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Home My WebLink About440 19TH ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT i JobAddress: 440 E y9TH ST Suite: Viciniry: NEW qETACHED GARAGE WITH 2ND FLOOR OFC Parcel Number: 42631112 Applicant: MIKE HEIL Address: Zoning: / . � � Phone: 714-997-3440 . . . ' Zip: Owner: HAR7ZELL, ANDREW KUTZ � � � � , " . �� Address �440 E�1gTH,ST � � - � � - , � � � � � ; �.. � - _ - - . ., ,.�`, %� '� :' � . . . . - � Phone: � � ;;`�� , _ • '� . . ' COSTA MESA. CA;:-.� � Zlp: 92627 . . �' , % �' -A . � ,� % contracror: HEIL CONSTRUCTION SERVICES � � � � ' � Addressi 2721 � pUINCY AV � � � - � . � ' , . � , , - Phone:. 714-997-3440 � � � � ; - ORANGE, CA � � � . Zip: 92867 � . . License: 678817 , . � � , Arch : THOMAS BURGER '" Eng: MICHAEL GABRIEL Address: 20331 IRVINE AV � '� � - .. Address:� 3620 B1RCH ST . �� STE 7' . ,. ��' Phone: 714-850-W00 - SUITE 250 , , Phone: 949-261-5083 SANTA ANA HEIGHTS, CA N.B., CA ' ' Zip: 92707 � � � License: 15902 92660 �, License: 52939 � - � � � � , •� SCOPE OF PERMIT � � � CONSTRUCT A NEW 575 SF DETACHED GARAGE WITH A STORAGE AND LAUNDRY.AREA AT TNE REAR OF THE EXISTING SFD. A 500 SF 2ND FLOOR OFFICE ANq BATHROOM WILI BE CONSTRUCTED ABOVE THE GARAGE WITH A 56 SF BALCONY. REF: ZA-03-94 AND MM-03-57 � . ISSUED BY: Status: ISSUED Applied: OS/19/2004 Issued: OB/24/2004 � � - � -- FEE SUMMARY- � - " � 'PlanCheck: $532.19 "- � C I Val f� 8�500000 •, Permit: $818.75 SMIP Res: $7.50 SMIP Com: $0.00 , � � • Other. . `�;$0.00 In`spection: $0.00 `Totai: $1,358.44 . �� i;� � .� 'l. \� �' � SETBACKS �� ; � } �. MAIN STRUCTURE �Front � 0-0 , •. ACCESSORY Front 15- 3� � PARKING Existina: 2 ` �� a c ua ion. , Claim Valuation: � . 3�s,000.00 � '� -�PLANNING & ZONI � � _� �-• _ _ � , _ �/- Rear . 0- 0 Left 0. 0 i .� Rear. 0-�4 � Lefl 2&0 �_Requtretl: �._3 � . Proposed: NG ��' �/ %.; : ;� !✓� ' � i, 7 ' - � Right - , 0- 0 �� '% " Right - �&�0-' 3 i� i � � � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-g2) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned. for a period of 180 days. /�''�� INSPECTIONS: In order for the vrork authorized under this permit to be consitleretl legal, such work must comply with all applicable-codes, and all required inspeetlone 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) 7545626 2408d8 (6/00) WORKERS'COMPENSAnONDECLARAnON: � � � � � � � � � I hereby attirtn under penelry ot perjury one of ihe tollowing daclarations: -, .' , - ❑ I have and will meln�ein a certlflcate of consant �o setl-Insure for workers' compensetion, as Drovidetl tor by seclion 3700 of the Lebor Cotle, for the peMortnance of the work tor whlch this pertnit is issue0. ��I�have antl wlll malnWin workere' mmpensetion insurance, as requiretl by sectlon 3700 oi Ne Lebor Code, for Ne perfortnance of the work for which this pertnit is Lssued. "My workars' wmpensation Insurance rtier en0 Ilq nu ber are: ' I Carcier` �ic. �L �w.- � Policy Nu_ m_ber. � 1`-( 7 2 Z� O�� (Thls s'ection need not be comp/eled ll the permit is veluetl e1 one hundred dollers ($100) or /ess.J ❑ I certify thet in the pertormence of Ihe work for whlch this permit is issued, I shell not employ eny person in eny menner so es to bacome subject to the workera' compansetlon lews af Calitomia, en 9%�4JJ/y��p t I��XX??jj/��u/�� co/rt�e /sup�ecl to the workare' compensetlon provlslons of Section /y700 oi ihe Lebor Code, I ahell torthwith comply with these provisions. �.6/�� L �/!e// / -7 // �,/ APPIIranlSignetu,re: � � �.Date:-. �/ /. 7(� / WARMNG FNLURE TO SECURE WORI(ERS' COMPENSATI COVERAGE IS UNLr1WFUL M!D SHALL SUB1ECf AN ENPLOYER TO CRIMINAL PENALTIES M1D CML FlNES UP TOONE MUNDRED T/iIX15�WD DOI.URE (5100,OW), IN ADDfTION TO TME COST OF COMPEN54TION, DMi4GES AS PROVIDED FOR IN SECTION 31O80F THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 1 hereby aHirm thet I em licensed under provis^< IorceenBeNecc.IJc.a�� F-e7��SI ; CONSTRUCTION LENDING AGENCV: of Chapter 9(commencing with Section 7000) of Division 3 al the Code, and my Ilcense is in tull ❑ I hereby aHirm Ihet there Is e consirudion lending egency for Ihe pedormence ot the work for which this pertnit is issued. (Sec. 3097, Civil Cotle). Lendels Name: Lendels AGdress: SlgnaNre: OWNER-BUILDER DECLARATIONS: Date: I hereby aHirm that unGer penelty oi per�ury thet I em E7(EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions Cotle: My ciry or counry which requires a pertnit to construct, elter, improve, tlemolish, or repair eny structura, pdar to its issuance, alsa requires the appliwnt tor such pertnit to flle a signed stetement that he or she Is licensed pursuent to the pravisions o1 ihe Contractors License Lew (Chapter 9(commendnp with Section 7000) of DMsion 3 of the Busineu entl Profeuions Code) or that he or she Is exempt therefrom end the 6asis for ihe elleged ezemption. Any violatian of Sectlon 7031.5 by any epplicant for e pertnit subjects ihe applicant to e civil penalry of not more ihan five hundred dollars ($500).): ❑ I, as owner of the property, or my employees wlth wages as their sole compensalion, WILL DO THE WORK, end Ihe structure Is not Imentletl or oflered for sele (Sec. 7044, Business and Professions Code: The Contrectors License Law tloes not apply lo an owner of property who tuilds or improves Ihereon, antl who does such work himself or herself ar through his or her own employees, provided ihet such Improvements ere not Intended or oHeretl for sele. If, however, Ihe building or Improvement Is sold within one year of wmple�ion, ihe ownervbuiltler will heve Ihe burden ot proving ihat he or she did not build or improve tor purposa of sale.). � ❑ I, as owner oi the properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS lo wnstruct the project (Sec. 7044, Business an0 Pmfessions Code: 7Te cantractoro License Lew tloes not appty to an owner of pmperry who �uiltls or improves Ihereon, and who contracls lor such pro�ect with a contractor(sJ license pursuant ta the Contractors License Lews.). ❑ I em exempt unEer sec. Signeture: Owner ID venfied by driver's license. 0 Yes ❑ No Business end Professions Cotle br this reeson: Vedflcetian of Ownership by (rype ol dxument, I.e. - property tez bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: Driver's License No. Date: Expires: ❑ I �ereby certify that no exwvation fve (5) or more feet in tlepth into which e person is required to tlescentl, wlll be made in connection wlth work authorized by Ihis permit, and ihat no builtling siructure, scallolding, lalsework, or demolilion or dismantling thereol, will De more than thirry-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ttle B, Califomla Administretive Cotle). � As owner-builder, I will not employ anyone to do work which would require e permit from ihe DIVISIon ot Industriel Setery, as noted ebove, unless such person hes a pertnit to do such work from Ihe division. SlpnaNre: Date: Division of Indusirial Sefery Permit Number: CERTIFlCATE OF COMPLIANCE AND Al7IHORRATON OF ENTRY: I certity untler penalry of perjury that I have read this appliwtlon anC state that the informetlon given is cortecL I agree ro wmply with ell state laws and ciry ordinances relating to building constmction, antl aui�odze representatives ot the Ciry of Costa Mesa to enter upon the ebove-descnbed O�operty tor inspection purposes. I agree not to acupy or allow acupancy ot eny building au�horizetl by this permit until tinel inspection. COpE t. IHSPECTIONttPE Qdj( II�ELS 1616 Fixetl System Final Pire Prevention 1288 200 201 202 203 Paol Spe Finel Final Re-Roof Final BIaWReiaining Wall Final FactOry Fire Place Final Sign 204 Final Demolition COOE I INSPERION TYPE 206 Final Mechanical 208 Final Plumbing 210 Finel Elecirical 212 Finel Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Finel Building/OCCupenCy � PRIF It�45 i .lob nddress: 440 E 19TH ST Suite No Vicinily: Parcel Nunmber: � 42631112' � ' Applicant: HEIL, MICHAEL Address: 2721 EQUINCXAV,- ORANGE, CA' � ' � � �_ , ELECTRICAL PERMIT �. � , i Owner:' - HARTZELC, ANDREW.KUT2 Address , 440 E'19TH SL�� - � �, . i COSTA MESA,.CA � Contractor: HEICCONST,RU „ � . Address: 2721�.E QUINCY AV ORANGE, CA . R�F: B04-009: AREA AT THE REF: ZA-03-94 ELECT � �, Phone: 714-9973440 Zip: 92867 . Phone: Zip: 92627 SERVICES Status: ISSUED Applied: 09/02/2004 Issued: 09/02/2004 ' ISSUED B' . � � , _- �, „` � � �� -'i� � . �, �\ , A � , / , � " Phone: 714-997-3440 � � Zip: 92867 - License: 678817 � • / SCOPE OF PERMIT „ " � i-CONSTRUCT A NEW 575 SF DETACHED GARAGE WITH A STORAGE AND LAUNDRY 2EAR OF THE EXiSTING SFD. A 500 SF 2ND FLOOR OFFICE AND BATHROOM WILL BE ) ABOVE THE GARAGE WITH A 56 SF BALCONY. '� 4ND MM-03-57 � - . ' fIS FOR 30 FIXTURES, 24"Ol'1TLET$, 11 SWI7CHES& 200 AMP. SERVICE � I- - -. - .. , . . . , � /i� j FEE SUMMARY . _ � , �uantiry �uantity�, � 'Temp'Dist System / Lighting 50.00 �- 0' ' �°;%� � �� Busway /100 ft ,_ 30.00 ' ; � 0 ` � ,,:, .��`�, ' Sfanding Section�� $0.00% � 0 , � . � - 0 . ` - , Miso Electrical Equipment-� �; $0.00 j� 0 ,-,_ � � � 0 � ' �� , Transfortners up to f kva/kw `"'' $0.00 . 0 ' " ,.�� -. , ,-, ; 0 . - ....:..........uptol0kva/kw ' i�$O.W<i 0 � � ,` � 30� � � ' -" � .................up to 50 kvalkw, -- ! $0.00' �;i 0. !r ' � � �24'>`��_:. ' ! 0 :......:.........upto.100kva/kw-'� ..$OAO,��.:.0 ��j � 11 ' -� ' .� �•: .,� -. --.......:over-t00kva/kw, ' �':30.00� � 0 • : , . , - .......... , - -0 - � Low Voltage Equipment ��.� � 50.00 ��0 j � 0 � �, � Low Volt Wiring Systen5l Ckt � $0.00 ";� ;0 1 � - Misa Conduit " � � ' $0.00 �/ 0 0 ; � Misa Conduclor ��', ' � " $0.00� 0 � 0 ` -- �. 'Circus ( gen or ride) _ �- � � �� $0.00 0 -_ 0--� -'-_, Circus (mech nde or lights)i $0.00 0 0�-�-�'�-� -_, __.,_- Chrisimas Tree Stand �� $0.00 0 0 --- - ��FireworksStand 30.00 0 0 Other Electrical Fee $0.00 ISSUE FEE - ' , 523.50 Temp�service test � ' $0.00 Res. a/c package .� , , $0.00 New Res (1-2 units) - $0.00 ��, New Res (3+units) � $0.00 ; Pool / Spa � ; $0.00 . LighUng Fixls � - �� $29.30 ReceptOutlets �� $24.92 � Switches � ` �\ �$12.10 Non Res Appl � � � $0.00 Res Appl � �� $0.00 Service to 200a ' � $30.50 Service to 1000a $0.00 Service over 1000a $0.00' Motors to ihp $0.00 Motors to tOhp E0.00 Motors lo SOhp $0.00 MofOrs to 100hp $0.00 I A NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-g2) EXPIRATION: This permit shall automatirally expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a penod of 180 days. , INSPEC710NS: In order tor the work authorized under this permit to be consideretl legal, such work must comply with all applicable codes, antl ell required Inspeetione and }inal epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of thls parmlt. FOR INSPECTIONS CALI: (714) 7545626 �•Fi.:YIP'lill WORKERS' COMPENSATION DECLARATION: I hereby eMirm unOer penalry of parjury one of the following Ceclarations: ❑ I heve end wlll maintflln e ceNficate oi cansent ro setl-Insure tor workers' compensetion, es proNded tor Dy section 3700 oi the Lebor CoOe, for Ne peAortnance of Iha work for whiCh IhiS pertnit is issuetl. � ensation Insurence, as requiretl by section 3700 of ihe Lebor Code, for Ne pertortnance of the work for which this pertnit Is issued. carder end policy number ere: �.�� . O C/ POUcyN` umher:y �ermit Is velued er one hundred dollars ($100) or less.) \/ ❑ I cerlly Ihet in the peRortnance of ihe work for which Ihis permit is Issueq I shall not employ eny person in eny manner so es to become sub�ect Io ihe workers' compensation laws of Califomia,�[ p e e ihet 5 d ac e bject to the workers' compensatlon proNSions of Sectl n 3700 ai Ihe Labor CaAe, I s�all forthwith comply with ihese pravisions. (/ Applicant Slgnature: Date: y Z�0 7 WARNINO: FARURE TO SECURE WORKERS' COMPENSA WVERAGE IS UNLAWFUL M!D SIULI. SU&IECf AN EAIPLOYER TO CRIMINAL P� E LTIES AND qVIL FlNES UP TO ONE HUNORED TTIOUSAND OOl1ARE (E100,000�, IN A�DITION TO THE OF COMPENSATION, DNMGES A$ PROVI�ED FOR IN SEGTON 31O80F THE LABOR COOE, INTEREST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eMirm that I am Ilcensed under rovisions of torcB e'nd effect. Lic. a 8 �� i Cpmracto�s Signeture: with Section 7000) of Divlsion 3 of ihe B pass p � Date: _ CONSTRUCTION LENDING AGENCV: ❑ I hereby ettirtn Ihet Ihere is a construction lentling epency for ihe peAortnance oi the work for which this pertnit is issuetl. (Sac. 3097, Civil Code). Lendefs Name: Signature: _ OWNER-BUILDER DECLARATIONS: Lentlers AGdress: Date: my license is in tull I hereby eXirm that under penalry of perJury thet I em E%EMPT FROM THE CONTRAC70RS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business antl Professlons Code: Any ciry or counry which requires e pertnit to construcl, alter, improve, tlemolis�, or repair eny strucWre, pnor to its iuuance, also requires the epD��nt for such pertnll to file a signed atetement Ihat he or she Is Ilcensed Dursuent to the provlsians af the Cantrectors LJcense Lew (Chepter 9(commencing w0� Sectlon 7000) ot Dlvision 3 oi the Business end Professions CodeJ or thet he or she is exempt iheretrom and ihe basls for the allepetl e:emption. Any violation o� Section 7031.5 by eny epplicant for e permit subjacis the epplicent to e civll penalry of not more ihen Ilve hundred tlollers ($500).): ❑ I, es owner of Ihe property, or my employaes wilh weges as their sole compensation, WILL DO TME WORK, end Ihe structure is not Intended or oMeretl for sale (Sec. 7044, Business and Professions Code: The Contrectors License Lew does not apply to en owner ol property who builds or improves ihereon, end who tloes such work hlmsetl or herself or through his or her own employees, providad ihat such improvements ere not Intendetl or oNered for sele. II, howevar, ihe building or Improvement Is sold within one yeer of completion, ihe owner-builder will have the burden of proving ihat ha or she ditl not build or improve tor purpose of sale.). • � I, as owner of the properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions Catle: The contractars License Lew does nat epply to en awner af properry wha bu1105 or Improves ihereon, entl w�o croniracts for such proled with a contractor(s) . licensa pursuant to the Contractors License Lews.). ❑ I em exempt undar sec. SignaNre: Owner ID verified by drivels license. ❑ Ves ❑ No Business end Professions Code for this reeson: Vedfication ot Ownerehip by (type of tlocument, i.e. � property tarz bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CER7IFICA710N: Drivefs License No. Date: Expires: ❑ I hereby certity thet no excavation five (5) or more leet In depth inio which a person is required to descend, will be matle in connedion with work authonzed by this pertnit, and that no building structure, scalloltling, lalsework, or tlemolition or tlisman0ing thereol, will be more than thirty-slx (38) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, T1Ile 8, Cellfomia Atlministrative Code). ❑ As owner-bullder, 1 wlll not employ enyone to tlo work which woultl require e permlt irom Ihe Dlvision of Indusirial Safety, es notetl ebove, unless such person has e permit to tlo such work irom the division. Signature: Date: Division of Industnal Satery Pertnit Number. CERTIFlCATE OF COMPLIANCE AND AU7HORIZA710N OF ENfAV: I certify under penelry ot perjury ihat I have read this epplication end state that the informetion given is correCt. I egree to comply with all ste�e lews end clry orCinences relating to builtling consiruction, end euthonze representatives ol the Ciry of Casia Mesa to enter upon the ebove-descnbed property far inspection purposes. I egree not to accupy ar allow occupency of eny building autharized by this permit until finel inspeclion. GOUE �. INSFECTONTYPE 1616 Flvetl System Flnal Fire Preventi0n 1266 Pool Spe Final 200 Final Re-Roof 201 FInaIBlock/Retainingwall 202 Flnel Fectory Fire Place 203 Flnel Sign 204 Finel Demolition PAIE 1[�6@ �ate C'-�-�� Date CODE I INSPECTION TYPE 206 Final Mechanical 20B Finel Plumbing 210 Finel Electricel 212 Flnal Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Buildingi0aupanq PAIF l�EL@ MECHANICAL PERMIT JobAddress: 440 E 19TH ST Suite No Vicinity: Parcel Number: 42631112 Applicant: MIKE HEIL , , ' Address: 2721E�UINCYAV: � � ' -"�! .�- ,_ � Phone:.714-997-3440 ORANGE, CA ' ' . � _ � -Zip: 92867 - / " - Owner.' HARTZELL, ANDREW KUTZ � AddBss: 440 E 79TH ST -� -� � � . ,� , - Phone: COSTA MESA, � A Zip: 92627 Contractor. HEIL�CONSTRUCTION SERVICES Address: 2721 E�QUINCY,AV , � ORANGE,CA ; � Phone: 714-997-3440. Zip: 92867 License: 678817 Status: ISSUED Applied: OB/24/2004 Issued: 08/24/2 ISSUED BY: SCOPE OF PERMIT � CONSTRUCT A NEW 575 SF DETACHED GARAGE WITH A STORAGE AND LAUNDRY AREA AT 7HE REAR OF THE EXISTIIJG SFD. A 500 9F 2ND FLOOR OFFICE AND BATHROOM WILL BE CONSTRUCTED ABOVE THE GARAGE WITH A 56 SF BALCONY. REF.: B04-00925 REF: ZA-03-94 AND MM-03-57 MECHANICAL TO INCLUDE: 1 REPAIR/ALT COOLING/HEAT, 1 INST/REP RECESS WALL HEATER, AND 1 VENT FAN._ . � �� , � FEE SUMMARY � Quantiry ISSUE FEE �. 523.50 Inst FAU <100 k BTU �� 50.00 0 � Inst FAU�>700 k BTU" $0.00 0 � Repair I Alt Cooling/H�at ,, $13.70 7 - �� Inst I Rep. Recess Wall HV �$14.80 7 �' - Refrig Sys <100 k BTU �� $0.00 -'0 ' � Refrig Sys >100 k BTU i% $0.00 0 " Gas Piping ' � ' �/ , 50.00„ �0 � � , Faotory Fireplace,. �� , ' $0.00 � 0 � � . Hood w/Mech Exhaust, � - ' �50.00 �0 - �_ . VAV Box � � �� 50.00 �`0 � � - ` Vent Fan / Single Duct �,�, 57.25. �,1 , Appliance � , $0.00 , �0 ' , Fire Dampers � $0.00 ' 0 �. , � Smoke Dampers j0.00 - 0 � Inst or Relocate Appl Vent $0.00 - 0- - -- � AirHandlers< t0000qfm $0.00 �'0 �-� '-�%._�� Air Handlers > 10000cfm So.00 0 ��- °- � Floor Fumace 50.00 0 - �- . � Quantity Repair I Alt Absorbtion Unit � 50.00 � 0 . � Repair I All Refrigeratlon Unit �� , .� 50.00 0� ' � Ventillation System � $0.00 0 � Evaporative Cooler � � $0.00 0 - Commercial'.Incinerator � ,�'� � " $0.00 0 Domestic Incineiatoi^ �` � $0.00 0 ,i, . , Compressors / Absomtion Svstems � � � Up l0 3 hp I 700 k BTU -//�;' ' ; 50.00 � 0 3Tot5hp/500kBTU,- � ,; �� ",�50.00 0 � `15 To 30 hp I 1,000 k BTU `; �, i�� %�' 50.00 0 � � ��30To50-hp/1,750kBTU,'�.�`�:/ , � � 50.00 0 Over 50 hp / Over.1,750 BTU � ,- � � 50.00 0 Boilers ' � ' " � '' Up to 3 hp 1 -�� /� $0.00 0 , 3 To 15 hp _ _ � � � , ; ,� �� $0.00 0 15 to�30 hp -� i- � $0.00 0 30fo50hp�.