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Home My WebLink About427 19TH ST - Building Permits� • � t ' r (714) 754-5273 • Fax (774) 7%-4858 • www.cl.coste-mesa.ca.us 77 FAIR DRIVE, GOSTA MESA, GA 92626 BUILDING PERMIT Job Address: 427 E 17TH ST Suite: B Viciniry: BLDG B (ISOLD IT) Parcel Number: 42514336 .. ApplicanC SANCHEZ, GARBIEL Address: 3500 W BURBANK BL 2ND FLOOR Zoning: Phone: '81&557-1225 BURBANK, CA - . � Zip: 91505 Owner. FLOWER INVESTMENT CO Address 4061/2 CLUBHOUSE AVE � � , � � . � , � � . Bhone: _ - ' NEWPORT BEACH, CA �- Zip: 92663 � Convacior: 'DORADO DESIGN AND CONSTRUCTION INC Address: 3500 W BURBANK BL Status: ISSUED Applied: t0122/2004 issued: 10122/2004 ISSUED BY: :� ---_,-.��T 2NDFLOOR Phone: Bt&557-1225 EXPIRyo` � - - BURBANK. CA � � � -, 'Zip: 91505 License:. 778969 ,� , Arch : Address: Zip: �' Phone: License: Eng: Address: � SI:VYt Vt YtKMI I � ' ' INTERIOR 1496 SF NEW CUSTOMER SERVICE AREA AND NEW OFFICE IN THE BACK STORAGE AREA IN AN EXISTING COMtv1EFiCIAL BLDG �FOR� iSOLD IP IN BLDG B. WORK TO INCLUDE.NEW NONBEARING PARTITION WALLS AND MINOR ELECTRICAL. - . . ,� . , . . . . . - � .. ' FEE SUMMARY , Plan Check . . $99.61 , \ , .. , ,'�, Calc Valuation: Sa,000.00 Permit: $153.25 � _ ._ _ _- _ _ � �� ' ; � Claim Valualion: Se,00o.00 SMIP Res: $0.00 - SMIP Com: , $1.68 �� _ , � Other. ', $0.00 , Inspection: $0.00 � �� . ,� ..�,:.:.��_ _ � �� Total: $254.54 � Y`" � � �� _- � � � PLANNING R ZONING � ,� . / !�-. '�A , - � ' . ' � SETBACKS • , , �' �, � �� MAW STRUCTURE�Front 0.�0� � � — �Rear ,�' 0- 0 ' , Left 0- 0 _ � Righ[ 0- 0 � � � � , \� -` � � � _ � - _ - . .- � . . ACCESSORY �Pronh- 0- 0' r ; Rear 0- 0 LeR 0- 0 RigHt - 0-.0 � � � � � i •_ � , � i PARKING Exish7lp:��-0-__ Repui2d:`' 0 - �-PFotiosed:, -0 ' ' -�� -- � � ' . � 'j, � `-\ _ - _ -- - �� . . . .. .-' , ' , _ i' , i NOTICE: The work authorized by this permit shall compty with all flpplicable handicap access requirements under Calitornla statutes and re�ated regulations. (Ord. No. 92-28, § 1, 12-21-92) � EXPIRATION: This permit shall automaticalty expire flnd become void if vrork Is not commenced within 180 days, or il work is suspended or abandoned for a period af 180 days. INSPECTIONS: In order for Ihe vrork aulhorized under this permit to be consl0eretl legal, such work must comply wl�h eli epplicable codes, and all requlred Inepectlona end final approval must be obtained. Failure to obtein Inspectlons and tinal epproval will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2dd&dB(6D0) E WORKERS' COMPENSATION DELLARATION: � � � - . • 1 hereby eHirm untler penalry of perjury one of the �allowing tledaretions: ' • ❑ I heve end will meintaln a cenificete of consent to self-Insure for worliers' compensation, es proNded for by section 3700 of the Labor Code, for t�e pertortnance oi Ine �work 1or which this permit Is issuetl. : I heve end will meintain workers' compensetlan insurenCe, es requiretl Cy section 3700 oi Ihe Lebor Code, far the pertormance of t�e work tor which Ws permit Is iuued. My workers' co pens tlon Ins.,u�rence ca1rria� end policy number ere: p D �y Cerrier: � � � !-i�✓1 d • Poliry Number. ��=� 36 03' � / (This secNon need no be complefed if the permit Is valuetl ef one huntlretl dollers ($100) or IessJ ❑ I cenity thet In Ihe OeAormence oi Ihe compensatlon laws ol Callfomia, entl comply wit� t�ese pmvlsions. Applicant SiBneture: -- WARNINO: FAILURE TO SECURE WORKERS' CC TMWSAND DOILARE (E100,000), IN �DDRION T( LICENSED CONTRACTORS DECLARATION: I hereby ettirm ihat I em Iicensed under provislc torce end ettect. Llc. a. '-]-1 � L contraciors signawre: 'or whic� t permit is issued, 1 shall not employ eny person in any menner so es to become sub�act to ihe workers' thet II Itl Decome sub�ect to the workers' compensetion provislons of Sealon 3700 of ihe Lebor Cotle, I shall tort�with oe�e: lo - z z -o �/ ✓ E IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNORED b5 OF PENSATION,OAMAGESASPROVIDEDFOFINSECTION31080FTHELABORCODE,IMEREST,ANDATTORNEI"SFEES. Section 7000) ol Division 3 0l lhe Business antl Prolessions Catle, end my license is In full _ qau a� (� _ oe�e: � c�- 2Z - o �1 CONSTRUCTION LENDING AGENCY: �' � ❑ I hereby eHirm t�et there is e consiruIXlon lending egency for the peAarmance ol ihe wark far which ihis permit Is Issued. (Sec. 3097, Civil Code). Lenders Name: Lendefs Address: SipnaNre: OWNER•BUILDER DECLARA710NS: Date: I hereby aNlrm Ihat under penelry of perjury that I em EXEMPT FROM THE COMRACTORS LICENSE LAW tor Ihe lollowing reasan (Sec. 7031.5, Business and Prolessions Cotle: Any ciry or counry which requ'ves e permit to construct, elter, Imprwe, demolish, or repeir eny strucWre, prior to its Issuance, elso requires the epplicent for such pertnit to file e signed statement that he or s�e Is licensetl pursuent to the provisions ot the Contractors License Lew (Chapter 9(commencing with Sectlon 7000) ot DlNsirn 3 of the Business end Prolessions Code) or that he or she is exempt therelrom antl t�e basis for the alleged exemptian. Any Woletion af Section 7031.5 by eny epplicent tor e pertnit subjects the epplicem to e dvil penalry of not mor� then five hundred dollars ($500).j: ❑ I, as ownar ot the propeny, or my employee8 wlih weges as their sole compensation, WILL DO THE WORK, antl the structure Is not intendetl or offeretl tor sale (Sec. 7044, Business and Protessions Code: The Contraciors Ucense Lew does no� appty lo en owner of properry who Duilds or improves thereon, entl who does SUCh work himsetl or herselt or through his or her own amployees, pmvided fhat such improvemenls are not intendetl or oHered br sele. It, however, ihe building or improvement is sold within one year of completion, the ownB��builder will have ihe burtlen oi proving that he or she did not build or improva br purpose oi sale.). ' ❑ I; as owner of the property, am EXCLUSIVELV CONTRACTING WI7X LICENSED CONTfiACTORS to construct tha project (Sec. 7044, Business end Prolessions Cotle: The conirectors Llcense Lew does no� eppty w en awner oi property who builtls or improves thereon, and who contrects tor such pro�ect with e wntractor(s) license pursuant to the Contrectors License �ews.). ❑ I am exempt untler sec. Busineu antl Protessions Code for this reeson: Signatwe: Date: Owner ID vertlied by dnvefs license. �Ves ❑ No Driver's License No. Expires: Venficatian af Owner�x ��.. '_ P rtY )� pby NYPe.ot documeng I.Bt-�pm e tax bill or tleetl DIVISION OF INDUSTRIAL SAFETY PERMI7 CBRTIFICATION: ❑ I hereby certlly that no excevetlrn INe (5) or moie feet in dapth into which a person Is required to descend, will be matle In connaction wlth work euthodze0 by this pertnit, end thei no building slructure, scaHo�tling, lalsework, or demolition or dismantling thereol, will be more then thiny-six (38) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Tltle 8, Celllomla Atlministrelive Catle). ❑ As ownervDuilder, I will not employ enyone lo do work which woultl require e permit from Ihe Division ol Industriel Sefety, es notod ebove, unless such person has e partnit to do such work Irom Ne tlivision. Signeture: Date: Division of Indusirial Setery Permil Number: CERTIFICATE OF COMPLJANCE AND AUTHORI7ATON OF ENiAV: I cenity under penelty ol perjury that I heve read this epplication entl steta �hat t�e intortnation given is correa. I egree to compty with all stete laws end ciry ordinences relating to building construction, enC aut�odze representatives ol the Ciry ol Casta Mesa to enter upon the ebove-described properry lor Inspection py(�osep y09�ee not to occupy or allow occupancy of any building authorize0 by t�is permi� until tinal inspection. cooe�. wsvecnoNrne - � 7616 Fixed System Final Fire Preventlon 1266 Pool Spe Flnel 200 Final Re-Rool 201 Final BIocWRetelning Well 202 203 204 Ffnal Fecrory Fire Place Finel Sign Flnal Demolition ' Date �o-zz-�v Date COOE� INSPECTIONTYPE 206 Finel Mechanical 20B Finel Plumbing 210 Finel Electdcal 212 Flnel Fire Preventlon 220 Final Plenning Approval 222 Final Site 250 Final Bullding/OccuDency � �� ' : i (714) 754-5273 • Fax (714) 754-4856 • www.cl.eosta•mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: 427 E 17TH ST B BLDG 8 (iSOLD It) a2514336 Appiicant: SANCHEZ, GABRIEL Address: 3500 W BURBAIJK BL 2ND FLOOR - � '�/i BURBANK,CA- -, . Owner: Address Contractor: Address: Phone: 818-557-1225 Zip: 91505 ' FLOWER INVESTMENT CO ' 406 1!2 CLUBHOUSE AVE - � i Phone: NEWPORT BEACH, CA Zip: 92663 DORADO DESIGN AND CONSTRUCTION INC 3500 W BURBANK BL 2ND FLOOR � � Phone: 818-557 �1225 BURBANK.CA . -.--Zip: 91505 � � � License: T78969 Status: ISSUED Applied: 50/2272004 Issued: 70/22/200a . , ISSUED BY: EXPII � SCOPE OF PERMIT �' � � INTERIOR 1496 SF NEW CUSTOMER SERVICE AREA AND NEW OFFICE IN THE BACK STORAGE AREA IN AN EXISTING COMMERCIAL�BLDG FOR "iSOLD IP�IN BLDGB. WORK TO INCLUDE NEW NONBEARINGPARTITION�WALLSANDMINOR.ELECTRICAL.� . . �. ..- 9 ELEC OUTLETS, 1 SWITCH-- -� _ REF:BOd-01797 � � , . ._ , . ' , ., � -.- �- _ " , '.�' �� ISSUE FEE Temp service test Res. a/c package '� � New Res�(1-2 units). ' New Res, (3+units) Pool / 6pa � ° Lighting Fixts` � � � Recept Outlets� ' Swilches � � � � Non Res Appl � � Res Appl � �-�� Service to 200a �` � � Service to t000a Service over 1�OOa Motors to 1 hp Molors to 10hp Motors to SOhp Motors to 100hp ' � - FEE SUMMARY -i , — � Quantity �� ' �, Quantity; 523.50 Temp Dist System ! Lighting $0.00 07 � � $0.00 Buswayri00ft� � $0.00 �0 �'% °� ' $0.00 . Standing SecUon SOAO 'U � ' �'.' 30.00 0 ^��% 1 Misc ElecWcal Equipment 50.00 ':0 � ��,$0.00 0 1�':�:`" �� Transfortnersup,tot kva/kw $0.00 ��z°'0 ' .'50.00 0 `�; � �` ................up to 10 kva/kw. _ $0.00; � � 0 � � � �50.00 -.. 0.. �� .................up to 50 kva/kw-':'- 50,00 ' 0 , • $9.90;: � 9�. , � . : .:................up to 100 kva/kw $0.00 0 %31.10 ` ; . ; 1 � . . . :........:........over 100 kva/kw- . --" 50.00 � - 0 50.00 `- `0 , �Low VolWge Equipment. ,: � ,.- � $0.00. , -� 0 � $0.00 , - � 0� � � .;�; 'Low Volt Wlring SystemY Ckf , = $0.00�: '�0 50.00 . � 0 � _ � - - Misc. Conduit - - � 30.00 �. � 0-� , � $0.00 ' , , � , , 0'� - Misc. Conductor � , ,$0.00 . �- 0 � �` � � 50.0� - , � 0 �� ; - Circus ( gen or ride) � � $0.00 0� � 50:00-, - 0 � � � _ Cirws (mech.ride or lights) a0.00' �� 0 $0.00.��; , 0�' '. + ,ChristmasTreeStand " �,§Qb0 0 $0.00 �� =--0�,, �- - - : � � 6ireworks Stand "� c�, �$0.00 0 $0.00 -� .0 � Other ElecVical Eee � - � $0.00 � - _ � . . .� �-i,- �. � � _ : NOTICE: The work auihorized by thfs permit shall compty wfih all applicable handlcap access requirements under Caliiomia statutes and related regulations. (Ord. No. 92-28, § t, 12-21-92) EXPIRATION: This pertnit shall eutomaticalty expire and become vold if work Is not commencad within 180 days, or if work Is suspended or abandoned for a period af 180 days. I INSPECTIONS: In order lor the work authodzed under this permlt to be considered legal, such work must compty with all applicabte codes, arxl all requlred Inapeet{ons end tlnal epproval must be obtalned. Fetlure to obtain Inspeclions arW tinal approval wtll result in the expiration ot ihis permit. FOR INSPECTIONS CALL: (714) 75d-5828 zuwu �aw� �� WORKEFS'COMPENSAnON DECLAPAnON: � ' I hereby eXirm under penelry ol perjury one of tho following declerations: - ❑ I heve end will meinuin e certiflcate oi con4em m sell-Insure tor workers' compensetlon, es pmvided for by sedion 3700 0l the Lebor Cade, for Ne pertortnance of the work for w�ic� this permit is issued. , . � al heve end will maintein wwkers' compensat� �suranca. es requlreA by section 3700 0l the LehOr Code, tor Ihe pertwmance ot the work for w�ich this pertNt Is IssueE. My workers' campe?s�a,tlon Insurance carri�r and poll�y number ere: / p � Cerrier. �iC �U✓�� PolicyNumher. �(�i3�163��Dy (Tnis secBon need not e completetl i! Me mut is valu , t one hunared dollers ($100) or less.) ❑ I certify that in the pertormance ol wark to ich ihis permit is issue0, 1 shall not employ eny person in any menner so es to become suDjeM ro tha workers' wmpensetlon laws oi Celltomia, egree � houltl ecome subJect to the workers' campensetlon provislons of Sectlon 3700 ot the Labor Cotle, I shall fan�with comply with these provislons. �[ AppllcentSipneture: Date:e ��ZZ—�"( WARNINO:FAI�URETOSEWREWORKE 5' WVERAGEISUMAWFULANDSHALLSUBIECTANEMPLOVERTOCRIhUNALPENALTESPNOCM�FlNESUPTOIXJEHUNDRED THOUSAND DOLIARE (5100,000), IN ADDR O THE COMPENSAT70N, OAMAGES AS PROVIDED WR IN SECTION 37080F THE LABOR CODE, IMEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLANATION: I hareby aHlrm t�et 1 em lorce end BHect. Uc. N� Contrectols Signawre with Sec�lon 7000) of Divlsion 3 oi Ihe Buslness antl Prolessions Cotle, end my license Is In tull Class M � oece: � /o—Zz—o �/ CONSTRUCTION LENDING AGENCV: ° '�� ❑ I hereby aHirm thet there is e wnsiruction Ianding egency for the peAarmance of �he work lar whlch ihis permlt is issuad. (Sec. 3097, CiNI CadeJ. Lender's Name: Signature: _ Lendefs Atltlress: Date: OWNER•BUILDER DECLARATIONS: I hereby eXirtn thel under penalry ol perjury thai I am EXEMPT FROM THE CONTRACTORS LICENSE LAW torlhe following reeson (Sec. 7031.5, Buslness and Professions Code: Any city or counry which reQulres e pertnit to wnstruct, elter, Improve, tlemolis�, or repeir eny strucWre, prior to its issuance, elso requires the flpplicant for such permit to file a signed stetement Ihat he or s�e Is licensatl pursuent to Ihe provisions of the Contrectors License Lew (Chapter 9(commencing wlih Section 7000) of Dlvislon 3 ot the Business and Pmfessions Cotle) or ihet ha or she is exempt iherelrom end the basis tor ihe ellegad exemption. Any violatlon o� Section 7031.5 by eny epplicam for a pertnit suhjects tha applicant to a civil penalry ol not more than five huntlretl dollars ($500).): ❑ I, as owner ot the property, ar my employees with weges as their sole compensetion, WILL DO TME WORK, and the slrucWre Is not Intended or ottereC for sela (Sec. 7044, Business antl Protesslons Code: The Contractors License Lew dces not appty lo an owner ol property who builCs or improves thereon, and who tloes such work hlmself or herselt or through his or �er own employees, provitletl that such impmvements ere not Intended or oHered far sale. It, however, ihe building or improvement is sold within one year ot complelion, Ihe ownerbuilder will have iha burden of proving that he or she tlid not build or improve for Durpose of sale.