00 0 COMMENTS / SPECIAL CONDITIONS NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes regulations. (Ord. No. 92-28, § 1, 12-21-92) / EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is for a peF(od of 180 days. INSPECTIONS: In order for the work euthorized under this permit to be considered legal, such work must comply with all required Inepectlons and final approval must be obtained. Failure to obtain inspections and final approvai will result in the e� FOR INSPECTIONS CALL: (714) 7545626 z+auas (emo� abandoned Ne codes, and ell of ihis pertnit. WORKERS' COMPENSATION DECLARA710N: . I hereDy effirm under penalty of perjury one of ihe following declarations: � ❑ I have entl will maintein e certificate oi consent to sell-Insure tor workere' compensation, es pmvided for by sectlon 3700 0l the Lebor Code, for the peAormence o1 the work fOr whiCh Ihis pertnil is issuetl. ❑ I have flntl will maintain workers' compensation Insurance, as required by section 3700 of the lahor Code, br Ihe peAortnance of Ihe work or which Nis pertnit Is ls.wed. M workers' com ensatlQ�n ^I� u� �ce came n � number are: Carrier.Y P L 1U 1..X� �.. _ � Policy Number � ly ycertify thet in the pertormance of Ihe ...>� wmpensatlon laws ol Califomia, antl comply with t�ese prOvl5ion5. Appllcent Signature: WARNING: FAILURE TO SEIXIRE W TTIOUSAND DOLLARE IS10D.0001. I DITI C LICENSED CONTRACTORS DE I hereby aflirtn ihat I am Iicense0 lorce end eNect. Lic. N Contrector's Signature: _ et om m�dred dallers ($100) or less.) y s ermit I,5 iwuetl�l shell not e y any person In eny manner so as to become ubject to the workers' me subject to the workers' compensatlon provisions oi Sectlon 3700 of �e Layp� Cod� II torthwilh Data: gI �I COVERAGE IS UNLAW FUL AND SHALL SUBIECT PN EMPLOYER TO CRIMINAL PENALTIES M'D CML FlNES UP TO ONE HUNDRED = COAIPENSATION, DAhNGES AS PROVIDED FOR IN SECiION 3]O60F THE LABOR CODE, IMEREST, AND ATTORNEI"S FEES. pmvisions of Chapter 9(commencing wilh Section 7000) of Dlvlslon 3 of t�e 8usiness and Professions Code, end my license is in full Class M Date: CONSTRUCTION LENOING AGENCY: ❑ I hereby affirtn that there is a consiruction lending agency for ihe pedormance ot lhe work tor which ihis permit is issued. (Sec. 3097, Civil Cotle). Lendels Name: Lenders AUtlress: SigneW re: � Da�e: OWNER-BUILDER DECLARATIONS: I �ereby ettirtn ihat under penalry ot perjury that I am EXEMPT FROM 7HE CONTRACTOHS LICENSE LAW tor the following reason (Sec. 7031.5, Busineu end Protessions CoAe: Any ciry or counry which requires a permit to construct, alter, improve, tlemolish, or repair any sWCNre, prior to its issuance, also requires the applicant for such permit to file e signetl statement thet he or she is Iicensed pursuent to the proNsions ol the Contrectors License Lew (Chapter 9(commenUng with Section 7000) of DlWslon 3 oi the Business tl Proteuions Cotle) or t�at he or she is axempt therefrom antl Ihe besis tor Ihe allegetl esemption. Any violation oi Section 7037.5 by eny applicant for e permit suhject e applicant to a civil penalry of not more ihan live hundred dollero ($500).): I, es owner oi Ihe property, or my employees with weges as their sole compensation, WILL DO TME WORK, and the siructure Is not intended or ottaretl lor sale (Sec. 7044, Business and Prolessions Code: The Contractors License Law tloes not apply to an owner of property who builds or improves Ihereon, antl who does such work himself or herself or Ihrough his o her own employees, provided Ihal such improvaments ere not Intendetl or oHeretl for sale. If, however, ihe building or improvement is sold within ona yeer of completi r-builder wiil have the burden of proving that he or she tlid not build or improve for purpose ot sale.). ❑ I, es owner of the prope XCLU ELY CONTRACTING WITF1 LICENSED CONTRACTORS to consiruct tha project (Sec. 7044, Business anA Professions Code: The conirecto cen La s not epply to en owner oijro�tly who bullds or Improves Ihereon, and who coNrects tor such prqect with a contrector(s) licen5e pursuant t he C ra Li :). ❑ 1 am exempt under sec. Business end Protessions Code for this reason: Signeture: Da� Owner ID venfietl b ver license. ❑ Yes ❑ No Dnvers License No. �' Expires: � Varification of nership y(type oi documem, i.e. - property tax bill or deed): DIVISION OF INDUS'IRIAL SAfE7Y PERMIT CER7IFICA710N: � ❑ I hereby certity that no ezcavation five (5) or more feel in dep�h into whlch e person is requiretl to tlescend, will be made in connection with work euthorized by Ihis permit, and Iha� no building siructure, scaitolding, felsework, or tlemolition or dismantling ihereol, will be more than Ihirty-slx (38) faet high. (Chap. 32, Grp 2, Ah 2, Sec. 341, Title B, Celifomia Adminisirativa Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a pertnit irom Ihe Division of Industriel Satery, as notetl ebove, unless such person hes a partnit to do such work fmm ihe division. Signature: Date: Division of Industnal Salery Pertnit Number: 1 Will the applicant or present or future building occupant neetl m file entl certity a Business Plan for emergency response to release or Ihreatened release ol a haiartlous metenal7 ❑ Yes � No (Section 25505 of the Celifomie Healih and Salery Code requires, wilh some exceptions, that a Business Plan be tiled with the Costa Mesa Fire Depertment by every business which hes at any one time dunng a reportetl year a quantity ol hazardous matenals equal to or greater than a wei9ht of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard tempereture and pressure). ........................................................................................................................................................................................................................................................................................................................................................................................ 2 Does or will �he applicant or pre58nt or future buildinp ocCupant need 101i1e e regis�retion brtn for ecutely hezardous matenels7 ❑ Ves ❑ No (Section 25533 of the Cellfomia Healih entl Safery Code, wlih some exceptlons, requires registratlon with the Costa Mesa Fire Oepariment by each business w�ich at eny one time haz on hanA e quantiy oi ecutely harardous matanals equel to or greeter than a weight ol 500 pounds, or e volume ot 55 gallons, or 200 cubic feet of �O�essed 9as et standartl tempereture end pressure). es or will the epplicant or present or future bullding occupant need to prepare an RMPP (Risk Management and Pravention Progrem for acutely hazarUous matenals)7 Yes ❑ No �ction 25534 of Iha CaliFornia Health end Setery Cotla provides ihet ihe Costa Mesa Fire Deperiment may require the preparetion, certification and filing wilh �he Fire oanment ot an tiMPP bv busineues which ere reQuired to reoister eatelv hazerdous metenels with the Fire Deoanmem. It 9n HMPY IS pfB5en0y fequlfeQ has 58CIIOn 25534 Ot Ibe GeIItOmIB HBeIIII Bntl 58tety Gotle bBen tUlly COmpllea Wl�h7 �,J VB9 �J NO ................................................................................................................................................................................................................................................................................................................................................... Does or will ihe epplicent ar present ar fuNra building occupant requlre lor Ihe work which is ihe subject of Ihis e�Jplication a armit for such consimctlon or irom tha Soulh Coesl Air Oueliry Managament �Isitict or fwm any other eir polWtion conhol tlistdct or agent)? I.J Vas � No (Seclion 658502 ot ihe CeliFomia Govemment Coda requires ihat the requested infortnation be furnished on applications for non-residential building permits). ....._ ................................._............................._..............._............................................................................................................._.................................................................. ....................... ...................................... Will any pah oi the faclliry to he constructed under this permit be wlthin 1000 feat trom the outer boundanes ot a school'1 ❑ Ves ❑ No (If yes', t�e tecility must meet the requirement ot Sectlons 25534 entl 42303 0l Ihe Calitomia Heallh antl Setery Gode). e Signature: have all ol the tlisclwures agency is requiretl for ihe wark which is Ihe suDjecl of [his made7 ❑ Yes ❑ No COMPLIANCE: I ceniry that untler penalry of perjury the infortnation given above is correct. I agree to comply wit� all state laws entl ciry artlinances is Meterials and Emissions. Date: CEHTIFlCATE OF COMPLIANCE AND wrrect. 1 agree to compty with all st e la , ebove-descnbed propeny far inspeclion p Sig � Antl/O Authori cooe �. 1616 Fixed System Final Fire Prevention 1266 Pool Spa Flnel 200 Final Pa-Roof 207 Finel BIaWRetaining Well 202 , . Final Factory.Fire Place 203 Final Sign . 204 Final Demolition EMAY: I certity under penalry oi perjury that 1 have read this epplication and state that the inlormation given is ices relating to bulltling consiruction, an0 euthonze representatives ol the Ciry ot Costa Mesa to entar upon the _taoccupy or ellow occupancy-ol eny building authorized by ihis per i�until ' al ins� �5� Da�9 Qd¢, �j CODEt IMSPECIIONTYPE 206 Final Mechanical 20B Flnal Plum6ing 210 Final Electrical 212 Final Flre Preventian 220 Final Plenning Approval 222 Final Si�e 250 Final Building/Occupanq BLIF IIIIIDlL,4 �-i3-o3 FF+� .- -^ '' . 'r' • - ` (714) 754-5273 • Fax (714) 7544856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT �ob Address: 396 LA PERLE LN Suite: Vicinity: REMOVAL OF ROOF AND EAST WALL Parcel Number: 42531206 Applicant: ROSS, ERIC C TR Address: 396 LA PERLE LANE COSTA MESA, CA : � j� ; � , Owner. ROSS,�ERICC TR' Address � 396 LA PERLE LANE ." , � � OOSTA MESA, CA � � Contrector. � OWNER-BUILDER Address: - � - Zip: Arch : Address: Zoning: . Phone: (949) 548-2026 Zip: 926273759 i Phone: (949) 548-2026 � Zip: 926273759 Phone: License: 0 Eng: ' � � �" ' ' Address: Status: ISSUED Applied: 07/01/2002 Issued: 07/01/2002 ISSUED BY: ��__ i � � � . . � . - Phone: � . ' . Phone: _ - ... .- - �, " _ , Zip: � License: " License: � _ � , SCOPE OF PERMIT _ _ � • � � DEMO PERMIT TO REMOVE THE ROOF AND EAST WALL FOR A RESIDENAL ADDITION/REMODEL. PLANS IN PLAN CHECK � FOR ADD 238 SF GARAGE, 396 TO KITCHEN NEW BATHROOM AND FRONT HALL REPLACE EXIST WINDOWS WITH SAME � , SIZE, INTERIOR WORK TO EXIST BATHROOM AND REPLACE 4 EXIST DOORS . �' � REF: B02-OOZ49 � � � Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $54.00 $0.50 $0.00 $0.00 $0.00 i_ _ $54.50 ; � SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Pront 0-0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0- 0 �� Required: 0 - FEE SUMMARY . Calc Valuation: Claim Valuation ..,., .: " PLANNING & ZONING Left . 0- 0 Left " 0- 0 Proposed:. 0 �� Right 0-0� �, Right �0. 0 si,soo.00 $1,500.00 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 ord0r tor the work authorized under this permit to be considered legal, such work must comply vrith all applicable codes, antl all required inapeetlone ahd final approval must be obtained. Failure to obtain inspections and tinal approval will result in the ezpiration of{his permit. u FOR INSPECTIONS CALL: (714) 7545626 , ?aawe I�'oo) WORKERS'COMPENSAnON DECLARAnON: . � � I hereby aHirtn under penelry ot perjury ona of the following declaratlons: � � I have entl will melnlain a certificate of consent to self-Insure for workers' compensetlon, es provitletl for by aection 3700 of the Lebor Code, for ihe pertormenca of Ihe wOrk fOr wNch this permi� is issuetl. . ❑ I have aM will maintain workers' compensalim insurance. as required by section 3700 of the Lebor Cade. fw t�e performance of the work for which this pe�mit is IsweE. My workers' compensation Insurance cartler and poli�y number ere: Cartier: Policy Number: (mfs section need not be complered il tAe permif !s ve�uea et one nundred dd/ars (Stoo) or �ess.) � ❑ I certify thet in t�e pertormance oi the work Por which this permit Is issuetl, I shell not employ any pereon in eny manner so as to become subject to t�e workerg' wmpensetlon lews oi Calltornle, end egree that If I should becoma sub�ect Io ihe workars' compensetlon provisions ot Sectlon 3700 oi Ihe Lebor Cotle, I shell lonhwtlh comply with ihese provisions. Applicent Signeture: Dete: WARNING: FAILURE TO SECURE WORKE0.S' CAMPENSATION COVEMOE IS UNLAWFUL AND SHALL SU9IECT rW EMPLOYEP TO CRIMINAL PENALTIES MID CIVIL FlNES UP TOONE HUNDRED THOUSMIO DOLLARE (5100.000), IN ADDITIIXJ TO TNE WST OF COlAPENSATION, DMIAGES AS PROVIDED FOR M SECiION 3)O60F THE LABOR CODE, IMEREST, M1D ATfORNE1"S FEES. LICENSED CONTRACTORS DECLARATION: I hareDy aftirm that 1 em licensed under provislons ot Chapter 9(commencing with Section 7000) of Divislon 3 ot the 8usine55 end Prolessions Code, end my license is in tull torce entl effect. Lic. # Class s Conirectors Signa�ure: Date: CONSTRUC710N LENDING AGENCY: � � I hereby affirtn that there is a construction lending agency tor the peAormance ol the work for which Ihis permit is issuetl. (Sec. 3097, Civil Code). Lendefs Neme: LendeYs Atltlress: Slpnature: Date: OWNER•BUILDEfi DECLARATIONS: I hereby aflirtn that under penalry ot perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business entl Professions Code: Any ciry or counry which requires a pertnit to construct, elter, Improve, tlemollsh, or repair any structure, prior to its luuance, elso requires the applicant tor such pertnit lo file e signed stetement that he or she Is Iicensed pursuent lo the praWsions oi the Contrectors license Lew (Chepter 9(commendng wit� Section 7000) ot Dlvision 3 of Ihe Business end Professions Cade) or thet he or she is exempt iherelrom end the basis for the ellegatl exemption. Any violation ot Sectlon 7031.5 by eny epDlicant for a permit �su �ecls the epplirent to e civil penelry of noi more Ihan five huntlretl dollers ($500).): I, as owner of t�e properry, or my employees wlih wages es Iheir sole compensetlon, WILL DO TME WORK, end the siructura Is not intentlatl or offeretl tor sale (Sec. 7044, Business antl ProFessions Cotle: 7Te Contractors tJcense Lew dces not apply Io an ownar of proparty who builas or improves theraon, and who does such work himself or herselt or throug� his or her own employees, pmviaetl ihet such improvements ere no� intended or ottered lor sale. If, however, the building or improvement is soltl wit�in one year of completion, the owneo-buildar will heve the burtlen ot proving that he or she tlid not build or improve for purpose of saleJ. ❑ I, as owner of the propary, am EICCLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to construct the project (SecJ04d, Business end Prolessions Code: The conirectors Li ensa oes not eppy to an owner oi pro0erty who builds or Improves thereon, end who contracis br such project wi[h e contractor(s) license Dursuant to ihe actor icense Lews.). // ❑ I em exempt un se BuSines9 Bnd Profes5ions Coda tor this reeson: SignaNre: Owner ID venfietl b s license. ❑ Ves ❑ No Driver's Licensa No. Vedlication ershi by (rype of documenL i.e. - property tax bill or deed): DIVISION OF INDUS�RIAL SAFETY PERMIT CERTIFICATION: ❑ I hareby ceniy ihet no excavetion five (5) or mora teet in depth inta which a pereon is required lo descentl, wlll be metla in connection with work authonzetl by Ihis permi�, and ihat no building structure, sceMolding, talsework, or demolition or dismentling thereoi, will be more than Ihirry-six (38) leet high. (Chep. 32, Gry 2, ArI 2, Sec. 347, Title B, Californie Adminisirative Code). ❑ As owner-builder, I will not employ enyone to do work which would require e pertnit trom Ne Division ot Intlustnal Safety, es noted ebove, unless such person has e pertnit to do such work from the division. Signature: Date: Division ot Indusinal Sefery Permit Number: CERTIFlCATE OF COMPIJANCE AND A R�aN OF ENTRY: I certify under penalry ot peryury that I have read this application and state that the infortnation given is wrrect. I egree to comply with ell statvl en ry�n rrelating to building construction, and authodze representatives o1 the Iry of Coste Mese ro enter upon the above-descnbed property for inspection p p s e not to occupy or ellow occupancy of any building euthonzed by ihis permit unti inal spection. 7 / d %— Sipnat Legal Owner(s) - � D �e nN(1r uthnmxA AnolitaN Dele COOE I INSVECTIONTYFE 1618 Fizetl System Final Fire Preventlon 1286 Pool Spe Flnel 200 Finel Re-Rooi 201 Final BIaWRetaining Wall 202 Finel Factory Fire Place 203 Final Sign 204 Final Demolilion ' DATE INfITIALS �( INSPEC110NTYPE 206 Finel Mechanical 20B Final Plumbing 210 Final ElectAcal 212 Final Fire Preventlon 220 Final Plenning Approval 222 Final Site 250 �FinalBuilding/Occupancy �lfi �:$ (774) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.cBaUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 396 LA PERLE LN Suite: Vicinity: DETACHED GARAGE Parce�Number: 42531206 Applicanr. ROSS, ERIC Address: 1679 TUSTIN AVE COSTA MESA� CA owner: ROSS, ERIC Address 1619 TUSTIN AVE COSTA MESA� CA Contrador: O WN ER-B U I LDE R Address: Zip: Arch : , Address: Phone: Zip: License: Zoning: Phone: (949)548-2026 Zip: 92627 Phone: (949)548-2026 Zip: 92627 Phone: License: � 0 � Eng: Address: ISSUED BY: Status: ISSUED Applied: OS/14/2001 Issued: 05/14/2001 Phone: License: ' ' - . � SCOPE OF PERMIT - ' ' .' REPLACE EXISTWG HEADER (CIKEFOR LIKE)�IN DETACHED GARAGE. ' �- � - ` ' , , � Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $23.50 $0.50 $0.00 $0.00 $0.00 $24.00 ` �,- . FEESUMMARY _ __ ` Calc Valuation: -- � � - Claim Valuation: � � '� -- ji; .�.. : � �' �-„ � , .:, �� _ _ , - _ ��, ., :a"' . , ,�'�� ,;// .� ��\�\�\\\, �� SETBACKS �� i � ". �, � , - � i �_.; _ _ � ��: . MAIN STRUCTURE� FronC �0- 0, Rear� �0- 0 `.�-, �„ ACCESSORY Front �0- 0A'� �' Resr _�0- 0 PARKING Existinq: ` .0 : ' .�Required: o NOTES: ING:& ZONING- '' � � � � � � ,F .�� .0 % ` ° ,Jj �\ : / Left : �0.�0 ��" Right " 0 ;Oi � '� � - .. � ,, ��. 'i .