-="��- � $0.00 0 ��-�Over50hp-�'- 30.00 0 Other MechaniCal Fee NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92•28, § 1, 12-21-92) EXPIRATION: This permit shall automatically explre and become vold if work Is not commenced wlthin 180 days, or il work is suspended or abandoned for a period of 180 days. INSPECTIONS: In orqar for the work authodzed under this permit to be considered legal, such work must comply with all epplicable codea�8nd ell � required Inapectlons end final epproval must be obtained. Failure to obtain Inspections and final approval will result in the axpiration ot thts pennit. FOR INSPECTIONS CqLL: (714) 754-5628 2a6&48 (NW) WORKERS'COMPENSAnON DECLARAnON: � ' �- ' • I hereby ettirm under penalry ot peryury one ol tha following tleclaratlons: � ' ❑ I heve end will malntein e certllicete ot consent to sell�lnsure tor workers' compensetlon, es provided for by sectlon 3700 ot ihe Lebor Code, for Ihe peAormence of Ihe work for which Ihis permii is IssueC. ,� I �ave entl will malntain workers' compensation insursr�ce, es requiretl 6y secUon 3700 ot the Lebor Code, for Ne pertortnence ol t�e work fw wh�h Ihls pertnit is Lssued. My workers' compensatlon I� urence rertjer antl1 pollcy number ere: M,// Certier. c� �� ,b POIicyNumber: U`Y �?z'U�l (ihls secNon need nof be oompleted I/ the pemtitls ve/uetl et one hundredCWars ($f00) or less.) ❑ 1 certlly Ihat in ihe peAortnence oi the work for which this permit is issued, I shell not employ eny person In eny manner ao es lo become subjecl lo tha workers' compensetian lews of Celllomia, end eprae t I s�oultl Eecome ub�e o the warkera' compensatlon provisions ol Sectlon 3700 I lhe Lebor oAe, I shell torNwith comply with these provisions. p �o�� s�a�e��a: , oe�a: �l 2�/ d y WARNINO: FAILURE TO SECURE WORNEPS' C�MPEN ATION � G IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES PND GVIL FINES UP TOONE HUNORED THIXISAND OOLLARE (5100,000�.IN ADORIIXJ TO TNE ODST OF PENSATION, DAMAGES AS PROVIOED FOR IN SECTION 3708OF THE IABOR CODE, INTEPEST, AND ATTORNEI"5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby eXirtn that I em Ilcansed under p� ��is force and ellect Llc. x �� r, � Contrectofs Signature: CONSTRUCTION LENDING AGENCY: 9(commendng with Sectlon 7000) ot DlWsion 3 oi the Buslneu qntl P�ol�ions Code, entl my Iicense Lq in tull �� Class a B /� Date: 0 ❑ 1 �ereDy aNirtn t�at there Is a construdlon lentling egenty for the pedortnance of t�e work for wNch I�is pertnit is issue0. (Sec. 3097, Civil Code). Lentlefa Name: Lenders ACtlress: Slpnature: OWNER-BUILDER DECLARATONS: Date: I hereby effirm that under penelry ot perjury thel I em EXEMPT FROM THE CONiAACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Buslneu flnd Protesslons Code: Any ciry or counry which requires e pertnit to canstrud, alter, improve, demolish, or repair eny aW cNre, prior to Its issuance, elso requires the epplkant for such pertnit to file a signad stetement thet he or she Is licensetl pursuam ro t�e provisions of Ihe Coniractors License Lew (Chepter 9(wmmencing wit� Section 7000) of DlNslon 3 o1lhe Business end Protessions Cotle) or that he or she is exempt Iherefrom anE Ihe basls for t�e elleged exemption. Any violation of Sectlon 7031.5 by any eppllcant for a permit sub�ects the epplicent to a clvll penalry af not more then five hundred dollere ($500).): ❑ I, es owner of Ihe property, or my employees with weges as iheir sole compensetion, WILL 00 THE WORK, end t�e structure Is not Intendetl or oHeretl tor sale (Sec. 7044, Business and Prolessions Cotle: The Contractors LJcense Lew dces not apply to en owner ol property who builtls or improves ihereon, and who tloes such work hlmself or hersetl or �hrough his or her own employees, provided that such impravemenis ere not intended or oHered for sele. If, howevar, Ihe builtling or Improvement is sold wit�in one year of completion, t�e owner-Duilder will �ave the burden of proving that he or sha did not build or improva tor purpose ot sale.). � ❑ I, es owner of �he D�WBrtY. am EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to construc� Ihe pro�ecl (Sec. 7044, Business antl Professions Code: The contradors Ucense Lew does not appty to an owner ol property who bullds or Improves thereon, end w�o wnirects br suc� pro�act wiih e cantrector(s) licensa pursuant to the Contractors License Laws.). ❑ I em exempt under sec. Signature: Owner ID verified by driver's Ilcense. ❑ Yes ❑ No Business and Professions Code lar this reason: Vedilcatlon ol Ownership 6y (rype ol document, i.e. - properry tex blil or tleetl): Drivefs License No. Date: Expires: DIVISION OF INDUSTRIAL SAFETV PERMR CERTFICATON: ❑ I �ere0y cerUfy ihat no excava�on Me (5) or more feet in depth into whlch a person Is required to descen4 wlll be mede In wnnectlon wiN work aulhorized by ihls pertnit, and thet no building struciure, scefloldinp, talsework, or demdl�ion or tlismentling thereof, will be more than thirtysix (36) feet high. (Chap. 32, Gry 2, Ah 2, Sec. 341, T1tle e, Celifomia Administrative Code). ❑ As owner�Duiltler, I will not employ enyone to do work whic� woultl require e permit trom Ihe Division ol Industrlel Sefery, es natetl ebove, unless such person hes e permlt to do such work tran the division. Signatura: Dete: Divislon oi Indusirial Salery Permit Numbar: CERTIFICATE OF COMVLIANCE AND AllIHORIZATON OF EMAV: I certity untler penelty of porjury thet I heve read this epplicalion and state Ihet the inlortnetion given is correct I egree to comply wilh ell stete laws entl ciry ordinences relating to Duilding construction, end authodze representetives of t�e Ciry of Costa Mesa to eNer upon the ehova-tlescribed property for inspection puryoses. I agree no� to occupy or ellow occupancy ol any building euthoAzed by thls pormit until final inspectlon. cooe �• INSPECTIONTYPE 1818 Fixetl System Flnel Fire Pravention 1288 Pool Spe Finel 200 Finel Re-R0o1 201 Flnel BIxWRetaining Well 202 Final Fectory Fire Place 203 204 Flnel Slgn Flnal Demolliion PAIE Itt�ELS � ZY D�/ oete Date GOOE I INSPECTION TYPE 208 Finel Mechanical 208 Finel Plumbing 210 Final ElectdCel 212 Finel Fire Prevention 220 Finel Planning Approval 222 Finel $Ite 250 Finel BuildinglOCcupency �. � .�w. . . . :L (714)754-5273 • Fax(714)754-4856 • a Job Address: 440 E 19TH Suite No CITY OF COSTA MESA "� BUILpING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT PLUMBING PERMIT Vicinity: � � 1 , Parcel Nunmber. 42631N2 - .. -.. — .� , / 77 FAIR DRIVE, PERMI NUMBEH PO4-00612 :OSTA MESA, CA 92626 Status: ISSUED Applied: 09/02/2004 Issued: 09/02/2004 ` : . ISSUED BY: Applicant: HEIL, MICHAEL";= " / � 'I":- - ' � ' � . � Address: 2721 E QUINCY AV � . � - ,, � , �'� � " � �� ' ; Phonei� 714-997-3440 ; , � _A .ORANGE. CA. , �' ' _ " 2Ip: 92887 � • � ' �� '..; � � �� _ - - ' � -/ _ -�" � - _ Owner:� HARTZELL,-ANDREW KUTZ Address 440 E 19TH ST �, � � ' ' � Phone: � i I . � . � , , COSTA.MESA,CA Zip:. 92627 Contractoc - -HEIL CONST�RUCTION SERVICES Address: 2721 E �UINC AV _„" ,. � � . �� , \ -. . > „ . � . . ' � � � � - Phone: 714-997-3440 . . . : ORANGE,CA'� , Zip: 92867 ' License: 678817 � � � . - � �-. —� . � i � - , . . -Arch / Eng : ... _ . . � � � . . . . �- � � ., � Address: � �• , . . � . . Phone: . , , , , . _ . , ,_ Zip:' . . , . i __.� --. . -- _ —. . , • -� .. � � � - " �Cicense: - • - i % , ,. � I SCOPE OF PERMIT � ' '' � �� REF: 804-0092SCONSTRUCT A NEW 575 SF DETACHED GARAGE WITH A STORAGE AND�LAUNDRY AREP. AT THE F2EAR OF THE EXISTING SFD. A 500 SF 2ND FLOOR OFFICE AND BATHROOM WILL BE �,'� CONSTRUCTED ABOVE THE GARAGE WITH A 56 SF BALCONY. �� -� . REF: ZA-03-94 iIND MM-03-57 . -.', , ' � - , . , , � , . , _ `/ . . PLUMBING PERMIT�IS FOR 1�BATHTUB, 1 GAS SYSTEM ( OVER 4 OUTLETS). 7 LAUNDRY -, � TUBNJASHER, �1 WASH BASIN & 7 WATER CLOSET. . �;'i ' ' , � �`�� , . � " � " . �� . �� '� � � � � �`��- FEE SUMMARY � �� ' '�� \ ,��AMT� �TY � ''- _' ' --^ AMT -.(.�Ty � (� � � "� �/ ISSUE FEE \$23.50 � �� Laundry Tub / Washer $9.80 .1 �� Sump Pump�� Backflow irrigation �SOAO 0 Candsrape Irrigafion . $0.00 . 0• �� Swimming Pool Backflow Preventer i0.00 0� ". P-Trap� $0.00 �0 ,Trap Primer Bathtub $9.80 .1 � - Pressure Regulator , $0.00 � - 0 ; , �Urinal � Clarifer System $0.00 0�- - � Process Piping (per 10 H) $0.00 0-.-- ,�' .� Vacuum Brkr BkFlow(14) ConnectQce,Soda,etc) 50.00 0 �� ,�Receptors ,� $0.00 �-0 � �- � Vacuum Brkr BkFlow(5+) DentalUnits S0.00 0 SepticTank"_�-'-' ''$0.00- --0 Wa5hBa5in Dishwasher 50.00 0 Sewer Cap for Demo �� $0.00 0 Wash Basin Set AMT QTY $0.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 , $9.80 1 $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be consitlered legal, such work must comply with all applicable codes, and all required inspeetlona and tinal epprovall must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 750-5626 xaac�se Idool � WORKERS' COMPENSATION DECLARATION: I hereby eflirtn under penalty oi per�ury one of ihe tollowing decleretions: ❑ I heve and will maintain e ceNficete ot consent lo sell-Insure lar workers' compensetion, es provldeG for by section 3700 0l the Lebor Code, for the pertortnence of the work for which this permlt Is Issued. ❑ I have and will mainteln workere' compensatlon Insurence, es requlred by section 3700 of the labor Cotle, for Ihe peAortnance ot Ne wark tor which Ihls Dertnit Is Issued. �My orkers' comprn�Ilon In ance cerrier end policy numDer ere: � /�� G �/ �CeMe� �j�� ... �I . Pollcy Number: (J[ � Z � Z'� 7 .(7fils secHon neetl�be cdmplefed i/ the permif is velued et ane hunOred Oollers ($f 00) or less.) ❑ I ceNty that in Ihe pertartnanca ai Ihe wark for which t�is permit is issued, I shall not employ eny parson in any manner ao es to become subject to ihe workera' compensetlon laws of Celifamia, nd e t � s NA eco su6Jact to the workers' compensation pmvisions of Sectl000rnn1 3700 of the Lebor Cotle, I shall forihwith compy wit� these provlslon�q c, 1�/ Applic�LSipnewre: t'Date 1 �� WARNINO: FAILURE TO SECURE WORKERS' COMPEN ON COVEMOE IS UNLAW FUL PND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO IXJE HUNDRED T/KNISAND DOIURE (5100,000), IN ADDfiION TO THE T OF COMPENSATION, DAMAGES PS PFOVIDED FOR IN SECTION 3%O60F THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby.a`firtn Ihat I em licensed under pfpvisions of Chapter 9 force end.effect. Lic. a t i.. Contreclofs SigneWre: � CONSTRUCTION LEN�ING AGENCY: wit�.Section 7000) of D'Msian 3 of the Cotle, end my license Is in full ❑ I hereby aHirtn that there is e consiruction lending egency for ihe Dedormance of Ihe work for which ihis permit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lenders AOtlress: SlgneWre: OWNER-BUILDER DECLARAT10N5: Date: I hereby eHirtn �het untler penelry of perjury Ihet 1 am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business end Protessions COCe: Any ciry or wunry whic� requires e permit to construd, alter, improve, demolish, or repair any siructure, D�ar to its iuuance, also requires the epD��nt tor such pertnit ro iile a slgned statement that he ar she Is Ilcensetl pursuam ro t�e pmvisions ot the Comrectors License Law (Chapter 9(commencing wlth Section 7000) of DlWsion 3 of the Business end Professions Code) or thet he or she Is exempt Iheretrom and ihe basis for t�e allegetl exemplion. Any Noletlon of Section 7031.5 by eny epplicent for e permit sub�ects the applicent to e civil penalry ot nat more then fiva hundred dollare ($500).): ❑ I, es axner ot the property, or my employees with wages as thelr sole compensatlon, WILL DO TME WORK, entl the structure is not Intended or oifered for sale (Sec. 7044, Business and Professions Code: The Conlractors License Law does not apply to en owner of property who builds or improves Ihereon, entl who does such work hlmself or herself or through his or her awn employees, provided thet such improvemenis ere not In�ended or ottered for sale. If, hawever, ihe bullding or Improvement is sold within ona yeer ot complation, Ihe owner-builder will heve the burden of proving tnat �e or she did not build or improve for purpose of sale.). ' ❑ I, es owner ol the property, em E%CWSIVELY CONTRACTING WITH UCENSED CON7RACTORS to construct the pro�ect (Sec. 7044, Business and Professions Code: The contractors License Lew tloes not appry to en owner ot properry wha builds or Improves ihereon, entl who conirects for such project with a conirector(s) . license pursuant to the Conirectors License Lews.). ❑ I em exempt untler sec. Business and Professions Cotle tor Ihls reason: Signeture: �ete: Ownar ID verified by dnvers Iicense. ❑ Yes ❑ No Drivefs License No. VerlNwtlan ai Ownership by (type ot dxumem, i.e. - property tex blll or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: Expires: ❑ I hereby certify Ihet no excavetion five (5) or more feet in depth into which e person Is required to descend, wlll be mede In wnnection with work authorized by this pertnit, antl that no building sirudure, swHolding, lalsework, or demolition or dismantling �hereol, will be mora Ihan ihirty-si: (36) teet high. (Chep. 32, Gry 2, Art 2, Sec. 341, T�e e, Celitomia Administrative Code). ❑ As owner-builtler, I will not employ enyone to do work which would require a pertnil Irom Ihe Division ot Industrial Sefery, as notetl ebove, unless such person has a permit to do such work from the division. Signatura: Data: Division ot Indusirial Sefety Permit Number. CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENTAY: I ceRify under penelty of perjury ihat I have read �his epplication end state Ihet the infortnation given is correcL I agree 10 comply wlth ell stete laws and ciry ordinances relating to building construction, end euthodze represeNatives oi the Giry of Coste Mesa to enter upon t�e ebove-descnbed property tor inspection purposes. I agree not to occupy or allow occupency ol eny building authonzed by Ihis pertnit until final inspection. COOE t. INSPECTONTYPE 1678 Fiaetl System Final Fire Prevention 1268 Pool Spe Final 200 Finel Re-Root 201 Final Block/Retaining Well 202 203 204 Final Fectory Fire Place Final Sign Final Damolition P�jE INiIiIRLS � lpat d / � �� ta� �ODEt INSVEC710NTYPE 206 Final Mechanlcal 208 Finel Plumbing 210 Finel EleCttltel 212 Final Fire Preventlon 220 222 250 Final Planning Approval Final Site Final Building/Occupency ueg umne�a �-17_O� � �'i , �. � y.. ��ia��sa-sz�s • Fax(��a��sa-aess • www.ci.costa-mesa��DING PERMIT Job Address: 440 E 19TH ST Suite: Vicinity: SPA @ REAR YARD Primary Occ: R-3 Dwellings/ Cong Res <10 Type of ConsWction: V-N Parcel Number: 42631112 Zoning: Applicanc BEARD, RANDY ' �"�_-`'""R� Address: 771 W. 17TH ST #G4 : -�"`"'l� � �" !N�`r'��1*-1 f�- 92627 � � ' ' Phone: '949� COSTA MESA;�6A � � Zip: . i��.-,�� \ o_ �� i,+l Owner. �ARTZELc'iL';'AND\RE � TZ` �oo� Address � 440:E�19TH.ST � .1 C �� ~�� C G �'� � �V �'`�j'r/.�� ctor. , PURE,WATER`POC iia-3;• ess ;',.,711 W. 17,TFI:ST #G4 j �� 262�fy% ��CO3TA�MESA, CA , . / / .ZiP� ��f �% �� s �/%i - ' , � � J; ��i, � � j .1 , �/✓: �% �� .J (�� '1h/oo /-; `3'i%a� �� jt� . �'' �� C'\ � i ��,f �.-� � .v Lia r � t! �) i � `� n,L_` ��i�_, / �� ;T NEW�49 SF IN-GROUND_GUP I� ��. /� � � ��1) � 1 :ck: � $208.81 �` � mit:`�%$321:25 `= Zes: ,��;�$2.00 �� ACCESSORY PARKING NOTES: Ezistinq: Phone: _ Zip: 92627 77 FAIR DRIVE, COSTA MESA, CA 92626 Sta[us: ISSUED Applied: 04/18/2005 Issued: OS/16/2005 ISSUED BY: \ 1;Phone: 949-8463466 \�`��\�� ., IJI �1 �\\�\ �' • . �License: • 615280 ° ��(�� r\ ��E.-�'_�- `yi� �! LI 1 � �1��\ �Q,^ n'Tti`_ `Eng;�� 1 � \`�1\�\ ✓�� T�--o -- -' _ ' 1--' ,.. � Add�ess:._ � /\_ � . .')\ , N��"• ., �✓p�' o `�i � e ,_�'. p o• pcD o � t .r OD...pOo��00 "0 'r,�tA,: a_ . u�� n0� �, flu '� E� a». �o"�4P7.L'4NNING�&'ZONING o ��B' � r),�u.00u il6'o \. a, - � � c0 �n' � ),�U�Left�O= Oi'" . ` � _— o—_..- "�---. ___'_ )- 0 Left 0- �� 1� � ,-, �� o 0� Proposed: Oj u � � / I Valuation: m Valuation: > �, i ..�r � i 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 it work is not commenced wi�hin 180 Aays, or if work is suspended or ebandoned for a period ol 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must compiy with all epplicable codes, and all requlred Inapeetlona and fi�el approvel must be oblained. Failure to oDtain Inspections and flnal approval will res�t in fhe explratlon of lhis permit. FOR INSPECTIONS CALL: (714) 754-5826 . � za+sae�eroo� 1 WORKERS' COMPENSATION DECLAflATION: � � � , .._- I hereby etfirm untler penalty ol perjury one ot tHa I011owing�tleUeretions� ^� � -� � . . ❑ I heve end WIII melntain e certlliceta of consent to sell-Insure br workers' compensatlon, as provided lor by section 3700 ot the Lebor Code, for tMe peAormence of the work lor w�ich Ihis permit is luued. ' � - I have entl WIII maintein workere' campensallon Insurance, es requiretl by sectlon 3700 0l Ne Labor Code, lor ihe pertormance ot the work br which this pertn�� is IssueC. / - rkers' compensatlon Insura�ce cerAer antl policy number ere: �� I I � Z C7O� Z �� Carrier. �p� �, Policyllu ber. �is secrion neetl not be completed i/ the pertnlf is valueU et one huntlred dollers (S 100) or less.) � I cenity that in the portormance ol the work lor which this permit Is issued, I shell not employ eny person in eny menner so es.to 6ecome wbject to the workers' compensatlon laws ol Celllomie, end agreo tha� ultl Dewme sub�ect to t�e workers' compensatlon provisions o1 Sactlon 3700 01 the Labor CoAe, I shell forthwlth compty wit� me ' ' . �,�� q� ApplicemSignawro�� Da1e:� � V lG —Z" "\ � /—. WARNING�PA1 UL R� 70 SECURE WORI(ERS' ODMPENSATION COVERAGE IS UNLAWFUL AND SWLLL SU6IECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED �^7FIOUSrFND DOLLApE (S10D.000�. IN ADDRION TO THE COST OF COMPENSAiION, DAMAOES AS PHOVIDED FOR IN SECTIIXJ 31080F THE IFBOR COOE, IMEREST, AND ATTORfJEY'S FEES. LICENSED CONTpACTORS DECLARATON: I hereby aHirm thgt I am Ilcensetl untlerprovlslons ot Chapter 9(commencing with Section 7000) ol Division 3 of ihe Busines/s entl P1rofessions Code, antl my license is in lull �OfCB`��IC.M V G959'p'�L��J Contrectors sl we:-J � ��`i '� S—� /(. — 2A�— i ) \\ .CONSTRUCTON LENDING AGENCV: � . .,�-�� ❑ I hereby aH�rm t�et there is e construCtion IerMing e8ency tor Ihe pedormence ot the work for which this permit is issued. (Sec. 3097, CiWI Cade). Lendefs Name: Lendels Address: Signeture: Oata: OWNER•BUILDFR DECLARATIONS: I hereby eHirtn Ihet under penfllry of per�ury Ihet I em E%EMPT FROM TME CONTRACTORS LICENSE LAW for ihe following reewn (Sec. 7031.5, Business end Profes5ions Cotle: Any ciry or counry which requires e permit lo wnstruct, elter, improve, tlemalish, or repeir flny structure, pnor lo its issuance, elso requires Ihe applicant lor such pertnit to file e signed ste�ement that he or s�e Is Iicensed pureuem to I�e proWsions ol Ihe Contradors Llcense Lew (Chapter B(commendng with Sectlon 70pp) of DMslon 3 of t�e Business and Proleulons Cadej w �hat he or she is axempt iherelrom end tha besis for the ellepetl ezemptlon. My vidation oi Sectlon 7037.5 Cy any epplicant for e permil suh�ects Ihe eppllcant ta a clvll penalty ol no1 more Ihan live �untlred dollers ($500)J: ❑ I, es owner ot t�e property, or my employees with wages es Ihelr sole compensatlon, WILL DO 7XE WORK, end the SlrucWre is not Intended or otteretl tor sale (Sec. 7044, Business and Proteulons Cotle: The Contractors License Lew does not epply lo an owner of propeny who DuIIGs or improves theraon, antl who does such work himself or hersalt or through his or her own amployees, D��tled that such improvements ere not intendetl or ottered for ule. I�, however, the building or improvement is sold within one year of completion, tha owner-builtler will have ihe burden of Oroving that he or she did not builA or improve For purpase at sale.). � ❑ I, es axner oi Ihe property, em EXCLUSIVELV CONTRACTING WITH LICENSED LONTRACTORS t0 construct the project (Sec. 7044, Bu5in855 and Professions Cade: 7Te comrectors Ucense Lew does not epply to an owner o1 property w�o bullds or Improves thereon, end who Contracts lor such project with a contractor(s) liCenSo purgueM to the ConiraCtorS Litense Lews.). ❑ I am exempt under sec. Busin95s entl Prolessions Gotle tor t�is raeson: Signature: Date: Owner ID vedlleq by tlrivers Ilcense. ❑ Yes � No Drivers Licensa No. - Expires: Verilication ot OWners�ip by (type oi tlocument, i.e. - properry t� bill or deed): DIVISION OF INpUSTRIAL SAFETY PERMR CERTIFICATON: ❑ I hereby certily thet no e:csvailon tive (5) or more feet in depth into which e person is requiretl to tlescend, wlll be matle In wnnection with work authorizetl by thls permit, end t�a� no building siruclure, scaHoltling, falsework, or tlemolltlon or dismantling thereot, will be more than �hlrty-six (36) feet hlgR (C�ap. 32, Grp 2, Atl 2, Sec. 341, Title B, Celiiomia AtlministretNe Cotle). ❑ As owner-bullder, 1 will not employ enyone to Ao work which would requlre e permit trom the DiNslon ot Industnel Sefery, es notetl above, unless suc� persan hes e pertnit to do such work Irom t�e division. Signetura: Date: Division o1 Intlusinel Safery Pertnit Number: ICERTIFlCATE OF COMPLIANCE AND AUiHORVAiION OF EMAY: I certify under penalry ot perjury that I have read Nis appliwtlon antl state that Ne intortnation given is I correct I egree to comply with ell slate laws entl ciry ortlinances relating to �uilding conswction, and auNorize representa6ves oi the Ciry oi Costa Mesa to enter upon Ne above-described prope!!ylor lnspeclionWrposea � e9ree not to occupy or allow occuyancy ot eny building euthorized by this pertnit until tinal inspection. � CQOE1.' INSPELTIONTYPE' 'H'"�'� ' 1616 Fixetl Sygtem Final Fire Preventi0n 1266 Pool Spa Final 200 � Finel Re-Roof � � � 201 Finel BIacWRetaining Well 202 Final F9ctory Fire Place ' 203 Final SVgn 20d Final D¢molitlon .�� . � '^ �'� MDEI INSPECTIONTYPE ' 206 . Final Methanic�al . . . 208 Final PlumDing 210 ' Final EleCtrical • ' 212 Finel Fire Prevenllm 220 Final'Planning Approval 222 Final Site 250 Finel BuildinglOccupency ' (714) 754-5273 • Fex (714) 754•4856 • www.ci.costa-mesa.ca.us 77 hAlli OFNE, GO51 A Mt,A, GF tlLbLO Job Address: 440 E 19TH ST Suite No Vicinity: Parcel Number: 42631112 Applicant: RANDY � Address: 711 W'7i Oviner:' '� � i Address � ��r.;,�/ � ��%� J J �� , / �Contiactor:, , � � �-/� Addressf �l �_/ i�r � ``, � � !� (,' ; `�� ;� jf!J �� I �t--, .IIq � CA 7TH ST ; �� MECHANICAL PERMIT �� KUTZ Status: ISSUED Applied: OSIt6/2005 Issued: OS/16/2005 �� ISSUED BY: �� ~ '� '4 �� %�n 66 - ,� v �\�\ � �� `� V � � �� // � �` \�� \��A / ,c� rnone: nvy-ino-�iiy ZiP: �262� � ^ \�� J � \\�� a IV � � � /` � I ,: �_ .� �, : �� -�--� '-n f� Phone: 949-64&3466"-;,,,�. _ Zip: License:615280 i; �- hlr�v- �n`�r SCOPEOF�PERMIT � r�r�r� �� ' "'' ,INGROUND GUNITE SPA�REF B05-00639� � � � �� ,, ,� I[� L ' � �-- ��1FAU>t00KBTU��—�=�- _��—�— ___ '�I � L� t VI ;'' i � r� I�! � U 1\ };, ;: ISSU �PEE � ;'�\ Inst�F.AU <100 k BTU � \ ( Inst FAU,?t00�k BTU� � Repaii,FAtt Cooling)Heat � Inst / Rep�Recess` Wall HU Refrig Sys�<100�k�BTU Refrig Sy's�>100 k BTU� 'Gas Piping��\ Qu $23.50 $0.00� 0 $18.20 1 so.00 0 $0.00 0 so.ob o �_$0.00 0 Factory Fireplace� �^/� \ Hood w/Mech E Yhau�� / VAV Box �� j %/� Vent Fan / Single Duct_�✓ / Appliance ( ( Fire Dampers � Smoke Dampers � Inst or Relocate Appl Vent Air Handlers < 10000cfm AirHandlers> t0000cfin Floor Furnace Floor or Suspend Heater c_ ; ;' _ _. J ion Unit �ation Unit-� i Evaporalive Cooler � �Commercial Incinerator ° Do'mestic Incinerator 0 1 ._,r ��'o�e�<pG.or�}°�`7Up4o3hp!'f100'kB' D�� ,� �� 3'To15Fip/500�k'.B� p � G� �Jo o ,15To�30hp;/,1,0001 0� `� o� ��A °�� ° 30 To 50"hpY �1,750.1 0\��` 0 d�"' '6 p0. Over.50,hp /.OveG1: 0 \ '��'-��xBaile`rs�l' 0 �.'.,—,."`_`== _ -Up 1o:3�hp 0�// �� 3 To 15 hp��\�\\\ �\ C { ��15,Io30:hP 1/ 0 V V Q �30�,to 50 hp� J rOver�5U hp� � 0�� . OtherMechanicab.Fe $�.�� 0 A. _ �'� % _;>i]c: Reinspection Fee ,��I,I u i,� � � �, IJI'�� 1 I n ��r �� ; � - � Quantity� � / 30.