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Home My WebLink About388 19TH ST - Building Permits(714) 754-5273 • Fax (714) 754-4&56 • www.c�.costa-mesa.�{ipLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 388 E 19TH ST Suite: Vicinity: _ Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Construction: V-N Parcel Number: 42630114 Zoning: npp�icant: BRENMAN-SCHMITT, KERRY Address: 388 E 19TH ST COSTA MESA, CA _ Owner. SCHMIDT, PAUL � Address 388 E 19TH ST COSTA MESA, Cq Contractor: O W N E R-6U I Lb ER ; Address: , - � �� Zip: - . , . , - Phone: 949-500-7748 ZiP: - 92627 Pt Phone: Stalus: ISSUED Applied: 70/30/2006 Issued: 10/30/2006 ISSUED BY: C� `� � 3�5 ` _ 32627 �. � �'�- .. — c', �;�"�. � �� ., , � �.. � � � ��.,�:,.�. r� � �; :�� . ,�.i License: 000000 ' � Arch : � " '- Eng: ' � � � Address: � Address: � � . � � Phone: ' ' � � � � Phone: � , Zip. � . . � license: �. , ��!� .. . . � • , License; � . SCOPE OF PERMIT _ - . REPAIR DRYWALL THROUGHOUT S.F.D. AND ATfACHED GARAGE. RELOCATE � WATER-HEATER TO GARAGE. - � Plan Check: $0.00 Permit: $38.75 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection $0 00 FEE SUMMARY Calc Valuation: � ' - . �� ,; � �� `��Clsim Valuation: _ � s�,000.00 Si3Ooo.00 Total: $39.25 PLANNING & ZONING SETBACKS ' MAINSTRUCTURE Front 0-0 Rear 0-.0�-��- �Lett`"�.'0-,0 Right , 0-0. �. � ' � ACCESSORY Front . 0- 0 � Rear� � 0- 0 - Le(t � � 0- 0 �� {•�� RighL. � , 0-,0; ` � -� � '�-.' " ' . . ' - ; - _. j i ' . , " ;, s /i / PARKING � Existina: 0`�', Repuired: 0-� � Pr000sed: 0 ; r j � . ,_ , �� ,'t� , _ �- � _ - .�� ," � � I�, NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Calitomia statutes and related ', regulatlons. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permlt shall autometically expire and become vold if work Is not commenced within 180 days, or if work Is suspendad or abandoned for a period ot 780 days. INSPECTIONS: In order for the work authorized under,.this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetlone end final epproval rhust be obtafned. Failure to obteln Inspections and Mal approval will resuit in the expiratlon of this permit. FOR INSPECTIONS CALL: (774) 754-5626 ewo-,n �vw� WORKERS' COMPENSATION DECLARATION: � � ' � hereby eftirm under penalry ol perjury one ot the tollowinq declarations: . ❑ I heve end wlll maintein a certificate of consent to satl-Insure br workers' compensation, as provided for by sectlon 3700 of Ihe Lebor Coae, tor the pertortnance of t�e wark for which Ihis pertnil is issuetl. � ❑ I have end will maintain workers' compensatlon Insurance, as required by sectlon 3700 of the Lebor Coda, for Ihe peAortnance of the work for w�icti ihis pertnit is IsweC. My workers' compensation Insurence carrier entl policy number ere: Carder. Policy Number: (This section need not be canp/eted U Me pemut is valuetl et one hundred dollars (E 100J or Iess.J �J-- I)certify ihat in tha peAortnence o1 tha work for which this pertnit Is issued, I shell not employ any parson in eny manner so as to become sublect to the workers' _�-tompansation laws` alifomla��,,,888nnnQQQ egree thppt if I shoultl Decome suD�ect to the workers' compensatlon provislons ot Section 3700 0l t�e Labar Code, I shall forthwith A comply�withthese vision� � r JD/�N ppllceni'Si nature: Dete:_ UO b9a5��"�`,� WAR IN NG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMeI:pYEfl,iO�CRI NA�ALTIES AND CIVIL FINES UP TOIXJE HUNDRED T'KKISAND Dd1FRE (5100.000), IN A�DITION TO THE CQST OF COMPENSATION, DAMAGES AS PflOVIDEO FOR IN SECTIIXJ 3]OB OF THE LABOR CODE, IMEREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARATION: 1 hereby eNirm Ihai I am Iicense0 untler provisions ol Chapter 9(commencing with Section 7000) oi Division 3 of the Business and Professions Coae, and my license is in tull force end eflecL Lic. # Clau a Cantraaofs SignaNre: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hareby aflirm ihat there is e construclion lending agency for Ihe pertormance