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Home My WebLink About379 19TH ST - Building Permitsi � U � � CITY OF COSTA MESA �S�pMFq B1/ILDING DIVISION � i� . � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 •�.ci.costa-mesa.ca.us �. ` FOR INSPECTIONS CALL: (714) 754-5626 ,�`w.o,mm ^` . PERMIT NUMBER: BX11-00372 PERMIT TYPE B MISC STATUS: ISSUED APN: 11729414 DATE ISSUED: 11l21/2011 Zoning: , ISSUED BY: KJB JOB ADDRESS: 379 E 19TH ST CM Vicinity: SQ. FT: 0 SuitelUnit: Primary Occ: Const Type �? Valuation: $9,900.00 SCOPE OF WORK: CHANGE OUT WINDOWS AND DOORS. LIKE FOR LIKE. NO INCREASE IN WINDOW SIZES OR LOCATIONS. OWNER: OWENS, BLAIR City/State: COSTA MESA, CA Phone: APPLICANT: RON PARKER City/State: COVINA, CA Phone: 626-252-7478 CONTRACTOR: RON pARKER Address: 282 GROVERDALE City/State: COVINA, CA Zip Code: 91722 ARCHITECT: Phone ENGINEER: Phone FEE SUMMARY Building Plan Check: Building Permit: Electrical Permit: SMIP Residential SMIP Commercial Bldg Std Admin Fund Address:: 379 E 19TH ST Zip Code: 92627-2349 Address: 282 GROVERDALE Zip Cade: 91722 License No. 753823 Phone 626-252-7478 $0.00 $18125 $0.00 $0.99 $0.00 $1.00 License No. License No. Unit Unir Unit: Cell: HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/1812010 - PER CMMC Sec. 13-279 Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays -9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal Holitlays: New Ye�ars Dav. Memorial Dav IndeoenAenr.r I�av I ahor Dav. Thanksaivina Dav and Christmas flav NOTICE: The work authonzed by Ihis pertnit shall comply with all applicable handicap access requiremen4s under California statutes antl related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 160 DAVS FROM DATE Of ISSUE OR DATE OF LAST INSPECTION. 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. U 9. INSPECPONTYPE DATE INTTIALS CODEt IHSPECTIONTYPE ORTE INi111RL5 7676 Fixetl Sysfem Final Fire prevention 206 Final Mechanical 12fi6 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Pinal Electncal _ 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Fac�ory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site � 204 Final Demoli�ion 250 Final Building/Occupancy � ' WORKERS' COMPENSATION DECLARATION: I hereby af(irm under penalty of perjury one of the following declarations: ❑ I have antl will maintain a certifcate of consenl lo self-Insure for workers' compensation, as providetl for by seaion 3700 of the Labor Code, tor the perfortnance of ihe work tor which this permit is issued. ❑ I have antl vnll maintain wurkers' compensation insurance, as required by section 3700 of Ihe Labor Code, !or the pertortnance of [he vrork (or which this pertnit is issued. My workers' compensa[ion Insurance carrier and policy number are: Carrier. (TM1i55ec1imneetlrrol0ewmplefeOAlhepe�mRisvaluetlalone untliedWll�rs(5100)wlessJ Policy Number. � � �certify lhat in the per(ormance of the rk for which this pertnit is �-�I�sued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Calitornia, and a9ree Ihat if I should become subje to the ork compensation provisions of Seclion 3700 of Ihe Labor Co I sha fo th comply vrith [hese provi(s�io�ns�. � / �.� / / gnaWre Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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 affrm that I am licensed untler 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 eHect. /� ic. ' _ g �as .: v G �' _- .Cs awre oa� +n-// CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrm lhat there is a constructbn lentling agency for the performance of the v,ork (a wfiich this pertnit is issued. (Sec 3097, Gvil Code). Lender's Name: Lender's Address: OWNER-BUILDER DECLARATIONS: I hereby aKrm that under penalty o( perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or coumy which requires a permit to consWct, alter, improve, demolish, or repair 2ny slmcWre, pnor to its issuance, also requires the applicant for such permit to file a signed statement that he or s�e is licensed pursuant to the provisions of the Contrec[ors License Law (Chapter 9(cammencing with Section 7000) of Division 3 of the Business and Protessions Cotle) or that he or she is exempt therefrom an0 Ihe basis for the alleged exemption. Any violation of Section 7031.5 by any applicaM lor a permit subjects the applicant to a civil penalry of not more than fve hundred dollars ($500�.�: ❑ I. as owner of the pmperty, or my employees with vrages as their sole compensation, WILL DO THE WORK, and the structure is not intended or oBered for sale (Sec. 7044, Business antl Pmfessions Code: The ConVactors License Law tloes not apply to an owner of properly who builds or improves lhereon, and who does suc� work himsel( or herself or [hrough his or her own employees, provided that such improvements are not in[ended or oRered for sale. I(, however, Ihe building or improvement is sold within one year of completion, the owner-builder will have the burden o( provinq that he or she tlitl no1 build or improve for purpose ot sale.). ❑ I, as owner of lhe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to conslruct the project (Sec. 7044, Business and Protessbns Code: 7he contractors License Law dces not appty to an ovmer of propeny who builtls or improves thereon, and who coNracts for such project with a contracta�s) license pursuant to Ihe Con[ractors License Laws.). ❑ I am exempt under sec. Business antl Professions Code tor this reason: SignaWre Dale 905]-46(3i01� , Owner ID veri/ied by drive�nse. ❑ Yes ❑ No Driver's License No. Ezpires: Venfication of Ovmership by (rype of document, i.e. - propeAy taz bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certi(y that no ezcavation (rve (5) or more feet in deplh into which a person is requiretl to tlescentl, will be made in conneclion with vrork authorized by this permit, and that no builtling struclure, scaffdding, falsework, or demolition or dismantling thereol, will be more Ihan �hirty-six (36) leet high. (Chap. 32, Grp 2, M 2, Sec. 341, Title 8, Cali(ornia Adminis121ive Code). ❑ As ovmer-builder, I will not employ anyone lo tlo work which woultl require a permit from the Division of Industrial Safety, as notetl above, unless such person has a pertnil to do such work from Ihe division. Apphtanfs SignaW re Division of Indusirial 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 tor emergency response to release or threatened release of a �azardous material? ❑ Yes ❑ No � (Section 25505 of Ihe California Health and Safely Code requires, with some ezceptions, that a Business Plan be fled with the Costa Mesa Fire �� Department by every business which has at any one time during a reported year a quantiry of hazardous matenals equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic teet of compressed gas at standard temperaWre and pressure). 