��0 ,� / $0.00�0 ��50:00�0 � �50.00> 0 so:oo,� o, � ao:oo 0 �� $O.DO 0 50.00 ' 0 $0.00 0 $0.00�� 30.00 0 NOTICE: The work authorized by this permit shalt comply with all applicable handicap access requiremenis unde� Calif �mi�e�tutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is no� commenced within 180 days, or if work Is suspended or ebandoned for a period o( 180 days. (. I `�: INSPECTIONS: In order for Ihe work aWhorized under this permit to be considered legal, auch work must comply with eII epplicable codes, end all requlred Inepectlone and finel epprovel must be obtained. Feilure to obtain Inspectiona and tlnal approval will result in the ezDlration of thla permit. FOR INSPECTIONS CALL: (71q) 754-5828 zaease(eroo) WORKERS'COMPENSATON DECLARATON: � ' � - � . I hereby eMirm under penalry ot per�ury one of the follor.ing tledare00�s: ' ' •� 9�' , ❑ I heve entl vnll maintein a cenllkate ol consent ro self-Insure for workers' crompensatlon, es provided lor by sectlon 3700 0l the Lebor Cotle, for the performanca ot the �Ork tOr whiCh this permil ls issuetl. *.+ 1Q I have ene will mainUin wwkers' oomoensation insurance es repuiretl by sectlon 3700 of Ne LeEor Cotle lor Ihe peAortnance oi Iho work br whitl� W5 rtnit is iss ed and policy number are: � �� umber. �43 � � —ZaO�'�. � veluetl a! one hundre0 tlollers ($100) oi less.) � ❑ I ce�iy �hat in �he peAortnanco ot lho work tor wfiich Ihis pertnit Is Issuetl, 1 shall not employ any person In eny manner so e5 to become su��ect to the workers' compensetlon lews ol Celitomia. entl agree t�et Ii I shoulA become sub�ect to the workers' compensetlon provislans o1 Sectlon�3700 0l the Lebor CoOe, I s�ell forthwllh COmply wlih ihe59 D�ovislon9. �Pu�.�� ,� l� /G -2ovS �- WAhNINO: FAI�URE TO SEGUFlE WORKE0.5' dJMPENS/TION COVERAGE NUW FUL M'D SHALL SUBIECf M! EMPIOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDREO T110USANDDOLURE(5100,0OO�.INADDITIIXJTOTHECOSTOFCOMPENSA , MUGESASPfiONDEDFIXiINSEC(ION31080FTHEUBORCODE,INrEREST.M1DnTiORNEVSFEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm Ihat I am licensetlyn�e�r� I�on�Chapter 8(rnmmencing wilh Section 7000) ol torce end eHegLLierN� l0 S Class p CONSTRUC710N LENDING AGENCVi ' ' � ❑ I hereby eflirm ihai �here is e consiruction lendinp egency lor Ihe peAormance of the work tor w�ich Ihis permit is issueC. (Sac. Lentlefs Name: LenAers Address: Signature: Date: Code, and my license is in full Civil Cotle). OWNER-BUILDER DECLARATIONS: I hereby eHirm that un0er penelty ot perjury Ihe1 I em EXEMPT FROM TME CONTRAC70R5 LICENSE LAW lor the tollowing reeson (Sec. 7031.5, Business @nG Professlons CoOe: Any ciry or counry which requires e pertnit to construct, eller, improve, demolish, or repeir eny strucwro, D�or to its issuance, elso requires the applicant locsuch permit to tile a signed slatement thet he or she Is Ilcensed pureuant to the D�oWslons at Ihe Contradors License Lew (C�apter 9(commencing with Sectlon 7000) of Divislon 3 of the Busineu end Pratesslons Cotle) or t�at he or she Is e:empt thereirom and Ihe basis lor t�e alleged exemption. Any vidatlon ot Sectlan 7031.5 by eny eppllcant tor a pertnit subJects the epPlicent to a cMl penalty ol not more then five hunAretl Aollere ($500).): ❑ I, es owner of the property, or my employees with wa9es aa their sole compensaUon, WILL DO THE WORK, end the structura Is nol intended or ottered lor sale (Sea � 7044, Busineu and Protessims Coda: Tha Coniractors Llcense Lew Coes not appty to an owner of properry who builds or Improves thereon, end who does such work himsetl or �erseN or through his or her awn employees, pmWded Ihet such improvemenis are not Intentled or oflered tor sale. If, however, the building or improvement Is sold within one year of completion, ihe owner-builder will have t�e burden ot provinq ihat he or sha tlitl not build or improve for purpose of sale.). - ❑ 1, as owner of the property, am E%CLUSIVELY CONTRACTINC WITH LICENSED CON7AACTORS to consiruct the prqect (SecJ046, Businass antl Professiore Cade: The contwctors License Lew tloes not appy to en owner ol propeny wno builds or Improves thereon, end who wntrects lar such project wiih a comrenar(s) license pursuent b the Contrectors License Laws.). ❑ I em exempt untler sec. Business end Professions Code lor this reeson: Signature: Dato: Ownor ID verifietl by tlnvefs license. ❑ Ves ❑ No Drivefs License No. Expires: Vedticetlan of Ownership hy (rype ol dacumem, I.e. - properry laa blll or deed�: DIVISION OF INDUSTRIAL SAFETY PERMIT CER7IFICA710N: ❑ I hereby ceriify that no excavelion tive (5) or more feet in depth into which e person is required to descend, wlll be matle In connecibn wiih work euthorized by Ihis permi6 and that no buildlrg structure, scallolding, falsework, or demolition or dismanUing I�ereot, wiil Oe more Uan ihirty-six (36) teet hig�. (Chap. 32, Grp 2, Art 2, Sec. 341, Tilla 8, Ce111orniB AAmInlSireilve Cotle). � As owner-�uilder, I will not employ enyone to do work which would requlre e pertnil Irom �ho DlNslon ol Intlustrial Selery, es natetl ebove, unless such person hea e permit Io tlo such work Irom Ihe diNsion. SignaNre: Data: Division of Intlusirial Safery Pertnit Number. CERTIFlCATE OF COMPIJANCE /WD AUTHORIZATION OF ENTRV: I cenity under penalry of perjury thal I have read this epD�ication entl state that the infortnatlon given is I corred. I agree to comply with all ste�e laws and ciry ordinances relating to builtling construdion, entl authonza represenWtives of ihe Clry of Costa Mesa to enter upon the above-tlescnbed property lor inspection purposes. I agree not to occupy or allow occupancy ot any builtling authorized by this pertnit until �inal inspection. COOEI' INSPEC710NTYFE' ""-' 1616 Fized System Pinel Fire Prevention �.. . �� ' — �-iS --�e � � 0 Date p�Lg � • S4GE1 wsveerax me � . 206 Final Mec�anical 1266 Pool Spa Final 200 �Finel Ra-Root . . . . . . . 201 Flnal Blak/Retaining Well 202 Finel Factory Fire'Place " ' ' .. � . . . :i� .. , � .. 203 FinalSign 204 Final Demoli�ion 208 Final Plumbing 210 ' ' Finel Electrical 212 Flnel Fire Prevention 220 'Final Planning ApP��'el 222 Final Site 250 Final Building�Occupenry (714) 754-5273 • FAn (714) 754d856 • www.ci.cOsta-mesa.ca.us 77 FAIR DRIVE, CASTA MESA, CA 92626 1ob Address: 440 E 19TH ST Suite No Vicinity; Parcel Nunmber; 42631�12 Applicant: RANDY Address: 711 W 1 i r � �, /.�`/r! �,'��il',) j ,; JContractor: � � I L, / Adtlress:, � r i`� iil � i ' � \ J j�� ' ; , r� y � ,, ✓-- ,,,, � �; ,� � �, , ,, � PLUMBING PERMIT KUTZ Status: ISSUED Applied: 05/16/2005 Issued: 05/16/2005 ..--�" rrn+- : � _.�, .�� ISSUED BY: + / t, �� '�qC � V I��'�� ` ,, � � � � I � �� ione:�:9a9-6a6f3a66 _ /C�/ . `'� � O ``-� ` `\\ =Zip:^-� �d\� ` \ �� ' � °° \��° o � �--• �„ � ;/-/ Phone: �949-79&0714 � r � ,r, ;. 'MESA.CA Zip: ��92827 ��..` � , . � p r-- �• �. - '\ ^ ;, � ('� �'� r'� •-'� ^" � \, �. � � ' � � WATER POOLS ^� °o �lK.' ��-.I �/ . ° �(-'o `�L. = ..-- - �-: "' ' ,i � �, 17TH�3T #G4�r' .,.--r'�� ` ��=�� //� � ` J�i 'I �` <\'� J.J �-AA� Phone: 94&64G3466 �� MESA, CA�> Zip: " �� - � � �-Clcense:=�280=====�= = _� 1 L _�.<<� ,1 _�IIF"_ ,:Ih'I� ,�_I'� �'� c ,�, ��..� ��,.,,;,_ �_�_ ...�� _ SPA. AND 1 GAS OU,TCET-� �1 �---___ �� , Backtlow Preventer BathNb � � �-i Clarifier Syste� i/J Connect Qce.Soda;etc) Dental Units 4��`� Dishwasher Drain, Floor Drain, Rainwater a D2in, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 ouUets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceprors (GreaSe, Oil) Laundry Tub 0 La 0 M P- 0 I pr 3 -� i iUMMARY�� `-� 'AMT---�-aTY ;ner�.,�.. so.00 o s� m , �`"" � �$0,00 0 SH egulator, o g� °$0.00 ��0 ping:(per o0�ft).�� 50.00��.0 O'" UO p <50.00 0 k �� ' �4750i00 � �°0 �foi Demo'� ° � 50.00 ° 0 nect e - ��o ,� =$0'.00�0 $0.00\�` U� SBWOf�F'f1Va[Q;LI(18k��'-Y��U:UU�i"U/ $0:00 �>0 O //� Shower '-"�'' --"— '� S0. 0�0 ��CS nk; comm�ercial � �f50;00�0 �j $0.00�0\ Sink,Floor_f��U {$0.00�0� $6.15 1 �O�'Sink, kitchen f`U90:00 0� $0.00 0\�cSink',.service/mop__ __50.00��i% $0.00 0 Spa�(pnvate)� �-_i�iG830i2�1-"'� 50.00 0 Spa (public)-'-�-----'$0:00 0 $0.00 0 0 � .Wash Basin / $0.00 Wash�Basin'Set �� 50.00 Wa`ste�and�Vent System $0.00 YJat'e� Closet (Toileq� $0.00 Water Heatei I-verit 50 00 WaterPiping�(InstorRepJ 50.00 Watei Re-pipe $0.00 ,WaterService $0.00 Water Softener 50.00 OTHER $0.00 VIOLATION $0.00 PLAN CHECK E0.00 REINSPECTION � 50.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements urM�r regulations. (Ord. Np. 92-28, § 1, 12-21-92) F EXPIRATION: This permit shall automaticalty expire an0 become void 11 work is not commenced wllhin 180 days, or IIG for a period of 180 days. Y INSPECTIONS: In order for ihe work authorized under this permit to be conskleretl legal, such vrork must compty a requlred Inepectlone and final epproval must be obteined. Failure to oDtain Inspections and final epproval will result in FOR INSPECTIONS CALL: {714) 7545626 ze+e+e �eiao� an a 0 0 0 0 0 0 0 0 0 0 0 0 0 0 statutes antl related is suspended or abandoned all appliceble codes, and all explration ol this permit. WORKERS' COMPENSATION DECLARATION: ' ' � � 7 . 1 hereby aHirtn untler penalry ol perjury one oi the following deGeratlons: . ' .� ' - ❑ liheve entl wlll mainteln a certificate af �nsem ro self-Insure br workers' compensetlon, es DrovlAed lor Dy section 3700 0l Ihe Lebor CoCe, for the petlormence of Ihe � work tor whicli Ihis permit Is issued. I hevs end will maintain workers' camperuaiWn insurance, as required by soction 3700 of Ihe LEEor Catle, for Ne peAortnance oi Ne work for which this perml� is IswpC, �d ero' compensatlon Insurance cerder end pollcy number are: '1� 'Cerrier: �-� � Polity Number: I T3 � � �� d � _ � (T�is section nee nof be tomp/eled U(he permif is ve/ued ef one hundred dollers ($ I00) or less. a � I certity ihet in the DeAomiance of the work for which this�pertnit fs i53ued, I ahell noI employ any person in eny manner so as to become subject to the workars' ' canpensatlon laws � Celifomia, antl'egree that iU.slwu�d become suD�ecl �o the workers' compensatlon provisions at Saction 3700 of the Labor Coda, I shell tort�wit� com .wiN�t ��j < � � p ntSfg ature. /G. —"�–_�_ Dat�e: S—�� 2'� WARNINQ: FNLURE iOSECURE WORNEPS' COMPENSATION COVERAGE IS UNLAWFUL ANO SNALL SUBJECT AN �LVIEIi TO CflIMINAL PEWICTIES AND CIVIL FlNES UP i00NE HUNDRED TTIOUSMlD OOLLARE (5100,000�, IN ADDITIIXJ TO 17�E COST OF COAIPENSATION, OAAUOES tiS PROVIOED FOR IN SECTIIXJ 3]OB OF THE UBO(i CO�E, INfEREST, AND ATTOqNE1"5 FEES. LICENSED CONTRACTORS OECLARATION: n Ilcensed untler provi8ions of Chepter 9(wmmencing with Sectlon 7000) of Division 3 of t�e Business and mfessions Code, end my license Is In full z- cia:s» G� �— �oe� .�1; - �s—�e�� CONSTRUCTON LENDING AGENCC, � ❑ I hereby aHirtn Ihet there is e consiruIXiOn lentling agency for Ihe peAormance oi t�e Lentlefs Nema: Lenders Address: Signeture: whic� ihis pertnit is issued. (Sec. 3097, Civil Code). Date: OWNER-BUILDER DECLARATIONS: I �ereby aHirtn t�at untler penally ol perjury thet I em EXEMPT FROM TNE CONTtiACTORS LICENSE LAW for the fdlowing raason (Sec. 7031.5, Business anG Professions Coda: Any dry or rnunry whic� reqWres e permlt l0 construct, elter, Improve, demolish, or repair any struclura, pdor ro its issuance, also requires the epplicant for such pertnit to tile e signetl stetemen� that ha or s�e Is IlcqnsaA pursuant ro the pmvislons of 1he Contrectom License Lew (Chaprer 9(wmmendng with Sectlon 7000) of Divislon 3 ot t�e Business end Professlons Code) or Ihet he or sha is a:empt therelrom end Ne besis br Ihe alleged exemptlon. Any violatlon of SecUon 7037.5 by eny epplicant tor e pertnit subjects t�e ap0licent to e dvil penelry o1 not mare Ihan live hundre0 Gollars (E500).): ❑ 1, es awner a( the pmperty, ar my emplayees with wages es their sole compensal(an, WILL DO THE WOHK, end t�e slrucNre Is not fntended or oHeretl far sele (Sec. 7044, Business end Protessions CoOe: The Coniractors License Lew does not apply to an owner ot property who builds or improves thereon, entl who does such work himseN or herself or Ihwugh hls or her qwn employees, providetl thet such improvements ere not Intended or oMered tor sale. If, howaver, the building or Impwvement is soltl wit�in one year ot completion, ihe owner-builtler wiil hava the burden of pmving that he or she did not build or impmve br purpase ot sale.). � ❑ I, es or.ner of the property, am EXCLUSIVELY CON7RACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business antl Professions Cotle: The comrectors License Lew tloey noi apply to an owner oi property who bullds or improves �hereon, and who conirects tor such project wl�h e contrector(s) license pursuant to ihe Conirectore License Lews.). ❑ I am o:empt untler sec. Business and Prolessions Cotle lor Ihis reeson: SlgnaNre: Date: Owner ID veAlieO by tlrivers Iicense. ❑ Yes ❑ Na Orivefs License No. Vedficatlon oi Ownership by (type of tlocument, I.e. - properry tax bill or daed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: Expires: ❑ I hereDy certify that no e:cavelion tive ($) or more teet in depth into which e person is requiretl to descen4 will 6e mada in connection wiih work euthorized by Ihis permit, end that no building siructure, sCattolding, talsework, or demolition or Cismantlirg thereol, will be more than thirty-sia (36) feet high. (Chep. 32, Gry 2, Art 2, Sec. 341, Tille e, Celifomla Adminislrative COtla). ❑ As owner�builder, 1 will not employ enyane to tlo work which would require e pertnit Irom the DiWslon ol Intlustrial Sate,y, as noted ebove, unless such person has e permit to do such work irom the divi5ion. Signelure: Date: Division ot Industrlel Safety Permi� Number: ICERTFlCATE OF COMPLIANCE AND AIffHOflVAT10N OF ENTRV: I cenify under penalry of perjury ihat I heve read this epplicatlon end stata Ihet ihe Informatlon pNen is I correct. I egree to comply wlth all state laws entl ciry ordinances relating to bullding wnstruction, entl euthodze representatives ot the Clry of Cos1e Mese lo enter upon the ebove-described property br inspection purppses. I egree not to occupy or ellow oaupancy of eny building euthorized Oy this pertnit un�il tinel inspection. Signature CODE I' INSPECTONTYPE' ' • 7616 Fixetl System Final Fire Preventlon Q'ii 200 Pool Spa Finel Final Fo-Rool � ' � 201 Finel BIocWRetaining Well 202 Final Factory Fire Plece '� 203 Finel SiBn 204 Final Demolltlon . . � It�LS S' • f(, -Z��S f�Q1�j INSPECTIONTYVE 206 � Final Mechanical 20B Final Plumhinp 210 Final Electrical 212 Final Flre Prevention 220 � Final Planning Approval 222 � Final Sita 250 Final Building/Occupancy PdIE - 11�64 � n (714) 754-5273 • Fax (714) 754-4856 • www.Ci.Coste-mBSe.Ce.us 77 FAIR DRIVE, COSTA MESA, GA 92626 ELECTRICAL PERMIT dob Address: 440 E 19TH ST Suite No Vicinity: Parcel Nunmber: 42631112 Status: ISSUED Applied: OS/16/2005 Issued: OS/16/2005 Applicant: RANDY BEARD ��iC'�r��-(`�r'�?� �-�"'� ISSUED BY: Address: 711 W. 17TH ST #�G4�� ' `�� i �`^ "��`°�, ,d,✓�Z^ , ' � � ��^ � � ' - , � 92627 �,�' ^/' /,�a':r� � Phone � 94&646-3466' � r�') n` r� Tli' -� � � � �✓ . � V�� .A COSTAMESA,_CA /' Zip � � �� _ . r 'i r�': � , � r /Jy`.� ��,'�� t _ - ,/ ;,� ' ��_ . i��'�j � ^�� 1V/d.A./�.�.,.�=,. } \ �'�\�. J � ��.i \ \� Owner: �� ; HARTZELL; ANDREVVIKUT•Z� �� 1` � �, Z ,..� ; � � � ,= �� ' / �� Address� ' 440 E 19TH ST„��' 1 /.r � . 'i �i ��/� Phone: 949-79&0714 �� . �� i � . �. `/�!%�� , i + �"'�� ' COSTA�MESA, CA Zip: 92627 ��-�.� `�� \�l ��.,/ ,. , ',�n! , ' i �� "f ' `�� %.%.9. i-,.. . � / A � S, i../� -, � ��.j�;� � _ , '�� ` \ � � I-� Contwctor: � PORE WAT.ER POOLS 2 �� "�� " �\ r',. ! ,��r/,=. ' �%� � . ' �, °o°' j� �i � �.�,\V �-> � �: �¢ , { � .Address ��7�11 W_ 17TH ST #G4 �. � '� " r l � �^ r `1�,� � � �V \ �1 0 � �� - � 926� � � /��-�J r, -- � Phone 949-848_3466�,�� . \ U��', ; ��I . ��/COSTAMESA,:CA°�° �� - Zip: . ��'�j`�� ,��\` � � �'. ,A . ' o J J�� V` � LICen5e:615280 _� / ��'��y � "'� , A i � t � ��,-�� ' � �� '� �� - ' , !� -`- �- _ --'---- -_— - -- - _ _� 1 4.�' � � ' � ,� �� . . _ ;�•q ,�. "'___ /� ," v �' _ , '� � INGROUND GUNITE:SPAT. REF ._,1 t1��,_y �,.'14�11SPA. '_ �%IC/ 1 �� ' � ; �� , ---� �, ISSUE FEE/ � A'. �� Temp `service test �l``.`�,+ Res:'a/c package \�;\ New Res�(1-2 units) \, l, New Res.(3+unitsj 1 Pool / Spa �� :�= "� Liqhting Fixts�� Recept Outlets\ Switches '��\` Non Res Appl Xi ��, Res Appl � �. Service to 200a �� `, Service to 1000a � Service over 1000a Motors to 1hp Motors to tOhp Motors to SOhp Motors l0 100hp Motors over 100hp Communitation drop; Sub panel to 200a Pole Li9ht Pkg Sign Circuits 523.50 $0.00 $0.00 $0.00 , $0.00 i-, ' = -: ��" FE ;Quantiry -- �'-� �i i i � au uu '�,,, $1�10 � $0:00��'�' /��$0.00� �`' .�, (, �� $0.00 � ��,. V' $0.00�. �' 0 0 1 0 � F;PERMIT�:_.., li � ` -__- _'� �--��----- MMARY =f•'��`��'� _ _ _ �/,G � : :- _� _:,,k -.��,; -- � Temp Dist System / Lighting ' Busway'%100 ft'' _ SWndirig;Seotion: Misc Electrical�Eouipment ., -` � , .�ek; �d '�ia . o��..�fr. i ��.�<�' `%,� ��.� , . �o o.. �� U`� �� Low �` .J�'.,:q�Low �o � a o;'(� MIS( �.i " �.v_ "D"' up to 1 kva/kw to 10 kva/kw ,n � �_ I` �-- I I; = -' ( rl. � C -�i,. �� .� Quantity � �� _ J 50.00 0 �/ � - _ _$0.00 0 �� $0.00 0�%' /� � � � $0.00 �0� � i $0.00 ,�0 � O ;� /�; $0.00� �0 �i ��I) $0.00�/� 0 $0:00� 0 � ..`'fi`'-.5-� 50.00 0 au.w -/-� � �`t`.:;: ' misc.wnaucio�.�"�/ -�o.�v y`:: � �. �- - --- � $0�00��`>/,0� ' �_-'_�-` _.Grcus_(genb�.ride) ��v30:00 $0.00 \L��O � � � �..:. . ' -Circus (mech ride,or lights) ��., '$0:00 $0:00 'v0 i/':;�r�,--�ChrisimasTree�Stand�� ' $0.00 $0:00� 0 �s �' � � � � � � -' FirewoAc's Stantl � �. L � � /30.00 $0.00 �\0_ - .�-��, ��COthe�,ElectriplFee'� /�/%50:00 $0.00��0_�=;--- ,., .. - .� :; ,. $0.00 0 � _ -'=�� _ - - -Inves6gaUon Fee'�� $0.00 $0.00 0 � =_ �"�'PIariClieck�Fee�`� $0.00 $0.00 0 Reinspection Fee $0.00 $0.00 0 0 � NOTICE: The work authorized by this permit shall compty with all applicable handicap access requirements under Califomia slatutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become vold if work is rrot commenced withln 1B0 days, or if work is suspended or abandoned for a period of 180 days. INSPEC710NS: In order tor the work authorized under this pertnit to be considered legal, such work must comply with all applica6le codes, and all requlred Inapectlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiratlon of this pertnit. FOR INSPECTIONS CALL: (714) 754-b828 '�I(�'i�.); . . WORKERS'COMPENSAnONOECLARAnON: - ' ' _ .+ �- I hereby eNirm untler panalry of perjury one of ihe following declaratlons: .:' . , � "' „ . �❑ � heve antl will melntain a ceniticate oi consent to self-Insure for workers' compensation, es provided for by section 3700 oi the Lebor Cotle, br the peAormance of Ihe � wark for which ihi5 permit is issuetl. � ' � • � � � ' � � ' � p . I heve entl will maintain workers' compensatlon insurence, es required 6y sectlon 3700 �of the Labor Cotle, for ihe pertortnance of ihe work for which Ihisp� rtnit " ssued� My workers' compensation Insuren�(e carrier entl policy num6er are: t1� Q . :Ca � . .��.-�'L �.�Nil Palicy � � 17� � �2i`�,�" � ` x� (Thls sectlon need nof be completed i/ (he perm/f is va/ued ef one hundretl dollars ($100) or less.) ❑ I cenity�that in the pertormanca of the work for which ihis pertni(is issueq I sh211 no� employ any peison In any manner so es t6 hecome subjeG lo tha workers' compensetian laws of Califomia, and eaaareeennnttthhhat It I should become subject to the workers' compensetion pmvisions ot Section 3700 bf the Lebor Code, I shall torthwith A� comply with these '� D ^� /� J .-�M � �� 'm ntCe 51 aWre: J � � !h� f r--y [y—� 21B" WARtJING: FAILURE TO SECURE WORKERS' COMPENSATIIXJ COVEMGE IS UMAWFUL AN� SMALI SUBJECf AN EMPLOYER TO CRIMINA� PENALTIES M1D CML FlNES UP TO ONE MUNDRED THOUSAND DOLIARE �5100,000), IN FDORION TO THE C0.5T OF COMPENSFTION, OAMAGES AS PROVIDED FOR IN SEGTON 31a60F THE LABOR CODE, INfEREST, AND ATTORNEI"5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby eflirm,��ha ..t flml licensed undarp.ro.visioL ls,Qt Chapter B(commencing with Section 7000) ot Divlslon 3 of the Busines a P� 4fesslons Cotle, entl my license is in full torce antl e—ffed. Lic. a_ ��o� J 22N Gass.N �� > Comrectw'e�SlgJnalu � _ _�� ( y1t,��-� C�— i(o—�J�6 �� CONSTRUCTION LENDING AGENCV: ' ' . ' � ❑ I hereby ettirtn thal Ihere is a consWction lentling egency br ihe pedormance ot the work for which ihis permil is issuetl. (Sec. 3097, Civil Code). Lendefs Name: Lentlers Address: Signeture: OWNER-BUILDER DECLARATIONS: Date: I hereby etlirtn thet under penalry of perjury thet I em EI(EMPT FROM THE CONTRACTORS LICENSE LAW far ihe tollowing reason (Sec. 7031.5, Business end Professions Code: Any ciry or counry which reQuires a pertnit to construct, alter, improve, tlemolish, or repeir any structure, pnor to its issuance, elso requlres the applicant tor such permit to tile e slgned statement ihat he or she is Ilcensed pursuent ta ihe provisions ol the Cantrectors License Law (Chapter 9(cammencing with Sedlon 7000) 01 Division 3 of the Business end Pmfeuions Code) or Ihat he or she Is exempt theretrom and the basls for the ellegatl axemptlon. Any violatlon of Section 7031.5 Dy eny epplicant tor e pertnit sublects Ihe applicant to a civil penatly of not more then ilve hundred dollars ($500).): ❑ I, es owner ol Ihe property, or my employees wlih wages as Iheir sole compensation, WILL DO 7ME WORK, antl ihe structure Is not intendetl or oHered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not epply lo an owner ot proDerty who builds or improves ihereon; and who tloes such work himseN or herseN or �hrough his or her own employees, D�ovitletl that such improvemenis are not Intended or otlered for sale. II, however, the building or improvement is soltl within one year of wmpletion, t�e owner-builtler wlll �eve ihe burden of proving Ihat he or she did not build or improve tor purpose ol sele.). � ❑ I, as owner oi the properry, am EXCWSIVELY CONTRACTING WITH LICENSED CONTRACTORS ro construct the project (Sec. 7044, Business and Professions Cotle: The contractors License Lew does not epply to en owner of propeny w�o builtls or Improves Ihereon, and who wn�racts lor such projact wlth a contredor(s) license pursuant to Iha Cantracbrs License Laws.). ❑ I am exempt untler sec. Signature: Owner ID ventietl by tlnveYs license. ❑ Ves ❑ No Busineu antl Pmfessions Cotle tor t�is reason: Vedfication of Owners�ip by (rype oi tlocument, i.e. - property taz bill or deed): �IVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: Driver'S License No. Date: Expires: ❑ I hereby certlfy that no excavation five (5) or more fee� In depth in�o which e person Is required to tlescend, will be matle in connectlon wlth work euthorized by ihis permit, entl ihat no builtling siructure, sceHolding, falsework, or demolition or disman�ling Ihereof, will be more �han thirty-six (36) leet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Ttle 8, Calitomia Administrative Cotle). ❑ As owner-builder, I will not employ anyone to do work which would require e permi� trom ihe Division of Indusinel Satery, es noted ebove, unless suc� person has e pertnit ta do such work trom Ihe tlivision. SignaWre: Date: Division ot Intlustnel Satety Pertnit Numbar: ICER7IFlCATE OF COMPLIANCE AND AUTMORVATION OF ENTAY: I cenity under penalry ot perjury that I have read �his application and state that the information given is I correct. I agree to comply with all state laws and ciry ordinances relating to building construciion, end authorize representatives ol Ihe Ciry ot Costa Mesa to enter upon the above-descn0ed D�operry for inspection purposes. I agree not to occupy or allow occupancy ot any building authonzed by this permit until finel inspection. COOE 1' INSPEC710NTYVE' ,� ' .' • , " .. .