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Home My WebLink About970 19TH ST - Building Permitsr'�.. — --- -- .lob Address: 970 W 19TH ST Suite: Vicinity: LIVING ROOM AND BEDROOM Primary Occ: R3 Dwellings/ Cong Res <10 Parcel Number: 42253112 npplicant: BRIGGS, ELDON Address: 970 W 19TH ST Type of Construction: V-N Zoning: -- .Phone: _. 949-650-1432 ISSUED BV: COSTA MESA, CA � `�<-:�,- r� 'Zip � 92627,- ^��,-. ��, -.._ � � - .. Owner. BRIGGS, ELDON Address 970 W 19TH ST - . -�� , . „ � , , - . . . - - . � Phone. . . COSTA MESA, CA - - Zip: _- 92627 � _. �� - � � _ . _ � . ,��.. . , . _ _ Comrador 'OWNER-BUIL'DER•'° �-�' � ��=�r;�� - Address �� , , _� . � _ _. , . � , � , � . ,: � Phone:. . . - . , � � -, .. z�' ^ ' wyf'- " < � , �- Zip: License: 000000 , '� �' - - Arch : � �� Eng: , - ' � Address: - � � Address: � " . _ . . , Phone: . � ..; . � ` Zip: �- '. . e -_ License: - � � Status: ISSUED Applied: 10/OS/2005 Issued: 10/05/2005 Phone:'` License: < �. SCOPE OF PERMIT �` n i -_; :.LEGALIZE WORK DONE WITHOUT PERMITS. CHANGE OUT WINDOWS IN THE LIVING ROOM AND 1�BEDROOM-TO MEET 1997 U.B.C. -EGRESS -'REQUIREMENTS. HEADERS REMAINED THE SAME. ` ' - � � � � a� � . . . ,,.. .. .. .-. a, � � FE�, `R '' ^' E SUMMARY � . N ' `:` Plan Check. $0.00 Calc Valuation $3,aoo.00 � Permit:.�� .$97.25 � � � Clair'riValuation �'°,�, : $3;aoo.00: SMIP Res: �` $0:50 � � ^�r� _ ., SMIP Com� .,, i, $0.00 y: < Other: � �.` $0.00 � � � ...� �� ; .F � - _ - `_ ' ., [e . � ` Inspection: -_ $0:00 �� ,`�� Total: ��$87 75 , , - � `� PLANNING 8 ZONING � . SETBACKS MAIN�STRUCTURE Front ��0?�0� � Rear ° 0-�0 , . Left- 0 0'„�'-. —Right 0='0� .. . ACCESSORY Front 0- 0 � Rear -0- 0 LeR` 0- 0� ��Right �`�- 0- 0` �� PARKING „ e � , _._-_ , ' .. xistin .. 0- Reauired - 0, - - Pr000sed ' �0� � ��" � � _ - _ . .. . . � ,* .. � .. _; a �^ '. : . , . . " , .. .. - .. . . ,:.tx , ' - ' .. . _ .., .,�,,:_'._ �, NO710E: The work authorized by this permit shall comply with all applicable handicap�access requirements under Califomia statutes and related � regulations. (Ord. No. 92-28, § 1, 12•21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inapectlons and final approval must be oblained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zms�as la'ool i WORKERS'COMPENSAnON DECLARAnON: I hereby aHirtn under penalry of perjury one ot the �a�lowing tledaretions: _ ❑ I heve antl vcill maintafn a ceNficate ol consent to setl-Insure for workers' compensatlon, as provlded tor by sectlon 3700 of �he Lebor Code, for Ne peAortnflnce of Ne work lor which ihis permit is issuetl. . ❑ I have arW will maintain workere' compensa[ion Insurance, es requlred by section 9700b1 the Labor Code, foistheRperlormance of� h ivork tor whidi Ihis permit La issued. My workers' compensation Insuranca card6r end policy num6er ere: s�', y y.� jt, �-, _. l,. �! � Certier: '$ � POIIcyNumber. �•��r`1 (TAis section need not be completed i/ fhe perml! Ls ✓elued et one hundred dWlars ($100)� less.) � �:,' �;,y ,�,d �. . ❑ I cartily that in the pertortnance ot the work tor w�ich Ihis pertnit is issued, I shall not employ eny person in eny manner so es to become subject to the workers' compensetion laws ot Celifomia, end egree ihet if I should become subJect to the warkers' compensetlan praWsions of Section 3700 of [he Labar Cade, I shell ionhwith comply with Ihese provisions. Applicant Slgnature: Date: WARNIN(3: FNLURE TO SEWRE WORKERS' COMPEN�nOPo COVEMGE IS UNUW FUL ANU SMALL SUBIEGT Ml EMPLOVER TO CRIMINAL PENALTIES AND GVIL FINES UP TO IXJE HUNDRED T/IOUSAND OOIJ.ARE (5100,000). IN AODRION TO THE CQST OF �MPENSATION, DAMAGES AS PROVI�ED FOH IN SECiIIXJ 3708OF TME UBOR CODE, IMEREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirtn that I am licensed under provisions of C�apter 9(commencing with Section 7000) of DiNsion 3 of the Business and Professions Code, and my license Is in full torce antl eNect Lic. N Gess a ConireqoYs Signature: Dete: CONSTRUCTION LENDING AGENCY: �I ❑ I hereby aK�m t�at there is a construction Ianding agency for Iha pertortnance of Ihe work tor which this pertnit is iuued. (Sec. 3097, Civil Code). � Lendefs Neme: Lenders Address: Signeture: Date: OWNER•BUILDER DECLARATIONS: I �ereDy elilrtn that untler penelry of perjury Ihe� I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Pmtesslons Code: Any ciry or counry which requires e permit to construct, elter, improve, tlemolish, or repair eny slructure, prior �o ils issuance, also requires the epplicanl for such pertnit to file e signetl atetement that he or she Is IlcenseG Dursuent to the provisions of the Contractors License Lew (Chepter 9(commencing with Section 7000) oi Divislan 3 af the Business entl Profeuions Code) or thet he or she is exempt therefrom end tha hasis for the elleged exemption. Any violetion of Sectlon 7031.5 by eny epplicent for e pertni� '��u jects the eppliwnt to a cNil penalry ot not mote than five hundred dollers ($500).): . as owner of tha property, or my employees with weges es their sole compensatian, WILL DO THE WORK, end the structure Is not intendetl or oHered for sale (Set. 7044, Business and Professions Code: Tha Contrectors License Lew does no� apply �o an owner of p�operry who builds or improves Ihereon, end who tloes such work himself or hersetl or Ihrough his or her own employees, provi0etl ihat such improvements ere not Intended or ottered for sele. If, howaver, the builtling or improvement is soW within one year of completion, ihe ownarvbulWer will heve the burden W provi� lhat he w she did not buiW or improve ta purposa of sale.}. ' ❑ I, as owner of ihe properry, am E%CLUSIVELY CON7AACTING WI7H UCENSED CONTRACTOfiS to consWct the project (Sec. 7044, Business entl Professions COAe: Tha contractars License Law tloes na� eppy ro en owner o1 property who bullds or improves Ihereon, entl who conirecls lor such pmject wlth e comrector(s) _�jce�se pursuant to the Contractors License Lews.). by ❑ No Business and Professions Code tor ihis reason: Vedflcation of Ownership by (rype of document, I.e. - property tex bill ar OIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certity that no excevation five (5) o� more feet in Aepih into which a pereon is required to tlescend, wlll be made in connection with work euthonzed by t�is pertnit, end Ihat no building s�ruciure, scaHO�ding, falsework, or demolition or dismantling ihereof, will 6e more Ihan Ihirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Califomia Administretive Cotle)� ❑ As owner-bullder, I will not employ enyone �a do wark which woultl require e perml� from iha Dlvislon of Industriel Safety, as natetl ebove, unless such persan has a permit to tlo such work from ihe division. Signature: Date: Division of IndusMal Safery Pertnit Numbec CERTIFlCATE OF COMPLIANCE AND AUTHORILUION OF EMAV: I certity under penelry of perjury that I heve read this application entl state that the informetlon given Is correct. I agree to comply with ell state lews entl city ordinences releting to building constructlon, and euthorize representatives of the City of Costa Mesa to enter upon the ebove-descnb�tl Qrope{ty,for�nspection puryoses. I agrea not to occupy or allow occupancy oi any building euthoriza by tpis perryit �ntil final inspectlon. ! /7 /!.l c'� E :i E1i// / � S � l � �tuie,gl Legal Owner(s) _ � iDate �• �• _ ��. Antl/Or Authonzed Applicant �L1 Date COOE I. QfSVECTIONTYPE 1616 Fixed System Final Fire Preventlon 7266 Pool Spa Final 200 Finel RaRoof 201 Flnal BIocWRetaining Well 202 Final Factory Fire Place 203 Finel Sign 204 Pinal Demolition - PAIf INRMLS COOEI INSPECTIONTYVE 206 Finel Mechanical 20B Finel Plumbing 270 Final Electriwl 212 Final Flre Prevention 220 Flnel Planning Approval 222 Flnal Site 250 Final Building/Occupancy PAIE 3 �-a(o 1�� (7t4) 754-5273 • Fax (714) 754-4856 • www.ci.costa•mesa.c�ILDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 .lob Address: 970 W 19TH ST Suite: Vicinity: GARAGE, KITCHEN AND DINING ROOM Primary Occ: RE Type of Construction: V-N Parcel Number: 42253112 Zoning: Appliwne BRIGGS, ELDON Atldress: 970 W 19TH ST COSTA MESA, CA . � Owner: BRIGGS, ELDON Address 970 W 19TH;ST � . � . COSTA MESA, CA . 4 Contrectoi:"�OWNER-BUILDER ,' Address: � . � . . Zip: �, ,€, Arch : Address: Zip: ' � ,��Phone: �"949-650-1432 � - � _ Zip: 92627 ... _ r. Slalus: ISSUED Applied: 12/OB/2005 Issued: 12/OS/2005 ISSUED BY: . � ' � Phone ' - � - Zip: 92, � e.. � Phone: ,License: 000000 Phone: � c�..:,.-, , - . License: �� - Eng: Address: Phone: � License: SCOPE OF PERMIT �� .`�DRYWALL WORK:FOR.FIRE DAMAGE REPAIR TO GARAGE, KITCHEN, DININGROOM AND CEILING FOR:SFD. , ',,�� , � � ^ " �. ` FEE�SUMMARY� _ � ; ` Plan Check: $0.00 _ , , Calc Valuation: , ,. $s,7oo.00 ,' Permit - $97.25 � '" ' � 4 Claim Valuation: ,, $3,�oo.ao SMIP Res: ' '$0:50 ` SMIP Com: $0.00 � a, . � � Other: $0.00 � � , ` ' Inspection: � "'$0.00 ' ` Total: . $97.75 � � � � PIANNWG & ZONING SET,BACKS MAIN STRUCTURE� Front 0. 0 Rear � 0. 0 Lek 0- 0�, Right ACCESSORY Front ..0-0 - Rear- 0-0 - Lefl 0-0 ., �Right . PARKING �� , Existina: �. o ''.Required. 'p:.