of ihe work for whic� ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lendels Name: Lentler's Address: Signature: Date: OWNER•BUILDER DECLARATIONS: I hereby aNirm that untler penalry of per�ury thet I em EXEMPT FROM THE CONTRACTOHS LICENSE LAW tor Ihe fdlowing reason (Sec. 7031.5, Business and Protessions Cotle: Any ciry or counry which requires e permit lo construct, elter, improve, demolis�, or repair any sirucNre, prior to its iuuance, elso requires the eppliwnt for such permit to tlle e signetl statement ihat he or she Is Ilcensed pursuent to ihe provlsions o1 Ihe Contrectors Llcense Lew (Chapter 9(commenUn9 wlth Secllan 7000) ot DMsion 3 of the Busineu end Professions Code) or thet he or she is e:empt therefrom end the basis tor the alleged exemptlon. Any Wolatian at Seclion 70.31.5 by eny epplicant tor a permit su Je—c-t�s t�e epplicant ro e civil penalty of not more ihan five hundretl dollers ($500).): I/es owner of Ihe proparry, or my amployaes with wages as their sole wmpensatlon, WILL DO THE WORK, antl the structure Is nol intentletl or oNered for sale (Sec. 7044, Business and Professions Code: The Contractore License Lew tloes no� apply to an owner of property who builtls or improves Ihareon, antl who tloes such work himsetl or herselt or ihrough his or her own employees, provided �hat such improvemenis are not intended or oNeretl for sale. It, however, the builtling or Improvement is sold wit�in one year oi completion, Ihe owner-builder will heve the burden oi proving that he or she did nat build or improve for purpose oi sale.). ❑ I, es owner of the property, am EXCLUSIVELV CONTRACTNG WITH LICENSED CON7RACTORS to construct the pro�ect (Sec. 7044, Business end Professions Code: The comractors License Lew does not aDPh to an owner ol property who builtls or improves thereon, end who coniracts tor suc� pro�ect with e comractor(s) licensa pursuent to the CoNractors License Lews.). under venfeC by tlrivafs lleans2. ❑ Ves ❑ No Business end Profassians Cada tor this reeson: Verification of Ownership by (type of documenL i.e. - property laa bill DIVISION OF INDUS7RIAL SAFETY PERMIT CER7IFICA710N: ❑ I hereby certity thet no excavatlon five (5) or more feet in depth Into which e person is required to descend, will be matle in connection with work authodze0 by this permit, end that no builtling structure, scalloltling, falsework, or tlemolition or dismantling thereof, will be more then thirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sac. 341, Title 8, CelAomia Atlminisiretive Cotle). ❑ As owner-6uildar, I will nat employ anyone to do work which would reduire a permil from ihe Division al Industrial Sefery, as noted above, unless such person hes a pertnit to do suU work trom ihe division. Signatura: Date: Division oi Indusirial Safery Pertnit Number: CERTIFICATE OF COMPLJANCE AND AU7HORIZA710N OF ENTRY: I certify under penalty of per�ury thet I have reatl this applicetion end state Ihat Iha informatlon given is conecL I egree to w ly with ell sta ciry ordinances releting to Guilding construction, end euthodze representatives ot tha Clry o1 Costa Mesa to enter upon the above-descnb pm ny for insp on purpo . I egre ot to occupy or ellow occupancy ot eny building eu�horize0 by this pertnit un}il finel ipspection. /D�, v/i�'�" Sfgneture"OfLega ner_��_�y i';��' e .�. And/OrAuthonzed Applicant . , Date CODE 1, INSPECTIOHTYiE QejE 1618 Fized Sys�em Final Flra Preveniion 1286 Pool Spe Final � 200 Final Ra-Root 207 FIna181ocWRetaining Well 202 Final Factory Fire Place 203 finel Sign 204 Final Demolition � . . �$ ' fQpEa INSPECTIONTYPE 206 Finel Mechanical 20B ' Finel Plumbing 210 finel Elec�riwl 212 Final Fire Prevention 220 Finel Planning Approval 222 Finel Site _ 250 FlnelBulltling/Occupancy �g � i z-4 -0 6 �_ .