�;. ; Left 0-.0 ,. ��, � Rijht;`�' 0-,0 � / i i. Pr000sed: 0�� -' �.;%% - � $soo.00 ssoo.00 NOTICE: The work authorized by thi9 permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 9&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 7 BO days. INSPEC710NS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all required inspeetione and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pertnit. FOR INSPECTIONS CALL: (774) 7545626 � zans�as �dao� � WORKERS' COMPENSATION DECLARATION: - I hereby atfirm under penalry of parjury one of tha following tleclaratlons: ❑ I heve end will maintaln e certilicate at consent to self-Insure tor workers' compensetlon, es provlded for by section 3700 of the Lebor Code,lor the peAormence of the work for which lhis pertnit is issued. ❑ I have arM will malnWin workero' compensation insurence, as required by secUon 3700 of Ne Lebor Code, for Ihe perfortnance of the work for which this pertnit Is Issued, My workere' compen58tlon InSurenta wrrier end policy number ere: - Carnar: Policy Number (This sectlon need nof be complefed i! the permit 75 ve/ued ef one hundred dd/ers ($100) or /essJ ❑ 1 certify t�at in t�e pertortnance of the work tor which Ihis pertnit is IssueA, 1 shell not employ any person in any menner so es to becoma sub�ect to the workers' compansetion laws of Cfllifomia, end agree Ihet il I ahould become sub�ect to Ihe workers' compensatlon provlslons of Sectlon 3700 of the Labar Code, I shell tort�with comply with these provisions. Applicant Signeture: Dete: WAHNIN�: FAILURE TO SECUPE WORKERS' OOMPENSATION COVEMGE IS UNUW FUL M!D SHALL SUBIECT AN EMPLOYER TO CflIMINPI PENALTIES AND GIVIL FINES UP TO ONE HUNDRED T/iOUSAND DOLLARE (5100,000), IN ADDfiIIXJ TO TME COST OF COMPENSATION, DAMAGES AS PFOVIDED WR IN SECTION 3108OF TME LABOR CODE, IMEREST, AND ATfORNE1"3 FEES. LICENSED CONTAACTORS DECLARATION: I hereby atfirtn that I am licensed under provisions of Chaptar 9(commencing with Section 7000) of Divlsion 3 ot Ihe Business and Professions Coda, end my license Is in tull force end ettect. Lic. q Clau a Contractofs Signatura: Oate: CONSTRUCTION LENDING AGENCV: ❑ I hareby alfirtn that there is a construction IenCing egency for the peAormance ol the work tor which Ihis permit Is issuad. (Sec. 3097, Civil Cotle). Lentle/s Name: Lendars AdAress: Signature: Date: OWNER-BUILDER DECLARAT10N5: 1 hereby afllrtn �hat untler penalry ot perjury that I em EXEMPT FROM THE CONTflACTORS LICENSE LAW for the tollowing reasan (Sec. 7037.5, Business enC Professions Cotle: Any ciry or counry which requires a pertnit to consWct, alter, Imprwe, tlemWlsh, or repair any slrucWre, pdar to its issuanco, elso requires Ihe epplicant lor such pertnit to file e signed statemant thet he or she is Ilcensed pursuent to the pmvisions oi the Contractors License Lew (Chepter 9(commencing with Sectlon 7000) oi Divislon 3 01 the Business end Professions Gotle) or thet �e or she Is exempt therefrom end the basis br the alleged exemptlon. Any Nolation ot Sectlon 7031.5 by eny epplicant for e pertnit sub� cts ihe epplicant to e civil penalry of not more than fNe hundretl tlollars (5500).): es owner of t�e properry, or my employees with wages as thelr sole compensetlon, WILL DO THE WORK, antl the structure Is not intentletl or oflered for sale (Sec. —7044; Bu3iness anC Professions Cotle: The Contrectors License Lew does not epply ro an owner of property who builds or Improves thereon, end who does such work himself or �erself or through his or her own employaes, provided thet such improvements ere nat Intended or oHered br sele. H, however, t�e building or improvement is sold within one year ot completion, ihe owneabuilder will heve the burden of pwving Ihet he or she did not DUIIE or improve for purpose of seleJ. ❑ I, as owner of the properry, am EXCLUSIVELV CONTRACTING WI7H LICENSED COMRACTORS to consWct t�e pro�act (Sec. 7044, eusiness and Professions CaEe: TTe conira Lew does not appty lo en owner ol property who builtls or Imprrnes thereon, and who contrecis lor such pro�ect with a cantractor(s) license pur the Co ctors Licensa Lews.). ❑ I am exe pt u ar s � Business entl Professions Code tor this reawn; i/ / ID ve " y Arivers license. ❑ Ves ❑ No Driver's License No. �/ � of nership by (type ot tlocument, i.a. - properry lax bill or Oeetl): ��--- � - DIVISION OF INDUSTRIAL SAFETY VERMR CERTIFICATON: ❑ I hereby catlity ihat no excavatlon flve (5) or more teet in depth into which e person is required to descend, wlll De made in connection wiih work euthodzed by Ihis pertnit, and thet no builtling stnidure, scaHolding, talsework, or demdition or dismantling thereof, will be more than thirty-slx (36) feet high. (Chap• 3.2, Grp 2, Art 2, Sec. 341, Titla B, Calilamia Adminisireilve Code). ❑ As owner-builder, I will not employ anyone to do work which would require e pertnit trom the Division at Intlustrial Safery, es noted ebova, unless suc� person has e permit to tlo such work Irom tha division. Signature: Division of Intlusinal Sefery Pertnit Number: Date: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 7 Will Ihe epplicant or present or future buildinq occupent neetl to lile entl cenity a Business Plen lor emergenry response to release or threetenetl release of a hazertlous material? ❑ Yes ❑ No (Section 25505 of t�e Califomia Health antl Satery Cada requires, with some exceptions, that e eusineu Plan be filetl with ihe Costa Mesa Fire Depanment by every 6usiness which has at eny one time dunng a reported year e Quantlty ot hazerdous materials equal to or greater than a weighi ot 500 pountls, or a volume ot 55 gallons, or 200 cuDic feet of compressed gas at standard tempereture antl pressure). ..............__.........................................._................................................................_............................_........................_........................................................_._.............................................. ....................... .................................................. 2 Does or will Ihe applicant or present or tuture builtling occupant neetl to tile a repistretion form for ecutely harardous materials7 ❑ Ves ❑ No (Section 25533 of t�e Celitomia Health end Sefery COCe, vrith some exceptions, requires regisiretion with the Casta Mesa Fire Department by eech 6usiness which at any one time has on hend a quantity ot aculety �aiardous matedels equal to or greeter ihen e weighi ol 500 pounCs, or e volume oi 55 gellons, or 200 cubic feet ol COmpre%ed Aa5 BI 5landard iempere�ure 8nA pre55ufe). 3 Does or will Ihe applicant or presenl or fuNre Duildine oCcupant neetl to preDere en RMPP (Rlsk Management ei ❑ Yes ❑ No (Section 25534 af the Calitomia Health anC Satery Code provides that the Coste Mesa Fire Depertment may ri Depertment ot an RMPP Oy businesses which are repuired b register acutely heeardaus meterials with tha Fire ............_.._ ....................._._..............._......................................................._.........................._.__._..........."'_.............._.........................._.__...... 4 If an RMPP is presently required, has Section 2553M1 ol the Californie Health end Safery Code been fully complie ........................................................................................................................_................................._.........................__................................................................. 5 Does or will tha applicant or present or future builtling occupent requlre lor Ihe work which is the subjecl ol this tmm t�e South Coast Air �ually Manegamant Distdct or Irom eny other eir pollutlon con�ml dlsMct or egencyl (Sedlon 658502 oi Ihe Califomia Govemment Code requires lhat lhe reQuesletl inlormation ba tumished on ep� .................._.._.....................__...._.........'_'_'.................._..—_._........................_...__.................._................_-..............."___............ 6 W ill any part of the laciliry ro ba conslructetl untler t�is pertnit be within 1000 teet Irom the outer bountlaries ol a (N yes', tha faciliry must meet the requirement oi Sections 25534 end 42303 oi t�e Califomia Heelth antl Setery ihe preparation, certification and tiling wi�h �he Fire ment. ............................................ _...................... _....................... _................ ? ❑ Ye9 ❑ No ............................................................................................................... Etion apB rmit for such consiruction or moEiticetion 4 �J No ns br non-residential bullCing permlis). a permit irom the South Coast Air Ouelity Manegement olsMct or otner etr pollutlon coniroi tlislnct or egency is reqmrea ror tne wonc wnicn is tne suo�ecl ot mis iplication, have ell ot tha tlisclosures prescnbed by Califomia Health end Salery Cotle Section 42303 been mede9 ❑ Ves ❑ No ....................................._...................—_..................._..__.................................'"'........................_..............._._..........................._................................................._.._....................._..................._......................................_.. 'yes', ettach certificate ot wmpliance from t�e eppropriate eir pollution control oNicer). cRTIFICA7E OF COMPLIANCE: I ceniry that under penalry of perjury the intortnation given ebove is wrrect. I egree to comply with all siate laws antl ciry orCinances oarCina Hazardous Matenals antl Emissions. Signature: Dete: CEFi71FlCATE OF COMPIIANCE A D�NiMOR TIO F EMRY: I cenity under penalry of perjury that I have read this applicatlon and state t�at the infortnation given is correct. I egree to wmply with e t3(e laws d it ordinances relating to building wnsWction, end euthodze representatives at the Ciry of oste Mesa o enter upon the above-described propeny lo�i sp ction pur � s. I egree ecccGpy or ellow acupency af eny building authonzed by t�is permit umil tinal i specti �S' LegalOwner(s) .- �Ie/ /� � CODE �, 1676 i:etl System nal Fire Preventlon 1266 Pool Spa Final 200 Finel Re-Rooi 207 Finel Block/Retaining Wall 202 Final Fectory Fire Plece 203 Finel Sign 206 Finel Demolition aeie �$ 4QQ�( INSPECTIONTYVE 206 Finel MeChaniCel 20B Finel Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approvel 222 Final Si�e 250 Finel Builtling�Occupancy PdIF I[�4S �F a o3 �� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT » FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 396 � LA PERLE LN � Status: ISSUED Suite: Applied: 07/26/2002 Vicinity: DETACHED GARAGE Issued: 08/OS/2002 Parcel Number: 42531206 Zoning: Applicant: ROSS, ERIC C TR ISSUED BY: ,<_ :- .. ,_ � - _. � Address: 396 LA PERLE LANE �-_' � ��/�-""_ _ -: �-, / %/' - �Phonei, (949)548=2026 �` ;�� COSTA MESA;.CA � � � . � � Zip: 92627 3759 � � � - �/��/ � �, _ . , ..� �� i �� Owner. ROSS� ERIC C TR .. � � _ • - _ _ _ � �' � Address ,396 LA PERLE�LANE . / � - v �, __ ; ; � - ;'- .: � ��A ��. �,. . %.-� ,, �. � ' Phone: � (949) 548=2026= � V �� A, .�� -� �COSTA MESA, CA , - - Zip: 92627-3759 -�'� �� - � �� ,�� ,� � _ �, � i �• � � � % ' � A � �/�- � � � ./ Contractor: ' � j�'�i; � � � � � � : \ �� i. - �� ,� / � `_ _ � � Address: � ". �% A' �; , . � ; �` , ' . ';�� Phone:;. � � � � i,' � V',�, , ! � � - � ; �, . " , " Zip: � �,�� License: % ' � - _ - -- � �� `\ r � i �� , , Arch�:_ , ". , � � �/- � � E�9; '' 1 i � , � . . � Address: ` �' i j ,-�'A ! _ , ' � Address:�, -, � � ' , . . . . , � � � - - — -' - � . �� . - . .. . , l ��Phone: - � - ; � \ ��, /j \ Phone: . ' \ �; \ Zip: � � ; � License: � �License: �� V � � �� - SCOPE OF PERMIT � � � ' �� i t`:;,��r.`:J' n^` '_`T"r. � �� CONSTRUCT 598 SQ. FT. GARAGE. 200 SF OPEN-PATIO ATTACHED TOSHE"RIGHT SIDE OF THE GARAGE. ORIGINAL GARAGE DEMOLISHED. REF: B02-00987. SLAB TO�REMAIN. �J . ` _ . _. _ ., _ . . .. _ . _ � � , SEE 802-00749 FOR FURTHER DETAILS. '' , - � � _ - _ _ _ _FEESUMMAR �.'Plan Check: $108.71 � � • - � � � ` Permit: � $167.25 � �SMIP Res: .� $0.86 � � SMIP Com: . .,' $0.00 ` Other: - • $0.00 �`"�-�� ,�� , _�.�:��`>`' _ • .. , Inspection: $0:00 • , �-.' . � . . �. - " � ' V�:�, � � ��TotaL• � $276 82 � � i'�-. ` ' � \. �/, •�. „ - , •��,� - ' ' �` PLANNING&ZONING . '-� ��; ��' ' SETBACKS ��-:� . - ' �".-. .. . " ,_ - �:�; �i MAINSTRUCTURE Front 0=0"� �, �Rear 0-0 Left �0-0 Righf,-�0-0 .��-�' '� . -'- . , ,'��' ,'� . , �. ' � /i�, ACCESSORY Front��64-0 �_ � �.Rear, � SO , � �'Lek 0-0 , Right_- 41-0� �� j \ ' PARKING Existinq: 2��-Required:_,_ 2 "��--Proposed:� 2`;' � � ��-� " "- .� ,-. ,..��- _. - . NOTES: - - � - - ; � - Calc Valuation: Claim Valuation � � - ;,� as:s�s.00 so.00 '��'/ � -,; � i�% . =_ %"� . ' �!% � �i. . 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; an� required Inapectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this p�ertnit. FOR INSPECTIONS CALL: (714) 7545828 �wo-+o law� WORKERS'COMPENSAnON DECLARAnON: . � I hereby aftirm untler Oanalry of perjury one of the tollowing declarations: .. � . ❑ I hava antl will maintain a certificete of consent to setl-Insure tor workers' compensation, es provitled for by sectlon 3700 of ihe Labor Cotle, for Ihe peAormence of the work for whiCh ihis permit is issued. . - � ❑ I have antl will maintain workers' compensation insurance, as requiretl by section 3700 of ihe Lebor Code, tor the pedortnance of ihe work tor which this permit is issued. My workers' compensation I ren�olicY number ere: � I _/L Carriec l Policy Number. � C'� �(This secfion need nof be c'omplefed il the p it is velued af one hundred dollars ($100) ar less.) tlity [het Idthe peAormence of the worlcJe hich ihi rmit is issued, I shall not employ any person in any menner so as to become su6ject to ihe workers' compensetion laws of Califomla, antl ege4e tl t if I s hecom ubjecY101he workers' compensation provislons of Section 37 of t Labor Cotle, I shall forthwith comply with these provisions. /f�� Applicant Signatura: Date: �" �� WARNING FAILURE TO SEWRE WORKERS' C SATIdJ COVERAGE IS UNIAWFUL AND SHALL SUBIECT AN EMMOYER TO CiiIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED T110USAND DOILARE (5100,000), IN ADDI TO E GVST OF CAMPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SECTION 310fi OF THE LABOR CODE, IFIrEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS DECLARAT�bN: I hereby aHirm that I em licensetl untler provisions of Chapter 9(commencing with Section 7000) ot Division 3 of the Business antl Protessions Code, end my license is in full force and ettecL Lic. N Comracbfs SignaNre: Class x Date: _ CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm ihat there is a consimction lending egency for ihe pedormance of the work for which this permit is issued. (Sec. 3097, Civil Cotle). Lentler's Name: Lendefs Adtlress: Signature: � Date: OWNER-BUILDER DECLARATIONS: I hereby aflirtn thet untler penalry oi perjury that I am EXEMPT FROM THE CONTPACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business end Protessions Code: Any ciry or counry which requires e permit to constmct, alter, improve, demolish, or repair eny stmcture, prior to its issuance, elso requires the epplicant tor such pertnit to file a signed statement that he or she is licensetl pureuent to the provisions oi the Contractore License Law (Chapter 9(commencinq with Sectlon 7000) of Division 3 of the usiness and Professions Code) or Ihet he or she is exempt therefrom and the besis for ihe alleged exemption. Any violation of Section 7031.5 by any eOP�icant for a pertnit bje ihe epplicant to a civil penalry of not more ihan five hundred dollers ($500)J: I, as owner of the pmperty, or my employees with wages es their sole compensation, WILL DO TME WORK, antl the structure Is not intenaetl or otlaretl tor sale (Sec. 7044, Business and Pmfessions Code: The Coniractors License Law does not apply to an owner ot property who builds or improves theraon, and who tloes such work himselt or herseli o� through his or her own employees, provided that such improvements are not intended or oNered for sale. If, howaver, the building or improvement is sold within one year of completion, the own -� r will have lhe burden ot proving that he or she did not 6uild or improve tor purpose of sale.). ❑ I, as owner of iha property, am E SIVELY C 7RACTING WI7H LICENSED CONTRACTORS to construct the project (Sac. 7044, Business and Protassions Code: The contractors Lice does no ly to an ow y who buiids or improves ihereon, and who contrads for such pmject with e conirector(s) license pursuant to ihe Conirect s Lice ws. . ' , ❑ I am exempt untler sec. Signature: Owner ID verifietl by tlrrve Verification of Owne p by ( Business and Professions Code for Ihis reason: s ❑ No DriveVs License No. i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL�AFE7V PERMIT CERTIFICATON: Date: ❑ I hereby cartity Iha� no excavation tive (5) or more fee� in depth into whic� a pereon is required to descend, will be mede in connection wi�h work euthodzed by ihis permit, and that no building simcNre, scaffoltling, talsework, or demolition or dismantling ihereof, will be more ihen thirty-six �36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle 8, California Admini5irative Cotle). ❑ As owner-builder, I will noi employ enyone to do work which would require a permit from the Division of Industriel Satety, es noted above, unless such person has a permit to do such work tram the division. Signature: Oate: Division of Industnel Safery Permit Number: CERTIFlCATE OP COMPLJANCE AND AUTHOR TION OF ENTFiV: I certify under penalry ot perjury that I have read this application and state that the information given is wrrect. I egree to comply with all state laws e ordin ces relating to building construction, and euthorize represeniatives N the Ciry of Costa Mesa to enter upon the e6ove-descnbetl properry for inspectin�,pw es. I not to occu rai o�ocCupancy oi eny buildinq authonzed by IhisGy,[� rt �unyL{)ina��l�'{1�)pedion�. _ TU � /V�� c�nnerivnnf � nr/sl - / Date cooe r, iNsvecnoxtrre 1616 Fixetl System Final Fire � 12fi6 Pool Spa Final 200 Final Re-Roof 201 Final elocWRetaining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition � Qeie u�S 0 COUE 1 INSPELTION TYVE 206 Final Mechanical 200 Final Plumbing 210 Final Eledricel 212 � Final Fire Prevention 220 222 250 Final Planning Approval Final Siie Final Building/Occupency 121�q � o� J ' (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BU�LDING PERMIT �� FAIR DRIVE, COS7A MESA, CA 92626 .7ob Address: 396 LA PERLE LN Suite: Vicinity: Parcel Number: 42531206 Zoning: Status: ISSUED Applied: OS/29/2002 Issued: OB/OS/2002 Applicant: ROSS, ERIC . - � _ ISSUED BY: Address: _ - " - '. -" -- ' � ,-' ; �,_�- _ '__: �, . -- �; % . � � Phone: 94&548-2026 —. , / \ /� �..: � ; . � , . - , . Zip; r'_' — = �' ,\ � / i �- � � - � , . ' � � � � � � Owner. ROSS ERIC `� � � � � % � .� • �. Address , 396 LA PERLE LANE � - . - � , , �� ; , `. � \ � ', � � . •- - Phone: (949) 54&2026 \ � � � �, � � � �. . . �' , COSTA MESA. CA . . : Zip: 92627-3759 � , � � .� "� � � ` i ,\ ' i': -_ � _ . \ , . : i �� i�= .,A Contractor: '/'� ' , " �� : �� /� � � � �"Address: ' i�;, � � ��. �� . i �i Phone: � � ;' ��'' •r%/ _. V_C,�� . . i. : � 1 i � ,V ` \ , ',� LP �/;� ,i .License:<. • .. , � _�� - , ��\ � � � Arch ' " � -�-e�:�!'/ Eng: HAROLD LARSON � , �\ Address: . " � �.: � � Address:� 1437 GLENNEYRE : � ' � � V �� . . .. . _. _ . . i . . . �;5 Phone: __ -�� ,'�� Phone: 949-497-5203'. , ' �' . . __ �, , / �"� �... LAGUNA BEACH ' \' �'� � � . :� . ��Zip: ` � . � � ; � License: 92657 -� �License: C33222 � �- � JI:VYt Uh YtKMI I � � ��.. . y. . r• _ � /�� ADD 396 SF DINING ROOM AND LIVING ROOM AREA.'LIVING ROOM WIL'L HAVE-A�NEW MFG. FIREPLACE. BATHROOM, . AND FRONTHALL. REPLACE EXISING WINDOWS WITH SAME SIZE. INTERIOR WORK TO EXISTING BATHROOM AND ' � REPLACE 4 EXISTING DOORS . ' " . , 40Yo — OR 2,794 SQ.FT. — OPEN SPACE REQUIRED; 56% = OR.3;948 SQ.Ff. OPENSPACE BROVIDED. 800 �, SQ.Ff. REAR YARD COVERAGE OK; 516 SQ.FT: PROVIDED. - — -� � � � � �_ � - ��'� . - ' ,. . , . , . ; . � � _ . , i , ,'' � i�°� � � . ' l, , GARAGE UNDER SEPERATE PERMIT. SEE 802-00145. NUMBER OF BEDROOMS NOLINCREASING. - � .. � � � - .. , - _, � FEE SUMMARY ' Plan Check: ; $427.54 •-,, _� Calc Valuation: 35i,a3�so � Pe}mit: $657 75 , � Claim Valuation` � � So.00 SMIP�Res: , � $5 93` � � _ =.� � � �, � SMIP�COfII: .�. : ,�0 00 �o. 1 ' .. ..a-,. ' • t"T,s.-rn �z ;,r_ - i ��/j/ i /�, � � � , _ ' - i Other: ,$0.00 �� %�' ' v , Inspection:�', - $0.00 � %��"�.� � � '��:. . . ` - .. ' _ , - �;..i. � � "i Total: A51;090.42� , � � �� ; ` ; �,� ,� i,; ;,." , .��, �� .% �. - - ' � i; � � � � PLANNING & ZONING `-�; �."