`' �� ..', Pr000sed ``'o . o- o 0- 0 � . . NOTICE: The work authorized by this permit shall comDly with all applicable hantlicap 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 1B0 days, or if work Is suspended or abandoned tor a period of 180 days. ' INSPEC710NS: tn order tor the woAc euthodzed urtder this permii to be wnsideretl legal, auch work must comply with all applicable codes, and aA r�qulred Inapeetions end flnal epproval must be obtained. Failure to obtain inspections and tinal approval wili result in ihe expiration of this permit. . FOR INSPECTIONS CALL: (714) 754-5828 �Ln:r:lf•'i� ill WOAKERS'COMPENSAnON DECLARAnON: . , , ' ' , � -� I hereby aflirm under penalty of perjury one of the tollowing declaraiions: ' � ' � " ❑ I �eve antl will malntain a certificete of consent to selt-Insure for workars' compensatlor',�as'pFovlded for by sectlon 3700 of Ihe Lebor Code, lor the performence ot,�he work tor which t�is parmit is issued. � SBCflO/I itl mainlain warkers' compensation Insurance, as repulred by sectbn 3700 of Ne Lebor Code, for the peAomiance af Ne work for whlch Ihis pertnit is 45.wed. compensation Insurance carder enC policy number ar��: —� � J':�z, " ' O/IB of I655.J rtify t�at fn the peAortnence al ihe waric tor w�ich this peimil Is issued, I shall not employ eny persan in eny menner so es to become subject ta ihe workers' ' ' mpensatlon laws of Celitomie end e9r thet If I should become sub�ect to the workers' compensetion provislans o1 Sacti 3700 ot the Lebor Code, I shall forthwlth comply vrith these provisi //�/ �' `� � qpPlirant Signa4ue:• �// �� .l Date: / l 5 _ WqpNING FAILURE TO SECURE WORKERS' COM SAT COVEFAOE IS UNLAWFUL M1D SHAllSU&IECT AN EMPLOYERTO'CNIMI PENA IES AND CIVIL FlNES UP TOIXJE HUNDRED TFpUSAND DOLLARE (51 W,000), IN ADdT10N TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEGTION 3]O60F THE 1A80R CODE, IME`iEST, M1D A7TORNEI"5 FEES. LICENSED CONTRACTORS I hereby atlirtn 1 em licen under provisions ol C�apter 9(commencing wi�h Section 7000) ot Dlvision 3 oi Ihe Busift9ec.dnd Professfons Cade, end my license Is In full force antl effecC Lic. �less.b -- ��. Cont Icre ors'Sign�: Date -.�--�y° ' � r""`-_ : . ! �- CONSTRUCTO LENDING AGENCV: �� ❑ I �ereby ettirm that there is e consiruction lentling agency tor Ihe peAormance ol the work lor w�ich this permil is issuad. (Sec. 3097. Civil CoAe). Lenders Name: Lenders Address: S{gneture: Date: OWNER-BUILDER DECLARATIONS: ' -.� � I hereby eflirtn lhalunder penalry of pe�ury that I em EXEMPT FROM THE CONTRAC70R5lICENSE LAW for the tollowing reason (Sec. 7031.5, Business end Professions Cotle: My ciry or counry whiU requlres e pertnit ro conswct, alter, Improva, tlemolish, or repair any strucWre, pdar ro its issuanca, also requires the eppliwnt for such permit to tile e signe0 slatement ihat he or she Is iicensad pursuam,to the provisions N the Contrectore License Law (Chepter 9(commencing w�ih Sectlon 7000) af DMslon 3 N the Busi�eu flntl Pmfessions Code) or that he or she fs exemptiherefrom and �he basis for Ihe allegeC exemption. Any Wolation o1 Sectlon 7031.5 by any apDlicant for e pertnit sub�ecis ihe eppllcent ta e civil penelry of not more then fiva hunAred dollars ($500).): �'� I, as owner ot the pmperty, or my employaes wlth weges es iheir sole compensation, WILL DO THE WORK, antl ihe siructura Is not intended or oftere0 for sele (Sec. �ti 7044, Business end ProtesSions Code: The Contraqors Ucense Law does not epply to an owner of property who builds or improve5lhereon, and who tloe9 Such work himself or herself or through hLq or her own employees, provided that such Impravemenis ere not intended or oNered tor sale. It, however, ihe Duilding or improvament is sold within one year ot completlon, the owner-builder will have ihe burden ol proving that he or she tlid �ot build or imD�ove for purpose of sele.). ' ❑ I, as owner of Ihe property, am EXCLUSIVELV CONTRACTNG WRVI LICENSED COHTRACTORS to construct the project (Sec. 70A4, Business and Professions Code: The comrectore License Lew does not apply to an owner of propeny who builds or Improves thereon, end who contrects tor such pm�act wNn a contractor(s) license pursuent I�yha Cyptwctors Licensa Lews.). lam Business and Profassions Cotle for Ihis reason: Owner ID verifiea by tlrivefs IicASs'e. � ❑ Yes ❑ No Vedflcation of Ownership Gy (type of documem, I.e. - pmperty tax blll or DIVISION OF INDUSTRIAL SAFETY PERMR CER7IFICATION: ❑ 1 here0y certity ihat no excavation tive (5) or more feet in Oepih Inlo which e person is requiretl to tlescend, wlll be made in wnneclion with work euthorizetl Uy thi9 permiL and that no building swMure, scallolding, talsework, or tlemolition or Cismantling thereol, will be mare Ihen ihirry-six (38) teet high. (Chap. 32, Grp 2, An 2, Sec. 341, Title 8, Celifomie Atlminl9trelive Cotle). ❑ As ownarvbuilder, I wi11 not employ srcyon0 to do work which wou1C require a permit irom ihe Division of Industrial Satery, as noted ebove, unless such person has e permit to do such work from lhe division. SignaNre: Date: DiviS�on of Indusinal Safety Permit Number: CERYIFlCATE OF COMPUANCE AND AUTHORIZAiION OF ENTAY: I certify under penalry of perjury ihat 1 have read this appliceUon and state that the inlormatlon given is corre��. � agree to comply with all stete laws end ciry ortlinances relating to 6uil0ing conswcUan, enU authodze representaUves of the Clry ot Coste Mesa to enter upon the ebova-tlescribed pr=erj�or�s ction uryoses. I egree not to acupy or ellow occupancy of eny building euthodzed b� Ihi�it until � I in�ction. ---�-61 sign :LeDal Owner(slY-�..,� °---=-.••�'^.-=�,r�,-�"� � r Gl De ✓`� � >�-.:F. AnNOr Aut�orizeU Applicant Date COOEG INSPECTIONTYPE 1678 Fi:ed System Final Fire Prevention 1268 Pool Spe Final 200 Final Re-Rooi 201 ;Final Block/Retaininq Well 202 Final fedory Fira Place 203 Final Sign ppq Final Demolitlon' ' � �. � �a INSPEG710NTYYE 206 Final Mechanical 208 Finaf Pl�mbing 210 Final Electrical 272 . Flnal Fire Preven�ion 220 Final Planning Approval � 222 Final Site � 250 Final Buil ing�Occupency � (714) 754-5273 • Fex (714) 754•4856 • www.ci.costa-mesa.ca.us 77 FAIR ORIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job AddreSs: 970 W 19TH ST Suite No Vicinity; Parcel Nunmber: 42253112 Applicant: BRIGGS, ELDON Address: 970 W 79TH ST . -. _ j� COSTA'MESA; CA� " _, � �� ' � - ISSUED BY: Phone: 949-413-6442 � `� Zip � 92627 � . � '� � /� � � � Owner: BRIGGS, ELDON =. � � Addr�ss��= 970 W 19TH-ST- ; �'- � -� � /i,! % �, , � � � COSTA MESA; CA � ��i� , ��/ �./ Convactor. ' ON/NER-BUILDER 'Address: � �� ' , � � � . Phone: Zip: 92627 � � . , ;;�_. � �'Phone: i. Zip: -.. - .. License: 000000 .` Status: ISSUED Applied: 01/06/2005 Issued: 01/06/2005 `. .� ' ' � A � ,'�"',` �� ` ✓ ;SCOPE OF P_ERMIT;' :l;;" •� -` �� ELECTRICAL WORK TO-INCLUDE:`REPLACE 200 AMP�SERVICE PANEL`� �� 07/1?105 REVISED: REPLACE 20 LIGHT FIXTURES, 35 OUTLETS, ]S�SWITCHES AND 20 DEDICATED CIRCUITS. REWIRING S.F.D. ,�� FEE SUMMARY,�; � ,�` " ' ' � � Quantity ,' Quantiry> ISSUEFEE � $23.50 TempDistSystem-/lighting '$0.00 0'� % ,', Temp servicE test � � $0.00 Busway /100 ft �' S0.00 .0 - ' � Res. a/c package � �� , $0.00 � � � -. Standing Section �$0.00 ;0� � �� „ , New Res (1-2�unils) � � `�� $0.00 : 0 -; �r'�� MiscElectrical Equipment E0.00 „��0 `� � ; � � New Res, (3+units) ',��$0.00 0 �`�% ✓�� " � TransfoiPners up�to t kva/kw 50.00,' �� 0 , Pool / Spa � - A $0.00 0 �'- ' � � � - . ...,up to 4 0 kva/kw 50.00%% 0 � , , . - . ..:,....... _ Lighting Fizts�-,. - $22.00� J ?.�2p.; �. �� . � :..............up to 50 kva/kw "i�z.. `30.00' 0 " � ;. � Recept Outlets- �� ,' � $47.55V�` �55� , � ' ... ....up to 100 kva/kw 50.00 - - 0 , Switches � ��$16.50� V'� 15 �� ..".......over100kva/kw�-,.�$000� %,0 �: ; Non Res Appl �� ; $0.00 � � �0`_ � � � � . � � Low Voltage Equipment � ��' $0 00 `�� 0 . - .' Re5 Appl V �� -$0.00�,.. �-0�� ' Low Voll Wiring System / Ckt .-� $0.00;� 0, "- �� Service to 200a A,� ��:, � $30.50 / , � i - . - _ _ " . Misc.- Coriduit-� .= � ' �. . "50.00- , 0 ' Service to 1000a � �� a0.00 � i � ' 0,� ' Misc. Conductor . - ' \ $0.00 � � ;' 0 - Service over 1000a � �'�$0.00 � �. ��/ . 0 � • i- � , Ciras ( gen or ride)' �, ` '. � "$O.00I'. � �, 0 Motors to 1hp ��$0.00;�- "' 0 � � , � � �Circus:(mech ride or IigNts) ,-$0.00 � 0 Motors to 10hp $0:00 -- � 0� , � CFiristmas Tree Stand-� �" $0.00 0 Motors to 50hp $0.00 � � - 0�_ -- ' ` � �� Fireworks Stand ; -'$0.00 0 ' �� T� Motors to 100hp $0.00 � �--�0 � � � ..OthecElectriral"Fee'' $0.00 Motors over 100hp $0.00 0 - ' - - '� � �' � � - Communication tlrops $0.00 0 -�� Investigalion Fee $0.00 Sub panel to 200a 50.00 0 Plan Check Fee 50.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulatlons. (Ord. No. 92-28, § 1, 12-21-92) ' EXPIRATION: This permit shall automatically ezpire and become void it 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 Inspectlona and finel approval must be obtained. Failure to obtain inspeclions and final approval will result in the axpiration of this permit. � FOR INSPECTIONS CALL: (714) 7545626 zaae�ae laroo) WORKERS'COMPENSArON DECLARATON: I hereby elfirm untler penelry of perjury one oi Ihe tollowing tlecleratlons: ❑ I have and will melntein e certifiwte ot consent to self-Insure tor workers' compensellon, es pravided lor by section 3700 ot the Lebor Catle, for the perlormance of the work for which this Permit is iuued. ❑ I have and will maintain workers' compensatlon Insurance, es requlretl by seclim 3700 of the Lebor Code, tor Ihe pBAortnencB ol the work for which this pertnit is iswetl. My workers' compensatian Insurance cerrier end policy number ere: Cartier: Policy Number. (Dds section need nof be comp/eted I/ the permit is valued et one hundred tlollers ($100J or less.f I certity that In iha perfortnance of the work for which this pertnil Is issued, I shell not employ eny peroon In eny manner so es to become subject to the workers' compensetlon IewB ot Calltamla, end epree Ihat if I shoultl become sub�ect to ihe workers' compensetlon provislons ot Sedlon 3700 ot the Labor Code, I shall forthwith compty wiU ihese provislons.