2. Does or will the applicanl or present or fuWre building occupant need to fle a registration (orm (or acutely hazartlous materials? ❑ Yes ❑ No (Section 25533 ot the Califomia Health and Safety Cotle, with some exception5, require5'regiSlralion with lhe CoS�a Mesa Fire Department by each business which at any one time has on hand a quanlily of acutely hazardous ma�erials equal to or greater Ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standard temperature and pressure). 3. Does or will the applicant or present or luture building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials�? ❑ Yes ❑ No (Section 25534 0! the Cali(omia Health antl Salety Code pmvides that the Costa Mesa Fire Depanment may require the preparation, certifcation antl (ling with Ihe Fire Department of an RMPP by businesses which are required to register acutely hazartlous malerials with the Fire DepartmeM. 4. If an RMPP is presently requiretl, has Section 25534 0! Ihe Cali(omia Healih and Satery Code been fully complied with4 ❑ Yes ❑ No 5. Does or vnll the applicant or present or tuture building occupant require for the vrork which is the subject of this application a permit !or such consWction or modifcation fmm the South Coasl Air Ouality Management Dislrict or from � any other air pollution control district or agency4 ❑ Yes ❑ No (Sectbn 658502 of ihe Calitomia Govemment Code requires that the requested information be fumished on applications fa rwn-residential builtling permi�s). 6. Will any part of the lacility to be consWcted under this permit be within 1000 feel from the outer bountlaries of a school? ❑ Yes ❑ No (I( yes", the faciliry must meet the requiremenl of Sections 25534 antl 42303 of Ihe California Heal�h and Safety Code). 7. If a pertnit from the SoWh Coast Air Qualiry Management DisMcl or olher air polWtion control dislrict or agency is required (or the work which is the subjecl ol this application, have al1 of the tlisclosures prescribed by California � Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (If'yes", anach certificate of compliance from the appropriate air pollution conlrol oKceq. CERTIFICATE OF COMPLIANCE: I certify Ihat under penalty of perjury the in(ormation given above is correct. I agree to comply wilh all state laws and ciry ordinances regarding Hazardous Matenals and Emissions. Signalure Dale CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I certify under penalty o( perjury that I have read this application and state that the in(ormation given is correcl I agree to comply with all state laws and city ordinances relating to building conslruction, and authorize representalives of the City of Cosla Mesa to enter upon ihe above�escrihed pmperty for inspection purposes. I agree not lo occupy or allow occupancy of any building authorized by this permit u �il final inspection. Sig awre o l ga Owner Date r -- ��-�-�'/( � ' 3tnoirzeb�Applic3ht�,a, �SIE�j,,,. �t CITY OF COSTA MESA - ; � BU/LDING DIVISION �. DEVELOPMENT SERVICES DEPARTMENT E98-00488 �� PERMIT PERMIT NUMBER (714) 754-5273 • Fa�c (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 379 19TH ST Sulte No Vicinity: Parcel Nunmber: 11729414 Appliwne WALKER, ABRAHAM R TR Address: 379 E 19TH ST COSTA MESA,CA owner: WALKER, ABRAHAM R TR Address 379 E 19TH ST � , - COSTA MESA,CA , " . Contractor: Address ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts �Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over t00hp Communication drops Sub panel to 200a Pole Light Pkg Si9n Circuits Temp Pwr Pole Intermed Pole Phone: Zip _ 92627 Phone: �. � . _ Zip: 92627 Phone�`. Zip: License' Status: ISSUED f�i(,� Applied: O6/03/1998 Issued: O6l03l1998 � SCOPE OF PERMIT � , ' , ELECTRICAL OUTLET FOR LEGALIZATION OF ADDITION. . - $22.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1.00 80.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY, Temp Dist System I Lighting Busway /100 ft � � Standing Sectiom - Misc Electrical Equipmenl- Transformers�up to 1 kvalkw ................uP to,10 kva/kw ..............:..up to 50 kva/kw .................up to 700 kva/kw ...........:......over 100 kva/kw Low Voltage Equipment Low Volt Winng System / Ckt Misc. Conduit Misa Conductor Circus ( gen or ride), Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand � ' Other Electrical Fee � Investigation Fee Plan Check Fee Reinspection Fee Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 U $0.00 0 $0.00 0 50.00 ' 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES 523.00 COMMENTS / SPECIAL CONDITIONS EXPIRED � o� � a p EXPIRATION: This pertnit shall automatically expire and become voitl if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order tor the work authoilzed under this permit to be considered legal, such work must comply with all aPplicable codes, and all required Inapectione end finel epprovel must be obtained. Failure to obtain inspections antl final approval will result in tha expiration of this permit. FOR INSPECTIONS CALL: (714) 7545826 WORKERS' COMPENSATION DECLARATION: I hereby eNirtn under penalry of per�ury one W the tdlowing dedere4ons: ❑ I heve entl will meintaln e certlticate oi consent to sell-Insure tor