/ _ / , SETBACKS � ; _ � � _ : A�, . , . - � - � , %v" % MAIN STRUCTURE Front 20- 0 �,�Rear>; 9g- 0-_ _ Left_ 10,0:., �'�'� � Right 17- 0 � . . ,. .. . . �. - _ � ACCESSORY Front 0- 0 Rear 0- 0 �-" � LeFC 0- 0 Right 0- 0 PARKING Existina: 2 Reauired: 2 Proaosed: 3 NOTES: I 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 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 work authorized under this permit to be considered legal, such work must comply with all applicahle-c� nd all required Inspeetions and final approval must be obtained. Failure to obtain inspections and (inal approval will result in the expiration`ol this permit. FOR INSPECTIONS CALL: (714) 7545626 �«o-,a iau,i WORKERS'COMPENSAnON DECLARAnON: � � I hereby aHirtn untler penalry ot parjury one of the tollowing tleclerations: . ❑ I �eve end will maintain e certificete of consent to seli-Insure br workers' compensetlon, es provltled Por by section 3700 of tha Labor Code, for Ihe pertortnance of ihe work lar w�ich this permit is issuea. ❑ I �ave and will maintain workers' compensation insurance, as required by section 3700 0l ihe Lahor Code, for the pertormance of thB � lor whic� ihis pertnit is issued. My workers' c mq p�r�aC6 n,j u_re�nce�c er entl policy number are: � 1 Cerner. `KJ j'Y�jf PolicyNumber: �J hls secfion need not be com0leted i/ the rmit is velued ef one hundred dollars ($100) or IessJ � I rtiy ihat in ihe pedortnance at t hich this permit is issued, I shall not employ eny person in any manner so es to bewpppqqq��e sub�ect to the workers' mDensation laws ol Calitomi egre P �tis utlY�sutj�ct to the workers' wmpensation prohsions of Section 3�(1� f the��¢¢¢ bor Cotle, I shall fonhwith comply with Ihese provisions. �/ /'/ �� ApplicantSlgnaNre: Data: J/� / WARNINCa: FAILURE TO SECURE ERS' COMPENSATION ODVERAGE IS UNLAWFUL AND SHAl1 SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED TFKKISANODOLIAfiE�5t00,�, !� DITIONTOTMECOSTOFCOMPENSATION,DAMAGESASPROVIDEDFOqINSECf10N31060FTHElABORCODE,INrEREST,ANDATTORNEI^SFEES. LICENSED CONTRACTORS DECLARATION: I hereby aftirm that I am licensetl under provlsions of Chaptar 9(commencing with Section 7000) of Divislon 3 oi ihe Business and Professions Code, end my Ilcense is in full force an eHect. Lic. # Class # G ect ry5i'gnelera:— Date: CONSTiiUCT10N LENDING AGENCY: ❑ I hareby aHirtn tha� �here is a construction lending agency tor �he pedormance ot ihe work lor which this pertnit is issuetl. (Sec. 3097, Civil Code). Lentlers Neme: LentleYs Atltlress: Slgnatura: � Date: OWNER-BUILOER DECLARATIONS: I hereDy eMlrm [hat under penalry ot perjury Ihe� I am EXEMPT FROM TME CON7RACTORS LICENSE LAW For Ihe following reason (Sec. 7031.5, Business and Professions Code: Any ciry or wunry which requires e permit to construct, elter, improve, demolish, or repair eny strucWre, pnor to its issuance, elso requires the applicant tor such permit to Ille e signed statement Ihat he or she is IicenseA pursuant to Ihe D�ovisions of Ihe Coniractors Llcense Lew (Chapter 9(wmmencing with Sectlon 7000) ot Division 3 of Ihe Business entl Professions Code) or that he or she is ezempt therelrom and ihe basis lar the alleged exemption. Any violation of Section 7031.5 by eny epplicent for e pertnit subje a applicant to a civil penaly of not more then tive hundred dollars ($500).): I, as owner ot the property, or my employaes with weges as iheir sole compensetion, WILL DO THE WORK, ana the simcture Is not intentletl or oHeratl tor sala (Sec. 7044, Business and Protessions Code: The Contraciors License Law dces not apply to an owner of property who builtls or improves ihereon, entl who does such work himself or herself or Ihrough his or her own employees, provided ihat such improvements ere not intended or oHeretl for sale. It, however, the buildinp or improvement Is soltl within one year of completion, tha owner-builtler will have the burden of proving that �e or she did not build or improve tor purpose of sale.). ❑ I, as owner of ihe property, am EXCLUSIVELY CONTRACTNG WITH LICENSED GONTRACTORS to consiruct ihe project (Sec. 7044, Business and Professions Cotle: The contraaor License Lew does not epply to an owner of pmpeny who builds or Improves thereon, and who comrects tor such pmject with e contractor(s) license pursuant t trectars License Laws. . ❑ I em exempt de Business and Professions Cade tor t�is reason: Signeture: Data: � Owner ID venfietl ver's license. es ❑ No DriveYs License No. /� �� _ Ezpires: / Vedticetlan ership hy (rype o1 dxument, i.e. - pmperty tex blll or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cartity ihat no excevation five (5) or more feet in tlepih into which a person Is required to tlescenq wlll be mede in connection with work euthodzed by this permit, and ihat no building siructure, scaXolding, falsework, or demolition or tlismantlinp ihereot, will be more then thirty-slx (38) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Ttle 8, Celifomia AdmlNSlreiive Cotle). ❑ As ownerbuiltler, I will not employ anyone to do work which would require e pertnit fmm the Divislon of Industrial Safery, es natetl above, unleu such person has e pertnil lo da such work from Ihe divisian. Signeture: - Date: Division ot IndusMal Sefery Pertnil Number: 1 WIII ihe flpplicant or present or future builtling occupant need to file end certity e Business Plan for emergency response to release or threatened release of e hazardous meteriel7 ❑ Yes ❑ No (Saction 25505 of ihe Calitornie Health entl Sefety CoOe requires, with some e:ceptions, Ihet e Business Plan be filed with the Coste Mesa Fire Department 6y every busineu which has at any one lime dunng a reported year a quantity ot hazardous materials equal to or greater ihan a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic teet of compressed ges at standard temperature and pressure). ..............................................................................._............................................................................................................................................................................................................................._.........._............................................................ 2 Does or will the applicant or present or future builtling occupant need to file a registration lorm for aately hazartlous matenels7 ❑ Ves ❑ No (Section 25533 of ihe Galifomla Health ena Safety Code, wlt� some exceptions, requlres reglslretlon with t�e Costa Mese Fire Department by each business which a[ any one time has on hantl a quentiry oi ecutely hazerdaus metenels equal to or greeter then e weight of 500 pounds, or e volume o1 55 gallons, or 200 cubic feet of compressed gas at standard tempereture entl pressure). ........................................................................................................................................................................................................................................................................................................................................................................................ 3 Does or will ihe applicant or present or tuture building xcupant need to prepare en RMPP (Risk Management and Prevention Program for acutely hazertlous materials)7 ❑ Ves ❑ No (Section 25534 ot ihe Califomie Health and Sefary Code provi0es �hat the Costa Mese Fire DeDertment may require Ihe preparation, certilication entl tiling with the Fire bepartment ot an RMPP by businesses w�ich ere required to register acutely harardous meterials wi�h the Fire DeDartment. .......'_" ....................__.................'_'_.......................................................__......................_..�__........._.�._............. ... 4 It en RMPP is D�esently required, has Section 25534 of Ihe Califomia Health antl Safery Code been fully complied with i 5.......trpomsihe Sol ih Co st Ni�Ouelity ManegaUment D�Ist�tic9o�fromaeny o h e urpoeu�an wntrol tlist ct obegenc�? 15 �pVe: (Section 658502 of the Califomia Govemment Cotle reduires that the requested Infortnetlon be lumished on applicatio� ...................................................................................................................................................... _................................ _........................ _. _.................................................. 6 WIII eny part oi tha taciliry to be consWded under Ihis pertnit be within 1000 feel tmm Ihe outer boundanes ot a school (If'yes", ihe faciliry must meet Ihe requirement of Sectlons 25534 and 42303 of Ihe Gelilornia Healih antl Safery Cotle). .......................................................................................................................................................................................................................................................................... 7 H e perml� from �he South Coest Alr Queli�y Management Oistrict or other air pollution contml tlisirict or egency is eoollcauon_ hava all of the disclosures orescdbad hv Celitomla Health and SafeN Code Sectlon 42303 been mede7 C tor nan-residential No or Qf yes", attach certiflcate of wmpliance from the eppropnate alr pollutlon control omcer). CERTIFICATE OF COMPLIANCE: I cenity Ihat under penalry of perjury the informetion given above is correcL I egree to comply with all steta lews end ciry ordinances regarding Hazartlous Matenals and Emissions. SlgnaWre: �-1 Date: CER71FlCA7E OF COMPLIANCE AND AUTH wrrect. I egree to comply with all sate laws ebove-described properry far inspection purp� GOOE �. INSFECTONTYPE 1618 Fized System Final Fire Previ 1268 Pool Spa Finel � 200 Final Re-Roof 201 Finel BIocWRetaining Well 202 Final Factory Fire Place � 203 Final Sign 204 Final Demolition . . . . TAY: I c ' Iry ol perjury that I have reaC this application and state Ihet the infortnalion given is ing �o building Consiructlon, antl authorize represenlaiives of Ihe Ciry of Caste Mesa to enter upon Ihe occupy or allow accupency ol eny building authonzad by Ihis permit until final inspection. Qd¢, INTITIRLS � CODE� INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing .. 210 Final Eledrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Finfll Building/Occupancy P� . 1lIIIDSLS r. . . ,,s� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: Address Contractor: Address: 396 LA PERLE LN DETACHED GARAGE 42531206 ROSS, ERIC 1619 TUSTIN AVE COSTA MESA,CA ROSS, ERIC 1619 TUSTIN AVE COSTA MESA, CA OWNER-BUILDER Phone: (949)548-2026 Zip: 92627 - Phone: (949)548-2026 Zip: 92627 Phone: Zip: License: 0 ' ' SCOPE OF PERMIT INSTALL MISC CONDUIT IN EXISTING DETACHED GARAGE�.. -: . ., REF:801-00680 �� ISSUED BY: status: ISSUED Applied: OS/14/2001 Issued: OS/14/2001 � �� FEE SUMMARY ' ' - � �� • Q ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa li9hting Fixts Recept Outlets � Switches Non Res Appl �� Res Appl � Service ro 200a Service to 1000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over t00hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole uantiry $23.50 $0.00 , $0.00 $0.00 0 $0.00 0 $0.00 0 $0.00. ,��-'-�0�, : . $0.00�.'� - 0�� , � $O.00��Q��O ' � ,. $0.00, �0�. �� . $0.00-; ��0� � ��::_ $0.00 �-�. 0 - � � 50.00 � � 0 -, � . $0.00'-�; _� ' 0 ' so.00 , o $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 - Quantity, - Temp Dist Systemd Lighting .$0.00 0 Busway7100 R � - $0.00 ; 0� � - Standing Section $0.00 . � 0 - � Misc Electrical Equipment $0.00 -� - 0 ' ' Transfortners up to 1 kvalkw $0.00 �", 0 ................upto'10:kva/kw _ $0.00��- 0. � , ' .................up to 50 kJalkvr .':' �50.00' 0 � � ..................up to 100 kvalkw - � �� $0.00 . , 0 ,-; �� ..................over 100 kva/kw: . �`.$0.00 � � 0 , - , � Low Voltage EquipmeM ,- � $0.00 �i �0 � ' Low-Volt Wiring-System /.Ckt� -- $0.00 ��' �"0 � � � � Misa Conduit ' . '$1820� �� 1� � Misc. Conductor ,80.00 � 0 Circus ( gen or ride) �� , �$0.00 0 � � Circus (mech ride or lights) $0.00 0 Christmas Tree Sland ' $0.00 0 � - � Fireworks Stand � - � $0.00 0 Other Electrical Fee � ' � $0.00 � Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES 541.70 COMMENTS / SPECIAL CONDITIONS i NOTICE: The work authorized by Ihis permit shall comply vnth all applicable handicap access requiremenis 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 abantloned for a period of 1 BO days. . i INSPECTIONS: In order for the work authorized under this permii to be considered legal, such work must comply with all applicable codes,-end�all requlred inspeetions 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) 7545626 ' ��/ �ii{:�.!y�] WORKERS' COMPENSA710N DECLARA710N: I hereby eHirm under penalty oi perjury ane ol the fallowing tleclaratlons: � ❑ I heve end will maintein a ce�ilicete ot consenl to sell-Insure for workers' compensetion, as provided for by section 3700 of �he LaDor Code, for the peAormence oi Ihe work for which this permll Is Iuued. ❑ I have end will maintain workers' compensation Insurance, as requiretl by section 3700 of Ihe LaOor COGe, for ihe pertortnance of the work for which Ihis pertnit Is Issuetl. My workers' compensetlon Insurance carrler antl pollcy number ere: _. Certier: Policy Number�- (ihls section need nof be completed lllhe permif is valued et one huntlreU tlollars ($100) or less.) ❑ I cenity that in ihe peAormance of the work for which this pertnit Is issueq I shall not employ eny person in any menner so as to become subJect to the workers' compensation laws ol Califamla, entl egree t�at it I should become subjecl ro Iha workars' compenution provlsions ot Sectlon 3700 of the Lebor Cotle, 1 shall forihwlth cOmply with t�ese provlslons. - Applicant SipneNre: Dete: WMNIN�: FNLURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWRIL PND SFULL SUBIECT AN EMPLOYER TO CRIMINPL PENALTIES AND dVIL FlNES UP TOONE NUNORED TIKKISAND OOLLARE (5100,000), IN ADOrt10N TO THE C06T OF COMPENSATION, DAMAGES PS PROVIDED WR IN SECTION 3�Ofi OF THE IABOR CODE, IMEREST, AND ATfORNE1^S FEES. LICENSED CONTFiACTORS DECLARATON: 1 hereby affirtn ihat I am licensed under provisions of Chapter 8(commencing with Section 7000) of Division 3 ot the Busineu and Pratessions Cotle, entl my license is in tull force anA eHecL Lic. p Class N Contraaor's SlgnaWre: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby eHirtn Ihat thare is e conslruciion lending egency for ihe Derfortnance oi Ihe work for which this permit is issued. (Sec. 3097, Civil Cotle). LentleYs Name: Lendefs Address: Siqnatme: Date: OWNER•BUILDER DECLARATIONS: I hereby aflirm ihat untler panelry ot per�ury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW far the following reeson (Sec. 7037.5, Business end Professlons Code: Any ciry or counry which requires a pertnit to construct, alter, improve, demolish, or repair eny structure, pnor to its issuance, elso requires the eppliwnt tor suc� permit to file a signetl stetement thet he or aha is Ilcensed pursuant to the provisions of the Cantradors License Lew (Chepter 8(commendng with Sectlon 7000) 01 Divlsion 3 of the Business entl Professions Cotle) or that �e or she I5 exempt t�eretrom and the basis for the elleped exemption. Any violation oi Section 7031.5 by eny applicanl for e pertnit s �eds Ihe applicant to e civil penelry at not mora than tive hundred tlallers ($500).): es owner ot t�e properry, or my employees wIU wages es t�elr sole compensatlon, WILL DO THE WORK, end the structure is not Intendetl or oHered lor sale (Sec. J7044, Business antl Professlons Cotle: The Contractors License Law does not apply to an owner of properry who builds or improves thereon, antl who does such work himself or he�self or ihrough hls or her own employees, provided thal such improvements ere not intended or ottered for sele. II, however, the building or Improvemant is sold within one year of completion, the owner-builder wlll heva the burden ot proving that he or she did not build or improve Por purpose of sele.). ❑ I, es owner of th propetly, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consimct the pro�ect (SecJ0d4, Business entl Professions Cotle: The cont ctors Licanse Lew tloes not apply lo en owner oi Dmperty who bullds or Improves thereon, end who contrects lar such pro�ect with e contractor(s) license pureua ontrecto cense Lews.). ❑_ I am e pt der ec. Business and Pmtessions Code tor this reason: G/ y� �� ID venfi tlrivefs Ilcense. ❑ Ves ❑ No Dnvers License No. ti nerSNp by (lype ol document, I.e. - proper�y lex blll or deed) - - ' DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certity Ihet no excevetlon five (5) or more feet In depth Into which a person is required to descend, will be mede In connection with work authorized by thls pertni�, and that no building structure, scattalding, lalsework, or demolition or dismaniling Ihereof, will be more than thir�y-six (36) feet high. (Chep. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Calitomia AdministratNe Code). ❑ As owner-�uilder, I will not emplay enyone to do work which woultl require a permit irom Ihe Division oi Industriel Satery, es noted above, unless such pereon has e permit to do such work Irom Ihe tlivision. Signature: Date: Divislon oi InGusirial Sefery Permit Number: 1 Will the applicant or presant or future building occupenl nead to lile end certity a Business Plan for emergency response to release or threatenetl release ol a hazartlous meterl917 ❑ Ye5 ❑ No (Section 25505 ot the Celilomie Heelth end Safery Gode requires, with some e:ceptions, that a Business Plan ba filed with Ihe Costa Mesa Fire Depertment by every business which has at eny one time tlunng a reportetl year a quantiry of hazartlous materials equal to or greater than e weight of 500 Dountls, or e volume of 55 gallons, or 200 cubic leet of compressed gas et stantlarC temperature and pressure). ........�_..._ .............................'_'.....................'__'_...........__.—..........................._......................_.__............_..................._........................................................... ....................... _................_......................._. 2 Does or will Ihe applicanl ar present or tuture building occupam need to lile a regisiration fortn br ewtely ha¢ardous materials7 ❑ Yes ❑ No (Sactian 25533 of Ihe Gelltomia Heelih entl Safery Code, with some exceptions, requires registretlon with the Costa Mese Fira Department by aech husiness which at any one time has on hantl a quemlry oi ecurely hazerdous metadals epual to or greater Ihan a weight of 500 pounds, ar e volume of 55 gallons, or 200 cubic feet of compressad gas at stendard tempereNre end pressure). ............................................................................................................................................................................. ......................................_.........................................................._........................................................................... 3 Does or will ihe epplicent or present or future builtling occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely �azardous materials)7 25534 of the Calltomia Heelih ant ot an RMPP by �usinesses ihat the Costa Mesa Fire DeparimeM may require the preparation, certification antl filing with the Fire er ecutely hazardous materiels with ihe Fire Department. o it an HmrY is presenny reqmrea, nes �ecuon zeasa m me ceinorma neann ano earery cooe oeem m�y wmpnea wnmr LI xes LI rvo ........................................................................................................................................_....................................................__....................._......................................."'......._............................................................_......................................... 5 Does or will the epplicant or present or future builtling occupant require for ihe work which is t�e subject of this a plication a armit for such consiruction or motlitication Irom Ne South Coes� Air Qualiry Menagement Disinct or fmm any other air pollutlon contwl tllsirict or agenc�? � Yes � No (Section 658502 of the Cellfomla Govemment Cotle requires Ihat Ihe requested information be lumished on applications lor non-residential bulltling permits). ......................................................................................................................................................................... ................... ....................... ................................................................. 