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Home My WebLink About1035 19TH ST - Building Permits(714) 754-5273 • Fax (714) 754.4856 • www.ci.costa-mssa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 1035 W 19TH ST Suite No Vicinity: MARINA VIEW PARK Parcel Nunmber: 42431102 Applicant: FEILMEIER, RICK Address: Owner:' CITY OF COSTA MESA Address CITY HALL " COSTA MESA, CA Phone: 949-770-2269 Zip: Phone: Zip: 92627 Contractor: R & M ELECTRICAL CONTRACTING Address: 22541 ASPAN STE C LAKE FOREST, CA Phone: 949-770-2269 zip: qa&U-63 as License: 813655 Status: ISSUED Applied: 08/06/2003 Issued: 01/06/2004 ISSUED BY: iL SCOPE OF PERMIT , INSTALLATION OF A COMBINATION OF 7 SHRUB AREA LIGHT FIXTURES WOR WALKWAY LIGHT FIXTURES WITH FOUNDATIONS AT "MARINA VIEW PARK OK WITH PLANNING - SHIELDING WILL BE REQUIRED IF PROBLEMS WITH LIGHT SPILLOVER. WBK NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2448-x6(8/00) FEE SUMMARY , Quantity Quantity ISSUE FEE $0.00 Temp Dist System / Lighting $0.00 ,0 Temp service test $0.00 Busway /100 it $0.00 0 " Res. a/c package $0.00 - - Standing Section $0.00 0 New Res (1.2 units) $0.00 0 - . - Misc Electrical Equipment $0.00 0 New Res (3+units) $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 Fixts $0.00 0 .................up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 .................up to 100 kva/kw $0.00 0 Switches $0.00 0 ..................over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System / Ckt $0.00 01 Service to 200a $0.00 0 Misc. Conduit $0.00 ' 0 Service to 1000a $0.00 0 Misc. Conductor $0.00 0 Service over 1000a $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 $0.00 -. 0 Christmas Tree Stand - . $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 Investigation Fee $0.00 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 order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2448-x6(8/00) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. - ,1 have and will maintain workars' compensation Insurance, as required by section 3700 of the Labor Cade, for the pertort anco of the work for which this permit is Issued. My worker ' tion I nce card r?d Policy number are: /f/1 A �1 Carrier: 1ctolt � Policy Number: 6V A6 (This section ne of be completed if the perm/( is valued at one hundred dollars ($100) or less.) ❑ I certify that in the performance of the work for which this permit Is Issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of C4eLforma, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these prov�c}1s. Applicant Signature: ��y�/ �k�E� oats: WARNING: FAILURE FAILURE TO SECURE WORKERS' COMPENSAlbN COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIAAINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed �pQyr pr to of h (commencing with Section 7000) of Division 3 of the Busin and Pjg} flsslons Code, and my license Is in full force and effect. Uc. a ]� / i0 ` class a C� Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, Prior to Its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not Intended or offered for sale (Sec. 7044, Business and'. Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself art through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement is sold within one year of'`ompietion; the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property`am,EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractors) license pursuant to the Contractors Ucense Lewys.). ❑ I am exempt under sec. �<vBusiness and Professions Code for this reason: Signature: `•n Date: Cwner ID vedfied by ddvers license. Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of d umenI, i.e. - property tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth Into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 WIII the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which hes at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ............................................................................................................................................................................................................................................................................................................................................................................................ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Sectlen 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Masa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a Volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .......................................................................................................................... ..................... ................................................ ....................... ................................................................. ... .................................................................. _.................. __...... 3 Does or will the applicant or present or future building occupant need to prepare an ?MPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .............._.................._......................_................................................................................._................................._._......................._...................................................................................._.__........................._..........._.�.................___........ 4 If en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ._........................................................................................................................................................................_................................................................_....................................._......................................................._........................................... 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication aermn for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes a No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). ......_........................_..................__.._................. _____.___._......................................____............................_.....................__..................................................... ._...._.................._._.............__.._...........__......... 8 Will any part of the facility to be constructed under this permit be within 1000 1ee1 from the outer boundaries of a school? ❑Yes ❑ No (If 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ........................................................................................................................................................................................................................................................................................................................................................................................... 7 If a permit from the South Coast Alr Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No __............__..................._............_................_....................................................._..__........................._.__....................__..................................................................._.._._........................ _................. __............... _................... 8 (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the Information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cenity under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to Occupy or allow occupancy of any building authorized by this permit until final inspection. igMore Of pa gal Owner(s) Date �C 9po44Ama.L. A Or HUITOOzed Applicant Date OM" INSPECTIONTYPE LAiE INTRIALS SOLE! INSPECTION TYPE PATE KTMA 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final RIocWRetaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final BuildingrOccupancy (714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa. BUILDING PERMIT 77 FAIR DRIVE, GUS IA MESA, GA 9ZWeb Job Address: 1035W 19TH ST Suite: Vicinity: MARINA VIEW PARK Parcel Number: 42431102 Zoning: Applicant: FEILMEIER, RICK Address: , Phone: 949.770-2269 Zip: Owner: CITY OF COSTA MESA Address CITY HALL Zip: License: 813655 Status: ISSUED Applied: 08/06/2003 Issued: 01/06/2004 ISSUED BY: Arch : Eng: CHIRU MALI Address: - Address: MALI ENGINEERING CONSULTANTS Phone: GILBERT, AZ Phone: 480-722-2022 1480 E ERIE ST Zip: License: 85296 License: 52811 SCOPE OF PERMIT INSTALLATION OF A COMBINATION OF 7 SHRUB AREA LIGHT FIXTURES. WOR WALKWAY LIGHT FIXTURES. BLDG PERMIT FOR POLE LIGHT FOOTINGS ONLY AT "MARINA VIEW PARK." Phone: COSTA MESA, CA Zip: 92627 Contractor: R & M ELECTRICAL CONTRACTING Address: 22541 ASPAN SMIP Res: STE C Phone: 949-770-2269 LAKE FOREST, CA Other: Zip: License: 813655 Status: ISSUED Applied: 08/06/2003 Issued: 01/06/2004 ISSUED BY: Arch : Eng: CHIRU MALI Address: - Address: MALI ENGINEERING CONSULTANTS Phone: GILBERT, AZ Phone: 480-722-2022 1480 E ERIE ST Zip: License: 85296 License: 52811 SCOPE OF PERMIT INSTALLATION OF A COMBINATION OF 7 SHRUB AREA LIGHT FIXTURES. WOR WALKWAY LIGHT FIXTURES. BLDG PERMIT FOR POLE LIGHT FOOTINGS ONLY AT "MARINA VIEW PARK." PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 010 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become vold if work Is not commenced within 180 days, or If