•Fd7F' . •• U�J9L5 7616 Fixed System Final Fire Preventiom ' ' 1266 Pool Spa Final 200 201 202 203 Final Re-Fioof ' Final Block/Rataining Wall Final Factory Fire Place Final Sign 204 Final Demolition � " �(' INSPECTIONTYPE` � �� - 206 Final Mechanical ' . 20B Finel Plumbing 210 � Final Electricel 212 Final Pire Prevemion 220 � Final Planning Approval 222 Final Site �� :,`Datg� . . .� pAIE It�L9 �.�' � 250 Finel Builtling/Occupancy _ (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us BUILDING PERMIT Job Address: 440 E 19TH ST Suitg: Vicinity: DETACHED GARAGE Parcei Number. 42631112 Zoning: Applicant: MIKE HEIL Address: 2721 E QUINCY AV - �,- " � Phone: 714-997-3440 ORANGE, CA- � � . Zip: 92867 Own�r: HARTZEI:L, ANDREW KUTZ ' Address '440 E�19TH ST � , � - . � `- j � �. � , . � _ Phone: � ,COSTA MESA. CA' � - Zip: 92627 Contractor: HEIL CONSTRUCTION SERVICES � Addregs: 2721 E QUINCY AV . , , Phone: �714-997-3440 ,ORANGE,CA _ 2ip: 92867 , License: 678817 , .., - Arch : � � " � Eng: Address: ' ' � ' ' Address: Phone: i i rnm unrvc, i.w i r, mean, t,M azozo SWlus: ISSUED Applied: OB124/2004 Issued: OB/24I2004 ISSUED BY: . , � Phone: Zip: - , L{cense: , License: SCOPEOF PERMIT DEMOUSH OETACHED GARAGE. REF.: 604-00925 � • � ' � APPL�CANT WILL CONTACT A.Q.M.D. PRIOR TO DEMOLITION. - � FEE SUMMARY. � � � Plari CheCk: $0.00 • Calc Valuation: 53,soo.00 Permit: $97.25 Claim Valuation: Sa,50o.00 SMIP Res: $0.50 , SMIP Com; $0.00 _ �; Other.,� ��$0.00 •.�� , ,' ' . Inspection: $0.00 � � ' Total: 597.75 � " ' . c / . �'� ' � '<� SETBACKS �� ' � ` � � � - ' � MAINSTRUCTURE�Front-�0-0 _ .�-,Rear. _0.0 ACCESSORY Front ��- 0- 0� _ �Rear. 0- 0 PARKING Exisung: o`� _Reauired:-. o �LANNING 8 ZONING � ��.% `�!� �'; �� . �.%- � � -,. . - , - ' = � : . Left 0- 0 ,�� Riglit ��0. 0 �'- �� i � � i - Left � 0-�0 - � � ' ,� Righl.� �0.�0- �- � � �i , � � , , _,�., .- Pr000sed: -0 �%/� I NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Calilornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) El(PIRA710N: This permit shall automatically expire and become void Ii work is not commenced within 180 days, or if work is suspentletl or abandoned for e period of 180 days. INSPECTIONS: In order for the work authorized under this permit to ba consldered legal, such work must comply with all applicable.codes, and all required Inapeetlone and final epprovel must be obtained. Failure to obtain inspectlons and final approval will result in ihe expiral� fiis permit. FOR INSPECTIONS CALL: (714) 7545828 2MBd8I8100) WORKERS'COMPENSATON OECLARAnON: � � ' � I hereby ettirm under Denalry oi per�ury one of t�e following dacleretions: " ' I have end wlll malnteln e ceNficete ol consent ro self-Insure for workers' compensetion, es provided for by sectlon 3700 ot the Labor Code, br Ihe peAormance of Ue work tor which Uis pertnit Is Issued. I ve antl will malntaln wwkers' canpensatlon Inwrence, as requiretl by section 3700 0l the Labw Catle, for the peRwmance ot the woAc tw xTiCi NLg pgmtit is lswetl. y workers' compensat n In urence fagier entlrm1 iq number are: Cartier. �� Kn �n ,A Policy Number. t�y 2 22 -v�� (Thls secNan need not be campleted!! Me mtit Is re/ued et one hund�eC dd/eis (5100) or less.) � I certity Ihat in the pertortnanca of Ihe work tor which Ihls permit is IssueC, I shall nat amploy any Derson in eny manner so es to becrome sub�ect to the workers' wmpensetian lews ai Calllomie, en r h I c me �ect to the workers' compensetlon proNslons of Sedlan a700 0l Ihe bor Code, I shall fort�with comply wlih thesa provlslons. / L � � Applicent Signeture: � � �ete: � Z� Q � WAfiNINO:FNLURETOSEWREWORKERS'COMPENSAT ODVEMOEISUNLAWFULMIDSNALLSUBIECTrWEMPLOVERTOCRIMINALPENALTIESANDGVILFlNESUPTOONEHUNDRED TIIIX15M1D OOLLARE (5100.0001. IN ADDRIOH TO THE COuT OF GUf.IPEN$ATlpy UAANGES 0.5 PRON�ED FOR IN SEGTON 37080F THE IABOR CODE, INfEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATON: I hareby aflirtn Ihat I am licensed un r's� force ana eHect. Lic. M Contractor s Slgnature: CONSTRUCTION LENDING AGENLV: 7000) of Division 3 0l the Buslnessgq tl P olessions CoOe, end my license is in tull Cless a /S � / oa�e: , 7 �/ i ❑ I hereby alfirm Ihat ihere is e construction lending epency tor che peAormenca of iho wark lor w�ich this permlt is Issued. (Sec. 3097, Glvil Cotle). Lendefs Name: Lendafs Address: Signeture: OWNER-BUILDER DECLARATIONS: Date: I hereby aNirtn t�et under penelry ot pe�jury Ihet I am EXEMPT FROM TFiE CONTRAC70RS LICENSE LAW for the lollowing reason (Sec. 7031.5, Business entl Professions Cade: Any ciry or wunry which requires e permrt to consWct, elter, improve, demolish, or repalr any structure, pdor to Its issuence, elso requires t�e epplicent for such pertnit to Ille e slpned statement thet he or she Is Iicensed pursuent to Ihe proNsions of Ihe Contrectore IJcense Lew (Chepter 9(commenGng wlth Sectlon 7000) of Division 3 of Ihe Business entl Professions CadeJ or t�et he or she is exempt lherelrom and the basis lor Iho elleged exemptlon. Any violetion oi Section 7031.5 Dy any epplicent for a permit sub�eds ihe epplicant to a cMl penalry oi not more ihan live hunAretl Aollars ($500).): ❑ I, es owner of the properry, or my empiqrees wit� weges es Neir sole compensetion, WILL DO THE WORK, end Ihe sUuctura Is not IntenCetl or aHeretl for sale (Sec. 7044, Business antl Professions Code: The Coniradors License Lew does not apply to an owner ot pmperry who bullds or impmves theraon, and who tloes such work himself or herself or throug� his or her own emplqrees, provided that such impravemenis ere not intended or oHerad tor sale. If. however, the builCing or improvement Is wid within one yeer of completion, Ihe owner-bulltler will �ave the burden ol proving Ihat he or she did not build or improve for purpose of sale.). � ❑ I, as owner ot the property, am E%CLUSIVELY CONTiiACTING WITH LICENSEO CONTRACTORS to cronstruct the O�alect (Sec. 7044, BuSiness end Professions Code: The cnmractors Ucense Lew does not appy to en awner ot property w�o builds or Improves thereon, and who comracis tor such pra�ect with a cantradoqs) license pursuant �o the Contrectors License Laws.). ❑ I am exempt under sac. Business and Pmlesslons Cotla tor this reeson: Signature: Deta: Owner ID verified by drivars license. ❑ Yes ❑ No Oriver's License No. Vedficetlon of Ownerehlp by (type at tlacument, i.e. - properry tac bill or tleed): Expires: DIVISION OF INDUS7RIAL SAFE7Y PERMR CERTIFICA710N: ' � I hereby certliy that no excevatlon tive (5) or more faet In tleplh Into which e person Is requlred to descand, wlll be metle In cannadion wlih work euthorizetl by ihis permiL antl ihat no bulltlinp sWcture, sceHolding, lalsework, or demolition or tlismantling thereot, will ba mora then �hirry-six (38) teet hig�, (Chep. 32, Grp 2, Art 2, Sec. 341, 71i1e 8, Celilornla Administretive Code). ❑ As owner-huilder, I will not emplay enyane ta do work wMch would require e permil Irom Ihe Dlvision ot Induslrial Sefery, es notetl ebove, unless such person �as e pertnit to do such woAc Irom Ihe tlivision. Slgneture: Dete: Dlvlsion of Industnel Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORQAiION OF ENTRY: I certify under penalry of perjury Ihat I have read Ihis application and stata Ihat the Infortnation given is correct. I egree to comply with ell state laws antl Gry ordinances relating ro bullding conslrucUon, end authodze representatives of the Ciry ol Coste Mesa to enter upon Ue ebove-descnbed property lor Inspection purposes. I egree noI to acupy or allow occupency ot eny building authodzed by t�is permit unGl finel insDeclion. � , (y � � `//v �Date � Md/Or Au�b izetl Appllcani , , Daie COOE �. IXSiECTONTYPE Qa¢, IIiI�LS 1818 Fixed System Flnal Fire Prevention 1288 200 201 202 203 Pool Spe Flnel final Re-Rool FIne181xWRetalninp Well Final Fadory Flre Place Final Sign 206 Final Demditlon CO�E 1 INSPELTION TYPE 206 Final Mechanical 208 Finel Plumbing 210 Final Electrical 212 Final Flre Prevention 220 Final Plenninp Approval 222 Final Slte 250 Flnal Builtling/Oaupancy Qe� u�eis � (714) 754-5273 • Fex (714) 754-4856 • www.ci.costa-me58.Ce.us 77 FAIF DRIVE, COS7A MESA, GA 92626 MECHANICAL PERMIT Job Address: 440 E 19TH ST Suite No Viciniry: NEXT TO GARAGE Parcel Number: 42631112 Appliwnt: MOCKLER,SCOTT Address: 5082 BOLSA AVE # 106 HUNTINGTON BEACH CA Owner: HARTZELL, ANDREW KUTZ Address: 440 E 19TH ST COSTA MESA, CA StatuS: ISSUED Applied: 04l18/2005 . Issued: 04/1 B/2005 ISSUED BY: � Phone: 714-373-5331 Zip: 92649 Phone: Zip: , 92627 Contractor: CONTEMPORARY AIR CONTROL Address: 5082 BOLSA AVE # 106 � - Phone: 714-373-5331 � HUNTINGTON BEACH CA Zip: 92649 License: 575613 SCOPE OF PERMIT REF 804-00925 NEW�CENTRAL AIR LOCATED NEXT TO THE GARAGE. 1 FAU <t00K BTU. AND 1 AC UNIT < 100 KBTU , - ISSUE FEE Inst FAU <700 k BTU Inst FAU >100 k BTU Repair I Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refng Sys >100 k BTU Gas Piping Factory Fireplace Hood wlMech Exhaust VAV Box Venl Fan / Single Ducl Appliance Fire Dampers . Smoke Dampers Inst or Relocate Appl Vent � Air Hantllers < 70000cfm Air Hand�ers > 70000ctm Floor Fumace Floor or Suspend Heater $23.50 $74.80 50.00 $0.00 $0.00 $14.80 $0.00 50.00 $0.00 30.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Repair I Alt Absorblion Unit Repair / All Re(rigeration Unit Ventillation System Evaporative Cooler Commercial I nci nerator Domestic Incinerator Compressors / Absorplion Systems Uplo3hp/100kBTU 3 To 15 tip / 500 k BTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU - Over 50 hp / Over 1,750 BTU Boilers Upto3hp. � �, 3To15hp �� , 15to30hp 30to50hp� . � - Over 50 hp Other Mechanical Fee Investigation Fee , - Plan Check Fee . � Reinspectian �Fee Quantity 50.00 0 80.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 ao.00 0 50.00 0 $0.00 0 50.00 0 $0.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Calitomia statules and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period ot 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all epplicable codes, and all required Inapeetions end Iinal epprovel must be obtainad. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 �.aoao�aw� WORKERS'COMPENSAnON DECLAAATON: � I hBreDy ettirtn untler penelry ot perjury a�e of the tollowing declaretions: ❑ heve end wiil meintein B cetlific&�B oi cnnsent to sell�lnsure tor workaro' compensetlon, es providetl for by sadion 3700 of Ihe Labor Gotle, for the peAo.�nance of lhe work for which this pertnit is issued. �I heve eM will maintain workere' Wmpensetion insurance, es required by sectlon 3700 0l Iha Lebor Cotle, tor tha peAormance ot tho work for which thls pertnit Is issuetl. My wo ers' pen lo nsur9ilFe r ar entl Ilty number ere: ��nnn�r. ^�M� �'} • Policy.Nu� V — Q� OV J(p� (Th!s secNon need not be comp/e i! the pe it is velued e! one �undred tlollers (S I00) or less.) ❑ I ca�ify Ihai in �he perto nca o� Ihe work tor whlCh Ihis pertnil is I99uaQ I shell not employ eny person in eny menner 90 as to CeCome sub�eCi Io Iha workars' compensetion laws of C fo �ie end ree Ihef I I should become sublect ta Ihe workers' compensetlon provislons of Section 3700 o1lha ebor Code, I shell torthwlth comply with ihese p js n: �/ /� ^� �� y AppllC'ant �Slgn�aNrg:, ' �D'ete`~*�- / ••�� NfARM : FM(3 AILURE TO S OqKERS' COMPENSr1T10N COVERAOE IS UNLAWFUL AND SMALI SU&IECT AN E ER TO CRIMINAL PENALTIE$ AND CML FlNES UP TOONE HUNORED T1qU5AND DOLLARE (5100.000�, IN ADDITlOr1 TO TiE COST OF CAMPEN9NTION, OAMPQES 0.S PROVIDED FOR IN SECTION �O6 OF THE 1A80fi COpE, IMEREST, AND ATTOHNEV'S FEES. LICENSED CONTRAC70RS of Chepter 9(rnmmencing wilh Section 7000) of ONisian 3 Code, antl my license is in full CONSTAUCTON LENDING ACENCY: ❑ I herehy atlirm Ihat there i9 e Cona�ruc�ion lending egency tor Ihe peAormencB ol �he work �Or which t�i5 Oermi� is issuBtl. (Sec. 3097, Civil Cotle). Lender'S Neme: Lentler's Address: Signature: OWNER•BUILDER DECLARATIONS: Date: I hereby ettirtn thet under penalry ot perlury Ihet I em E%EMPT FROM THE CONTRACTORS �ICENSE LAW lor Ihe lollowing raeson (Sec. 7031.5, Businass and Professlons Cotla: A�y ciry w couniy which reQuireB e permit lo construct, eltor, improva, tlomoltsh, or repair eny strucWre, pAor lo its Issuance, elso �equires ttie applicant for suc� pertnil to file e signeA statement Ihet he or sh6 is licensed pursuenl ta the proNsions ol Ihe Contrectora License Lew (Chepter 9(commencing with Sedlon 7000) of Dlvision 3 of t�e Business entl Prolessions Cotle) or t�ei he or sho Is eaompt l�erelrom entl Iho basis tor the ellaped exemption. Any violaUon o1 Section 7037.5 by eny eppliceN for a permit subjacts the epplicent to e Gvll penalry oi not more Ihan Hve hundred dollers (5500).): ❑ I, as owner ol Ihe properry, or my employees with weges es Ihelr sWe campensatlon, WILL DO THE WORK, anC ihe siruciura is not intenaeE or ottereE for sale (Sec. 7044. Business and Pmfessions Gode: The Contrectors License Lew does not apply to an owner oi Dropeny who builds or improves Ihereon, and who dces such work himsetl or hersetl or through his or her own employees, provided thal such Imprwemenls ere not intanded or aflered for sale. H, however, t�e builtling or improvament is soltl wit�in one yeer ol completion. the owner-builder will hevo t�o burtlen ol proving that he or she did not builtl or improve br purpose of sale.). ❑ I, es owner ol the property, em E%CLUSIVELV CONTRACTING WfTH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Cotle: The conireclors License Lew tloes noI appty to en owner of OmpertY who builds or impmves theraon, en0 w�o contracts tor such project with a cont2ctor(s) liten58 pursuent to Ihe GontreMors Licensa Lews.�. ❑ I em erempi under sac. Business antl Prole55ions Cade tor ihis reason: Signature: Oate: Owner ID verified by drivers license. ❑ �es ❑ No Drivefs License No. Verilication at Ownership �y (rype oi datument, i.e. - properry tax 0111 or deetl): Ezpires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 �ereCy caNty that no er.cavetion iive (5) or more faet in deplh Inm wNch a person Is requireU [o tlescentl, will he maAe in connection with woAc autM1orized by chis permit, antl that no Duiltling strucNre, scaHolding, telsework, or demolition or dismantling thereof, will be more Ihen thirry-six (36) feet hign. (ChaD� 32, Gry 2, Art 2, Sec. 341, Tille 8, Celilomia Atlminl5tretNe Cotle). ❑ As owner-builtler, I will not employ enyone to do work which woultl require e permil from ihe Division of Industnel Safety, es noted above, unless such person hes e permit to do such work irom the di�sion. Signature: Data: Divisian of IndusMal Safery Partnit Number: CER71flCATE OF C PLI CE AND A�ITNORVA710N OF EMRV: I cenify under penalty ol perjury Ihet I ham med this epplication entl state ihat the intortnation given is correct. I agree ta ply ith ell state lews anA city ordinences relating io bullding conswctlon, entl aulhotlze represenlelivos of the Ciry ol Costa Mesa to emer upon the ebove�descnbe0 pro ny I r InsDection Pwposes. I egreawol lo occupy or ellow occupency ol any 6uiltling au��orizetl 6y lNs permit until tinel inspeclion. LOOE �. IMSYEttION TYPE ifil6 Fixed System Final Fire Preven�ion 7266 Pod Spa Final 200 Final RB�Roof 207 Finel BIacWRetaining Well 202 Finel Fettory Fire Place 203 Final Sign 204 Final Demoli�ion QAIE It1�lEL5 COOE� INSPECiIONTYPE 206 Finel Mechanicel 20B Flnal Plumbing 210 Final Elecirital 272 Finel Flre Prevemion 220 Finel Plenninp Apprwal 222 Flnel Sile 250 Finel Builtling/Occupenry . 11 . r ,� � � � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: ApplicanC Address: 440 E�19TH ST UNIT ABOVE GARAGE 42631112 � SCOTT MOCKLER 5082 BOLSA AVE # 106 HUNTINGTON BEACH CA Owner:' HARIZELL, ANDREW KUTZ Addreu 440 E 19TH ST Contractor. Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+uniLs) Pool / Spa Lighting Fixts Recept Outlets s�mnes Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors lo thp Molors to 10hp Molors to SOhp Motors l0 100hp Motors over t00hp Communicalion drops Sub panel to 200a Phone: 714373-5331 Zip 92649 Phone: COSTA MESA, CA 2ip: 92627 CONTEMPORARY AIR CONTROL 5082 BOLSA AVE # 106 , Phone: 714-373-5331 HUNTINGTON BEACH CA Zip: 92649 � License:575613 SCOPE OF PERMIT NEW CENTRAL AIR UNIT LOCATED NEXT TO GARAGE: REF.: BOS00925 � � � ECECTRICAL TO INCLUDE: 1 AIC UNIT Quantity $23.50 $0.00 $54.50 50.00 $0.00 50.00 $0.00 $0.00 ao.00 so.00 $0.00 so.00 50.00 50.00 50.00 50.00 $0.00 $O.DO 30.00 $0.00 $0.00 FEE SUMMARY Temp Dis[ System / Lighting Busway /100 ft . Standing Section Misc ElecUical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw � .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt W ring Syslem / Ckt Misc. Conduit Misa Conductor Circus ( gen or nde) Circus (mech ride or lights) Christmas Tree Stand - . Fireworks Stand ' � Other Electrical Fee � . � Investigalion Pee Plan Check Fee a 0 Status: ISSUED Applied: 04I18/2005 Issued: 04/18l2005 �1. �1�. ISSUED BY: Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 ao.00 0 ao.00 0 $0.00 0 $0.00 0 ao.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 � + - . ___ ..._ � - , NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automalicalty expire and become void il work is not commenced within 180 days, or ii work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe vrork authorized under ihis permit to be considered legel, SUCh wotic must comply wi�h all applicable codes, and all requiretl Inapactiona end flnal epproval must be obtained. Failure to obtain inspections and final approval will result in the ezpiratlon of this permit. FOR INSPECTIONS CALL: (714) 7545626 �aawo �aw� �� WORKERS'COMPENSAnON DECLARAnON: I hereby eMirm under pena�ry of per(ury one of the tollowing declere�lons: ' ❑ I heve entl will maintein e certlNcele at mnsent to 5e11-Insure lor workers' compensation, es providetl br by section 3700 of the LaDor Code, �or the perto:mance W Ihe woA tor which this pertnil Is IssueO. ❑ I have enA will maintain rkers' pensatlon insurence, es required by sectlon 3700 of the Labor Code, for the pertormance of t�e work for which this permlt is issued. My wo/*+ ers' pens I n Insu ca cartlerP policy number ere: /�' /1n n�1 q11 [i Cartier. 1 �� N 11 A_. `T ( LC . Policy Number: W� � WQ/i `��U � (7hls sectbn need nof be c'�pl iithe pertni( is lued e one hunArad dallers ($ f00) or less) ❑ I cetlity thet in the pedu an 8 0l �he work far whith thl9 permli Is IgSued, I shell na� employ any person In flny mannet so a9 to hecome sub{ect co the workars' compenselion laws o� C Ilfo ie, end egree thet f I should bernme sub�ecl lo the worker9' compen9etlon provisions of Section 3700 ot tha Lebor CoEe, I shall fonhwl(h comply with these pro`ri 0. _/�/� � � Applicant Signeture: Date: � � WARNING: FNLURE TO E ORNERS' COtdPENSATION COVEMOE IS UMAWFUL ANp SHALL SOBJECT rW EMPIOVER TO CFIMINAL PENALTIES r1ND CMl FlNES UP TOONE HUNDqED T1qU5AND DIXIARE (St0p,0001. IN ADpT10N TO TME WST OF COMPENSATION, pRM50ES /.5 PRpVIUEO FOR IN SECTION 31060F THE LABOR OODE. IMERES?, AND ATiORNEI^5 FEES. LICENSED CONTRAC70RS I �ereby eHirtn that I am licen; �OlCB BOtl BRBCi. LI6 M_^ Comrecror's Signature: _ of Chapler 8(Commancing wl�h Sec�lon 7000) o� Dlvision 3 oi lhe Businas�and�o� ssions Cotle, and my litense i5 in full CIeSS � — - oA�a: 5�- /�9 � o CONSTRUCT�N LEN�ING AGENCY; ❑ I hereby aMirtn that ihere is e COnsiruction lending egency lor ihe pedormence ol Ihe work for which ihis permit is issued. (Sat. 3097, Civil COE9). Lender's Name: Londer's Atldress: Signeture: Date: OWNER•BUILDER DECLAAA710NS: I here6y ettirm Ihet under penelty ot perjury chet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW lor ihe following reason (Sec. 7031.5. Businass and Professlons Coda: Any ciry or tounry which reQuires a pertnit to consWcl. etler, Imprwe, tlemdish, or repalr eny slrucWre, pnor lo its issuance, elso requires ihe apD�� or suU pertnit to lile e signed statement iPet ha or sha is Ilcensetl pursuent to the provislons of the Gomrectors License Lew (C�eD�ar 9(commencing wlth Section 7000) of Division 3 0l the Busineu end Pmtessions Code) or thet �e or s�e is ezempl Iherelrom entl ihe Oasis lor Ihe ellegetl e�emption. Any vidation ot Section 7037.5 by any aODficant for a pertnit subjects t�e epplic�ant to e dd� peaalry ol rwt more t�an 1'rve hundred ddlars (5500).