{ �J�) � ,�r –7 � U :ent SlgneNre:- C '�� N �—Date: _�/l � 'dN0`FAILLRE TO SEa1RE WORKE0.5' G�DMPENSA ON CO�ERAQE IS UNLFWFUL ANO SHRl1 SUBIEGT AN EAIPLOYER TO CRIAUNAL PENALTES PND CML FlNE$ UP TO ONE HUNDRED :nun m � aac n�m.OWI. IN FODRION TO THE WST OF COMPENSAT70N. DMIACaES AS PiiOVIDED WR IN SECf10N 3�080F TNE LABOR CODE, INfEREST, AND ATfORNEVS FEES. LICENSED CON7AACYORS DECLAFiATION: I hereDy aHirm thet � em Ilcensed under proNslons ot Chap[er 9(commencing with Sectlon 7000) of Divislon 3 of ihe Business and Prolessions Code, end my Ilcense Is In tull torce ene ettact. uc. a class a ConVacto{s Signature: Oata: CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm ihaf�here is e consimctlon lending agency for the pedormanco of ihe work for which this permit is issued. (Sec. 3097, Civil Code). LenEeYs Name: Lendefs Address: Signeture: Dete: OWNER-BUILDER DECLN�ATIONS: I hefeby effirtn Ihet un08� penelty of pe�jury thet I am El(EMP7 FROM TME CONTAAC70RS LICENSE LAW for Ihe fallawing reeson (Sec. 7031.5, Business end Profession9 Code: My ciry or counry which requlres e Dermit to conslNct, elter, improve, tlemolish, or repair any struc�ure, prior to its issuance, elso requires the epplicem for such permit to Nle e signetl statemen� �hat he or she Is IlcenseG pursuant to the provisions of the Cantrectors License Lew (Chepter 9(commenGng with Section 7000) 01 Dlvlsi0n 3 of the Business end Professions Code) or tha� he or she is exemp� theretrom entl t�e Desls ior the elleged exempNon. Any violation of Secdon 7031.5 by any epplicent fo� e pertnit subJects the epplicent ro e cfvil penalry of not more Ihan tive huntlretl tlollers ($500).): ❑ I, as owner of the p�aPeny. or my employees wiih wages es Uelr sole compensation, WILL DO THE WORK, entl the structure is not intended or otteretl for sflle (Sec. 7044, Business end Professions Catle: Tha Contractors llcense Lew Oces not apply to an owner of properry who bui105 or Improves iheraon, and who does such work himseli or herselt o� through his or her own employees, provitled that such improvemenis are nat intendetl or oNered for sele. II, however, ihe 6ulltlinp or improvement is soltl within one yea� of completion, the owner-builder will heve Ihe Durden of provinp t�at he or she did no� builtl or improve for purpose at sele.). � ��I, as owner ol the properry, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consWc� Ihe prolec� (Sec. 7044, Business and Professians r�"Cotle: The wnirectors Ucense Lew does not epply ro an owner ol property who bullds or Improves therean, entl who contracis ior such project wit� a contractor(s) licen5e pursuant to �he Contractors License Lews.). ❑ I am exem t O� ec. Busineu and Professions Cada tor this reason: 0 �J Signeture: -�' _Y _ 7! P � � Owner ID veMetl by tlrivefs license. Yes ❑ No rOrive7s License' No:� � Vediicetion of Ownershlp by (type oi tlocument, I.e. - property ta: bill or tlee�:^"�"J�M DIVISION OF INDUSTRI�L SAFETV PERMIT CERTIFICATION: ❑ I hereby cartity thet no excavefion five (5) or more feet In depth into which a person Is requlretl to Cescend, will be mede in connectlon with work euthorized by this permit, antl Ihat no building structure, sceftoltling, falsework, or tlemdition or tlismentling thereoi, will be more Ihen Ihirry-slx (36) feet high. (Chep. 32, Gry 2, Art 2, Sec. 341, Tille 8, Caliiomla ACmIniSlrelive Code). ❑ As owner-Dulltler. I will not employ enyone to do wo�k which would require a permit from ihe Division of Industrial Sefey, es noted ebove, unless such person hes e pertnit to do such Work irom the tlivision. SignaNre: Date: �ivisian of lndustriel Sat�ly Pertnit Number: CERTIFlCATE OF COMPLWNCE AND Alli}10HQATION OF ENTRV: I certiry under penalry of perjury Nat 1 have reatl this epplicetlon anG state [hat �he Infortnalion gNen is cortect. I egree to comply wit� ell state laws entl dty ordinances releling to building construclion, flntl authoAze representatives of Ihe Ciry of Cosla Mese to enter upon the above-describe�qr�pe f r inspection purposes. I agree not to occupy or allow occupenry of eny building euthonzed by ��h/is permit un il final ins ian. C �l l� /J�2�0� � I natureOt.LepalO_ woer(s) �- �"'�. Date "� _`—�> Mtll�r Auttwrized Applicant Date COOE I. INSPECTIONTYPE 1676 Fixetl System Final Fire Prevention 1266 Pool SDe Final 200 Final Re-Roof 201 FInaI BIacWReteining Wall 202 Final Fectory FIr9 Plece 203 E�� Flnal Slpn Final Demolition aeiE I�e� CO�E I Itl5PEC710X TYYE 206 Final Mechanical 208 Flnel Plumbinq 210 Finel Electncel 212 Final Fire PrevenGon 220 Flnel Plenninp Approval 222 Flnel Site 250 Finei BuOdlnyOccupency �g 1�� 1 . A� (714) 754•5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Viciniry: Parcel Nunmbec 970 W 19TH ST 42253112 App�irane BRIGGS, ELDON Address: 970 W 19TH ST COSTA MESA, CA Owner: BRIGGS, ELDON Address 970 W 19TH ST COSTA MESA, CA Convactor: O W N E R-BU I LDE R Address: ISSUE FEE Temp service test Res. alc package New Res (1-2 units) New Res (3+units) Pool / Spa Lighling Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Servfce over t000a Motorg (p 1hp Motors to tOhp MotorB to SOhp Motorg to 100hp Motors over 100hp Communicatlon drops Sub panel to 200a Pole Light Pkg Sign Circuits ELECTRICAL PERMIT Phone: 949-413-6442 Zip: 92627 Phone: Zip: 92627 Phone: Zip: License: 000000 SCOPE OF PERMIT ELECTRICAL WORK TO INCLUDE: REPLACE 200 AMP SERVICE PANEL. 523.50 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 330.50 $0.00 50.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantiry 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway /700 ft Standing SecUon Misc Electrical Equipment Transformers up to 1 kva/kw ..:.............up to 70 kva/kw ..........:.:. :.up to 50 kva/kw ..............:..up to 100 kva/kw ..................over 100 kvalkw Low Voltage Equipment Low Volt Wiring System ! Ckt Misc. Condui[ � . , Misc. Conduclor � Cimus ( gen or ride) Circus (meth ride or lights) , Chnstmas Tree Stand\ Fireworks S�and � Other Electrical Fee . Investiga6on Fee - Plan Check Fee� " " � Reinspection Fee Status: ISSUED Applied: 07/O6/2005 Issued: Ot/06/2005 ISSUED BY: Quantity 50.00 0 ao.00 0 30.00 0 50.00 0 50.00 0 30.00 , 0 50.00 0 50.00 0 30.00 0 50.00 0 50.00 0 $0.00 0 50.00 0 50.00 0 50.00 0 50.00 0 $0.00 0 $0.00 50.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all appllcable handicap access requirements under Calitomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRpTION: This permit shall automatically expire and become void if work Is not commencad within 180 days, or If work is suspended or abandoned for a period of 1B0 days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work musi comply with all appttcabie codes, end all requlrgd Inapectlone and finel approvel must be obtained. Failure to obtain inspections and tlnal approval will result in the expiration of lhis permit. FOR INSPECTIONS CALL: (714) 7545626 2aa6d6(6q0) WORKERS'COMPENSAnONDECLARAnON: �I hereby eNirm under penelry ot perjury one of ihe followinq tleclaretlons: ❑ I have end wlll maintaln e ceRificete ot consent to sell�lnsure for warkers' compensetion, es provided for by sectlon 3700 0l the Lebor Coae, lor the peAormence ol the work far whlch Ihis pertnll Is IssueO. ❑ I heve end wiil maintein workers' compensetlon Insurence, as requlred by section 3700 0l the Lebor Cade, far the pedortnence of ihe work for wNch this permlt Is Issuod. My workers' compenseilon Insurence carrier antl policy number ere: Certier. one or less.) Polky Num6or: :,��cenify t�at in Ne peAortnance of the work lor wMch thls permit is Issued, I shell not emplq any person in any mannor ao es to become suD�ect b the workers' compensetion laws ot Califomla, and egree that It I should become sublect ta the workers' compensatlon provisions of Sectlon 3700 ot Ihe Labor CoOe, I shell lonhwlth comp�wlt� t�esa proNsions.� ,e �"� V!