workers' compensatlon, es provided for Dy aectlan 3700 of ihe Lebor Gotle, for the pertortnence ot the work for which this pertnit is issued. ❑ I heve end will meintain workers' compensatlon insurence, es required by section 3700 ot Ne Lebor Code, for Ne peAortnance ot Ne work tw which this pertnit is issuetl. My workere' compensation Insurence cartler end policy number are: Cartier. Policy Numbec (Th/s sectlon need not be com0leted ll fhe permlt As velued et one hundred dollars ($700) or less.) ❑ I certity ihat in the perfortnence oi the work 1or whlch this pertnit Is iuued, I shall nm employ eny persan in eny manner ao es to become sub�ect to ��e workera' compensetlon lews of Celifomie, end egree �hel if I shoultl become sub�ect to the workers' compensetion proNslons of Section 3700 of the Lebor CoOe, I ehell torthwith wmply with these pravisions. Applicent Signeture: Dete: WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNIAWFUL AND SMALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDFED TpU$M1D OOLURE (5100,000), IN ADDRIIXJ TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED WR IN SEGTION 37080F THE LABOR CODE, IMEREST, M1D ATTORNEVS GEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirtn thet I am licensetl untler provisions ol Chepter 9(commencing with Sedion 7000) of Divislon 3 of the Business end Professions Cotle, enC my Ilcense is in full lorce anC etfeci. IJc. N Class M Contrectols Signeture: Date: CONSTRUCTION LENDING AGENCY: � ❑ I hereby eiflrm thet ihere is a consiruction lending egency for the perfortnance ot the work tor which this permit is issued. (Sec. 3097, Civil Code). Lendefs Name: LenAefs Address: Signawra: Date: OWNER-BUILDER DECLARATONS: I hereby eHirm t�et untler penalry oi per�ury �het I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for tha following reason (Sec. 7031.5, Business antl Protesslons Cotle: Any ciry or couny which requlres e pertnit to consiruct, alter, Improve, demolish, or repalr eny structure, prior to Its Issuance, also requires ihe epplicant for such pertnit lo tlle a sl etl stetement that he or she is IlcenseA pureuant to tha pravisions of the Contrectors Licensa Lew (Chepter 9(commencing with Sectlon 7000) oi Dlvlslon 3 of the Busine end Professions Code) or that he or she Is exempt therefrom end the basis for the elleged exemptlon. Any violation of Sactlon 7031.5 by any eDPlicant for e pertnit sub the applicent ta e civil penalTy of not more then 9ve hundred dollars ($500).): 1, es owner of t�e praperry, or my employees wlth wages as their sole compensation, WILL DO THE WORK, entl ihe structure is not intended or ottered tor sele (Sec. 7044, Business end Pratessions Code: The Contrectors Llcense Lew does not aOPN �o an owner of property who builds or improves ihereon, end who does such work hlmseN or hersetl or Nrough his or her own employees, proNded thet such improvements ere not Intended or oflered tor sale. If, however, the bulltling or improvement Is soltl wlthin one year of completlon, t�e ownervbuilder will have the Curtlen ot proving that he or sha did not Dulltl or improve tor puryose of sale.). ❑ I, es owner of the properry, am EXCLUSIVELY CONTRACTING WIiH LICENSED CONTRACTORS Io consWct the pmject (Sec. 7044, BuSiness end Protessions Cotle: The^coniractore License Lew does not apply to an owner of properry wha builds or Improves ��ereon, entl who contrecis for such projed wilh e contrador(s) IiCBOSB PWivaN to the Coniractors License Lews.). ❑ I am exe� nder se .� euslness a� Signature: �. , 1.1./u�Si\ Owner ID veritied by drivefs license. ❑ Yes ❑ No Vedflcation o1 Ownership by (type o1 tlocument I.e. - properry tex bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CEflTIFICATION: 9rofession5 Cotle br lhis reason; Date: Driver's License No. E:pires: ❑ I hereby certtly that no excevetlon ilve (5) or more feet in dapih Into which a person Is requlretl to tlescen4 will be mede in connedion with work authorized by this perml6 end that no 6uiltling structure, scettoltling, felsework, or demalition or dismantling Ihereof, will be more than thirty-six (36) feet hig�. (Chep. 32, Grp 2, Art 2, Sac. 341, Title 8, CeliFomia Atlminlsiretive Code). 0 As owner-buildar, I will not employ enyone to do work whlch woultl require a pertnit irom �ha Division at Indusiriel Setety, es noted ebove, unless such person has a pemiit ta do such work from the dlvlsion. Signature: Date: Dlvision ot IndusMel Safery Pertnit Number: CERTIFlC OF COMPLIANCE AND AIIT}10RIZATON OF ENfAY: I certity under correct. e ree to compl with all stet ews a d clty ordlnences relating,�o :buildinc above- nbed proper�for inspec�ion�urpo�. I agree not to axupy oyellow�occ MdiOr Authorized Applicant -. COOE �. INSPECTIONME 1616 Fixad Systam Final Fire Prevention 1266 Pool Spa Final 200 Flnel R�Roof 201 Final BIocWRataining Wall 202 Finel Factory Fire Place 203 Finel Sign 204 Finel Demolition ��...�;�.,,y of perjury that I have read this application end stele that the Iniormetlon given is iclion„and.authodze representatives af Ihe Ciry of Costa Mese to eNer upon the ��n��'uif`dir'�g euthoAzetl by t�is�rmit � firl�l�ppytion. �� / ( ��7 Date Date �¢ �{$ �.Q�j INSPELTIONTYPE � 206 Final Mechenicel 20B Flnal Plumbinp 210 Final ElectrlCel 2t2 Finel Fire Preventlon 220 Finel Plenning Approval 222 Final Site 250 FlnalBulltling/Occupancy CdiE ltl�l�a .. a • � y�--- • CITY OF COSTA MESA ` � svao�N� �ms�oN f � DEVELOPMENT SERVICES DEPARTMENT 898-00954 � � � PERMIT PERMIT NUMBER �� (714) 754-5273 • Fax (714) 754-4856 77 FAIR ORIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 379 19TH ST Suite: Vicinity: Parcel Nunmber: 11729414 Applicant: WALKER, ABRAHAM R TR Address: 379 E 19TH ST COSTA MESA,CA Owner: WALKER, ABRAHAM R TR Address 379 E 19TH�ST � COSTA MESA,CA ` � � Conlrador. � _ - Address:. . � � Status: ISSUED �� Applied: 06/03/1998 Issued: O6/03/1998 Zoning: Phone: Zip: -92627 - i _ � , Phone:- , �� , ' � � Zip: 92627 . - , � � . �. - ., , .. . ; -� �� - . � � . " Phone: ^ `�. - V- • . �/ Zip: A'; ;�-- �'' � � � � � , � . License: �- . � , , Arch / Eng : ' - . . . _ � � Address: . � ' � � ... ' . .... i . . , � � Phone: � , �- " � � 2ip: " � � � � � , � , � '� ��' _ . License: _ , , . • , . . . , , SCOPE OF PERMIT � Legalize 130 sf laundry. room on right side of house and 144 sf delached enclosed patio areaw/spa in the rear of house. Replace windows in existing house �, FEE SUMMARY Plan Check: $0.00 . '- � Calc Valuation: Sio,oso.ze Permit: $174.75 i � Claimed Valuation: ,Sto,oso.00, SMIP Res: $1.00 — � , SMIP Com: $0.00 " — _ - Other: $0.00 Inspection: $0.00 ` � - Total: $175.75 � • ' � � � ' , PLANNING & ZONING � SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 8- 0 PARKING Existi"a: o NOTES: Rear 0- 0 Rear 52- 0 Required: 0 ieR 0- 0 Left 78-0 � Proposed:. 