� r (714) 754-5273 • Fa�c (714) 754-4856 • www.ci,costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: Applicant: Address: 388 E 19TH ST ��I� � � � _ l� F 42630114 Y � BRENNAN-SCHMITT, K RRY 388 E 19TH ST � - 7" COSTA MESA,-CA �� " '�,' i � � ��, � �� ii'-'� �; Owner. �SCHM1Tf, PAUL� � � Address � �3B8-E 19TH ST . - > � � ,� � � COSTA MESA, �CA . �, �; � �� ,. -i" � Contracfor. OWNER-BUILDER , �� ;��"%/ , '�Address: � ; �,� . _ i �, i �Phone: 949-500-7748 Zip: 92627 , Phone: 949-500-7748� , - Zip: 92627 Phone: Zip: License: 000000 ' ' SCOPE OF PERMIT � � RELOCATE �ltkfftEl'� WATER HEATER TO GARAGE. REF.: BO6-01830 FEE SUMMARY - �' AMT QTY . , . �. �� - _ � _ AMT � ISSUE FEE 523.50 ' ' �� Laundry Tub! Washer � 30.00 0 Backflow irrigation 50.00 0 Landscape Irrigalion $0.00 0 �,BackOowPreventer 50.00 0 P-Trep. 50.00 0 Bathtub . � 50.00 0 ,- Pressure Regutator 50.00 0� Clarifier System . 50.00 0.� � Process Piping (per 70 ft) � 50.00 ,�- 0 Connect Qce,Soda,eic) 50.00 0�. Receplors . � $0.00- � 0 DentalUnits 50.00 0 SepiicTank 50.00 0� Dishwasher � 50.00 0 Sewer Cap for Demo $0.00 0 Drain, Floor 50.00 0 Sewer Connecl 50.00 0 Drain, Rainwater � 50.00 0 Sewer Private Line 50.00 0 Drain, Roof 50.00 0 Shower $0.00 0 Drinking Fountain . A $0.00 0 Sink, bar . ' � � ' $0.00 0 ExpansionTank ^ �$OAO 0 Sink.commercial' -$D.00 0 Gas Earthquake Valve , 50.00 �� 0 Sink,-Floor 50.00� � 0 Gas (1-4 outlets) - � 50.00 . � 0 � �Sink, kitchen $0.00 � 0 � Gas(Over4outlets) � 50,00�� ;0,� � � �Sink,service/mop 50.00 0'� Gas Repipe , 50.00 �, 0�: .� Spa (private); 50.00 0 Gas Service �� ,'S0.00�) 0�� `� � Spa�(public): � 50.00 0 Interceptors(Grease,0il) .50.00�/ �0 �- �, � � - Intercepiors (Sanq Aulo,)� , 50.00 ��0/ �_, � � ��`= � �„ � � ' " � �� -' COMMENTS / SPECIAL CONDITIONS � ' `- �., � _ �� ` - � `; . . Status: ISSUED Applied: 1727I2006 � Issued: 11272006 ISSUED BY: SampPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bktlow(1-4) Vacuum Brkr Bktlow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toileq Water Heater! vent Water Piping pnst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION -PLAN CHECK - REINSPECTION TOTAL CALCULATED FEES: AMT 50.00 30.00 50.00 50.00 50.00 50.00 50.00 50.00 $0.00 50.00 512.30 $0.00 30.00 50.00 50.00 50.00 50.00 50.00 50.00 535.80 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 NOTICE: The work authorized by this permfl shall compty with all applicable handlcap access requiremenis under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 7241•92) EXPIRATION: This pertnit shall automatically ezpire and become void if work Is not commenced within 180 days, or If work is suspended or abandoned tor a period ot 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all appiicable codes, and all requlred Inepeeti0na and finel approvel must be obtalned. Failure to obtain inspections and final approva� will result in tha expiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 rr.,:�..f•1:1] WORKERS'COMGENSAnON DECLARAnON: �' ' ' I hereby eNirm under penalry ot perjury one of the lollowing declaratlons: ❑ I hava entl will melntain e cenilicate of consent to self-Insure lor workers' compensetlon, es provitletl for by section 3700 at the Lebar Cade, lor the peAortnence ol Ihe work for which Ihis pertnit Is i55ued. ❑ 1 heve end will maintain workers' compensatbn Insurance, as required by sectlon 3700 ol Ne Labor Cotla, for ihe peAormance ol the work for whitl� Nis pertnit Lq issuetl. My workers' compensation Insurance cartier en0 policy number ere: Certier: Policy Number. (Thls sectlon need nof be comple(ed // the perm�Ns valuetl ef ine hundretl dW/ars ($100) or less.) ❑ I certity thet in tha peMormenco of the work for which this permit L9 Lssued, I shall nol employ any pereon In any manner so as to become subject to Ihe workers' compensetion laws of Califomia, entl dB�ee Ihet il I s�ould become sub�ect to the workers' compenaetlon provislons of Sectlon 3700 of Ihe Labor Cade, I shell tort�wit� camply with Ihese Provlslons. ApPlicent Sipneture: Date: WARNINO: FAILURE TO SECURE WORKEFS' COMPEMS4TION CWEMOE IS UMAW FUL AND SWLLi SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED T110USMlD