�b lo�� / Deta WARNIN(i: FAILURE TO SEGURE WORKERS' CdAPENSA710N COVEMGE IS UNLAWFUL AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE HUNDRED TIIOUSMIO DOLJ.ARE (5100.000),IN A�DRION TO THE CO6T OF COA/PENSATIIXJ, DAMAGES AS Pl70VIDED FOR IN SEGfION 3706OF TNE UBOH OODE, IMEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATON: I nereEy eMrm that I em Ilcensed under provisions ot Chapter 9(commencing wilh Section 7000) 01 Divislon 3 at the Business and Professions Cotle, antl my Iicense is in tull force entl eflect. Llc. a Class a Contractars Signature: Date: CONSTAUCTION LENDING AGENCV: ❑ 1 hereby attirtn that there is a conswction lending agency for ihe pedortnance ot the work br which Ihis pertnit is Iuued. (Sec. 3097, Civil Code). Lentlel9 Name: Lentler5 AddreSs: ' Signature: Date: OWNER-BUILDER DECLARATONS: I hereby attirtn that under penalry ot per�ury thet I am EXEMPT FROM THE CON7RAC70RS LICENSE LAW for the lollowing reason (Sec. 7031.5, Business entl Professlons COOe: Any dry or county which requires a pertnit to conslrucl, alter, improve, demolish, or repeir eny SlrucWre, pnor to its issuence, also requires the epplicant tor such permit to file e signed stetement thet he or she is Iicensed pursuent b the pmvlsions of the Comractors Ucense Lew (G�epter 9(commendng with Section 7000) ot Dlvision 3 ot �he Business antl Prolessions Code) or that he or she Is exempt t�eretrom end the besis tor the ellepetl exempUon. My viWeUon ol Sectlon 7037.5 by eny epplicent far e Oermit subjecis Ihe applicent to e GNI penalry ol nm more than tive huntlred Oollers ($500).): ❑ I, es owner ot the pmperty, or my employees with weges es Ihelr sole compensation, WILL DO THE WORK, antl the aWcture Is nm Intended or otteretl for sale (Sec. 7pM14, Business end Protessions CoCe: The Contractors License Lew does not apply to en owner ol property who builtls or improves ihereon, and who does such work himself or herselt or throug� hIs or her own amployeas, pmvidad Ihet such imprwements are not Intended ar oHered lor sale. If, however, the builtling or Impmvemem Is soltl wit�in ane yeer ol completion, the owner-builtler will have the hurden ol proving ihat he or sha did not build ar improve tor purpose o1 sale.). ' ^%s owner ot the property, em EXCWSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe pro�ect (Sec. 7044, Business end Pratessions Cotle: The croniractors License Lew Coes not eppry to en awner of pmpeny who bullds or Improves Ihereon, end who comrects br such pro�ect wlih e contrector(s) license pursuen� to Ihe Contractors License Lews.�. Business end Pmlessions Coda tor this reeson: �er ID verifled by ddvers lic�nsa. ' Yes ❑ No Vedfication ot Ownership by (type ol docu e .e. � property tax blll DIVISION OF INDUSTRIAL SAFETY PERMI� CERTIFICATION: ❑ I hereby certity thet no excevatim five (5)�ar more feet in tlepth into whic� e person is requlred to descend, will be made in connection with work euthorized by this pertnit, antl thet no Culltling structure, scaHoltlinp, lelsework, or demolitlon or tlismantling thereol, will Ee more than thlrty-six (36) feet hiph. (Chep. 32, Gry 2, Ar12, Sec. 341, Tltle 8, Celilamia Administrative Code). ❑ As owner-Duilder, I will not employ anyone to tlo work which woultl require e permlt Irom Ihe DMsion of Industrial Selery, es noteA ebove, unless such pereon hes e permit to do such work Irom the divlsion. Signeture: Date: Division oi Industrial Safety Pertnit Number: CERT1FlCAiE OF COMPLIANCE AND AUTHORVA710N OF ENTAY: I cenily untler penelry of perjury that I hava read thfs flpplicatlon end state that the intortnation gNen Is conecc I egree to compy wit� ell state laws end clty ortlinances relating lo bullding construdlon, end euthodze re0�esematNes oi the Ciry ol Casta Mese to enter upon the ebove-des bed operty tor inspection Durposes. I egree not lo occupy or ellow occupancy of any building authorizetl by this permit until finel inspection. %� �j��. a� !a� joy--., Signat e.Of.l.ega40w�(s)-,—..�.7 —� Da cooe �. i616 Fixetl Syst Finel Fire Pi 1266 Pool Spe Fi I 200 Finel Re-Roo 201 Final BIocWRe ' ' Wall 202 Final Factory Fir ace 203 FinalSign 204 Final Demolilion P�I& 11��$ �� INSVFCTIONTYPE t 206 Final Mechanical 208 Final Plumbing 210 ' IXrlcal Preventlon 222 Final Site 250 FinalBuildinyOccupency QLIE It�LS �na� ioa-azi� • rex pta� �5qoe56 • www.cl.costa-mesa.ce.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber. 970 W 19TH ST 42253112 npp�icant: BRIGGS, ELDON Address: 970 W 19TH ST COSTA MESA, CA .. -�Phone: � °. . � .�� `-��"-.Zlp "92827 � . ". ' Owner. BRIGGS, ELDON Address 970 W 19TH ST ' ,_ _ � �� . � . . , Phone: COSTA MESA, CA � Zip: 92627 Contractor: O W N ER-BU I LD E R Address: Phone:- Zip: License: 000000 SCOPE OF BERMIT TEMPORARY POWER POLE W/METER. - � ' � FEE SUMMARY ISSUE FEE Temp service test Res. alc package New Res (7-2 units) New Res (3+uniLs) Pool / Spa Lighting Fixis Recept OuUets Svritches Non Res Appl � � � Res Appl Service to 200a , Service to t000a Service over 7000a Motors to 1hp - MolorS to 10hp Motors to SOhp Molors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0;00 30:00 50.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 .50.00 $0.00 $0.00 50.00 30.00 $0.00 $0.00 $23.50 Status: ISSUED Applied: 07/26/2005 Issuetl: 07/26/2005 % ISSUED BY: �uantiry � - . Quantity' .:�.. ,� . �- � � . .- ...... , Temp.Dist System / Ughting $0.00 0 . . �� - � Busway /100 ft 50.00 0 Standing Section 50.00 0 0 Misc Electrical Equipment 50.00 , 0 0 Transformers up l0 1 kvalkw 50.00 0 0 ................up to 70 kva/kw $0.00 0, 0 �� -� � .................up to 50 kva/kw $0.00. 0 _ _, . 0 •��' ....:....�.... :up to 100 kva/kw 50.00 0 ` 0 s. ;;;� ' - � ...^......;...' ...OJer 100 kva/kw - $0.00 � 0 „'. - 0 ;. �- 3 • � . Low Vollage Equipment ,_ �- .,, � .. 50.00 0 ,- � 0 �� ' . � �� Low Voll Wiring System / Ckf - �50.00 0 � 0 �� ' Misa Conduit 50.00 0 ; 0 �� - --- Misc..Conductor � - .� , 50.00 0 � , 0: �� Circus ( gen or ride) , 50.00� 0 � � � 0 - ' � �' � � � Circus (mecfi nde or lights) 50.00 0 � � : 0 � - --. Chrislmas Tree Stand � ' 50.00 � 0 - 0 ' ' - Fireworks Stand ' � 50.00 � 0 " 0' � . . � ' Other Electrical Fee � S0.00� �. .0 - . . , . . - . . 0 �-� . � �Investigatlon Fee � 50.00 � 0 -� . Plan Check Fee- . 30.00 0 � - . � � Relnspection�Fee 80.00 0 1 TOTAL CALCULATED FEES 547.00 NOTICE: The work authodzed by ihis permit shall comply wlth all applicable hendicap access requlrements under Calilornla statutes and related i regulations. (Ord. No. 92-28, § 1, 12-21•92) �� E%PIRATION: This permit shall automatica�ly ezpire and become vold if work is not commenced wflhin 7B0 days, or it work Is suspended or abandoned I tor a peAod of 180 days. , � INSPECTIONS: In order for the work euthorized under this permit to be considered legal, such work must compty with all applicable codes, and all requlred Inepectlona and final approval must be obtalned. Failure to oblain inspections and Iinal approval will result in the expiratian of ihis permit. FOR INSPECTIONS CALL: (714) 7545628 2ae8�8 (flND) WORKERS'COMPENSAnON DECLARAnON: I hereby effirtn under penalry ot perJury one ol lhe tollowing tlecleretlons: ❑ I heve end wlll mainteln e certificate ol consent to seli-Insure for workers' compensatlon, es provided lar by sectlan 3700 01 tha Lebor Cade, for Iha peAarmance of t�e work for which Ihis permil is issuetl. ❑ 1 heve and will meinian vrorkeis' compensetirn Insurance, es reqWred by secllon 3700 01 Me Labor Cade. fw the peAortnante of the work ta whMh this pBrtnit IS ISsued. My worken' compensetlon Insurence cerrier end policy number ere: Cartier. PWiry NumDer: (mis secrMn neeo not ee comWe�ed u �Ae pemur �s vewed er a�o nuneree ea�ers (Sl oo) w �ess.) ❑ 1 certity Uet in the perlortnence o1 the work 1w whlch this pertnil Lv I55ueE, I s�all not employ eny persan In eny menner so as to Decome sub�od to the workers' compen5ation lews of Califomle, end epree t�et N I should Decome sub�ecl to the workera' compensetlon proNsions ol Sectlon 3700 ot t�e L.eDor CoAe, I shall tort�with comply with lhese provisions. Applicent SlBneture: Dete: WARNIN�: FAILURE TO SECURE WORKERS' COMPENSATIdJ Q7VERAOE IS UNIAWFUL PND SMALL SU&IECf AN EMPLOYEF TO CRIAUWIL PENALTIES AND CML FlNES UP TO ONE HUNDRED TFIWSNND OOl1ARE (5100.000). W ADOf710N TO THE COST OF COMFF1dSAT�OM, DMNGES AS PROVIDED FOR W SECTION 3708OF TME UBOR OODE, IMEREST, AND ATTORNEI"5 FEES. LICENSED CONTAACTORS DECLARATON: I hereby effirtn t�et I am licensetl untler proNslons of Chapter 9(commencing with Sectlon 7000) of Dlvision 3 of ihe Business end Pratessions Cade, eiW my license Is in full torce and eHect. Lic. p Gau N Cantraaors Signamre: Date: CONSTRUCTION LENDING AGENCV: ❑ I �ereby amrtn thet ihere is a construction lending agency for the peAormance of the work for w�ich this permit is Issued. �Sec. 3097, Civil Cotle). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILOER DECLARATIONS: I hereby effirtn IhBI undef penelty 01 pe�jury l�et I em EXEMPT FROM TFIE CONTRACTORS LICENSE LAW tor Ihe lollawing reeson (Sec. 7031.5. Business and Professiane Cade: Any dry or counry which reQuires e permit to construcL elter, improve, tlemolish, or repelr any structure, prior to Its Issuance, elso requires the applicant tor such permit to file e signed stetement that he or s�e Is IlcenseC pursuent b the proNslons ot t�e Cantrectors License Law (Chapter B(commendng wit� Secllon 700D) ot DMsion 3 of the Business entl Professians Code) or Ihet he or she is exempt theretrwn and Ue besis for the elleged exemptlon. Any NoleUon of Section 7031.5 by eny applicant for e permll sublecie ihe eppllcent to a civil Oenalry of not more ihan tive hundred dollers ($500).): ❑ I, es axner of the property, or my empbyees wii� weges es their sde wmpensallon, WIIL DO THE WORK, and the stiuciure Is not InterideA or ottered for sale (Sec. 7044, Business and Pmtessions Code: The Contradors License Lew Coes not appty to an owner of pmperry who builds or improves Nereon, end who tloes such work himselt or hersel� or Ihrough �Is or her own empl0yees, provitle0 that such imprwemems ere not intended or ottered for sale. If, however, the building or Improvement Is soltl wlthin one year at completion, the owner-builder will have iha Durden of O�oving that �e or she did not bulld or improve for purpose ol sele.). ' ❑ I, es owner of the property, em El(CLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to cronstruct t�e prolect (Sec. 7044, Busineas end Prafesslons Coae: The cantrectors Llcense Lew tloes no� apply to en owner oi Droperty who builds or Improves therean, end who wnlrecls tor such pro�ect with e coniredor(s) license pureuent ta ihe Conirectors License Laws.). verlfletl ❑ Ves ❑ No Buslness end Prolessions Coae tor this reasan: Verllicatlon ol Ownershlp by (type af document, i.e. - properry tex bill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMR CERTFICATION: ❑ I hereby certity that no excevetlon flve (5) or more feet In depih Into which e person is requlred to descend, will be matle In connectlon with work euthorizetl by ihls pertnit, entl ihet no bulltling siructure, sceMoltling, talsework, or demalilion or dismantling I�ereol, will be mare than thirry-sia (38) teel high. (C�ep. 3.2, Grp 2, Art 2, Sec. 341, Ttle B, Calllomia AdminblretNe Cotle). ❑ As owner-builder, I will not employ anyone to do work which would reQuire e permil Irom the Divisian ol InCusirfa� Safery, es noted ebove, unless such person hes e permit to do such work irom Ihe division. Signature: Date: Didsion ol Intlustrial Satety Permit Number: CEHTIFlCATE OF COMPLIANCE ANU AUT}10pVATON OF ENfAY: I certily untler penelty oi perjury ihat I have reed Ihis apD�� and stete thet the Infortnation given Is correct. 