�: ❑ I, as owner of ihe property or my employees with weges es their sde compensetion, WILL DO THE WORK, antl Ihe structure is not inientletl or otteretl lor sale (Sec. 7046. Business and 7�o�essions Cotle: TTe Coniractors Licensa Lew Ooes not apPN �o an owner ol properry who builds or imprwes thereon, anA who Goes such work nimSeN or herseN or through �is w �er own employees, prmdded t�at such improvemaMs ere not Intantletl or ottered for sale. 11, however, i�e buifEing or imprwement is sold within one year 0� rompletian, the owner-builder will have the �urtlen ol proving Ihat �e or sha ditl not build or improva for purpose ot sale.�. ❑ I, as owner ol ihe property, am E%CWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 704a, Business and Protessions Cotle: The contractors License Lew tloes not eppty to an owner ol property who builds or Improves thereon, end who contrects lor such projeci with a contrector(s) license pursuant to t�e Contrectors Ucense LawsJ. ❑ I em exempt under s6�. BUSiness enA Profe55ion5 Code �or �his reasOn: Signatura: Date: Owner ID venfied Dy drivefs license. ❑ Ves ❑ No Dr'rvers Ucense No. Ven(ication ol Ownersnip by (NPe ol Eocument, I.e. - property lex bill or tleetl): DIVISION OF INDUS7RIA4 SAFETY PERMR CERTIFICA710N: Expires: ❑ I �ereEy cenify ihat n0 eacavetion live (5) or more lee� in depih into which e person is required to descenq will De made in connection with work authorized by Nis pertnit, and tha� no bUilGing slructure, scaflolding, falsework, or tlemolition or dismaniling l�ereol, will 6e more thaa thirty-six (36� leet hig�. (C�ap. 32, Gfp 2. Art 2, Sac. 341, Title B, Calitomia Adminisirative Cotla). ❑ As owner�Duilder, I will not emplay enyane ta tlo work which would require e permit irom lhe Dlvislon of Indusirial Selery, as noted ebove, unleu such person hes e permit to do suU work hom �he tlivision. Signature: Dale: Division oi Intlustrial Sefery Permil Number: SOOE �. INSPECTIONTYYE 1818 Fized System Final Fire Prevenilan 1288 Pool Spe Finel 200 Flnel Re-Rool 201 Final BIocWReteininp Well 202 Final Fectory Fire Plece 203 Final Sign 204 Final Demolition Pd7F ItlIQ1eL8 COpE� INSPECTIONTYPE 208 Flnal Moc�enical 20B Flnnl Plumhing 210 Flnal Electdcel 212 Flnel Flre Preventlon 220 Finel Plenning Approval 222 Finel Sile 250 Finel Building/Occupency oe�e u�i �� r1�7 - ��- (714) 754-5273 • Farz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DFNE, GOSTA MESA, GA 92626 ELECTRICAL PERMIT .lobAddress: 440 E 19TH ST Suite No Viciniry: Parcel Nunmber: Applicant Address: 42631112 HEIL CONSTRUCTION SERVICES 2721 E QUINCY AV ORANGE,CA Phone: 714-997-3440 Zip: 92867 owner: HARTZELL, ANDREW KUTZ Address 440 E 19TH ST Phone: COSTA MESA, CA Zip: 92627 Contrecmr: HEIL CONSTRUCTION SERVICES - Address: 2721 E �UINCY AV ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighling 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 l0 50hp Molors l0 100hp ORANGE,CA Fhone: 714-997-3440 Zip: 92867 ' License: 678817 Status: ISSUED Applied: 12/21/2004 Issued: 72/21/2004 �- j� � � : �'�/ SCOPE OF PERMIT REF: 604-00925-CONSTRUCT A NEW 575 SF DETACHED GARAGE WITH A STORAGE AND LAUNDRY AREA AT THE REAR OF THE EXISTING SFD. A 500 SF 2ND FLOOR OFFICE AND BATHROOM WILL BE CONSTRUCTED ABOVE THE GARAGE WITH A 56 SF BALCONY. REF.: 804-00925 AND E04-009>3 REF: ZA-03-94 AND MM-03-57 ELECTRICALTO INCLUDE: 1 TEMPORARY POWER POLE. - - $23.50 $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 $0.00 Quantity 0. 0 0 "0 'p 0 0 0 0 0. 0 - , 0 0 0 0 FEESUMMARY - �uantity ,�� Semp Dist System / Lighting 50.00 0 � Busway /700 ft $0.00 -�, 0 Standing Section, ._ $0.00 � -" 0 Misc Electrical Equipment $0.00 0 Transformers up to 1 kva/kw $0.00 0 .................up to 10 kva/kw $0.00 " 0 � .................up to 50 kva/kw . � $0.00 _ 0 � .................up to 100 kva/kw 30.00 - 0 ..................over 100 kva/kw 30.00 , 0 . � Low Voltage Equipment � $0.00� , 0 Low Volt Widng System / Ckt 30.00 0 Misa Conduit ' $0.00� 0 - Misc. Conbuctor; - , $0.00' 0 � Circus ( gen or rid`e) �$0:00 0 �� Circus�(mech ride or Iighls)� ��- $0.00 0 - ChrisVnas Tree Stand-- " $0.00 0 "� Fireworks Stand $0.00 0 Other Electrical Fee $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access iequiremenis under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: 7his permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetlona and final app�oval musl be obtained. Failure to obtain inspections end finai approvai will result in the expiration of this parmit. FOR INSPECTIONS CqLL: (714) 7545626 (�--�---- -^�"" 244&-0B (8/00) WORKERS' COMPENSATION DECLARATION: I hereby elTirtn under penalty of perjury one of the following declarations: ❑ I have and will maintein e certificate ot consenl to self-Insure lar workers' compensatlon, es pravided tor by sectlan 3700 0l ihe Lebor Code, for the pertormance at t�e work tor which thi5 permlt Is Issuetl. [�E' � I'hqve and wlll malntain workers' compensatlon Insurence, es reQuiretl by seclion 3700 of the Lebor Cotle for the pertormance of the woAc for which this rtnit Is Is d ❑ I cenity that in t�e per compensatlon laws oi comply wit� Ihese pro hKK154ND DOLLARE (5100,000). IN ADDRION carrler end policy numbar ara: 'rL /' ^�,+�t� • pe sue . i�aollcyNumOer. �Olv^��"1 7 � C'V-� rermit Is valued at one hundred dollers ($700) or /ess.) wo i r w� ch is rtnit iqissu I shall not employ eny person in any menner so es to become sub�ect to che workers' e�I I rfie s �ect ro the workers' compensatlon provisions of Section 370001 ihe r Code, I shell lonhwlth � • ;�."tDete: '^� �Z�z�rO �� MPENSAT COVERAG IS UNLAWFUL FND SHALL SUBJECT AN EKAPGOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO qJE HUNOqED i TME OF COMPENSATION, DMMGES 0.5 PROVIDED FOR IN SECTIIXJ 3%080F TME U80R CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: ot Chepter 9 CONSTRUCTION LENDING AGENCV: 7000) ot end my license is in tull ❑ I �ereby aflirm thet Ihere is a construction lending agency Por t�e peAormance of the work tor which this permit is issued. (Sec. 3097, Civil Code). Lentlers Name: Lendar's Address: Signature: _ OWNER•BUILDER DECLARATIONS: Date: I hereDy eKrtn that un0er penelry ot perjury ihet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW lor the tollowing reason (Sec. 7031.5, Business entl Professions Cotle: Any ciry or county which reQuires e pertnit to construct, alter, improve, tlemolish, or repair any structure, pnor lo its iuuance, alm requlres tha epplicant for such pertnit lo file e signeA statement thet he or she Is Iicensed pursuent to the provislans ot Ihe Comrectars Llcense Law (Chepter 9(commencing wlth Section 7000) of Didslon 3 of the Business and Prolessions Gode) or ihet he or sha is exempt t�eretrom and ihe basis for tha allegad exemption. Any violation af Sedion 7031.5 by eny applicant for a permit subjecis ihe applicent to e civil panalry of not more ihen five hundretl tlollars ($500).): ❑ I, as ownar of tha properry, or my employees wlih wages es �helr sole compensation, WILL DO THE WORK, antl the structure is noi Intended or oNered for sele (Sec. 7044, Business end Prolessions Code: The Contractors License Lew does not apply to an owner of property who bui105 or improves ihareon, and who does such work himself or herselt or ihrough his or her own employees, provitled ihet such improvements ere not Intended or oHeretl for sele. If, however, ihe builtling or Improvement is sold within one year of completion, the owner�builtler will heve Ihe burtlen ot proving thel he or she did not build or improve tor puryose oi sale.). � ❑ 1, as owner of tha properry, am E%CLUSIVELV CON7RACTNG WI7H UCENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Business and Professions Coda: The coniraaors License Law Coes not epply to an owner ol property who bullds or Impmves t�ereon, and who contracts for such project with e contrector(s) license pursuant Io t�e Contraqors License Lews.). ❑ I em exempt under seC. Signe�urB: Owner ID verified by drivers Ilcense. ❑ Ves ❑ No Business entl Professions Code for this reason: Verification af Ownership by (type ot documem, i.e. - pmperry tax blll or deed): DnvefS LiCenSe No. Date: Expires: DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby ceM1lly t�et no excavation tive (5) or more teet in depth into which a pereon is required to descend, will be matle in connection with work euthonzetl by this pertnit, antl that no building structure, swHoltling, felsework, or demolition or dismantling t�ereol, will be more than thirty-sla (36) taet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, T�Ie B, CBIlfomia AOminiSlra�iv8 Cotle). . ❑ As ownerDuiltler, I wlll not employ enyone to do work which would �equire a pertnit irom t�e Division of Industrial Safery, es noted above, unleu such person hes e permit to do such work irom �he division. SignaWre: Date: Division of Intlusirial Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUiHORVATON OF ENTRY: I cehify under penelty ol perjury ihat I have read thls epplication en0 atate Ihat ihe information given is correct. I agree to comply wilh ell state laws end cily ordinances relating to building consiructlon, antl authonze represen�atives of the Ciry ot Costa Mesa to enter upon the above-descnbed property tor inspection purposes. I agrae not to occupy or allow occupency ol eny building authorized by this permit until finel inspection. CODE �. INSPECTIONTYVE 1616 Fixed Sysiem Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final8locWRetalning Well 202 Final Fectory Fire Plece 203 Final Sign 204 Final Demolition 1731q INTRIALg f�,QQEa INSFECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Finel EIetMCel 212 220 222 250 Final Fire Prevention Final Planning Approval Final Site Final Building�0aupancy Date / / �. ueg — Ir�le�fl (714) 754-52i3 • FaX (714) 754-4856 • wW W.Ci.COSta-meSe.Ca.Us 77 FAIR DHNE, COSTA MESA, GA 9'L626 BUILDING PERMIT Job Address: 440 E 19TH ST Suite: Viciniry: ENTRY, KITCHEN, AND PATIO ENCLOSURE AT R Parcel Number. 42631112 Applicant: HEIL, MICHAEL Address: 2721 E QUNICY AV Zoning: - � Phone: 714-9973440 ORANGE, AV � � , Zip: 92867 � Owner. HARTZELL, ANDREW KUTZ Address 440 E 19TH ST � " ' " � Phone: , , COSTA MESA, CA � . Zip: 92627 ��- Contracror: HEIL CONSTRUCTION SERVICES Address: 2727 E QUINCY AV - � Phone: 714-997-3440 � ORANGE;CA . , Zip: 92867- License: 678817 � Arcn : THOMAS BURGER Address: 20331 IRVINE AV . - - STE 7� � Phone: 714-850-0700 SANTA ANA HEIGHTS, CA ZiA� 92707 � � License: 15902 ISSUED BY: eng: DESA STRUCTURAL Address: 4500 CAMPUS DR Slatus: ISSUED Applied: 04/O1/2003 Issued: 03/24/2004 Phone: 949-251-0440 NEWPORTBEACH,CA 92660 � License: 3572 � . ai.�r� vr r��cmi i CONSTRUCT ADDITION OF 13 SF TO THE ENTRY OF AN EXISTING SFD, CONSTRUCT A WALL�IN THE KITCHEN TO ACCOMODATE A WINE COOLER AND RAISE THE STRUCTURAL BEAM FOR A FLUSH BEAM CEILIIJG, RELOCATE BEDROOM #2 WINDOW AT THE REAR TO THE SIDE NEXT TO AN EXISTING WINDOW, AND CONSTRUCT A 465SF LIVING ROOM ( FROM A PREVIOUSLY NONHABITABLE AREA) .(TOTAL 498 SF ADDITION ON PLANS) Plan Chgck: $454.84 Permit: $699.75 SMIP Res: $5.72 SMIP Com: $0.00 � Other: $0.00 Inspection: $0.00 Total: $1,160.31 SETBACKS MAIN STRUCTURE Front 25- 3 ACCESSORY Front 0-0 . . PARKING Existinp: 2 - - FEESUMMARY - Calc Valuation: 55�,2is.ao Claim Valuation: So.00 Rear 4- 3 Rear 0- 0 ..Required: 0 PLANNING& ZONING Lek 5- 0 ' Left 0- 0 Pro�osed: 0 Right .10- 0 , Right 0- 0 ,' � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRATION: 7his permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 1 BO days. , INSPEC7lONS: In order for the work author'rzed under this permit to be considered legal, such work must comply with all applicable codes, and afl requirad inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2adG46 (6I00) WORKERS' COMPENSA710N DECLARATION: � I hereby aNirm under penalty oi perjury one of Ihe following declarations: �heve entl wlll maintain e cehificate of consent to setl-Insure tor workers' compensation, es provided for �y section 3700 of the Lebor Cotle, for Ihe perfortnanca of the work for which Ihis permit is issuetl. have entl will m�ntei�� pensation insura.n� s requiretl hy section 3700 of ihe Labor Code, for the perfortnanca ot the work for which this pertnit is Issued. My worker a enseti i I suran cartler entl pc�'cy number are: Carrier: (7� Policy Number: (This section nee'd nof b completed i/ the eimit is valuetl at one hundred dollars ($100) or less.) ❑ I certify that in the performance of tha work for which this permit is issued, I shall not employ any person in eny manner so as to become subject to the workers' compensetion laws of CalHomie, ndpgree that if I s ou ecome subJect to t�e workers' compensation provisions ot ction 3700 o ihe Labor Cotle, I sha0 forthwith camply with these provisions�jJ/ ' b� �^ �� r (, Applicant Signeture: �� Dete: �� ,___ ~� WARNING: FAILURE TO SEWRE WORKERS' CO NSAiION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE HUNDFE� TFKKISPNDOOLLARE(5100,000),INNDDITIONTO ECOSTOFCOMPENSATION,DAMFGESASPROVIDEDFOqINSECTION3]OfiOFTHEL4BORCODE,IMEREST,ANDATTORNEVSFEES. LICENSED CONTRACTORS DECLARATION: 1 here6y aHirtn that I am licensed undel p�ovisions oF Chapter 9(commencing with Section 7000) of Oivision 3 of the Business and Professions Code, enA my license Is in full force and eHect. Lia u Class N Contractor'sSignaWre: � Date: 'i-1 / � CONSTRUC710N LENDING AGENCY: ❑ I hereby eHirtn that fhere is a wnsiruction lending agency for the peAortnance of ihe work br which this permit is issued. (Sec. 3097, Civil Cotle). Lender'S Name: Lendar's AdAress: SignaNre: OWNER-BUILDER DECLARATONS: Date: I �ereby attirm ihat under penalry of pe�ury that I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Professions Code�. Any ciry or wunty which requires a permit to consinut, alter, improve, tlemolish, or repair eny s\rucWre, prior to its issuance, also requires the applicant tor such permit to file a signed statement that he o� she Is licensetl pursuant to the provisions ol the Contrectors Llcensa Law (Chepter 9(commencing with Sectlon 7000) of Division 3 ot ihe Business end Professions Code) or tha� he or she is eaampt therefrom and the besis br the alleged ezemption. Any violation of Section 7031.5 by eny applicant for e permit sublects the epplicent to a civil penally of not more than tive hundretl dollars ($500).): ❑ I, as owner of ihe properry, or my employees with weges es Iheir sole compensation, WI�L DO THE WORK, and the structure is not intended or offered tor sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves ihereon, antl who does such work himself or hersetl or through his or her own employees, providetl that such improvements ere not intended or oflered for sale. If, however, ihe building or improvemant is sold within one year of completion, the owneo-builder will heve t�e burtlen of pmving ihat he or she did not 6uild or improve for purpose ot sale.). ❑ I, as owner of the property, am EXCLUSIVELV CONTRALTING WITH LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business end Protessions Cotle: The coniraciors Llcensa LAw doas not epply to an owner ot propeny who 6uilds or Improves thereon, antl who contracis tor such project with a contractor(s) license pursuant to Ihe Contrectors License Laws.). ❑ I am exempt under sec. Business and Protessions Code for this reason: Signature: Date: _ Owner ID varified by drivers license. ❑ Yes ❑ No Onvers License No. E:pires: Venfication oi Ownership by (type of do�ument, i.e. - property tez blll or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATON: ❑ I here6y certify thal no ezcavation fi�e (5) or more feet in depth inro which a person is requiretl to dascend, will ta matla ia connection wilh wark auttwrized by this permit, end ihat no building simcture, scaHolding, falsework, or demolition or tlismantling ihereot, will be more ihan ihirry-six (38) tee� high. (Chap. 32, Gry 2, Art 2. Sec. 341, Title 8, Californla Adminisira�ive Code). ❑ As owner-builder. I will not empl0y enyone to tlo work which would require e permit trom the Division oi Intlustnel Satety, as noted ebove, unless such pereon has a pertnit to do such work irom the division. Signature: Date: Division of Industrial Safety Permit Number: CERTIFICATE OF COMPLIANCE AND A�ORVATON OF ENTFiY: I certity under penalry of perjury that I have read this applicetion and state that the information given is correct I egrae to comply with all stata lews and ciry ordinances relating to builtling construction, and authonze representatives of the Ciry of Costa Mesa to enter upon the above-descnbed property for inspection purposes. I agree not to occupy or allow occupancy of any building authonzed by ihis permit until finel inspaction. SignaNra CODE �. INSPECTIONTYPE U� �NfIfI�LS 1616 Fivetl System Final Fire Preve�iion 1266 200 201 Pool Spa Final Final Re-Roof Final BIocWRetaining Well 202 Finai Factory Flre Place 203 Final Sign 204 Final Demolition LODE� INSPECTIONTYVE 206 Final Mechanical 20B Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approva{ 222 Final Site 250 Final Building/Occupancy P6� It�4$ (714) 754-5273 • Fan (714) 754-4856 • www.ci.coste•mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: 4d0 E 19TH ST 42631112 .4pp�icant: BOB GORELIK ELECTRIC Address: 2211 STAR PINE WAY TUSTIN, CA , Owner., HARTZELL, ANDREW KUTZ Address 440 E 19TH ST .' " � COSTA MESA, CA� Contracror. BOB GORELIK ELECTRIC Address: 2211 STAR PINE WAY . ISSUE FEE Temp service test Res. a/c package New Res (1-2 uniLs) New Res (3+units) Pool / Spa Lighting Fixts TUSTIN, CA Phone: 714-665-8766 Zip: 92782 Phone: Zip: 92627 - Phone: 714-665-8766 Zip: 92782 License: 469781 ISSUED BY: Stams: ISSUED Applied: 04I26I2004 Issued: 04/26I2004 SCOPE OF PERMIT CONSTRUCT ADDITION OF 13 SF TO THE ENTRY OF AN EXISTING SFD, CONSTRUCT A WALL IN THE ISITCHEN TO ACCOMODATE A WINE COOLER AND RAISE'fHE STRUCTURAL BEAM FOR A FLUSH BEAM CEILING, RELOCATE BEDROOM #2 WINDOW AT THE REAR TO THE SIDE NEXT TO AN EXISTING WINDOW, AND CONSTRUCT A 485SF LIVING ROOM. REF: B03-00534. ELECTRICAL TO INCLUDE: 46 LIGHT FIXTURES,.35 OUTLETS, 22 SWITCHES, 6 RESIDENTIAL APPLICANCES, 1 SERVICETO 200 AMR . .- Recept OuUets � Switches Non Res Appl � , � Res Appl Service to 200a Service to 7000a Service over 1000a Motors ta ihp Motors to 10hp $23.50 $0.00 $0.00 30.00 $0.00 50.00 540.98 532.95 $23.46 50.00 528.50 $30.50 $0.00 30.00 $0.00 $0.00 Quantity 0 0 0 46 35 22 0 . 6 1 0 0 - 0_. 