6 Will any part of the faciliry m De constmcted under Ihis permlt be within 1000 feet from the outer boundanas of a school7 ❑ Ves ❑ No (N "yes", the tacility must meet �he requirement of Sections 25534 and 42303 of ihe Calibmia Heel�� and Safe�y Cotle). ........................................................................................................................................................................................................................................................................................................................................................................................ 7 If 9 permi� irom Ihe Sou�h Caest Air Ouality Manegement Disirict or o�her air pollution conirol district or egency is requiretl lor Ihe work which is Iha subject of Ihis epplicatloq have ell ot ihe dlsclosures prascribed by Califomle Heelth antl Safery Code Section 42303 been made7 ❑ Ves ❑ No .e.......(It'yes", ettach �certilicate ol complience from the aPPropriaie eir�polluiion controi�oHicerj ................ ....................................................................................................................... CERTIFICATE OF COMPLIANCE: I certify Ihat under penelty ot perjury ihe information given above is correct. I agree to comply with ell state laws end ciry ordinances regartling Hazardous Materials antl Emissions. Slpnature: Date: CERTIFlCATE OF COMPLIANCE a76 A�ORIZA Ii�OF ENTRV: I cenify under penalry of perjury �ha� I have read this epplication and stata fhat the inform§tion given is correct. I agree b comply wlt stet�Q.i ws e �ordi�guees�lating to building conswction, and authonze representetives ol Ihe Ciry ot Cost ese to fiter upon the ebove�descnbetl pmperty for ns ecYrJfi pury gr�not to occupy or allow occupancy of eny building authorized by this permit until final inspe ion. � re'O� Legai Owner(s) I D' e COOE I. 1616 1266 200 201 202 203 204 Fixetl System Fjhal Fire Preventlan Pool Spa Finel� Finel Re-Roof Finel Block/Reteining Well Final Fecrory Fire Place . Finel Sign Final Demalition CO�E I INSVECTION TYPE 206 Final Mechanical 20B Final Plumbing 210 Fina1 Electriwl 272 Final Fire Preventlon 220 Finel Planning Approval 222 Final Site 250 Final BuildincyOccupancy (714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 396 LA PERLE LN DETACHED GARAGE 42531206 Status: ISSUED Applied: OB/OS/2002 Issued: OB/OS/2002 Applicanr. ROSS, ERIC C TR ISSUED BY: Address: 396 LA PERLE LANE , " ,-�.� i� " � � " - � � : /i�� - � � '� � � / � Phone: (949) 54&2028 / /, � COSTA MESA: CA , � . Zip: 92627-3759 � / ' /� .^ _ �. _,A r ��' � / � ��%� . � �' , � . . . /� / � ' � \ \ /��' - , _ � - - .i _ . , /, � �� "' '- " ' �� . . Owner ��. ROSS, ERIC C TR%-, : � � - - � „�_ `-� � �� '� � �� " �.� -��' �: i � �._ � Address�, 396LAPERLELANE -� � �� ` `_ " , � " � - \,�;�:� � . ". ; �� ,.' > �'. . Phone: (949) 548-2026 . � . � � � � ,� � .. �� ' COSTA MEBA, CA Zip: 928273759, _ . . � '� ,-�, . . . , : �"� - , . .� �,� � �, . Convector: . OWNER BUILDER • � � ', `�� ` .. . � � Adtlress: - . . - ` , � � .. . . �` - � � ' i,.. .:�Phone: � " . . ' ' _ ,. ' � , . ,/ , l.' - '_ Zip;_ .. ., ' : � , , '�� __ �� - -= , , � � / . - - Llcense: 000000 _ �, �.� � . � - . �� . , � � SCOPE OF PERMIT ' / . REF: B02-01145rCONSTRUCT NEW DETACHED GARAGE. EL'ECTRICAL TO INCLUDE: 3 LIGHT � FIXTURES, 4 OUTLETS, 3 SWITCHES: - - ` � � - --' � • � � - � � � � � - �' � ' - - �. .,, �,;i � - FEE SUMMARY �%i � �� . � �uantiry - . , . ; j ;� ., Quantity i� , ' ' ISSUE FEE , $23.50 Temp Dist System / Lighting $0.00 0 � � - . - ,� � Temp service tesf $0.00 , Busway /100.k $0.00 0 � '� � . � ' . Res. a/c package � 50.00 Standing Section � $0.00 0 -. � New Res (1-2 units) , $0.00 0 Misc ElecVical Equipment $0.00 �0 ' � New Res,(3+units) , , $0.00 0 - ',Transfortners up to 1 kva/kw $0.00 �,Q- - � � �• . Pool/Spa�` � � �.`. $0.00 0 -:'��'�" '...uptotOkva/kw $0.00 ' 0 ' � � Lighting Fixts. '��-$3.30 3 � ....... .�.:..up to 50 kva/kw $0.00�. % 0 _ � , �� , ..... , . ._ _ . Switches ' , � $ .40 .. 4 .,,; -: .................up to �100.kya/kw.= $0.00'- 0 - - , , Recept Outlets \$4 .. ., � ..y , . . ,,;.�,_ . . , 3:30� 3'" t, ' ................. over 100 kva/kw - - .50.00 0 � ' � ,' Non Res Appl -, $0.00 �,`� 0 � Low Voltage Equipment .$0.00 �� 0 -� j � Res Appl �� ; � $0.00 `- '. .�0 ' Low Volt Winng System / Ckt ", - $0,00 -, ,-0 , � Service to 200a A, �.��; , �.i $0.00-_ �-0��.,; - Misc. Conduit - _ � ` $0.00 � . 0 . Service to 1000a �� ,$0;00��; , �0 `- '� Misc. Conductor _ = �� ;_$0.00�: , � 0-'- / Service over 1000a � � �A $0.00 ; � � �� - .0 �' � � - - Circus ( gen or ride) ^� ;$0.00 " � 0; / Motors to 1hp ��<� $0.00� =, /; �. 0 � - Circus (mech ride or lights) � -$0.00 �� 0 � Motors to 10hp � �-50.00 � - � �. 0 i " �� % � Chnstmas Tree Stand - �= `$0.00.'- %0 Motorsto50hp ��$0.00_-, `0 � - FireworksSWnd-- �� , ,-$0.00.'� 0 Mo[ors to t00hp $0:00 �� ' � 0 ' � � .-Othef EIeCMcal��Pee " - -�; ,30.00 Motors over 100hp $0.00�\- � �-0',- _ � - � � � - - � � �� '� Communicationdrops 30.00 �0� %_ ,_ �-. _ Investigation,Fee�..�'��_- $0.00 Sub panel to 200a $0.00 0 �- � _ � � � " - Plan Check Pee � � $0.00 Pale Light Pkg ' $0.00 0 ��Reinspection Fee $0.00 Sign Circuits " $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $34.50 Intermed Pole $0.00 0 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements untler California statutes and relafed 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 aba� ed for a period of 780tlays. / '� INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all epplicable�es, and all required Inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration.of this permit. FOR INSPECTIONS CALL: (714) 7545826 �woro �vw� WORKERS'COMPENSAnON DECLARAnON: • � I hereby aftirtn untler penalry of perjury one ol the foilowing tletlaratlons: � ❑ I have end wlll mainteln a certificate at conseni to self-Insure lar workers' campensetion, as provitleE tor by sectian 3700 0l lhe Lebor Cade, lor che pertormance of the work for whic� ihis pertnit is issue0. ❑ I have antl will maintaln workers' compensation insurance, as required by sectlon 3700 0l the LaEor Code, for t�e pertormance of t�e work tor whidi t�is partnit is issued. My workera' compensation I,n� �pnce carde nd Iicy number ere: fA �� Cerrier: . 1K �� PolicyNumber: �I �I J `(Thls s/ectlon need nof be comp/et Ne pe it is a/ huntlretl tlW/aro ($100) or /e55J �I �i certify t�at in ihe peAortnance ot t�e wo r wh' h th' rmit is , shall not employ eny person in any menner so es to become suDject to Ne workeis' �� compensetion lews ol Celifomia, end egre t� e sub�ect ta the workers' compensation provisions of Sectlon 37pppppp of ih Lebor Cotle, I shall foMwlth comply with these pro�risions. �� Applicent Signeture: Date: WARNING FAILURE TO SECURE WO PENSATION COVEMGE IS UNLAWFUL AND SMALL SUBJECT AN EMP�OYER TO CRIMINAL PENALTIES ANO CIVIL FlNES UP TOONE HUNORED THOUSAND DOLL4RE (5100,OW), I ITION iME COST OF COMPENSATIdJ, DAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE LA00R CODE, IMEREST, AND ATTOHNEY'S FEES. LICENSED CONTRACTORS DECLaHAT10N: I hereby atfirtn Ihat I em licensed under provisions of C�eO�er 9(commendng wlih Section 7000) of DMsion 3 of the Buslness antl Profeuions Cotle, enC my license is In full brce entl eflecL LIc. a Class tl Contrectors Signature: Data: CONS7RUCTION LENDING AGENCY: ❑ I hereby aHirtn ihat t�ere is e constructlon lending epency la Ihe peAortnance ol Ihe work for whicf� this permit is iuuetl. (Sec. 3097, Civil Code). Landers Neme: Lenders Atltlress: Signawre: � Date: OWNER-BUILDER OECLARATIONS: I hereby aflirtn thel under penalry oi perjury thet I am E7(EMP7 FqOM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Buslness flnC Professlons Code: Any city or county which requires a partnit to conswci, elter, improve, demolish, or repair any siructure, prior to its issuance, elso reqWres the applicant for such permit to tile e signed stetement that he or she is Iicensed pursuent to the provisions ol tha Comrecrors License Law (Chapter 9(commendng with Sectim 7000) ot Dlvisian 3 of Ihe Business enA Professions Cada) or Ihat he or she is exempt therefrom entl t�e be5is for the ellagetl exemption. Any violation oi Section 7031.5 by eny epplicant tor a permit ubjects epplicant m a dvil penalry of not more ihan five �untlretl dollars ($500)J: es owner of Ihe pro0erty, or my employees with weges es their sole campensetlon, WILL DO THE WORK, and t�e siructure Is not intentletl or ottered for sale (SeC. 7044, Business and Professlons Code: The Contrectors License Law dces not apply to an owner of property who builds or improves thereon, and who tices such work himsetl or hersetl or t�rough his or her own employees, provided ihat such improvements are not IntendeG or oflered for sele. It, howaver, the builtling or improvement Is sold within one year of completion, the owner-builder wlll have the burtlen ot O�oving ihat he or she tlid not build or improve for purpose of sale.). ❑ I, 85 owner of IhB proparty, am EXGLUSIVELY CONTAACTING WITH LICENSED CONTAACTORS to cnnstruct Ihe project (Sec. 7044, Business and Professions Cade: The cnntrectors ' oes not eppry to en owner of pmperry who �uiltls or impmves thereon, antl who contrects tor such project wlih e contrectoQs) license pursuam to ontracto "cense Law ❑ I am exempt unAer se . Business and Pmlessions Code for this reeson: Signature: Date: Owner ID venfietl by icense. Yes ❑ No Drive(5 LiCensa No. �� Ex ires: %� Verlficetian at ers p by (rype oi docum nL i.e. - property tar blll or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFlCATON: ' ' ❑ I hereby certlly t�at no exwvetlon tive (5) or more feet in dept� in�o which a person Is required to descenq will be matle In conneciion with wark euthorized by Nis pertnit, end that no building structure, scaHoltling, lalsework, or demolitlon or tlismantling ihereof, will be more then ihirry-si: (36) teet high. (C�ep. 32, Grp 2, An 2, Sec. 341, Tltle 8, Celltomia Adminislreiive Catle). ❑ A5 ownerbulltler, I will not employ enyane to do work which would requlre e pertnit fmm the DlWsion at Industdel Sefery, as noted ebove, unless such person hes e pertnit lo do suU work Irom the division. Signature: Date: DlWsion of InduStnal Setery Permit NumbOr: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will t�e eppllcanl or present or fumre builtling occupen� nee0 to lile end certly a Business Plan for emorgency response lo releese or threetenetl release ol a hazertlous meterlal7 ❑ Yes ❑ No (Seqion 25505 of Iha Califomia Health and Salery Catle requlres, wii� somo exceptions, I�et e Business Plen �e tiled wit� Ihe Costa Mesa Fire Department by every business which hes e1 any one lime tluring a reporteC year e quantity ot hezertlous materials equel to or greater Ihen a weight of 500 pountls, or e vdume of 55 pellons, ar 200 cubic feol of comOressetl gas at stendard lemperelure and pressure). ..................._"'....................................._._..._..._........__......._..... ...........—..............__.......................__........................._..."'._._._....."__'_'............._._ ._ . 2 Does ar will the epplicant or present or luture building occupant nead to file a repistretion form for aculely hezar0ous metenals7 ❑ Yes ❑ No (Section 25533 0l Ihe Calitomia Healih antl Safety Cotlo, with wme eaceplions, requires registratlon wlih the Costa Mesa Fire Depanment by eec� business whlch et eny one time has on hentl e quentiry ot ecutey halardaus matedels equal lo or greater than a welght of 500 pounds, or a vWume ot 55 gallons, or 200 wbk feet of wmpressed gas et standard IempereNre end pressure). ...._._ ............._..__........o"_"—_"'_ ""....—................._.__..........................._........................__...................................................__....."'............_..._......_...__...............__._, 3 Does or will the applicam or present or tuture Dullding occupan� need to prepare en RMPP (Risk Manegement antl Prevention Progrflm tor ecutety hazartlous matedals)9 ❑ Yes ❑ N (Section 25536 of ihe Calitomie Healih end Safery Code provides that the Costa Mese Fire Depertment may require tha preparation, cenification antl fling with the Fire bepertment of en RMPP by businesses which ere required to register ecutely �arardous meterials wi�h the Fire Depariment. ........................................................................................................................................................................................................................................................................................................................_.............._.................'_"..........._ 4 II en RMPP is presenity required, has Saction 25534 ot Ihe Calitomia Heelth and Sefery Code been fully complietl with7 ❑ Yes ❑ No uoes or wm me eDP��em or presem or mmre ouuamg occupam reqmre ror me wonc wmcn is me su��ea oi trom t�b Soulh CoaSt Air Ouelity Manegament Disidct or tmm any othar eir polWtion contml distdct or egenc� (Secllon 858502 of the Calilomle Govemment Cotle requires Ihat Ihe requested information be furnishetl on (tl yes", the tadliry must meet the far non-resitlential _"_' ...............__.........................__..........................._.........................:..:........._........................................ � this pertnit De within 7000 feel trom Ihe outer boundanes at a sc�aol9 ❑ Yes [ SecUons 25534 and 42303 0l Ne Califomia Healih end Safety Code). ...............................'__.........................__............................._............................_..............._..._................_ nagemem Distdct or other air polWtion contml disirict or egency is reduired tor the � 6v Callfomla Health and SaleN Cotle Section 42303 been matle? ❑ Yes ❑ No or CERTIFICATE OF COMPLIANCE: I certity Nat untler penalry of perjury the inlortnation given ebove is wrrect. I agree to comply with ell state laws and ctiry ordinences regarding HazerAous Materials and Emissions. Signalure: Date: CER'IIFlCATE OF COMPIIANCE AND Ayp� �H 1�� OF EMAV: I cenity under penelty of perjury that I have reatl ihis epplication anC state ihat t�e informatlon given is wrrect I egree to comply wlih all stet�a 6 end jt ordlnences r � lo bullLing construction, entl euthonze representetives of the Ciry of Costa Mese to enter upon �he ebove-descdbed property lor Inspectian p os . �e e occupy or e bw occupency of eny building eulhorized by this permi til fi � ggction. / \ Sig egalOwner(s) �te COOE �. INSVECTIONTYPE 1fi76 Flxad Syslem Pinel Fir Prevontion 1288 Pool Spa Finel 200 Finel Re-Rooi 201 Finel BIxWRetalNng Well 202 Finel Factory Fire Place 203 Finel Sign 204 Final Demolition � PAIE 11i�EL5 GOOE 1 INSPECTION TYVE 206 Finel Mechanicel 20B Flnal Plumbing 210 Flnal Eletldtel 212 Flnal Fire Preven0on 220 Finel Plenning Approval 222 Final Site 250 Finel Building/Occupency Date Geg V�ELS � .. ; (714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 396 LA PERLE LN Suite: Vicinity: GARAGE Parcel Number: 42531206 App�icanr. ROSS, ERIC Address: 1679 TUSTIN AVE - COSTAMESA�CA�;.� ��, _ i . . i" / / Owner. ROSS, ERIC �,\ ` Address ,1619;fUSTINAV��- . � i. ' COSTA MESA, Cq �- _ � Contractor: `OWNER-BUILbER ndaregg: � Arch : Address: Zip: Zip:. � � ."i � r� Phone: � . � ` %License: Zoning: Status: ISSUED Applied: 70/15/2001 Issued: 10/15/2001 ISSUED BY: ' Phone: (949)548-2026 � - � - � ' Zip: 92627 � / � , � . i , . � � � � , � _ ; � � .Phone: (949)548-2026, _ . ' � .' � Zip: 92627 - . � , , A Phone: ' - License: . 0 Eng: � , Addiess: .% REPAIR EXISTING FOOTING FOR ATTACHED GAR Plan Check: Permit: SMfP Res: SMIP Com: Other: Inspection: Total: $35.10 $54.00 $0.50 $0.00 $0.00 $0.00 $89.60 SETBACKS.� � � � MAINSTRUCTURE�Front� 0=0 Rear 0-0 ACCESSORY � Pront� 0-0 Rear, 0-0 PARKING Existinu: o Re uired: 0 NOTES: � =;�;� ' Phone: . ' �� „ � � License: I:UYt Uh YtKMI I _, E. - ' I ' � . FEE SUMMARY Calc Valuation: - Claim Valuation: PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Right- 0-0 Right . 0-0 �$1,500.00 $1,500.00� NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutas and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permil to be considered legal, such work must comply with all applicable�codes, ana ell requlred inapectiona and finel approval must be obtained. Failure to obtain inspactions and final approval will result in ihe expiration of tliis permit. FOR INSPECTIONS CALL: (714) 754-5628 /� zuws (doo) WORKERS' COMPENSATION DECLAFiATON: � I hereby eftirm under penalry of perjury ane of the following declaratlons: ❑ I heve end wlll meinteln e certifiwte of consent to self-Insure for workers' compensetion, as provided for by sectlon 3700 of the Lebor Cotle, lor the perlormance of the work for whic� Ihl9 Oermit is issuetl. ❑ I �ave and wlll melntaln workere' compensation insurence, es requiretl by sectlon 3700 ol the LeOor CoOe, for the peAortnance of the work for which t�is pertnit is issued. My warkers' comDensatlon Insurence carrler and policy number a�e: Cerner: Policy Number: (fhis sectlon need nof be comp/eted il the permit is va/ueo' et one hundred dollers ($f00) or /ess.) ❑ I cenify Ihat in the pertormance of the work for which Ihis permit Is issued, I ahell not employ any person in eny manner ao es to become subject to iha workere' compensetion laws af Califomie, and egree that it I s�aultl become sub�ect Io the warkers' compensetion provlslons ot Sectlon 3700 ot Ihe Labor Code, I shall Iorthwiih comply with �hesa provisions. Applicant SlgnaNra: Date: WARNINO: FAILURE TO SECURE WORNERS' OOFAPENSAiION COVERAGE IS UNLAW FUL AND SHALL SU6IECT AN EMPLOYER TO CHIMINPL PENALTIES AND CML FlNES UP TO ONE HUNDRED T/qU$AND pOLLAqE (5100,000), IN ADDITION TO THE CQST OF COMPENSATION, DAM1NGES 0.S PROVI�ED FOR IN SECTION �OB OF THE LABOR COOE, INTEREST, AND ATTOqNEY'S FEES. IICENSED CONTRACTORS UECLARATON: I hereby atfrtn ihat 1 em Iicensed under provisions of C�aO�er 9(commencing with Seaion 7000) ot Division 3 ot the Business enA Professions Cotle, end my license is in full +orce ana enea. uc. x class x Cantrectols Signeture: Dete: ' CONSTRUC710N LENDING AGENCY: ❑ I hereby ettirm thet ihera is a cons�ruction lending egency for ihe pertormence of the work for which ihis permit is issuetl. (Sec. 3097. Civil Code). Lenders Nama: Lentler's Adtlress: Signature: Date: OWNER•BUILDER DECLARAT10N5: I hareby ettirm that under penelry ot per�ury thet I am E%EMP7 FROM THE CONTRACTORS LICENSE LAW for [he tollowing reason (Sec. 7031.5, Busineu end Professions Code: Any ciry or County which requires a permit to construct, elter, Improve, demolish, or repair any sWcture, pnor to its issuance, elso requires Ihe epplicant for such pertnit to file a signed stetement that he or she Is licensed pursuant to the Orovlslons of the Cantrectors LJcense Lew (Chepter 9(commencing with Section 7000) of Division 3 of the Business end Protessions Code) or that he or she Is exempt Iherefrom end t�e basis for the ellegetl exemption. Any violation af Sectlon 7031.5 by eny applicant for e pertr�' su ecis the applicent lo e clvll penalry of not more than ilve hundred dollers ($500).): I, es owner of the properry, or my employees with weges es Iheir sale compensatlon, WILL DO TNE WORK, anOlhe structure is no� Intended or oHereG for sale (Sec. _�7044,-8usiness and Professlons Code: The Contractors IJcense Lew does not apply to en awner of property who builds or improves Ihereon, end w�o does such work himseli or hersetl ar through his ar her own employees, providatl that such improvements era nm intentleA or ottered for sele. It, �owever, the builtling or improvement is sold within one yaer of co pletion, Ihe awner-builder will heve Ihe 6urden oi pmving ihat ha or she did not builG or improve tor purpose of sale.