1 egree lo comply with ell stete laws antl clry ordlnances relating l0 6uilding wnsWGloa, and authwize representetives ot the Gry ol Cosle Mesa to enter upon t�e ebovedescribed prope 1 ms on 0.uryoses. I agrBe not to oaupy or allow occupenry ot eny building authodzed by NLv pe it until fi I ins Oon. �'/°�.�� %�� Sgnature L alOwner(s)��,_. T— Dat+ e �.. �� AnNOr Aut�orized Applicent Data MOE �. MSPEGTIONTYPE , 1616 FIxeC System Final Fire Pravention ' 1268 Pod Spe Final 200 Final RaRoot 201 FInaI BIocWFetaining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition QAg IMI�eL6 4QQ[a INSPECTIONTYPE 208 Final Mechenicel 20B Final Plumbing 270 Final ElectAcal 212 Final Flre Preventlon 220 222 250 Final Planning Appro�el Final Site Final Building/Occupenq PAIE Iti�EL$ (714) 754•5273 • Fau (714) 754•4856 • www.ci.costa•mesa.ca.us 77 FAIR ORIVE, COS7A MESA, CA 92626 MECHANICAL PERMIT JobAddress: 970 W 19TH ST Suite No Vicinity: Parcel Number: 42253112 i . Applicant BRIGGS, ELDON � . � � ' _ Address: 970 W 19TH ST � �.. � � , � � � � . - � . . � � � � Phone: _94&650.1432' � � � COSTA MESA. CA - _ r---Zlp: `92627- '= - - _ � . "� i.� . � �/ , - _ ovmer. �BRIGGS, ELDON.` %"� Address: 970 W 19TH ST �"�" Phone: � " COSTA MESA, CA Zip: " 92627 i , Contractoc OWNER-BUI6DER , . Address: � ' - - � � � , . . . � ' - Phone: � . � . � i � , , . Z.p: ' _ " � � License:000000 . �i Status: ISSUED Applied: 07112/2005 Issued: 07/12/2005 SCOPE OF PERMIT , MECHANICAL WORK DUE TO FIRE DAMAGE TO INCLUDE: 1�_INST. FAU�< 100K BTU AND 1 UP TO 3 HP COMPRESSOR/ABSORPTION SYSTEM. ' '. - � � � � FEE SUMMARY � Quantlty�- � � � . � - . ISSUE FEE $23.50 • - - Repair / Alt Absorbfion Unit Inst FAU <100 k 6TU $14.80 1 Repair / AIE Refrigeration Unit Inst FAU >100 k QTU $0.00 0 Ventillation System � Repair / Alt CoolinglHeat . $0.00 0 EvaporatiJe Cooler Inst / Rep. Recess Wall Htr $0.00 0 Commerdal Incinerator Refrig Sys'<100 k BTU , $0.00 0 �:.=;Domestic Incinerator � Refrig Sys >100 k BTU . 50.00 0 ." Compressors / Absorption Svstems � i Gas Piping; �� $0 00 0 i�� .� , Up to 3 hp�l 100 k BTU ,<% Factory Firgplace ' �$0.00 0 ` : 3 To 15 hp /.SOO.k BTU, �. - Hood w/Mech Ezhaust � ,��$0.00"'0'��1 '' � " - 15 To 30�hp l 1,000 k�BTU �� VAV Box �`� - �� . � �$0.00� - 0 � - . � �� 30 To 50 hp / 1,750 k BTU'�� , -. Vent Fan I Single Duct �� / � $0.00. ;0 � �- � , � Over 50 hp / Over 7,750�BTIf � - � � �� ApPliance '�� . � ; / .$0.00� �0 ,'; � . " Boilers . ' , Fire Dampers � -_ � .� /, $0,00 0 � _ __ � �� Up to 3 hp _ � . i . �-��! � SmokeDampers �� ,�$0'.00`�0� - � �3To15hp-' _ � , Inst or Relocate Appl Vent��; ��. $0.00 � � ,0 , -� - 15 to 30 hp, , - , � Air Handlers < 1QOOOcfm �' �$0.00 � 0 � - . 30�to 50 hp �; '. - . AirHandlers> 10000cfm , ��$0.00 0 �_t . ' � Over50hp- ,. -� � '" L " Floor Fumace $0.00 � 0 , -� � Other Mechanical Fee--� �= ,, " Floor or Suspend Heater $0.00 0 -� " Investigation Fee , � � � - _ - Plan Check Fee , � � , ' Reinspection Fee � �uantity 50.00 0 ,'; $0.00 0 , $0.00 0 , so.00 0 $0.00 0 50.00 0 , 50.00,' 0, ` , $0.00 0 � $0.00 �,"0 $0.00 0 ; 50.00 0 � �- �$14.70 1 $0.00 0 $0.00 0 $0.00 0 $0.00 0 ao.00 $0.00 $0.00 NOTICE: The wbrk authorized by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and related regulations. (Ord. No. 9248, § 1. 72-21-92) EXPIRATION: Tt1is permit sliall automatically expire and become void it work is not commenced within 180 days, or it work is suspentled or ebandoned 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 Inapeetiona and finel epproval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2sewe (6�001 WORKERS' COMPENSATION DECLAHATION: •. I hereby eflirm under penelry oi perjury one ol lhe tollowing tlocleretlons: —� ❑ I heve end wlll mainteln e certlficete ol cansent lo aelf-Insure lor workers' compensetion, es proWded lor by sectlon 3700 of the Lebor Code, lor the peAormence af the work tor whlch �his pertnl� I51ssUetl. � 1 have and wlll malntain wwkers' camponsellon Insurence, es requlre0 by sectlon 3700 ot the Lebor Cotle, lor Ihe peAortnence of ihe work tor whlG� this pertnit is issuetl. My workers' compensatlon Insurence certier end pollcy number ere: Cartier: Pdiq Number. (Thls sectbn neetl not be complefed!! fhe permit is veluetl ef one hundretl tlollers (8100) or less.) ily that In t�e peAormence ol ihe work for which this permlt is IuueO, I shall not emplay eny person In any manner so es to Decome sub�ect to t�e workers' �ensetlon laws of Caltlomla, entl egrae thet It I shoulA become su6�ect to the workera' compensetlon proWsions of Secllon 3700 t�e Lebor Cotle, I shell fonhwlth �tywithiheseProvisions. ,�/� ,�� 7� � Z�US Ilpneture:- � . '�� OT��/�/ rDare:� �ARURE'TO bEWRE WORI�RS' COMPENSATqJ COVERA(iE IS UNLAW FUL M10 SW1LL SU9IECT AN EMPLOYEpTO'CPoMINAL PENALTIES M1D GVIL FlNES UP TO ONE HUNORED DOLIARE (S10D.000). W AOOITION TOTME COST OF COM7Ef1SA7�ON� OAMACaES l5 PRONOED FOR IN SECTION 37080F THE UBOR COOE, INfEREST, AND ATTORNE'fS FEES. LICENSED COMAACTORS DECLARATON: I hereby atfirtn thet I em Ilcensetl under provlsions of Chepter 9(commencing with Sectlon 7000) of Division 3 0l Ihe Buslness antl Prafessians Cade, end my license is in lull torce end ettect. Lic. a Clau N Coniractofs SlgneWre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby ettirtn �het there is e constructlon lending egenq for the peAormence of the work tor which thLq pertnit is issued. (Sec. 3097, Civil Cotle). Lenders Nama: Lender's Address: Signature: Date: OWNER•BUILDER DECLAfiATONS: I hereby elfirtn Nat wWer penalry af pe�jury ihet I em EXEMPT FROM THE CONTRAC70R5 LICENSE LAW iw Ihe to0owing reeson (Sec. 7031.5, BuSiness end Profas5ion4 Code: My ciry or counry which requires a pertnit to conslruct, elter, ImD��'e, Gemolis�, or repair any strudure, D�w to i1s issuance, elw requires the epD�� or such pertnit lo (le e slgneC stetement thaf he or she is Ikensed pursuant to Ihe provisions of ihe Contrectors Lkense Lew (Chepter 9(commendng wIU Sectlon 7000) of Division 3 of ihe Business end Protesslons Coda) or thet he or she Is azempt therefrom end the besls lor the elleged eaemptlon. Any violaUon of Sectlon 7031.5 Dy eny aDPlicent for e permit subjecis ihe epplicent lo e ciNl penalry of not more ihan Ilve huntlred dollers ($500).): ❑ I, as owner ol t�e property, or my employees with wages es thelr sole compensetlon, WILL DO THE WORK, end the struCWre I9 not intended ar otteretl br sale (Sec. 7044, Business ena Profassions Code: The Contrectors Licensa law does nol epply to en owner oi property wha builds or improves Ihereon, end who does such work �imseli or �ersell or t�mugh his or her own employees, proNded Ihat such improvements are not InterMetl w ottered tw sele. �f, however, �he bulltlinp or Improvement Is �soi�tl,withln one year of campletion, the owner-bulltler will heve Iha burden ol proving Ihat he or she did rrot builA or improve br puryose of saleJ. ' �, I, Bs owner o1 the proDerty, em E%CLUSIVELV CONTRACTING WfTFf LICENSED CONTFiACTORS to construct the project (Sec. 7044, Busineu end Professlons �'Cade: The contrectors Ucense Lew tloes not epply lo en owner ot property who OvilCs or imprwes Uereon, aiM who contrec4s for such pro�ect wlth e contrenor(s) license pursuant to t�e Contrecbrs Ucense Lews.). ❑ I em exemptync�r se� �_ Business entl Prolesslons Coda for this reason: ' � � 'ow�er io �er�nad by drn�ers ncefise. ❑ v� ❑ No Veriticetbn of Ownership by (type of document, i.e. - properry tex Dill DIVISION OF INDUSTRIAL SAFETY VERMIT CERTIFICATION: � I hereby certity Ihet no excavetlon Ilve (5) or mora teet In depth into which e person is requireO lo tlescenA, wlll be meOe in conneclion with work euthorizetl by thls pertnit, entl t�et no building siructure, scafloltling, telsework, or demolillon or dismantling Uereoi, will be more Ihen Ihirry-sla (38) taet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle B, Calllomia Atlminl5trative Cotle). ❑ As owneo-builder, I vrill nof empby enyone to do work which woultl reqWre a pertnit trom ihe DMsion of Industrlel Setery, es noted ebove, unlesa such person hes e pertnit to tlo wch work trom the division. Signature: Dete: Division ot Intlustrlal Safery Pertnit Number: CEHTIFlCATE OF COMPLIANCE ANO AUTHORQATON OF EMRY: I ceNy under penalry of perjury Ihel I heve read Ihis eppliwtlon end stete t�at t�e Infortnation gNen Is cortect. I agree lo compty with ell stete laws end ciry ortlinances relating to builtling constructlon, and euthodze representetivas ol Ue Clry of Coste Mese to enter upon Ihe ebovadescnbeQ property fo_ r Inspoctlon purposes. I egroe not to occupy or ellow occupancy ol flny Dullding euthonzed 6y t�ls pertnit until final inspectlon. { /\ CZ . �/ / �/ �� / ps'�.1/Y —*__� . ' SlgnflWre OI Legel Owner(s) - --� � Date �--�'' MNOr Authorized Applicant Date CODE I. INSVECTqN TYPE 1616 Fixetl System Flnel Flre Preventlon 1266 Pod Spe Finel 200 Flnel Re-Root 201 Flnal Black/ReWining Wall 202 Final Factory Fira Place 203 FInalSlpn 204 Finel Demolltlon �g �� COUE� INSPECfI0NT1PE 206 Final Mechanlcel 208 Final Plumbing 270 FlnalEleclriwl 212 FNaI Fire Prevenlian 220 Finel Planninp Approval 222 Flnal Site 250 Flnel BulldinglOccupency �.1 LIIII. + , y�� na� ioa-ozis • rax �nv� iaa-anx • www.a.cos�e•mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT ,lob Address: 970 W 19TH ST Suite No Vicinity: Parcel Nunmber: 42253112 Applicant: BRIGGS, ELDON Address: 970 W 19TH ST . COSTA MESA�, CA .