OOLLAPE (5100,OW� IN �UIXiqN TO TME COST OF COMPENS1TIpN, DAANGES AS PROVIDED FOR IN SECTION 37060F THE LABOF CODE, INfEREST, AND RTTORNEY'S FEES. LICENSED CONTRAC70RS DECLAFiATON: I here6y eHlrm ihat I am Ilcensed under provls�ons oi Chflpter 9(commenUnp wilh Section 7000) of Divislon 3 oi the euslness antl Profeuians Code, and my license Is in full force end etlect. Lic. p Cless a Conirector's Signature: Dete: CONS7RUCTON �ENDING AGENCY: ❑ I �ereby etlirtn Ihat there is e construn�� lentling agency tor the paAormanca ol ihe work for which this permii is issued. (Sec. 3097, Civil CoOe). Lentlefs Name: Lentlefs Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirtn thet under penalry oi Derjury that I em El(EMPT FROM THE CON7RACTORS LICENSE LAW for the I011owing raason (Sec. 7031.5, Business antl Protessions Cotle: My Gty or counry which requires e pe�it to consWct, alter, imprrne, demolis�, or repair any struciure, pdor to its iuuence, alsa requires the epplicant tor such pertnit to tile e signed etatement thal he ar she Is Iicensed pursuent to the provisions ol the Cantrectors License Lew (Chepter 9(commencing with Sectlon 7000) 01 Division 3 ot the Business entl Professions Gode) or Ihat he a� she is exempt therefrom end t�e besls for the elleged evemptlon. Any vloletlon of Section 7031.5 by eny epplicant for e pertnit suhlects the appltcant to e Gvil pe�alry c� aot more then tive huntlretl tlollars ($50a).): � �J, es ownar of the properry, or my employees wl�h wages es Ihelr sole compensation, WILL DO THE WORK, end the structure is not intended or oXeretl lor sale (Sec. 7044, Business and Professions Code; The Contractors License Lew does not appty to en owner of Droperry who builds or improves thereon, and who Aoes such work himselt ar herself ar ihraugh his or her own employees, proNded thet such imprwements are not Inlended or oXered tor sale. If, however, Ihe huilding or improvement is sold within one year of compleuon, the wmerbuilder will have ihe burden ot proving ihat he or she Eitl not build or improve for purpose of sale.). ❑ I, es owner of the property am E%CLUSIVELY CON7RACTNG WITH LICENSED CONTBACTORS to consWct the pro�ect (Sec. 70d4, Business antl Pmfesslons Catle: The cnntreciors License Lew does not eppty to an owner at property who �uiltls or impmvas �hereon, entl who comracis tor such prqect with a coniractor(s) ��ikensg pursuant ro the Contreaors Llcense LewsJ. under by dliv§�3' .Acense. � �es ❑ No Business and Prolessions Code for this reeson: Vedlication of Ownership by (rype of docume�4 I.e. - properry taa bill or tleeA): OIVISION OF INDUSTFiIAL SAFETY VERMR CERTIFICATION: ❑ I hereby certily thet no evcavatlon INe (5) or mora teet in depth into whlch e person is requlred to descen4 wlll be mede in wnnectlon with work auNorized by Ihis permit, entl that no bullding sirudure, B�allolding, lalsework, or demoliiion or tlismentling thareoi, will be more �hen thirty-sls (36) feet high. (Chap. 32. Grp 2, Art 2, Sec. 341, Title B, Celitomia AdministretNe CadeJ. ❑ As ownervbuilder, I will not employ enyane to Oo work w�ich would require a permii trom the DlNsion af Industrial Sefery, as noted a6ove, unless such person hes a pertnil lo tlo such work 1mm t�e d'Msion. Signeture: Date: Dlvision ot Intlustnal Safary Parmit Numbor: CEIiTIFlCATE OF COMPLIANCE AND AllTHORIZA710N OF ENTRV: I cenity under penalry of perjury Ihet I �eva rea0 Ihis epplicaiion entl state that the Informetion given is correct. I agree to co� ply with ell stete laws end dry oNinan s relating to Euiltling consWction, and authodze representetives ot tha Ciry ol Costa Mese to enter upon the ebove-described p �aerry for inspec' rp es• I agree upy or ellow occupenty ot any building authodzed by Uis pertnit un�il fi I inspeption. _ -- i�2�-'�.I.1� SigneWre eID'�'�er(s)'-'^� D te VA AnNOr AUIhodYed Appllcant Dete f�QQ� INSPECTIONTYPE 1818 Fixetl System Flnel Fire Prevention 1288 Pool Spe Finel 200 Finel Re-Roof 201 FIneI8locWRetalnlnp Well 