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Home My WebLink About459 19TH ST - Building Permitsm (714) 754-5273 • F�( (714) 754-4856 • www.CI.COSfe-mBSe.Ce.US 77 FAIH [JHIVE, GU51 A MtSA, GA 92ti26 Job Address: 459 E 19TH ST Suite No Viciniry: Parcel Number: 11734129 Applicant: TINGLEY, JEFF Address: 11861 CARDINAL CI'� UNIT F GARDEN GROVE, CA Owner: Address: � Contrador. Address: tii MECHANICAL PERMIT Phone: 714-534-8474 , Zip: 92&43 ALLEMAN, JASON.AND KRISTIN ''459 E 19TH ST - � � � • � � Phone: COSTAMESA,CA:�� Zip: 92627-2313 BEL AIR COOLING AND HEATING 11867 CARDINAL CI � � UNIT F Phone: 714-534-8474 GARDEN GROVE, CA 2ip: 92&43 , � � � License:710334 . � � SCOPE OF I 1' FURNACE CHANGE OUT, LESS THAN 100 K BTU ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt CoolingMeat Inst / Rep. Recess Wall Htr Ftefrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Faclory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Ducf Appliance � Fire Dampers Smoke Dampers Insl or Relocate Appl Vent Air Handlers < t0000cfm AirHandlers> 10000cfm Floor Furnace � Floor or Suspend Healer � � � QuaNity 323.50 514.80 1 ' ; 50.00 0 30.00 0 $0.00 0 $0.00 0 � 50.00. 0 - $0.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 $0.00 0 50.00 0 , $0.00 0 _ � . $0.00�.-+0� �50.00 0 50.00 . 0 50.00 �, 0 �. FEE SUMMARY � Status: ISSUED Applied: 01I03l2006 Issued: Ot/032006 -i ISSUED BY: I Repair / Alt Absorbtion Unit , RepairlAllRefrigerationUnit Ventillation System Evaporative Cooler Com mercial I ncine rator �Domes�ic Incinerator • ', � Compressors"I Absomlion Svstems Up to 3 hp I 100 k BTU 3 To 15 hp I 500 k BTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp I 1,750 k BTU Over 50 hp / Ovar 1,750 BTU . . Boilers Up to 3 hp 3To15hp 15 l0 30 hp . 30 l0 50 hp . ' , . Over 50 hp � -0lher Mechanical Fee " ' Investigation Fee Plan Check Fee Reinspedion Fee TOTAL CALCULATED FEES COMMENTS I SPECIAL CONDITIONS �uantiry 50.00 0 50.00 0 $0.00 0 $0.00 0 � $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 $0.00 50.00 538.30 NOTICE: The work authorized by thls permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ottf. No. 92-28, § 1, 72-21-92) EXPIRATION: This permit shall automatirally expire and become void if 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 work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all requlred inapeetlone and finel epprovel must be obtained. Failure to obtain inspections and final approval will result in �he expiratlon ot this parmlt. FOR INSPECTIONS CALL: (714) 754-5626 zsoa+s (e�oo� WORKERS'COMPENSAnON DECLARATON: � I hereby attirtn untler penalry of perjury one of ihe following detlarations: , ❑ I have antl will mflintain e ceniliwte ol consent to seN-Insure far workers' wmpensation, as provi0ed tor by section 3700 ot the Lehor Cotle, lor the pertortnance of the work tor which �his permit is Issuetl. . �I ha e end will maintain workers' oompensation insurenca, as required by sectlon 3700 of Ihe Lebor Cotle, lor the pertortnance of ihe work far which this pertnit is Issued. 'i �My worker ' cam �satlon Insurance carrler and pdiq number are: .,�, 1/� �m� �Z�-.(,�P �'l l� � P' Num6er. bz� �t T7 "�� Is es ctlon need not bB etetl il Ne pemtit ls va/ued et me hwMred dollars ($100) w less.) ❑ I certify �het in Ne peAortnence of the wark tor wttich fmi[ is issue4l shall fwt employ any person (n any manner so es to hecane snhject to the workers' compensation laws ol Galilomi nq�r� t�at it I shoul e sub�ect to iha warkers' compensatlan provisions of Section 3700 ot the Lebor Cotle, I shall forthwith complywith�t7Bse{Zrqti;jpy!�/� � TO THOUSAND LICENSED CONTRACTORS DECLARATON: that I em Ilcensetl un0er rDete�l � ^ ��7 � IU UL PND SHAIL SU6IECT rW EMPIbYEP TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED I, D GES AS PFOVIOED FOR IN SECfION 3]OB OF THE IABOR CO�E, INTEREST, AND ATTORNEI"S FEES. wlth Sectlon 7000) ol DlWsion 3 of Ihe Businass�And Prafessi e, end my license is In full Class p, l " % � te: � � 7a .. n �� CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm Ihat there is e construction lending agency for ihe perlormance ol iha work br which Ihis permlt is issuetl. (Sec. 3097, Cidl Code). Lendefs Name: Lentlers Atltlress: Signature: Date: OWNER•BUILDER DEC4NaAT10NS: I hereby ettirm thet untler penelry af perjury thet I am EXEMVT FHOM TME CONTRACTOHS LICENSE LAW tor the following reason (Sec. 7031.5, Business antl Prolessions Cotle: Any ciry or counry which requires e permit ta consWci, atler, improve, demdlsh, or repeir eny structure, pdor to its Issuance, also requires �he flpplicant tor such permlt Io Nle a signed statement that ha or she is Ilcensetl pursuant to Ihe provlsions of Ne Contractors License Lew (Chepter 9(commenUng with Sectlon 7000) of Dhnsion 3 of Ne Busineu end Protession5 Code) or Ihat he or she is exempi Neretrom and Ihe Casis lor the alleged exemptlon. Any violation ol Seciion 7031.5 by any applicant for e permit subjects the epD�icant to e�� penalry at not more than five hundred tldlars ($500).): ❑ I, es owner W the propeny, rn my employaes with wages as iheir sole compensetion, W ILL DO 7HE W ORK, entl t�e structure is not intendetl or oHeretl for sale (Sec. 7044, Business and Professions Cotla: The Contradors License Law does nol apply to an owner ot properry who 6uilds or improves Ihereon, end who tices such wwk himseN or herself or through his or her own employees, provitled that such improvemenis are not intended or ottered for sale. If, however, the building or improvement i5 sold within one year ot completion, the owner-buildar will have Ihe burtlen ot Droving ihat he or she did not huild or improve for purpose of saleJ. ' ❑ I, as owner of tha pfoperty, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 704d, Business antl Professions Cotle: The coniract0�s License Lew does not apply to an owner ol propeny who 6uilds or Improves thereon, antl who contracts for such project with a coniractor(5) license pursuant to the Contractors License Laws.). ❑ I am eaempt untler Sec. Business entl Professions Cotle for this reason: Signature: Date: Owner ID veriliad by drivers license. ❑ Ves ❑ No Drivers License No. Verllication of Ownership by (type of tlocument, i.e. - property tax bill or tleed): DIVISION OF INDUSTRIA� SAFE7Y CERMR CER71F1CATION: Expires: ❑ I hereby certity that �o excavetion five (5) or more feet in depth into which e person is requiretl to descenQ will be mede in connection with work authodzad by tNs permit, antl t�at no building sWcture, scaftolding, talsework, or demolitlon or tlismantling thereol, will be more ihan thirty-siz (36) leet high, (C�ap. 32, Grp 2, Art 2, Sec. 341, Tllle 8, Calitomla Atlministretive Cotle). ❑ As owner-builder, I wiil no� employ enyane