0 ' - FEE SUMMARY Temp Dist System / Lighting Busway /100, ft , Standing Seclion'. . Misc Electrical Equipment �� ' Transtormers up to 1 kva/kw ........:.......up to 10 kva%kw .................up to 50 kva/kw , . ' .......:.........up to 100 kva/kvi . . ......:..:....:.:.over 100 kva/kw, -�, Low.Voltage Equipment � Low Volt Wving System / Ckt � - Misa Conduit � Misa Conductor � - � Circus ( gen or ride) - Circus (mech ride or light"s)-� _ - Christmas Tree.Stand �� QuaMiry $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 -",Oj� $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 INOTICE: The work authodzed by ihis permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related regulations. (Ord. No. 9248, § 1, 7241•92) �, EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 780 days, or it work is suspended or abantloned '� for a penod of 1 BO days. I , INSPECTIONS: tn order For the work authorized under this permit to be considered legal, such work must comply with all appliCable Codes, and all � required Inapeetiona and }Inal epprovel must be obtained. FaiWre to obtain inspections and final approval will result in tha ezpiration ol this permit. I FOR INSPECTIONS CALI; (714) 754-5626 '', 2C<6i6(NW) i WORKERS'COMPENSATON DECLARATON: � I hereby eifirtn under penalry of perjury one of Ihe tollowing dederaUons:. � ❑ I have antl wili malntein a cenificate of cansent to self-Insure for workers' mmpensation, es provided tor by sectlon 3700 of ihe Lebor Cotle, tor ihe peAortnance oi the rk for which this permi� Is iuuetl. I heve an II intain workers' nsatio i urance, as required by sectlon 3700 0l Ihe Lahor COGe, lor the pertortnance of Ihe work for whlch this pertnit is issuetl. My warke ' ens�tion Ipsy(e carrier number ere: Carder: .t/lJ�l l Policy Number. (ihls section need ot comple ed i! the permUls valuetl ef one hundred OWlers (S 100) or /ess.) ' �� ❑ I cenity Ihat in Iha paAortnence of the work for which this pertnit is issued, I shell not employ any pereon In eny menner so es to become suC�ect to Ihe workero' compensation laws ot Cell a, end egree Ihet II I should be me sub�ect to the waBers' compensetion provlslons ot Sect n 3700 0l Ihe Lebor Code, I shall forthwiih Compty with IheSe pro a� � Applicant SlgnaNre: L_ Dete: WARNINO: FAILUPE TO SECURE W RI(ERS' COMPENSATION COVERAGE IS UNLAW FUL AND SWLLL SUBIECT AN EMPLOVER TO CHIMINAL P NALTIES AN GVII FlNES P TOONE HUNDRED THOUSAND OOLURE (E100,000�, IN ADOITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECiION 3]08 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm that I em Ilcensetl untler proNslons of C�epter 9(commenGng with Sectlon 7000) ot DlNsion 3 of the Buslness antl Prot sslons Cotle, anC my license is In tull lorce entl eHect. LJc. q �J Class q Contractofs Signature: Date: CONSTRUC710N LENDING AGENCY: ❑ I hereby ettirm thel thare Is e constructian lending egency for the peRormance ol ihe work for which ihis permlt is Issued. (Sec. 3097, Civil Cotle). Lender's Nama: Signeture: _ Lender's Address: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirtn thet under penelry ot perjury thet I em EXEMPT FROM THE CONTpACTORS LICENSE LAW tor Ihe Iollawing reeson (Sec. 7031.5, Business anO Protesslons Code: Any ciry or counry which requires e pertnit to construct, elter, improve, tlemollsh, or repair any structure, pdor to its issuance, elso requires the eppliwnt tor such permit to file e signed stetement thet he w she Is licensed pureuent Io Ihe pmvislons of the Contraciore LJcense Lew (Chaptar 9(wmmenGng wIN Section 7000) ot DlNsion 3 ai the Buslness entl Profeuions Cotle) or �hat he or she is e:empt therefrom and Ihe basis lor the allegetl e:emptlon. Any Wolation of Section 7031.5 by any epplicant for a pertnit sub�ects the epplicant to e clvll penelry oi not more then five huntlreO tlollars ($500)J: ❑ I, es owner ot Ihe properry, or my employees with weges es their sole compensellon, WILL DO 7HE WORK, and Ihe siructure Is not Intendad or oHered for sale (Sec. 7044, Business and Professions Coda: The Contrectors License Law does not apply to an axner ot property who builds or improves thereon, and who does such work himsetl or hersetl or Ihrough his or her own employees, provided ihet such improvements ere not intentled or oflered tor sale. If, however, the building or impmvement is sold within one year ol completioq Ihe ownerbuiltler will have ihe burden ot proving that he or she tlitl not build or improve tor purpose of sale.). - ❑ I, es ov.ner oi the properry, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTAAC70R5 to construct the project (Sec. 7044, Business antl Pmfessions Code: The contractors License Law tloes nat appy ro en owner ot pmperry who builds or Imprwes t�ereon, and who contracis far such prqect with a contractor(s) license pursuant to ihe Contractors License Laws.). ❑ I am esempl under sec. Business entl Professions Code for Ihis reeson: Signature: Date: Owner ID venfied 6y drivels lic6nse. ❑ Ve9 ❑ No Dnvefs License No. Vedflcation af Ownership by (rype ol doament, I.e. - property tax bill or tleetl): Expires: DIVISION OF INDUSTRIAL SAFETY VERMR CERTIFICATON: ❑ I hereby certiy Ihet no excevation live (5) or mora feet in depth into which e person ls required to descend, wlll be made in connBction with work euihorizetl by this permit, end that no building strudure, scalloltling, talsework, or tlemditlon or tlismantling thereot, will be more ihen ihirty-six (38) leet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Celifomia Adminislrative Code). ❑ As ownerbuilder, I wlll nat employ enyone to do work which would requlre o permit from ihe Divislon ol Industrial Satety, es notod ebove, unless such person has e permit to do such work trom the division. Signatura: Date: Didslon of Industdal Satery Pertnit Number. CEHTIFlCATE OF COMPLIANCE AND AUfHORQATON OF ENiAV: I ceniy under penalry oi perjury thet I heve read ihis flppllcation en0 state that Ne infortnetfon given is correct. I agree to wmpry witn all stete laws and dry ortlinances relating to builAing wnstruction, enA euthodze representatives ot Ihe Ciry ol Costa Mesa to enter upon the ebove-descnbed property lor inspection purposes. I egree not Io occupy or allow occupency ot eny building euthonzed by this permit until linel inspection. CQOE I. INSPECTIONTYVC 1616 Fixed Sysiem Finel Fire Prevention 1288 Pool Spa Finel 200 Finel Re-Roof 201 Final Black/Retalninp Well 202 Final Factory Fire Place 203 Finel Sign 204 Final Demdllion psg J�$ �Q�f.a INSPECTONTYPE 208 Finel Mechanical 208 Finel Plumbing 210 Final ElettdCel 212 Flnel Flre Prevention 220 222 250 Flnal Plenning Approval Final Slte Flnal Bulltling/Occupency PAIE UII�LS �� ' _i1d �, (714) 754-5273 • Fax (714) 7543856 • www.ci.costa-mesa.ca.us ii rnin univo, wa � r mwr, �r y<o�o MECHANICAL PERMIT Job Address: 440 E 19TH ST Suile No Vicinity: Parcel Number: 42631172 ISSUED BY: Applicanc HEIL, MIKE Address: 3131 LINCOLN WX , , Phone: 949-6973418 CELL COSTA MESA, � -- ', Zip; 92626-2822 ' Owner,' HARTZELL, ANDREW"KUTZ�� ' Address:.' 440 E 19TH�ST> -/,i- - . - � - , . - -. .--i � - � Phone: - ' � COSTAMESA,-CA�--"� Zip: 92627 � . 'Con(racror: HEIL�CONSTRUCTION SERVICES ' ,Address:� 3131.LINCOLNWY - ,: . ' , Phone: 949-697-3418 CELL � . COSTA MESA, ' Zip: 92626-2822 , . . . , , . �. � License: 678817 � . . � . . � " �'. . � Status: ISSUED Applied: 03/03/2006 Issued: 03/03/2006 � � -� � ''�� . �' ��SCOPE OF PERMIT �� CONSTRUCT ADDITION OF 13 SF TO THE ENTRY OF AN EXISTING SFD, CONSTRUCT P, WALL IN THE KITCHEN TO ACCOMODATE A WINE COOLER AND RAISE THE STRUCTURAL BEAM FOR A � FLUSH BEAM CEILING, RELOCATE BEDROOM #2 WINDOW AT THE REAR TO THE SIDE NEXT TO AN EXISTING WINDOW, AND CONSTRUCT A 485SF LIVING ROOM ( FROM A'PREVIOUSLY � NONHABITABLE AREA) .(TOTAL 498 SF ADDITION ON PLANS) � REF: B03-00534- - -y . �� _ _. . . , _ % � � �I� -� �� 7 FACTORY FIREPL"ACE, 1 HOOD W/MECH EXHAUST � -"" ' FEE SUMMARY � � - _ �Quantiry. _ � __ _ _ � � � - , _ � � ' Quantiry ISSUE FEE $23.50 �- �� - - . Repair / Alt Absorbtion Unit $0.00 0 Inst�FAU <100 k BTU $0.00 0 Repair / Alt Refrigeretion Unit . $0.00 0- Inst FAU.>100 k BTU $0.00 0 Ventillalion System '� $0.00 0 Repair/Alt Cooling/Heat $0.00 0 EvaporativeCooler , $0.00 0 Inst I Rep. Recess Wall Hlr , $0.00 0 �Commercial Incinerator , 80.00 0 Refrig�Sys <100 k BTU '. :- $0.00 0 .. Domestic Incinerator " $0.00 0 Refrig Sys >100 k BTU 50.00 0 � ' � Compressors / Absomtion Svstems Gas Piping $0.00 0 � � - �� Up l0 3 hp / 100 k BTU $0.00 0 Fac[ory Fireplace - . ,$10.65 1 � � 3 To 75 hp / 500 k BTU , $0.00 0 Hood w/Mech Exhaust � �' :- $10.65�-._.1,, '.�� " - , " 15 To 30 hp / t,000:k BTU � $0.00 0 VAV Box ` :� -. i; � ��;$0.00 , 0 �� .. ' `� - , 30 To 50 hp / 1,750 k BTU ' � $0.00 0 Vent Fan / Single Duct �� $0,00, �� 0 �, , - - ,;;Over 50 hp / Over 1,750 BTU �. � -� $0.00 0 Appliance ��.�� :�� . $0.00_,�0� .'. � - Boilers , Fire Dampers V �- �� - � i $0.00 0,=-" � . - " - � Up to 3 hp � � � $0.00 0 Smoke Dampers `, � � - ' $0.00, 0 _ " _ , � - 3 To 15 hp � • - � $0.00 0 Inst or Relocate Appl Vent � �� _ � .$0=00 ; 0 - ; -- � 15 to 30 hp - $0.00 0 Air Handlers < 10000cfm ��,� $0.00� i Q;� 30 to 50 hp � $0.00 0 Air Handlers > t 0000cfm ' - ��.� $0.00, 0 . _ . Over 50 hp , . � . , $0.00 0 Floor Fumace '.$0.00 y 0. ,� �� Other Mechanical Fee Floor or Suspend Heater �� $Oi00; - 0, �� _ �, � Indestigation Fee , � $0.00 � - _ ' - Plan Check Fee � $0.00 - � Reinspedion Fee $0.00 TOTAL CALCULATED FEES 544.80 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized undar this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetiona and tlnal epproval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of ihis permi� FOR INSPECTIONS CALL: (714) 7545626 244666 (flb0) WORKERS' COMPENSATION DECLARATION: — I hereby aHirm under penalty of perjury one of the �ollowing tleclarations: ❑ I heve end will malnWin a certificate of consent to self�lnsure for workers' compensation, as provitled for by section 3700 of iha Labor Code, for the pedormance of the work for which this pertnit is issuetl. � 1 have antl witl maintain workers' compensation insurance, as requirad by section 3700 of the Labor Code, for tha pertortnance of the work for which Ihis pe(mit is issued. My workers' c mpensation�lnsur nce cartier and pollcy number are: �� S�}� �,�,.� �� a� a�: Otx/6 -o/y222-2ov6 __.__.�-----,_._.:,.�----.:_.._,._, . _,__.,_.. ._.__. ❑ I certify that in the pertormance of the work tor which this permit is issued, I shall not employ eny person in any manner so as to becoma subject to the workers' com1 pe [sation laws of Calii��e h��become subject to t�e workers' compensation provisions of Section 3700 oi the Lebor Code, I shall forthwith comply with Ihese provisi s �-7 sv A�picantSi Qtur. pa'�jp�,� ) �-`-�j RNING:FAILORETOSECUREWOKERS' NSATIONCOVERAGEISUNIAWFULANDSHALLSU&IECTANEMPLOYERTOCRIMINALPENALTIE$ANDCIVILFINESUPTOONEHUNORED THOUSAND DOLLApE ($100,000), IN ADDITION TO THE COST OF CAMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 3]O60F THE tABOR CODE, INTEREST, AND ATTOflNEV'S FEES. LICENSEU CONTRACTORS DECLARATION: I ha�eby aNirm that I am license/d� u e(r�p�roVvisions of C�apter 9(commencing wilh Section 7000) of Division 3 of Business an� iote3ions Code, antl my licertse is in full forGe antl ettect. ic. F'1 �-T (1( � _ - � C S COnir 9rt 1DTe� � �� ^ } 'C�fi CONSTRUC710N LENDING AGENCY: ❑ I hereby eHirm thal there is a consiruction lentling agency tor Ihe pedormance oi lhe work tor which this permil is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: SignaWre: Date: OWNER•BUILDER DECLARA710NS: I hereby aHirtn that untler penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Protessions Code: Any ciry or counry which requires a permit to construct, elter, improve, tlemolish, or repair any strucWre, pnor to its issuanca, also requires the appliwnt tor such permil b t0e a signed statement �hat he or she is licensed pursuant to Ihe provisions of ihe Conirector5 License Law (Chepter 9(commencing wit� Section 7000) of Division 3 of Ihe Business and Pro�essions Code) or Ihat ha or she is exempt theretrom and the besis for the elleged e:emption. Any violation oi Section 7031.5 by any applicant for a permit subjects Ihe applicen� to e civil penalry of not more ihan five hundred tlollars ($500).): ❑ I, as owne� ot ihe property, or my employees with weges as Ihair sole compensation, WILL DO THE WORK, and iha structure Is not intended or oNered tor sale (Sec. 7044, Business and ProFessions Code: The Contractors License Law does not apply �o an owner of propeny who builds or improves thereon, antl who does such work himsetl or herself or through his or her own employees, provided ihet such improvemenis are not intended or oHered for sale. If, however, Ihe builtling or improvement is sold within ona year of completion, ihe ownervbuilder will ha�e ihe burden of proving that he or she did not builtl or improve tor purpose of sale.). � ❑ I, as owner of the property, am E%CLUSIVELY CONTRACnNG WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Protessions Code: The contractors Ucease �aw does not apply to an owner ot pmperty who �uiltls or Improves theraoo, antl wtw contracts br such project with a contrector(s) licensa pursuent to the Contrectors License Laws.). ❑ I am exempt under sec. SigOaNre: Ownar ID varifietl by dnvers license. ❑ Ves ❑ No Business antl Professions Code br this reason: Veriiication ot Ownerehip by (type of tlxument, i.e. - proparty tax hifl or daetl)�. Drivers License No. Date: Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CER7IFICATION: ❑ I hereby certity that no excavation five (5) or more fael in depth into which a person is required to descentl, will be made in conneciion with work authodzed by this permit, antl ihat no builtling SlrucNre, scattoltling, telsework, or demolition or tlismantling Ihereot, will be more Ihen thirty-5ix (36) feet �igh. (Chap. 32, Gry 2. An 2, Sec. 341, Ttle B, Califomia Adminis�ra�ive Code). ❑ As owner�Duilder, I will not employ anyone to do work which would require a permit trom Ihe Division of Indusirial Safery, as noted a6ove, unless suc� person has a permit to tlo 5uch work from the division. Signature: Date: Division of Intlusirial Safery Permit Number: CER7IFlCATE OF COMPLJANCE AND AllT}iORIZATON OF ENfRY: I certity under penalry of perjury that I have read ihis app�ication and state that the information given is I corre�. � agree to compYy with all state laws snd ciry ortlinances �efating to builtling constmction, and auttwrixe reprase�tativas ot the Giry ot Gosta Mese to enter upon Ne 1 above-described property for inspection puryoses. I egree not to occupy or allow occupancy of eny building authorized by Ihis permit until final inspection. I CO�E t. INSPECTION'[YPS ' PdIE INTRIALS 1616 FixaO System Final Fire P�evention 1266 200 201 202 203 204 Pool Spa Final Final Re-Roof Finel BIocWRetaining Wall Finel Facrory Fire Place Final Sign Final Dem0lition 206 Final Mecnanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final S%e 250 Final BuildinyOccupancy .�-1�-06 � ,, ., , �-��, � - , a ,. „ ..� _�� - ......._..___._ ...--- -- - Job Address: 440 E 19TH ST Suite No Vicinity: � 1 Parcel Nunmber: 426�1172 Applicant: MUILENBERG, LEE Address: 6840 ORANGETHORPE AV BUENA PARK, CA PLUMBING PERMIT Phone: 714-994-8700 Zip: 90620 Owner: HARTZELL, ANDREW KUTZ Adiiress 440 E 19TH ST Phone: " COSTA MESA, CA Zip: 92627 Contractor: KCB PLUMBING CONTRACTORS Address: 6840 ORANGETHORPE AV Arch / Eng : Address: BU�NA PARK, CA Phone: 714-994-6700 Zip: 90620 License: 604044 : . .- _� ' Phone: Zip: - . - License: �" Status: ISSUED Applied: 04/16/2004 Issued: 04/76/2004 ISSUED BY: SCOPE OF PERMIT REF; B03-00534. CONSTRUCT ADDITION OF 13 SF TO THE ENTRY OF AN EXISTING SFD, CONSTRUCT A WALL IN THE KITCHEN TO ACCOMODATE A WINE COOLER AND RAISE THE STRUCTURAL BEqM FOR A FLUSH BEAM CEILING, RELOCATE BEDROOM #2 WINDOW AT THE REAR TO THE SIDE NEXT TO AN EXISTING WINDOW, AND CONSTRUCT A 485SF LIVING ROOM ( FROM A PREVIOUSLY NONHABITABLE AREA) .(TOTAL 498 SF ADDITION ON PLANS)- " P�UMBING TO INCLUDE: 1 ICE CONNECT, 1 GAS (1-4 OUTLETS), 1 KITCHEN SINK, 1 HOSE BIB, 1 WATER HEATER, 1 HOT WATER RECIRCULATING SYSTEM AND PUMP, 1 SEWER CONNECT (PRIVATE LINE)" � � � � � AMT ISSUE FEE $23.50 Backtlow irrigation $0.00 Backflow Preventer $0.00 Bathtub $0.00 Clarifier Syslem 50.00 Connecl (Ice,Soda,etc) 59.80 FEE SUMMARY QTY . AMT QTY LaundryTub/Washer . 50.00 0 0 Landscape Irngation � 50.00 0 0 ' P-Trap . , � $0.00 ` �0 0 � � Pressure Regulator� �� $0.00 0 0 Process Piping (per 10 ft) 50.00 0 1 Receptors - 50.00 0 SumpPump Swimming Pool Trap Primer Urinal -- � Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) AMT QTY 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 NO710E: The work authoiized by this permit shall compty with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 7, 12-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned tor a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspections and flnal approval must be ob�ained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaa6�a5lsiool WORKERS' COMPENSA710N DECLARA710N: I hereby aflirm under penalry of perjury one of the tollowing declerelions: ❑ I have and will maintain e certiFicate of consent to self-Insure tor warkers' compensation, es provided tor by secllon 3700 0l Ihe LaDor Cotle, lor the pertormence ol lhe work tor which ihis permit is issuetl. ❑ I have and will malntain workers' compensaI{�n Insurence, es requiretl by section 3700 of the Labor Code, for Ihe pertortnance ot fhe work lor whiU this pertnit Ls issued. My workers' w�pery4atloryir�urance ca� eytl9olicy number are: Certier. one Poliry NumDer: or less.) cenity ihat in Ihe pertormance of the worK �o� w ilfi7i�his pertnit is issuad, I shall not employ any person in eny manner so es m became sublact to ihe workers' compensatlon laws oi alifomia, and egrea that if I s ould become sub�act to the workers' compensation provisions of Section 3700 of the Labor Cotle,�I s�jell ionhwith comply wit� Ihese p sions. /ry��y/�� ,` /� ^ (� Applicent Signature: �/ i' IL �� Date: �� y r O �\ � WAPNING: FAILURE TO SE RE WORKERS' CC PENSATION COVERAG 5 UNUWFUL AND SHFLL SU&IECT AN EMMOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOO EN HUNDRED hKKISAND DOLLAFE (5100,000). IN q�DfTION TO TME C06T OF G1�MPENS�TION. DMUGES AS PilOVIUED FOR IN SEGTION 3]Ofi OF THE LABOF CODE, INTEPEST, AND ATTORNEI^5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn tha� I em lice ed under pm� torce antl eHect. Lic. x� Cantracbr's SignaWre: with Section 7000) oi Division 3 of the Business and Professions Cotle, end my license is in tull Class a Date: _ . �( „ /\ CONSTRUCTION LENDING AGENCV: " ❑ I hereby aHirtn that t�ere is a consiruction lending agency toi Ihe peAormance of the work for which t�is permit is issuetl. (Sec. 3097, Civil Catle). Lenders Name: Signature: _ lendar's Address: Date: OWNER•BUILDER DECLARATIONS: I hereby aHirtn that untler penalry of perjury ihat I am EXEMPT FROM THE CONTFiACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business antl Profassions Cotle: Any ciry or wunty whic� requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires Ihe epplicant tor suc� pertnit to lila a signed statement thet he or she Is licensed pureuam to t�e provislons ot the Conirectors License Law (Chepter 9(commencing with Sectlon 7000) of DiWsion 3 of ihe Business entl Prolesslons Code) or ihat he or sda is axempt thereirom and the basis for the elleged exemption. Any violation of Section 7031.5 by any ep0licent for e pertnit subjacis tha applicent to e civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner ol the propeny, or my employe�s with wages as Iheir sole compensatlon, WILL DO THE WORK, enOlhe structure is not Intendetl or oNered for sale (Sec. 7044, Business entl Professions Cotle: Th� Contractors License Law does not apply to en owner of proparty who builds or improves ihereon, antl who does such wo�k himself or herseN or �hrough his or her own employees, provitletl that such impmvemants ere noI intended or oHered lor sale. If, howaver, the building or improvemant is sold wiMin one year of compfetioq the ownar-buiVdar will have the burtlen of proving ihat he or she did noi build or improve tor purpose oi seleJ. ❑ I, es owner of Ihe proparty, am E%CWSIVEIY CONTRACTNG WI7H LICENSED CONTRAC70RS to consiruct Ihe projact (Sec. 70a4, Business and Professions Code: The coniractors Ucense Lew does not eppty to an owner ol proDerty who bulltls or impmves thereon, end who contracts for such pmject wlih a contrector(s) license pursuent to ihe Conlracbrs Licensb L.ews.). ❑ I am exempt under sec. Business and Protessions Code for this reason: Signeture: Date: Owner ID verifietl by driver's license. ❑ YeS ❑ No Driver's License No. Veriflcelion oi Ownership by (type ot document, i.e. - property tas blll or deed): DIVISION OF INDUSTRIAL SAFETY VERMIT CERTIFICATION: Expires: ❑ I hereby cetlify Ihet no ezcavation live (5) or more feet in depih into which e person is required to descend, will be metle in connec�ion with work euthonzed by �his pertnit, and ihet no building siructure, scattolding, falsework, or demolition or dismantling I�ereol, will Ge more t�an thirty-si: (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttla 8, Celifomia Adminisiretive Code). ❑ As ownar��uilder, I will noi employ enyone to tlo work whlch would require a pertnit irom ihe Division of Indusirial Salety, as notetl above, unless such person has a pertnit to do such work fram the division. Signatura: Date: Division ot Induslnal Setery Pertnit Number. CERTIFlCATE OF COMPLIANCE AND AUiHORW710N OF ENTRY: I cehity under penalry of perjury that I have read this epplication ana state that the informetlon give� is correct. I agree to comply with ell state laws end ciry ordinances relating to building consWction, and authonze representatives ot the Ciry oi Costa Mesa to enter upon the above-descnbed property for inspection purposes� I egree not to occupy or allow occupancy of any building autharized by Ihis pertnit until tinel inspection. [�I77l1�CF17i3�i.P.i�79i 1676 Fized System Final Fire Prevention 1266 Poal Spe Finel 200 Final Re-Root 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition 17�i�inr�u.