202 Finel Fectory Flre Place 203 Flnal Sipn 204 Final Demolition P�ff II�LS COOE� INSPECTIONTYPE 206 Finel Mec�anicel 20B Finel Plumbing 210 Finel Electricel 212 Finel Flre Prevention 220 Final Plenning Approvel 222 Finel Slle 250 Finel Bullding/Occupancy QAg I[�4S r � � Job Address: 388 E 19TH ST Suite: Vicinity: ROOF Primary Occ: R3 Dwellings/ Cong Res <70 Parcel Number: 42630114 App�icanc LEMUS, RAFAEL Adqress: 2016 WALLACE AVE UNIT B COSTA MESA, CA Type of Constr � -N` in �Phone: 949-642-7057 Zip: 92627 Owner: ACTON, �AY SUSANNE AND FREDA MAE TRUST Address 388 E 19TH ST .. � Contractor. Adtlress: � .. Zip: Arch : Address: 2ip: COSTA MESA, CA LEMUS ROOFING 2016 WACLACE AVE UNIT B COSTA MESA, CA 92627 ' . . Phone: License: Phone: Zip: 92627 Phone: 949-642-7057 License: 826813 Eng: Address: Status: ISSUED Applied: 70252006 Issued: 7025/2006 ISSUED BY: L%��I?�%✓' Phone: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTA�C 2 LAYERS OF 15# FELT, 3.5:12 PITCH, 30 YEAR COMPOSITION SHINGLES FAND REPAIRIREPLACE �SHEATHING AS NEEDED. 77 S�UARES INCLUDES ATTACHED GARAGE. . , FEE SUMMARY Plan Check: 50.00 Permit: 597.25 SMIP Res: $0.50 SMIP Com: . 50.00 Other: 50.00 InspeCtion: $0.00 Total: ' $97.75 SETBACKS MAINSTRUCTURE Front-. 0-0�� , Rear 0-0 ACCESSORY' �,- Front 0-0 �" Rear � 0-0 PARKING � Existinq: � 0 Reauired: �, 0 PLANNING & ZONING Lefl 0- 0 Left 0• 0 .Pr000sed: � 0 Calc Valuation: Claim Valuation: � Right , 0- 0 i. . Right ' 0. 0 , . �. $3,500.00 83,500.00 � � � NOTICE: Th9 wprk authorized by this permit shall campty with all applicable handicap access requtrements under Catifomia statules and related regulations. (Ord. No. 92-28, § 1, 12-21•92) EXPIRATION: Thls permit shall autometically explre and become void if wark is nat commenced wlthin 180 days, or if work is suspended or abandoned for a period of 780 days. INSPECTIONS: In order tor the work euthorized under this permit to be considered legal, such work must comply with all applicable codes, end all required Inspgctlons and final approval must be obtained. Failure to obtaln inspections and final epproval will result in the expiration ol ihis permit. FOR INSPECTIONS CALL: (714) 7545628 smo-ae �eAo� WORKERS'COMPENSAnON DECLARATON: I hereby aflirtn under penalry of perjury one oi Ne following tleclaratlans: ❑ I hava and will malntain a certllicate of consent ro setl-Insure for workere' compensatlon, es proNtleC tor by sectian 3700 ot Ihe Lebor Cotle, br Ne pertormance of ihe �work for whtch this pemtit is issued. . . � . �l.have and vnll maintain workers' compensatlon inwrance, aa requireG by sectim 3700 oi ihe Lebor CaOe, Iw Ue peAortnance ot Ihe work tw whiC� Utls pertNt Ls IsweC, My workers' c9mpensation Ij�4urence cerrier entl policy number are: t ry� ��1 Cartier: .� ��1'�ii'`'{�. }^ Ui�Ci� " PolicyNumber: �� \��5 LJ 4� -(TNs�secnon need n�comp/eted ll fhe permit is veluetl et one hundred tlollers ($100J oi less.) ❑ I certity t�at In Ihe pertortnence ot Ne work for which this permit is luuetl, l shall not employ any person In eny manner so es lo become subleM to ihe workers' campensation laws of Califomia, end egree t�at i I s�ould became sublect to Ihe workers' compensatlon provlsians ot Sectlon 3700 0( t�e Lebor Code, I shall forihwlth Compty with t�ese prq on . 1 / App cent Si�� ' L— r-Date:"�--•I n I ZS E D Fi WAiiNINO.'FAILURETOSEWPEWORf(ERS'COMPENSAT7 COVEMOEISUNUWFULM'DSFUl15UeJECTANEM_P10YER�TOCRIMI�SANDCMLFlNESUPTOONEHUNDRED THOUSANO DOIURE (5100,00�, IN ADDfiION TO THE OOST OF OOf.1PEN$ATION, DMi4GE5 0.S PRO��DED FOR IN SECTION 370fi OF THE LABOR OODE, INTEREST. AND ATTORNEV'S FEE$. LICENSED CONTRACTORS DECLARATION: ot C�eO�er 9(commencing with Section 7000) ot Dlvision M�the'Business en0 Prof Q� Catla, antl my license is In full � Clase.p—G— �`1 Da`� ie: � Z5 L� F> CONS7RUC710N LENDING AGENCY: ❑ I �ere0y ettlrm tfiet there is e construction lending egency tor Ihe peAormance ot the work br which Ihis pertnii is issueA. (Sec. 3097, Civil Cotle). Lenders