to tlo work which would require e permit from the Divislon of Industriel Setery, es noletl eDove, unless such persan hes e permit to Co such work tmm Ihe Civision. Signature: Date: DiWslon ol Intlusirial Safery Permit Number: CERTIFlCATE OF COMPUANCE AND AUTHORIZATON OF ENTAV: I cenity under penalry of per�ury thet I heve read this applicalion end stete that the infortnatlon given is correct. I agree to comply wlih ell stete laws entl ciry ordinances relating to building consiruction, antl authonze representatives ol ihe Gry ol Coste Mesa to enter upon the above-descnbed propeny ta inspection purposes. I agree not lo occupy or ellow occupancy of eny 6uilding euthonzed by ihis pertnit until final inspection. [dV7;7�CFiJ�9�I.1:i�Y7 1816 Fixed System Final Fire Prevention 1268 Paal Spe Final 200 zoi 202 203 Final Re-Rool Final BIocWReteining Well Final Factory Fire Place Finel Sign 204 Final Demolillan � GODE� INSPELTIONTYPE 206 Finel Mechanical 20B Finel Plumbing 210 Finel Elecidcal 212 Flnel Flre Prevenqon � 220 , Final Planning Apprwel 222 Flnal Site 250 Final Bullding/Occupancy �. 1 .1111." " �: r� (714)754-5273 • Fex(714)754-4856 • Job Address: Suite: Yicinity: Primary Occ: Parcel Number: 459 E 19TH ST R3 11734129 y CITY OF CC �' eva��N6 DEVE�OPMENT SER' npplicant: ALLEMAN, KRISTIN Address: 459 E 19TH ST DEPARTMENT Type of Construction: V-N Zoning: �5 � z�, af �PER T �_...,e`� -01691 �� 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 09/23/2005 Issued: 10/31/2005 `c-+�t Phone: .�949-645-6980 ISSUEDBY: COSTA MESA, CA =- �� Zip: '- 92627,-2313 " �� r4 �, . = r.^�- "« � - - owner: ALLEMAN,'JASON AND'KRlSTIN Address 459 E 19TH ST � ' �'� �'� ` . � `�'.. �„ .�� . ,,z, - � � � , � Phone ' 949-645-6960 - COSTA MESA, CA � ,. ' L �, �' Zip. �� 82627-2313 =- ` �° ' _ g'>;r � j ` �� 3P% ' Contracto'r: r; OWNER-BUILDER'-' '�� - � ��""' �' �� ' - Address: �� , � � � ' � •: s� �T Phone: ' "3� �. _, �; Zip: ;�,. , License: 000000 � `r�. r Atch : ' Adtlress> z�P;� •�s � Plan Check Permit. SMIP Res � + SMIP Com ; Other ;", „�, Inspection ` ' �.� Total Phone: �N � � �+"= Licetise �, ` `�,,� eng: JAP '� Address: � ,.:_r -- -_. �?"�;. J I tKKY . Phone:�,'.714-838-1124 - ,. License:. ,17014 _ ` . ^� `.il:VYt Vh YtKMI I f�. r, «� TEND THE �KITCHENaCREATE A FAMILY ROOM, CREATE A NEW BATHROOM INSIDE�EXISTINGARE, a' „�`` ° �� + � 'FEE SUMMARY " � '""" `= '° �:�' $486 69 � , .a�.� -F �s � Caic Valuation �t, $748�75" �� ° �-' � � � �� Claim�Veluation E � � �• '$6 49 �:$0.00 � � � a �$0.00.�� t r.F ;�_-» y�d ; �� ` �:, $0.00 "� - � _ � � _ � ��;� ��' �. i1,241.93 ��:. • � ,� _ _ k SETBACKS "--z � : �' MAIN�STRUCTURE'Front '*0-0 "- rz-�;*c ACCESSORY Front 0-0,�-= PARKING �� Ex�shn �,2 R �. ,J .� � s.; " ^ii � ssa.e�s.2o` $o.00 ��r ,r�� ,�,, y� , �. � � � �-4: 51-0"-•` " -.�Cefl 28-O;;�F Right 5-6'-- -' �;;�, - -:.;�, � f 0-0: Lefl z�0-0 -�+�^ Righli =0-0 . .W �, .. ,...th y e - � 3 '�� . Pro�osetl , 2�.� -e� -- �_ �n"r,', �.�,,: �„;� , r . �i ' �� ,�� - . .. ' a . _ . � �'" - k.. \ jb r _ .. ,�... ^_t t� a. y" - yi i° a tN � �% � . - .�-" '. . . 4 R - r< :�tR <..,v<--"_ ' RIP NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related regulatians. (Ord. No. 92-28, § t, 12•21-92) E7CPIRATION: This permit shall automatically expire and become vold if work is not commenced withln 180 days, or if work is suspended or abandoned for a period ot 780 days. INSPECTIONS: In order for the work authorized under this permit to be consldered legal, such work must comply with all epplicable codes, and all required Inepeetions end tinal approval must be obtained. Failure lo oblain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545826 WOFN �MPENSAnON DECLARAnON: ' .�a ' . ' � � . . . I �ereb, �ntler panalty of perjury one of the tollowing declarations: � '' � " � �� ❑ I have end will m8intain a certificate ot consent to self-Insure for workers' compensation, es provided for by section 3700 ot Iha Labor Code, for the pertortnance of the work for which ihis permil is issued. � ❑ 1 have and will maintain workers' compensatlon Insurance, as required by seclion 3700 of the Lebor Code, for ihe DeAortnance oi the work For which Ihis pertnit is issued. My workers' compensatlon Insurance carrler antl policy number are: Cerrier: Policy Number: (This section need nof be comp/efed i! fhe permit Is valued af one hundred dollars ($100J or Iess.J . ❑ I cetlity Ihat in ihe pedormence of ihe work tor which this pertnit is issued, I shall not employ eny parson in any manner so as ro become subject to tha workers' - compensatlon laws of Celifomla, end agree Ihet ii I should become subject to Ihe workers' compensation provlslons of Section 3700 of the Lebor Code, I shall forihwlth comply with these provisions. Applicant Slgneture: Date: WARNING: FAILURE TO SECURE WOqKERS' dJA1PEN$AT1IXJ COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND qVIL FlNES UP TO ONE MUNDRED TMOUSAND DOl1APE ($100,000), IN ADDITIIXJ TO THE COST OF COMPENS/TION, DAMAGES AS PPOVIDED FOR IN SECTION 3108OF THE LABOR CODE, INrEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: j I hereby aNirm thal I am licensetl under provisions of Chapter 9(commancing with Saclion 7000) of Division 3 of the Businass and Profeuions Cotle, end my license Is in full force antl eHect Lic. N Class q Contractors Siqnature�. Date: CONSTRUCTION LENDING AGENCY: '� ❑ I hereby eHirtn tha� ihere is e construction lending agency for ihe perfortnance ot the work for which this permit is issuetl. (Sec. 3097, Civil Code). LendeYs Name: Lendels AOdress: SignaNre: Date: OWNER-BUILDER DEC�A7�ONS: I �ereby aXirtn thet untl�r penalry of perjury that I em EXEMPT FROM THE CON7pACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business antl Protesslons Cotle: Any ciry or counry whic� requires a permit �o construct, alter, improve, demolish, or repair any structure, priar to Its iuuance, elso requires the applicant far such pertnit ro file a signed stetement thet he or she is IicenseG pursuant to the provisions of lhe Contmctors License l.aw (Chapter 9(commenGng with Sectbn 7000) of Division 3 0l ihe Business antl Piofessions Code) or thet he or she is exempt iheretrom and ihe basis tor the ellaged esemption. Any violation of Sectlon 7031.5 by any epplicent for a permit subleds ihe applicant td a civil penalry of not more ihen tive hundred tlollars ($500).): ❑ I, as owner of �he properry, or my employees with weges es iheir sole compensation, WILL DO 7HE WORK, antl the structure is not Intended or olfered for sele (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of properry who builds or improves Ihereon, and who does such work imself or herself or Ihrough his or her own employees, provided ihat such impmvemems ere not intended or oHered br