�� COOE� INSPECTIONTYPE 206 Final Mechaniwl 20B Final Plumbing 210 Final EleCttlCal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Oaupancy PAg IIiIl�LS ✓. ._i r • �\ ' CITY � COSTA LIVI�S/� 'Project Addr,esYJ�� ' I Appli=ant's Mailing qddress /'_ i... i RMIT Applicant to fill in ail spaeei excepl Ihose within heavy DorEe� Iines anC sign all aDG�oO��ate Eeelarations. btddress " � " -' � ,. : Arch/Eng. C�� 50~ � License No. 0O `—. aee,e�s �S'[J A� -Ee( a s�i'Ee /8' OraK,� C,ar�� 9(��6�67" Convactor's Nam � � PhoneVLTuL4�? Addreu (mailing) � � .. " � Ciry License No. LICENSED CONTRqCTOR DECLA0.ATION � ' I hereDy aftirm Iha[ 1 am Iicen5e0 untler provi5lon5 Of Charter 9(commentlng � wltM1 Sec[ion ]000) of Dlvislon 3 Ot the Busine55 antl Profession5 Gotle, antl my license Is in fuil fprce antl eftect. License CIasS li¢¢nso No. '� Date Signature � WORKERS'COMPENSATION DECLARATION , �reby aHirm that 1 nave a certlficate oi consent to self-insure or a certificate /orkers' Compeqyytion InSurance, o� a cert(fietl copy thereof (Sectioh J, Lab. CJ � 'i Policy No. ComOany eCe•tifietl mpy is qyreby furnishetl. -�. .' Certiiletl mpy is fi�etl witM1 tne city Builtlin9 Oivision. ,¢ _'� Date Applicant EXEMPTION FROM WORKERS' COMPENSHTION DECLARATION '�.. (This seciion neetl m[ be complotetl ii the permt[ is for one huntlretl ($100) or lezs). i"•, '� 1 certi/y [hat in the perfoYmance ot th¢ wo�k tor Which this pe�m�t i5�issuetl; 1. snall not employ any persOn in any man er So as t become su ect to tne Worker o pe n Laws of Californ �^, Date Signature NOTI E: Ii, afte� n dkjng thi5 tlecla�atiOn, yo shoultl become subjeCt to the Wo�kers' Comp¢n5ation prOvislon5 Of [h� bor Cotle, you must forthwlth comply with suc� prOvfsions or t�Is pe�mit'shall Ge tleGmed �evoketl. CONSTRUCTION LENDING AGENCV �. I hereby affirm that Ihere is a conitruction lentling agency (or the peAorman<e ol tne work for .y,�hich �thiz permit is issuetl (Section 309]JCiv. CJ Lentler's Name Lentler's HtlEress ' - � � OWNER BUILDER pECLARATION I hereby aHirm thai ��'am exempt from the Contractor's License'CSw tor lhe following reason (Sectlon 7031.5 Buslne55 anG Prote55ional Cotle: Any city or county whicn requiry5.a pe�mit to conSVuct, alter, improve, tlemolish or �epair any structure, orior tb Rs issuance, also requires the applicant for such permit � m tiie a siqnetl statement tbat neisne is licensetl pursuanl to [he provlsions of 'llvl5ion 3 of [ne tluslness antl Nrotessions coae) or mac na/sne i ze nyi vefrom anC the basi5 for ttte allegetl ezemPtion. Any vlolabon of Section 31.5 by any apbliCanl tor a pe�mit 5ubject5 tlte aOPlitant t0 a civil :nalty of not more than tive huntlretl tlollars (E500). ❑ I, as owner oi the'property or my employees with wages as their sole compensation, will tlo the work, antl the structure is nof in[entletl or offereq for sale ($ection 7044, Buziness antl Professional Cotle: The Con[ractor'S LiCGnse ldw tloes nOt apply to dn own¢r of a prope�ty who builtls or im0/oves thereon, antl who Qoes such work himseli/herself or through his or ner own employees, provitleq that such improvements are not Intentl¢tl or offeretl for . sal¢. It, howev¢q [he builCin9 or Improvemeni is soltl withln one year ot com- pletlon, tne owner Wil1 have the burtlen of proving ne/she tlitl not builtl or Im- prove for lM1e purpoSe of sale). ❑ I, as owner of the property, am exclusively coniractiny with licensed con- VaCtorS to construct �he prolect (Sectlon 7044, Business antl Professions Cotlef The Contractor's Lfcense Law does not apply to an owner of property who builtls or improves thereon. antl wno contracts tor such projects with a con- tractoi�s) ucense pUnuant to the Contractor's �icense Law). I am aware tha( root ol tneir Worker's Com en � surance should be rovl0etl to me. �1 am exempt untl¢r Sectfon—o�� B. & P. CP(or tnis �eason Date /L—/—,�' /_ Owner . I hereby certify that I have reaa inlormatlon iz correcL 1 agree to C antl state laws relating to builtling sentatives of t�is ciiv to enter inspection pur ses. Signature Drivers' LICA(ise SS CMF 0865-46, �ev. 10/84 iOnetl P�operty tor Dai� �-��i �� TVPEOFCONSTRUCTION NEW ADD ALTERATION ❑ REPAIR ULI�" ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# �'�jl _ 12 ,DESCRIPTION F WO K/USE OF BLDG. � �^ — • ��O S' Main Buildin9� 1 �V E TVPE OF PERMIT GRA�ING OUNDATION STRUGTURAL T Front .O TENANT ELECTRICAL PLUMBING ❑ MECHANIGAL g R ' ❑ OTHER PROJEC7 DESCRIP710N CONSTRUCTION 7V RcmarW: ,{ Preventer Irrigation ClariFlers Dishwasher , Drinking Fountains Floor Drains Floor'Sinks GasService Outl Interceptors ' Kitchen Sink LavatoFie"s P—Trap . ' rM Roof 6]feins . '� ,- , Reinspection Fae A ear C Right 'T. �Z OCCUPANCV � vAIUATION 5 27� % �-C7 �� $ Left GRADING CV. VDS. ACRES Ping. Ref. # _Qr%, Planning Notes: $15 Boiler Dun - Under Ground Duct - Svuctural Duct � Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting � ❑ 0. 7 00,000 BTU O 100,000 BT'� � �_� �� ' I Reinspection Fee WM1ite - Builtling; Canary - qpplicant; Pink - Acwunling; Goltlenrotl - ASSessor $15 1 Showers Service Sink Sewer Cap Sewer COnnection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Cbset Water Heater Water Service � _ Auto-Wash Issue Fee Hood or Typel ❑ Canopy Type II ❑ Refrigeration Sys[em ❑6100,000 BTU ❑700,000 BT System Repair/Alteration Fire Dampers Registers Issue Fee FEES $ 3 $ 3 Automatic Washer Construction Pole Sub. Cookin9 Unit Dishwasher Dryers ❑Gas ❑Electric� Fan F.A. U. Switches Garbage Disposal Generator.�0-5 KW Fee DEVELOPMENTSER Zoning APProvad BY _ Building Approvetl By � '�j � i � ZonO Building: Z 0 ........ N I N G p �Req./Provided E � M � T S ELEC7RICAL ' Transformer �� 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over-100amps Sub Panel ' Motors �0-1 HP �1'f.-8 Inc.Solar �9-15 HP �1fi- Microwave Pole Light Standing Sections 5-75 KW Tiash Compacmr 5Mo t $15 Issue Fee SUMMAtR�V OF FEES' BUILDING PERMIT $ �1 �,q� •G'�Y�J SMIP PLAN CHECK 5 � PERMIT PLUMBING $ OD �SSUANCE PLAN CHECK 25% 3 2• %S ENERGV P.C. ELECTRICAL $ SC•i�% GRADWG PLANCHECK 50% $� 2•bO MICROFILM MECHANICAL $ TOTA� FEE PLAN CHECK 25% $ � FEES 7 $ 3 $ $ $ $ s 333, -CONSTRUCTION AND PLANNING � ' �� POOL & SPA APPROVALS �-Permit# Date Inspector qppROVALS Pe it# ' Date Inspector 7! Temporary Electrical"�Ser'vice or Pole ' � 52. Pool & Equipme Location � �..� 2. Soil Pipe-Undrgrnd. %�--- 53. Steel Reinforcement -. ' 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical ConduiT-Undrgmd. 55. Electrical Bonding -' 5. Steel Reinforcement!., - 56. Rough Plumbing & Pressure Test . 6. Electrical UFER Gmd.'.�. 57. APPROVAL TO COVER-GLINITE � 7. FUotings �! � 58. Electrical Conduit-Undrgind: 8. Foundation�''•-'� '.i-. 59. Gas Pipe, O Undrgrnd., Test ' � 9. Water Pipe-Undrgrnd. �� '�;�0 60. Backwash Lines, P-Trap,`L7.Undrgrnd. 10. Struciural Floor 5ystem;/'' -'� 61. APPROVALTO DECK � � 11. PropertY Sewer Line�&"House'Connection, 62. Backwash & Receptor-Final ' - 12. Sewer Cap 63. Heater & Vent-Final ''�'� . ': 13. Roof Drains 64. Plumbing System - Final � - 74. RoughPlumbing rff 65. Electrical-Final . . ' _ 15. Rough Elec[rical-Conduit 66. Solar System-Final � 16. Rough Electric W�ring B-�-s� F, 67. Fencing & Access Approval � ' 17. Rough Wiring Sign , �� 68. APPROUED FOR PLASTERING 18. Rough Electrical-7 Bar Ceiling , 69. POOUSPA SYSTEMS FINAL r' 19. Rough Heating & Air Conditioning � FIRE DEPT. REO.UIREMENT �, ' 20. Rough Factory Fireplace � . APPROVALS Permit # _ � � 21. DuCts, in Structure 70. Underground Hydro ' 22. Ducts, Ventilating 77. Product Piping OGas ❑Oil ��' J 23. Gas Pipe-Rough & 7est 72. Underground Flush ' •, �i 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil �� 25. Roof Sheathing 74. Overhead Hydro . 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � ' 27. Frame and Flashing L �+ _ 76. Dry Sta,dpipe , �� i� 28. Lathing & Siding L 77. FIXED SYSTEM FINAL • i;�', ._ 29. Insulation 78. FIRE PREV. FINAL ; 30. Drywall Nailing j/ HEALTH DEPT. REQUIREMENT i�� 31. Plaster Brown Coat 79. FINAL INSPECTION � f _. - 32. Electrical Power Meter-Final . FOOD CERTIFICATE ISSUED ' `� � .� �• 33.FinalElectric " �� 5� C{�dcFC /�/�f I c�1�" �,"�,� " 34. Final Heating & A�r Conditioning 8 C'� �ST�� n / 'C`F. l.G.�CIr . � • � 35. Final Gas Pipe-Test • - •- � � i 36. Hood or Canopy G1 .a ' G 1 37. Final Factory Fireplace � , 38. Final Plumbing � � �� . . 39. Water Service-Final . 40. Gas Service-Final - � 41. Solar pomesticFinal � �. - r 42. Backflow Preventer �� , 43. Backflow Irrigation • . ' 44. Landscape�l�iigation System ' 45. Sound Atfenuation � . ' 46. Handicap Regulations .. i ' 47. FINAL STRUCTURE & BUILDING a /' � � � 48. Special Requirements Completed ' ' 49 � Electric Release to Edison • . ' , fl 50. Gas Release to Southern Califomia Gas Co ' - - , ., � 51. CERTIFICATE OF OCCUPANCY � , • No. Date : . ADP�iean� �o fill in all spaces ezeCpl those wit�in �eavY bortler Iines anC si9n ail aocrooriate tleclarations. CITY OF�03TA MES//A CONSTRUCTION /P+ER�yMIT / ProjectAddruss ��'("� EA51 �RrN o(OSG�/L��CSbLM ApplicanYsMailin Address �n�A�-5T I'(��I..OS�a [5�4Z-.�� Owner'sNam ��a�^K2�'�X0.Y�/'11'CxtONphone�qG� Adqreu ��5� �9� ��i'Spt��n) �fS0.��—��— Arch/Eng. � Cifense ' o BU j eip r Adqress Contractor'sName D'�/�eC-.�✓��d2tr Phone-7�%ZZ&SZb' Adqress (mailing� �T � �'� � /T� � �Stl� �+5�� 2 Ciry License No. LICENSED CONTRACTOR OECLARATION I he�eby alfi�m Ihal I am IlcCnsetl untle� O�oviSiOnS'ot Cha�tC/ 9(commencin9 �+��h section 7000) of Dlvision 3 of the Business antl Profe55ions Cotle, antl my license is in full torce antl effect. LicQnse Class ' l.icense No. Datc Signature WOqKERS' COM7ENSATION`DECLARATION I nereby atfirm that I have.a certititate of consent to zelt-Insure or a certHicate ' Workers' Compensation fnswance, or a certitietl copY [hereot (Sectlon .00, Lab. CJ ( • ., ��cy No. COmOany 8 Certifietl cOpy is hereby, (urnishetl. ' Cer ifie copy Is tiletl•With Ihe city BuilEing Oivision. Date_ '� APPlteant E%pMPT10N FROM WORKERS' COMPENSATION DECLARATION (Thisseclion n¢eG no[ be�cOmpleletl if the parmil IS for ona hupd�etl (E100) or less), ' p . � �• I certity tnat in the pertormance of the work /or whlch this oerm�t Is Issuetl, I 5ha11 noI emPloy any 0¢rson in any mannC� so d5 to becoma subjec lo the workers' C pensy�1 n Lawi ot Califomla. � . Date =1 '�T'-d � Signature �� - • ,u �� NOTICE: It, after making this tleclaration, You �oultl become subject to tha Workers' Compensalion provlslons of the or Cotle, you mu5t forthwith cort�ply with suGh �p�ovi5ion5 or tnis parmil snall be tleemetl �evoketl. CONSTRUCTION LEN�ING AGENCV 1 hareby afflrm that lnere IS a conit�uction lentlin9 agency for the pertOrmdnce of the work for whicn thls vermit Is Issuea (SecUon 309] Civ. C.) L.entl¢r'S Namo �• La�tler's Atltl�¢ss OWNER BUItOEN �ECLARATION I 4areby affirm that �I am oxOmpt irOm tho Contrdclor'S Llcense Law br Ihe t011owing reasOn (Section ]031.5 Buzln¢5z antl PrOtesilOnal COtle: Any clly or countv wblch requi�es a DMmil to con5truct, dlt¢�, improve, tl¢moll5h o� rCpai� �hAretwm antl tn¢ ba5i5 10� lh0 alle9etl exorOp[IOn. AnY NOiation o� pocuon �31.5 by any applicant for a permit zubjects lne applicant to a civll �pally ot nol Tore than fiv¢ huntl�etl t1011a�s ($500). � 1, as owner ot the property or my emploYees wlth wages as thoir sole Coippensdtion, will Oo thC work, antl lhe St�uclure is not IntNntleA or O�foretl IOY sal8 (S�ctiOn 7044, Bu5Ine55 antl PfolBisional Cotle: The ContfaCtOr's Lic¢nse law tloe5 noI dpply to an owne� O/ a prOpetty who bulltls or Improves Ih¢reon. antl who tloes sutM1 work IJmsalf/haR¢H ot thrOu9h his or hOr own erp0loyoe5, ProviOetl Ihat such ImproveTents are not Intentle0 or oHeretl tor 5DI<. !1, however, the bulldln9 or Improvom¢nt IS Soltl wlthin One yea� of com- P�etlon, the owner will have tho burtl2n Ot PrOvlpg h¢/She tlitl not builtl o� im- prove for tno purpose of sale�. ❑ I, as ownC� oi the proDerty, am e%clusivety Conttactlng wi[h licenietl Con- VBctotS to con5truct the prOject (SeGtion 7044, Busine55 antl ProteS51on5 Cotla: The Contra<torY Licenu Law aoes not applY to an owner o� o�ooerty who bUiltls or Impwvez tnemOn, antl who contract5 for suG� Proj¢ct5 with a con- trbct r(z licanse pursuant to tne Contractar's License Law). 1 am awa�a that � t o� lheir Wo�ker'S Compen tio insuranc¢ Shoultl b¢ prOvitled [o me. I am exempt untler Sectlon��y�v 8. & P. C. for this reason Ddl¢ ��'�`.�" '66 Owner I hereby certity tnat I have reaE intormation IS correct. 1 agree to a antl state laws relating to bull�in� sen�atives oi tnis city to enter Signature �(Q�dL Drivers' LIce05e OrS: CMF b865-46, rev. 10/Ba Date� �'a0 � �S 3 Z3 0 0 �. �z� VPE OF CONSTRUCTION NE� - � CONVERSION d DEMOLISH DESCAIPTION OF WORK/USE OF B ADD LJ ALTERATION LJ REPAI TVPE OF PERMIT- L-I GRADING LJ FOVNDATION LU�STRUCTURAL ❑.T.�ENANT ❑ E/LECTRICAL ❑ PLUMBING ❑ NJE HANICA� �O OTHER / R-PO -�IC�'I'Q ( dU�P PROJECT DESCRIPTI N 50. Fr. OCCUaarvCv �rCONSTRUCTION TYPE VALUATION 5 ZONE GRADINGCU.VDS. ACRfS Y � Prevenrer Irrigation rinking Fountains loor Dra7ns loor Sinks 85$CIVICE ��UtICLS ..n.ru..m.e / _ ' l Kitchen Sink � Lavatories P-Trap� " ' ' Rooi Drains Reinspaction Fee $15 Boiler Duct� UntlerGround Duct - Svuctural Duct � Ventilating Exha`ust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Hea[ing System & Duciing ❑a � oo,000 s ru O i oo,oao ar Reinspec[ion Fee � $15 White - Builtling; Canary - Appllcant; Pjnk - AGcounting; GOIOen�otl - ASS¢550� NG Servite Sink Sewer Cap Sewer Connection Solar Collectors Solnr Pipin9 Solar Tank Swimming Pool w/Spa Urinal W2l¢f CIOSEL Water Hea[er Water Service Trays Isue Fee Hoodor Typel ❑ Canopy Type I I ❑ Refrigeration System ❑aioo,000aru ❑ioo,000 System Fiepair/Alteration Fire Dampers Registers Issue Fee FEES S 3 FEES S3 A.P. aW S Main Buildi E T Front '�' 0 Rear A C Right K Left S Ping. Re(. # Planning Notes: 5632 2/24/P.' -�,'� � 3�� '� Zone Actessory Building: �� 4�/'4 e.. Parking Req./Provided Automatic Washer Construction Pole Sub, Cooking Unit Dishwasher Dryers ❑Gas ❑Elec F.A.U. Fixlures Device Boxes �U112L5 Switches Garba9e Disposal Generator �0.5 KW Fee ELECTRICAL Transformer ❑ 15�50 KW ❑ 50+KW Meter ❑up to 100 amps Merer ❑over700amps Sub Panel Motors O0.1 HP O1 Y. - 8 Inc. Solar �9-15 HP 016�15+ Microwave �Standing Sections i KW Trash Compactor � ..l . . $15 Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By BuildinB Approved By ��i BUILDING PERM17 $ PLAN CHECK $ PLUMBING $ PLAN CHECK 25% S ELECTftICAL $ PLAN CHECK 5096 $ MECHANICAL 5 PLAN CHECK 25% $ i r;^ou_i , 2 O N 1 N G R E Q M T $ FEES $ 3 'Z. ^23 - 4 i. SMIP $ `,� PERMIT ISSUANCE 5 ENERGY P.C. $ GRADING 5 MICROFILM $ TOTALFEE $ $�� CONSTRUCTION AND PLANNING ' POOL & SPA APPROVALS Permit # Date Inspector qppROVALS Permit # � Date Inspector � 1.;Temporary Electrical �Service or Pole 52. Pool & Equipment Location � r.% 2J Soil Pipe-Undrgrnd. � 53. Steel Reinforcement 3. Electrical Conduit Utili[y-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding . 5. Steel Reinforcement✓� , � 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. ,�L� � 57. APPROVAL TO COVER-GUNITE 7. Footings , � � 58. Electrica� Conduit-Undrgrnd. 8. Foundation . , 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Undrgrnd! � 60. Backwash Lines, P-Trap, � Undrgrnd. . 10. Structural Floor System � 61. APPflOVAL TO DECK � 11. Property Sewer Line &•HouseConnection 62. Backwash & Receptor-Final • 72. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Finaf 14. Rough Plumbing 65. Electrical-Final . 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 6S. APPROVED FOR PLASTERING 1 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • � 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT . i % 20. Rough Factory Fireplace ' APPROVALS Permit # � 21. Ducts, in Structure � 70. Underground Hydro � � 22. Duc[s, Ventilating 77. Produc[ Piping OGas ❑Oil - ' 23. Gas Pipe-Rough & Test 72. Underground Flush � 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil �_ , 25. Roof Sheathing y 8S 74. Overhead Hydro / 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � 27. Frame and Flashing , ty � 76. Dry Standpipe � Q_� 28. Lathin & Sidin '�. 9 9 L 77. FIXED SYSTEM FINAL . 29. Insulation 8� 78. FIRE PREV. FINAL � ' 30. Drywall Nailing �j � HEALTH DEPT. REQUIREMENT , 31. Plaster Brown Coat 79. FINAL INSPECTiON � ' ('•: 32. Electrical Power Meter-Fina� 80. FOOD CERTIFICATE ISSUED � 33. Final Electric Notes: � GO 34. Fina� Heating & Air Conditioning /.�fs.�C [M Z � 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 47. Soiar pomestic-Final - 42. Backflow Preventer 43. Backflow Irriga[ion � 44. Landscape Irrigation System 45. Sound Attenuation L / C v� 46. liandicap Regulations ,� 47. FINAL STRUCTURE & BUILDING � � ' 48. Special Requirements Completed � , 49. Electrie Release to Edison , 50. Gas Release to Southern California Gas Co ti 51. CERTIFICATE OF OCCUPANCY � No. Date _ _ � COUNTY OF ORANGE BUILDING DEPT. 636 No. Broadway Santa Ana, California Phone: KI 2-621I � ¢9 Application fo� Building Permit AND FOR A• Certificate. of Use and Occupancy Permit No._____�,1.�_-�_1__. D ate--`--'LO/.31.d __(J---""'----"----"-"-'--' 1. OW[�'ER'S NAME----------COAQT--ORAI�iF�'-A�------�--------------------------------�----------- PHONE:H.sAO�II._829� MAZLI[VG ADDRESS-----�BB._.I�'....i��L21._SLI�88�-----------------------...-------.,.CITY------OOB�(1..MA.9Q------------------ Naine Address City - ---- Statc Lic. No. ---.- (Amhiceco or Engineer) Phone ____ Name�or�o.li. Holetein_Fo_ 8one ___ _ (Concruaor) Address .._SETE3__E...17th._BLreoL....--------------------------- Ciry ---�iOQ'i� i-ie9Q_._.....-"'.---'_"'-' Stace 1v4W H Lic. N�_'---- "--'---'-----�•--'–_... Phor PROPOSED USE: --- H8$180i1CA - ---�-------- - --- --- �------------------ -- -� -. _. 2. JOH LOCATION_--� - �h�0----- �- - � - ---�= -- /�---` "�------- -- -----------C�B�--ISflAl1--------- -----------�- - -------------- (House No.) p (Name of Streec) ��Town or School Dis¢icc) 3. LEGAL DESCRIPTION: Loc -----_/__------------------ --Block -------`__--------------.--------Tract —e�'�----`------------- -- --- - (Me�es and Bounds Descriprion—Use reserse side of form) 4. CORNER LOT ( ) INTERIOR LOT (�) THROUGH LOT ( ) SLOPE OF LOT ( ) 5. S12E OF BLDG.:.'S��!'�.2`.AREA:_.._.�.y-�___._ _._ �- r SIZE OF LOT: _S�.Z._X.La�./.-r+REA: _.7..Z.dO.______.___.. 6. HEIGHT OF BLDG.: ____�� ____._.__..___.__CEILING HEIGHT:______._8�__.__._.___.__._.. NO. OF STORIES.__.___�____.___ 7. NO. FAMILIES ..___.___.�._..__........______..Size of Smallest Bedroom: ..��..,,�,!../..i... Size of Kitthen: _...p X�Z- --- . '----------------------- 8. EXTERIOR WALL CONSTRUCTIO[V�6.-.Btd�CQC.._..__..INTERIOR WALL COVERING ..___._P�8'E8I`-.--------- (Framq Smtco, Em.) r�'""/ "'"'""""'- (Plaemr-Drywnll- Hm.) 9. SETBACKS: Fron[ Yard from Ccn[cr Liae of Strac_____'�V..-_._. _. _.._____._ ................_______.___._.. �` i � Neares� Side Yard__._..___.Q.___....Rear Yard.._%�..�..-�Distance in Feet Between Bldgs. on Same Lot._..'� y----�--._ _ . _._._. lU. A COMPLETE PLOT PLAN IS REQUIRED, SHOWI[VG ALL STRUCTURES A[VD USE OF EACH. 11. I�or (a) Footing: Width ____.Z�M ..................... Dcpth in Ground ..._._._.1Q�..-..-...... Width of Wall .._._...SN. -" ---.' Accessory Bld s. and • Sim�lar (b� Size of Smds: .__.,Q. a..4.____... spacing._�A� ..................._"CC Matena� of Flooc _xQO.Q_.._._ ...._ ._.._ Structures: (c) Sizc of Floor Joists: _.I3..7C-.8-----------------_.Spating -- -- ],�M-.-_' -.-__--_--_"CC {d) Size oE RaEtcrs: --'- --Q,•..�..Q.-".- -----'--'--"' Spating .---'-S4N-------__"----- ��CC 12. VALUATION OF PROPOSED �X�ORK: Intluding all laboq plumbing, electrical wiring, heating, fire sprinklers, paino ing and sewage disposal �._�� __� _______'."'_"_________ I~ 73. I HEREBY CERTIFY THA7' TO THE BEST OF MY KNOWL6DGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL I LAWS OF THC COU[VTY OF ORA[VGE AIVD THE STATE OF CALIFORNIA APPLICABLE THERETO. Sign /Y/ ^ _'G�D__'_ Plans Filed :............_---------� ---...._-'---' Bldg. PermiC, Plan Chetk Total - - Receip[ No. � Paid to - 'D�Ce .__.------ DA 5N-� 90 FEES: �A - � -----�3 -�------ - $---^`�' - $----- �?--------------- G FOR DEPARTMENTAL USE ONLY GROUP....-- --•-� --- ----- TYPE.-------- -�--- -- ---- DIST. /�� M A P------------Gl�.---- � �-------- SHEET [VO.-----�--..----- C�[VG BY APPLICATION .._ HEALTH.._________________________ FIRE ZONIIVG --- ---- ---- - MARSHAL-�----------------�-- - PLAIVS AIVD SPEC'S._------------------------ STATE ----- ----- --------...----- CORRECTIONS ENGINEER VERIFIED----------------._ CAL- -------------_------------------ PERMIT ISSUED BY: -- f :��ILDING ^ '�� ` - ..TOR --�---- ----------i ---------------- ------------ ------------- _. -- ------------- ----------- ---------- oEPurr Grr,J COUNTY OF ORANGE BUILDING DEPT. 636 No. Broadway Santa Ana� Califarnia Phonc: KI 2-6211 Application for Building Permit � AND FOR A Certificate of� Use and Occupancy Permit No.._--�_.�� .� Date.--'----'__ /�_-�_�_�."'---'---'-""' QOABT �AlI� ��-----------------�----- --. PHONE:BOAflOA--B�F- I . O W NER'S NAME ------------- -------- � =- --- - - ------------------ - -------� MAILING ADDRESS.-------��_Fr�---1�-t-��-h----�.�@6ti_------------------------------- CITY._.00A�Q-AIOOEl----------------------- . Name ... Address Ciry._... "'______".'---� $tate Lic. No._.------'-�---- (Archi[ect or Enginc¢r) Phonc PROPOSED USE: _.___�a$. 2. JOB LOCATION. ------�-��-------------�-�----� (Houtc No.) (Nume of Namc.��.-A�--t+V�� oC �«acoo�l -.�__'----'---""--- Add�oss --��..�.._.�...-5�--=�:S--�QQ�----- ----------------------- CitY -'.WiQ 110..119�"'--------_"__--"---' State Lic: No�•1�r3�----'--�------'--- Phon Qoeta (Town or Sthoo! Dietrict) 3. LEGAL DESCkIPTION: Lot .----f--------- ----------------- Block -------�--- - - --- -- -----Trac� --� ------------------- - (Meocs and Bouhda Description—Use reserse side of Eorm) 4. CORNER LOT ( ) INTERIOR LOT (� THROUGH LOT ( ) SLOPE OF LOT ( ) � � � p,, 5. SIZE OF BLDG.:._-_-_.-_-......-------.AREA:__3�-_:^!1-_�_----SIZE OF LOT:-��i_X._�.T�AREA:-7%�_--_----.-- � 6. HEIGHT OF $LDG.:.___14... .__.._CEILIIVG HEIGHT:.___......__._.___.__.____.