�. ❑ 1, as owner a� the prope , CLUSIV CONTRACTNG WI7H LICENSED CONTRACTORS to construct the projed (Sec. 7044, Busineu end Professions Code: The conirectors nse Lew doe epply to an owner ol property who bullds or Improves thereon, antl who contrects lor such prolea with a contreqor(s) licensa pursuant t trettor5 ' se Lews.). � , Business and Professions Cotle for this reason: Owner ID verilied by drivi censa. ❑ Yes ❑ No Vetlficatlon of Ow by (type of dacument, i.e. - proparty taz 6ill ar DIVISION bF INDUS RIAL SAFETY PERMR CERTIFICATION: ❑ I hereDy certlly het no excavetion fiva (5) or more feet In depth Into which a person Is requlretl to descend, wiil be mede In connection wllh work authodzed by this pertni�, end th t no building strucNre, scettolding, lelsework, ar demolitian or dismemling thereot, will be more ihen thlrry-six (36) feet �igh. (Chep. 32, Gry 2, Art 2, Sec. 341, Tille 8, elitomla Atlministrative Code). � As owner-Duiltler, I will not amplay enyone to do work which would raquire e permii from the Divislon ol Indusinel Sefe�y, as notetl above, unless such person hes e permit to do such work trom the division. Signawre: Date: Division ot Indusirial Sefery Pertnit Number. WIII the epplicant or present or tuWre building occupant need to tile entl certify e Business Plan for emergency response to release or Ihreecenetl release of a hazartlous matedel7 ❑ Ves ❑ No (Section 25505 of the Celifomia Health and Safery Code requires, with some exceptions, thet a Business Plan be liled with the Costa Mesa Flre Department 6y every 6usiness which has at any one time tlunng a reporied year a quantiry oi harardous materials equal to or greater �han a weight o1500 pounds, or a volume of 55 gallons, 2 Uoes or wm 1ne appuwm or present or tuwre ounaing occupam neea m nie a registrauon rorm mr acuteiy na�mous metenais7 LJ Yes LI No (Sactlon 25533 of Ihe Calllornle Heelth entl Safery Catle, with some exce tlons, requlres registration with the Costa Mesa Fire Depatlment by each business which at eny one time hes on hend e quantiry of acutely hazerdous meteriels equaPto or greater then e weight of 500 pounds, or a volume ol 55 gellons, or 200 cubic feet ai compressed ges et standerd tempereWre entl pressure). ....................................................................................................................................................................................................................................................................................................................................................................................... 3 Does or will Iha applicant or present or future building wcupant nead to prepare an RMPP (Risk Manegement and Prevemlon Progrem for ecutety �azardous materials)? 25534 of ��e Calitomia Health 3nt of en RMPP by businesses Section 25534 of Ihe Calitomie Heallh Fire DepartmeN may require ihe preparetion, certificatlon and tiling with tha Fire materlels with t�e Fire Deperiment. ................._..................._.__................................................................................................................................. Code been tulry comDlietl with9 ❑ Yes ❑ No 5 Does or wnl ine eppucam or preseni or tumre buntlinq ocapant reqmre mr tne wonc wmcn is tne suo�ect or �ms e F trom the South Coest Air Oualiry Menagement Dlstda or from eny other eir pollutlon comml disidd or egenc%� � (Section 65850.2 oi Ihe California Govemment Coda requires t�et the requestetl infortnation be fumished on applica .......................__..................."'__..._............................—_..._............................__................._._....................._.............._.�.._........... 6 Will eny part of Ihe taciliry to be consirucied under thls permit be wlthin 1000 feet from t�e outer boundaries of e uh (II yes", t�e fadliry musl meet the requirement ot Sectlons 25534 entl 42303 ot the Califomia Healih and Sefery Coc ..._ ..........................._...................................................................................................................__........................._.........................._......................_._................. 7 It e pertnit from the South Coast Air Ouality Menegement DlsMct or other eir pollution control disMct or agency eppllcation, heve all of the tllsGosures preuribed by Califomle Healt� antl Safery Coae SeMion a2303 been made7 (Ii yes', ettach certi/l CERTIFICATE OF C ragarding Hazertlous Signeture: CERTFICATE OF correcl. I egree Io ebove-descdbed p cooe .. 7616 1268 200 201 202 203 20d Pod Spe Finel Re- or �J No non-resitlantial No I certity ihat under Denalry ol perjury the Infortnation given aDove is conect. I agrea to compy with all state lews enC ciry ortlinances Emissions. Date: JAML` AND A RVA710 F ENTRY: I certify under penalry of perjury ihat I have reed thls applicatian and state that iha inform tion given is �Cvit� I state s end ' o ces releting to builGing construc0on, and authodze representatives ot Ihe Ciry of Cogte Mesa to ter upon t�e for i pecti puryo gFee not to occupy or allow occupency of eny building authorized by t�is permit until fy�� ns 4ction.' v � �7 -�galOwner�s)� � (�D�_� And�Or Authorized Applicant Date Fire Prevention Finel BIocWReteining Wall Final Fectory Fire Place Finel Sign Final Demolition PAg II�L$ cooer 206 20B 210 212 220 MSPECiION TYPE Final Mechanical Final Plumbing Final Electricel Final Fire Prevention Final Planning Approval 222 Final Site 250 Final Building/Occupency PAg It�dLfr i (714) 754•5273 • Fax p14) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 � Job nddress: 396 LA PERLE LN Suite No Viciniry: Parcel Number: 42531206 Applicane ROSS, ERIC Address: 396 LA PERCE �'� Address: � Contrector. Address MECHANICAL PERMIT i�//�.�. � � , / 'i \\ , COSTA-MESA,CA'- %" � / � \ � . �'�, �� ` _ . �. ; ROSS,�ERIC'C TR :. �, - � � � � 396 LA PERLE LANE� �.\ `/� i �i;/-' COSTA�MESA; CA i � i' � ��- OWNER BUILDER Status: ISSUED Applied: 08/05/2002 Issued: OB/OS/2002 - - - ISSUED BY: , . , , ... �. .. __ _. ,, i , . _ _ _ -,A �, � � / - \� Phone: (949)548-2026 � Zip: 926D-3759 ` . . . . , � � - - � - - � Aj��_ A � r�:- -. - � ��'� �,. � ' � � . �A`. Phone: (949)54&2028 �\ �� \_ ,�� Zip: 92627-3759 �� : �',�A: � � -� � � /,:�. �- , " . .� �� - � � � �� -� ) �. �..'Pho e �- . ; i �.�_ . � �.V A`, /� / r �/;� - Zip:" _.. ��_ . � � .�'. . � _ � �j` ` lV� . - % ' 1 _ - License:000000 - - - � ' . � i I , ,' /�'�A�� . � - ��' V'�-_ .� _ .. � ' SCOPE OF PERMIT ' �� ADD 396 SF TO KITCHEN, NEW BATHROOM, AND FRONT HALL. REPLACE EXIST WINDOWS WITH� � � SAME SIZE. INTERIOR WORK.TO EXIST BATHROOM AND REPCACE4 EXIST DOORS . REF: �. � " B02-00749. MECHANICAL TO INCLUDE: 1 FAU CHANGE OUT < 100 K BTU, 1 FACTORY �' � � FIREPLACE. 2 VENT FANS TO A SINGLE DUCT, 2 AP-RLIANCE VENTS. � . � . � . � ,_ '" � ' FEE SUMMARY � j; , � � - - , � i ..�.Quanlity�- - - - " _./ !�_ ' ;� ��. Quantity , ISSUE FEE ' � � $23.50 � � � � " ' Repair�/�Alt Absorbtion Unit . �$0.00 0 . � .� Inst FAU <100 k BTU � $14.80 1 Repair I Alt Refrigeration Unit �, $0.00 0' Inst FAU >100 k BTU $0.00 0 , Ventillation System " $0,00 �0 �� Repair/Alt Cooling/Heat„ $0.00 0 Evaporative.Cooler ,�$0.00 - 0 Inst / Rep. Recess VJall Htr�� $0.00 0 _ Commercial Incinerator ' `� �-� $0.00�� 0� Refng Sys'<100 k BTU $0.00 0 _,. ,i:"-� � """-DomesliC Incinerator �-�.s �,` ��. $0.00 , 0 � Retng Sy's>100 k BTU `��;� $0.00 0 Co'mpressors / Absorption Systems , � -. Gas Piping "� , � ` $0.00 0 � � � Up to 3 tSp / �100 k BTU -" -- � $0.00 � . �0 � FactoryFireplace � �\$10.65.;�:.1,,-. � 3To15hp%.SOO;k�BTU-� �,%"�� -� $0.00 ��0 Hood w/Mech Exhaust � �`$0.00 0` � � , 15 To 30 hp / 1;000 k BTU, � ' ' $0.0,0 % 0 VAV Box . �J�� , %� �50.00,� 0 � "' � ' 30 To 50 hp / 1,750 k BTU- �� .50.00� 0 Vent Fan I Single Duct ��", �$14.50�� 2� �� - � Over 50 hp / Over 1�,750 BTU .,' �� ,, � 50.00 0 Appliance V` �� " - $2430 �-2�--" � ,Boilers � �'� � � Fire Dampers ��` `� � ' � $0 00 _ 0� � � � - , ; Up to 3 hp - " � ; „ � , ��, � $ .00 0 SmokeDampers ��=` ��;$0.00� -0�, � � . 3To15hp �� \ �� ,.� �./�� $0.00 0 Inst or Relocate Appl VentA �� $0.00 j� O�i �� ; 15 to 30 hp, �" � -'� ' $0.00 0 Air Handlers < t0000cfrn � �� $0.00 . 0 " � � � � ' _ � � 30 to 50 hp�� ' �� . � �'�� $0.00 0 � Air Handlers > 10000cfm \�,,' $0.00. 0 �'-� -„ , Over 50 hp ",' � ,'� � � $0.00 0 Floor Furnace �$0.00 > 0-�, _ �.�� , , Other Mechanical Fee i��; .�� Floor or Suspend Heater $0.00'�;0�� . � , - Investigation�Fee � " ' $0.00 � ��.. � '� - =,�„� ; ; .�Plan Check Fee-� $0.00 - - - _. _ . Reinspection Fee $0.00 TOTAL CALCULATED FEES E84.75 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Cali(ornia statutes regulations. (Ord. No. 92•28, § 1, 12•21-92) EXPIRATION: This permlt shall automatically expire and become void if work is not commenced within 780 days, or If work is 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 Inepeetiona and final approval must be obtained. Failure to obtain inspections and (inal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2448-18(6D0) WORKEHS'COMPENSAnON DECLANAnON: " I hereby eflirm under penelty of perjury one of the following declarations: ' ' � ❑ I heve end will maintein a certiticate of wnsent to setl-Insure lor workers' compensetion, es proWded tor by section 3700 0l ihe Lebor Code, lor Iha pertortnance of ihe work tor which t�is permit is issuad. ❑ I have and will maintein workers' compensation insurence, as required by sectlon 3700 of the Labor Code, tor I�e perfortnance of the� r which this partnit is issued. My workers' comden tlon �ur� �"er end policy num6er are: Cerrier. 1 f/ Policy Number: his se /on neetl not befcamp etetl/l f permit ' velued et one hundred dollers ($100J or Iess.J cerllty Ihat in ihe OeAortna the wo r which t�is pertnit is issued, I shall not employ eny person in any manner so es tqqq become subject to the workers' compensalion laws oi Calif ', antl et If I sh me subject to Ihe workers' compensation pmNsionS oi Se�r�700 p� thg Lebor �a, I 5hall toR�wlth comply wiih t�ese provision // `/I �� Applicant Signature: Date: i�� V`/ WARNING: FAILURE TO ORKERS' COMPENSATION COVEPAGE IS UMAW FUL M!D SHFLL SU9IECT PN EMPLOYER TO CHIMINAL PENALTIES rW D GVIL FlNES UP TO ONE HUNDRED hKK1SM10DOLLAR ,INADOfiIONTOTHECOSTOFCOMPENSATION,DPMAGESASPROVIDEDFOqIN5ECT10N31O60FTHELABORCODE,IMEREST,MlDATiORNE'fSFEES. LICENSED CONTRA�ORS DECLARATION: , � I hereby attirm that I em licensed under provisions of Ghepter 9(commencing with Section 7000) of Division 3 of Ihe Business and Professions Code, and my Iicense is in tull tarce and eNect 11c. M Cless a Contrectofs Signature: Date: GONS7RUCTION LENDING AGENCY: ❑ I hereby aflirtn that there is a construction lentlinp egency for the pertormance of Ihe work for which t�is permit is issued. (Sea 3097, Civil Code). Lentlefs Name: Lenders Atldress: Signatura: � Date: OWNER-BUILDER DECLARATONS: I hereby ettirtn Ihat untler penelry ot perjury Ihat 1 am E%EMPT FROM 7HE CONTRACTORS LICENSE LAW for the tollowing reawn (Sec. 7031.5, Business end Professlons Cotle: Any ciry or counry which requires a permit to conslruct, alter, improve, tlemolish, or repair any sWcture, pnor to its �ssuance, elso requires the appliwN for such permil to file a si ed statement Ihet ha or she Is licensed pursuant ro t�e pmvisions oi Ihe Contractors License Lew (Chepter 9(commencing with Sectlon 7000) 01 Division 3 af ihe Busine and Professions Coda) or Ihat he or she is exempt thereirom end ihe basis for ihe alleged exemption. Any violation ot Sectlon 7031.5 by any applicenl for e permit ubj s the epplicant to e clvil penalry of not more �hen flva hundred Oollars ($500).): I, es owner of ihe property, or my employees wltM1 weges as their sole compenseNon, WILL DO THE WORK, end the strucWre is not intended or oHeretl lor sale (Sec. 7044, Business end Professions Code: The Contrac�ors License Law tloes not epply Io an owner of property who bu�lds or improves ihareon, and who tloes such work himself or herself or through his or her own employees, provitled that such Improvemen4s ere not intentled or oHered for sele. II, however, ihe building oi Improvement is soltl wi�hin one yeer of completion, Ihe owner-builder will have �he burden of proving that he or she did not 6uiltl or improve tor purpose oi sele.). ❑ I, as owner of ihe prop rty, a CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolecl (Sac. 7044, Business antl Professions Cotle: 7Te camractor � nse does nat eppty to en ownar ol property who builds or improves thereon, and who contracts lor such project with e contrenor(s) licanse pursuan e Contr rs License Lews.). . ❑ I am exempt untl sec. Business end Protessions Code for this reason: Signature: ate: Owner ID venfi efs Ilcense. Ves ❑ No Driver's License No. �� Expires: : Veniiwtl Ow rshlp by (rype oi tlocument, i.e. - properry tax 6ill or tleetl): DIVISION OF IFJDUSTRIAL SAFETV PERMR CERTIGICATION: ❑ I hereby certily Ihat no excavation five (5) or more teet in depth inta which a person Is requirad to descend, wlll be mada in connection wilh vrork authorizetl Dy this permit, end ihat no building structure, scaHdding, felsawork, or demdition or Oismaniling thereoi, will be more �han ihirty-siz (36) feet high. (Chap. 3.2, Grp 2, An 2, Sec. 341, TiUe 8, Celifomia Adminisiretive Code). ❑ As ownervbuilder, I will not employ anyone to Ao work which would require e parmit trom the Division of Intlustrial Safery, es noted ebove, unless such person has e permit to do such work from �he division. Signetura: Division of Indusinal Satery Pertnit Number: Date: W ill the applicant or present or fuNre building occupent neatl to file end certity e Business Plan for emergency response to release or t�reatened release of e haxartlous material? ❑ Yes � No (Section 25505 oi the Califomie Healih end Safety Cotle requires, with some exceptions, thet e Business Plan be tiled with the Casta Mesa Fire DeOertment 6y every business whic� �as et eny one time during a reported year a quanti�y of hezerdous materials equal to or graater ihan a weight of 500 pounds, or a volume o155 gallons, or 200 cubic teet o� compressed gas at standard tBmperature antl pressure). ............................................................................................................................................................................................................................................................_................................................................................................................ Does or will the ep0�icant or present or future builAing occupant naed to tita a registration torm tor acutely hazardous matenels7 � Yes ❑ No (Section 25533 of tha Califomia Hea1N end Safery Catle, with some excep[ions, requires registretlan with t�e Costa Mesa Fire Department by each business which at any one time has on hantl a quantly of ecutely ha�rtlous matedels equel ro or greeter ihan e weight of 500 pounds, or e volume ot 55 gellons, or 200 cubic teet of wmpressed gas et stentlertl temperature and pressure). ......._ ........................._.........................__._............_................................................._.........................._.............................'_'..................__.............................................................__............_._.......................,...................__.... Does or will the applicant or present or tuWre builtling occupant need to prepare an RMPP (Risk Management entl Prevention Program tor ecutely harardous matenals)? (Section 25534 of the Calitomia Heal[h and Sefety Code provides that the Cosla Mesa Fire Deperiment may raquire tha preparation, certification and liling with �he Fire Depariment of en RMPP by businesses which ere required to ragister acutely hezerAous materiels with ihe Fire Depariment. ................................................................................................................................................................................................................................................................................................................................._................................................._ 4 If en RMPP is presently requlred, has Saction 25534 of ihe Californie Heallh end Salety Code been tully complied with7 ❑ Ves ❑ No ........................................................................................................................................................................................................................................................................................................................................................................................ 5 Does or will the epplicent or present or future huilding occupant requlre tor the work which is ihe subject ot this e plication a ermit for such constmctlon or moditication trom the Sou�h Coast Air Ouality Menegement Dlsldc� or from any mher eir pollutlan control disidct or egency7 � Yes � No (Section 658502 of the Califomia Gwemment Code reQuires that the requested Intortnation be fumished on applications for non-resitlentiel builtling permits). .....................__.............................—...._..............._..................................................�._................._�................__..___............._._.__._...__..._..___ 6 will an _ .............---............__........... y pan of 1he tadliry to be conswcied under this pertnit be within 1000 teet from the outer bounAaries of a school? ❑ Yes ❑ No Qf'yes', the faciliry must mee� Ihe requiremen� of Sections 25534 and 42303 of the Califomia Health entl Safery Cotle). ........................................................................................._............................................._._............................................................_......................_..................................................................__......................................................................... 7 If e pertnit from Ihe South Coas� Air Ouality Manegement Disiric� or other elr pollution conirol dlsMct or egency is reQuired br the work which is t�e subfec� of ihis eppliwtlon, �ave ell oi the tlisclosures prescnbetl by Celifornia Healih and Sefety Cotle Section 42303 baen matlel ❑ Yes ❑ No ........................................................................................................................................................................................................................................................................................................................................................................................ 8 (If'yes", attech certificate of compliance from Ihe eppropnate air pollution wntrol oNicer). CERTIFICATE OF COMPLIANCE: I certiy ihet under penalty ot perjury Ihe informa�ion given ahove is correct. 1 agree �o comply with ell sWte laws and ciry ordinences regarding Hazardous Materials and Emissions. SlgneNre: � Dete: CERTIFlCATE OF COMPLJANCE conect I agree to comply with ebove-tlescribadpropertytor sp cooe �. 1616 1266 200 201 202 203 204 Fixed Sy�tem Final Fye Prevenuon Paol Spa Final / Finel Re-Roaf Finel BIocWRe�aining Well . Final Factory Fire Place Final Sign Final Damolition b81ZATON E : I cenity under.penalry of perjury that I �ave read this ap0��ion end state t�at ihe infortnetlon given is and ciry i ces tinglo—building constmdion, and authorize representatives of the Ciry of Costa Mesa to enter upon the �ses. I o cnpy or albw cecupancy ot any bniltli�g authorizetl by ��s- rmi nto''I tine� tion. wnarlsl Date 17i1� � �� INSPECTIONTYPE 206 Final Mechaniwl 20B Final Plumbing . 