sale. If, however, ihe 6uiltling ar improvement is sold within one yea� of completion, the owner-builder will heve the burden oi proving ihat ha or she did not builtl or improve for purpose of sale.). I, as owner of ihe property, am EXCLUSIVELY CON7RAC71NG WITH LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business and Professions Code: The wntraG�ors Llcense Law tloes not apply to an owner of property who builds or Improves ihereon, and w�o contracis for such pro�ect wlih a con�rector(s) license pursuant t01he Conlracrore License Laws.). and Professions Code tor this reason: ID verifietl by tlnvers license. Ventication of Ownership by (type of Ves ❑ No �e. - property tex blll DIVISION OF INDUS7RIAL SAFETV PERMI7 CERTIFICATION: ❑ I hereby certity that no excavation five (5) or more feet in depth Into which e person is required to descentl, wlll be made in connection with work authorized by thls permit, and ihat no building simcNre, scaXolding, talsework, or demolition or dismantling thereoi, will be more ihan ihirry-six (38) feet high. (Chep. 32, Gry 2, Art 2, Sec. 341, Title B, Califofnia Adminis�rative Cotle). ❑ As owner-builtler, I will not employ anyone to do work which woultl require e permit trom the Division ot Industnal Safety, es notetl above, unless suc� person has a pertnit ta do such Work irom the division. SignaNre: Date: Division ot Indusirial Satery Permit Number. CERTIFlCATE OF COM7VANCE AND AUTHORIZATION OF ENTRY: I certify untler penalry of peryury that I have read this eppliWtion and state Ihet the infortnation given is correct I agree to comply with all state laws antl ciry ordinances relaiing to building construction, end au�honze representatives of ��e City of Coste Mesa to enter upon [he ��ebove-desc' pr erty or spection puryoses. I agree not ro occupy or allow occupancy ot any building authonzed by this pertni� until final inspectlon. D l l� � �.! -YD�- Sig ga Own (s) And/Or Authonzed Appliwnt Date CODE t. INSVECTIONTYPE pd¢ II��lLS . _. �� INSVECTIONTYVE , , jId]j �g, 1616 Fixed System Final Fire Prevention 206 Final Mechanical � 1266 Pool Spa Final. �: 200 Final Re-Roof 201 . • Final Blxk/Retaining Well 202 Final Feclory Fire Place 203 Finel Sign 204 - Final Demolition � 20B Final Plumbing 210 Final Electrical 212 . Final Fire Prevention 220� Final Planning Approvaf 222 Final Site ` '250 " Final Building/Oaupancy d (714) 754-5273'••Fax�.(714)�754=4856°�••www.ci.costaemesa.ca.us� 77�FAIR'DRIVE;.COSTA MESA; CA 92626 MECHANICAL PERMIT Job Address: 459 E 19TH ST Suite No Vicinity: Status: ISSUED Applied: 11/14/2005 Issued: 11/14/2005 Parcel Number: 11734129 _ _ . , - " - ' „� -. , ISSUED BY: Applicant: ALLEMAN, KRISTIN,�;%;r"�-�.. ' - �--��-�-. �;�� Address: 459 E'19TH ST.�f � � �..1,,� � - . ' � '� �� ... ,, � F .�,, � S.r� ��-� � �=yPhone: 949-645-6960 ' '� �� — . . COSTA MESA; CA.: . �'� � 'Zipi _ ` 92627-231�3 '� �,- i ' � �� - - = :' , - . Ownec ALLEMAN,`JASON AND KRIST,IN - c ` `� ��'� ��.. � , Address � 459 E'19TH ST ' � . i!!-,!i �� ,�,. �/ ,� / ` �• � s �, .i �' �. .. `'��j j.� Phone: 949-645-6960 �� ;ti\� -,� �l r i �`� �.��. - ' 'i , COSTA MESA;:CA;�" Zi 92627-2313 �� ''�� ' � i �'� � / P' �., � . . . . .� , .. . Contractoc � � OWNER-BUILDER � �`��' �'� � �_ Address: � 7 �; - � � . , �. ,./.. Phone: .. . � . i \. �.'iv - '.�� 'EZ�P {, � �. '- _, �i �' i y - ' ,'�. . � .� :' `+ � ' � �: License �000000 � �t �L . - -' . . . ,. ' �+t�4' \• . . � � ' ' �r� r'F, ~'! . �7 � ' ' � .a +: `1' � � ��:%' '"'a �g ' SCOPE OF PERMIT - ',� :; -, c, -'-. , .. �' 648SF ADDITION REF 805-01691. � � ,^�� , _. ,� � _� .- � ,-1 FAU 2�FACTORY FIRE PLACES 1 KITCHEN HOOD 7 VENT FAN 1 APPLIANCE �� , � - , . �� " .. > � . .' - - - . � ,. . FEE-SUMMARY ,.. � _ . , T ; � F_ � '� , � � - � Quantiry !r'. �_i .-7+ � ',�. � � .'_ , ISSUEFEE ", � $2350 � ;.__�... . '�r ,- , ._ "' Repaii/AlfAbsorbhonUnil ��' ' Inst FAU <100 k BTU �, � $14.80 �� 1 Repair / Alt Refrigeration Unit ' . Inst FAU�>100�k�BTU' : ' $0.00 0 ,r.-, Ventillation System . Repair/Alt CoolingMeat � $0.00 Of� f � . ' -, . - . ...Evaporative Cooler . InsURep.,RecessWallWr $0.00 0_T,�==��` -- � � '� Commercialincin_erator..' Refrig�Sys d100 k BTU":; '. . . $0.00 `�-0:"� � . - ,,, ' � Doinestic Incineralor � `" - " Refrig'Sys >100 k BTU '. $0.00 0 � Comoressors / Absorption Svstems Gas Piping � - $0.00 0 Up to 3 hp /'100 k BTU Fadory Fireplace � $21.30 � 2- 3 To 15 hp / 500 k BTU �� Hood w/Mech Exhausl �' �� $10.65 1 , 15 To 30 hp /.1;000 k BTU � VAV Boz' ' -.',�- � $0.00 0 . 30 To 50 hp /1,750 k BTU �..- :...-_•.. � . Vent Fan ) Single Duct � , , � 57.25 1 � � . ,,:�.� ;, , .� Over 50 hp / Over 1,750 BTU ' - Appliance . � � � $10.65 1 -�f;- Boilers : � " � ' � -� � ' Quanlity l $0.00 ., 0 $0.00 0 � $0.00',, 0 ;� ' . $0.00 - 0- . 50.00 0 � $0.00 0 -� � $0.00_ �0.� '.��I so.00 0 $0.00�., 0 ' $0.00 l 0 �'.� � �$0.00� 0 � � Fire Dampers " 7 ' _, $0 00 0 Up to 3 hp'�.,-, , ,� j% f$0 00 !. 0.- Smoke Dampers � ' , � `: �$0 Otr 0 .�, ' � '<3 To 15 hp r �- � -;�„ r$0 OOi �� 0 � �': InstorRelocateApplVent ;$000, -0-=�� - . 1 =�- q5to30hp �� '�"�1� r,�.� ' $0.00 0 Air Handlers < t0000cftn % $0 00� 0 � � � <30 to 50 hp- " ` %- � ; �� $0.00 ,- 0 AirHandlers> 10000cfm : �1 -">$000 �0 � -,; � , e � .Over50.h'p > , y � ��%�� ,;-, �� _ $0.00� 0 FloorFumace -- � ��$000 0: �`�� `�,�' . OlherMechanicaFFee�' �'`�'��r� /=� � Ploor or Suspend Heater �� $0.00� -,0''� �� ,_ • Inv_estigation'Fee ;= '� i �'�.-, -� ; �; $0.00 - � -,�. , �Sr� .- — �-Plao-CheckFee' '�`� - !;' $0.00 ... � ' a � � r , -- Remspection Fee-�� S � , !,: �� $0.00 . . `, �� J '�?:'r �..��J\i`�� j.r, .� �-�_�� " � �; i `r '� , �� ,. ( � . �,TOTAL��CALCULATED FEES" E86.15 _ - �_` v � . �l_��'Y �-i�%� , ,��..�. _ '- . -�"--'-' , RI-�P R „. ?NOTICE::. The work�authonzed�.by,thiSspermitishalCcomply;with�all'Bpplicable�handicap�:accesssrequirements:undecCalifomla--statutes and related iregulationsr(Orcl::No:�92=28^§ct; 7221-92)', Y I �EXPIRATIONa:This,permit��shall'automatically.expire�and,become;void itwork�is�.noLcommenced:within�180�"days;:or.if�work'is suspended.or,abandoned �for: a� period � of:180'days e. ziNSPECTIONS:�.lmorder�tor,the:work!authorized.under;this;permitito:be�considered�,legal;�such�work.musbcomply;with•all�applicable�codes, and ell �requlred�.Inapectiona�and,flnal.approval:must,be�obtained:��Failurerto obtaircinspections�and�.finabapprovai:wlll�.result'�in:ihe�,expiratlomof,this�permit. :(714) 75456265 zaaeee le�ool. WORKERS' COMPENSA710N DECLARATION: � � - ' � � � ' . I hereby aHirm under penalty of perjury one of the followinq tleclerAlions:. � , - ,� � ,� ❑ I have and will'maintain a cenifiwle ot consenf to sell-Insure br workere' compensetlon, es pmvitletl br hy section 3700 ot Ihe Lebor Code, tor the