0 Right 5-0 Right 25-0 �x� � 2�� ' � 2 ��'�D� EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applirable codes, and all required Inepectlone end final epproval must be obtained. Failure to obtain inspeclions and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 WORKERS'COMPENSATON DECLARA710N: ' I hereby eHirtn under Oenalty of perjury one of the following tledaretions � . ❑ I �ave entl wlll meintein a certificete af consent to eeli-Insure tor warkers' compensalion, es provided tar Dy section 3700 of t�e LeDor Cade, tor ihe pedortnence of the work for which t�is pertnit is issuetl. ❑ I have arM wlll meintain woAcers' compensetlon insurance, as required by section 3700 of ihe Lebor Cade, for the perfartnance of Ne work br which this pertnit is IssueG. My workers' wmpensation Insurance cartler end policy number ere: Certier. Policy Numbec (Thls sect/on need nof be completetl i1 fhe pemrit 75 va/ued et are hundred dollers ($ f 00) orless.) ❑ I certly that in the pertortnence oi the work lor which this pertnit is issuetl, I shall nat employ eny person in eny manner eo es to become sublect la ihe workers' compensation lews of Califomia, end epree thet if I s�ould become sub�ect to the workers' compensatlon proNsions af Sectlon 3700 of the Labor Cotle, I ahell farthwlth comply with ihese provisions. Applicant Slpnature: Date: WAqNIN6: FAILURE TO SECURE WORI(ERS' OOAIPENS4TION WVERAGE IS UNLAWFUL AND SNALL SUBJECT M! EMPLOYER TO CRIMIWll. PENALTIES AND dNL FlNES UP TO ONE MUNDRED TIpUSAND DOLLARE (5100,000). IN ADORION TO THE OOST OF COIAPENSATION, DAMAGES AS PRMIDED FOR IN SEC7IIXJ 3708OF TNE LABOR CODE, INTEREST, ANO ATTORNEI^S FEES. LICENSED CONTRAGTORS DECLARATION: I hereby effirtn ihet I am licensed under proNslons of Chapter 9(commencinq with Sectlan 7000) of Division 3 oi the Business end Professions Code, an0 my license is In full force end etfect Llc. N Class q ConVectors SlgnaNre: Date: � CONSTRUCTION LENDING AGENCY: � I hereby atfirtn that there is a construction landing egency for the peAortnanca of tha work for which this permit Is issued. (Sec. 3097, Civll Code). Lendefs Name: Lenders Address: Signature: Date: OWNER•BUILDER DECLARATIONS: I hereby elfitm that under penalry o1 perjury t�at I em E7(EMPT FROM TME CONTAACTORS LICENSE LAW for iha following reason (Sec. 7037.5, Business entl Professions Cotla: An Ciry or counry whic� raqulres a pertnit ta canstrua, alter, Improva, tlemolish, or repalr any sirucWre, pnor to its issuance, elso requires Iha epplicent for such pertnit to file a B�eA stetement that he or sha Is Iicensed pursuant to ihe provisions af the Coniraclora Llcense Lew (Chflpter 9(commencing with Sectlon 7000) 01 Division 3 of the Busi and Pmfessions Cotle) or thet he or she is exempt therefrom end Ihe besis far tha elleged exemptlon. Any viWetion of SeMion 7031.5 6y any aOP�icent for a pertnit su cla Ne epplicent to a civil penelry ot not more Nan fve hundred dallare ($500).�: I, es owner ot Ihe property, or my employees with wages as their sole compensatlon, WILL DO THE WORK, entl the structure Is not intentled or oHered for sele (Sec. 7044, Business antl Professions Cade: The Coniractars License Law does not appty to en owner of property who huilds or ImD��'es thereon, entl who does such work himsell ar herself or ihrough �Is or her own employees, provitled thet suc� Improvements ere not intentled or oXeretl for sela. II, howevei, the building or improvement is sold wlihin one year of completion, the owner-bullder will have the burtlen ot provinp t�at he or she did not bulld or improve for puryose of sale.). ❑ I, es owner oi the properry, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct ihe pro�ect (Sac. 7044, Business and Professlons Code: The wntractore License Lew does not epply to en owner oF properry who bullds or Improves thereon, end who contrects for such proJect with e contrector(s) Iicens ursuant to ihe Conirectors License Lews�). ❑ I am mpt un r see ( Business and Prolesslans Cade tar this reason: Signature: r i Date: � 3 Owner ID venfled by drivers license. ❑ Ves ❑ No Orivels Llcense No. Ezpires: Verification of Ownership by (rype of dacument, I.e. - properry tsx blll or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I �ereDy ceNly that no excevetion tNe (5) ar more teet in Aepih into wNch e person I5 requlretl to tlescen4 will be made Im m�nection wit� work authodzetl by t�ls pertnit, end that no buildinq atructure, sceHoltling, felsework, or tlemolition or tllsmentling thereof, will be more ihen thirtysix (36) feet �Ig�. (C�ap. 32, Grp 2, An 2, Sec. 347, Tltle B, Celifomia AtlmiNstretive Coda). ❑ As owner-bulldar, I will not employ enyone to do work which would requlre a pertnit from ihe Dlvision of IndusMal Sefery, es notad ebove, unless such person hes e pertnit ta do such work irom the diNsion. Slgnature: Date: Division of Indusiriel Safery Pertnit Number: CERTIFl TE OF COMPLUWCE AND AUTMORQATION OF EHTAY: I ceRify under penelty ot per�ury that I have read this epplicetion flnC slate Nat the infortnfltion given is conect.i agree ro co�iply vnlh all state laws end ciry ortlinances relating to Guilding construction, entl authorize representetives of the Ciry of Coste Mesa to emer upon the ebove� scribed pr erty for inspec n urpos .