The URL can be used to link to this page

Home My WebLink About460 19TH ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.g�LDING PERMIT 77 FA�R DRIVE, COSTA MESA, CA 92626 JobAddress: 460 E 19TH ST . Suite: Vicinity: ADDITON Primary Occ: R3 Parcel Number: 42632118 Appliwnt: GOODWIN, JOHN P Address: 460 E 79TH ST Type of Conslrudion: V-N Zoning: COSTA MESA, CA - " , "�� . � %� Owner. GOODWIN, JOHN P " Address 460E19TH�ST ��.�- - � •� ��%i' � 1 � %�/i � A `�' \ � � COSTA MESA, CA\ i � �. . - �i�� . ��'�. _ - Contractor: OWNER-BUILDER=;- ` � , ' � �� /j' ' Address: - -� _ j; '%� �� . �/� � �� = �; ', �� . %.=i , %i :-':� / , i Zip: - ' - : � � i � �� i ,'Afih > � , /.,/�,%, Address_ ' - �� Zip: � Phone: . -License: %° � Phone: 949-574-0643 Zip: 92627 ISSUED BY: Status: ISSUED Applied: 10I052006 Issued: 10I062006 Phone: 949-574•0643 - � - Zip: 92627 ,� � , Phone: License: 000000 (^ Eng: Address: �, � . _� _— C--- ,FFone s r ( — .� License: ' SCOPE OF PERMIT ADD 580SF TO EXISTING�SFD, NEW 110SF FORNT PORCH AND 369SF REAR DECK. WORK TO INCLUDE; DEMO OF (E) REAR 240SF BEDROOM CONSTRUCT 2 NEW BEDROOMS, 1 BATHROOM, LAUNDRY ROOM, NEW FRONT ENTRY PROCH, A REAR DECK AND CHANGE THE ROOF LINE BEDROOM. � �� INTERIOR REMODEL TO CONSIST OFDELETION OF 1(EO WALL TO.EXTEND KITCHEN, RECONFIGURE (E) CLOSET AND (E) BEDROOM. , / ..- � �i ��, ,�� q ,.- i . ' , PLANNING: �vl.� t ( _ _ �L , . . - -. - • d- _. . � RESIDENCE: 1,603 S�.FT. , . � . � GARAGE: 369 S�.FT. .,"�� ,..,� . ,, . , � DRIVEEAY: 80 SQ.FT. ' - � - , , ' , � _ �LOT COVERAGE: 2,057 S�.FT. (27°k) �'. „.. - -, _ . - ' : . , -, � OPEN SPACE: 5,703 SQ.FT (73%) � �� " ' �� . � , i i FEE SU .Rlan Check:� � �°�� $0.00 � �� . � Perrtiit: � A �$0.00 � � �ti,: �";._ . SMIP Res: $0.50 SMIP Com: $0.00 � � � �Other: - $0.00;�: �. _ -.. �i' ., � Inspection: ,-$0.00�� -: � � „ Totalc��\�$0.50�� \�� V /: �_�" �`' � � ��.�/i ��-� ��PLANNING SETBACKS �,'�;�_ ''� �,; _� � _ � . -�, MAINSTRUCTURE Front 0.0 �� Reai 0-0 .�- �' Lefl �; � � _i „��, ACCESSORY Front 0.0 Rear;;__0.0. Lefl �\� " ' � „� , . . — Calc Valuation: so.00 Claim Valuation: 5o.00 - _ - ; � " �. 0.p �' , 0-0� , RigM ' O 0 Right 0. 0 NOTICE: The work authorizad by this permit shall comply with all applicable handicap access requirements under-Calilornia statutes end related regulations. (Ord. No. 92-28, § 1, 12-21-92) V EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or if work Is suspended or abandoned lor e period of 180 days. INSPECTIONS: In order for the work aulhorized under this pertnit to be consldered legal, such work must comply with all applicable codes, and all requlred Inspaetiona and finel approval must be obtained. Failure to obtain Inspeaions and final approval will result in ihe expiration ot this pertnit. FOR INSPECTIONS CALL: (714) 7545626 2a4&e8 (flN0) WORKERS'COMPENSATONDECLARATON: - I hereGy eNirm untler penelry of per�ury one of the following tleclaretlons; � ❑ I heve end wlll melnteln e ceNlicete of tonsent to selt-Insure tor workere' campensatlon, es provltletl for by eectlon 3700 of t�e Lebor Cotle, for ihe peAormence o1 Ue work lor whlch Ihis perml� Is issued. ❑ I heve erM will maintein workars' compense6on insuraxe, es requiretl by secllon 3700 of Vre LeDor Code, lor I�e perfortnance of I�e