paAortnence ot Ihe wark tor which ihis pertnit is issuetl. � � �- � �• � � ❑ I have and will meintain workers' compensallon insurance, as required by sectlon 3700 oi the La6or Gotle, for Iha pertortnance of the work for which Ihis permit Is Issued. ' My workars' compensatloq Insurance carner and oolicv number ere: . . ' Carrier: Policy Num6er: (This sectian need nof be comp/eted il the peimit is velued at one huntlretl tlallers ($100) or less.) ❑� I cetlity ihat in the pertorrnence of iha work for which Ihis permit is issued, I shall not employ eny person in any manner so as lo become subject to the Cvorkere' � compensation laws of Celifornla, and egree that II I should become sub�ect to the workers' compensation provisions oi Sectlon 3700 of ihe Lebor Code, I shell forthwith Canply wrth IheSB provi5ian5. Applican� SignaNre: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNUWFUL AND SIVdL SUBJECT AN EMPLOVER TO CRIMINAl. PENALTIES AND CIVIL FINES UP TOONE HUNDRED TFKKISAND DOLLARE (5100,000), IN qpDfilIXJ TO THE COST OF COMPENSATION, DMAAGES AS PROVIDED FOR IN SECTIIXJ 3'lOfi OF THE LA90R CODE, IMEREST. AND ATTORNENS FEES. LICENSED CONTRACTORS DECLARATON: I hereby aHirm that I am licensetl under provisions ot Chapter 9(commencing with Section 7000) of Divislon 3 ot t�e Business en0 Professions Cotle, end my license Is in tull force and ettect Lic. M Clau a ContractoYs Signeture: Date: CONSTRUCTION LENDING AGENCY: � ❑ I hereby attirm Ihat t�ere i5 a construction lending egency for the pertortnance of the work tor which ihis pertnit is issued. (Sec. 309�, Civil Code). terMers Nertre: Lender's AtlUress: Signatura: Date: OWNER-BUILOER DECLARA710NS: I hereby aHirtn that untler penel�y of per�ury that I am E%EMPT FHOM THE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Buslness entl Professlons Code: My dry or counry which fequires e permit to construct, alter, Improv0, demolish, Or repeir any 5iruclur0, prior to Its IssuenCe, elso requir05 lhe aDPliwn( fOr SUCh pertnit to fle e slqnetl statement that he or she is Ilcensed pursuent to Ihe D�oNslons ot the Contrectors License Lew (Chepter 9(commendng wlth Section 7000) ot Division 3 of the Business antl Professions Code) or ihet he or she is exempt ihereirom and the basis for t�e allegetl asemption. Any violalion ol Section 7031.5 by eny epplicant tor a permll subleds tha applicant to e civil penalry oi not more then five huntlred dollars ($500).): ❑ I, as owner of t�e property, or my employees with wages as their sole compensailon, WILL DO 7ME WORK, antl Ihe structure is not intanded or oMeratl for sale (Sec. 7044, Business and Protessions Coda: The Conirectors LJcense Law Coes not appty Io an owner ot properry who builds or improves Iherean, and who tloes such work selt or herselt or through his or her own employees, provi0ed �hat such Improvements ere nat intended or ottered for sele. If, however, Ihe building or improvement Is sold wi�hin one year at completion, the owner-builder will have the burden of praving Ihet he or she did nat build or Improve for purpose of sele.). � as owner of the property, am EXCLUSIVELV CON7RACTING WITH LICENSED CONTRACTORS lo consiruct Ihe project (Sec. 7044, Business end Professlons Code: The contrecmrs Licgnse Law does no� eppty to an owner ol propeny who builds or Impmves thereon, entl who conirecls tor such prqect wtlh e contractor(s) license pursueni to the Contrectors License Laws.). ❑ I eze p� er ec Business end Prolessions Cotle tor this reeson: ture: .✓ verifieA by drivefs licen5e. �scF ❑ No 'vets Lice o. Veritication of Ownership by (type of documem, I.e. � property tax bill or tl DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFICATION: ❑ I hereby cerlify Ihat no excavetion tive (5) or more teet in dapth Into which a person is requiretl lo tlescend, will be made In connection wil� work eut�orizetl by t�is permit, and that no building structure, sceflolding, felsawark, or tlemolition or Cismantling thereof, will be more than ��Irry-sl: (36) teet hig�. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ttle 8, Califomia Adminisirative Cade). ❑ A5 owner-builder, I will np� employ enyone to do work which woultl require a pertnil irom �he DlNsion oi Intlustrial Setery, as noted ebove, unless suc� person has e permit to tlo such work trom the division. Signature: Date: Division of Indusirial Safery Pertnit Number: CODE L INSPECTIONTYPE •` . ..' ' ^ . .•Qa7E 1676 Fixed System Final Fire Prevention " 1266 Pool Spe Finel 200 Final Ra-Rool � " � _ 201 Final BIocWRetainin9 Wall _ 202 Final Fectory Fire PlaCe . _ 203 Final Sign _ 204 Final Demolition _ •+'f�$ " �( INSPECTONTYPE � � . ZOs Finel Mechanlcal � � 208 Finel Plumbing ' 210 Finel Electricel � ' 212 Final Fire Preventian � � �� ' ' '�220 Finel Planning Approvel 222 Flnel Site � � 250 Finel Building/Occupenq . PASE • . II�LH �g-o6 � (71a) 754-5273 •-Fa�c (7ta) 754-4856 ' WWW.CI.COSiB-ff18S8� I�MBING PERMIT n FAIH UHIVh, GUS I A MtSA, GA 82616 ,lob Address: 459 E 79TH ST Suite No Vicinity: Parcel Nunmber: 11734129 Applicant: ALLEMAN, KRISTIN -- ; Address: 459 E 19TH ST ' � � - � - � - Owner: Address Contractoc Address: �� . � "� � '�� Bhone: 943645-6960 ~ �ir, COSTA MESA, CA'� ,� , � Zip: 92627-2313 / � � � /""1` ` 1 , � _ /, _. ALLEMAN, JASON.AND'KRISTIN� _ 459E''IBTHST, �} � `i/�r�� _ -� : �� . `r. . / ,,^_,,, .- r ,� � � Phone: COSTA MESA,CA�-` % � Zip: � " / OWNER-BUILDER _ �•c� 949-645-6960 92627-2313 Status: ISSUED Applied: 11/14/2005 Issued: 11/14/2005 ISSUED BY: �_ � �� r��: : j� i /% �� l ;:�,:.�; '� . '-:-'; :� �. �� , > A� \ �. / `' �,�� `<' � . ; Phone: � ' . , . � � ,.: � __�:_ _._.' .:`Zp'.�"� ' - ' ��.. ' � �..,.: .. �� .� i\ �., . � ; � ��;%I *. .-��+ i: , ,License:�000000 .''• � � ..,' .`} ,/. . , . , �' . - _ ' i' %� � rr _ _ -' -� , _ " ' ' ' SCOPE OF PERMIT ' ' , � � ' � � 648SF ADDITION REF BOS-01691. ' -� ' 1 CONNECTQCE) 4 GAS (1-0 OUTLETS) 1�C�AS REPIPE 1 SHOWER,.1 BAR SINK 1 KITCHEN SINK - 3 WASH BAS�N 1,TOICET 1 TANKL'ESS'WATER'HEATER 1'WATER REPIPE� , ' � � ," - - /-, . � . i. FEE SUMMARY � �• � AMT QTY �' AMT QTY -AMT �TY ISSUE FEE � $23.50 - . - �L'aundry Tub /-Washer :' �'- $0.00 �P� ., , _ Sump Pump $0.00 0 BackOow irrigation , . $0.00 0 - Landscape�lrrigalion . �-_ � - -.$0.00. � 0 " : . - Swimming Pool $0.00 0 Backflow Preventer � � - $0.00 0 �� P-Trap - - - $0.00 � �0 �- - , Trap Primer $0.00 - 0 Bathtub $0.00 0 Pressure Regulator 50.00 0 Urinal $0.00 0 Clarifier System $0.00 0.. Process Piping (per 10 fl) 50.00 0 ,. Vacuum Brkr BkOow(1-4) � 50.00 0 Connect (Ice,Soda,etc) 59.80 1 Receptors � 50.00 ,�0 . Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units -.