Neme: Lendefs Address: SignaWra: _ OWNER-BUILDER DECLAfiAT10NS: Date: I hereby eMirm that untler penalry of perJury Ihet 1 em E%EMPT FROM TME CONTRACTORS LICENSE LAW lor iha tollowing reeson (Sec. 7031.5, Business antl Professions Code: Any ciry or counry which requlres e permit lo construct, elter, improve, demdish, or repair eny slructure, prior to its issuance, also requlres the epplicant tor suc� pertnit to lile e signetl stetement Ihat �e or she is licensed pursuam ro the pmWslons of �he Gontrenors Licensa Lew (Ghapter 9(commencing with Sectlon 7000) of DlWsion 3 0l the Business end Pmtessians Code) or t�at he or she is exempt Iherefran antl the besis lor the alleged exemption. Any violatlon of Saction 7031.5 by any appliwnt for e pertnit sub�ects Ihe epplicani to a dvil Denalty oi not more than five hundred dollars (5500).): ❑ I, es owner of ihe property, or my employees with wages as thelr sde compensation, WILL DO THE WORK, end Ihe struciure is not IniendeO or ottered tor sale (Sec. 7044, Business and Professions Cotle: The Contractors Llcense Lew does not apply Io an owner oi property who builds or Improves Ihereon, end who does such work himself or herself ar through his or her own emplqrees, provided that such improvements ere not imendetl ar oMered tor sale. II, however, Ihe buiitling or imprwement is sold wiihin one year ol completion, Ilie owner-builder will have the burden ot proving i�at he or she did nol build or improve lor purpose of ule.). ❑ I, as owner ot the property, em E%CLUSIVELY COMRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions Code: The coniraciors Llcense Law tloes not apON �a an owner ot pmperry who builds or improves thereon, end who con[racts lor such prqed witb a contractor(s) license pursuant to the Contrectors License LewsJ. ❑ I am esempt under sec. Signature: Owner ID venlied by drivers IlCensa. ❑ Ves ❑ No Business end Prolessions Code tor this reason: Vedllcatlon of Ownership by (lype at tlwument, i.e. - property tav Dill or tleed): OnverS Litense No. Date: Expires: DIVISION OF INDUSTRIAL SAFETV PERMR CEHTIFICATION: ❑ I hereby certify ihat rw excevetion tNe (5) or more fee� in tlep�h Into which a person is raquired to descend, will be made in connection with work authorized by Ihls permit, antl ihat no bulltling structure, sceHolding, falsework, or tlemolition or dismantling Ihereol, will ba more than thfrty-sis (38) feet high. (Chap. 3.2, Gry 2, An 2, Sec. 341, lltle B, Califomla Administretive Code). ❑ As owner-builder, I wlll nol employ anyone to do work which woultl require e permil Irom the Dlvlslon al Indusinal Satety, es notetl e6ova, unleu such persan hes e permit to tlo such work from the tlidsion. Signature: Date: Division ot Intlustrial Safery Permit Number: CERTIflCATE OF COMPLIANCE IWD A(!T}10RIZA710N OF ENTAY: I certity untler penalty al perjury thet I have read ihls epplication antl staie Ihat the Infortnatlon given is correct. I aqree to wmply with all stete laws end ciry ortlinances releting to Ouilding consWctlon, end euthodze representetives of the Clry of Costa Mese to emer upon the ebove-0escribed properry tor inspection purposes. I agree not ta occupy or allow accupency of any building euthonzed by this permi� until final Inspection. GOOE �. INSPECTONTYPE ' - • 1616 Fizetl System Finel Fire Prevention 1266 Poal Spa Flnel 200 Finel RaRoof 201 Finel Blxk/Reteining Well 202 203 204 Final Factory Fira Place Final Sign Finel Damolition PdIE 1t�A45 COOEI INSPECTIONTYVE 206 Final Mechanical 20B Finel Plumbing 210 Finel Eleqdcel 212 Flnal Fire PrevenNon 220 222 250 Finel Planning Approval Final Site Final Builtling�Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT ,lob Address: 388 E 19TH ST Suite No Vicinity: Parcel Nunmber: 42630114 npp�icant: BRENMAN-SCHMITT, KERRY Address: 3B8 E 19TH ST COSTq MESA, CA Owner. SCHMIDT, PAUL Address 388,E 19TH ST ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa . Lighling Fixts Recepl Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Morors to 1hp Motors l0 10hp Motors l0 50hp Motors l0 100hp, Molors over t00hp Communication drops Sub panel to 200a Pole Light Pkg � Sign Circuits Temp Pwr Pole Intermed Pole COSTq MESA, �CA OWNER-BUILDER Phone: 949-500-7748 Zip . 