__. NO. OF STORIES___L.._ ............. 7. NO. FAMILIES .__..___.__..._..._._.._________...Size of Smallest Bedroom : ............_______._._.._. Sizc of Kitthen: 8. EXTERIOR WqLL CONSTRUCTION: �._B�.OQ._.__INTERIOR WALL COVERING ___.. (Frame, Stucco, Eac.) (Plnscer-Drywnll� E[c.) 9. SETBACKS: Front Yard from Center Liae of Street.--_'�._�--71--_'--'-"'-"'-------"'---'---_"__'_""------"'_'-"-'------------------"---'--- , ' ,�y � IVcazesc Side Yard ._..__.�__..__._.Rear Yard _._.._.�_.._.....Distance in Fcet Between Blcigs. on Saine Lot ..._..__ ----� ----.. .. __._... IU. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCI'URES AND USE OF EACH. � 1 L For (a) Footing: Width _��__.._ ..................... Depth in Ground ..��._._......____.__ Wid�h of Wal� ._8 °- �-- ---------- - Accessory Bldgs. and b Size of Smds:.______.Z.X._.Sl..._...5 acm � .... CC Material of Floor Similar ( � P 6-"'-_...._.- -'---"'--' �� i�._.....--' Struuures: (c) Size of Floor ]oists: (d) Size of Rafters: __._____.Q. �_�.__ "CC Spacing N . "CFC ---- ---'-------- - 12. VALUATION OF PROPOSED WORK: Including all laboq plumbing, electrical wiring, heating, fire sprinklers, paint- in and sewa e dis osal _ �'' S S P S--' %�0-----------'-------'------------ 1;. I HEREBY CERTIFY :HAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE IIVFORMATION •IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. Plans Filcd:--__-•----_�� - � - J� - -------- ----- ----------------- ------- Bldg. Permie Plan Check Total - • Receipt No. Paid ro Date ............. FOR DEPARTMENTAL USE ONLY FE�S: . �----------- GROUP-----._�T....------ ' $------ --------� . +�------�-��--------- T'YPE.-------._.�.------ --- �------ -��--'-----_-- DIST. /�� " ----y�3.l�----- h9AP-----------4�G.�r----...---- • lti/?� SHEET NO.-----1(._._..-------- —r _ . Cr`+ H<�CK NG BY APPLICATIO .. _..._.... HEALTH _________.._____._,___. �/� FIRE ZONING --� ..... ......... . �MARSHAL.------ ------------- PLANS AND SPEC'5----------------------------- STATE--- ------------------ CORRECTIONS ENGINEER VERIFIL'D-------------------� CAL._--------------------------- PERMIT ISSUED BY: i-�- ,��—' ,� � : �� DATE•:---- ------------------------------- --- -� -- -- --------� ---- - � - ------------------------- SM-]-0O � ' C,�.,,,:TY LUILDIPIG , ,, . _ '. r_TOR �e�uTv G12� Pfl0.1ECT p00flE55: Q Q O W 19 TH S T owseesenme: LAWRENCE SOM�RS AODflE55: Z O S SH I PYARD WAY 7i 8 NEWPORT BEACH 92663 714) 675-7207 APCNIENGINEEN: ADONESS: pEG.NO.: UNIT: UNIT: PEflMIiTEE: f.1ARiE AIRES (719>631-5392 ADOflE55: t] Q O j�j 1 91'j�j $'j' C.M. CA 92627 LICENSEO CONTBACTOH DECUINATION: I �ereby at�irm t�at I am IicenS¢a un0er O�avivons ol Cnapter 9(commencinp wilh Seclion 7000� oi Division 3 0l t�e Business antl Pmlessions Code, antl my Ilcense is in lull farce antl eliect. CITV LIC.: STATE LIC.: LUSS: Date: Signamrc: WORNEBS' COMPENSR710N OECIABpTION: I hereby afli�m Ihat I bave a certiliw�e of consem to ulbinsurt or a certilicate of Workers' ComDensation Insurance. or a cerlilieC cooY ��ereol (Seclion 3800. LaE. C�. POLILY NO.: EXP. DFTE: COMPANY: ❑ Cenilied coDY is �ereGy �umis�eG. ❑ Cenilie0 copy is file0 wit� IAe ciry Building Oivision. late: APVlicant: E%EMPTION FflOM WONIIERS' fAMPENSIT10N DELUIIATION; (This SetfiOn neN iro1 b¢ canWet� i� VC Ogm� �s �� e hunCreO (S11f0� or kSs�. I Cetli�y I�ai in ��e petlormanCe at I�e wOB lOr whiU IhiS permi� is �cSueU. I � yoµaey. 16 6emme Su cl b th Wotl 5' fA. ensatian L ol Caliiami � _ y � Sipnau p' �l- NO71CF� il. alt makinp Nis Geciaraiion, you s�oultl become sublect to ihe Workers' Campensation D�ovieimS.OLln^ �• Caae/you m t IonRwii� compry vnih suc� Omvisions or I�is permit shall be Eeemed revakeG. LONSTBIlCTION LEN�INC RGENCY: I �ereby allirm tna� ��ere is a wnstmction IenOinq apency for t�e Oe�ormance al t�e wark for wmcn mis oermii is esum (Sec�iw 3oB7. Gv. cl. LENDEfl: AUOPESS: OWNEP BUIL�EN OECLRNRTION: I �ere�y aflirm ihat I am exempl Imm ��e Canlraciors' State License Law lor the I011owin0 reason (Sedion 7031.5 Business an0 Pmlessional Cotle: Any ciiy ol county wAlc� repuirts a Oermil ta constmct, alter, improve. tlemollsA, ar r¢pair any Slmtiure, O�ior IO ils i55uanc¢. alio r¢puire5 IAe applitanl lar SUCII Oeflni� to Iil2 a SiOnlO Stdi¢meni ltWi AUSAe is IitenSeG Dursuant to ine vrovisions ol tne Comractors' State Licensp Law (Cnapte� 9lcommencinA �� ol Oivision 3 0l tne Business anE Prafes4on5 CoOe) or Illal �e/s�e is exem0� ��erelrom ana tne �asis lor Ine allep¢G eaemption. My riolation ot Section 7031.5 Gy any applicant for a permil su0�ects tne apvliWnl ta a tid� penalty of not mare Nan five tlunEreO a011aR (5500). I, as owner o� me propeny ar my emyloyees witA wa0es as tneir sole campenutlon. will Oo me woM, anA I�e ❑ svucWre is not imenAed or oflere0 for sale (Seclion 7044, Business anE Pmtessional CaOe: T�e Contractars' Stata License Law Ooes not aD01y lo an ownet ot a DmDetly w�o �uilOs or impmves t�ereon, anU who Goes suc� wodc himsell/hersall or thrpuAh his or het awn employees, pmviaetl t�at suc� improvements are no� intenAeO ar oflereJ lar sale. If, Oawever I�e 6uil0inp or improvemenl 6 5oltl wrtnin one year ol complelion. Ihe owner wiil have ine our0en of pmvin0 he/she ai0 not EuilO or imD�ove far Ine purpOse ot Sate1. I, as owner al t�e pmpeny, am extlusiv¢ly conlraCting wilh IicenseG wnlratmrs Io construci t�e pmle�� 1��on 7044. Busine5s ❑ anE Pmlessims CoGe: IDe Contractars' Siate Licpnse Law �oes nol apON �o an owner al Drope�tywho buil0.s or imDroves I�ereon anC who conuacts lor sucn pmlects witn a comracbqs) license pursuant to tne Contracmrs' State License law�.,�am aware «� D�aol al ineit Worker's Campensation insurance shoula Oe pronae0 to me. � I am exemv� un0ei Sectian: H P 7 O 4 4 B. 8 P. C. /� lo� mrs reason: OWNEA (,�/J/��/ �— % � C1 l� o�e�: SGo neRoy cendy tlwt I am awdte oi antl uMerstan0 tne requirements al Cahlornia Health anA Sdfety Code SECtioni 25505, 25533, anA 2553< an0 ttut I or any future OuilJmg acupanl wilVvnll not (cirGe one) neeE to camON ��h uid stne aOa anE the repuiremems lor a permii lo� consiNction or mOGilicalion irom t0e AiTr u�alpy ManaAement qslritL BCVEeniul ton9ruttion applitations are exempt ItOm �nese pmvisions. Daie: I nem�y certify Inal I Dr� t646a6 ADDlican��.. Ihis ap0licaiion ana 51aie a0ove inlormalion eaniya: Green—COEo Enlorcemeni; Canary—Appticant; Pmk—Revenue; GolOenroE—Assessor CITY OF COSTA MESA — SIGN PERMIT PERMIT NO: SB 065987 PLAN CHECK NO: 00476-94 S CONSTRUCTION TYPE: V—S PERMIT TYPE: STR ST_G PERM NO: SB 065987 GOVT: N SUPP; N PURPOSE: NEW JOB DESCRIPTION : INSTALL FOAM LETTERING SZGN SQ FT: CLAIM VALUE: 100.00 CALC—VALUE; 100.00 GROUP OCC: B-2 / COMMENTS: FOR " FLORAL AFFAIRS " 1E M 1E k it it it 9t af iE -k� �)f it it # R iE iE it iF it iF it 1f it iF i41f iE iE �lt iF �1F iF �lE iF it itif �1! iF if i49t ik 9F if �Y df i! if it it it it 3E-0t �it ic M it if i! iF ih 1E if iE iF it ih M iF if if iF �lf iE R S I G N I N F O R M A T I O N DISTRICT: 1 TYPE: FOAM WALL SIGN ILLUMINATION: NON CATEGORY: NEW DIMENSIONS: OFT OSIN X 4FT OOIN AREA: 4.00SQFT LETTER HT: 8 STREET FRONTAGE 1; 130,00 STREET 1: w 19TH ST STREET FRONTAGE 2: 0.00 STREET 2: PARCEL: 41920515 ZONE: C1 LOCATION > FRONT; X REAR: BUSZNESS NAME: FLORAL AFFAIRS > LEFT; RIGHT: O T H E R T O T A L S G R O U N D S I G N THIS ACTIVITY . 9.00SQFT OVERALL HEIGHT; OFT OIN THIS SITE , 9.00SQFT GROUND CLEARANCE: OFT OIN ITEMS OF INFO 1 PLANTER AREA: O,OOSQFT ITEMS FOR ACTIVITY: 1 HLDG SET BACK; SFT COPY VERBIAGE : FLORAL AFFAIRS PLANNING NOTES: it�exitit*it*it*+r�tx�rir�r*�ftfr***it*x�+�itx*iritit�+�*ititiFit+t*itifitit*it�+t+r***it*+t�it*+r*+�ir***it*�t*�*jtir*�r�+r D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY �� DATE: 2 5�� HUILDING APPROVED HY ; �� DATE; Z 9� APPLICATION ISSUED HY: C�� DATE: 2 —''C7 � iFiFifiFiEififitkiEMitif�iEiEiEifitififitiE . IfrtifiF*-ifiEififi! iFi� LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING PERMIT 15,00 4,00 PLAN 9,"75 SMIP/NO�N—RES ISSUE FEE HUILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 19.50 0.00 9.75 29,25 29.25 ,00 REVENUE DIVZSION TOTALS--> COLLECTED: 29,25 OVER/SHORT: ,00 HLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN—CI-IECK 15.00 9,00 .50 9,75 iE it i! k it 1k �t i! it if it it if if if 1E if if iE k if 1f'!f 1E iFlh iF iF it if if if if i! iElF it �t it if 1f 1k it if fE iP iF if if �E i: k iE 1f if i! if ff �If i! it 1E ic ik iF 1f ff k iF iE 1E 1! 1f if if i! if iE 1F I N D I V I D U A L F E E B 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 NO FEES WERE SELECTED FOR TAIS PERMIT 01 U0155156—D�15�1`9 TG T 29.25 DATE� 02/09/94 TIItE: 04:02 I � CONSTRUCTION AND PLANNING POOI &, a APPROVAIS Permit # Date ' Inspector p.PpqOVALS Permit # Oate Inspector 1. 7emPorary Electrical Service or Pole 52. Pool & Equipment Loca[ion 2. Soil Pipe�Undrgrnd. ' 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Elecirica� Co�duit-Und�grnd. 55. Electricel Bonding 5. Steel Reinforcement . 56. Rough Ptumbing & Pressure 7est 6. Electricai UFER Grnd. 57. APPROVAL TO COVER-GUNITE �. Foot�ngs 58. Electrical ConduiFUndrgmd. i 8. Foundation 59. Gas Pipe, � Undrgrnd., Test , 9. Wate� Pipe-Undrgmd, 60. Backwash Lines, P-Trap, O Undrgrnd. ' 10. Structural Floor SYstem 61. APPROVAL TO DECK � 11. Property Sewer Line & House Connection 62. Backwash & Receptor•Final 12. Sewer Cap 63. Heater & Vent�Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical�Final 15. Rough Etectriwl•ConduVt 66. Solar SYstem-Pinal 16. Rough Electric Wiring 67. Fencing & Aecess Approval 77. Rough Wiring Sign � 68. APPROVED FOR PLqSTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEM1IIS FINAL 19. Rough Heating & Air Conditioning PIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21 . Ducis, in $tructure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping �Gas �Oil 23. Gas Pipe�Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling (Svuctura�l & Monocoat 75. Dry Chemical 2J. Frame and flashing � 76. Dry Standpipe 28. Lath�ng & Siding 77. FIXED SYSTEM PINAL 29. Insulation 78. FIRE PREV. FINAL 30. Orywall Nailing � NEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter Final � 80. FOOD CERTIFICATE ISSUED 33. Final Eleciric Notes: 34. Final HeOting & Air Conditioning 35. Final Gas Pipe-Test � 36. Hootl or CanopY 37. Finai Factory Fireplace � 38. Final Plum6ing 39. Water Se�vice�Final 40. Gas Service•Finai 47. Solar pomestic-Final 42. Backfiow Preventer , 43. Backflow irrigation ' � 44. Landscape Irripation System 45. Sound Attenuation 46. Hand�caP Regulations • � 47. F4NAL STRUCTUR£ & BU4�DING �j,; � � ri �- 48. FINAL P�ANNING : � 49. Electric Release to Edison 50, Gas Reiease to Southern California Gas Co 51. CER7IFICATE OF OCCUPANCY No. Dace � C"i �t 1' �I PR0.1ECf ADOflE35: tj a O W 19 TFi $ T owxee�sx�Me: JIM .SOMMERS noowess: 1601 .DOVE ST . � SUITE 13Q �, NEWPORT BEACH, CA 9266J ' 7L�) 675-7207 "IpLH/ENO�NEEB:•�` �ODRESB: uxir, t� /A . :.. -� flE0.N0.: . � UNIT: ' PEflM1TTEE:GINNEIiT ROOPINC, INC. . . (714)639-7090 nooaess: SQ65 N: DATAVIA �. ORANGE ` CA 92667 LICENSEO CUNtMCiUP OECIAPAiION: I �ere6y aK�m Ihat I am licensetl unUer OroNsinns of C�apter 9(commencing wil� Section 7000) ol Division 3 0l Ue Business antl Pmtessions CoEe, an0 my Ilcense I5 in tu0 tarce an0 eflecL �� . cm uc.I: Q a 3 8 8 3 ST�TE LIC.: A 3 L S r7 �� c�u�ss:� .C�.-, 3� 9 Oah: l�y4�� Si7 t '�_ .`�""�_"�� ' . ;�VOBKENS' COMPENSR710N DEClAM710N: I Oere a81rm I�at 1 have a certiticate of consem ro setl-insura m a cerliilcate N Wotners' -j�(, mpenSdGon Insuranca. or a certifieA fApy Ihereol (SEction 38f10, Lab. C). , ��uucr xo:: 6 4 9 5 21- £i � E%P. O�TE: O S�.Q 1/ 9 O coMraxr: STATE C•'UNA ❑ Certit�eC cupy is Mre6y fumi�eU. � CeNtietl copy a ttled with Ne dry BuilElnq Div¢inn. , � oate: � �2"`� `�7o nup�.,,,�� ? �— E%EMPf10N FNOM VlOBI(EBS' COMPENSATION DECIAMT10N: (T�is uqion nee0 not Oe completed ii Ne permit is fw one hunOreE �f100) or less). 1 certlty that in lM Dcenu�mance ol the wa�k for wNc� Ws pe�mil is issueC, I sNll rmt employ any verwn in any manner so as to �ewme subject to the Warkers' Compenution Lavrs at Califomia. � � � �ate�. � Si9natwe: NOTICF: I�, atter makinp I�is tledarauon, ynu slroultl hecome wDject to Ihe Workers' Compensation Drovisions of Ihe La�or Code, You must fotll�with compty with suc� D�oNsions ar Ihis permtl s�all De deemed revoke0. - CONSTBUCTION lFN0IN61GENCY: I hereby aflirm ihat I�ere is a constmction lendinp a0ency far tAe DeAormance ol tM wark Por which this permit is issuetl (Settion 3097, Civ. L). . IFNUEfl: ' . . . FOORFSS: - ". . . . . . . .. _ . - ' . <. OWNER BUIL�ER OECLAMTION: I herebY affirm [�at I am erempt trom t�e Cant2ctors' State License Law lor IAe followinp reason (Sectian 7031.5 Business anG Prohssional CaCe: My ciry al counry which requires a De�mit ta co�stmct, alter„impmve. demolisA, ar ' re7air any strucNre, O�a� �o fts issuanie, also. reQuires tAe apD��nt lor such permit ro file a 5ipneA statement Ihat he/s�e Is Iicense0 ��, pursuam to the provrsions al Na CoMractors Sut¢ licrose Law �Chapte� 9(commenunp vrith SecGon T000) ot Oivision 3 of t�e BuUmss ' an0 Pmfessians CoOe) or t�at he/s�e is exempt merefrom anE Ihe basis for �Ae allepe0 aremD��on. pny Nolation al Se6tion 7031.5 by y a00�icam lor a pe�mit suClects the applicant to a civil penalry ol nat more Ihan tive hunEreE Oallars (5500). � I, as owner ol tAe pmPerry'or my em loyees wiN wapes as t�eir sa�e compensation, will Oo� Ihe wark, and ihe I Q nn,cwre �s non�eenaee or arceree m� uie l��on 706C, Busines anE Professional Code: The Contractors' State Licenu Law dces not appy to an owner al a properry wAo Ouil0.s or imprmes tAereon, an0 who dces suc� work himself/herult ar IOrouph his or her own employees, pmvitlea Ihat such imD�ovemen[s are notinten0etl ar oMerea for sale. It, howeverthe buil4in0 0� improvement is sald vntMn ma Y� ai compktion, tha owner will tuve the 6urAen at pruvin0 I�e/sha did nut buAE a� impruve for tha Duryose oi ule�. ' � I, as mvmei ot tfre �prope�ty, am exclusWely coniractiip vrith NcroseC contractms ta constru<t thE project (Section 7044, 8us�uss ❑ and Prolessions CoOe: The Lontactors' State Liu�se Law Ooes not appry ro an owner ol prope�ty wlw Emlds or imDraves Neaon anU wAo cantracts for such projects vnt�-a wniroctaqs) license Dursuant to ihe Contractars',State License Law). I am aware ihal Oroof ol iheir WOM1er's Compensation Insurance s�oNtl De ProviOeU to me. , . . � I am eaempl unEer Settlon: B. 8 P. C. �- . � �for tnis reason: 1 ' ' Date�. . . . . O+mec " I da �ereW cerUy tAat I am aware of anE uneerslanG �he requiremenis ot Calilamu Healih anE Safery Catle Sectlons 25505, 25533, an0 25534 antl t11at I m any future 4uiPoinO acuyant vriNfvnll not �cNcle ona) n¢eE to compty with 5ai0 siate toCeS aIW tM reyNtements to( a permit lor construction or madilication Irom t�e N—r� Manapemenl Distnct ResiOentlal consiruciion ap0�ications are exempt imm tAeu O�odsions. ' , Date� ' Mvlicant: I M1ereGy ceniry that I Aave read tAis appliwtlm anO state that the a0ove In/ormatron is correce I apree lo camON �h all cRy an0 counry Of�lOdI1CC5 20tl SW�012W5 (BIdIIpQ�O hUIIUIfIA COOSfNtf100 dOE110f06Y dN110�30 �BplCSBO[d��05 OI�h15 CIfyIO EfIICf00011i110 d60V&RIEOtI00Cd m�m im imPKtion WN�es. . Oal¢: /� —'2�— SipnaL. ' ^!=A� A 'C/^ � ' Oriver's License or Social Secunry x; " ' � 1gt/A8 W�ile--BuilOino: Green—COEe EnlorcemenL Canerv=ApO�icant Pink—Revenua; GaltlenroC—Assessor ' CITY�UF COSTA MESA,- BUILllING PERMIT PERM NO: B'04SE330 PERMIT NQ: B �458,3Q PLAN CHECK NQ: N GOVT.: N SUPP: N CONSTRUCTION TYPE: 5 ' PERMIT TYFE: STR: ' : PURPOSE:� ALT �TOD DE5CRIPTION ::.RE-ROOI' CQMMERCIAL BLDG(HO'C MOP) '� � SQ FT: 4,610 CLATM VALUE: `4,610.00 CALC-VALOE; .. • 4,61Q.�Q � GROUP OCC: D-2 ( COMMENTS: +r*�r�r*�**+�**��e�****+��+�*****��r*�r**�+�*�*+��e**+r�*+��r�rwr�x�r�*�*�***�***+�*x�r+�*+r***+�**� � • Z O N L N G R.E Q U I R E M E N T S S E T Q A C K S = --------- -- MAIN BUILDING ---------- ------•--- ACCESSORY HUILDING --------- FRNT; F'L' IN REAR: , FT IN FRNT; FT' IN REAR; FT IN LEFT; . FT iN RGHT: FT IN . LEFT: FT IN RC,HT: `,f'T IN PARKING REQ • PROV: PARCEI,: 4192051,4 7.NE: RFF NO: PLANNING NOTES>• , . _ _. _ '. � . . . . ' . . itiexir�+t�r**it�rit**�atft�it**ir�it�r*it*it+t�rit+rie�titit**+�itat+t*�it*it**kitit**�e�r****it�it�it�r**at�iritit�ieit��t D E;V E L O P M E N T S E R V I C E S R E Q U I R E M E N;,T S . 20NING APpROVED BY � � DATE: BUILDING AF'PROVED FsX : � � DATE:; � � APPLICATION ISSUEli BY: � � 'DATE:.��,�-�� JEitiEitiEfkitiEfElhiliffE3tkiEitlkiEibfkiE'SF"ii�iFi �SF�FitikifitkN�iEftiEit iEN� fFiEdEifiElf.!l�EiFiEfEiElElEIE3Elf1E3l�1Elf3EiEiEiEibiElfifiEiEihdFiEiEiEiEitiE�EiE ltiE ffiEifiEiE)EfE1kiEltiEit'�lfififiElFiEiffYifiEiEikffl!#iE�E�l9EiE liEGALIZATIONyN , F.E E; S O M M A R Y' -"''STRUCTURAL.E'iEGMENTcY �fiLDG PMT �PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 72.00 ' . ' . �, " • SMIP/NON-RES PLAN , `' .69 • IS5UE FEF. , ' - ' � ' . HUILDING-DI.V->: PFRMIT' IS.SUE PliAN-CHECK TOTAL PAID llUE TOTALS----> .72.69' '•.0.00 • 0.00 , 72,69 72.69 ,00 REVENUF•. DIVI;TON TOTALS--> COI�LECTED: 72.69 OVER/SHORT: '.00 DLDG PMT PLUMDING'ELEC1'RIC MECHANIC FIRE SMIY/TOT GRADING PLAN-CHECK - 72.00 . ' ;; ' . ..69 �F iE if iE iE # iE iF 1! fE if it ff f! iE ik iF iE �ElE if- # if i! �E 1E 1F iE k ft iF iE iE 1! it * iE 1k k iE iE ik 1k iE iF 1E iP 3E k 1E if iE it iF it 1! iE k 1E iF iE iE iE fE iF ff if dt 1E it 1ElF # �k fE iF iE iE iF •' I N D I' V�I�' D U,A Ls� F E E A R L' A K.D O W N TYPE QTY D E S C' R;I P T I' O�N UNIT CUST TOTAL COST SFC 461:0 REROOF BY;VAI.UE COMMERCIAL NOZONE � 1.00 � 4,610.00 . END OF� FEES ; . . . . . . . . . . r3. � , . � � � ' . . 0 , � f 1 , P -- DATEQ�D1/2%90Q5TII&iE: .160 g , 72.69��_ �' r . ': ._ . ♦�, " . CONSTRUCTION AND PLANNIN� . - ' /.00L & SPA APPROVALS Permit # Date Inspector APPROVALS Permit # �� Date �Inspector 1. Temporary Electrical Service.or Pole �� 52. Pool & Equipment Location � 2. So�l�?iC'; Und�grnd: � �-_ ,, � 53. Steel Reinforcement _ .. ,� -'3.:ElectriFal Conduit�UtilitV-Undr9mdr 54. Forms "` `� 4._Electii'cal Conduit'Undrgrnd. ' - . - 55. Electrical Bonding � 5.:Steel Reintorcement . . - 56. Rough Plumbing & Pressure Test � `�6^Electrical UFER Grnd. _ ' � 57. APPROVAL TO COVER�GUNITE � � � 7 ^Footings � + ^ � 58. Electrical Conduit�Undrgmd. ' � ;; " 8. Foundation ' ' , 59. Gas Pipe, ��Undrgrnd., Test "� 9. Water Pipe•Undr9rnd. � �' "�� 60. Backwash Lines, P-Trap, O� Undrgrnd. �_ 10. Structural Floo� System - 67. APPROVAI TO DECK - 17. Property Sewer Line'& House Connection � . 62. Backwash & Receptor-Final � 12. Sewer Cap -� ' 63. Heater & Vent-Final _' - 13. Roof Drains . . � � � � 64. Plumbing System � Final . � 14. R4ugh Plumbing � �' - 65.. Electrical-Final ' � 75. Rough Electrical�Conduit • ' 66.' Solar SYstem-Final � � 16. Rough ElectricWiring _ 67. Fencing & Access ApProval _ 77. Rough Wiring Sign 68. APPROVED FOR P�ASTERING 18. Rough Electrica'I-T Bar Ceiling 69. �POOL/SPA SYSTEMS FINAL . � 19 �Rough'Heating & Air Conditioning � � � -� FIRE D,EPT. REQU)REMENT ,, _ - - 20i-RoughF.acto�yF.ireplace ` z.,� x 's '' ; �APPROVALS''�_Permit# , " � _ 21.-Ducts, in Stru`ctuie* ' • • '-+_' r - _ •��a� ` "70. Underg�'ound Hydro r,- 22 -.Ducts, Ventilating'i '' �� . a ;`.,Y �� y77. ProducE�Piping OGas O�OiI 23. Gas�Pipe-Rough & Test '^.� �� r, ^' - ' � ! . 7z, Underground Flush��- +� - ` 'r. m 24 ^-Roof Framing � "�� _ ' `;. x; 73` Undergrnd. Storage Tank�C7 Gas ❑ Oil 25. Roof Sh`eaihing �, � : � �: � � 74.� Overhead Hydro� � . 26�T-Bar Ceiling (Structuraq &-Monocoa[ ; ,-, �� 75_ Dry Chemical , - _, - � 27.�Fremeand F,lashing� �- - �ti : -�� - 76. Dry Standpipe r" i' � � � . r. - '-28. �athing & Siding � ' :_?� � � '' " ' `, ' 77:.' FIXED SYSTEM FINAL, ,._, - 29. Insulation • • •• � . ' ' 78l=FIRE PREV, FINAL ' ^ " ��30. Drywall.Nailing y_ y.` _ , �.��?; w _ HEALTH DEPT.i R'EQOIREMENT `.� 37. Plaster Brown Coati S. . � - �� %� +� � 79.�FINAL INSP_ECTfON r � � ',32>.Electrical Power Metei ,F�nal' `� �' �_ ��; !: BO.wFOOD CERTIFICATE ISSUED_ � . � 33r�Final Electric , -�• • = � � , %7�? a Notes: � � - ��A .a,�L. '-3 .=v � +' 34.��Final Heating & Air Conditioning`• .�� t � " • � `� `� {• � :' ,. -t .� _ ..._�� - - �. r' - - - C . .� �.., .. s � � , 35. Final Gas Pipe•Test � . {� H f;, �� - �: _. , : �36_Hood or.CanoPY = ' '" L = ' �^. �� ; . - " , � :� �37.:Final Factory Fireplace� '�, � ; � � �� ,;;�. . � -38. Final Plumbing ' '� * . ��;^, '� _ '� � `-.� ' � x . s�, - � c39. Water Service-Final� � ' ' ''; ' :n, � �• ' � 40. Gas Service�Final ^ �^'- " t� "' � • " � � - � - =41. Solar pome`ticFinal- � , �;. ,� -, _ � ; ;, - 42. Backflow Preventer � �� • 'x � ' r � `• � %i •., _ - - " � 43. Backflow Irri ation r'�� ` � �` �^: .� �: , �, g } #:� � a: S i r i � �-. �-44. Landscape IrriAation System'� ?C� - '� '� �- '��'' � �• � �� ` � i K � -45:�Sound .Atrenuaiion ".`l ' A: � `- - ��. ' `� F-' r'�'�. G'ti � ' - . .. - �7 . _ 4 . '46�Handicap Regulations �� t � - _ • - - - i �47=PINALSTRUCTURE&BUI�DINGJ ,s 31 Q/ n � .` V. 1 48rFINlALPLANNING �r � ,- <' ,. [- _ . L I . _r F ,' � Y I /ti : _ .�. 1 � � 49 "Electric'Re�ease to'Edison • � ?' " ' ' ' .: t ,i, w ,' . -. . 50: GasrRelease to Southern California Gas Co � • '�' � ^ �-� _' ' * ` '/< < :57. CER7IFICATEOFOCCUPANCY s ` + •' �� ' - + ' _ No. Date