work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2446-46 (6'00) FEE SUMMARY Plan Check: $0.00 Calc Valuation: $0.00 Permit: $0.00 Claim Valuation: $0.00 SMIP Res: $0.00 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $0.00 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 010 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become vold if work Is not commenced within 180 days, or If work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2446-46 (6'00) � e WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a ceNficate of consent to self -Insure for workers' Compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. I have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. M we r ' nsatlon nce card tl II number are: /jam(/' /1� Carder:y � �� Polley Number. ✓`� 6-' f�/3O-6 (This Sect/ eed not be completed If the permit Is valued at one hundred dollars ($100) or less.) ❑ I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to became subject to the workers' compensation laws of q4tornia, and agree thatif I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these pr ns. n Applicant Signature: yE, // � -w^- Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRI' NAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF OOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am lice sse`/ddJy�deryrov�l£io�5 of Chapter 9 (commencing with Section 7000) of Division 3 of the Buslne s antl Professions Code, and my license La In full force and effect. IJc. A'' i5liii f0 `moi Class p n — /'a Contractor's Signature: Date: 4 D CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city oncounty which requires a permit to Construct, alter, improve, demolish, or repair any structure, prior to its issuance, else requires the applicant for such permit to file a signedstetement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (Commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): r. ❑ I, as owner of the v✓fproperty, or myemployees with wages as their sole compensation, WILL DO THE WORK, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through Ms or.tier'own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of Completion, Ifie owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). - ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 704. Business and Professions Cafe: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who Contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID vedlied by drivers Iicanse. 6AZYes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth Into which a person is required to descend, will be made In connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which hes at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ..........................................................................................._............................................... ___............................... _._....................... ............................. ................................................. _.............................. ................_................. __............ _. 2 Does or will the applicant or present or future builtling occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some axes tions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the apppliant or present or future building ocapant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully Compiled withl ❑Yes ❑ No 5 Does hwill the applicant or present or future building occupant require for the work which Is the subject of this application aPpermli for such Construction or modification from thee South Coast Air Quality Management District or from any other air pollution control district or agency? Yes jJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ....................................................................................................................................................................................................................................................................................................................................................................._................. 6 Will any part of the facility to be Constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ..............._—.._.......—..._..—___.______..........,.__._.........___.........................................__.._............ _........ .._.. 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is mired for the work which Is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑ No .._............._._....._.__.—_______..__._.._._....___................._.............................._.__......_..______............ _.._..__......... _..___._._....___._..... 