The URL can be used to link to this page

Home My WebLink About292 19TH ST - Building Permits • • n f CITY OF COSTA MESA 4440111k° 4 9 BUILDING DIVISION F( ,,,,, " � I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER k PERMIT amc ' E06-00277 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 292 E 19TH ST Status: ISSUED Suite No Applied: 04/04/2006 Vicinity: Issued: 04/04/2006 Parcel Nunmber: 42628121 Applicant: IBANEZ, ADOLFO B Address: . 3101E ISSUED t3Y . V' l Phone: 800-503-2666 1 BREA,CA Zip 92821 • Owner: ELLISON, RONALD L Address 292 E 19TH ST Phone: 949-642-7778 COSTA MESA,CA Zip: 92627 Contractor: ECONO AIR " Address: 3101 ENTERPISE STREET Phone: 800-503-2666 BREA,CA Zip: 92821 License:445220 SCOPE OF PERMIT CHANGE OUT(E)FURNACE AND INSTALL NEW NC UNIT FOR SFD. • WORK TO INCLUDE: 1 MOTOR TO 10HP REF#:M06-00162 FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $54.50 ___ 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 . 4 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 - Misc.Conductor. $0.00 0 Service over 10000 $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 tOhp $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 Sub panel to 200a $0.00 0 . Plan Check Fee $0.00 Pole Light Pkg ,$0.00 ' 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 - TOTAL CALCULATED FEES $78.00 Intermed Pole $0.00 0 nfuupuTO $Ones.al nniar\ITIna1C NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California st utes 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 2446-46(6/00) • DECLARATIONS, WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I❑"1 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. My wo ars' ompensatlon Insurance carrier and y number are: 1Carner:J' ekt'''` Policy Number: la G z' G D 6-"j 743 C�� (Thins section need not be c plated it 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 become subject to the workers' compensation laws of California,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 provisions. ��] r— - Applicant Signa urt e:' r/ `Date: �' ' G WARNING:FAILURE TO SECURE WO ERS'COMPENSATION COVE GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOI,SAND DOI.LARE(5100,000),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 underprovisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force'arid effect:t icra,—__ `f c'/„S L t-'O r'—" _ Class#— C„' Contractor'sSignature:—.. - 'Sanas Dater/ .. — V CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: _ _ Lender's Address: 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 or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Le al Owner(s) Date ae 'A Or Authori ed'Appl' tDale,.r„_ CODE/ INSPECTION TYPE DATE jNTQIALS CODE! INSPECTION TYPE PATE DMA 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical /MG 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 4`asig M(5 9 CITY OF COSTA MESA BUILDING DIVISION 1. 1 man-uncut DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER PERMIT 06-00162 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 292 E 19TH ST Status: ISSUED Suite No Applied: 04/04/2006 Issued: 04/04/2006 Vicinity: Parcel Number: 42628121 t� ISSUED BY' Applicant: IBANEZ, ADOLFO B Address: 3101 E Phone: 800-503-2666 BREA,CA Zip: 92821 Owner: ELLISON, RONALD L Address: 292 E 19TH ST Phone: 949-642-7778 COSTA MESA,CA Zip: 92627 Contractor: ECONO AIR Address: 3101 ENTERPISE STREET Phone: 800-503-2666 BREA,CA Zip: 92821 License:445220 SCOPE OF PERMIT CHANGE OUT(E)FURNACE AND INSTALL NEW NC UNIT FOR SFD. E • - REF#::06-00277 WORK TO INCLUDE: 1 INST FAU LESS THAN K BTU, 1 REPAIR/ALT COOUHEAT AND COMPRESSOR 3 TO 15 HP/500 K BTU,REFRIG SYST LESS THAN 100 K BTU. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $14.80 1 - Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $13.70 1 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Ref rig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $27.15 1 Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 • 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00, 0 Boilers Fire Dampers '$0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp - $0.00 0 Inst or Relocate Appl Vent $0.00 ' 0 15 to 30 hp $0.00 0 Air Handlers< 10000cfm - $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm • $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 . 