«, Owner. BRIGGS, ELDON - � Address 970 N/ 19TH ST COSTA MESA, CA � �>, � Contrsdor: OW NER-BUI LDER Address: Phone: �949-650-1432 , �Zip:.,:��92627 . . , Stalus: ISSUED Applied: 12R7/2005 Issued: 1221/2005 ISSUED BY: �� r C i� S: Phone: Zip: License: � 000000 � SCOPE OF PERMIT � �- INSTALL 1 GAS LINE AND REPLACE WATER HEATER. ISSUE�FEE � : Backflow irrigation Backflow Preventer Bathtub' ClarifierSystem �� Conned (Ice,Soda,etc)� Dental Units Dishwasher � Drain, Floor , Drain, Rainwate� Drain; Roo( Drinking Fountain Expansion TanK . Gas Earthquake Valve,,, Gas (1-4 outlets) Gas {Over 4 outlets) Gas Repipe , Gas Service - Interceptors (Grease, Oil) Interceptors (Sand Auto )- AMT $23.50 50.00 so.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 50.00 $0.00 $0.00 ` 50.00 $9.80 ., $0.00 ' $0.00 $0.00 . FEE SUMMARY (3TY �'. � ' . - , , .. 'AMT . gTY _ � ' . . , ' AMT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 laundryTub/Washer $0.00 � O�F'- --•� � SumpPump � , $0:00 Landscape Irrigation 50.00 0� Swimming Pool '. - $0.00 P-Trap $0.00 0 Trap Primer , $0.00 PressureRegulator,-` $000 ,.. 0 " U�inal . �� • $0.00 '°` 'Proce'3s Piping (per10 k) � --$0.00' � 0 " ' -' '--� Vacuum Brkr Bkpow(1-4) `. $0.00 ' Receptors - 50.00 � 0 "� Vacuum Brkr Bkflow(5+) - $0.00 Septic Tank $0.00 ' 0 Wash Basin .�$0.00 Sewer Cap for Demo �$0.00� 0 Wash Basin Set' � �� $0.00 Sewer Connect .�$0.00 . 0 Waste and Vent,System ._ $0.00 Sewer Privale Line $0.00 �� 0 VJater Closet (7oilel) -$0.00 Shower � , ,� $0.00 0 WaterHeaterlvent $12.30 Sink, bar $0.00 0 Water Piping (Inst or Rep.) $0.00 Sink, commercial 50.00 - 0 Water Re-pipe ' 50.00 Sink;;Floor,.� , $000 ��0 ,. WaterService ._..$0.00 � ' � Sink, kitchen �� - � � �'$0.00 � 0 � � " "'� Water Sotlener "� �� ` $0.00 Sink, servicelmop 50.00 0 ' OTHER � - � 50.00 Spa (privale) $0.00 �� 0 . V�OLATION 50.00 � Spa(public) � �, $0.00 �"0�_'. �. - � PLAN'CHECK� $0.00 : i-�, - =�+- - � r � REINSP.ECTION• $0.00 _ . ., . . - _ S'- - . . , , . - - - -, � TOTAE�CALCULATED FEES: E45.60 . . . � , , _ . , ... ... ,.�: � 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 C NOTICE: The work authorized by this pertnit shall comply with all applicable handicap access requirements urMer Calitomia statutes and related regulatlons. (oM. No. sz-ze. § 1, �z-zt-sz) EXPIRATION: This permlt ehall autometicelly expire end become void if work is not commenced within 180 days, or If work is suspended or abandoned tor a period of 180 days. �j INSPECTIONS: In order for ihe work euthorized under this permit to be considered legal, such vrork must comply with all appllcabie codes„antl all requlred Inapeetlons end tlnal epproval must be obteined. Fellure to obtain inspections and final approval wlll result in the expiratio��permlt. FOR INSPECTIONS CALL: (774) 7545848 zaiaee (eroo> WORKERS' COMPENSA710N DECLARATION: � . � � , I hareby aflirtn under penalry of perjury one of ihe tollowing decleretions: � . " ' ❑ I have entl will melntain a cenificate of consent to setl-Insure tor workere' compensation, as provided for by section 3700 of Ihe Lebor Code, foi the performance W the work for which this permit is issued. " ❑ I have entl will mainWin workers' compensation Insurance, es required by section 3700 0l the Labor Cotle, for the peAortnance of Ihe work tor which Ihis permit Is Issued. My warkers' compansation Insurance cerrier and policy number ere: ' . Carrier Policy Number. (Thls secfion,need nat be campleted il the permit is velued af one hundred dollars ($100) or less.) . . . . ❑ I certity that in the pertormence of the work for which this permit Is issuetl, I shell not employ any person in eny manner so as to become subject to the workers' wmpensetion laws ot Celifornla, antl egree Ihet Ii I should become subjact to the workers' compensation provisions of Section 3700 of the La6or Code, I shall forthwith compty with these pmvislons. Applicant Signeture: Dete: WARNING: FAILURE TO SECURE WORKERS' CAMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNURED TIqU$AND DOLLARE (5100.000), IN ADDITION TO TNE WST OF WMPENSATION, DANAGES AS PFOVIDED FOR IN SEGTIqJ 3lOfi OF THE LABOR COOE, IMEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: 1 hereDy attirtn that I am licensed under provisions ot Chapter 9(wmmancing with Section 7000) of Division 3 of ihe Business antl Professions Code, antl my license is in tull force and affect. Lia e Cless p Contractors SignaWre: Dete: CONSTRUC710N LENDING AGENCY: ❑ I hereby aNirtn Ihat there is a construction lending agency for tha pertortnance of t�e work tor which this pertnit is issued. (Sec. 3097, Civil Code). Lender's Neme: Lendefs Adtlress: ' SignaNre: Date: OWNER-BUILDER DECLARATIONS: I hereby aXirtn Ihat untler penalry of parjury lhat I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reeson (Sec. 7031.5, Buslness an0 Professions Cotle: Any ciry or counry which requires a permit to construct, elter, improve, demolish, or repair any structure, prior to its issuance, also requlres the applicant for such pertnit to tile a signetl statement thet he or she is Ilcensetl pureuent ro ihe pmvislons of �he Contredors License Law (Chepter 9(commendng with Section 7000) of Division 3 of the Business entl Professions Code) or thet he or sha is ezempt therefrom end ihe besis for ihe ellegetl exemption. Any violetlon of Section 7031.5 by eny applicen� tor e pertni� subJecis ihe applicent to a civil penalry ot not more ihan five hundred dollers ($500).): ❑ I, as ov.ner of the property, or my employees wl�h wages as their sole compensation, WILL DO THE WORK, antl Ihe structure is not intended or ottered tor sale (Sec. 7044, Business entl Protessions Code: The Contractors License Law does not apply to en owner of properry who 6uilds or improves thereon, and who does such work himself or herselt or through his or her own emDloyees, provitled that such improvements are not Intendetl or oNered for sale. tl, however, the building or impmvement is sold wit�in one year of completion, ihe owner-�uiltler will have the burden of proving that he or she did not 6uiltl or improve for purpose of sele.). ' ❑ I, as owner ot ihe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Protessions Code: The contractors License Law tloes nat apply to en owner ot pmperty who 6WItls or Improves thereon, and who contracis tor such project with e contrector(s) ,license.pursuant to ihe Coniractors License Lews.). Business and Pmfessions Code for �his reason: ❑ Y85 ❑ No Venfcation of Ownership by (rype of document, i.e. - pmperry tex bill or deetl): DIVISION OF�INDUS7RIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify thet no excevatian five (5) ar more feet in depih into which e person is required to descend, will be mede in connection wlth work euthorized by ihis permit, and that no building sirucNra, scaHolding, falsework, or demolition or tlismantling ihereot wiil be more ihen ihirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Celltomia Adminisirative Cotle). ❑ As owner-builder, I will rwt emplay enyone to do work which would require e permil from ihe Division of Indusinel Sefery, as notad ebove, unless such person hes a permil lo tlo such work from the division. Signature: Date: Division of Industrial Sefery Permit Number: CERTiFlCATE OF COMPLIANCE AND AUTHORVATION OF ENfAY: I certity untler penalry of perjury that I have read this applicetion and state ihet the infortnetion given is correct I agree to comply with ell state lews and ciry ordinences relating to building construc�ion, antl authodze representatives of t0e Ciry of Costa Mesa to enter upon ihe ebove-describ �p for inspection puryoses. I egree nol lo occupy or allow occupancy of any building euthonzed � t�� it until inel inspection. .L {� / ..... —�_/— `^%%�TS�Ig�n'�eturejOi�Legal Owner(s)g:. "',�y��- = ' �Date �"�u AnNOr Authorized Applicant Date COUE t. INSVECTIONTYVE .1616 Fixed System Final Fire Prevention 1266 Pool Spa Finel ,. 200 Final Re-Root �201 Finel BIocWRetaining Well . 