$0.00 0� Septic Tank � 50.00 0 Wash Basin � $0.00 0 Dishwasher �$0.00 0 Sewer Cap for.Demo. _, -- $0.00 0 Wash Basin Set � _ $0.00 0 Drain, Floor � . �$0.00 0 Sewer Connect ,. '`• $0.00 0 Waste and Vent System $29.40 3 Drain, Rainwater 50.00 0 ' Sewer Private Line 50.00 �, , 0 Water Closet (Toilet) $9.80 1 Drain,Roof �� ' $0.00 �� 0 Shower � - , 59.80':1 . WaterHeater/vent ,512.30 1 DrinkingFountain � � 50.00�� : 0 i -'.^„�;Sink,bar, � � ;- $9.80-, ',1�...- .c;,�.-,?;.WatecPiping(InstorRep.)' S0.00 0 ExpansionTank��` $0.00 ��0_�, - :"Si'nk,commercial�' � o'�' �$0.00 0 � - '"<WaterRe-pipe ' $9.80 1 Gas EaAhquake Valve -�$0.00 0 �; �� Sink, Floor ' , '�� $0.00 '0 -,", jWater Service� � $0.00 0 Gas (1-4 outlets)" ` '524:60 ; �, 4 �� `�� Siuk, kitchen� � � � $9.80 � 1 `c-�- -- Water Softener � 50.00 0 Gas(Over4outlets) � $0.00" . 0> ��=�Sink,servicelmop � $0.00 0" �- - '� OTHER �'� � �- 50.00 Gas Repipe � $9.80._ �� 1!, � `Spa (private) - , _ --$0.00 :=0' ' " VIOLATION 50.00 Gas Service ' $0.00 '� i 0 � � ; � �Spa (public) _ - - - - $0.00-� 0 �:�� PLAN CHECK, � $0.00 Interceptors (Grease, Oiq �$0.00 '� �0 ��' ', , . � � � � �, ��REINSPECTION $0.00 0 Intercepiors (Sand Auto ) $O.OP� '� 0 �_� ' � . ` , " , � � �'�� ,� �� - � � - � ' , ., ��, �,:,�, �. % TOTACCALCULATED FEES: E158.40 .._. . ,r ._ - " ;"%i".'. ' COMMENTS / SPECIALCONDITIONS ; � --. , _ ,, . . � R 1� NOTICE: The work.authorized by this permit shalLcompty with all applicable-handicap access requiremenis under Cali}omia statutes and related regulations. (Ord. No.�92-28, §'1, 12-21-92) i 'EXPIRATION: - This permit shall.automatically expire'�and�.become void if work is not commenced within 7B0 days, or If wol/1 s suspended or abandoned for a-periodaf 780 days. INSPECTIONS: In order for lhe work-authorized under lhis pertnit to be considered legal, such�work must-comply with all epplicable codes, and ell � required Inspectiona�and flnel�approval�must be obtained: Fallure to obtaln Inspections antl final approvat wiil rasult in the explration of lhls permit. -F.OR'INSPECTIONS'CALL: (714)754E5828 � 2446J8 (flN0) WORKERS'COMPENSATION DECLARAnON: ' ` ' � I hereby eflirm under penalty of p¢rjury one of the following tleclarationsi ., � ❑ I heve entl will malntaln e certificate of consent to selt-Insure tor workers' compensatlon, �as provlded for by sectlon 3700 of tha Lebor Cotle, lor the pertortnance of the` work lor which this Dermit is issued. � ' " � � � � . ' ❑ 1 have antl will mainialn workers' compensatlon insurance, as required by section 3700 ot tha Labor Cotle, for Ne peAormance of Ihe work tor whkh thLs permil is issued. . My workers compensatlan Insurance carrier antl palicy number era: � � Carner: policy Number: ' (Th/s sectlon need no( be compietetl i! the permit is valued ef one hundred dollars ($100) or less.) ' ' ❑ I certity Ihat in t�e pertormance ot the work for which this permil is issued, I shall not employ any person in eny manner so es to bewme subjed to the workers' wmpensatlon laws ol Celitomie, end egree that It I should �ecome subjeq to the workers' compensation provislans of Seclian 3700 of Ne Lebor COGe, I shell forthwlth comply with these provisians. Applicant Signatura: Dele: WARNINO: FNLURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNIAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FlNES UP TO pNE HUNORED hKK15AND DOLLARE (5100,000�, IN ApOfiION TO THE COST OF COMPENSATION, DAMAGES AS PqOVIDED FOR IN SECf1IXJ 3]OB OF THE IABOfi dJDE, ItJrEAE5T, AND ATTOqNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I �ereby aHirtn that I am Ilcensetl under proNslons of C�apter 9(commencing with Section 7000) of Divisian 3 of iha Business and Professions Code, entl my license Is in tull force antl eNec4 Lic. A Class x Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: . ❑ I hereby aMirm the� thera is a construction lending agenty for the pedormance ot the work br w�ich ihis permit is issued. (Sec. 3097, Civil Code). Lantlefs Name: LenQer's AOtlress: Signature: Date: OWNER-BUILDER DECLARA710NS: I �ereby ettirm Ihet untler penalty of perjury that 1 am EXEMPT FROM THE CONTFiACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business and Protessions Code: Any clry or counry w�ic� requires e pertnit lo construct, elter, improve, demolish, or repair any structure, prior to its issuance, elso requires �he applicant lor such permil m fle a signed slatemenl t�et he ar she Is Iicensed pursuent to ihe pmvisions of Ihe Coniractors License Lew (Chapter 9(commencing with Sectlon 7000) of Dldslon 3 01 [he Business and Protessions Code) or ihet he or she Is exempt lhereirom end lhe hasis for the allegetl exemption. Any violation ot Saqlon 7031.5 by eny appllcant for e pertnit subjecis �he epplicant to e civil penalry of nol mora than tive hundretl tlollars ($500).): ❑ I, as owner ot t�e D�aPerty, or my employees wl�h weges es t�elr sole compensation, WILL DO THE WORK, end the siructure is not intended or oHeretl lor sale (Sec. 7044, Business antl Professions Code: The Contractors License Lew dces not apply to an owner of proparry wha builds or improves theraon, end who tloes such work hi elf or herself or I�rough his or her own employees, provided ihet such improvemenis are not intended or oHered tor sale. If, however, ihe building or improvement is Itl within one year of completion, the owner-builder will have the burden of provinq that he or she did not builtl or improve for purposa of sale.). I, es owner of ihe properry, am E%CLUSIVELV CONTRACTNG WI7N LICENSED CONTRACTORS to construct the project (Sac. 7044, Business and Protessions Gade: The conbacto�s License Law does rrot apply to an owner ot property who bulltls or improves thereon, and wlro contracts lor such project w77h a contrector(s) 'Cen50 pursuant to Ihe ComraCiorS Litense LawS.). exem tun ey�� BusinessendProf � od��r�is�ason: Signeture: �� // � venfied by drivers license. ❑ No Drivers Lice No. i s: �. /r�/ r� Veriticetian of Ownership by (rype of document, i.e. - property tex bill ar deed): DIVISION OF INDUSTRIAL SAFEN PERMIT CER7IFICA710N: ❑ I hereby certity Ihe� no exCavetion five (5) or more feet in depih Into which a person is required to descend, will be made in connection with work authorized by this pertnit, end ihat no buildin9 struCture, scatFOlCing, lalsework, or demolition or dismantling ihereof, will De more �han ihirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Celifomia Atlministrative Code). ❑ As owner-builder, I wlll not employ anyone to do work which would require e permit from ihe Division of Intlustrial Setety, es notad ebove, unless such pereon hes a permlt to do such work fram ihe dlvislon. SignaWre: Date: Division of Industrial Sefety Permit Number: CERTIFlCA7E OF COMPUANL`E�i`�IWD AllT}IOROA710N OF ENiTiY: I certify under penalry of perjury ihat I have read ihis application and state that the intortnation given is correct I agree ta compry`t�l�state lavis and ciry ortlinances relating�to;building conswction, anC aumonza representatives of t�e Ciry at Costa Mesa to emer upon the above-tles ' d pr e y for mSpe�tion pury�Qses. I egree nohl�acupy� p�(�Ilow�occupancy of any building au�horized by thi: �m�ii until final� sBgGtioa. ,�6r� �L Gt4� 4;t� fY� 6�W (�� 1�1 _ � C! d �h . re OI Legal Ow r(s) �B AnNOr Authonzed AOPlicent CODE t. INSPEC710NiYPE � . 