8 (It "yes'. attach certificate of compliance from the appropriate air pollution Control officer). CERTIFICATE OF COMPLIANCE: I cartily that under penalty of perjury the Information given above is Corect. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to Comply with all state laws and city ordinances relating to building Construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes... II agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. !4 4�fll� Legal iant.) Date AThd'O7-AuT7ToMMd Alpolicant Data GOOF /. INSPECTION TYPE PATE 9ITTLAL$ CODE I INSPECTIeNTYPE ga¢, iNirnA 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retalning Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Bullding/OCoupanay ADDRESS OF BOWING, 1 U 35_ _W 19TH ST UNIT.. OWNERS NAME IF IQ40M`N: CITY OF COSTA MESA �: ADDRESS 77 FAIR DR COSTA MESA "A,,,�2626 (714)754-5304 A PL. MAILING ADDRESS: ARCNIIECT OR ENGINEER: DAVID E VANS h ASS LIC No, V ARCH. OR ENG'S ADORE53: 800 N HAVEN AV UNT: 300 ONTARIO CA 91764 CpRRACTORS NAME CONTRACTOn IANLIN I ADDRESS: UC NO.: UNIT. LICENSED CONTRACTORS DECLARATION: I Mreby stem untied Pearly d perjury tlW I mn teamed Keds povoicw of Chapter 9 (cammerldrq wkh SecHm 7000) of Division 3 of the Buvrom W Prdm.iom Crile. end mY lioeme u in MI era Ord eMw. CITY LIC. NO.: 4C. cuss: UC. NO.: EXP: Date: cormact.. OWNER BUILDER DECLARATION: 1 hereby ati under pdoddity of Pwp y thel I em exempt From tM Co otdt n Lioerw LAW f« tM ,poi reason (Setlion ) 11S Buskmes aha Prolemiom Code: AM city «munty which ropuim a pemlil 10 ootd,luct. Mer, improve. mmanh. «rapes any etmdum, prier to b haudw m. a so is,u'vaot tM applimN 1« ouch perm/ to fie a signed matemdd Iw he d aha Is liarsed panuenl to tM povamors d the CWracz a Liovrae law (Chapter a (cmdnerlvrp "h section 7000) a Dhisen 3 of tM Buskmm aril Pra to,,O Cade) «that M or she is aaempl tlwrmftarn eM the base for the Ms9ed eaempioo. AM videtion d Section 7031.5 by any appSotud 1« a p do o mbpcts the appfrant to a aW pemtly of not mon Ihen Me hundred doW rS D. I, as owmr of 1M prapeoy a toy.mplvyeee wlh wepea m thek cote ampmuMa, wf0 do 0m pork, and Ne mlrpave h odd WO d dI «Merodfor sate (Sather 7001. Sum. and PWOuti ne Code: TM C«decton Lkxame Law does rat apphyto-owls Of PIOFedy wM holds or dt, 0 thereon, and wM does auto vmrk hbneeff «hereto or through M or her own mnplo w, povesd that wilt imp d,,, de mt bonded d send f« W. B. haw.. the WWim d'mpovemad I. sad vdhe oar year a mn,"ion, Ow Owrwho&hd vM have IM Lleden of p M or a did not WW « bnproye f« the pmpme of MN). I, m owner a tM pmpsry, am uakmivdy oomrm:m wuh Merced convacmn to alwum 0.e prajed (Section 7W., Babrrs and Prdeesem Cade: TM Conlrmfds Lissom Lew dem est apply to en owner d property wdlo W1iM d improv- ther.an aril who 000,e for eruct- pole= w a oomudc to.) lioenmd pursuers to IM Cor a is ds Liam. L.M. 1 em emnpt under Section: B. 8 P.C.. for the leaser: I do hereby certify dw I em aware of dd oo6tdO and dm r utdoerb of CttMf a 1 tudth «d Seery Cade Sectio- 25505. 25533, and 25511. aha bat I « my Mon ddMbq op pivvI "I I wB nal (amb ro comply with sad mile c • end IM redarmnem for a Pernd forcomauction ar naddi�ationhomthiAkLimTl%i .Reads." dw n kmmeuamplhOmiMaa pouviam. —Y . t/r,/z o / Aopiced r RKER'S COMPENSATION OECLARATION: I b..bY eRml Oder perattly d d dm w1ving ddlaratbs: I have end N me'deen a cMdaats d aruera ro sMhmn b waken' ion, as provN.d for by Seao13700 of IM Labor Code. l« IM W«mdaa d he work 1« wNtli Ne pamW a issued. 1 have end wit maiden porkers';&d. My cion i cotopa, od rwuked ,oc .d tod! poky Lebon Coto, er iM pdamdra d tM wok I« wdiial N'v pemk a u.ad. MY rakers' amps^edio^ imura«.w wrier end poW.y wester «s: carder popOy lumber: (Ire aeaioa need mfMcamlered/Ne pemrie Av aro hunMed tlolen (SI00fabaJ I o U1at a Cie pdammme d .. work dor which the Perms a iard! I shM real I sh. dry oonn a mry manner w m to beans w.n to IM wfM1afi arn7Mn the ewe C Ceklomin end itis 0W / I should bacanm sbloct to IM norlas' cornperrsatio^ Povhiom d Section 1700 a iM labor Code. I asD Idbwlh mnpy wvh dwn pmve'vs. Dile: Applicid: CIO lrry: up M ro.aeuro rodmf eenotp, u on cey.roim lit unddon arts elral f con f N mf on, d ro ddwdna Fwmltlm erb CIO w ro erre ObOl fh, 1 r; A,tOf (01«w. h h aMlfbn ro tlr. mf p/ rorrpmuetbM1 d rrrN.. m pevMM ter In $.CtloI13705 of tln IebOr Code. IntmesL .rld.wmry'a f.m. CONSTAR ION LENDING AGENCY: I hereby dfmn OMs pwaky of parody that IMn e e 000mewman Next aMo ,, M In mdolr r of tM work for whim the perms a issued (Section 31097. Civ. C). LENDER'S NAME: LENDER'S ADDRESS: 1 ceruty thin I here reed 91st awksJian end Sae that Ora save id« ydtfiM a toners. I epos to c«nply with