92627- . REPAIR DRYWALL THROUGHOUT S.F.D. AND TO GARAGE. REF.: BO6-01830 $23.50 50.00 $0.00 50.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 $475 $0.00 $0.00 50.00 � $0.00 $0.00 50.00 50.00 50.00 50.00 50.00 $0.00 - , $0.00 ; $0.00 $0.00 �uantiry 0 0 0" 0 p 0 0 1 0 0 0 0 0 ' 0' " 0 0 0 0 � p,� 0 0 ' Status: ISSUED Applied: 10/30/2006 Issued: 10/30/2006 � ��/ ,�a �v . �, �- � , . .... �-;...,.� .. .m ' ` -. � RELOCATE,TANKLESS WATER HEATER FEE SUMMARY � \ � , Quantity � ;- demp D�ist System./ Lighting; '. $0.00 0 � -� Bus�vay'/,t00.k � " � 30.00 0 � � - Standing Section � � � 50.00 0 Misc Electrical Equipment 50.00 0 Transformers up to 1 kvalkw 50.00 0 � . , , , ...............up to 10 kvalkw .. $0.00 0 � ' ....:........:...up to SO.kva/kw - - $0.00 0 . . .................up to 100�kva/kw ' $0.00 0 �. .................:over 100 kva/kw $0.00 0 - Low Voltage Equipment $0.00 0 � Low Voli Wiring System / Ckt -$0.00 0 Misa Conduit � $0.00 0' � �-,Misc. Conductor $0.00 �.0 •� � Cirws ( 9en or ride) � 50.00 � 0 -� =`'�, �- Circus (mech ride or lights) $OAO"�'' 0 .� - Christmas Tree �Stand 50.00�� 0 - � . Fireworks Stand� '� .. "-�50.00� 0 Other Electrical Fee�' � $0.00 � Investigation Fee . � $0.00 . � ; Plan Check Fee . : $0:00 A' - - � .. _ _ Reinspection Fee -�, - �.., �;; $0.00 � �, .. - - - � '` -, A� -� ; TOTAL CALCULATED FEES `.E2825 % - �� COMMENTS / SPECIAL CONDITIONS �. N0710E: The work authorizetl by this partnit shall comply with all applicable handicap access requirements under Califomia statutes and related regulatlons. (Ord. No. 92-28, § t, 12-27-g2) EXPIRATION: This permit shall autometically expire and become void II work is not commenced wlthin 180 days, or it work Is suspended or abandoned lor a pariad ol 180 days. INSPEC7YONS: In order for the xrork aulhorized urWer ihis petmit to De wnsidered legal, such work must compty with all applicable codes, and all requlred Inepeetlona and flnal epproval must be obtained. Failure to obtain Inspeclions arrcl finel appfoval wiil result in the ezpiration of this pertnit. FOR INSPECTIONS CALI: (714) 7545628 .«a.o ��,i WORKERS' COMPENSATION DECLARATION: � I �ereby effirtn under penalty ot perjury one of lhe following tleclarati0ns: � . . ❑ I have and will maintain e ceNficete of consenl lo self-Insure for workers' compensetion, es provitled for by sectian 3700 0l ihe Lebar Code, far Ihe pertormence o1 ihe work for which ihis permit Is Issued. ❑ I have anG will maintain workers' compensation Insurance, as required by section 3700 of I�e Labor Code, for the peAortnance of ihe work for which this pertnit is Issuetl. My workers' compensatlon Insurenca cerrier antl policy number ere: Carrier. Policy Number. (This secfion need not be comp/efed il the permit is ve/ued ef one hunUreU tlollaro ($100J or less.) � I certity that in the pertortnance o1 the work for which this Dertnit is issued, I shall not employ eny person in eny manner so es to become subjed lo the workers' compensalion laws of Cel'to ', antl agre +++'jjj I ould become sub�ect to the workers' crompensetion provisions oi Section 3700 01 the Lahor Cotle, I shall lorihwith comply with these provisl . � /�'` /y Applicent SignaNre: � Date: /V Y/�i� WARNINp: FAIWRE TO SECU WORKEFlS' COMPENSATION CAVERAQE IS UNIAWFUL AND SHALL SUBJECT rW EMPLOYER TO CRIMINAL� D CNIL FINE$ UP TOIXJE HUNDRED i/iOUSAND OOLLARE (5100,000�, IN ADDITION TO THE CQST Of COMPENSATIIXJ, DAMAGES AS PROVIOED WR IN SECTION 31W OF TME LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTAACTORS DECLARATION: I herehy affrm that I am licensed untler provisions ot Chapter 9(commencing with Section 7000) of Olvlslon 3 of ihe Business antl Professions Code, ana my license is in full torce entl