�occuPY or allow occupanq of any building authorized by this permiyuntil fi al ins on. a (o / 3 �r b� Signeture Ot Lepel Owner(s) Data Antl/Or AuthorizeC Applicant COpE �. INSPECTIONTYPE PAiE 1�64 1816 Fixed Syslem Finel Fire Prevenllon 1286 200 Pool Spa Final Flnel Re-Roof 201 Finel BIocWRetaining Wall 202 Final Fectory Fire Plece 203 Final Sign 204 Flnal DemWitlon ' zue-ae COOE I INSPEttION TYPE 206 Final Mechenical 208 Final Plum6ing 210 Final Electricel 212 Final Fire Preventlon � 220 Fnel Plenning Approvel 222 Fnal Site 250 Fnal Building/Occupanc Q9g II�9L4 > � y �DDNESSUFBWlOWO: 3 7 9 E 1 9 TH S T wm�a9wu+EiFa�n+: WALKER, ABRAHAM R TR �� 379 E 19TH ST COSTA MESA,CA 92627 uv�. �aiuw wonesa �xcxrtecron��x: APCN.ON E1Q'S /i00FE53: uc xo: CIX1f11ALTqfSNA1�: COHfHACTORBNARRIO 100PE53: IlG ND.: UNT: uNr: . an: UCENSED CONfPACfON4 DECIARATION: I M�aby Aim uds prWy d peryry Ntl I am 4wneC udx po.mwu d Cheqx B (oommana�Y xvA SeeYon 1000) N Diwion 9 d tM Bu�sq md Pmlpweu Cob. md my G�v�s b m Iu01au W Mlatl. cm uc. no.: uc. cuss: uc. No.: EXP : ome: cameea: OWNEfl BUILUEH DECUR�TON: I hraby elfum ivtla paW / d pai'vy Uul I en awnp Imn tlr CON'etlm Limms W Iv Na IdbxTq 2ewn (Setlun R11.5 BwiM� md Pmlesawu CoM: MYW a odroY whiN n�rym e Dam! lo mmtrW. eGb. "vnpo.a. 'smd'eh. a rwu �Y st�uetve. P� m m ew�m. eho e+G�+Ne mpGm'Y Iv wrh V�^e to Ae e W+e sW emeru tlW M a�he . Iim�ueE pvwvv to ihe pw'vione d tlr Catlreda� liowe faw �Cheqr 9(mmmanmp waA 5«fqn'!OW) d Divuim 3 W IM duemea erd Vralaaanro Codal a thel M a ehe u azemq Ilvahwn md iM Oeri� Ip Ts eOpeE mamqion. Nry vidation W Swion lro1.s A' �Y ecV�+ t> e o«rtN vAP� iM eoo�s+�+ w e ai D�M d m� maa uwi fin Mvd'ed dNen R`�D� �] i.mowwa�neo�w�r«mre�Now�wtnw+u+nNai.wmmv+��.raaomswakm�ememmm�auno�mtwae «dlwadM seb (5sclion 1oN. Bimiav ud VmlmdauCaEe: TM CaNraCas L"caua lawEom no1 WpYto en owrord poVenY Ma ddh a inpo� �hsom. ad Mn Eoo �uN wvrk 1'vnrL a MnN a MdW hu a Mr wn a^WM^N. Pa'� thel mch impawnMa r� iv iveWed a WIraG la u4. tl. howww. tM ddtlin0 a inpmemM u ctl rEhin arY� N mmddun. Ne mmarbubW vri0 hm �Ae dWen d V�'�q M a tlr 6d na1 puH v imPu+fa iM pupua W eebl. � I. m ox�w d tM pW�Y. am ssdm+W ca4raqnY xuA forueA mmrma� m mmtrutl IM pclb (Sepun MM. &n"vws eM a�aewio�. coae:lne cam�.au. �e«w �.. eo.. m rovM m en o.,w a o�w�r wno wia. w:�m�m mr.on .�w r�,o wwms lor wiN D�4a� wh e mvedMs) fcrosM o� a ihs CatlraGa� liosua lew�. � I em mp u!e e' B. 8 P.C..IgUvfjaewn: � // � L a..r.: �-CYl' ��' � w om.: I Eo Iweby �sniN tlul l em awua al end udr�iend Ihe �ommanwqa d CallarNs HmM eM SeMY COM Satliam 25505.255�J. ud 2553�. uM Ntl I a M' M�n W1fi9 � xiY / wL na (�Y ar) �ratl b aomW H� uk em� mM� ad �N �p�mrnsb br . o�e«om.wncnv madf�w�ion �mmtl,.Ai� Oiu�w. aWd.uw ooim�uaon.00�b�.«e m«nq enm New pwmone. ome: �cd�+: WONKEP'8 COYPpIS�TON DK WIATION: I Iwab/ dhm uWr pr�eCy d prjry ons M Yr bOoNrp dadvtliom: ❑ �n.r.m,awm.en.n.u,aiut.aoo�..umw;�w,.a.vk«.•w�ro.�w�...w��awam�a�wam.�.na coa.. i« ine wrt�. a u,. wn� i« �n w. w�+ a��.d. � � n... ene wi� meiM.n.mwn• mmo«mt:M wwenw. o nmowd M swc� amo a mme �ee« coe.� m, ine o«�«mvwe d me W01� Ip M�11d1 dW pMIM O mIM�. �' WCI�IM1� (d11�G11tY1011 YItIPNC� MR�OI Y14 D�Y Ml111blf O!!: c.� � �� (mis aalm raM rid bs cmbWM r �h wmt e b aa h�v�Ad eolYn Rfaul n ImJ ❑ I cenh Nm in Na oMmrorca d ��r rark br v.�kh tM o� 6 Imaa. � wo na wnMW NY oe� In anY mww �o m io bacoma e�bjetl lo �M workmY mip�netim lew� d CeNarde. aM pres tlW tl I JwuM bacmw wN�xl lo IM xwksri canD�+mion qwi�uro d Swion 9i00 M IM laba Cods. I MaA lon�w'nh mmW wE� Uaw qwbim�. Dele: �DW�� W�minp: F�Yun ro��cun woikr�' eonpwu�tlon eov�rp� h vnMrNl, �neWll �W/�cf �n wlployw� ro crlMrW pmiltl�� nC clHl fln�� q b om I�,.ndnL fho�wd LWNn ff1 W,OroA ti��n b tln cwf ol romqrwWM1 4nrps u povlWtl br In 9�ctlon J�O6 0l IM I.Mor Cob, Intra4 uW �flomry'� /wa CONSTf1UCfiON LENUINO AQENCY: I Mreby etfi�m u'Mar peneCy al psjvy IhellMrs b e auW�ud'an IaWnp ap�mcy lor Ns peAormaxa d tM xak la xfiid� ihe pami u'sawd (�� . CM. G). LENDEN'9 NMIE I.RIUEN'S �UDPE94: I unity thm I heva netl Uu �ppli�a�ion uM tltl� Ihtl tlw eba+ Warmetion n canW. I pne to oomply wilh NI �tly eM cauMy adiiw�cae enE elete lewa mleimp �a WilEip mimwion end MroEy anhwaa �epasanimiva d IM dry lo ema upon IM abon�memioneE pmperry ��vP"��"6°�AARAFIAM WALKER � ,-\ Pmt I L X� " " Dme: � \ SproNre d O�nr/�pnYlRppfmNCaa'surc (5151�aBWV) M/hnsBWd�q85etery:O�m�-Fb:Cmury-Appfu�q:Pink-Mwe:(3oitlanivA-Nro�mr CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: H 082037 PLAN CHECK NO: N PERM NO: B 082037 GOVT: N SUPP: N CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH JOH DESCRIPTION : T/OFF REROOF W/COMP. SHINGLE SQ FT: 2,500 CLAIM VALUE: 2,500.00 CALC-VALUE: 2,500.00 GROUP OCC: R-3 /U-1 COMMENTS: REROOF 1600SF RESIDENCE W/COMP 1E fE 1E fk 1k 1E 1ElklElElE �E 1E 1E 1k 141F 1E 1E 1ElF 1f iE 1Elf 1ElElE'k if 1F 1k f! 1E iF i! fk 1E 1F 1E ik 1E 1E k 1E 1E 1E k 1! 1E 1!'lE 1E iE k 1k 1F 1E 1! 1k 1k IE 1FlF 1E 1E iE 1F 1k 1k 1E 1F 1E 1E if f41klElF Z O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 11729414 ZNE: REF NO: PLANNING NdTES,>•. ._..- i �*�****�x *�r�*+��*x�*x ***�**,�� r**+�*x****�*�r+�+�*�r�r****�r*x *******x�r«��**��****� �+�+�* D E V E; L O P M E N T S E R V I C E S A E(j U I R E M E N'T S t+' %_, ZONING APPROVED"BY DATE: i. BUILDING APPROV,ED HY : DATE: ' "3 � t S,'� APPLICATION ISS,UED BY: DATE: iElfiEiEiFiFitifiEi(�i(-IE1E1E1ffEfElEiflEiEiEiF3F"iFiFiFiF3FiF3F'fFiF3F3FTf3FiF3F3f�FiFiEifiFiF� if if�FiFTFiFiFiEifiFfElEitiElfiF1F 7E LEGALIZATION:N F E E S U M M A R Y STRUCTURAL'SEGMENT:Y i BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GAADING PERMIT 74,75 50 SMIP/NON—RES � PLAN ISSUE FEE BUILDING—DIV—> PERMIT ZSSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 75,25 0,00 0.00 75.25 75.25 .00 REVENUE DIVISION TOTALS--> COLLECTED: 75.25 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 74.75 .50 iF 1F 1k 1E iE 1E 1E 1F 1E 1E i! 1f iE i(� 1k 16 if iF 1E 1E 1E IE iE iE 1E f! 1E 1! 