202 Final Factory Fire Place ' 203 Final Sign 204 � Final�Demolition � � � Q�g irnrtu�s 40UE I. INSPECTION TVPE 206 Final Mechanical 208 Final Plumbing , 210 Final Elecincal 212 . Final Fire Preventlon , 220 - Final Planning Approval � 222 Final Site . � 250 FinalBuilding/Occupancy - �q:YI�IJIII�] �� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 970 W 19TH ST Suite: Vicinity: ROOF Primary Occ: R Parcel Number: 42253112 Applicant: BRIGGS, ELDON Address: 970 W 1 gTH ST Type of Construction: V-N Zoning: COSTA MESA;CA,� � ` �' � Owner. BRIGGS, ELDON � � � Address /970 W 1gTH ST, " ,�,�COSTA MESA; CA"<�_� ,- � � � ; �i ,"� ' . _ Contractor: OW N ER-BU ILD ER � nddress:� �, ;',; , /�.>� %;', . Z{p;� �" �% Arch : Address: Phone: Zip: 943650-1432 -_ 92627� , Status: ISSUED Applied: 07/12/2005 Issued: 07l12/2005 ISSUED BY: � -- - - -'-- -- _. ' -� , , . _ . � Phone: � Zip: 92627 . . � � . �; -- �_ � � Phone: ; , -� , �License:� 000000 , , , . � , �. ' � - - -� ��_Phone: i� �__ � License: Eng: ' � ,Address.' � - _� - � �Phone: ` � � License: � ' � `�� SCOPE OF PERMIT.-,: . `�� ' TEAR OFF EXISTING ROOF. INSTALL 1�LAYER OF 30#�FELT, 20NEAR�ASPHACT�SHINGLES; AND-REPAIR/REPLACE SHEATHING AS , .NEEDED.1,600S.F.INCLUDESATTACHEDGARAGE: " "�" - " ��—� � � � � FEESUMMARY-' � Plan Check: $0.00 . _ Cafc Valuation: Ss,000.00 Permit' $83.25 Claim Valuation: < 83,000.00 �SMIPRes: $0.50 r,�,�-�� , � �„ ; SMIP Com.` $0.00 � - - . _ - � �� , ,: ; �Other: ` $OAO ,,,,�;��.y.. � ��j,' :,,�' � Inspection:' �$0:00 � :;i;'°"?+�`, .. „ _ �, � � `�,, , ��. �, - i��, � '' ' `� � �,d _ - , � . . �;,/ � . \Total: - $83.75 >\ � � ; iz ; " ` , / i • , , � , '. , � � � � - . ,, �`• :�/� /% � ��_ ; , � � PLANNING�& ZONING �': /��" � �; �� ' J��. �/ / /. SETBACKS �� .i�� , � � � `� � ; `� �, � - � � , � � ;� i, �, ��, , MAIN STRUCTURE�Front, 0- 0� �� Rear � 0 0`�, -� Lefl 0 0 ' Right 0 0� ��, ��A �� % ��-' / . ' � ` . '!.�� ACCESSORY FroM�0-0�. :; �Reai -0-0; "� "'��teft � 0-�0'�-' � V�. Right" �A�O',-' �, _ J . �,s�� , � . ��-;- PARKING Exi_stinp: 0'-.'"-Requlred: �0-� - ��.�� Pr000sed: � �0� - � - , —,. „= �- - "- , . _ NOTICE: The work au�horized by this permit shall comply with all applirable handicap access requiraments under Califomia statu[es and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permfl shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a pariod 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 Inspeetlons and final epprovel must be obtained. Feilure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zseuae (erool \I WORKERS' COMPENSATION DECLARATION: I �ereby aKrtn under penalry of perjury one M ihe following declaretions: ... ❑ I heve and wlll melntein a �ertificete of consent to self-Insure for workers' compenselion, es provlded for by section 3700 ot ihe Lebor Code, for the peAortnence ot ihe work for which �his pertnil Is issued. ❑ I heve end will meinWin woflcers' compensatbn insurance, es required by SeCtlon 3700 0l Ihe Lebor Code, for Ihe pBAortnance of Ihe work for wNCh Utls pB�� S Issuetl. My workers' compensatio� Insurence ceMer entl policy number ere: Certier. (Thls sectian need no( be comp�etetl il fhe pemuf !s velued et one w less.) Poliry Number: ��I.certify ihat in Ihe peAormance oi Ihe work for which this permit is Issued, I shall not employ eny peroon In eny menner so es to become subject lo Ihe workers' compensetion lews of Galifomia, end egree that If I shoulC become suD�ec� to tha workers' wmpensatian pravisions of Sedlon 3700 oi ihe Lehor Cotle, I shall forthwlih comply wlth these provisions. - / Applicen(SigneWre: - � 'n.' Datei� -� G Z/ G� �WARNING NF LURE TO SECURE WORKERS' COMPENS COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE HUN�RED THOUSFND DOLLARE (E100,000), IN �� TOTHE WST OF OOMPENSFTION, DAMAGES PS PROVIDED FOR IN SECTION 3�OB OF THE UBOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm ihat I am licensatl under provisions o1 Chapter 9(commencing with Seclion 7000) of Division 3 of the Business and Professions Cotle, anC my license is in tull force end aXect. LJc. a CIa9s N Contractols Slgneture; Dete: CONSTRUCTON LENDING AGENCY: ❑ I hereby affirtn that there is a constmdlon lentling agency tor t�e peAortnance ot the work far which this pertnit is issued. (Sec. 3097, qdl Code). Lendefs Name: Lendefs Address: Signature: Date: OWNER-BUILDER DECLAFiAT10NS: I �ereby elfirm thet untler penalry a� per�ury lhat I am EXEMP7 FROM TME CONTRACTOPS LICENSE LAW for the fallowing reeson (Sec. 7031.5, Business entl Professlons Code: My dry or counry which �equires e pertnit to consiruct, elter, impmve, Aemolis�, ar repair any struclure, priar to Its Issuance, elw requlres Ihe epplicant tor such pertnit to file a signetl stetement Nat ne or she Is IlcenseO pursuant to the proNsions of the Contrectors tJcense Law (C�epter 9(commendng wilh SecUon 7000) of DlNsion 3 of t�e Business anG Professions Cotle) or t�at he or she is eaempt theretrom end ihe basis for the ellegetl exemption. Any Nolatlan of Section 7031.5 by any epplicant tor e pertnit suD�ects tha eppliwnt to e dvil Penalry oi not more then tive nundred dollers ($500).): ❑ I, as owner of t�e property, or my employees with wages es ihelr sole wmpensatlon, W ILL DO THE WOHK, end the strudure is not IntenOed or ottered for sele (Sec. 7044, Business end Professions CoAe: The Contractore License Lew does not apply to en owner of properry who builds or improves t�ereon, end who does such work himself ar hersell or through his or har own employees, provitletl ihet such improvemants ere not Intended or oNered lor sale. N, however, the building or improvement Is sold within one yeer of completion, ihe owner-builder will heve �he burden of proving iha� he or she tlitl not Dulld or Imprave for purpose of sele.). � nµda�I;.as owner of lhe pmperry. em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS m wnsimtt the project (Sec. 7044, BuSiness end Professions +� �Code: The conhactors UGense Lew does not epply to en owner ot property who bulids or Improves thereon, antl who conirects far such projecl wlih e conirector(s) license pursuant to Ihe CO��ractors License Lews.). �_ I am exemp�ur�r s� � Business and Professions Cotle tor Ihis reason: �Owner ID vedfied by drivers lic�nsa. ❑ Yes ❑ No �DmreYs Liwnse No. �` � Ezpiies.' </[�`��% Verificetion ot Ownership �y (type af document, I.e. - property tex blll or tleetlj:�� DIVISION OF INUUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ i hereby certify Ihat no excavation tive (5) or more feet In tlepth into which a person Ls required to descend, will be metle in connection with work authorized by this partnit, end that no building structure, scattolding, falsework, or demolition or tlismantling �hereoi, will be more then Ihir�y-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Cellfomia Administretive Cotle). ❑ As owner-builder, I will not employ enyone to tlo work which woultl require e pertnil from t�e Division of �ndustrial Sefery, as notetl ebove, unless such person has e permit to tlo such work trom Ihe diWsion. Signature: Dete: Division of Industrial Safety Pert�it Number. CERTIFlCATE OF COMPILWCE AND AUfHORQA710N OF EMRY: I cenify untler penalry oi perjury that I have read this eppliwtion end state that the infortnation given is cortect. i agree to comply with dll stete laws entl Gry ordinences relatlng to Euilding constmction, end authotlze represeNetives ot Ihe Clry of Costa Mesa to enter upon the ebove-describe� operty r inspection purposes. I agree not to accupy or ellow accupency of eny building euthonzed by tt�is pe� until final inspection. ( � , — _ ... �/�z os r � Ure Of LB el Ownef S-� \�— (_i'-`-::.._,_ Date °4F MNOr AutMAzetl Applicant Date CQOE �. INSYECTIONTYPE 1616 Flxed System Flnal Fire Praventlon 1266 200 201 202 203 204 Pool Spa Finel Finel Re-Roof Flnal BIocWRelainin9 Well Final Fectory Fire PIac6 Finel Sign Finel Demolltion Pdffi 1�6� V" � COUE I INSPECTION TYPE 206 Final Mechanical 20B Final PIumDing 210 Final ElecMcal 212 Final Flre Pre�entlon 220 Final Planning Approvel Y22 Flnal Site 250 Finel Bulltling/Occupenc Pdg I�d�fi (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT �ob nddress: 970 W 19TH ST Suite: Vicinity: GARAGE Primary Occ: U Parcel Number: 42253112 Type of Construction: V•N Zonin9: Slatus: ISSUED Applied: O6/27/2005 Issued: O6/27/2005 Applicant: MARK BRANNIGAN "` �' ISSUED BY: Address: 11408 KNOTT ST . ' " � _ _ , � � � Phane: , 7148932953 - GARDEN GROVE; CA� -�� Zip: 92841 j -� � � �� . ' ' . �, % _ . � �' - : � . Owner: BRIGGS; ELDON- "' �� • - � � - � ' / � � Address /970 W �19TH ST � � � ' � �- -'_. _ �� i��, / . � �� ' Phone / �� - ��COSTAMESA;CA;�;-,�� Zip: 92627 - ., . i' ,% Contractor. SEACO-CONSTRUCTION INC Addressi 11408 KNOTT ST %-�/ - � GARDEN GROVE, CA , Zip: 92841� . Arch : ; Address: � , �. � .. Phone: �� Phone: 714-893-2953 license: "765826 ' Eng: Address:` - �' � �. Phone: i, � Zip: � , �-�'� License: �� ' License: , � % � � " , � �' i"` SCOPE OF PERMIT �), �; , � � � ` � DEMOLISH ILLEGAL ROOM LOCATEDiN'THE GARAGE�DUE TO FIRE DAMAGE.- -�� - ` � Plan Check: $0.00 Permit: $6925 • SMIP Res: $0.50 SMIP Com: ' $0.00 � FEE SUMMARY . ; �,s :; Calc Valuation: Claim Valuation: , i s2,000.00 sz,000.00 � Other. _ � � $0.00 � - � � Inspection: , $0.00 ' � %� " � . � . �: i � C, ; . . � , �. � . � _ .,< : . ' �� r � Total: , . $69 75, � ` , .,, ,' ' ' �r' r, . � � , ' ,�:�� ,,,-,ai<.. . . ... �i:�.-� �i/,, • - _ ��' �� ._ PLANNING&ZONING ,�,!� 'j /� � , ;_ ' / �> _ ; � = / /> ; ,i �. SETBACKS� � : . / � � �� i - � � ` . - i _��i ,. MAINSTRUCTURE�Pront �0-0 �; � � e � 0�0�� -,LeR - �0 0._-' % Right� �0=0 i �/ / �� ,> !