210 Final Electrical , 212 Final Flre Prevention . 220 Final Planning Approval 222 Final Site 250 Final BuildinryOccupancy Date P� � � 9-03 (714) 754•5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIfl DRIVE, COS7A MESA, GA 92626 PLUMBING PERMIT Job Address: 396 LA PERLE LN Suite No Vicinity: DETACHED GARAGE Status: ISSUED Applied: 08/OS/2002 Issued: 08I05I2002 Parcel Nunmber: 42531206 . � " , - � _ ISSUED BY: �- - ��:��,.� - -. _ _ i - i i //- _ -� ' • - � � Applicant: ROSS, ERIGC TR�.- � �� /�,'/ i �' ' � i; -. . Address: 396 LA,PER�E LANE � ' �. "�� /i�%//.. �� .� ` Phone: (949)54&2028� . '� ' V� . � COSTA MESA. CA � � ' � � � Zip: 92827-3759 . , _ , ' � �� ' � �i.. � � . _ - � - , _ � . •i �`� , � " ' . ��- A,� i . Owner: �ROSS, ERICC TR � � � � � � � � i� Address � 396 LA P,ERLE LANE �` �`; � ' ; ' � � , � - Phone� (949) 54&2026 A � ;� �' . . � � ; � � COSTA MESA, CA � Contracto�: OWNER BUILDER Address: - ' - -- �� Arch / Eng : Address: Zip: 92627-3759 � � �� - J . - .. . -� �`,, � _ . ., �' � _ � � � -� , � " . ., - .. �- -� Phone: _ ` ��,, �% �. _ � � . ,. " . \ Zip' � License: 000000 '� � . .,.-i . -�' ,.�._' �. . .�_. _ _�.... _ ...�� . \ \ : � � t � Phone: � i� , � � � - Zip: . , -, _ � . , . . - Licensef . , /./ _ _ . " : ' SCOPE OF PERMIT REF: 802-01145. CONSTRUCT DETACHED GARAGE.�PLUMBING TO INCLUDE 1 LAUNDRY TUB WASHER, � 1 P-TRAP, GAS LINE, 1 WATER HEATER. ,. � - �. . _, . � i-�� , �� `.;� FEE SUMN� . ' � AMT��A aTy..,._, ,-''-� �� , ISSUE FEE' `�� 523:50 �� Laundry Tub I Washer Backflow irrigation � . " $0.00 . �0 � - � - Landscape Irtigation BackBowPreventer � �' -50.00,', 0 � :- P-Trap � Bathtub �\ . $0.00 � - 0� ,�� Pressure Regulator� Clarifier System ��'� 50.00 : 0�-- , Process Piping (per 10 ft) Connect (Ice,Soda,etcj �� 50.00 �� 0' ' , ' Receptors DentalUnits �-50.00� � �0-; �i/ _� SepticTank Dishwasher 50.00� 0 �� Sewer Cap for Demo Drain, Floor 50.00 � � �0�'�� SewerConnect Drain, Rainwater $0.00 � 0� �`,'' - Sewer Pmale Line,\, Drain, Roof $0.00 0 ` ,\`ShOwef - Drinking Founfain 50.00 0 Sink, bar ' . Expansion Tank $0.00 0 Sink, commercial � Gas EaAhquake Valve $0.00 0 Sink, Floor Gas (1-0 oWeLs) $6.15 1 Sink, kitchen Gas (Over 4 outlets) $0.00 0 Sink, service/mop Gas Repipe $0.00 0 Spa (private) Gas Service 50.00 0 Spa (public) Interceptors (Grease, Oil) E0.00 0 Interceptors (Sand Auto ) 50.00 0 ,y ,�,%- i AMT r.�',i_ ::, , ,:-/ �� AMT as.eo 1 Sump Pump ; ao.00 $0.00 0 Swimming Pool ' , � $0.00 $9.80 'I Trap Pnmer� - $0.00 $0.00 � 0 .,- �- ��" Urinal ,- " : ,' $0.00 $0.00 0- " � , Vacuum Brkr,Bktlow(1-4) 50.00 $0.00 0 � ` Vacuum Brkr Bktlow(5+) $0.00 50.00 0 '. � Wash Basinj � 50.00 30.00 � 0' �� Wash Basin Set $0.00 $0.00 -0 � -�; Wa'ste and Vent System 50.00 So.oO- 0 --�" -=- ,Water Closet (ToileQ $0.00 $0.00 0. <"_ - Water Heater / vent $12.30 $0.00 �� 0' Water Piping (Inst or Rep.) $0.00 50.00� 0 Water Re-pipe 50.00 $0.00 0 Water Service 50.00 $0.00 0 Water Softener $0.00 $0.00 0 OTHER $0.00 $0.00 0 VIOLATION $0.00 $0.00 0 PLAN CHECK $0.00 � REINSPECTION $0.00 TOTAL CALCULATED FEES: 561.55 COMMENTS / SPECIAL CONDITIONS on 0 0 0 0 0 0 0 0 a 0 1 0 0 0 0 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 9248, § 1, 72•27•92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work Is suspended or�doned for a period ol 180 days. INSPECTIONS: In order tor the work euthorized under this pertnit to be considered legal, such work must comply with all appli� codes, and all requlred Inapectlona and final approval must be obtained. Failure to obtain inspections and tinal approval will result in ihe axpiration of ihis permit. � FOR INSPECTIONS CALL: (714) 754-5626 2aaB�8 (6'W) WORKERS'COMPENSAnON DECLARATON: I hereby aHirtn untler penalry ot perjury one of the tol�owing declareiions: � . ❑ I have and will meintain a certilicate of wnsent to seli-Insure br workers' compensetion, as pmvided tor by section 3700 of ihe Lebor Cotle, tor ihe peAarmance of the work for whic� Ihjs permit Is iuued. ❑ I have and will maMtain workers' compensa'on inwrence, es requiretl by sectlon 3700 0l the Labor Coda, lor Ihe peAortnance ot Ihe w�{ tor �Ich Ihis permit is issued Myworkers'comp9psatipn sure ce � r irynumberare: � - Cartier. �u �� '� Pollq Number. (Thls secfion need not be camp/ered il the rtniNs �undred dollars (5100) or /ess.J I certiy thet in t�e pertormance ol tha r whic i permit is.iseuaU"�I not employ any person In eny manner so es lo become subJect to the workers' crompensetlon laws ot Califomla, entl agr tha ome subject ta the workers' compensetlon provislons ot Sectlan� of the bor Cotle, I shell torthwith comply with these provisions. � Applicent Slgneture: Dete: WARNINO: FAILURE TO SEWRE WIXiK NSATION WVEMOE IS UNUWFUL AND SWW. SUBJECT rW EMPLpVER TO CFiIMINAL PENALTIES AND CML FlNES UP TOONE HUNORED hKKl$AND DOl1ARE (510p,000�, W T THE COfiT OF COMPENSr1TION, DAIAAGES r1S PROVIDED FOR IN SECTION 3]O60F THE LABOR CODE, INTEREST, ANO ATTOMIEI^S FEES. LICENSED CONTRACTORS DECLARA410N: I hareby eHirm Ihet I em licensed under provlslons of Chapter 9(commoncing wlih Sectlon 7000) of Dlvislon 3 0l ihe Business end Prolessions Code, entl my licansa Is in lull lorce end etteci. Lic. q Class q Cantractals Slpnature: Date: CONSTRUCTION LENDING AGENCY: ❑ I heraby eHirm thel Ihere is a cansirucilon lendinp apenty lor iha pertortnence of Ihe work for w�ich Ihis permit is issued. (SeC. 3097, Civil Cotle). Londer's Name: Lentlers Address: Signature: � Date: OWNER-BUILDER DECLARAT10N5: I hereby attirtn Ihet under penalry ot perjury thai l em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the lallowing reason (Sec. 7031.5, Business entl Pratesslons Code: Any ciry or counry which requires e permit to construct, alter, improve, demolish, ar repair any structure, prior to its issuence, elso requires the applicant tor such permlt to file a signed statement �het he or sha is licensed pursuent lo the provisions ol the Comrectors License Lew (Chapter 9(commendng with Section 7000) of Dlvfsion 3 of the Business antl Professions Code) or thet he or she is a:empt Iherefrom enA the Desls tor Ihe alleged axemptlon. Any violetlon of Sectlon 7031.5 by any epplicent far a permlt subje he applicant m e civil penalry of not more ihan five huntlretl tlollars ($500).): I, as owner of the properry, or my employees with wages es their sole compensetion, WILL DO 7HE WORK, and ihe structure is not intentletl or oXered tor sale (Sec. 7044, Business and Professions Cade: The Contractors License Lew does not apply to en owner ot property who builds or improves Ihereon, end who does such work himself or hereelt or t�rough his or her own employees, pmvided ihat such improvemenis are not intended or oflered tor sale. If, however, the building or improvement is sold within one year of completion Ihe owner-builder will have ihe burden of proving that he or she tlid not build or improve tor purpose of sale.). 0 I, es owner ol the property, am E CLUSIVELY CONTRACTING WITF1 LIGENSED CONTRACTORS to construct the project (Sac. 7044, Business entl Pmfessions Code: The contractors Licens s t appty ta en awner ot pmperty who bullds or improves Ihereon, antl who wntracis for such pmject wlth a wntraaor(s) license pursuant to ihe a se Laws.). ❑ I em exempt under sec. Busineu and Protessions Code for ihis reeson: i Sipnature: Owner ID venfied by � fs li . es ❑ No Drivars LitenSe No. ��/ � Ezpiras� / Venficetian of Ow ers�ip by ( at tlocument, i.e. - properry laz bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certliy ihat no excevetion tive (5) or more feet in tlepth into whlch e parson Is required to tlescentl, wlll be matle In connection with work euthodzeG by ihis pertnii, and ihat no builtling structure, scaNdtling, telsework, or Gemolition or tlismantling thereot, will be more than thirty-six (36) feet high. (C�ep. 3.2, Grp 2, Art 2, Sec. 347, Title 8, Celifomia Adminis�reiive Code). ❑ As owner-bullder, I will not employ anyone to do work which would require e permit Irom ihe Divislon ol Intlustrial Selery, es notetl ebove, unless such pereon has e permit to do such work Irom the tlivisian. s�eoaw�a: os�e: Division oi Indusiriel Safery Pertnil Number: MAZARDOUS MATERIALS AND EMISSIONS CERTIFlCATION: t WIII the epplicant ar present or tuture buildinp occupent need co lile end ceNty e Business Plan for emerpency response to releasa or NreateneE releese ol a hazerUws melerlel7 ❑ Yes ❑ Na � (Sedion 25505 of the Calilomia Health entl Satery Cotle requires, with some exceptions, t�at e Businou Plan be tiletl with ihe Costa Mesa Fire Department by every business which has at eny one time dudng e reponed yeer a quentiry ol haeardous materials equal to or greater than a weight oi 500 pountls, or e volume of 55 gallons, or 200 cubic leot ol compressed gas at sten0ard tempereture end D�essure). ....................................._............................._......................._.."_'_..................................__.........................................................................................................................................................................................................................._.. 2 Does or will the eppliwnt or Oresenl ar luture building occupant need to lile e regisiretion torm tor acutely hazardous meteriels7 ❑ Yes ❑ No (Sectlon 25533 0l t�e Califomia Heall� antl Safery Code, wlih some exceptions, requires registretlon witn Ihe Coste Mese Fire Department by eech buslness which et any one time has on hand e quantiy ol ecutey hazardous matenels equal to or greeter Ihen e weight ot 500 pounds, or e wlume oi 55 gellons, or 200 cubic feet of compresseE gas eI atentlard tempereWre antl pressure). ..................._.........................."_'............"_—_"'_'.....__..._.._......_—............._.._..................—_................"_'....._"'—__._... _ 3 Does or will the epplicam or present or fuWre builtling occupent neetl to prepere en RMPP (Risk Manegement and Prevention Program br acutely hezartlous matedals)4 ❑ ves ❑ Na (Sedion 25534 ot the Califomle Healih entl Safety Code provides that the Costa Mesa Fire Depariment may require the preperation, certlficailon end filing with the Fire bepartment of en RMPP by buslnesses whlch ere reQuireO io regisier ecutely hezerdaus meterlels with the Fire Departmenl. ......._ ............................._"_..........................._—................_...._......................'_'...................�.............................�........................................................_..... ........................ .....__....._"................__.........__.... 4 If en RMPP is presently required, �as Section 25534 of i�e Celifomia Healih antl Sefety Code been fully complied with7 ❑ Ves ❑ No 5 DOBs or will ine appliG9nt or present or tuture DWIGinB OCCUPani rBQlllra tor Ihe wotlt wblCll Is [be SubJBci of Inls a pIIC2tlon a $BrtO�t tor suUl COIIstNtl1011 or tram the SW UI C005t Alr Oualiry Management District or tmm eny oNer alr pollu0on Convol tlistrict or eponcy� � Ves �J No (Section 658502 oi Ihe Califomle Govemment Catle requires that the requested inlortnetion be tumished on applicatlons br non-resitlential buildirg pertnits). ........._...—._....__. ._..._'—_—__..__._.._............_........_...........—....._......._"'� 6 Wiil any part ol the leciliry to be constmcted under Ihis permit be within 1000 faet irom the outer bounEades of a school7 ❑ Yes ❑ No (tl yes', tha taciliry must meet Ihe requirement oi Sections 25534 and 42303 ot the Califomia Healt� entl Safery CoOe). ....................................................................................................................._................................................................................................................................................................................_....._.........._..................._.......... 7 If e pertni� irom the South Coest Alr Oueli�y Menagemeni Dis�ric� or other elr pollu�ion wnirol dlsirict or egency is required for the wOrk whith 15 Ihe 5t application, have all of the disclasures prescribed by Califomia Health antl Safety Code Section 42303 baen made7 ❑ Ves ❑ No Qt yes', atlach cetli(cate of complience Fmm the appropnate eir polWtion conird otticeq. CERTIFICA7E OF COMPLIANCE: I certiy t�ai under penfllry of perjury the intormetion given abova is correct. I agree to compty with all staie laws end ciry ordinances regarding Hazardous Materials and Emissions. Signature: _ — Date: CERTIFlCATE OF COMPLIANCE AND AU410i1��AT0 FE �certity under penelty of perjury that I have read this epplication and stete that the intortnation given is corcect I egree to comDly wf�h ell sat�s e A ces rela�ing to bulltlinp construction, end euthodze representecives of the City of Coste Mese to enter upon Ihe ebove-descnbed O�operty tor inspection purpo � ee nol ro occupy or ellow occupanry ot eny builtling euihorized by is pertnil until final inspection. Siana Of alOwnertsl � �a�e CppE �, INSPELIqMTYPE Q�jf. 1816 Fixetl System Final Fire Prevenllon 7288 200 201 202 203 20a Pool Spe Final Final RaRoof Final BIocWReteining Wall Flnal Fectary Fire Place Final Slgn Flnal Demditbn � fQpf,j INSPECTIONTYPE 206 Finel Mechanical 20B Finel Plumbing 210 Finel EleciriCel 272 220 222 250 Finel Fire Prevention Finel Planning Approval Finel Slte Final Building/Occupenq �-9 -0 3 <ni (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA�92626 PLUMBING PERMIT Job Address: 396 LA PERLE LN Suite No Vicinity: Status: ISSUED Applied: 08/OS/2002 Issued: OB/OS/2002 Parcel Nunm6er: 42531206 _ - � "-- ` -� � ISSUED BY: � ��,-- � " � _ - _ � _ � .�i� - -- � ' - � Applicant: ROSS,ERIGCTR;!.,'i- " �� `' � ' �;,'�� Address: 398 LA P.ERLE LANE" --' � � � �t i �� -� ��. / n%i �� • � � . , Phone:_ (949)54&2026 / j� i ��' � ;� COSTA�MESA, CA � � ` ; ` Zlp: 92627 3759 : � -� . % �� '�'� � � . �; ��i� \ �,� � . _ � �`�C� . : i.� � � �� -.A � i , ,�� . �,i'. . ' .��.�� : . � , �� Owner: ROSS ERIC.C'TR= ��` �'� �' `� ��`�� / ' �.� ; . i% ��o� � � � j�l�� Address �396 LA"FERLE �,4NE � � � V �� / . . i. A `� � � `� � � � � Phone: (949) 54&2026 . , �:./ ` `_'. '` i. �_ :�. � . � COSTA MESA, CA Zip: � 92627-3759 \ `� �` �. / � � � �, � �, _- � - � - � � �" - � � \ � . � Contractor �OVVNER BUILDER � � ' .• � � = �..�'�' , � Address: � , , / : �. � - ,/ � � � . `,. _ '. , �' , � � � � ! ,e .. Phone: .... , ' "-\ , /. �� .. - ' � V -� �� - . . , _. .� . . .. i �� Zip: - , , �- � - License: 000000 � � . _, _ � � Arch / Eng : Address: ' �� r ��- � - - ��_ __ �. _ ' -,,�,y� _ , ,i � . �. � Phone: Zip: " �- --_ - - -License: - . � . ��,� ;� .. . /� � • ' SCOPE OF PERMIT" ' � - ADD 396 SF TO KITCHEN, NEW BATHROOM, AND FRONT HALL. REPLACE EXIST WINDOWS WITH SAME �� . � SIZE. INTERIOR WORK TO EXIST BATHROOM AND REPLACE 4 EXIST DOORS . REF: 802-00749. �,' , ' PLUMBING TO INCLUDE: 1 BATHTUB;.tiDl§HWASHER, 1 GAS (1-0 OUTLETS), 1 SEWER CONNECT �-' i;- i . �" TO PRIVATE LINE, 1 SHOWER, 1.KITCHEN-SINK, 1 WASH BASIN, 1 TOILET. -,�,� � \ �. � � i _ , - - �:. . . � - rc� a�rvirvir � ^ \'.;. , - , . - - i AMT QTY � . . - � ISSUE FEE � '�$23.50 ; ��-,_ •;. Laundry Tub`/ Washer Backflowirtigation��'� SO.00f� 0�.. .-Landscapelrrigation � BackfiowPreventer�-'��50.00 : 0'- � ��P-Trap� '�=`-�� . - Bathtub � $9.80�� i1: �'� %�- Pressure Regulator _ - Clarifier System �50.00� �0.", �_` ' Process Piping (per 10 ft) Connect (Ice,Soda,etc) $0.00� ` � -0 �. � �Receptors • Dental Units $0.00�`�. �'0 � ` .. � Septic Tank . , � Dishwasher $9.80 � "I � - � � -- Sewer Cap for Demo. , . Drain, Floor $0.00 0 ,' SeWef ConneCt Drain, Rainwater $0.00 0 `- Sewer Private Line- �- Drain, Roof $0.00 0 Shower � Drinking Founfain $0.00 0 Sink, bar Expansion Tank $0.00 0 Sink, commercial Gas Earthquake Valve . $0.00 0 Sink, Floor Gas (1-4 outlets) $6.15 1 Sink, kitchen Gas (Over 4 outlets) $0.00 0 Sink, service/mop Gas Repipe $0.00 0 Spa (private) Gas Service $0.00 0 Spa (public) Interceptors (Grease, Oil) $0.00 0 Interceptors (Sand Auto ) $0.00 0 RY � . .. , � AMT aTY . - " � .� .' AMT $0.00 � 0 "" ''Sump Pump� '' i $0.00 $0.00 . 0 :, �',;= � .Swimming Pool; ; �; /� $0.00 $0.00 = 0� - � �,'� Srap Primer �� $0.00 $0.00 0 _� ` �` Urinal'� ,�%; $0.00 $0.00-,,'�0;, �� Vacuum"Brk�,Bkfiow(1-4) $0.00 $0.00 0�• ' � Vacuum Brkr BkFlow(5+) $0.00 $0.00 �0 / !Wa'shBasin 59.80 $0.00� 0 ,-„��--�WashBasinSel $0.00 $0.00 ,0 � �= = �� Waste and Vent System $0.00 $24.65� � 1 � Water Closet (Toilet) $9.80 $9.80 1 Water Healer / vent $0.00 $0.00 0 Water Piping (Inst or Rep.) $0.00 $0.00 0 Water Re-pipe $0.00 $0.00 0 Water Service $0.00 $9.80 1 Water Softener $0.00 $0.00 0 OTHER $0.00 $0.00 0 VIOLATION $0.00 $0.00 0 PLAN CHECK $0.00 REINSPECTION $0.00 TOTAL CALCULATED FEES: 5113.10 Qn 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 NOTICE: The work authorized by this permit s uirements under Calitomia statutes and reWted 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 a�oned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply vrith all applica� codes, and all requlred inspections and finel approval must be obtainad. Failure to obtain inspections and final approval will result in the expiration of this pertnit. FOR INSPECTIONS CALL: (774) 754-5626 ' zuaas �aroo� WORKERS' COMPENSAnON DECLAfiAnON: I hereby attirtn under penalry of perjury one ot the lollowinq tleclaretions: ❑ �I have and will maintein e cartificate ol consent ro setl-Insure for workers' compensetion, as provitled for by sactian 3700 of tha Lebor Code, far the pertortnence of the work for which this permit is issuetl. ❑ I hava and will maintaln workers' compe tlon insurance, as required by section 3700 of the LaDor Code, lor tha peAortnance of the �v� which this pertnit is issuetl. My worke�s' compen eN�oj�I� ura c nle tl poticy number ere: I Certier. �!