eHect. Lic. q Class k Contrectofs SlgnaNre: Data: CONSTRUCTION LENDING AGENCV: ❑ I hereby eHirm thet ihere is a construction lentling agency for iha pertortnanca of tha work for which Ihis pertnit is issued. (Sec. 3097, Civil Coda). Lenders Nama: Lendefs Address: Signature: Date: OWNER-BUILDER DECLARATIONS: • I hereby eHirtn that under penelry of perjury Ihat I am EXEMPT FROM THE CONTFiACTORS LICENSE lAW for Ihe following reason (Sec. 7031.5, Business end Professions Code: Any ciry or counry which reqWres e permit to construct, alter, improve, demolish, or repelr eny structure, prior to Its Issuance, elso requires t�e epplicant ior such permit to tile e signetl stfltement thet �e or she Is Iicensed pursuant ta the pmWsions of Ue Contredors Llcense lew (Chapter 9(cammendng with Sectlon 7000) oi DMslon 3 of t�e Business entl Professions Cotle) or Ihet he or she is exem0� �heretrom and the basis tor ihe allepetl e:emption. Any violation of Sectlon 7037.5 by eny applicant for a pertnit sub�ects the eODlicant to e civll penelty of nol more then five hundred dollars ($500).): � I, es awner at Ihe properry, or my emplayees with weges as Iheir sale compensa�lon, WILL DO THE WORK, antl the siructure Is not intended or otteree for sale (Sec. 7044, Business and Professions Code: The Contracto�s License Law tices not epply to an owner of propeny who builds or Improves ihereon, end who tloes such work himself or herself or ihrough his or her own employees, provltled Ihat such Improvements ere not Intentled or oNered for sele. If, however, the 6ullding or Improvemant is soltl wit�in one year oi wmpletion, ihe owner-builder wlll have ihe burden of proving that �e or she tliC not Duiltl or improve for purpwe oi sale.). ❑ I, as owner ot Ihe property, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consirutt Ihe projact (Sec. 7044, Business and Professions Cotle: The wntrectors License Lew tloes not epply to en owner ot pmperry who bullds or Improves t�ereon, entl who contrects for such project wit� a coNractor(s) license pursuant to the Contractoro License Laws.). ❑ I em e:empt under Signature: Owner ID veniietl by r" No Business antl Protessions Catle br this reeson: Date: l (> , 0(v Expires: � Y� Venfication of Ownership by (type oi daumenL i.e. - properry tax blll or deed): DIVISION OF INDUSTRI/LL SAFETY PERMR CERTIFICATION: ❑ I hereby certify ihat no excevetlon Five (5) or mora teet in depih into which e person Is required �o descend, will be made in connection with work authodzetl by t�is pertnit, and Ihat no bulltling siructure, sceftoltling, talsework, or demolition or dismentling thereof, will be more then thirty-slx (36) teet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Ttle B, Califomia AtlmiNstratNe Code). ❑ As owner-builder, I will not employ enyone to do work which would require e pertnit tram the Division of Industrial Sefery, as notetl above, unless such person has a permit to do such work from ihe division. Signature: Date: Division of Industrial Sefety Permit Number: CERTIFlCATE OF COMPLJANCE AND AIJfHOR¢ATtON OF EMAY: I certify under penalry of perjury that I have read this epplication and state that ihe inlormation given is correct I egree to comply wlth ell stete laws end clly ordinences releting to building rqnstructlon, end euthorize representetives oi the Ciry of Costa Mesa to enter upon Ihe above-descnbed prop f Inspection purposes. I egree not to cupy ar allow occupancy of any building authonzed by Ihis permit until f al ins ctlon. � _--��— ,b f�r� Slgnature Of Legal Own s Date AnNOr Aut�orized Appliwnt Date COUE 1, INSPECTIONTYPE 1616 FixeO System Finel Fire Prevention 1266 200 Pool SOa Finel Final Re-Rooi 201 Final BIocWRetaining Well 202 Final Fectory Fire Place 203 Final Sign 204 Final Demolition � jyj�� S,QpE� INSYECTON TYPE ' 206 Final Mechanical 200 ' Final Plumbinq 210 Finel Electrical 212 Finel Fira Preventlon 220 Final Planning Approvel 222 Final Site 250 Final Building/Occupancy QEIE 1[�L9