�. � ❑ 1, as owner of the properry, am E%CLUSIVELV CONTFiACTNG WITH LICENSED CONTRACTORS to canstruct t�e pro�ect (Sec. 7044, Business and Protessions Code: The coniractoro lJcense Law does noi appty to an owner of property who builds or improves �hereon, and who contracis tor suU project wlth e contractor(s) license pursuant to tha Contractors License �ws.). ❑ I em exempt untler sec. Business end Professions Cotle tor Ihis reason: SlgnaNre: � Date: Owner ID veniied by dnvers license. Yes ❑ No Dnvefs License No. Expires: Veriflcation of Ownership by (rype ot doc ment i.e. � property tax blll or deetl): v:r.�:. __ DIVISION OF INDUSTAIAL'SAFETV VERMR CEAnFICATION: ,.aa.,.i�. ❑ I hereby ceN1y that no excavation IWe"(5) o! more leet in depth into w�ich e person Is required to descend, will be metle in conneciion wilh work authorizeC Dy Ni5 pertnit, antl that no builtling siructure, scafldding, falsework, or tlemdition or dismantlinp thereof, will be more Ihan thirty-six (38) tee� high. (Chap. 32, Grp 2, An 2, Sec. 341, Title 8, Cellfomle AdminfstratHe Cotle). ❑ As owner-builtler, I wlll not employ enyone to do work which woultl require a permit from t�e Division ol Intlustrial Sefery, es noted above, unless such person has e permit to do such work from Ihe tliNslon. Signeture: Date: Divlsion af Industrial Sefety Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTMORWnON OF EMRY: I certity under penelry ot perjury that I have read thie epplicetlon antl state thet the informetlon give� is correct. I agree to comply with ell state laws antl ciry ortlinances relating to Cullding constructlon, entl euthodze representetives of the Ciry ot Coste Mesa to enter upon tha ebove-descnbed propetly for Inspection purposes, � egree not � occkpy or allow occupency ol eny building euthorized by ihis permit uniil finel inspection. CODE �. INSiECT10NT/iE 7818 Flaetl System Final Fire Prevenllon 1288 200 201 202 203 204 Pool Spe Finel Final Re-Rool Final Block/Retelning Wall Final Factory Fire Place Flnal Sign Final Demolitlon � QAT� It�ELi COOE 1 INSPECTION iYVE 208 Finel Mechanlcal 208 210 212 220 !O—zZ—o�( Date Final Plumbing . Finel Electrical Finel Flre Preventlon Finel Planning Approval 222 Finel Site �250 Final'Builtling/Occupency PAff It7�SL5 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us . i i rnin unrve, �ua i N M��r, �.. y�o�o MECHANICAL PERMIT Job nddress: 427 E 19TH ST Suite No Viciniry: Parcel Number: 11734136 Appliwnt: Address: Owner: Address: Contractor: Address: Arch / Eng : Address: BEEKER,ANDREW 73081ogan � SUITE H Costa Mesa, CA VALENTE, RICHARD 8 LINDA 201 E 21 ST ST COSTA MESA, CA KLONDIKE A/C & HTG 13081ogan SUITE H Costa Mesa, CA Phone: 979-2070 Zip: 92626 Phone: (949) 5243034 Zip: 92627 �Phone: 979-2070 2ip: 92626 License: 754456 Phone: Zip: License: ISSUED BY: SCOPE OF PERMIT REF. B00-1190, INSTALL NEW FAU UP TO 45,OOOK BTU IN THR AITIC AND 3 VENT FANS. ISSUE FEE Inst FAU <100 k BTU Inst FAU >700 k BTU Repair I Alt CoolinglHeat Inst / Rep.-ReceSs Wall Htr � Refrig Sys <100 k BTU Refrig Sys >700 k BTU Gas Piping � Factory Fireplace HOod w/Meth ExhauSt , VAV Box � Vent Fan / Single Duct� � Appliance Fire Dampers � Smoke Dampers � Inst or Relocate Appl Vent Air Handlers < 70000cfm AirHandlers> 10000cfrn Floor Furnace Floor or Suspend Heater Quantity $23.50 $14.80 1 $0.00 0 $0.00 0 ao.00 o $0.00 0 $0.00 0 $0.00 0' $0.00 0 ; $0.00�'�0 $0.00 0, ' ' S2175 3 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 30.00 0 S0.0o 0 FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refrigeralion Unit Ventillation System � � Evaporetive Cooler � Commerciallncinerator , Domestic Incinerator Compressore / Absorption Systems i Up to 3 hp I 700 k BTU '" ' 3 To 15 h/ SOO k BTU �� P 15 To 30 hp! 1,000 k BTU - �� , 30 To 50 hp I 1,750 k BTU - Over 50 hp / Over 1�,750 BTU �� Boilers � � � � Up to 3 hp 3To15hp�� , 15to30hp � " - . . 30 to 50 hp � Over 50 hp - - " Olher Mechanical Fee � � Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applietl: 08/15/2000 Issuetl: 08/15I2000 Quantity 50.00 0 50.00 0 50.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 50.00 � 0 �$0.00 0 50.00 0 50.00 0 SO.oO 0 50.00 0 50.00 0 50.00 0 50.00 0 $0.00 50.00 50.00 560.05 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period ot 180 days. . . INSPECTIONS: In order for the work authorized under this permit to be considered Iega1, such work must comply with all applicable codes, and all required Inspactions end finel epproval must be oblained. Failure to obtain inspections and final aDProval will result in the expiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 / 2ad&48 (6W) WORKERS'COMPENSAnON DBCIARAnON: I hereby ettirtn untler penalry oi perjury one oi ihe fWlowing dedarations: ❑ I have entl wlll maintein e cedificate of consent lo sell-Insure for workers' campensetlon, es Orovided for by section 3700 of tha Labor Code, lor the pertormance of Ihe work for which Ihis permit Is issued. � I have flntl will maintain vrorke�s' compensatlon Inwrance, as requiretl by section 3700 of Ihe LaOor Cotle, lor the peAortnance af I�e work tor wh�h Nis permlt ls Lssuetl. My workers' compensation Insurer�ce carrier e iq number ere: Cerrier: CI'i'_�. �D� PolicyNumber: (Th/s secNon need irot be oorrrpleted i1 the pertnlf fs luetl et one huntlred dd/ers ($100) or less.) ❑ I cenity that in Ihe peAormen � tha work for whic� this pertnit Is issuad, I shall not employ any person in eny manner so as lo become aub�ecllo the workers' compensetion lews ot Cell� m�a, en0 egree thet 1 shoul me sub�ed to the workers' campensatlon provisions of Sectlon 3700 of Ihe Lebor Catle, I shall forthwifh comply with ihese proWy ns. �' ��_ �^ Applicent Signature: Date�. O(_J WARNING: FAILUFE TO SE WORKERS' OOMPEMSATION OOVERACiE IS UNUWFUL M'D SNALL SU91ECf AN EMPLpYER TO CRIM1llW1L PENALTES AND CML FlNES UP TO ONE HUNDRED THOUSPNO OOLURE �E100,000), IN ADDmW TO THE WST OF COMPENS4TION, DAMAGES PS PROVIDED FOR IN SELTION 3]OB OF THE IABOR CODE, IMEREST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECUWATION: I hereby ettirtn Ihet 1 am lorce end ettect tic. a_ Contractofs Slgnamre: 9(commendng wlih Sedlon 7000) at DlNsion 3 0l the Business eng, ProZ Jp�s Cotle, and my Ikense Is N tull ,q_ Class # �— U : i Dale: 48 —f s^ OC7 �ir__ CONS7RUCTON LENDING AGENCV: ❑ I here6y aNirm t�et ihere is e W�sWction Iending epenry tor the pertormance at Ihe work for whic� ihis pertnit is issuetl. (Sec. 3097, Civil Cotle). LenCefs Name: Lendefs AtlAress: SignaNre: Date: OWNER-BUILDER DECLARATONS: I hereby eHirm t�at under penelry oi per�ury thet I em EXEMVT FROM 7HE CONTRACTORS LICENSE LAW lor the following reawn (Sec. 703Y.5, Business end Professions Code: Any ciry or counry which raqU��es a permit ta construct, elter, improve, demolish, or repair any swcture, pnor to its Issuance, also requires the applicant for suU permit to file e signeG slatement that he or ahe is Ilcensed pursuant to Ihe proNsions of the Contrectors License Lsw (Chapter 9(commendnq vrith Section 7000) ot Divislon 3 of Ne Business end Professions Cade) o/ that he or she is esempt therefrom end tha basis for Ihe alleged e:emption. Any vlolatlon of Sec6on 7031.5 by any epplicent tor e permit subjecis Ihe epplicent to a ciNl pen0lry at not more than Ilve huntlreA dollars ($WO)J: ❑ I, es owner of the properry, or my employees wlth wages es their sole compensa�on, WILL DO THE WORK, and Ihe structure is not intended or ottered for sele (Sec. 7044, Business and Protessio�s Code: The Contractors LJcense Lew does not apply to an owner of properry who huilds or improves t�ereon, and who tloes such work himself or hersell or through ��S or her own employees, prwided that such improvements are no� Intended or oHered tor sele. tl, hov.•ever, the builtling or Improvement is sold within one year of complb�o4 Ue owner-builder will �ave the burden of proving ihat ha or she tlid not build or imprwe br purpose of sale.). ❑ I, as owner of Ihe properry, am EXCLUSIVELY CONTRAC7ING WITH LICENSEO COHTAACTORS to construcl ihe pro�ect (Sec. 7044, eusiness an0 Professions Cotle: 7�e contractors License Lew tloes rwt appy ro en owner ol property who bu11As or Improves thereon, end who comrects for such project with e contractoqs) " license pursuent to the Contractors License Lews.). ❑ I am exempt under sec. Signature: Business ena Profeuions Code tor this reason: Owner ID verltie0 by drivers license. ❑ Yes ❑ No Dnvefs License No. Vedtication ot Ownership 6y (type o1 �mant, i.e. - propeRy taz bill or dead): Date: Expires: DIVISION OF INDUSTRIAL SAFETY VERMR CERTIFICATON: ❑ I hereby ceNfy Ihat no excaveYwi live (5) or more teet in tlepth Into which e person L5 requiretl to descend, will be matle In connection with work euihoAzeA Dy thls ' pertnit, end that no building stnicture, scattddinp, talsework, or OemdWon or dismanlling Nereol, wlll be mare than IMrty-six (38) feet hiph. (Chap. 3.2, Grp 2, M 2, Sec. 341, Title 8, Califomla Adminis«eUve Cotlej. - � As owner-builder, 1 will not employ anyone to do work w�ich would requlre e pertnit trom the Divislon of Industdel Sefety, as noted ebove, unless auch person hes e pertnit ta do such work irom the division. Signature: Date: DiWsion ol Induslrial Salery Parmit Number: CEHfIFlCATE OF COMPLJANCE AND AUiHOROA710N OF EMAY: I certity under penalry at perjury lhet I have reatl Ihis apD�� antl state ihal Ue Inlormation given is cortect. I egree to compty with ell ste�e laws and dry orAinflnces relating to building construction, antl eulhorize represenletives of tha City ol Coste Mese to enter upon Ne ebove-Uescn d'p aperry lar Inspectio� p�rposes. I agree not to oaupy or allow occupancy ol eny building euthorized by this permit untB finel inspection. Ignat Le Ow r(s) D te ' ��j — �� Md/Or Authorizotl Applice Date COOE �. INSFECTONTYPE QAIE Q�EL$ 1676 Flxed System Final Fira Pre�enpon 1266 Pool Spe Final 200 Finel Re-Roof 201 Flnal BIocWRelaining Well 202 Flnal Fectory Fire Place 203 Finel Sipn 20C Finnl DemWitlon �.( IXSPECfIONiYPE 208 Finel Mochanlcal 20B Finel Plumbing 270 Finel Electrlcal 212 Finel Fire Prevantlon 220 Flnel Plenning Approvel 222 Finel Site 250 Final Building/Occupenry �• �P r (��4) �54-5273 • Fax (7ta) 75a-4856 • www.ci.costa-mesa.��LDING PERMIT �� rAin �nivc, wai� m��r, �.. n�o�o ,lob Address: 427 E 19TH ST Suite: Vicinity: HOUSE & GARAGE Parcel Number: 11734136 npplicant: VALENTE, RICHARD & LINDA Address: 201 E 21ST ST COSTA MESA, CA Owner: VALENTE, RICHARD & LINDA Adtlress 201 E 21 ST ST COSTA MESA, CA Contractor: OWN ER-BU I LDER Address: 2ip: Arch : Address: 2oning: Phone: (949) 5243034 Zip: 92627 Phone: (949) 5243034 Zip: 92627 Phone: License: 0 Eng: Address: Status: ISSUED Applied: 08I03/2000 Issued: 08/03/2000 ISSUED BY: Phone: Phone: Zip: License: License: SCOPE OF PERMIT - � REROOF - TIO, USING EXISTING SHTG, INSTALL 1 LAYER OF 751f FELT AND 30 YEAR COMPOSITION SHINGLES. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $97.25 $0.50 $0.00 $0.00 $0.00 $97.75 SETBACKS` MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Ezistinq: o NOTES: Rear, 0-0 Rear 0- 0 Reauired: �0 FEESUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: _� "Right .0--0 ' ��' Right 0-0 $3,500.00 53,500.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access raquiraments under Califomia statutes and related regulations. (Ord. No. 92•28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced wlihin 180 days, or if work is suspended or abandoned for a period of 780 tlays. INSPEC710NS: In orcler for the work authorized under this permit to be considered legal, such work must comply with all app�ieabla codes, and all required inspeetlona and Iinel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of lhis pertni� FOR INSPECTIONS CALL: (714) 754-5628 z�s..b«, v WORKERS' COMPENSATION DECLARATION: � hereby atlirtn under penalry ot perjury one ot the iWlowing AeGaretions: � I have entl wiil maintain e ceNficate ai consent to selt-Insure for workers' compensation, as provitlatl br Dy section 3700 of Ihe Lebor Cade, tor Ihe peAortnenca ot the wOrk for wNch Vtis pertnit is issuetl. ❑ I have and will maintain workers' compensaUon Inwrence. es required 6y secUon 3700 ot Ne Lebor Coda, for the pertormance ol the xrork tw which Ws pertnit is Lswetl. My workers' wmpensation Insurence carner antl policy number ere: Carder: Policy Number. (Thls sectlon need not be completed i! (he permif Is valuetl ef one hundred tlW/ars ($100) or IessJ ❑ I certify ihat in ihe peAarmence ol the work for which this permit is issuetl, I shell not employ eny De�son in eny manner so as to Decoma subject to the workers' compensatlon lews of Calilamie, enA egree thet if 1 should �ecome sub�ect to the workars' compenSalion provisions ot Section 3700 0l the Lebor Code, 1 shell forthwith comply with these D�ovisions. Applican� Slgnature: Dete: WARNIN3: FAILURE TO SECUfiE WORNERS' COMPENSATION CpVERpGE IS UMAW FUL M1D SHALL SUBJECT Ml EMPLOYER TO CRIMIWLL PENALTES AND CM� FlNES UP R7 ONE HUNDRED T/qUSAND OOLLARE (5100,000�, IN ADDfTION TO THE COST OF COAIPENSATION, DAANGES AS PROVIDED FIXi IN SECTION 3]OB OF THE LABOR ODDE, INTEREST, AND ATTOpNENS FEES. LICENSED CONTRACTORS DECLARATON: I hereby aflirtn ihat I em licensetl untler provisbns ot Chepter 9(commenGng wit� Sectlon 7000) ol Divislon 3 ot the Business end Pmtessions Code, and my Ilcense Ls in full forCe enC BftBCL LIc. M Cleu N Comractor's Slgnawre: Date: CONSTRUC710N LENDING AGENCV: ❑ 1 hereby ettirtn thal Uere is a conswMion lending epenq tor the peAortnance of the work lor which �his permit is issued. (Sec. 3097, Civil Code). Lenders Neme: Lendels Address: Signeture: OWNER-BUILDER DECLARATIONS: 1 hereby aHirtn Ihat untler Code: Any ciry ar counry.