1k ik fE 41E 1F M 1t 1E 1E 1! 41k 1E 1f if ik 1f IF 1E 1E i! 1E k 1E if 1E 1k 1! 1E 1f k IE 1E 1E 1(� ik i(� ik iI� 1F f(� ik 1E iE iE fk iE IE iE if I N D I V I D U A L F E E H R E A K D O W.N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 2500 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 2,500.00 END OF FEES 03-14-1997/I0:05 M/f75.25 RCPTH:01-0fl03426 PERMITo082937 �'� t • CONSTRUCTION AND P�ANNING " . POC SPA � APPROVALS Permit # .Date �nspeaor qPPROVALS Permit # Date Ins0.ector � i. Temporary Electriwl Service or Pole 52. Pooi & Equipment Location Z. 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_ �Eletirical UFER Grnd. 57. APPROVAL TO COVER�GUNITE . � -7: Footings 58. Electrical Conduit•Undrgrnd. �8. Foundation ' 59. Gas Pipe, O Undrgrnd., Test .9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structural Floo� System 67. APPROVA� TO DECK i t. Froperty Sewer �ine & House Connection 62. Backwash & Receptor•Final 12. Sewer Cap -- • 63. Heater & Vent�Final 13. Roof Drains 64. P�umbing SYstem - Finai 14. flough Plumbing 65. Electrical-Final 15. Rough ElectriCal-Conduit 66. Solar System-Final ' 16. Rou9h ElettriG �'1�rfng 67. Fencing & Access Approval � 17. Rough Wiring Sign . - 68. APPROVED FOR PLASTERING ' 18. Rough Electrical�T Bar Ceiling -69. POOUSPA SYSTEMS FINAL . 19. Rough Heatiny & Ai�r Conditioning ,,,, FIRE,pEPT, REnUiREMENT _, 20. Rough FactoEy Fi�Eplace � -'' AppROVAI"5... Per.mit # 21 . -0ucts, iri-StrutturE �• � • ^ - - ' - 70.'Underyround h}.ydro '� Y � 22. Ducts, Ventileting:,. �- _ '� 77, Producti'iping OGas �Oil 23. Gas Pipe-Rough & Test ^-_ - ' - _ - 7y, Underground Flush.� ` `' � � 24. Roof�Framing ^_ ` "�: • � $ 73. Undergrnd.Stornge7ankOGas O�Oii 25. Roa�Sheathing �• , qJ�_Q? �� 74. Overhead Hyd�o,,. ` 26.,�T-Ba'r Ceiling (Structural) & Monocoat . ' 75. Dry Chemical �� - 27. Frame and Fiashing - • ' 76. Dry Stand'pipe = 28. Lathing'& Siding!_ .�'• ,_�;: F; - ,� " 77. PIXED;$YSTEM FINAL _ 29. Insulation �' _ •• � � 78. FIRE PREV. FINAL ' .r 30. Drywall:Nailing �. ' � � i . .{ � HEALT�H DEP.T. REDUIREMENT 31. Plaster Brown Coaty� •-. - - � 79. FINAL �NSPECTION ' ' 32..Electrical Pow.er MeterEinal 4� �'� � . SU. FOOD CERTIFICATE ISSUED , : 4 _ ' _ . 33. Finai Electric . ' � Notes: " - � 34. Final�Heating„& Ai�iCo,nditiohi�g � " ' ' • � ;, ' � - F, 35.'Fin51 Gas�PiPe:Tesi! : >' � j�. ' 36. Hootl or:CanopY «' - � �' ' x �� ' �, - ' .. ; . 37. Final:Factory Firepface c F�. . 38. Final Plu"mbing _ ' - _ ' ' 39. Wate� Service-Final, - " .. „ . . - . 40. Gas Service�Final � � � ' ' ' 41. $olar pomestic�Final ` . � ' . . , . . - 42. Backflow Prevenier- � � - '-' ' _ " - r ` - ,T - . . ' - ' 43. Backflow kngationr , - . 44. Landscape Irri9ation Syscem=-�^•� � ' � - - - , � _ _ Z . n ~ 45. Sound Attenuation - . . r `�' • . . - i 46. Handicap Regulations � � = �47.��fIMl1�STRUCTURE&BUIL'DING 9�/.7.�� _�' � � ![ 48.:�FINAL PLANNING � - � `� ' '- 49. Electiic Release ro Edison � : . � „ _ - 50. Gas Release to Southern Calitornia Gas Co _ ' 51. CERTIFICATE OF OCCUPANCY � No. Date �"' ' ! A PA]b T I I O� ' JAI� �O'7��MSfOO 696� '�****5.50 F! C a a = � x F C' 'V l Q ..7 Q � i' .� x w o. O C G. z{� S 3 COSTA MESA BUILDING-SAFETY DEPARTMEN P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 For Applicant to FID in Completely — Use Ink Only nooaess'3%� �• / /� � OWNER � �7A�I�J J . �� RI C. ADDRESS 379 C—' �� _ TEL.'('y/O `. CITY Y!`JS/YT Ii7�� NO. 4 BRANCH ADORESS ARCHITECT ADDRESS A�DRESS TEI.�y�� CITY �jQ'�[� NO. .�fl�� STATE CITV LIC. NO, LI0. NO. SIZE NO.OF BLDGS. OF LOT NOW ON LOT Z .8��. R�S��uc� �� Separate permits are required for electriq plumbing and heating work. BUILOING E1ND WORK TO BE PERFORMED �� USE I hareby acknowledBe that I have reatl thia epplicetlon end ate<e ffiat the abova Info�metion Is correct entl aprea to comply with all laws reB��etln8 bulldinp conrtruction, entl I shell not employ any person in ��olatlon of the workman's compeneation lawa of the State of Cellfornia. 1 heraby ee I}Y that I am ptoperly Iicenfed as e contractor undar the Stnte of alitornie Businau and Profeaslana Cotla, Dlvision 3, Chepier 9, a� thai such ticen�es are ln fu I force end eftect, or I em exampt fr the provizion� of the Ste af California Buslness antl ProfeSsions o D��Isio 3, C�epter . 1 Sipneture o ` Permlttea AuMorizad Atlont BUILDING ADDRESS FIRE FOR STRUCI'URAL PERMIT NO.OF USE OF N � 1 PLANS Z BUILDING 0 � YARDSAPPROVED YARDSAPPROVED MAIN BUILDING ACCESSOPV BUIIDING & VAR. iW C.V.P.k M L �. � n m i m m SQ. FT. N HE AMOUNTSHOWN UNDER VALVATION IS FOR N� THE PURPOSE OF E5TABLISHING A PERMYf FEE ON � VALUATION PERMIT FEE § � � N A' m � ' PLAN CHECK § 0 $�5 TAX E 5 µ V U TOTALPAI� E . S � nov�� CI7Y OF COSTA MESA GDNSTRUCTION PERMIT Addiess �i�l AJC " all Phone Arch/En9. License No. Address Con(ractor /1/A 1G Phone '� wilbin �mvy bo�Cer IlnesanQsign all apDrOp�ial! tlecla�ations. TRACT NO. LOT �BLDG. NO. � . � � � � � � LICENSED CONTRACTOR DECLARATION ' I hereby a(firm that 1 am licensetl untler proviilons of Charter 9(com- mencing wltn se<[lon �000) of Divislon 3 ot the Business antl Aofe551on5 Cotle, antl mY IICanSe is In fUll force antl eff¢Ct. License Class �icense No: Date Si9nature WORKERS' COMPENSATION DECLARATION I hereby a(tirm that 1 hava a certificate of tonsent lo self-Insure or a cerfliitate of Workers' Compensatlon Insurance, or a cartifietl copy ".reof (Sactlon 3800, tab. G.). :y No. Company .:ertitietl <opy Is hereby furnishetl: ❑ Certifietl copy is iiletl with the city BUIlOing Divislon. EXEMGTION FROM WORKERS' COMPENSATION DECLHRqT10N (T�IS 5¢ctian neetl no[ be <ompletea it the pGrmit IS tor One huntlretl SE100) or leul. . cartify tnat ln the pertarmance o( the work for which this parml[ is I55Uetl, I Shdll not emPioy any aerson �n any manner so as [o b«ome sub7ect he orkers Compensatlon o Califor a.