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $79.15 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statut and related regulations.(Ord.No.92-28,§1, 12.21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(WOO) DECLARATIONS' WORKERS'COMPENSATION DECLARATION: Ihereby affirm under penalty ry ofperjury one of Uefollowing dedarations: O I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I ❑ I fiave.and will maintain workers'compensation insurance,as moth by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. vioXs' pensation Insurance carrier and icy number e: [ _CarerA7 ��L�-' Policy Number: - an—mi G' / O 75 pcf1 C (This section need not be cram feted if the permit is lued et one hundred dollars(5100)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 California,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 provisions. Appiicant.Signature:;-" Corr- i 7 --ti D / - Cie' 0 WARNING:FAILURE TO SECURE WORKERS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO-CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND OOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37030F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I herebyaffirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Busines nd Professions Code,and my license is in full force and.effect.-LIc,.d= =y t 1-"]-43 Class a /0 • 1 Contractors'SIgnature: �.—� —Dior t-J — -°G 1 CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500).): ❑ 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 or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I.as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business end Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): 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 has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature_and pressure). __ 2 Does or will the applicant or present or future building occupant need to file a regis• tration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the Calif omia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes l No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Ouality 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 0 No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penally of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Le nen(s) Date — Y— Q to A Or Authorized Applies (Date ;ODEA INSPECTION TYPE DATE INTRIAL5 ;ODE1 INSPECTION TYPE MMME ILLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical - -a 4 -O6 RN 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy CITY OF COSTA MESA __ - 4 a- — BUILDING DIVISION 7PERt , DEVELOPMENT SERVICES DEPARTMENT UMBER f 1rnirariPERMIT4. 974 Stveftwaso.4* (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.usNG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDIJob Address: 292 E 19TH ST Status: ISSUED Suite: Applied: 12/05/2002 Vicinity: ROOF Issued: 12/05/2002 Parcel Number: 42628121 Zoning: Applicant TROY ALEXSON _ ISSUED BY: SIL Address: 1653 SUPERIOR AVE _ Phone: (949)642-7222 _ - - COSTA MESA,CA- , - Zip: 92627 _ i". ;,� - Owner: ELLISON, RONALD L �� / - - NI Address /292 E 19TH ST, _ / ,/// ' - Phone: // COSTA MESA,CA—I 1 Zip: 92627 ' Contractor: ' LEE ROOFING OF COSTA MESA � Address: 1653 SUPERIOR AVE \ '.\; , -, Phone::'(949)642-7222 :� COSTA MESA,CA - - , Zip: ' 92627 . License:'. 349686 "' Arch : �! Eng: Address: , G - __ Address: - - - Phone: - ., , // - ‘, Phone: - Zip: - . .-' License: N License: A N , ,,ti. , -. n-, SCOPE OF PERMIT, „ _. , TEAR OFF EXISTING ROOF.INSTALL 30#FELT UNDERLAYMENT,CLASS A,30 YEAR COMPOSITION SHINGLES.24 SQUARES. FEE SUMMARY 'n: Plan Check: ' $0.00 Calc Valuation: --$4,600.00, Permit: $111.25 %is = Claim Valuation: sasoo.oi SMIP Res: $0.50 /��i' , SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 c c ' l , ' =vTotal: ,,$111,75 ��i� Y PLANNING &ZONING SETBACKS",\ / / N , /' /// / / MAIN STRUCTURE Front ,-0.0 = ' Rear 0.0 Left 0-0 Right "'0.0 / - '/ ACCESSORY 'Front 0-0 ' Rear 0-0 Left 0-0 Right 10-0 V - , , ' ,- PARKING Existing:, 0 Required: '. 0 Proposed: 0 ', NOTES: • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2448-46(6100) DECLARATIONS WORKERS'COMPENSATION DECLARATION: - I hereby affirrryndor pei tIty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. tip>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. My work rs'coTpensatiyo nsur�Ice carrier and policy number are: q r ^7 Carrier STA-I-C .