� to file e signetl stetemen�. Business an0 Protession: �ects the epplicant to�a , I, as owner of.the pr 7044, Business and himselt ar hersetl ar sold within one year ❑ 1, as owner oi pr Catle: The n ctc license pu 1 to � Date: � ot per�ury that I em E7(EMP7 FROM THE CONTRACTORS IICENSE LAW for ihe following reason (Sec. 7031.5, Business entl Professions puires a pertnit to conswct alter, impmve, tlemolish, or repair any sWCWre, pdor to its Issuance, also requlres the appliwN tor such permlt or ahe is licensatl pursuant to the provisions at t�e Comrecmrs License Law (Chepter 9(commencing wlth Seclion 7000) oi Divlslon 3 at Ihe or thet ha or she is exempt therefrom and Ihe basis for the allegeA exemption. Any violation of Sectlon 7031.5 by eny applicant for e Oermit irie,ty�of1nat more than tive huntlretl ddlers (3500).): or my emplvyees with wages es their sole wmpenution, WILL DO THE WORK, and the structure is not intended or ottered for sale (Sec. ;ions Code:•TTe Contractors License Law tloes not apply to an owner ot property who builds or improves ihereon, and who Coes such work i hls or he?own employees, provitletl Ihai such imprwements are not Intended or oHered br sale. If, however, ihe huiltling or imprwement is pleGon; the ownerbuilder will have t�e burden of proving that �e or s�e did not build or improve for purpose of sale.). am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to conslruct Ne projact (Sec. 7004, Business and Professions u lew Ooes not appty to an owner oi property who bullds or Improves thereon, and who contrects lor suU prol� �'�N e contractor(s) �r�dors License Laws.). ❑ I am exe unde ec " Business and Professions Cotle for ihis reeson: Signeture: :> .[� / Expires: Vedflwtian oi Ownership Dy (rype ot documem, i.e. - pmperry tex bill or deed): UIVISION OF INDUSTRIAL SAFETY PEHMR CERTFICATION: ❑ I hareby certity that no escavation tive (5) or mora teet in tlepih into which e person is requiretl to descentl, will be made in conneciion wi�h work euthorized by Ihls pertnit, and thal no building struqure, scaHdding, talsework, or EemWition or dismantling Ihereol, will be more ihan Ihirty-six (38j teet hipR (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Calitomia AdminlstratNe Code). ❑ As owner-builtler, I will not employ anyone to do work which wauld require a pertnit irom I�e Divislon ol Industrial Selery, es notetl above, unless suc� person hes e permil to do such work from the tlivision. Signeture: Oate: Divlsion ol Industrial Sefery Pertnit Number. COOE 1. INSiECT10NttPE PdIE I�LS 1616 Fixed Sysiem Final Fire Preventlon 1266 200 201 202 203 20a Pool Spa Final Flnal Re-Rool Finel BIocWReteining Well Final Factory Fire Place Final Sign Final Demolition FOOE� INSVEITONTYPE 208 208 210 212 220 Finel Mechanical Finel Plumbing Final Electrical Finel Fire Prevantlan Final Plenning Approval 222 Finel Sile 250 FinalBuilding/Ocapency PA� Ili�llLfi (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.u5 77 FAIR DRIVE, GOS 1 A MtSA, GA yZti26 PLUMBING PERMIT Job Address: 427 E 19TH ST Suite No Vicinity: INTERIOR REMODEL OF SFD Parcel Nunm6er: 11734136 Applicant: VALENTE, RICHARD & LINDA Address: 201 E 21ST S7 COSTA MESA, CA Owner: VALENTE, RICHARD & LINDA Address 201 E 21ST ST COSTA MESA, CA Contractor: OWN ER-BU I LD ER Address: Arch / Eng : Address: ISSUED BY: Phone: (949) 524-3034 Zip: 92627 Phone: (949) 5243034 Zip: 92627 Phone: Zip: License: 0 Phone: 2ip: License: Status: ISSUED Applied: 08I03/2000 Issued; 08I03/2000 SCOPE OF PERMIT CHANGE OUT 2 BATHTUBS, 1 DISHWASHER, 4 GAS OUTLETS, 1 LAUNDRY TUB, 1 KITCHEN�SINK, 2 WASH BASINS AND 2 WATER CLOSETS FOR REMODEL OF SFD. REF:B00-01190 ISSUE FEE BackFlow irrigation �. Backflow Preventer Bathtub Clarifier System Connect (Ice,Soda,etc) Denial Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 oullets) Gas (Over 4 ouNets) Gas Repipe Gas Service Interceprors (Grease, Oiq Interceptors (Sand Auto ) AMT $23.50 $0.00 $0.00 $19.60 $0.00 $0.00 $0.00 $9.80 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $6.15 $0.00 $0.00 $0.00 $0.00 $0.00 Qn 0 0 2 0 0 0 1 0 0 0 0 0 0 7 0 0 0 0 0 FEE SUMMARY AMT Laundry,Tub / Washer $9.80 ; Landscape Irrigation $0.00 � P-Trep $0.00 Pressure Regulalor 50.00 Process Piping (per 10 ft) 50.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connecl $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar 50.00 Sink, commercial $0.00 Sink, Floor $D.00 Sink, kitchen $9.80 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) 80.00 Qn 1 0 0 0 0 0 0 �0� 0 0 0 0 0 0 1 0 0 0 COMMENTS / SPECIAL CONDITIONS - � ' � � � . , �AMT SumpPump �� $0.00 , Swimming Bool - - 50.00 Trap Primer ' , $0.00 Urinal 50.00 Vacuum Brkr BkFlow(1-4) 50.00 Vacuum Brkr Bkflow(5+) 50.00 Wash-Basin' $19.60 Wash Basin Set $0.00 � Waste and Ven[ System q0.00 water Closet (Toilet) $19.60 Water Heater / vent 50.00 Water Piping (Inst or Rep.) 50.00 water Re-pipe 50.00 Water Service 30.00 Water Softener 30.00 OTHER $0.00 VIOLATION $0.00 PLAN CHECK q0.00 REINSPEC710N $0.00 TOTAL CALCULATED FEES: 5117.85 Qn 0 0 0 0 0 0 2 0 0 2 0 0 0 0 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241•92) E%PIRATION: This permit shall automatirally expire and become void if work is not commenced within 1B0 days, or if work is suspended or abandoned for a period of 180 days. � - �INSPECTIONS: In order for ihe work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and Iinel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this pertnit. FOR INSPECTIONS CALL: (714) 754-5626 � zaaaae(evo) WORKERS'COMPENSAnON DELLARAnON: I hereby eflirtn untler penelry ol perjury one ot the tollowing declerations: ❑ I �ave enE will melntein e cenificate oi wnseM to setl-Insure br workers' compensatlon, es provided lor by section 3700 at the Lebor Code, lor Ihe pertortnance of Iha work for whlch this permit is is5uetl. ❑ 1 have aiM wi0 mainWin workers' comper�seUon insurence, as required by SecUon 3700 ot Ne Labor Code, for the peAortnence of Na