`' _,�_� ._ - - - _ - \\�� / i - i ACCESSORY Frorit��0-0 `�_ , Rear 0-0 Left 0_0 Right� ��'0-0�': �' " . . _� . , i - . - , . � � , � , , , �, , -_ , . � , ,. , . . �;� : , - � i � - PARKING Existinq��-�0 � --,Required: 'o ' ' . Pronosed: " o�,' - ; � ' � � i A � � i - NOTES: .-- � _' ' ' „��,< = ' . .. NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis 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 780 days, or ii work is suspended or abandoned � for a period of 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inepeetiona and final epproval must be obtained. Failure to obtain inspections and final approval will result In the expiration of this pertnit. FOR INSPECTIONS CALL: (714) 754-5626 zaaers (r✓oo) WORKERS' COMPENSATON DECLAFiATON: 1 hereby attlrtn urMer penalry of per�ury me of iho fWlowing deGeretions: -- � ^• ❑ I have end wlll malntein e ceNfkate of consent ta self-Insure lor workera' compensatlon, es provldetl tor by secllon 3700 of the Lebor CoOe, tor ihe peAortnence of Ihe work for which thls permit Is Issued. workers' compensetlon Insurance, es requlred by eecibn 3700 of the Lebw Cade, tor Ne peAortnance of the work tw which this permit Lv Issued. tlon Insu�e�ce cartle5end poliry number ere: 2 �L�•'\Q FdIL�Numher GJU '� '.�(��'(�Z� nplefe0!! Ne permlt Ls relued ef ine ��ndred dollers (5100) w IessJ � ❑ I ceN1y thet in Ihe peAortnence af Ihe work for which Ihis permil is issued, I shall not employ eny pereon in eny manner so es to Decome wbJect to t�a workera' compensetion laws of Cellfomia, end epree Ihet II � ehould Decome sub�act to Ihe workero' campensetion provisions al Sectlon 3700 of ihe Le6or Catle, I shall torthwith compy with ihese p�sions. . /� o�secdae wowcEas• oorar�snnori � (s100,000� W ADDRION TO TNE 00.ST OF LICENSED CONTRACTORS DECLARATION: ^J '�i oate� .b ^�L%—G � UNUWFUL rWD $HAl1 SUBIECf AN EA61.0'/Ei1T�CRIAUNAL PENALTIES M10 CML FlNES UP TO ONE MUNDFED 7N. DAlM�ES r1S PFOVIDED FOR IN SECf10N 3108OF THE UBOR COOE, INTEREST, AND ATTORNEV'S FEES. I hereby eltifm Ihat I am Ilcensetl er provislons ot C�e te 9 wm encinp wlth SecUon 7000) of Divlsion2oY414'BUsine�end�otessions Cotle, antl my license Is in full lorca'Hlid'eHact. 6c-N'"'—"'" �IazsY-- �C,�.antrectore�Slgnetiire""-'^ � . �L�iYL-r-+a.2.y� Date: � —07�—� � CONSTRUCTON LENOINO AGENCY: ❑ I �ereby atfirtn that Nere is a constructian Iending egenry tor ihe peAortnanca of Ne work tor which this permit is Iswetl. (Sec. 3097. Civil COAej. LentleYs Name: Lenders Address: SignaNre: OWNER•BUILDER DECLARATONS: Date: 1 hereby etllrtn ihet untler penalry oi perjury thet I em EXEMPT FROM THE CON7RACTOHS LICENSE LAW tw the idlowirg reason (Sec. 7031.5, Buslness and Protessions Cale: My dry or counly whkh raquires e pertnil to construcl, elter, imprwe, Oemdish, or repeir eny stnxtura, prior ta Its lswerxe, elso requlrea 1ho applkant for wch permil lo file a signetl stetement thet he w she is Iicensed pursuent ro Ne proNsions of the Canvectars Lkense Law (Chapter 8(commendng wiN SecUon 7000) of Divislon 3 of Ne Buslness and ProfeSsions Code) w ihet he or s�e Is exempt theretrom enA 1�e besis tor Ne elleped a:emption. My vldatlon of Secllon 7031.5 Dy eny applicant for a peimlt sub�ects Ue epplicent to e dvll penelry of not mora t�an Ove hundred dollers (5500).): ❑ I, as owner ot Ne properry, or my employaes wlth weges es thelr sole compensatlon, WILL OO TME WORK, and the structure Is not IntenOetl ar aHereC tar sale (Sec. 70C4, Business entl Prolessions Cade: The Contradore License Lew does not epply to en awner af properry who bullds or Impraves thereon, end who does such work himself or herself or Nrouph his or her own employees, provided thet suc� Improvements ere not intended or oHeretl tor sale. tl, however, the building or improvemen� Is soltl within one yoer o1 completion, the owner�6uilder will have the 6urden o1 proving t�at �e ar she did not builtl or imprwe tor purposa ot sele.). ' ❑ I, as owner of tho properry, em EIICWSIVELV CONTRACTNO WITH LICENSED CONTRACTORS lo consWct the prol�� (Sec. 7044. Busineas end Professions Cotle: The contrectore Llcense Lew tloes nat epply to en owner ol prapeny who builds ar Improves Ihereon, en0 who conirects lor such proled with e contractor(s) license pur6uent lo Ihe Contradors Llcense Lews.). ❑ 1 em exempt under sec. Slgneture: Owner ID veritietl by tlrNefs Ilcensa. ❑ Ves ❑ No Business entl Protessions Code lor Ihia reason: VeAlkatlon o1 Ownership by (type ot Cocument, I.e. - property tex blll or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMI7 CERTFICATION: Dnvers License No. Date: Ezpires: ❑ I hereby certity lhet no excevetlon Me (5) or more teet in depth into which e person Is requlreC to AescenQ w10 ba matle in connectim wiN work euNwizetl by this permit, fliM Ihat rro bullding SWMure, scefldtling, telsework, or dertwlitlon or dismantlinp Ihereof, will 6e rtare Ihen Wrty�slx (38) feet high. (C�ep. 3.2, Grp 2, Art 2, Sec. 341, litle 8, Celifomla AdminisiratNe Code). ❑ As owner-builtler, I wlll not employ enyone to do work which would requlre e pertnit fram the Division af Industrial Sefery, es noted ebove, unless auch peraon hes e pertnit to tlo such work from the division, Signature: Date: Division of Industrial Safey Permit Numbar. CERTIFlCATE OF COMPLIANCE AND AURI0ROJ1ilON OF EMfiY: I certlly untler penelty ol per�ury that I heve read thi9 epplicatbn antl stete Nat Ne infortnellon gNen i9 comacM. 1 egree Io compty wllh all stete lews end Gry ortlinences relating lo bullding constructlon, end euthodze representetives of the Ciry of Coste Mesa ro enter upon the ebove-described properry for inspectlon purposes. I egree no� �o oaupy or ellow occupenty ol eny bulldinp euthorized by Ihis pertnit until finel Inspeclion. cooe .. INSPECTON TYVE 1616 FIxeA System Flnal Fire Preventlon 1266 Pool Spe Finel 200 Finel RaRool 201 Final BIocWRetelning Well 202 Final Feqory Fire Place 203 FInalSlpn 204 Flnal Demolltlon QAIF IIffiIEIS � �. �� INSPECfIONTYPE 208 Finel Mechanical 20B Finfll Plumbinp 2f0 FinalElecMcel 212 Fnal Fre Prevenllon 220 Finel Planning Approvei 222 Flnel Slte 250 Inal BulldlnyOccupanq PAg Il�EL6 /I -�, Cm3ta Mesa Building Department � �' � 111 EAST 20th STREET � � COSTA MESA. CALIFORNIA FOYt APPLICANT TO FII. B��d��9 4 7 0 /9 . �r nddress ` Costa, Mesa, California Add No. (Attach Metes and Bounda) No. of Bldga Size Of Lot ��/ � Now on Lot Use oT I No. ot No. ot Existing Hldg. i Famflies I Roome Setback Lina from �� Rear Yard Center of SSreet Side Vard '— DESCRIPTION OF WORH New I Alteration I I Addition I Repair I I Movfng � I I Demolish I Build��9 No. of r Size � 5 n yA Rooms � Stories �-•erior Wall I Roof :fing �'�yCG.p Coverin9 ComD• . _.: of New � �r— APPLICATION FOdt PERMIT � - 940 BUILD,�NG ' � FOR OFFICE USE ONLY I Receivetl by I �Date Rec'd. Data Isa .2 a g Building Address Costa Mesa, California Cross St. CORRECTIONS APPROVALS Under-Pfnning Frame: Fire Stops, Bracina. Bolts I hereby acknowledge that I have read this Appiication and state that the above is correM and agree to comply with all City Ordinances and State Iaws regulating Lath. Ext. build3ng construction. . Signatureof i/ 0 � 1'�` Q� P�aster, Int. Permittee �16tt.ri-d�c. l�•s�e v/�Ftt. - -- - - - Valuation rermareey i.-� (eo Plan Check $ S Bond Beam $ �� 3 8 Total o0 Fee $ '3� �^"� FINAL ...e.. e..a r.-w au a-r.a G> 0 t � . . . � . !.� ' . .n � j� �'Y • • '- - � ��. • .� .'1 I '� �` . , , h.: :ti �.v . ` � . . .. , - - �� . _ �h — .` ' l \ . 1 1 � . . l . ' � . / , _ �� . i ' ,. . . �. r ' -- -- -- - � _ � - +-,_ . ... . , �I n . • i . __ _ _ _ . �_ i:)_ _ ' . � ,,r � . . �!': .c , , �. )1'.f��. . .IJ ' . 1 � 1�.n . 7 I, l r' ! � � _- 1 y' ` _ . OI �O. � ':dWC. II�- ." . � ' . .. . . �.,, � n. � � . `'�' •' - -- :�- .� ._ _ . .. "__ , : "',_—' _ "_'_ _ . ' "_ —� �' L LV1 1 LAL\ . � i. t .. • ' ( 7t: _ . . I . ul � a . ' Show Iocation and distances irom � - ' • _ . � • • � property Iine and between buildings. _ � „ ,. . ' � � _ t. _ � ' . - � � ' . _ ' �_ . _ _ . - . _ . . _ . . ,1 . . . ... .; .. . , . � - ' . ' •. 1 - _ _ ' i , �. , '__ . '_.' ' ""'. .. _ '_' _. ' � A r - . . . , � � .. . ,. i . . . �_ � , ' � ` ' ' ' ' _ . . •, i .- , . . � i . . _ y 1' . � 7'. � . ' � _ . , . ' . - . . . aa ' � � �925� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31] COSTA MESA, GALIFORNIA fOR APPL/CANT TO f/LL /N COMPLETEIY TYPE OR PRINT LEG6L �1 / 9 � MESA. CAI.IFORNIA STATE iC. NO. S -SO /- / �- �/ �� (� O/ I NO. OF BLOGB. / F / / NOW ON LOT _y_. USE OF � EXISTING BL�G. � SETO�GN L�NE FROM CENTER OP 6TFEET �� REAR YARD _��—` 1 I � /� �/ �SIDE YARD I�EFT 3 y R1GHi DESCRIPTION OF WORK ' NEW � IIALTEFA710N REPA... I I MOVING BUILDING // ✓ 3 0 ROOM' SIZE 10 /� EXTERIOR WALL ROOF I HEXEBY RCKNOWLEDGE TNI�T I XAVE qEAO TXI6 APPLIGATION •ND 8TA}E TMAT THE AOOVE 18 CORFECT /�ND AGREE TO COM- pLY WITN TLL QTY OHDINANCEB AND 8T/�Tfi LAWB qEGULATING BUILUINC CONSTfl ON. /� l SIGNATURE OF p��r. /PGaO/ PERMITTEE � // _ /i _ �� RECEIVEa c,K� ��:�� ; . ,,, . FII�ANCE DEPT. cirv �F rneTfl �n«� APPLICATION FOR 'PERMIT BUILDING fOR OFf/CE USE ONCY I RECEIpf NO. I AW � �� FECEIVEU BY /� OATfi RECEIVED I DATE ISSU COSTA MESA. CALIFORN FIRE type group�/G ZONE APPROVED 6Y DATE ZONlNG ZONE I NO. OF I USE OP NEW PLANS BUIlDIN6 APPROVED 8Y III. . ' �ATE c ' iaM THfi AMOUNT BHOWN tINOER VAI.UI�T�ON 18 FOfl TME PUHP08E OF EBTABLI9HIN6 A PEPMIT FH6 ONLY. VALUATION . PERMIT FEE $ ` �O "� 5 �� p0 PLAN CHECK $ V' TOTAL FEE $ �'� J �