�/X.Y / PolicyNumber. � �This section need not be comp eted i! ( ve f one hundred dollers ($100) or less.) certity Ihat in the paAortnanc�of IhE compensation laws of Celifomia, entl comply with these provisions. Applicant Signature: WARNING: FAILURE TO $ECURE THOUSNNDDOLLAFE(5100.000 ADDITI T LICENSED CONTRACTORS DE I hereby aHirtn that I am licensed force ena ettect Lic. # Contraaors Signeture: _ v/rk to t' rmit is issued, I shall not employ eny person in any manner so as to become subject lo the workers' gre s su6�ect to the workers' compensatlon provisions of Section 37 of Labor Code, I shall forthwith �� oe,e s�;s %� APENSATIqJ COVERAOE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENAL IES D CIVIL FlNE$ UP TOONE HUNDRED THE COST OF COhIPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOq CODE, IMEREST, AND ATTORNEY'S FEES. oi Chapter 9(commencing wi�h Section 7000) ot DiNsion 3 of the eusiness and Professlons Code, antl my license is in full Class a Date: CONSTRUC710N LENDING AGENCV: ❑ I hereby attirm ihet there is e construction lendinq egency for ihe performance of the work for which ihis permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lendefs Address: SignaWre: � Date: OWNER-BUILDER DECLARA710N5: I �ereby aRirm Ihat unGer Oenelry ot perjury that I em EXEMPT FROM TliE CONTRACTORS LICENSE LAW Por the tollowing reason (Sec. 7031.5, Business entl Pmtesslons Cotle: Any ciry or county which requires a permit ro construa, alter. improve, demolish, or repair any structure, pnor lo its issuance, elso requires ihe applicam tor such pertnit to file a signed stetement ihet he or she is licensed pursuent to the provisions oi �he ConiraGors Llcense Lew (Chepter 8(commencing wilh SeMion 7000) of DlWsion 3 oi the Business and Prolessions Code) or that he or she is e:empt therefrom end the basis for ihe alleged exemption. Any violation of Section 7031.5 by any epplicant for e pertnit �sublecl lhe epplicant to a civll penelty of not more than fiva huntlretl tlollers ($500).): es owner ot i�e pmparry, or my employees with weges as iheir sole compensatioq WILL DO THE WORK, end the strucWre Is not intentletl or oHeretl for sale (Sec. �� 70a4, Business end Professions Coda: The Contrac�ors License Law tloes not apply to an owner of property who builds or improves ihereon, and who does such work himself or herselt or thwugh his or her own employees, provided that such improvements are not Intended or otteretl for sale. It, however, the 6uilding or Impmvemen� is sold within one yeer of completion the ownao-builder will have the burden ol O�oving ihat he or she did not build or improve for purposa of sale.). ❑ I, as owner of the O�o , am E% USIVELV COMRACTNG WITH LICENSED CONTHACTORS to construct the project (Sec. 7044, Business and Professions Code: The wmr r icense tloes not apply to an owner ol propeny w�o builds or impmves therean, end who coniracts for such project with a comractar(s) license pursu to t Cont a Lews.). ❑ I em exempt under ec Business antl Profassions Code for this reason: Signamre: Vedficetion ot er Ip by (lype af document, I.e. - property taz 6111 or Ceetl): DIVISION OF INDI/STRIAL SAFETY PERMIT CERTIFICATON: ❑ I hareby ceYyry that no excavation five (5) or more feet In depth into which e person is required to descenQ will be made In connecNon with work authodzed by this pertnit, and fhat no building structure, scaffolding, falsework, or tlemolillon or dismantling iheraot, will be more than Ihirty-six (36) feet high. (Chap. 32, Grp 2, Ari 2, Sec. 341, Ttle 8, California Adminisiretive Code). ❑ As ownerbuilder, I wlll not employ anyone to do work which woultl require e peimi� from ihe Division af Indusiriel Safery, as noted abave, unless such person hes e permit to tlo such work irom Ihe division. Signature: Division of Indusirial Sefety Partnit Number: Date: W III tha applicant or present or future building occupent need lo file end certify e Business Plen for emergency respanse to relaese or threatened release oi e hezertlous matedal4 ❑ Ves ❑ No (Section 25505 of the Calitornia Health end Sefety Code requires, with some enceptions. ihet e Business Plen be tiled with the Coste Mesa Fire Depertment by every business which has at eny one time dunng a reported year e quantity ol hezerdous materials equal to or greater �han a weight ot 500 pounds, or a volume ot 55 gellons, uoes or wm tne eppucent or present or mwre ounamg occupam neea �o nie a regisvauon rorm ror aatery nazamous matenaisv L.1 res U No (Seclion 25533 oi ihe Callfomla Health and Sefety CoAe, with some esceptions. requlres registration with the Casta Mese Fire Deperiment by each business whlch et eny one time has on hend e quentiry of ewtey hezerdous matenals aquel to or greeter Ihan e weight ot 500 pounds, or e volume at 55 gallons, or 200 cubic feet of ComOfessed 985 fit S18003fC IBmpBfetufe Bnd pfessufe). Of an (Section 25534 0l t�e Califomia Health and Safery Code provides that Ihe Costa Mesa Fire Depanment may require ihe preparation, certification and tiling wi�h �he Fire bepertment of an RMPP Dy businesses which are required to register ecutely hezardous matenels with the Fire Depenment. ............................... _........................................................................................................................................................................................................................................................................,.............................................................................. 4 If en RMPP is presently required, has Section 25534 of the Calitomia Heelth and Safery Code been lulty complietl with7 ❑ Ves ❑ No ......................................................................................................................................................................................................................................................................................................................................................................................... 5 Doas or will the apPlicam or present or tuture builEing occupant require Por �he work whith is lhe subjec� of thl5 8 pliCallon a permil for Such ConSWction or modification from ihe South Coes� Air �uality Managemem Disidct or tmm eny other eir polWtion contml disMci or agencyt � Yes ❑ No (Section 658502 ot the Cfllitomia Govemment Code requires that the raquasted iniortnation be fumishetl on apDlica�ions for nomresidential buildinA Pertnlis). 8 ......... ............................_......_........_...._.__...........................'__............................__"...._...—........................_""'_"' N%in�any part ot the faciliry to be consbucted under t�is permit be within 1000 feet irom the outer boundades of a school? (II yes', the laciliry must meet the requirement of Sections 25534 and 42303 0l Ihe Calitomia Healih entl Safery Cotle). ............................................................................................................................ ........................................................................................._. If e permit from ihe South Coest Air Quelity Menagement Distric� or other eir polWtion contml distdct ar egancy isO eoolicatlon. have all of the disclasures orescdbed bv Calitomia Heelth antl Safetv Cotle Section 42303 been made? .. _ . ................................. � Yes ❑ 1 No CERTIFICATE OF COMPLIANCE: I certity that untler penalry of perjury the inlormetion given above is correa. I agree to comply with all state laws end ciry ordinances regardinq Haiartlous Materials and Emissions. Signature: Dete: CERi1FlCATE OF GOMPLIANCE AND AUiTi6 TON OF Y: I certily under penalry ot perjury Ihat I �ave read this epplication end state that the intortnallon given Is correct I agree to comply wilh all s;ate laws d ci ' ances relating to builtling construction, and eufhorize representatives at Ihe Ciry ot Costa Mesa to enter upon the ebove-descnbed pmperty for inspection purp �y or all_ow�pancy ot any Duilding authodzed by this p�i(�uMiYJln ' eclion. SYJ / Ainn wnalOwnnrtsl —�� Date COOE 1, INSPECfIONTYVE 1616 Fixed System Final Fire PrevenGon 1266 Paol Spe Final - 200 Finel Re-Roof � 201 Final BIocWReteining Wall 202 Final Factory Fire Place 203 Final Sign 260 Final Demolition p�jE �$ 40DE� 206 208 • 210 212 220 222 INSVECTIONTYPE Final Mectianical Finel Plumbing Final EleCirlcel Finel Flre Prevention Final Planning Approval Finel Site 250 Final Building�Occupanry Date - - 0 3 (�pL 3' J �• �f (714) 754-5273 • Fax (�/4) 754-0856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: 396 LA PERLE LN 42531206 Applicant ERIC ROSS Address: � owner.� ROSS, ERICC TR ,: " = Address �,' 396 LA PERLE LANE- � - � � � , COSTA MESA, CA . ConVactor: . , Address: -'ISSUE FEE Temp service tesl Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighfing Fizts Recepl Outlels Switches Non Res Appl Res Appl Service to 200a , � Service to 1000a � Service over 1000a � Motors to thp � Motars to tOhp Motors to 50hp Motors to t00hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole Status: ISSUED Applied: 07/15/2002 Issued: 07/15/2002 ISSUED BV: �' " Phone: 949-548-2026 Zip: Phone: (949)548-2026 Zip: 926273759 Phone: Zip: License: : c>, ,'i .. , - � .� , .�, . . SCOPE OF PERMIT TEMPORARYPOWER'POCE. � ' - � - •- � �� '- Quantity - $23.50 $0.00 $0.00 $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 ' $O.W 0 $0.00 0 so.00 0 $0.00 � � ' 0 ; $0.00 0 so.00 0 $0.00 . 0 $0.00 0 $0.00 0 $0.00 0 $23.50 1 $0.00 0 a . FEE SUMMARY Temp Dist System / Lighting Busway /100 ft ' Standing Section Misc Electrical Equipment Transtormers up to 1 kvalkw ......:.........up to 10 kva/kw .................up to 50 kva/kw ............:....up to 100 kva/kw ..................over 100 kva/kw . Low Voltage EquipmenC -� Low Volt Wiring System / Ckt Misc. Conduit - . Misa Conductor - - Circus ( gen or ride) . Circus (mech ride or lights) . . Chrisimas Tree Stand. � Fireworks Stand � . Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee 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 �- �$0.00 � D $0.00 0 $0.00 � 0 so.00 o ,. So.00 0 $0.00 0 so.00. $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $47.00 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12•21-92) EXPIRATION: This permit shall automatically explre antl become vofd if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this parmit. FOR INSPECTIONS CALL: (714) 7545626 , zsasae ��vna� WORKERS'COMPENSA�ON DECLARAnON: � I hereby aHirm under penalty of perjury one of the tollowing declerations: � ❑ I heve flnd will maint&in a certificate of consent to self-Insure br workers' compensatlon, es provided br by section 3700 0l tha Labor Cotla, for the pertortnence oi the work tor which Ihis pBrtnit is issuetl. ' . ❑ I hava and wlll mairttai¢ workers' compensation Insurence, es required by section 3700 of ihe Lebor Cotle, for Ihe pertortnance oi the work for which this pertnit is IssueO. My workers' compen�'atlon Insurence cerder and policy number ere: Cartier: Policy Number: (This sectlon need not be completed il the peimit is velued ef ane hundred dollers ($f 00) or /ess.) � • ❑ I certily that in the pertormance of lhe work for which this Oermit is issueA, I shall not employ eny person in any manner so as to become subject to the workars' compensation laws IN Califomia, entl eBree �he� If I shoultl become sub�ect to the workere' compensetlon provisions of Sectlon 3700 0l Ihe Lebor Catle, I shell forthwith comply with these provisions. Applicant Signature: Date: WARNINQ: FAILUPE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SW1LL SUBJEGT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED TFpUSPND Dd1FRE (5100,Opp�, IN ADDITIIXJ TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED WR IN SECTION 31O80F THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTOpS DECLARATION: I hereby eflirtn that I em licensed under provisions ot Chapter 9(commencing with Sectlon 7000) ot Division 3 ot t�e Busineu antl Professions Code, an0 my license is In tull farce and eXect. Lla It Class A Contracmfs Signeture: Date: CONSTRUCTION LENDING AGENCY: � ❑ I hereby aHirtn Iha� there is a construction lending agency for the pertormance oi the work for whic� this permit is issued. (Sec. 3097. Civil Code). Lender's Neme: Lender's Atltlress: SlgnaNre: Daie: OWNER•BUILDER DECLqqpT10NS: I hereby affirtn Ihat untler penalty ot perjury thet I em EXEMPT FpOM THE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business end Prolessions Code: Any ciry or counry which repuires a permit to construct, elter, Improve, tlemolish, or repeir eny sirucWre, Drlor to its Issuence, elso requires Ihe epplicent for such permlt to file a signetl statement ihat he or she is Ilcensetl pursuent to Iha provisions of ihe Coniwdors LJcense Law (C�epter 9(commencing wlth Sectlon 7000) of DlNslon 3 of the Business entl Prateuions Codej or t�at he or she is exem0� Iherefrom enO the Dasis tor the elleged ezemption. My violation at Sectian 7031.5 by eny applicanl for e pertnit subjecis Ihe applicant to a cNll penalry of not more then tive huntlred tlollars ($500).): ❑ I, as owner ol ihe property, or my employees with weges es iheir sole compensatlon, WILL DO TNE WORK, end Ihe struclure Is not Intended or offered tor sele (Sec. )044, Business and Pmtessions CoAe: Tha Coniractors License Lew does not eppty to an owner ot Droperry who builds or Improves thereon, end who does such work himself or herself or ihrough his or her own employees, provided thet such improvemenis are not Intentled or oHeretl tor sale. If, however, Ihe 6uilding or improvemen� Is sold within one year of wmpletion, Ihe owner-builtler will have tha burden of proving that �e or she tlitl not Euild or improve for puryose oi sale.). ❑ I, as owner oi the property, a E% SIVELV CONTRACTING WITH LICENSED CONTfiACTORS to wnstruct t�e project (Sec. 7046, Business end Professions Code: 7Te contrectom„ � w s not apply to en owner ol property who bulltls or improves thereon, entl who conirects for such pro�ect wlth e con ractor(s) license pursuant to ih n acto 'cen ❑ I am exempt under sgc. eusiness and Professions Code br this reeson: , r SignaNra: Dete� Owner ID verified by driver se. ❑ Ves ❑ No Drivets License No. Expi e: Verificallon of Ownere ' type ot documen�, i.e. - property ta+� bill or tlaed): � DIVISION OF INDUS7FilAL' SAFETV PERMR CERTIFICATION: ❑ I hereby certify �hat no excavetion five (5) or mora feet in tlepth Into which e pereon is required to descend, will be matle in connection with work euthonzed by this permit, and that no bUilding siruclure, scalloltling, talsework, or tlemollilon or dismantling ihereof, will be more than Ihirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Celifomia Administretive Code). � ❑ As owner-builder, I Will not employ anyone to do work which would requlra a permit from Ihe Division ot Indusirial Sefery, es notetl ebove, unless such person hes e pertnit to tlo such work from t�e division. , SignaNre: Date: � Division of Intlustrial Sefery permi� Number: CERTIFlCATE OF CO AND AllT}IORVATION OF ENfTiV: I certily untler penalry of perjury thet I have read this ep0�iration end state that the informetlon given is correct. I agree mply wl ell state laws antl ciry ordinences relating to building construction, antl euthonze representatives of the Ciry ol Cos M 5a to enter upon t�e ebov�descnbeil operty inspe � ses. I agree nat to occupy or ellow accupency of e y.building authorized by this pertnit until f�I ins ctio � �� d2i Signature Of Legal Owner(s) Da�' i e�d/nr AumnmaA Anolicanl Dei6 System Final Fire Prevantion 1286 Paol Spa Final 200 Finfll Re-Roof 201 FInaI8locWRetelning Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition esie u�e�s COOE� INSiECTIONTYPE 206 Finel Mechanical 208 Finel Plumbing 210 Final Electdcal 212 Flnal Fire Preventlon 220 Flnal Planning AOProval 222 250 Finel Site Finel Bulltling�Occupency �g � iQ �� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 396 LA PERLE LN Suite: Vicinity: FRONT, LEFT & RIGHT SIDES OF PROP Parcel Number: 42531206 Applicant ROSS, ERIC Address: 1619 TUSTIN AVE COSTA MESA, CA Owner: ROS$, ERIC Address 1619 TUSTIN AVE COSTA MESA, CA Contracror: OWNER-BUILDER Address: Arch : Address: Zoning: -�Phone: (949)548-2026 -. . . � . Zip: 92627 ' . . � � Phone: (949)548-2026 - � Zip: 92627 ' . Phone: Zip: . �� License: �" 0 -� . , Zip: , BUILD BL SETBACK REQUIREMENT ISSUED BY: ' Eng: ' i . ., . . _ . . -_ Address?" � . '� - _ _ i - Phone: - � � ' � � �- License: ;K WALL VARYING IN_HEIGHT FROM_309NCHES'TO;6FEELIN HEU PER CITY STANDARDS �.� Plan Check', ;,, � : $72.31 ' Permit: , ��' � $11125 SMIP Res; �, : . $0.50 SMIP,�Com _ ��$000 � Other ; $0 00 Inspechon �$0 00 ti �\�F: ,Total "$184A6 \ r�� _i_� _. _ _:j�� i � � _ " - J � � '>i �. n :. � �5.�: �'� i"`y r , � �'� ��- i � o� . � 'G , t' �. �.. y ,,, ' n ��; i i t. � T� " '� � n ✓ �. � � , \C�_ i: �idi : c ' Status: ISSUED Applied: 05/22/2007 Issued: OS/22/2001 � � .. Phone: . � , License: � � �- ? WI7H Cil'Y � �i . " �, , �' . _—.. . 1�, , J.j ; �1, , - r_i ;, _ �" , 7, � _,,,, - Galc Valuation: 1 � � � 8a,`aoo:oo i. � p, ClaimValuation:/>f�; r So.00 � y,, : �� -, ,,. �� ,� ; �iri ,.; ,,,.; %, , ,i i! � , �� l ��. � `i r-; � , � � , i �'� l�� t n �, +t..»� �� / � � � r%/ i = t; � .. :%'%/i / ,l / � ; � , � �f �> � � � „'�PLANNING'&ZONING�� -�� SETBACKS .�� ./�� .� ''r - . � ° '� � %%��",��)j � MAIN STRUCTURE��Front 0 �0� - � /��',_Rear 0 0�� '_LeR� 0 9 � � Right '"�0 0 /� � /' / � � � ��'�"��[ ��r_ �. �' �� /-��: ACCESSORY Front� �1 0� �i �Rear 0-0 ' � i�Le(t �� 0 0 �� Right 0�0 r �. : I � .; ! � �'_.�. fi i• , i PARKING Existina�l; Reouired: �0'-�' • ��.�-Proqose�d:�-�0 ,-�j;�� vV ",_ — _ �/�, NOTES: � -- � "_'-,c,e=�,.i�i9 _ ' NOTICE: The work authorized by ihis 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 tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 2446-4fi(6/00) WORKERS' COMPENSAY��N OECLARATION: – � . I hereby efllrtn under penelty of perjury one of ihe following tleclaretions: ❑� I have end will melntaln a certificate ot consent to self-Insure for workers' compensation, es provitled tor by section 3700 of the Labor Code, for the pertormance of the work for which this pe�mit is issuetl. ❑ I heve end will maintflin workers' compensation insurance, as required by section 3700 of Ihe Lebor Code, for the pedortnance of the work for which Ihis pertnit is issued. My workers' compengatlon Insurance cerner and policy number ara: Cerrier: ' Policy Number� (This section nee0 not be completed il Me pertnif is valuetl et one hundred dollers (E100) or /ess.) ❑.I cerlity ihet in t�e peAormance of t�e work for which this pertnit is issued, I shell not employ any person in eny manner so as to become subject to the workers' � compensation laws of CalNomia, and egrae that H 1 should bacome subject lo Me woMers' campensetfon provislons ot Section 3700 ot the Labor Cotle, I shall forthwNh comply with these pro�sions. Applicant Signeture: Dete: WARNING: FAILURE TO SECURE WORKERS' COMPENSATIdJ COVERAGE IS UNUW FUL AND SHALL SUBJECT AN EMPLOYER TO CPIMIWIL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED hKKISAND DOl1.ARE (5100,OOP�. IN ADUTION TO TME COST OF COMPENSATION, DPM4GES 0.S PROVIDED FOR IN SECfION 3]O60F THE UBOR COOE, INTEREST. AND ATTORNE`fS FEES. LICENSED CONTRACTOFS DECLARATION: I hereby aMirtn that I em licensetl under provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Cotle, and my license is in tull torce end eftect Lic. A Class x � Contractofs Signature: Da�e: CONSTRUCTION LENDING AGENCY: ❑ I hereby etfirm thel thore is a construdion lending agency for the pertormance oF ihe work tor which ihis permit is issued. (Sea 3097, Civil Code). Lentler's Neme: Lander's Adtlress: Signature: Date: OWNER-BUILDER DECLAAATIONS: �� I hereby eHirm thet untler penelty of perjury thet I em EXEMPT FROM TFiE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5. Business end Professlons Cotle: Any ciry or county which requires a Oermit to construct, alter, improve, demolish, or repair eny stmcture, prior lo its issuance, elso requires ihe epplicant tor such pertnit to flle e slgnetl statement thet ha or she is Ilcensed pursuent to ihe provisions of the Contrectors License Lew (Chepter 9(commencing with Section 7000) ot Divisian 3 of ihe Busineu and Professlons Code) or that he or she is exempt therefrom end the basis for the elleped exemption. Any violation of Section 7031.5 by any aOPlicant for a permit sub ects the epplicent to e c��l penalry of not more than five huntlretl tlollars ($500).): as owner of ihe property, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, end ihe structure is not in�ended or ottered for sale (Sec. 7044, Business and Professions Code: The Coniractors License Law does not apply to an ownar ot properry who builtls or improves ihereon, and who does such work himself or herself ar thraugh his or her own employees, provided Ihat such improvemenis ere not In�e�tled or oHereO for sale. It, however, the huiltling ar improvament is sold within one year o1 c mpletion, ihe owner-builder wiil have ihe burden of proving Ihat he or she tlid not build or improve tor purpose of sale.). ❑ I, as owner of the pro Ry. am E%CWSIVELV CONTRACTING WITH LICENSED CONTRAC70RS to wnstruct ihe project (Sec. 7044, Business and Pmfeuions Code: The contrec tloes not apply to an owner of property w�o builtls or Improves thereon. entl who contracis lor such project with a contr ctor(s) licensa p o p Contr ors ' nse Laws.). ❑ I em exempt und seC. Business and Professions Cotle for ihis reason: Signaturai �+ Date: ti � Owner ID verifietl vets license. ❑ Ves ❑ No Drivers License No. Expir s: Venficatio n rship by (rype of daument, i.e. - property tax bill or deed): DIVISION OF If�bUS7RIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify tha� no excavetion five (5) or more feet in depih into which e person is required to tlescand, will be matle in conneciion with work authonzed by this permit, end ihat no bui�tling strucNra, scaHolding, falsework, or demolition or dismantling thereoi, will be more than ihirry-six (36) feet high. (Ghap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomla Atlministiative Code). ❑ As owner-builder, I will not employ anyone to do woric which would require a permit irom Ihe Division of Indusirial Safery, as noted above, unless such person has a permit to tlo such worK irom the division. Signature: Oate: Division oi Intlustrial Sefety Permit Number: HAZARDOUS MATERIALS �o EMISSIONS CER7IPICAnON: 1 Will ihe epplicant or present or future building occupant neetl ro tile antl certity e Business Plen br emergency response to release or threatenetl release of a hazerdous materiel? ❑ Ves ❑ No (Section 25505 oi ihe California Health and Sefery Code requires, with some exceptions, thet e Businass Plan be filed with ihe Costa Mesa Fire Depariment by every business w�ic� �as e� B�y one time dunng e reported year a quantity ot hazardous materials equal to or greatar than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperaWre antl pressure). .......'