1616 Fized System Finel Fire Praventlom 1266 Pool Spe Finel 200 Finel Re-Rooi ,' � 201 Flnel Blak/Re�aining Well 202 Final Factory Fire�PlaCe 203 Finel Sign 204 Finel Demolllion . ��, INSPECTIONTYCE , .� .206 � Final Mechaniwl .. 208 Final Plumbing 210 , Final Electrical �. � 212 Final Fire Prevention , :220` �� Final Planning Approval PdIE II�dLi 3-Zr1�6 � 222 Final Site ' � � � � � � _ 250 Finel Builtling/Occupancy ' ' ' ' ' � � (774)�754-5273 •° Fau (77a)��54-aess� •�www.ci.costa-mesa��TRICAL PERMIT ��FAIR DRIVE; COSTA MESA, CA 92626 ,lobnddress: 459 E 19TH ST Status: ISSUED Suile No Applied: 11/14/2005 '. Vicinity: Issued: 11/74/2005 Parcel Nunmber: 11734129 Applicant: ALLEMAN, KRISTIN Address: 459 E 19TH ST -- �.�, -' . - �� Phone( 949-645-6960' - 1SSUED�BY:, COSTA MESA, CA - Zip 92627-2313 � � " � � , . , � i�;., �, �� . - 1 � i � � \ . � � . , � �i � �. Owner: ALLEMAN; JASON,AND'KRISTIN` " � � �" � -� ,•. ;'�. Address 459 E 19TH ST ''- - - - _ , �- � � � � � ,� � - - � �\' . � �� -�Phone: 949-fi45-6960 ' � �- . � COSTAMESA,CA� jJ' � ' Zip: 92627-2313 ` �\�:\< . .i.,�� ,� �� . . . '�, ' /. .;� � � � 'A Contracroc: OWNER-BUILDER � , �, Address: ,� , � �, - � ' , Phone: �� . � ` �- . , i Zip: � . , � ' . , � � ' "-� • Licenaei 000000 � � ` �� • , � v', � �! i � � � _ �ys�� .. � �, r . ' � . ' �. • ' ..'�'`�.��'t� � • :�+4�'..n';` ' . . . ` . ,. . ' , , � i_ , '--f , _ . , ; , . - - ' SCOPE OF PERMIT . �' �'648SF ADDITION REF BOS-01691. - . , , � , 17 LIGHTS 201 LOW VOLTAGE WIRWG. , ', � . , �- OUTLETS, 9 SWITCHES, 1 SERVICE TO 200 AMP. �- ' � „- - - ; FEE SUMMARY .:� i � `; ` � � � � � ' � - ._.. � � . . .. Quantiry� . . � . - Quantity - ISSUE FEE 523.50 Temp Dist System / Lighting 50.00 0 Temp service test 50.00 r,; Busway I100 ft ��" � $0.00 0, � � � Res,a/cpackage �' $0.00 . f'-'- - � StaridingSection�=�,�;, $0.00 0 . . . New Res_(1-2 units), ��. $0.00 . � A-- - _-- - - Misc Electrical,Equipment - ., 50.00 0 � , � New'Res (3+units) $0.00 " `0 � -- - "' Transformers up to Ykva/kw-- $0.00 0 " , Pool / Spa , $0.00 0 ................up to 10 kva/kw 50.00 0"� �� Lighting Fixls 51870 . 17 .............:.:.up l0 50 kva/kw � $0.00 0� � Recept Outlets $22.00 20 ...........:.....up to 100 kvalkw $0.00 0 � Swilches . . $9.90 . 9 ..................over 100 kvalkw $0.00 0 � � Non Res Appl � � $0.00 � 0 - "Low Voltage Equipment $1820 � -1 � ; � Res Appl - � . $0.00 0 - ' �. � Low Voll Wiring System / Ckt $0.00 -' '- 0 ' ' Service to 200a $30.50 1 . " ' Misa ConGuit.-, $0.00 -� ,' 0 , Senice to 1000a � $0.00 0 - . Misc. Conduclorf . _ $0.00^�.' 0 � � , , Service over 1000a -' $0.00\ S.`r-t0;`r �-;. ., --Circus ( gen orride)-,-, �-, S.w.�-",g0.00' 0�'- Motors to 1 hp ' . /. % $0.00 �-,\ _ -. 0�' ' � Circus (mech ride or lights) J �� ; $0.00 ; � 0 - Motorato10hp � �.� - � $0.00 � ��0 �-� � , � ChristmasTreeStand � ;�$000" � 0 ' , Motors to 50hp � � '$0.00, � __0��,;� � _ � Fireworks Stand'" -� ;' � $0.00 �=i0� , Motorsto100hp ' 50.00 '0'v,'_� , � � . �OtherEleclrical.Fee:� �� _ -50.00- `� ' � Motors over 100hp , 50.00 ,�, �� 0��-^ _ ' - . � _ � � - " . � _� , � Communicationdrops � � SO.00l/ � ,0,-� � - _Investigation�Fee \�\ .$0.00- . . - Sub panel to 200a � � $0.00 � �� !� 0- - ="� Plan Check Fee� �`� •. � `-$0:00 ; ;'' � Pole Light Pkg �\$0.00._ ,= 0 "",-� �� ', "-" Reingpection F.ee \�� $0.00 ' � Sign Circuits $0.00 � � �, 0 �' '_ � � ' ^ " ' � � �. � 3 J , �; -, . TempPwrPole $0.00��` `��0, � _- ��;`TOTALCALCUCATEDFEES;5122:80 Intermed Pole 50.00 ' - -o - - ' � � , - - _ . - -� ,ii'"' `" - , COMMENTS / SPECIAL CONDITIONS RR r _�� .�� •� 1 � NOTICE: The work authodzed.by�this permiCshall.comply•with all applicable handicap access requirements under regulatlons. (Ord: No: 92-28, § 1, 12-21-92) : E%PIRATION:'This permit shall.aWomatically explre an0��become void iLwork is not commenced.within 180 days,-or ll�w � for a period of 180 days. INSPECTIONS: In.order for the�.work authorizad.un0er thispermit to.be:considered lepal, such.work�mushcompty� -� requlred�InepecUons�and�flnal approvel.must be�obtainedrFailureto obtain inspections and final approval�wiif resul)�in: CALL:, (714)75445626 :..� ..�.:i(?C:)] P. slatutes and related suspended orabandoned �le codes, arM all o� thls permit. WORKERS' COMPENSATON DECLARATION: � , � � I hereby eflirtn under penalry oi perjury one of Ihe tollowing dederehoris:' • ,' . ,,.� ❑ I have end wN malnteln e cerlificate of consent to self-Insure for workers' compensation, es proNOed lor by section 3700 0l tha Lebor COCe, for. Ne pertortnance of ihe work for which this permlt is issued. ❑ I �ave ana wlll meintain workers' mmpensfltbn insurance, as requiretl by secylon 3700 of the Labor Code, for the peAortnance of the vrork for which Nis permit is issued. My workere' compensation Insurence cerrier end polity number are: � Cerner: Policy Number. (Thls sec(ion need not be complete0!! fhe permit Is valued af one handreC dWlars (3100) or IessJ ❑ I ce�ity that in tha peAormence ol ihe work lor w�ich I�is Oertnit is issuaA, I shall not employ eny person in any manner so as to become subject to ihe workers' compensetion laws ol Celitomia, entl apree thet i1 I shoulC became sub�ect to the workers' compensatlon proWsions ol Section 3700 01 the Lebor Cotle, I shall forthwith compty with these provisions. Applicant Signature: Date: WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION WVERAC.E IS UNLAWFUL M1D SIULL SUBJECT lW EMPLOYER TO CRIMIWLL PENALTIES AND CML FlNE$ UP TO ONE HUNDRED THOUSAND DOLIARE (5100,000�, IN ADqT10N TO THE COST OF COMPENSATION, DAAIA�ES AS PROVIDED FOR IN SECfION 3lOB OF TIE UBOR COOE, IMEREST, AND ATTORNEYS FEES. LICENSEO CON7RACTORS DECLARATION: I �ereby eNirm Uat I am Iicensed under provisions ol Chepter 8(commencinp wil� Sectlon 7000) ol Divisian 3 0l ihe Business end Proteulons Cotle, enE my license is in tull brce entl eHect. lJc. a Class a Contrector's SigneWre: Date: CONSTRUCTION LENDING AGENCY: � ❑ I hereDy ettirtn t�et Ihore Is e consiruction lentling egency for ihe Dedormence of the work Por which this pertnit Is Issuetl. (Sec. 3097, Civil Cotle). Lentlers Name: LentleYs AEdress: Signature: Date: OWNER-BUILDER DECLARATONS: I hereby eHlrm t�at untler penelry ot per�ury thal I em EXEMPT FHOM THE CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Buslness entl Professions Cotle: Any ciry or wunry whic� requires e permit to wnstruct, elter, Improve, demdish, or repair any structure, pnor to Its Issuance, elso reqWres the epplicant lor such pertnit b file a signatl statement thet he or she is Ilcensed pursuant to the pmvlsions ol Ihe Contrectors Llcense Lew (Chapter 9(commencing with Section 7000) of Division 3 ot ��e Business end Pmtessions Code) or that �e or she is eaempt t�eretrom anE Ihe besis for the ellegetl eaemption. Any violation o� Section 7031.5 6y any epplicent for e pertnit subjects Ihe applicam Io e civll penalry ot not more then five hundretl tlWlars ($500).): ❑ I, as owner of the properry, or my empiqrees with wages as thelr sWe compensatlon, W ILL DO THE WORK, end the siructure Is not intended or aHereE tor sale (Sec. 7044, Busineu antl Prolessions Code: The Coniraqors License Lew does not eppty to an owner ot Droperry wha builds or Improves Nereon, flnd w�o tloes such work himself or herself or through his or her own employees, provided ihat such imprwements are not Intended or ottered lar sele. If, however, Ne building or impmvement is �solA wit�in one year of complelion, the owner-builder will have Ihe burtlen of proving that he ar she Aitl not build or improve for purpose of sele.). �p `�as owner oi ihe property, am EXCLUSIVELV CONTFiACTNG W17T1 LICENSED CONTRACTORS b construct Ihe project (Sec. 70M14, 6usiness end Pmfessions Cade: The comractors Llcense law tloes not epply to an owner ol properry who builds or Improves thereon, antl w�o comrecis tor such pmject with a contractor(s) license pursuant to the Contractore License Laws.). venfied by tlnvers No 8usine55 and Prolessions Coda lor this reeson: Verilication af Ownership by (type ol document, i.e. - Droperry tac Dill or deed): No. DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hareby cenity that no excavetlon five (5) or more leet in depth Imo which e person is requlred to descend, will be made in connection wlt� work euthodzetl by Nis permit, and that no 6uilding struqure, scaHoltllnp, falsework, or demolition or dismantling t�ereof, wlll be more than thirry-six (36) feel high. (Chap, 32, Grp 2, Ar12, Sec. 341, Title 8, Califomie Administrative Coda). ❑ As owner-builder, I will not employ anyone to tlo work whic� would require e pertnit irom t�e DlNsion ot Indusirial Selery, es noted ebove, unless such person hes e permit to Co such work irom the divi5ion. SignaNre: Dale: Division of Indusirial Sefory Permil Number: COOE �. INSPECTIONTYPE 1816 7266 200 201 202 203 �g � Fizetl System Flnal Fire Preventlan - Pool Spa Flnal Finel Re-Rooi Final BIocWRetelning Well Final Fectory Fire Place ' Finel Sign 204 Finel Demdition , , ��$ ' ' j�Qy[a INSPECTONTYPE ' � 208 Final Mechanical 208 Final Plumbing _. ___ ' 210 Finel Electdcal � 212 Finel Fire Prevention 220 Final Planning Approvel 222 Final Site 250 Finel Building/Occupency (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us ' 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 459 E 19TH ST Suite: Vicinity: ROOF S.F.D. AND DETACHED GARAGE Parcel Number: 11734129 Zoning: Applicant: GEORGE CARRALEJO Address: 8218 PEPPER CIRCLE Phone: 714-952-4958 BUENA PARK, CA Zip: 90620 Owner: ALLEMqN, JASON AND KRISTIN Address 459 E 197H ST Phone: COSTA MESA, CA Zip: 92627-2313 Contractor: GEORGE AND SONS ROOFING Address: 8218 PEPPER CIRCLE BUENA PARK, CA Zip: 90620 Arch : Address: Phone: 714-952-4958 License: 443547 Eng: Address: Slatus: ISSUED Applied: 12I20/2004 Issued: 12/20/2004 Phone: Phone: Zip: License: License: SCOPE OF PERMIT . TEAR OFF EXISTING ROOF, INSTALL 15# FELT, 40 YEAR COMPOSITION SHINGLES, RIDGE GLASS AS CAPS AND REPAIR/REPLACE SHEATHING AS NEEDED. 1500 S.F. FOR S.F.D. AND 400 S.F. FOR DETACHED GARAGE. WORK TO BE DONE CONCURRENTLY. Plan Check: $0.00 Permit: $125.25 SMIP Res: $0.55 SMIP Com: $0.00 Other: $0.00 Inspection: $O.OD Total: $125.80 SETBACKS MAIN STRUCTURE Front 0. 0 ACCESSORY Fmnl 0.0 PARKING Exfstina: p Rear 0. 0 Rear 0- 0 ReQuired: 0 FEE SUMMARY Galc Valuation: Claim Valuation: PLANNING & ZONING Left 0- 0 Left 0- 0 Pr000sed: 0 �; .- Right 0- 0 Right 0- 0' - ss,soo.00 $5,500.00 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, 12•21-92) EXPIRATION: This permit shall automatically expire and become vold if work Is not commenced within 180 days, or If work Is suspended or ebandoned for a perlod ol 180 days. � INSPECTIONS: In order tor ihe work aNhorized under this pertnit to be consitlered legal, such work must comply with all applicable eodes, and all requlred Inepeetiona end final epprovel must be obtained. Failure to ob�ain inspections and (inal approval will result In t�e ezpiretion of lhis pertnit. FOR INSPECTIONS CALL: (714) y5q-562fi zaasa la.vo) WORKERS'COMPENSAnON DECLARAnON: I hereby eflirtn under penalry of perjury one oi Ne lollowing deGareUons: ❑ I have end will malntein e tertiflcate ol cansent ro selt-Insure for workers' compensetion, es providatl far by section 3700 ot Ihe Lebor Cotle, for Ihe pertortnarice ot tha work lor which this pertnit (s issueC. ❑ I hava antl wlll melntain workers' compensatlon Insurence, es requiretl Dy sectlon 3700 of ihe Lebor Cotle, for the perto�ence of the work for which Nis permit is IssueC. My workers' compenselion ��surence carrier and poliq number are: Cerner: (This s� Ih09B t�e perm/t !s �� work toi Hr,p egree th WARNINO�fRICORE TO SEGURE WORKERS' OOMPENSATION 1 THIXISAND OOLLARE (5100.000), IN AOOITION TO THE �T OF LICENSED CONTRACTORS DkCLARATON: Policy Number: ired ddlars (5100) orless.) is i u O, I shell not employ any paraon in eny manner so as to become sub�eM to Ne workers' n ject to the workers' compensetlan provisions ol Section 3700 of t Lebor C%°e,L�I shall fort�with i oa�a: �l %.U/ G / UNLAWNL AND SHFLL SUBJECT AN EM L YO ER TO CRIMINAL PENALTIES M1D CNIL FlNES UP TO ONE NUNOREO ]N, �hNAGES AS PfiOVIDED FOR IN SECiION 9]OB OF THE IABOR CO�E, INfEREST, M!D ATTORNEYS FEES. 9 (commendng wlih Sectlon 7000) Coda, entl my Iicense 4s in full CONSTRUCTION LENDING A6ENCY: ❑ I hereby ettirm thet ihere is e wnsWction lending egency for ihe peAormence ot t�e work br which INs permit is Issuetl. (Sec. 3097, Civil Cotle). Lendefs Neme: Lentlers AOdress: SlgneWre: Oate: OWNER-BUILDER OECLARATIONS: I hereby eHirtn Ihet under penelry oi Der�ury Ihet I am E%EMPT FROM TME CONTRACTORS LICENSE LAW br Ihe follawinp reason (Sea 7031.5, Business entl Prolessions Code: My dry or tounty which reqWres e pertnit to construd, elter, Imprwe, Oemdish, or repair eny slruMure, prior to Its Issuance, also requires ihe eppliwnt tor such pertnit ta tile e signed stetement t�at he or she is Ilcensed pursuent ta Ihe provisions of ihe Contrectors llcense Lew (Chepter 9(commenUng with Secllon 7000) of ONision 3 ot Ne Business and Protessions Code) or Ihat he or she is exempt t�erelrom end Iha besis for the elleged e:emptlan. Any violation ai Section 7031.5 by any applicant for e pertnit subjects the eppllcant m e clvil pa�elry ot not more Ihan Me hundrea tlallars ($500).): ❑ I, as owner ot the propany, or my employees with weges es thair sole compensatlon, WILL DO THE WORK, end the siructure Is not intended or oMered for sale (Sec. 7044, Business end Professions Cotle: The Contractors LicenSe Lew does not epply to an owner of property who bu�ltls or Improves Ihereon, antl w�o does such work himself or herselt or through hls or her own employees, providea ihat such improvements are not Intended ar oHered for sele. If, however, Ihe building or imprwement is sold wit�in one year ot comD�etion, ihe owner-builder will have ihe burtlen ol proving that he or she did not builtl or improva tor purpose of sale.). ' ❑ I, as ov.