work lor which this pqrtnit is lssueE, My workers' compensatlon Insurence cartler entl poliry number ere: Cartier. Poliq Number: (Thk sectfon need nof be completed il the pemJf 15 velued et one huntlred tld/ars ($ f00) or less.) ❑ I certity t�at in ihe pertormance oi the work for wNch ihis permit is issueQ I s�all not emplay any person in any manner so as to become subject ro the workers' compensaiion laws of Califomia, antl agree that If I should become subject ro the workers' compensation provisions of Sectlon 3700 of the Labor Cotla, I sha0 forthwit� comply with these provisions. Applicam Signature: Date: WARNINO: FNIURE TO SECORE WORNERS' COMPENSATION WVEfiAOE IS UNLAWFUL AND SW1LL SU6IECT AN EMPLOVER TO CRIMIWLL PENFLTIES AND CIVIL FlNES UP TOONE HUNDRED TFKKISAND DOLLARE (f100,000). IN ADOITIIXJ TO THE C06T OF COIAPENSATION, DFMAGES AS PROVIDED FOR IN SECTION 3lW OF TNE UBOH CqDE, INTEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS DECLARA710N: I hereby eMirtn that I em licensetl unOer provisions of Chapter 9(wmmencing with Sectlon 7000) ot Division 3 oi the Business end Pratessions Code, and my license is In tull brce end eMect. Lic. x qass a ContractoYs SlgneWre: Data: CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirm that there is a construction lentling agency for ihe pedortnance oi t�e work tor which this permit is issuetl. (Sec. 3097, Civil Code). Lentlefs Name: Lendefs Addreu: Signeture: OWNER•BUILDER DECLARATIONS: Date: I �ereby eHirm that under penalty of perJury ihat I em E%EMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe fallowirg reason (Sec. 7031.5, Business flnU Professions Cotle: My ciry or counry which requlrea e permit to consWct, elter, improve, tlemolis�, ar repair eny siructure, prior to its Issuance, alw requires Ihe epplicant for such pertnit b file e signetl statemem t�et he ar stre Is Iicensed pursuant to the provisions of Iha Contrectora Llcense Lew (Chapter 9(commendng with Section 7000) ot DMslon 3 ot the Business flntl Professions Cotle) or t�at he or she is exempt therefrom and the besis tor the ellepeA e:emption. Any vldaHon ol SecHon 7031.5 by eny epplicant tor a pertnit su�jects Ne ap0��en� �o e civil penalty oi nat mare than five �undred dollars (5500).): � I, es owner of Ihe properry, or my employaes wIN wages as t�eir sole compensetlon, WILL DO THE WORK, end Iha structure is not intentled or otterad for sele (Sec. 7044, Business and Professions Code: The Contractors License Law tices not appty to en owner of properry who 6uilds or improves t�ereon, and who does suc� work himself or hersetl or ihrough his or �er own employees, provitled �hat such imprwements era not inientletl or oHeretl tor ule. If, however, ihe building or improvement is soltl within one year of completion, �he ov.ner-builtler will have the burtlen of proving Ihat ha or sha did not builtl or improve tor purposa of sale.). ❑ I, as owner oi th pr perty, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to cansiruct the proJect (SecJ044, Business anC Professions Catle: The ca ec rs License Le tloes not appty to en owner oi propeny who bullds or Improves ihereon, and who contracts lar such prolect with a comrector(s) license pureu nt ihe Cgnir�Llqr�cense Lews.). ❑ I am exemp�(� r se i_� Business anC Professions Code lor this reason: Signeturo: // _ � �� E:pires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenity that no excavatlon tNa (5) or more feet In depih into which e person is requirad lo descend, will be matle in connectlon with work authorized by [his permit, end that no building strudure, scaflolding, falsework, or demolition or dismantling thereot, will be mora than thirry-six (36) feet hig�. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Caliiamia Adminisiretive Cotle). ❑ As owner-builtler, I will not employ anyone to tlo work whic� woultl require a permit from the Division al Indusirial Sefery, es notetl above, unless such person has e permit to do such work irom Ihe division. Signeture: Dete: Division ot Intlustnal Satery Permit Number: COOE I. INSVEC710NTYVE Q� IIQIDeLS 7878 Fixetl System Finel Fire Prevenllon 1266 200 Pool Spe Finel FinBl RB-Rool 201 Flnel BIocWRetaining Well 202 Final Fectory Fira Place 203 Final Sign 204 Final Demolition GOOE� INSiECTIONTYPE 206 Finel Mechanical 208 210 212 220 Final Plumbinp Finel Electrical Final Fire Preveniian Final Planning Approval 222 Final Site 250 Final BuildinglOcaperwy P7.1i�I:pur.1F7 CIN OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPAFTMENT PERMIT ��ia� �sa-s2�a • Fax (714) 754-4856 • www.ci.cosia-mesa.c� ,�LDING PERMIT Job Address: 427 E 19TH ST Suite: Vicinity: REMODEL OF SFD Parcel Number: 11734136 Appliwnt: VALENTE, RICHARD & LINDA Address: 201 E 21ST ST COSTA MESA, CA - Owner: VALENTE, RICHARD & LINDA Address 201 E 21ST ST COSTA MESA, CA Contractor: OWN E R-BU I LDER Address: Zip: Arch : Address: Phone: Zoning: Phone: (949)524-3034� Zip: 92627 Phone: (949) 5243034 Zip: 92627 Phone: License: 0 Eng: Address: NUMBER B00-01190 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: OB/03I2000 Issued: 08/03I2000 ISSUED BY: �__ Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT NEW 3' X 6' BAY WINDOW IN DINING ROOM, CONSTRUC'f NEW 22" X 9' PASS THRU OPENING IN � KITCHEN, CHANGE OUTAIL WINDOWS, CLOSE UP MAN DOOR�IN SIDE OF GAR4GE,�RELOCATE WATER HEATER, � ' ENLARGE ATTIC ACCESS, CLOSE SIE DOOR IN LIVING ROOM, RELOCATE FRONT DOOR. - Plan Check: $208.81 Permit: $321.25 SMIP Res: $2.00 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $532.06 SETBACKS MAIN STRUCTURE Front 0. 0 ACCESSORY Front 0-0 PARKING Existinq: o NOTES: Rear 0. 0 Rear 0- 0 Reauired: U FEESUMMARY Calc Valuation: Claim Valuation , PLANNING � ZONING � Left 0- 0 Right 0- 0 Left - 0- 0 � - Right 0. 0, Proposed: 0 � Szo,000:oo $20,000.