...._ ... ......................................... .............................................................. . ........................................ ............................ ................... ......... .......... 2 Does or will ihe aDPlicaO� or present or tuWre building wcupant need to file e registration form for acutely hazardous matenals. ❑ Ves ❑ No (Section 25533 of the Califomia Heatlh and Safery Code, with some exceptions, requires registration with Ihe Costa Mesa Fire Department by each business which et any one lime has on hantl e quentiry oi acutely �azardous matenals equal to or greater then e weight of 500 pounds, or e volume ot 55 gallons, or 200 cubic feet oi compressetl gas at stanCartl tempereture an0 pressure). .............................._............ ..................................._..._................................................................................... ............................_................................................................._........_...................................._. .................. 3 Does or will the applicant or present or future builtling occupant neeC to prepare an RMPP (Risk Managemen� an0 Prevention Program tor acutely hazartlous matenals)? ❑ Ves ❑ No (Seclion 25534 of the Calitomia Health and Safery Code provides that the Costa Mesa Fiw Department may requira the preparation, certification and tiling with the Fire Depertment oi en RMP7 by businesses which ere required to register ecutely hazardous matenals with the Fire Department. .......................................................................................................................................................................................................................................................... ........................ .................................................................... 4 If an RMPP is presently required, has Section 25534 of Ihe Califomia Heallh and Safery Code been tully complied with7 ❑ Yes ❑�No 5 Does or will the epplican� or presem or tuture Duntling occupant requlre for the work which is the subject of tnis a pliwtion a permit for suc� consiruction or motli(icatlon trom Ihe South Coast Air Dualiry Management Disirict or from any other air pollution control Cis�nct or agencyl � Ves u No (Saction 658502 of the California Government Code requires that the repuestetl information be turnished on applications for noo-residential building permits). ...................................................................................................................................................................................................................................................................................... ...................._. ................................................................, 6 Will eny part of the faciliry to be constructetl under this permit be within 1000 feet from Ihe outer boundanes of a schooll ❑ Yes ❑ No (It "yes", Ihe tacillly mus� maet the raquirament of Sections 25534 entl A2303 of the Cetifomia Heatth an0 Safery Cotle). ............. ...................... ............_....................................._...................................._.................._._...................... .............. 7 If e permit from the South Coest Air Quality Management District or other eir pollution control distnct or agency is required for the work which is the subject ol this applicaiion, have all of tne tlisclosures prescri6ed by California Healih and Safety Cotle Section 42303 been matla7 ❑ Ves ❑ No . ....... ............................................................................................................................................................................................................................................................... ................................. �B ��(If'yes", atlach certificata of compliance trom ihe appropriate air polWtion conirol otticer). � CERTIFICATE OF COMPLIANGE: I c rig ity �hat untler penalry ot perjury the information given above is correct. I agree to comply with all state laws and city ordinences regerding Hazartlous M��erials and �lissions. Siqnature: ,� �—� Date: CERTIFlCATE OF COMPLIANCE AN6 AUTp6aiznn F ENTFiY: I cenify under penalty of perjury that I �ave read this application and s�ate ihat ihe in(ortnation given is correct. I agrea to comply with ell {ate H rdinances releting to building construction, end authorize representatives of the City ot Costa Mesa j10 enter upon the above-descnbetl property tor insp �� es. I agree not to occupy or allow occupency of eny building authonzed by this permit until final i� ction. / / v� �6 naWreot_lagalOwneQs}� �te � � / � COOE�. INSPECTIONTYYE � 1fi16 Fixetl System final Fire Prevention 1266 Pool Spa Final 200 Finel Re-Rool 201 Final8locWReteining Well 202 Final Factory Fire Place 203 Final Sign 20d Final Demolition o"h �$ CO�EI 206 208 210 8'7�z- � 212 INSPECTION TYGE Final Mechanical Final Plumbing Finel Elecincal � Final Fire Prevenllon 220 Final Planning Approval 222 250 Final Site Final BuiltlinyOccupancy OpTE i rm��s „_• _ � 2 s�� '.�—�. �j a � e � rC v}�-' � �C'i r �j LD Li{-- f� �','LL.-i _ _ _ __ - - - --- -- - ,o., - -- _ . , — — — - - f�a �i-� �.' _” '_ ' ' _. ._ ..nnr_n— r ci ADD{?iONS� DEL@T!Q[�iS;-0"�C�n„ci�rl0id r-or1RlL _ BE Af'?t�4'�fED 8Y 1t+E �+�;1i;Iriil"�_i;_�;i';•:�'N -- -- - - - - - . _ _ . . _ - . G - 6D7_3 - �� CITY OF COSTA MESA I _ _ _ _ , _ PIANNUdG DIV. SUBJECT TO BLDG. DEPT. REG. � - - BY-.p.iTu�--DATE �/3 � 1 ��` �P�-�C b° � �J�PJ �.t>��c>�.-�... -s. �s�.. �-sc�..:.�„r ; �P� ,� ; �J `�� •� r y ��/ ✓ -- � �Ol--o � 7 3 � Dl�r'i�IG�:J OF BUILD►\v SAFEi'Y CITY GF COSTA MESA _.. - A�PI'R V�D r �� _� S ZZ T. a xl :�t plzns xr:� cK:d;ic ;ons AR� � be k:pl m Uus job at a6 tunes and'd is n. 4;e �ry ch3rr�es ca aCerali;n on sam: x^th�t wr�ter partrriesion ftun ihe D'rr'sb. a ;�fet�.Citysf;.vitau:s:, T. 5(dn{�ry ct'w'w'; ria�;:ri �dfi.�-,tiu;t�.iY+�11 I. �IC � Ga he4� io yxmd a lo �x e�i�. viclatr.c n! ar.r x,ai:io: ; o� aa� City o� C:x.ts t,1•�sa O��nancs andioi TTZY2. pId'i :�+_ OPfiil ,i�31: nAyi:e i:r'n�'-4j'!p', 9�h]l.i:lt(i'!::":V!A vD:d d i}tE WL'�k,o Iq: •.a'li"C'.:X ^7 �itafL:![iF': _:!:c� rt7 �'iS:: 9J:J j0) bY!17' IBb Ili}S �. IU �-s'' i ��s __ '_ . _ " _ "� '_ "'_ " "_'.. .... . __ - 1. , .. i ;::.,•i v� wr� (�J' t�. �7��— �,J � �L- c� r� -� •;�, i ,� ? i � � r i`� '� �' I � � �� ! � e _1 ,� r� v � ,,....., , j _. -�,2�rn y ��5�� G� t� i� �r L� I �� - . � �a�' �, � � ra � � ✓G'f Cc �r-%�" �� L� L��/� � I � � �-LL W'ri�"L''� i�jV t i.-r_ � �S r rfb- �-,-r4 �f�fl-�v. ; -- j- - . . _ _ - � - - _ -�---- - -- - - - _� _ _ (l�l �C i MU N�l" -F(�(��Q- - - � - �� i n,�.a�,� w� . 4 _ Wro��- ira,� � -(-r, (o � � - . � q(� ��- I�- . %!`2� � 2' 6 i� j�[ra � „J �i� rl iT� .� i s P�STc�' �. W 1 �'�� r � iz{�� ( 7� G�'> � ,�'j7�i•'`� � C��,' ' �� '° �e, � � o', � � � � 3 AOC��ant to flll in all spaces wilhin heavy EorEer linos anE sign all aOPropriala tleclantions. CITY OF WSTA�SA - P MIT NO. � TRACT NO. ILOT NO. BLDG. NO. , CONSTRUCTION PERMI �'a-/7l � - 9987 I,'�-/,29�81_ 5.00 TL •, - .. - Projec[ Address • TVPE OF CONSTRUCTION � � �, . � `. • : ' ' Owner " .: \ P one ❑ New. Q�ADD ❑.ALTERATION --' " ' " '" - " ' ' 'Atldfe55-- -�- O�REPAIR ❑CONVE0.510N ❑OEMOLISH. . ��ArchlEng: �- - - � License No � � oTHER ZONING REGULATIONS � � DESCRIPTION OF WORK A'P' � ' Address' . . . . . - . - � ZONE PLNG. REF. � COntreCtO( one" - � � ING TVPE OF PERMIT 5E7 Ac 57. ��t'PV LINE Addfess � • ❑'GRADING ❑ FOUNDATIO ❑ STRUCTURAL 51 VqqD - "- ' ' LICENSED � ONT ACT CLARATIO � - �-TENANT O ELECTRICAL �LVMBING ❑MECHANICA �,5ioE v - � - � - I hereby affirm that 1 am Iicensetl untler provislons o( Gharter, 9(com- � RlGHT menUng' wltn s¢ction l000) of Divislan 3 of the Business� entl- �❑ OTHER � REqR VARD (TO P/L) Professions Cotle an y Ilcensa is In (ull force antl effect.- pROJECT DESCRIPTION. - . License lasj� ' Uc,seNo. � �� - � PKG.SPACEREQ. VROVIDED � DatO Si9nature � SQ. FT. . WOR RS' COMPENSATION OECIARA ION - OCCVPANCV�CONSTRVCTION TYPE STREET WIDTH PARK FEE b � har<Cy affirm that I have a cerUficate of consent to selNniuro or,a VALUHTION ZONE ZONING A7PROVED BY DATE tertlfiwte of Workers' CompCnSation Insuronte, or a cmtHiotl copy � � � "' ' SPECIAL CONDITIONS: • � i thermf (Setlion 3800, Lab. C.), GRADING GV. VDS. ACRES 'Icy No. �� Company ' � CBrtlfletl cOPy Is hereby turqishetl. - � ' L qEMAi2K5i ' - - _ . . . _ . J C¢rtlti<a copy IS tilatl with Ihe cily Builtlln9 DlviSion. _, . „ , ; EXEMPTION FROM WORKERS' COMPENSATION DECLARATION '" � ' �-�" ' - - (This 5action neeG not be cort�pleteC. if tho permit 6 for_one huntlretl � _ _, _ ' __ ' . SE300) Or less). � � • _ �< � � ' certify that in the.performan�¢' pf 1he work tor wMch this permit iz ,. _ _ _. Issuetl, 1 shall not employ any person In any manner so as to become PLUMBING� PLAN CHECK � ELECTRICAL - PLAN�CHECK ' - SUD�e<t to tha Workorz' Compensation laws ot Ullfomia.. ' . " ' ,. Date Si9natu�e BATHTVBS SHOWERS - - NOTICE: I! attor makfnq thfs tleclarat(on, you ihoultl Decoma 5ub�oCt TOILETS ,� ' URINALS GENERATOR p.l I(W_ I-10 KW - � ) to tha Workers' Compensation provisions of [ho Labor Cotlo, you mus[ TRANSFORMER • N fortnwitn comply wilh such provisions or thii permit shall De ticemetl LAVATORIES DOVBIE'LAVS APPLIANCE 10-50 KW_50 t'KW � . revOk<4.-. ' _ _ _ _ _ . _ . ' .' ' - = . ._ _ . _. CONSTRUCTION LENDING qGENCV KiT.51NK5 �'DISHWASHER$' MOT00.5 04 HP_1d0 HP, I bereby atfirm [bal thora is a cons[ructlon lentling a9ency for tho per- SERV ICE SINKS -: i' SUMPS -UNC. SOLAR)� �-10-50-HP=50 t HP- - � 1 fOrmantt of the work for whlch thi5 permlt is issuetl (Sectlon 3097 � ^ C1°' �'�' � FLOOR SINKS FLOOR�DR{11N5 F�X7VRES OUTLETS`"SWITCHES - \ �entler's Name __'" __ ' ' .,.'�""' _ ' ' "_ � Lentler'SACtlress DRINKINGFOVNTAlIVS - - - - 'GASTUBESIGNS '-- "' -' " ' �OWNER BUILDER DECLARATION '" ' ' - ' ' ' ' - WTERCEGTORS CLARIF�ERS� - POLE LIGHTS - - " " - ' 1 h¢reby alfirm Iha[ 1 am ex¢mpt from the Gont�dttOr'S License Law fOr t�e totlowing'reason (Sectlon ]031.5"Bu51nes5 antl Professlanz-Cotle:� SWIMMING POOL � P.T0.AP ` � � - - ' - ' ' ' • � � Any dty or county which requlres a permlt to consVutt, altor, POLES METERE� UB - Improve; tlemoll5�'or repair any sVucture, prlor to Its"issuanca, also ro- yyqTER SERV ICE � ALTERATION PANECS MAIN ' SOB . ' pulros the ap4��nt for suth permit ro file a slgnetl statement that ho �' Is Ilcense0 pursuan["[o tno proy�sions'Of tne ConVactor'S Llcenso'Law GASSERVICE OUTLETS � SERVICE - -" - '- AMP - ' (Chapter 9(commen<ing with Settlon 7000) of Dlvlsion 3 of lM1e - - BuSinesS antl'Prolesslons Cotle) or'tnat ne I5 exempt t�erefrom antl Ihe ' y.�qTER HEATERS � BTU OUTPUT " -` -- . "- '''' "5 (or the allegetl exemptlon. Any violaliOn 01 Sectlon ]031.5 by applifantYOr-a permit spD�ettsthe appllrznt co a'Uvll'penalty SEWERCONNECTION n 5/� �ot morE than five huntl/¢tl d011ars (E500). u I, as owner of the Oroper[y, or my employees wlth wages at their� SOLAR TANK �-'-�COLLECTORS - - " - " ' ' -- '"' " SOIC COTpenSdtion,.wi11 GO llle wofk,.dntl the StNclufe i5 nOt.lntentletl_ _ or offeretl for ule. (Sectlon �044, Busine55 antl Rofessions Cotle: The SOLAR PIPING SVS �ISSUE FEE - "` � �. Cantractor's Licensa. Law tloeS.not apply to.an owner of. a property - - "AGPLI�ATION APPROVED BV '�' ' ' DATE' - � wh0 builtls o� improvM Ihe�eOn, antl who tloe5 SUCh wo�k bimsnlf or ISSUE FEE through hi5 Own Cmployeei, prOvitletl lhat such ITprOv¢ment5 a�c not intentic0 or olleren tor saie. if nowever, tne bulltling o� improvement MECHANICAL PLAN CHECK SUMMARV OF FEES � Is.zoltl wlt0ln onayear of mmpletlon,.tna ownor will have.[he burden �._ , . � � 01 proving he tlitl not bulltl or improva for the purpOse ot saloJ. - ' BUILDING ' ' ❑ 1'. 'as owner- of the property, �am exclusively con[ratting with HEATING SVSTEM 0-100,000 BTU PERMIT E ._ _ dSMIP 5 Iicensetl contractors to constrUct the Pro)oct (Section ]044, Businass AND DUCTING 100,000 t BTU PLAN CHECK S PERMIT antl Professlons'Cotle: The Contractor's Lfcunse Law tloes not apO�Y �o - - � ISSVANCE E an owner of proporty who bUiltls or improves therean, antl who ton- REFRIGERATION 0-300,000 BTU PLUMBING E� •' �' '+ tracts 1rom �svch projetts �witp-a contractor(5) Iittsnetl-pursuanF to SVSTEM " ' ' ' - - - - GRADING S � Ine Contractor's �icense Law�. 300,000 + BTU PLAN CHECK , S' - �. - ' � ❑�1 am exempt untler Sectlon '" —� -'B. & P. C(or this" ELECTRICAL S �s BOLLERS BTU � - � � 'reason ' ' -' — ' PLAN CRECK E � ' - � MICROF111N.S SVSTEM REPAIR,ALTERATION � .r Dala � - Owner - - - 'MECHANICAL E � -- - TOTAL FEE'§� � I �ereby.Cerlifylhat.l have reatl (his appliwtion antl state that Ih¢ abOve EXHAUST SVSTEM MULTIPLE ' "^' � I�'1� L•E55 AO-' � -Inlormatlon is coirect.'t-a9�ec fo comply wlth all Nty antl county , - PCAN'GHECK E - -- VANCEPC S_ - � � � Ortllnance5 dnd slate IawS relatlM1g [O cOnstfucllon, antl helGDy autM1O�I20 , C� 1''�� , � ' 'raD�esentatives of thls Nty to enter upori lha above mentlonotl ' � .proDerty. for U P _ _ _ _ /�� s Slgndtura �. Date/�..�.� _ _ ' 1' � . FINAI FEE E Drivers' License ar 55 $ "ISSUE FEE - - - - - - - - - - CMF 0865-46 Wnite-BuilGinq; �nary-Applicant; Pink-Accounling; Goltlenrotl-Assessor CONSTRUCTION AND PLANNIN� POOL & SPA � � . APPROVALS Permit# -, a/7..� Date Inspector pppROVALS . � Permit# �� Date-� Inspector 1. Temporary Electrical Service or Pole �43. Pool & Equipment Location � •- ,--- -• � • � 2. Soi ipe-Un rgrn 44. Steel Reinforcement -- •- -- --� 3. Electrical Conduit Utility-Undrgrn 45. Forms - - 4. Elearical Conduit-Undrgrn 46. Electrical Bonding , - . tee ein orce � 47. Rough Plumbin &'Pressure Test - � 6. Electrical UFER Grn 48. APPflOVAL TO COVER-GUNITE- �- - - . . .---..... _ , _ 7. Footings - 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn ' 57. Backwash Lines P-Tra ❑ Undr rn �� • 10. Structural Floor System 52. APPROVAL TO DECK "-" """ "�" '• '•• 11. Property Sewer Line & House Connection ' 53. Backwash & Rece tor-Final 12. Street Sewer Connection • 54. Heater & Vent-Final 13. Rough Plumbing � 14. Rough Electric-�onduit � �56. Electrical-Final 15. Rough Electric-Wiring � � 57. Solar System-Final ' 16. Rough Heating & Air Conditioning • encing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating � 19. Gas�Pipe•Rough &Test ' • 60. POOL/SPA SYSTEMS FINAL � . -20. Roof Framing � 21. Roof Sheathin NOTES��M�.q�a L � �� 22. Frame and Flashin M�:,J� I" YM9� 23. Insulation � .. 7r 24. Lathing & Sidin 25. Drywall Nailing - ' � - 26. Plaster Brown Coat - 27. Electrical Power Meter-Final 28. Final Electric � 29. Final Heating & Air Conditioning 30. Final Gas Pipe-7est • ` " 31. Final Plumbing 32. Water Service-Final - � 33. Gas Service-Final - 34. Solar pomestic-Final � 35. Landsca e S rinklin S stem ' 36. Sound Attenuation • � � � 37. Handicap Regulations � � � � 38. FINALSTRUCTURE&BUILDING 39. Special Requirements Completed • - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co: 42. CERTIFICATE OF OCCUPANCY _ No.� � Date , . ,, COUNTY OF ORANGE BUILDING DEPT. 636 No. Broadway Santa Ana> California Phone: KI 2-6211 i. OWNER'S NAME. h9AILING ADDRE Name--'-----"'--"-"--- Address .-__'___---_'.. CIty- ------� -----'-'- - State Lic. No. --------------' -- Application for Building Permit AND FOR A Certif�cate of Use and Occupancy (Atthi[ec[ or Enginccr) Phone a� ;� Ciry ----- State Lic. No. Permit No...�N.��-�-'_ -...---- ---- /PH)ONE:.-------q--�---------------- CITY .---1. .�.i,--�'9�-�-"F-------- Phone PROPOSED USE:.�d_'_�.�(.�7�'i(/ ..... __ _.._( . ._ _ --- --- ------ -- - - ---- - - � � - ------------- - --- ---- s - .. ... - - 2. JOB LOCATIOIV.--��Gl..----------- ---'�-�--• �•_/�! ----•--�- -�- ,--------- - �---��'��.�.�.C.�._<r�..------------ ----------- (House No.) (Nnme of Sr.eec) (Town or School District) 3�_ LEGAL DESCRIPTION: Lot ---�------ ------------------------Blodc ---------------------------.---Tract .�I-�I� --- (Metes and Bounds Desctiption—Uee reserse side of form) 4. COR[VER LOT (� INTERIOR LOT ( ) THROUGI-I LOT ( ) SLOPE OF LOT ( ) 5. SIZE OF BLDG.: ��%i.�Q___.AREA:.�G�----��-.SIZE OF LOT:._Ct��.�dlrAREA:�2D� � 6. HEIGHT OF BLDG.:____�__/._._.._______.._______CEILI[VG HEIGHT:__._____________.___._.._.._NO. OP STORIES ........................ 7. NO. FAMILIES of Smailest Bedroom: Size of Kitthen: 8. EXTERIOR WALL CONSTRUC'I'IO[V:.',G.!(!�'..A _�_ "_.INTERIOR WALL COVERING._.____._.________ .................... (Frame, Smtto, Etc.) � (Plasrer-Drywall, Etc.) 9. SETBACKS: Front Yar� from Center Li�c of Street.---- --- -""'"�,�/'-----__'-"_'_'-_"--"_'-----_-'-_'_""__"-"'-"'--'-- / / / / / IVcarest Side Yard.lQ._._.__._...Rear Yard..._ . �istance in Feet Between Bld s on Same Lot._../�.._... ...... 11�----�-------� g . IG. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. .� i r _"-_-----De th in Ground.._L�--._._ --_.Wid�h oE W�tL�� _--.- 11. For (a) Footing: Width.-�y------.--_ p --_- Accessory �� C � Bldgs. and (b) Size of Smds:._2�%Y..__....__.Spacf�g.__._,�G .___.__...__"CC Macerial of Floor...`�..tF./i/.G/� __ Similar -- --- ------'- $trucmres: � (c) Sixe of Ffoor Joists:.-------'---'-_...--'-----`_Spacing .-.---------------'------'----�<CC y �j /� (d) Size of Ra£ters: _..�.11___�---._._""--'_"_.Spacing ---�-l---------------------'_"CC -. � - 12. VALUATION OF PROPOSE • K�nduding all laboq plumbing, clectrical wiring, hea[ing, fire sprinklers, pain[- i ing and sewage disposal $-- � --C-------------'------------- l;. I HEREBY CERTIFY TT-Ir�T TO THE BEST OF MY KIVOWLEDGE AND BELIiF THE INFORMATION IN THIS APPLICATIOF�I I5 CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. Signed Plans I'iled: � ----- -------- -- "-'_----'---- B / Y FEES: Bldg. Pcrmit - Plan Check - Total - '''"�'�� Receipt No. 1 � Paid to - - Date--` ---'---"---------- ��.. � � ------- - �------------- � - ------� ° c �-- a S'� G'7j FOR AL USE ONLY GROUP.._._..._S! - TYP E _-------� ------ ------ DIST. MAP----------��- -- r---- SHEET NO..._.__...�.,�.......... DATE-------------�---/�-- --��------- �M-9-lO � PLANS AZQIT SPEC'S ------------------------- CORRECTIONS VERIFIED .--.-----___--.--.� NG BY h-IEALTH..--------------- -- --- FIRE M A RS H A L.---------------------- STATE.---� �-----------------�---- EIVGINEER PERMIT SSUED Yr. ,� v s � ------------------------ -- -------- -�'~'y -------�- -- • --- G