•ner of the properry, am E%CLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to construct the prol�� (Sec. 7044, Business antl Prafessions Code: The con(ractors License Lew tloes not appty to fln owner ot properry who builds or improves thereon, and who coNrects lor such prolec� with e contracior(5) license pursuanl Io the Contraclors License Laws.). ❑ I am exempt under sec. Signatura: Owner ID verltled by tlnvers license. ❑ Yes ❑ No Business end Professions Code lor this reason: Venficetion ot Ownership by (rype oi tlocument, i.e. � property tar bill or deedj: DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFICATION: Drivefs License No. Date: Expires: ❑ I hereby certily thet no exc3�etlon Ilve (5) or more leet In depih Into which a person Is requlred to descend, will be made In connection wlih wark euihorized by this pertnii, end that no building sirucWre, sceHolCing, lalsework, or demolitlon ar dismentlinp ihereof, wlll be more then Ihirry-slx (36) feet hig�. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Tltle 8, Cellfomia Adm�nislretNe Cade). ❑ As owner-hulltler. I wlll not empby enyone to tlo work which would require e partnit fmm the Olvislon ol Industrial Sefery, es noted ebove, unless such person hes e permil lo tlo suth work Irom the divislon. Signature: Date: Divislon oi Industrial Selery Perm�� Number: CERTIFlCATE OF COMPLIANCE NdD AUTHOR¢ATION OF EMRY: I certify unCer ponelry oi perjury thet I have read this epplicetion end state lhat the infortnation given is correct. I egree to comply with all state laws end ciry ordlnances releting to bulltling rnnstruction, end euthorize representatives of the Ciry of Coste Mesa to enter upon the ebove-tlescribed property lor inspe�tion purposes. I agree not to occupy ar ellow occupancy ol eny building euthorized by this permlt until tinal inspection. COOE A' INSPECTIONTYPE `� I618 FIxeE System Finel Fire P�evontim 1266 200 201 202 203 Pool Spe Final Final Ro-Rool FInaI8locWRetelning Wall Finel Factory Flre Place Finel Sign 204 Final Demolitlon Pdgi II�ELS Da e � � 7O'� � COOE� INSPECTIONTYVE 206 Flnel Mechanical 208 Finel Plumbing 210 Finel Electdcal 212 Finel Fire Prevenilon 220 finel Planning Approval 222 Finel Site 250 FinalBuilding/Occupancy � � � 431-6 � COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING �y, ((�� u� ADDRESS �-� �% �O� 1' , \�. �,� �✓l • _j_, OWNER �IJiM'O YIYY�f,�Gi2 -�Il ADDRESS I�� 'XY�'y � TEI. ciTv A\.�� \�.,nn�Y 1�.-12'� 11- . No. l�llr l� BRANCH ARCHITEI OR ENGINE ADDRESS ADORESS CITY rF-i STATE � LIC. NO. {ad SIZE 6. OF LOT " a TE CITV LIC. NO. NO.OF BLDGS. NOW ON LOT y USE OF — � EXISfING B�OG. y FSeparate permits are required for o electric, plumbing and heating work. FW., USE OF BUILDING AND WORK TO BE PERFORMED a � i„d _ ' � .�.1 C w a BUILDING ADDRESS IRE ED JUL 14 1977 STRUCTURALPERI� L� ZON(�1� NO.OF /( PLANS VARDS APPROVEO MAIN BUILDING I i REAR �i7 DISTANCE BEL MAIN BLDGS. VAfi. sW '7' �'�' S'�. LOT ,j BLOCK l T CIFLE ; J NALUE L $ GfiOUP V DATE ' — � USE OF NEW • � BUILDINC� �� (/ VARDSAPPqOVED �� ACCESSORV BUILDING � FT. � � FT � BET. MAIN ACCESS. BL DATE APPROVED � 1 hereby aeknowledBe that 1 hava reatl ihis appllcaiion antl state � That ihe ebove InfOrmation is corraLt and a8�ee to comply wlth a ell laws reguiatinp buildinB eonstruc��on, and I shell noi employ z any person in violation of the workman's compensatlon laws of 5 tha Steta ot Celifarnle. l 3 I hereby certify that 1 am properly Ilcenaetl as a contrector untler SQ. FT. ffie Stata of Califomle Bucinasa and Protasslonf Cotle, Dlvislon 3, THE AMOUNT SHOWN UNDER VALU Chapter 9, and that such Iicenses are in full foree antl effeci, or I THE PURPOSE OF ESTABLISNING A PEflI em exampt from-tho provlsions of the Stata of Calltornle Businecs entl Professlons Co e, Dlvlsion 3, ChaP�a� 9. VALVATION PERMIT FEE E PLAN CHECK $ SlBnetu a �/�, 0 Permlttee 5 V V TAX E Auihorizatl Apant . TOTAL PAID y „� (� 'J 7 \n. `Y\ V' �� m m�N ON IS FOR m � FEE ONLY: � a N m � �_ m 0 D�` f U E"^ � a ..V7. � F A F a G �..7 � � ..1 a w a � a a z W �.�i 3 . �i;`�� CQSTA MESA BUILDING•SAFETY DEPARTMENT i P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applican[ to Fill in Comple[ely — Use Ink Only � BUILDING �� ,��+ � /C `T/�� ?' ADDFESS / // � OWNER InAsr/I �A-GiC IL�.. MAIL AD�RESS CITV • CANSTRUCTION BFiANCH ARCNITECT ADDRESS CONTRACTOR ADDRESS CITY � STATE LIC. NO. SIZE {� OF LOT V� USE OF 9 �J y TEL. TE�NO. CITV �{ � IIC. NO.(/ NO.OF BLOCS. NOW ON LOT Separate permits are required for elec[ric, plumbing and heating work. UIIDING AND WORK TO 8E PERFORP a�4685 gjjpj�g ' —� - '' ; .-- APPLICAT ON FOR STRUCTURAL PERMIT ECEI D DATE RECEIVED D TE ISSUEC � _ �'� .� � BUILDING ADDRESS FIRE ZONE APPROVED � S/ VALUE ZONE /j I p�-4N3 Z I BUILDING E W �a d V�' l� � VARDSAPPROVED VARDSAPPROVED MAIN BUILDING ACCESSORY BUILDING G �. � �{ CK..i I C URf FT. � FT. 3 PT. O FT. U FT. O FT. �. BET. MAIN & ACCF�. BlDGS. DATE AP7ROVED w� M nnrc Q//7-- I hereby acknowletlge theS I nave reatl this applicetion antl scate that the above Information is conect antl agree to comply with all laws regulating builtling canrtrucHon, antl I shell not employ any Gerwn in violation of the workman's compensation lews of the State of California. �r ' I hereby certify that I em proParty licensetl as a contractor untlar �� SQ. FT, tha Stete of Calltornia Busina4s and Professions Cotle, Divislon 3, THE AMOUNT 51 Chapter 9, antl that such licenses are in full force and effect, or I THE PURPp$E OF am exampt from the rovisions of the State of Callfornia Business VALUATION end ProfessionsC e, Dlvislon 3, Cha ter BO Slgnatura of !/ oO � Permittee $ � . � AuthoAzea Ageni n m i m N VN UNDEF VALUATION IS FOR m 'ABLISHING A PERMIT F E ONLV: ' � PERMIT FEE $ d L � m PLAN CHECK $ !� ^� 0 TAX $ � � � L TOTALPAID S �