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 7241•92) EXPIRATION: This permit shall automatically expire and become void il work Is not commenced within 180 days, or it work is suspended or abandoned for a period of 180 days. � - INSPECTIONS: In order lor the work authorized under this permit to be considered legal, such work mu5t comply with all applicabla codes, and all required Inepeetiona end final approvel must be obtained. Failure to obtain insDections and final approval will result in the expiration of ihis permit, j FOR INSPECTIONS CALL: (714) 7545628 � zaas..e �aroo� v WORKERS' COMPENSATION OECLARATION: I hereDy ettirm under penalry of perjury ane ol the following deGaretions: ❑ I have end wlll meintaln e ceNfiwte at coment to selt-Insure tor workers' compensation, es provitletl for by sec0on 3700 at Ihe Labor Cotle, for the pertormance ot the work tor which thls pertnit is issuetl. ❑ I have and will maintain workers' mmpensatbn insurance, as repuired by section 3700 af the Lebor Code, for the peAortnence o� the work for which Nis pertnit is Iswetl. My workers' compensatlon Insurance certier entl pdicy number are: Carrler. Policy Number. (Thls secfion need nof be comp/eted i! fhe permlf Is veluetl ef one hundred dWlers (5100) or less.) ❑ I certify Iha� in the peAarmance ol the work lor which this permll is issued, I shall noI employ any person in eny menner so es to become suh�ect to Ihe workers' compensetlon laws ot Calllomia, antl agree Ne1 II I should becomo sub�ecl lo the workers' com0ensetion provislons oi Sectlon 3700 ot the Lebor Code, I shell torthwlth comply with these provisions. ApPlicam Signature: Date: WARNING: FNLURE TO SEWRE WOfi1�R5 COMPENSATqN COVEMGE IS UNUW FlJL �VlD SHALL SUBJEGf Ml EMPLOYER TO CRIMIN�L PENALTIES AND CML FlNES UP TOONE HUNDRED TIKKI$M10 WLLAqE �5100.0OO�.IN ADdTION TO THE COST OF COMPENS4TIpN, DAANGES AS PROVIDED FOR IN SECfION 3]OB OF THE LABOR COD� IMEREST, qND ATfORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby atfirm thet I em Ilcensed under provlslons at Chepter 9(wmmencing wlt� Sectlon 7000) ol Dlvision 3 ot the Buslness antl Professions CoAe, and my license Is in full torce entl ettect. Lic. a Cless a �I Contraaors Signemre: Dete: CONSTRUCTION LENDING AGENCV: ❑ 1 hereby eHirtn Ihet ihere is e wnstruction lending egency tor Ihe pertormance ot Ihe waB lor which ihis pertnit is issuetl. (Sec. 3097, Civil Code). Lentler's Name: Lontlor'S Address: Slgnatura: _ OWNER•BUILDEH DECLARATONS: Dete: I hereby eNirtn that under penelry of perjury that I flm E%EMPT FROM THE CON7FiACTORS LICENSE LAW For ihe tollowing reason (Sec. 7031.5, Business antl Protessions Code: Any ciry or counry which requires a pertnit to construct, alter, improve, demolish, or repeir any slrucWre, pnor to its issuance, alw requires t�e eppliwnt for such pertnit to tile e signed stetement Ihet �e or she is Iicensed pursuam to the provlsions of ihe Contrectors License Law (Chepter 9(commendng with Sectlon 7000) ot Divisian 3 of t�e Bu5ine55 end Prolessions Code) or that �8 or 5he i5 exempl Iheretrom antl Ne ba5is lor Ihe allegeA exemption. Any violatian a� Seclion 7031.5 by any epplicent far e pertnit sub ts Ihe appliwnt to e civil penalty of not more t�an tive hundred dollers (5500).): I, es owner ol t�e property, or my employees with wages es their sole compensation, WILL DO THE WORK, and the strucWre is not intentletl or otteretl tor sale (Sec. , Busineu end Proteuions Code: The Contractors License Lew tloes not apply lo an owner ot property who builds or improves thereon, end who tloes such work �imself or herseli or ihrough his or her awn employees, Orovided ihat such impravemenis are not Intended or oHered lor sale. If, howaver, the builtling or improvement fs sold within one year ol completion, the owneo-builtler will have Ne burden of proving t�at �e or she did not build or impmve for purpose ot sele.). ❑ I, as owner of theprpperty, am E%CL�ELV CONTRACTING WITH LICENSED CONTRACTORS to conSWtt t�e projec� (Sec. 7044, Bu5ine55 and Professions Code: The cont cidrs License Law tl not appty to an ov.•ner ol proparty w�o builas or Improves thereon, entl who conirects Por such pmject with e contractor(s) license oursu t to�4�e Contracbis nsa Laws.l. ❑ I am axem d r sec. Business antl Professions CoOe for this reason: P Signature: -7T . -� Owner ID venRetl by ddvefs lice . ❑ Yes ❑ No Drivefs License No. „ —� Venficetion oi OwnersND by (type of documem, i.e. - praperry tsx bill or deetl): DIVISION OF INDUS7RI/LL SAFETY PERMR CEHTIFICATION: Ezpires: ❑ I hereby certity Ihat no excavation tive (5) or more leet in depih inio which e person is required to descenA, will be metle in connection with work euthorized by IhiS permit, antl thet no 6uiltling siructure, scaflolding, talsework, or demolition or dismantling �hereot, will be more than Ihirly-six (36) leet �igh. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle 8, Calibmle Atlministrative Cotle). ❑ As owner-builder, I will nat employ enyone to tlo work whic� would roquire e pertnit Irom the Division of Industrlel Sefely, es noted ebove, unleu suc� person hes e permit to tlo suc� work from the tlivision. Sipnature: Date: Di�nsion ol Industrial Selery Pertnil Number: CERTIFlCATE Of QI�APLIANCE ��AUTHORVA710N OF ENTRY: I cenify under penalry ot perjury Ihel I have reatl this application antl stete t�at the infartnation given Is wnect. I agree 6mp al ate laws entl dry ordinances releting to building mnswctlon, and authonza representetives ot Ihe Ciry ot Coste Mesa to en[er upon t�e ebove-Cescnb per�i r p tlon I egree not to occupy or ellow accupency of any Duilding euthanzed by thi ertnit until fnel inspection. %�I� u-`� � 3 -�-�� Sianature OI Leael Owner(s1 Daie AnNOr AUlhodzed Applicant GOOE �. INSPECTIONTYVE 1616 Fixetl System Finel Fire Prevention 1268 Pod Spa Finel 200 Finel Re-Rool 201 Finel BIocWRetalning Wall 202 203 Final Fec�ory Fire Place Finel Sign 204 Final Demditi0n PAg U�LS COOE I INSPECTIONTYVE 208 Final Mechanical 208 Final Plumbing 210 Finel Electrical 212 Final Fira Preventlan 220 Final Planning Approvel 222 Final Site 250 Final BuiltlinryOccupency � It� (7t4) �54-5273 • Fex (7�4) 754-a856 • www.ci.costa-mesa.ca.us 77 FAIH UHNt, G051A MtSA, l:A y2ti2ti ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: ApplicanC Address: 427 E 19TH ST REMODEL OF SFD 11734136 VALEN7E, RICHARD & LINDA 201 E 21 ST ST . COSTA MESA, CA owner: VALEN7E, RICHARD & LINDA Address 201 E 27 $T 5T 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 t000a Service over 7000a Motors to 1hp Motors to 10hp Motors to SOhp Motors to 100hp Motors over t00hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole COSTA MESA, CA - OWNEF2-BUILDER Phone: (949) 5243034 2ip: 92627 Phone: (949) 5243034 Zip: 92627 Phone: Zip: License: 0 ISSUED BY: SCOPE OF PERMIT 22 LIGHTS, 25 OUTLETS AND 15 SWITCHES FOR REMODEL FO EXISTING SFD. REF:B00-01190 523.50 $0.00 $0.00 $0.00 $0.00 $0.00 S27.a6 523.65 816.50 $0.00 $0.00 50.00 $0.00 50.00 $0.00 $0.00 50.00 50.00 50.00 50.00 50.00 80.00 $0.00 $0.00 50.00 Quantity 0 0 0 22 25 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEESUMMARY Temp Dist System / Lighting Buswayl100ft Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw ..............:..up to 50 kvalkw .................up to 100 kva/kw ...........:......over 100 kva/kw - � � Low Voltage Equipment � Low Volt Wiring 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 Status: ISSUED Applied: 08/03/2000 Issued: 08/03/2000 Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0. so.00 0 So.ao 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 - $0.00 0 $0.00 ' 0 $0.00 50.00 $0.00 $0.00 TOTAL CALCULATED FEES E85.71 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requiremenis under Calitomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatirally expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned lor a period of 180 days. � - INSPECTIONS: In order for ihe work aulhorized under tnis permit to be considered legal, SUCII work must Comply with all applicable codes, and all, required Inspectlone and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.