�-Grxd( •2 lcy.Number: 2D !a /1000 Chis section need 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 become subject to the workers' compensation laws of fomla,Q�d agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Coda,I shall forthwith Comply with theeb prew3 //nom T-� Date: ��NS gnet� `eta:_—P - - 0! •WARMNG:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML 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 lice ed u•der•r•vi ons of Chapter 9(commencing with Section 7000)of Division 3 of the Busineend P,ofpsgions Code,and my license is In full DtaceAndeffecil3e rtr- _ . - > cDatyP Contractor'sSignature: Ir /4.rein - C1-r-- CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there Ls a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: 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 end Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of properly who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): 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,faisework,or demolition or dismantling thereof,will be more than thirty-six(38)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,TIlle 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Flre Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutelyhazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 if an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application akermit for such construction or modification from the South Coast Air Ouality Management District or from any other air pollution control district or agency? Yes U 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 feet from the outer boundaries of a school? 0 Yes 0 No (If yes•,the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No 8 (if'yes*,attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signal ., Of Legal Owner(s) Date ij /2 , S- 2lL ✓ do 7.1 . 1.r•pplRanr GDate_? cODE P, l$SPECTION TYPE PAIE ILIIIaLS ODDE! INSPECTION Mt j?AIE ILIILBALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final (� 208 Final Plumbing 200 Final Re-Roof 12-lo-�� rfi44 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition _ 250 Final Building/Occupancy • - MF Pi CITY OF COSTA MESA111011 c � BUILDING DIVISION PERMIT NU ER y , r„,, DEVELOPMENT SERVICES DEPARTMENT �.....g PERMIT BO -01443 %Poami • (714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 292 E 19TH ST Status: ISSUED Suite: Applied: 09/15/2000 Vicinity: REAR PROPERTY LINE Issued: 09/15/2000 Parcel Number: 42628121 Zoning: Applicant: ODDO, FRANK ISSUED BY: Address: Phone: 714-991-7773 Zip: Owner: ELLISON, RONALD L Address 292 E 19TH ST - Phone: COSTA MESA,CA Zip: 92627 Contractor: ORANGE COUNTY FENCE Address: 534 S ATCHISON ST Phone: (714)991-7773 ANAHEIM,CA Zip: 92801 License: 506245 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: - SCOPE OF PERMIT - APPROXIMATELY 50 LF,6'HIGH BLOCK WALL TO BE CONSTRUCTED ON THE REAR PROPERTY LINE. FEE SUMMARY Plan Check: $25.19 Calc Valuation: sl,000.00 Permit: $38.75 • Claim Valuation: $0.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other $0.00 Inspection: $0.00 Total: $64.44 • PLANNING &ZONING SETBACKS • , MAIN STRUCTURE:Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ' PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: 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. C- 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 26464e(aro0) WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ..„2^ 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. My workers'compensation Insurance carder and policy number are: Carrier: Policy Number: (This section need not be completed if the permit Is valued at one hundred dollars($100)or less.) ❑ I certify that In the performance of the work for which this permit Is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree the If I should become subject to the workers'compensation provisions$actlon 700 of the Labor Code,I shall forthwith comply with thpr ons. Applicant Signature: - �7 Date: L WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOL ARE($10D.000).IN ADDr1ON 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 under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full force and effect.Lk.p �M\ IA % Class N Contractor's Signature: �' Y,Vt` 1 ,� Date: { 1C71ra) CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: 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).): 0 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 or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. . Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Driver's 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,fatsework,or demolition or dismantling thereof,will be more than thirty-six(38)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 Safely,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 W III the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). . or c pant need _... ._ . 2 Does or will the applicant or present or future building occupant neto file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Flre Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas et standard temperature and pressure). .licant_. ante- Pre;;;;-151O 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safely 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 2c5.14 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application erm apit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes P No (Section 65850.2 of the California Govemment Code requires that the requested information be fumished on applications for non-residential building permits). ._...__._ aceta 6 Will any part of_the facility 1 o to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. - t e Legal Owner(s) CAn u Applicant ate 44aE1. INSPECTION TYPE PATE INTI. PODEE INSPECTION TYPE PATE =AU 1616 Fixed System Final Fire Prevention 208 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof �y1 _ 210 Final Electrical — 201 Final Block/Retaining Wall 9icU Cd, ' 212 Final Flre Prevention • 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Bullding/Occupancy 'I Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. C1 PERMIT NO. TRA N L T UNIT NO. CITY OF COSTA MESA 1 F.. UCTION PERMIT 3 o . A•P•# �� z' Zone RI /Pr�{act Address 2�7 .c-• G• 1 �TH Lf�, S Main Building: Accessory Building: fplicant's Mailin Address SAMC TYPE OF CONSTRUCTION U NEW ADD U ALTERATION ❑ REPAIR / / / . �L A C 1 1 ❑ CONVERSION 0 DEMOLISH 0 OTHER T Front 4 �qt�e✓L *0 h�� 0 O er•s Name p Y F-�+-1 ST)N Phone (a L'l 2.4 8 ( N d aq a-. 1, 19 T-1-1 sT 1LOSTA J1nESA DyB§RIPTION OF WORK/USE OF BLDG. A Rear ZS I rAddress ) l` U C Right N Arch/Eng. License No. TYPE OF PERMIT GRADING U FOUNDATION U STRUCTURAL Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING 0 MECHANICAL S Left G ❑ -OTHER ..S Ping. Ref.# Parking Req./Provided Q Contractor's Name • Phone E PROJECT DESCRIPTION SQ. FT. zZ&' OCCUPANCY rr..v- Planning Notes: ^ L M Addre551mailing) `� CON ST RUCTION TYPE 'V ) - 'VALUATIONS lb 0.1),. �2$��, " e C 0tor" T City License No. ZONE GRADI NG CU.YDS. - ACRES S. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: with section 7000) of Division 3 of the Business and Professions Code,and /license is in full force and effect. ELECTRICAL FEES L4nse Class License No. `ie Signature PLUMBING I FEES Automatic Washer Transformer ❑ 15.50 KW WORKERS' COMPENSATION DECLARATIONConstruction Pole Sub. 050+KW I hereby affirm that I have a certificate of consent to self-insure or a certificate • Bar Sink Showers of Workers' Compensation Insurance, or a certified copy thereof (SectionCooking Unit Meter ❑up to 100 amps 3800, Lab. C.) • Backflow Preventer Service Sink - Policy No. - Company • Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 imps A Certified ropy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Date Applicant Fan Motors❑Q7 HP ❑i,X-B EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors - (This section need not be completed If the permit is for one hundred ($100) or Dishwasher Solar Piping F.A.U. less). Inc.Solar 09-15 HP 016-15+ I certify that in the performance of the w•rk for - Ich tris permit is issued I Fixtures Microwave - shall not employ any person in any mal er so to bton1B subject to the Drinking Fountains Solar Tank • wortC e t' n Laws of Callfor. x. I`'y1, Device Boxes yFp�pa �d Pole Light NDateoT :•/ /- "1 /Signature ;�` Floor Drains Swimming Pool w/Spa 9 17 Rel making this T•u ''y Id becom subject o the OuH¢[s Range - ii Workers' Compensation provisions of the •bol Code, you must forthwith Floor Sinks. - Urinal - comply with such provisions or this permit shall be deemed revoked. Switches CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Sign I hereby affirm that there is