� .Dale Z Si9natureX' � �� NOTIC . If after making Ihis Ceclaratlon, you snoultl become suD�ect to the Workers' Compensation provlsions o/ the Labor Cotle, you must tor[hwith comply with such provi5ion5 or Ihls permit shall be Deemetl revoketl. - � CONSTRUCTION LENDING AGENCV I hereby affi��ll that there is a COnit�uction Ilntling agency fo� ihC Oer- formance ot the work !ar which this permlt Is Issuetl (Section 3097 Civ. C.�. Lentler's Name Lentler's AtlOress reason �s i�censea pursuant [o tne provlslonz of tM1e Contractor's License Ldw (Chapter 9(cOTmenGing with SeCtlOn. 7000) of Dlvision 3 ot the 'ness antl ProfeSsions Cotle) or that ne is exempt therefrom antl tne for the alle9etl ezemption. Any.violatlon of Section ]031.5 by applicant to� a p¢rmit subjects the applitdnt �o a clvil p¢nalty m not more than five huntlretl tlollars (E500). ❑ I, ds own¢r of the p�ope�ty, Or my emD�oyees wlth wd9e5 as Ihei� Sol¢ compensation, will tlo lhe wo�k, antl fh! structure is not in[�ntletl or oHeretl (or Sale. ($ection 7044, Buslness antl Aote551on5 COGe: The Cont�atior's Litense Law does nOt dpply-to an owner of a property who Duiltls or Improves thereon, antl who tloes such work hlmself or througn nis own employees, provitletl that such improvemen[s are not intentletl or offeretl for sale. If, nowever, the bullUing or improvement is so�tl within one year of comoletion, [he owner will have tne buraen ot p�oving he tlI0 not builtl o� Imp�ove tor Ih¢ purpoie o� sale�. � I, ds owner of the property, am exCluSivGly cont�acting wi[h licensetl contractors to <onstrutt the projec[ (Section ]044, Business antl Professions Cotle: The Con[ractor'S License Law tloes not apply to an owner of property who builtls or improves Ihereon, an0 wno mn- traCts frOm suth prOjecls witb a contlactor(S) lit¢Sn¢E pulsuanl IO the Contrac[or's Licenze Law�. ❑ I am ¢x¢mpt untle� $¢Ctlon B. 6 P. C. fo� [his reawn � � Date ' Owner 1 nereby certily thdt I have �eatl Ihis appliWfion antl stale [ndt thB above information is correGt. I agree to comply with all city antl munly ortlinances anA state laws relating to construclion, antl� hereby authorixe �epresentativ¢5 Of [h15 city to enlGr upon Ne abOVG T¢ IoneU proper�y for I on] �pu,rpo�spj A n Si9nature'� �1 ii•. L7,�f'd..✓K pata Z� Drivers' Licen58 or 55 �. }� /. TVPE OF CONSTRUCTION ❑ NEW ❑ AOD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK � TYPE OF PEFMIT — ❑ GRADING ❑ FOUNDATION ❑ STRUCTVRAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHAI ❑ OTHER PROJECT DE CRIPTION 5�. FT. � z' OCCUPANCV �'CONSTRUCTION TVPE � VALUATION ZONE GRADING CIJ. ACRES PLUM8ING BATHTUBS TOILETS LAVATORIES KIT. SINKS SERVICE SINKS PLAN CHECK SHOWERS URINALS DOUBLELAVS DISHWASHERS SUMPS FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS INTERCEPTORS SWIMMING POOL WATERSERVICE GASSERVICE WATER HEATER' CLARIFIERS PTRAP ALTERATION OUTLETS BTU OVTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOIAR PIPING SYS. ISSUE FEE MECHANICAL aLAw CtiECK HEATING SVSTEM 0-300,000 BTU AND DUCTING 100,000 + gTU REFRIGERATION 0-300,000 BTU SVSTEM 100,000+8TU 801LER5 BTU SYSTEM REPAIR,ALTERATION EXHAUSTSVSTEM MULTIPLE ISSUE FEE ZdNING REGVL'ATIONS ' A.P. � ZONE ^ PINTGp. 8RUEFL. p� SEpTBACK 5 . PROPE�RTVNLINE L5EDF YARD .�G . R�IGHT REAR YARD (TO P/L) � PKG. SPACE RE�. �� ' STREET WIOTH ZONING APPROVEO B OAT� SPECIAL CONDITIONS: ' ELECTRICAL PLANCHECK GENERATOR 0-1 KW_1-30 KW TRANSFORMER APPIIANCE 10-50 KW_50 i KW MOTORS 0-1 HP_1-30 HP (INC. SOLAR) 30-50 HP 50 * HP FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS POLE LIGHTS ' PANELS MAIN SUB SERVICE AMP ISSUE FEE 'LICATION APPROVED SUMMAHV BUILDING ,OO PERMIT S PLAN CHECK 5 Q• �Z' PLUMBING § PLAN CHEGK S ELECTRICAL S PIAN CHECK E MECHANICAL E PLAN CHECK E FEES SMIP PERMIT ISSUANCE GRAOING S MICROFILM 5 TOTAL FEE S LESS AD- VANCE PC $ FINALFEE S�_Li�_ CMF 0865-46 White-Builtling; Gnary-Appliwnt; Pink-Actounting; GolOenrotl-Assesior � T . CONSTRUCTION AND PLANNING _ POOL & SPA �� APPROVALS Permit # Date Inspector qppROVALS Permit #-- Date Inspector ' i. Temporary Electrical Service or Pole 43. Pool & Equipment Coeation '� � " - � � �' . Soil ipe-Undrgrn 44. Steel Reinforcement �-� � 3. ElectricaFConduit Utility-Undrgm, , 45. Forms 4. Electrical Conduit-Undrgm . ' ' 46. Electrical Bonding . tee ein orce ' " 47. Rough Plumbin & Pressure Test _ - 6. Electrical UFER Grn . 48. APPROVALTO COVER-GUNITE 7. Footings - 49. Electrical Conduit-Undr rn 8. Foundation - � 50. Gas Pipe, ❑ Undr m, Test � 9. Water Pipe-Undrgrn 51'. Backwash Lines P-Tra ❑ Undr rn 70. Structural Floor System "52. 'APPROVALTO DECK 11. -Property Sewer Line & House Connection � 53.---=Backwash & Rece tor-Final � 12. Street Sewer Connection � - 54.� 'I-�eater & Vent-Final � � ' 13. Rough Plumbing - � - - 14. Rough Electric-Conduit � �56. Electrical-Finai � � 15. Rough Electric-Wiring 57. Solar System�Final � ' ' 16. Rough Heating & Air Conditioning � encing & Access Approval - 17. Ducts in Structure - � APPROVED FOR PLASTERING- • � 18. Ducts, Ventilating - � - � • 19. Gas Pipe-Rough & Test 60. POOL/SPA SYSTEMS FINAL - � 20. Roof Freming - � 21. Roof Sheathin ,. 22. Frame and Flashin NOTES: • 23. Insulation ' 24. Lathing & Siding 25. Drywall Nailing � � 26. Plaster Brown Coat � 27. Electrical Power Meter-Final � � 28. Final Electric ' - 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test � � 31. Final Plumbing -' • 32. Water Service-Final 33... Gas Service-Final • � 34. Solar pomesticFinal . � � 35. . Landsca e S rinklin S stem� 36. Sound Attenuation 37. Handicap Regufations� ' � � � � . 38. FINALSTRUCTURE&BUILDING ' 39. Special Requirements Completed � 40. Electric Release to Edison � 41. Gas Release to Southern California Gas Co: �� ' 42. CERTIFICATE OF OCCUPANCY . � ..'No Date . � � , r' - A7P�icanl to fill in all spacez witbin �eavy EorEer Unes anG ilgn all apProOriate tleclantions. � -OF COSTA MESA PERMIT NO.