M dry add mlrmy ordbmrnr aha mme ewe mlakq to MiMip oonmmmon and hereby euthorbe dp hive+ Of tM dry to"Od Upas IM a a ddfliomd property torlmpOomwpama DAVIDALKEMA Dae: I AppGanVCOnIrM« (51511 WP) Moo Buiklkq d Saery: Gmen-Fite: Canary-Appfonl: RnkJietada: Oddenmd-Asnvor CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: B 085485 PLAN CHECK NO: 03965-97 L CONSTRUCTION TYPE: PERMIT TYPE: SYR PERM:)48D- PURPOSE: PURPOSE: ALI Sub DESCRIPTION ; REMOVE ACCESSIBILTY BARRIER Su FI: 40,000 CLAIM VALUE: 40,000,00 CALC-VALUE: 40,000.00 GROUP OCC: A-4 / COMMENTS: TOT LOT CURB RAMPS H.0 PARKING SIGN 6 WALKWAY 6 DRINKING FOUNYAiN wwwwwwwwwwwitwwwwwwwwwwwwwwitwwwwwwiewwwwwwwwwwwiewwwwwwwwwieiewiewwwwwieitie witwwwwiewwieww Z u N 1 N G R E Q U I R E M E N T S S E 'T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ----------- FRNT: FT IN REAR: FT IN FRN'T: F"T IN REAR: F1 IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: F'i IN PARKING REQ: PROV: PARCEL: 00000000 ZNE: i6R REF NO: PLANNING NOTES> TOT LOT AND HANDICAP ACCESS. 7C ft x X ft ft fy X 1t 9t ft It x 1t ft R it w fl' 1l' f! 1! ft ft x It ft lilt } lF ft ty ft st 1t 1<Yt ft ly ft ft 1t w 9t 1C it 1t it x It w R'lt'lt it it 9t'rl' lt'R'!t X it tie 1t It 1<w;)t'!t il"lt'It wit x ft'it D E V E L O P M E N T S E R V I C E S R E Q U 1 R E M E N T,S ZONING APPROVED BY = DATE: BUILDING APPROVED BY DATE;-- z. op _ _ ___ APPLICATION 1SSUE5 bY; �1�� DATE:` at x w ww ie ie i't's. w w ie w iF w ii w w w ie ie w,r tie ar>r st>r tie x x se at>r st w: ar se at at x tie x 7! 7<� 9F 1C 1C ........... �-•�•-••-•�.... at It X lt9t at 9t 1C It h ]t>t It } at R 9t at ]R T' X at'lt x 9t tC lt'R F LEGALIZATION:N F E E S U M M A R Y STRUCiURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIPiRES GRADING PERMIT 484.75 SMIPiR S PLAN 315.09 ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 0.00 0.00 0.00 _ 0.00 OQ .00 REVENUE DIVISION TOTALS--> COLLECTED: J_ .00 OVER/SHuRT:,, vv BLDG PMI PLUMBING ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAN-1.EE K ))sift ltiiiiiiiiiaiii##ifeiiiiiilit fewiiifiiii#: iiiiw iitw Ri#wwwwwwwwwwwwwwwwwwwwit it it it it ie it ii it irw I N D I V I D U A L F E E B R E A lit D O W N TYPE QTY D E S C R I P T I V N UNIT LOST TO'1ALkCOST SFC 40000 ALTER BY VALUE COMMERCIAL NOZONE 1.00 40;000.00 A- N�D{y _F FEES comp/ wFll'QIAy6�} ack,e (0 Hob Qnd ell Q /y� 6/ �Q� t aball 10-29-1997/89:23' AN/f8.08 82d@ /Qt& d9, C AQP RCPT6:61-6814624 §t't22�g8uletiansa PERMIT. -085485 " 'All" .CON�$TRUCTION AND PLANNING PO(.r� &SPA \ ., ARPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Coriduit Utility,-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding -- „5, Steel Reinforcement 56. Rough Plumbing & Pressure Test 6 ElectricahQFER Grnd. 57. APPROVAL TO COVER•GUNITE 7. Footings ,• - 58. Electrical Conduit-Unclrgrnd. •8. Foundation 59. Gas Pipe, 1:1 Undrgrnd., Test - r 19. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final •- 13. Roof Drains "' _. 64:'Plumbing System - Final - r66. 14, Ro ugh Plumbi ng Electrical-Finat -. 15. Rough Electrical -Conduit - 66. Solar System -Final 16. Rough Electric Wiring -' i , 67. Fencing=& Access Approval 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT - j APPROVALS'. ,-.Pe}mit # �T' 20. `Rough Fjctory Fireplace '' " r , S �:, i ' 2L bucts,.in Structure •• - - _' ` = 70. 'Underground Hydro 22.;Ducts, Ventilating: ° ; 71. ProductPiping'OGas bOil 23. Gas Pipe -Rough & Test • - - 72. Underground Fiush - 24. Roof Framing -_ ", % �' 73. Undergrnd.StorageTan( 0Gas 0"Oil 25. Roof. Sheathing .- _ v _ _ i� r 74: 'Overhead Hydro r 26. T -Bar Ceiling (Structural) & Mai,ocoat '� " 75, pry:,Chemical ,� 27. Frame and Flashing, +- - -. �. 76. Dry Standpipe,; -^ r _ ' 28. Lathing & Siding ' • - - - "i "Ik 77, FIXED.SY5TEN}'FINAL _ 29. Insulation c 78. FIRE PREV. FINAL ' - - 30. Drywall Nailing } ! t3 r it -,HEALTH DE(T.: REQUIREMENT V 31. Plaster Brown Coat -• i` '. 79. FINAL INSPECTAON - - 32. Electrical Power Meier=Final' • ° 1w 80�. FOOD CERTIFICATE.JSS.UED _ 33. 'allElectric; V n y 16, 34. 'Final Heating'& Air 'Conditioning, : i a '� r _' !7 7 35. Final Gas, Pipe; Test 36. Hood or Canopy " _ _ _'' -• •i - - - _. _ " % a•J 37. Final.Factory Fireplace -• -., r r '` N `8 N 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final _ • • -� *i `• i -= , :�, j':� 41. Solar Domestic•F;nal - �' .. - - •� .a 42. Backflow Preventer• 1 i _43. Backflow Irrigation. 44. Landscape Irrigation System - rt '45. -Sound Attenuation _ 46. Handicap Regulations _ �•, 'R B- _ SIM ' 47. FINAL STRUCTO,RE&BUILDING 46. FtNALPLANNiNG- --' �gtit R � 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51'. CERTIFICATE OF OCCUPANCY No. Date