a construction lending agency for the performance of the work for which this hGarbage Disposal Standingermit is issued (Section 3097 Civ. C.) Interceptors Water Heater - Sections Lender's Name Lenticr's Address Kitchen Sink Water Service ' Generator 00-5 KW 05.15 KW Trash Compactor BUILDER aUILDER DECLARATION olein affirm that I am exempt31.5from theand Contractor'sofioLicense Law for the Lavatories Auto-Wash ,;,2ih.;Wowing re uiresi an t Business t, Professional Code: Any cityy or ,;sty which requires irto a itspermitissuance, to,arequires s t,Improve,demolish or repairP-Trap Laundry Treys r.5''afile structure, prior m t shat alsohe/, licensed the applicant for such ipermitso - hie a tactor statement that hq/She is licensed me pursuant to the provisions of - Roof Drains the Contractor's License Law (Chapter 9(Commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3 ' 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 anally of not more than five hundred dollars($500). s $ 3 DEVELOPMENT SERVICES REQUIREMENT S:�T r ry y�I, as owner of the property or my employees with wages as their sole Zoning Approved By s.•! J Date 1 ��\ compensation, will do the work,and the structure is not Intended or offered Reinspection Fee I $15 Issue Fee -- - -�� for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date License Law does not apply to an owner of a property who builds or Improves .. ___—-_ -_ -.------.- - - ----- --- thereon, and who does such work himseaf/herself or through his or her own Boiler Hood Or Type I ❑ Application Issued By Dataan �J�1 employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of corn- Canopy Type II ❑ • SUMMARYFEES elation, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground rove for the purpose of sale). BUILDING PERMIT $ SSSMIP $ 0)-- t) `❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ 7 7 7-1 PERMIT tractors to construct the project (Section 7044,Business and Professions Coder The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $ builds or Improves thereon. and who contracts,for such oroiects with a con- tiactor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation Insurance should be provided to me. ELECTRICAL $ GRADING $ ❑ 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers • MICROFILM $ (/ PLAN CHECK 50% $ _ -d Date -s�,i��/Owner ///'.�(1) / Heating System& Ducting Registers MECHANICAL $ TOTAL FEE $ SL>zS I hereby certify t at I ha readht is application and state that the above ❑O-100,000 BTU 0100,0008 PLAN CHECK 25% information is torr ct. I agr to comply with all city and county ordinances $ and state laws rel ing to ildn nss/ruclion, and hereby authorize repro- sentatives of th ity to nt poo the above- enteone• •rowarty for AIns estion Pur es ,(1 n,� q1� g ature t /d'C7�Pl / Date . " as • $15 ' Drivers' Licen e or S �aess� •_ •ODD4047E-00040450 TOT r, •i 0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod -Assessor OATE: 08/IT/89 ' TINE: C8:52 • • CONSTRUCTION AND PLANI OOL& SPA Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit# • 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' 3; Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings, 58. Electrical Conduit-Undrgrnd. 8.-Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. 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 • 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil tt,237 Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil X25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical -27. Frame and Flashing 76. Dry Standpipe -28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 2. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy • 37. Final Factory Fireplace -38. Final Plumbing - t39. Water Service-Final. _ 40. Gas Service-Final f 41. Solar Domestic-Final; 42. Backflow Preventer 43. Backflow Irrigation; 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL/STRUCTURE & BUILDING cl to(q' /' r- 48.48. Special Requirements Completed 49. Electric Release to Edison -50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. . Date _ _ i LJI ' /ZYs•— 9vv:_ '_ - --•__ i z. PAID /34 022 MAY 20-77---cA 996* ****68.74 COSTA MESA BUILDING-SAFETY DEPARTMENT 1 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only BUILDING ,...z._ �j 7r/ RECEI DAAAIE RECEIVED DATE ISSUED 7 ADDRESS t1 a /97/ s //G oT �O•" `� _ l -7/ �r PERMIT NO. OWNER 00 • SSoC - es A.P. NO. ,-13 —sem MAIL BUILDING q E /y ADDRESS P Q ; /'Q X 3 26 A��))DDRESS p?9d TEL /r`w�y� �rq"" /J ��p_ ADDRESS CITY .