- TR�T NO. LOT NO. � BLDG. NO. /1 , � "- STRUCTION PERMIT � %3�L JQ� � �� -Pmject Address 9 �' TVPE OF CONSTRUCTION . -- _ OW�Ef �� Phone �2-7/" ❑ NEW ❑ ADD ❑ ALTERATION � P�lress 379 EA.f'1` �/ � S ❑ REPAIR ❑ CONVERSION ❑DEMOLISH Arch/EnB� � License No. �❑ �7HER A.P. Sf II - � / D SCRIPTION OF WORK 'Address � � �A�s.t/i /i�v_, /J/��lJ�i . _ " . ' ZONE R� Contractar ' Phone TVPE OF�PERMIT - ' AddfCss � ' ❑GRADING ❑ FOUNDATION- ❑STRUCTVRAL LICENSED CONTRACTOR DECLARATION ❑ TENANT O ELECTRICAL �PLVMBING ❑MECHAI I hereby affllm that I am IltanSetl untler provl51on5 of Charter 9(COm- menting'wlth Settlon 7000) ot O�y151on 3 Of the� BUsiness anG ❑ OTHER Profasslons Cotle, antl my Ilcenze Is In tull force antl effett. pROJECT DESCRIPTION License Class U�ense No. � -� ' - ' � ' Da[e SlgnaCure - SO. FT. . � . WORKERS' COMPENSATION DEC�qRAT10N. � . OCCVPANCV CONSTRUCTION TVPE 1 hereby aftirm lba[ I have a certlfiCate of consent to selt-in5ur8 or a VALUATION ZONE c¢ftlfiUtB'Of WOfklR' CATpGnSatiOn Insuranm, or�a celtlfleG coDY � � ';=:�eoi (Sectlon 3800. Lab. G�. GRADING CU. VDS. ACRES Y=-i==ay No. - Compahy - "-��ertlfietl copy�is nereby fumishetl. . _ . pEMARKS . . ._ ._ .. . .. .. � Certifi¢tl cOpy ii filetl with the city Builtlin9 Dlvlslon. _, E%EMPTION FROM WORKERS' CQMPENSATION DECLARATION - " ''- �This seCtlon neetl not be Completetl.if tha pefmlt 15 tor one huntlretl 53001 or loss). ' - " ' certfty t�at In the performance of the work tor w�ich tnis permit Is 3suatl, I sndll not emD�oY any person In anv manner so as to becoma PLUMBING PLAN CHECK' " . Date Si9�atura NOTICE: If alt r Takin9 �hls tleC a(�p�, y0U ShOultl Gtom¢ sub�ecl [o the Workeri' Compeniatlon provisloni ot tne LaDor Cotle, you must forthwlth <omply with suth provl5lo�s or thls permit 5hall be tleemetl revoketl. . . � . CONSTRVCTION I.ENDING AGENCV I herGby atflrm thdl thGre IS d ConStrUCtiOn IBntling agency for tha per- fOrTanCG Ot Ih0 wOrk fOr which thib pBrTlt IS ISSuBtl (5¢CtI00 3097 dV. C.).._ . ... . LenOer's Name •T � � - � Lentler's AdCress� DWNER BUILDER DEC�ARATION ' ' - ' ' � � I hereby affirm that I am exempt from phe Contracror's License Law lor the following reason (Section 7031.5 Business antl Professlons Gotle: i\ny clty or county which require5 a permit to construct, dltar, appllWnl (o� d pi o� not TOrO [han flM Q I, as owner ot ina sole compansatlon, wlll or offeretl (or sale. (Se� Cantractor's Llcense L wha bulltls or Improve I Secuan ]000) ot DiviSion 3 of the r tha{' he Is ¢%emp� thCrCfrom dntl tM1e Any ��olatlon of Sectlon 7031.5 by etts tM1e aOP��ant to a Civil penalty ollars (E500). or rtiy employaes wl[h wages as tnalr ofk, antl tho Stluctule i5 nol IntentleC l, B4sines5 antl Aofesslons Cotlo: The at apply t0 dn Ow0¢r Of a plOpCfty antl who tlOes SUch wo�k hlm5elt o� 9tletl [nat such Improvements are not oweyer, the bulltliny or improvoment ition tho owner wlll have [he burtlan r Improva lor the purpose o( zalc). owner of lhe property, am antrd<lOrs IO constfuct tlle p ssions Cotlo: Tne Contraetoe'S dn own¢r o1 prOporty wh0 builtlz Or ir tracts lrom zuch pro�ecC. tne Contrac[or's License L fl I am exempt untler 5ec reason Date O� I nerebycevtlfylhat I have Information is correct. 1 d COntracto�(s) Ilcesnetl pwtuant [a B. & P. C. for lnls this aODliwtlon antl state that tne above f to comply wlth all city antl county ig to cpnsVuctlon, dntl hGreby dutha�Iie .o entpr on above mentlonetl � Date � BATHTUBS � SHOWERS� � TOIlETS VRINALS �LAVATORIES �OOUBLE LAVS KIT.SINKS DISHWASHERS SERVICESINKS SUMPS - FLOOR SINKS �� FLOOR DRAINS DRINKING FOUNTAINS ' � ' - INTERCEPTORS CLARIFIERS SWIMMINGPOOL PTRAP WATER SERVICE �ALTERATION GFSSERVICE OUTLETS � WATER HEATERS BTV OUTPUT SEWERCONNECTIONS ' SOLARTANK COLLECTORS�� , SOLAR PIPING SVS. ISSUE FEE - � MECHANICAL vLAN CHECK HEATING SVSTEM 0-300,000 BTV ANDDUCTING 100,000+BTU REFRIGERATION 0-300,000 BTU SVSTEM 100,000 + BTV BOILERS BTV SVSTEM REPAIR,ALTERATION � EXHAUST SVSTEM MULTIPLE DNvers' L�cenSe or 55 � I ISSUE FEE CMF 0865•46 Whlte-Builtling; Unary-Applicant; Pink-Actounting; Goltlenrotl-Asussor REAR YARD (TO P/L) PKG. SPACE REQ.n` STREETWIDTM �� ITIO ELECTRICAL ,REGULAT,IONS �o ��' TL PLNTGp. gRVEFL. p$ PROPE�RTY LINE - PROVIDED PARK FEE S � ' ��:�1 DATE W , _ . . 1 PLAN CHECK GENERATOR 0-1 KW__1-10 KW _ TRANSFORMER APPLIANCE 30-50KW_50+KW_ MOTORS 0-1 HP_�1-30 HP _ QNC.SOLAR). ]p-50HP SO+HP_ F�XTURES• ' iOUTLETS` SWITCHES- - GAS TUBE SIGNS POLE LIGHTS ' - ' � � PANElS' MAIN SUB - AMP APPLICATION APPROVED BV � . DATE SUMMARV OF FEES ///��j� BUILDING Q �Q SMIP S__V�a�L.0 PERMIT § PIAN CHECK § PERMIT ISSUANCE. E PLUMBING S—�QO. GRADING S PLAN CHECK E • ELECT0.ICAL y� ' E PLAN CHECK $ MICROFILNI E MECHANICAL $ TOTAL FEE E LE55 AO- PLANCHECK $ VANCEPC �S_ FINALFEE S� CONSTRUCTION AND PLANNING APPROVALS Permit # - 1. Temporary Electrical Service or Pole . Soil ipQ-Undrgrn � 8. Foundation 9. Water Pipe-Undrgrn 10. Structural Floor System. 11. Property Sewer Line & House Connection 12. Street-Sewer Connection •. 13. Rough Plumbing 14. Rough Electric-Conduit 15. Rough Electric-Wiring � ' i 6. Rough Heating & Air Conditioning 17. Ducts in Structure 18. Ducts. Ventilatina 23. Insulatibn ' 24, lathing & Siding �25. Drywall Nailing - 26. Plaster Brown Coat 27. _ Electrical Power Meter-Final 28. :Final Electric 29. �Pinal�Heating & Air Conditioning ' � 30. Final Gas Pipe-Test 31. Final Plumbing 32. �Water Service-Final 33. Gas Service-Final 34. Solar pomestic•Final 35.- 'landsca e S rinklin S stem'- 36. Sound Attenuation • 37. Handicap Regulations � - 36. FINALSTRUCTURE&BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to $outhern California Gas Co. 42. CERTIKICATE OF OCCUPANCY No Date Date Inspector pppROVALS 43. Pool & E� 44. Steel Reii 45. Forms � ' �46. Elecirical 47. Rou h PI 48. APPROV 49. Electrical � � � POO L & SPA , „ Permit #- ent Location ' & Pressure Test 53. ''Backwash & Receptor-Final 54. Heater & Vent-Final 55 Pl�mbinp Cvstem - Final �56. Electrical•Final 57. Solar System-Final . encing & Access Approvai . APPROVED FORPLASTERI 60. POOL/SPA SYSTEMS FINAL NOTES: ' 0 Date I Inspectorn n