� FOR INSPECTIONS CALL: (714) 75q-5826 � � �eaa.a iaxw � . - WORKERS'COMPENSAnON �ECLARAnON: I hereby aHirtn unGer penalty of perjury one of the following decleretions: ❑ I �ave end will maintaln e ceNficate of consem ta selt-Insure br workers' compensation, as proNded lor 6y sectlon 3700 of the LaDor Code, tor the pertortnence ot the work lar which this permit is issued. ❑ 1 have entl will maintain workers' compensaUon insurenca, es requiretl by section 3700 of tha Lebor Code, tor the perfortnance ol the work for which Nis pertnit Is iswed. My workers' compensation Insurarwe cartier antl pdicy number are: Cartier. Policy Number. (This section need not De completetl i! Ne pertnl�ls velued et one hundred tlollers ($100) or less.) ❑ I ceniy ihet in the peAormance of the warl< �or w�lch this pertnil Is iuued, I shell not employ any person in eny menner so as to bewme subject to Ihe workers' compensatlon lews of Celifomia, anC apree that If I should become suD�ect to Ihe workers' wmpensation pmvislons o1 Section 3700 0l the Lebor Code, I shell Ionhwith comply with Ihese O�a��s�ans. Applicent SlgnaNre: Date: WARNING: FAIWHE TO SECURE WOPo(ERS' COMPEN�PON CWEMGE IS UMAWFUL AND SHALL SUBJEGf Ml EMPLOYER TO CRIMINAL PENALTIES M1D CML FlNE$ UP TOONE HUNDRED THIXISPND OOLLARE (Sf 00,000�, IN AOIXiION TO THE �T OF COMPENSRTION, DAANGES PS PROVIDED FOR IN SECTION 3]OB OF TNE LABOR CODE, IMERE$T, pND ATTORNEYS FEES. UCENSEU CONTRACTaRS DECUIRATION: I hereby eHirm that I em Ilcensed under provisions of Chapter 9(cammenUng with Section 7000) of Division 3 of Ihe Business and Prolessions Code, entl my license Is in tull force antl eNecL Lla p Cless a CantractorsSigneWre: � Date: CONSTRUCTON LENDING AGENCV: ❑ I hereby aMirm ihat there is e construction lentling agency lar the peAormence of Ihe work tor which this pertnit is issued. (Sec. 3097, Civil Code). Lentlefs Nama: LentleYs AOdress: Signeture: Date: OWNER-BUILOER DECLARATIONS: I hereby attirm t�at untler penelry of perjury that 1 am EXEMPT FROM TME CONTRACTORS LICENSE LAW tor the lollowirig reason (Sec. 7031.5, Business and Profes5lons Catle: Any ciry or counry which requires a pertnil to construct, elter, improve, demWish, or reDeir any strucWre, prior to its Issuance, alw requires the applicant tor such pefmit lo lile e signed statement ihet he or she is Iicenge0 Dursuant ro the provisbns of ihe Coniracmrs LJcense Law (Chapter 9(commendng with Section 7000) of Divfsion 3 0� ihe Business antl Professions Code) or Ihat he w s�e Is exempt therefram antl the Oasis tor the ellepetl ezemption. Any Wolatlon of Sec6on 7031.5 by eny applicant for a pertnit i ub' s the applicant to a civil penalty ot not more than frve hunEretl dollars ($500).): I, as owner o� t�e properry, or my employees wlih wages as iheir sole compensetion, WILL DO THE WORK, and the siructure is not intentleC or otterad for ule (Sec. 7044, Buslness and Professions Cotle: Th9 Contractors License Lew tloes not apply �o an owner of property who builds or improves Ihereon, end who tloes such wo�k himsetl o� herself or through his or her own employees, provided that such improvements ere not intentletl or oflered for sale. If, however, the builtling or improvement is sold within one year nt completion, the owaeo-huilder will have the burden ot proving that he or she did not buiW or improve for puryose ot sate J. ❑ I, as owner ot �h� prD�r�y, am EXC�VELY CONTRACTING WITH LICENSED CONTRACTORS to construci �ha 0/alect (SeC. 7044, Busines5 and Prafesslon9 Cotle: Tha comr ctorf License Law d na� appy ro an owner ol proparry who builtls or Improves thereon, enA w�o contracts tor such project with a contractor(s) license pursuaq �i Slfe ContrafJors nse L.ews.). ❑ I am eaempt Signa�ure: Owner ID venfi I Vedfication af Owr ke 9et. Business antl Pmfessions Coda tor this reason: ^ � �� _ � drivafs license. ❑ Ve4 ❑ No Drivers License No. Expires: by (type oi tlocumeM, i,e. - properry teu bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hareby certity Ihet no excevation tive (5) o� more teei in depih into which e person Is required lo descentl, wlll be mede In connection with work authorizetl by Nis pertnit, end thal no building sWcture, scattdding, talsework, or demolition or tlismantling thereot, will be more t�an thirry-six (36) feet high. (C�ap. 3.2, Grp 2, Ari 2, Sec. 341, Title 8, Celitomia Administrative Catle). ❑ As ownervbuilGer, I wlll not employ anyone to do wark whic� woulC repWre a permit Irom Ihe Oivislon of Industnal Safey, es noted ebove, unleu such person hes e permit to do such work trom the tlivision. Signature: Date: DiviSion af Industrial Salery Pertnit Number. GOOE I. INSPEGTIONTYPE QdjF 7�45 �QQE� INSPECTONTYiE Q� �1� � 1616 Fixed Sy51em Final Fire Preventlon 208 Final Mechenical 1268 Pod Spa Finel 200 Finel RaRaol 201 FIneI BIwWRetaining Well . 202 Final Factory Fire Place 203 Final Siqn 20a Final Demdition 208 Final PlumDing 210 Final Electdcel 212 Final Fire Prevention 220 Finel Planning Approval 222 Final Site 250 Final Building/Occupenq i �� . r � ��05� COSTA MESA BUILDING•SAFETY DEPARTMENT P. O. BOX 9f7 C08TA MEBA. CALIRORNIA For Applfeant fo Fill In Complefely TYPE OR PRINT BUILDING 2 � / S ADDRESS — C05TA MESA CALIFORNIA OWNERS��/ � �� D� R� V � ADORESS` O�� U^t Y � �✓� /�� TEL. CI �S / �/ SA' NO. ARCHITECT TEL. F{RE F�E RECEI�ED �;�•—MAR 1513fi1 � FINANCE DEPT. C1TY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Offiee Use Only ev COSTA MESA. CALIFORNIA nooeess2 O� � cH .TSl� a. -�ONING ZOHe No.os use or c�TY Uf ^ �oh �/gC- I Purve � I em�oirv LTC.TNOI Q O N L. �—O O I� LenAl /- y-- �. D69CNIPiION Y/ I 6IZE � // � NO. OP BLD08. � 1 L� / OF LOT O X� 1 NOW oN LOT A. P. NO. / �� // G U6E OF YARDS EVES EXIBTING BLDG �- APPROVED ALLOWF � � (CENTlR LINH 9T4 BCTBACK LINB PROM _rS ! /� ./�� CeNTCR OP BiFteHT REAR YARD i� FRONT � FT. l � / �� - SIDE YARD ILEFY � RIGHT �� b R.61DE J FT. � DESCRIPTION OF WORK , �,�� ,��_ REPAIR I IIMOVING I IIDEMOLI6H APPROVED BY 1 DAT�'-/S I BUILDING � NO. OF / " 81ZE ��2 R�OMfi t 6TORIE6 CO ER'INGwA'��VGG�COVERINGJN�kC U82 OP BUILDINO.°.ND WORK TO BH PERPORMED / O nr � �Y S .�' �e .�-�, / � �s o'' AT 7je�rS�C� ��yK�v� 1 HHHEBY ALNNOW�DOC THAT I HAVC PBAD TH18 APPLIGTION THE AMOUNT BXOWN UNOEP VALUATION 19 FOR TX8 •ND BTATe THAT YH6 ABOVB 18 CORR AND AGR86 TO COM- pUPP086 OP eBT/�BLIBHING A PHqMiT PEE ONLY. PLY W�TH AL ORDINANCHB AND ATB lAWB Ii6OULATINO BuaolNa NB V o � VALUATION �O BIGNATURB O � PERMIT FEE $ � PERMITTE � . �/� ��/ � TOTALCFEEK S/� � �AUTHORIZE� AGENT z n