� 5 i y NO.g3f-//•J TRACT I TOT BLOC K CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOI ISH LENDER v BRANCH h ,,/ / /• / ' OWNER gO Oy `l- /15-50 ../,4 /( -C ADDRESS 4,4€7 �� ,�rr //�,// ARCHITECT TEL. USE //X4CI //J1D/L/V$ /v0� OR ENGINEER bu, /f• Ada r/4-44 NO.S3A95.14- I n Alr/ �1 FIRE }' ADDRESS �6 lS N• Al4J/4/57, 4r t�NytC ZONE T E IL-GROUP' ^ ,sem APPROVED / _ J� CONTRACTOR//OOP �y/T-S�7So�C/A/G;S BY C DATE C/ / / ADDRESS r Bo X {/ /6 ZOJyE NO OF USE OF NEW tiJ —`F N TEL. K , PLANS BUILDIINN�p�4 �/ F CITY /./ r5- / / NO.r,��y3SS� AA//// p/r�.� 1-1 STATE CITY G YARDS APPROVED YARDS APPROVED , LIC.NO. a 72 /86 LIC.NO. 6 /sZ Z MAIN BUILDING ACCESSORY BUILDING /'� (FROM Q. OF LOT/j17r /5- X 4//.01 G INOW ON LSIZE NO.OF OT FRONT C/L$IF i-.4 � I^ FT. V Q USE OF /�J i. * s' EXISTING BLDG. — R SIDE S.35ff. FT. ,1 , �/ `\i-- 5 Separate permits are required for L.SIDE 5;. r FT. [- electric,plumbing and heating work. REAR F 3a / �J FT. W F.r USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& t Q A MAIN BLDGS. �J// ACCESS. BLDGS. I7.1 VJ/.V O///N�/ �//7T�A'I'fX 9C DATE C URP.*C--! // AAPPROVED,. 9-17 C4 HOLD FOR SPEC 1. C2 E k TS Wi›• APPROVED --Mhe n 0 I hereby acknowledge that I have read this application and state n to that the above Information is correct and agree to comply withco O. all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of �7 �JY /,//G / 2 the State of California. /2( V SO. FT. Y! se At •v m 3 I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions rode, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR as Chapter 9, and that such lice :s are in full for e and eff- t,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the .rovisi-..s of the State of aliforn'. siness sr and Professions Cod 1 Divi • 3,Cha ter 9. VALUATION PERMIT FEE $ '� Jr in Signature of 7 �ps PLAN CHECK $ �4 SO o Permittee / , I $' 3? oOV TAX $ 'O LL 2,p Authorized A./nt TOTAL PAID $ e5 5 PAID h ({I IIN 13-7701492 MI*** 133.00 ' 1 4 1 o I2' EIIS/. ri COSTA MESA BUILDING-SAFETY DEPARTMENT I P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 PLIC TION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only (,' �+ R C F BY DATE RECEIVED' DATE ISSUED BUILDING SS p79 / / 74 S r et?. C ��RRRJJJyyy111 �zz OWNER O e,�JjY /rSsa e,,,,..4 /(- A.P.NOBUILDING MAIL `> ADDRESS D r(7 OJC ��(�` ADDRESS 9�-0 7 1541/CITY ')4/ 5 // At NTEL. air ` TRAC (/ /['��7' LOT BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVINfi OFMOI ISH LENDER /1/4"- BRANCH OWNER /7`E t c1 V,4$3', ?„6 ADDRESS III "' inVALUE ARCHITECTSE OR ENGINEER 4Y//7•/�/l/r lei( NOSj7ff fy7'�• RE $ ADDRESS 20 75" /yf//WJAN s 7.�0vq $C ZONE TYPE GROUP O oc / A,S,S D`- ,:4-Tc APPROVED CONTRACTOR,�J / BV DATE ADDRESS y'• Q . eQ x 3 2 6 ZONE No.OF USE OF NEW CITY <5 /, N NO fJr—ggJSss PLANS BUILDING .~i STATE � CITY YARDS APPROVED YARDS APPROVED LIC. NO. 07 2r, f 0 p 6 LIC.NO. 6 f1,1 2, MAIN BUILDING ACCESSORY BUILDING SIZE A �J (J 4 /NO.OF BLOCS. (FROM C/L STREET) S OF LOT 1/07/ /,S .. y//p,6 NOW ON LOT __EBONT FT. FT. yUSE OF EXISTING BLDG. EL SI nF FT, FT. 1 \\ Separate permits are required for L,SIDE FT. FT. �\F-' h Cl- electric,plumbing and heating work. REAR FT. FT. F USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& Q / MAIN BLDGS. ACCESS. S.BLDGS. Q / Q (LlicV //// Cr.4777 / i-/A/`` VAR.# C.U.P. y DATE APPROVED APPROVED ›m —B_Y DATE ..1 IY W 0 I hereby acknowledge that I have read this application and state n In fY that the above Information is correct and agree to comply with m L all laws regulating building construction, and I shall not employ i Z any person In violation of the workman's compensation laws of 2 the State of California. 3 I hereby certify that I am properly licensed as a contractor under 4 �7,� A�_ SQ, FT. a / the State of California Business and Professions C•de, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that suc licenses are In full fore and e • t,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLYrss::-r� u em exempt from the p •vlsi• of the State of •alifor a : Innen VALUATION PERMIT FEE $ /33 Ls o and Professions Cod •Iv', 3,Chapter 9. r v+Signature of In PLAN CHECK $ t9 0 Permittee / $ TAX $ a .•••••• U Authorized Int TOTAL PAID $ /3 3