work for whlch Ihls pertnit Lv IssuaA, My workera' wmpensatlon Insurence cartler and policy number ere: Certier. Policy Number. (Thls secfion need nof be comp/ered il fhe permit is valuetl ef one hundred dollars ($700) w less.) � I.certiy Ihat in.the Aortnence ot Ih � rk for which this pertnil is Issuetl, I shell not employ eny person in eny manner so es to become subjact to the workers' L�compansation I s f��Iltomia, end � rae that H i shoulC become sub�ect ro the workers' compensatlon provisions of Se tion 3y00 of the LeDor Code, 1 s�all forthwit� compty with Ih ro 4ionv. y� // Q WAPMNO:'FNLURE TO WRE WORKERS' COMPENSATION COVEMGE IS UNUWFUL ANO SHFLL SUBIECT AN EMPL�R TO �/" TI� uJD CML FlNES UP TO 0NE MUNDfiED THOUSWDOOLLARE(E ,OW),INAODRIONTOTHEWS70FCOMPENSATION,DMMGESASPROVIDEDFOHINSECTION37080FTHEUBORCOOE,IMEREST,ANDATTORNEV'$FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm that I am licensed under provisions ot Chapter 9(commencing with Sectlon 7000) of Divislon 3 oi ihe Buslness and Prolessions Code, and my licensa is in tull brce end ettect Lic. a Cless a Contreaofs Signature: Date: CONSTRUCTION LENDING AGENCV: ❑ I �ereby effirtn that �here is e consWdion Iending egency for ihe perlormance of the work for which this pertnit is issuetl. (Sec. 3097, Civil Gode). � Lendefs Neme: Lendefs AAdress: Sipneture: Date: OWNER•BUILDER DECLARATIONS: I hereby eflirtn that undar penelry of perjury tha� I em EXEMPT FROM THE CONTFiACTORS LICENSE LAW lor tha tollowing reason (Sec. 7031.5, Business end Protesslons CoCe: Any ciry or counry which requires a pertnit to construc6 elter, Improve, demdis�, or repalr eny strudure, pdor to Its luuance, elso requlres Iha applicant for such pertnit to file e signed stetement thet he or she is Ilcensed pursuent b the provlsions ol Ihe Coniranom License Lew (Ghapter 8(commeridng wlth Sectlon 7000) oi Dhdslon 3 oi the Business and Professions Cade) or thet he ar she is exempt therefrom enA t�e basis for the elleged exemption. Any violation af Seclion 7031.5 by eny epplicant far e permit s,,u.,b-�e�n�s ihe appllcant to e cMl penelry o� not mora Ihan tive hundred dallars (5500).): �µy �, e9 oviuer of Ihe properry, or my employaes with wages as t�eir sole compenuGon, WILL DO THE WORK, end the structure is not intendad or otteretl for sale (Sec. -�-7044, Business and Professions Code: The Contractors License Law tloes not appty to en owner oi properry who builds or improves thereon, antl who does such work himselCor hersalt or thmugh his or her own employees, provitleA Ihet such improvemenis ere not intentled or oflered for sale. II, howaver, the builtling or impmvement is sold withn o�eI�yea?otbompleti�nulhF owner-builder will have the burtlen of OroNng Ihat he or she ditl not Cuild or improva tor Ourpose ol sale.). � I, es oWnedof the property,lem�EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS ro construct the pmlect (SecJ044, Business end Pmteuions Code: The contractors Llcense Levrdoes not apply to en owner ot pmpeny wha builtls or Improves thereon, and who cnntrects lor such pro�ect wlih e contrector(s) Iicense pur�ant to the Conjractors License Lews.). ❑ lem Verlficatlon ot Business end Prolessians CoAe tor this roeson: license. ❑ ves ❑ No by (type of tlocumenL i.e. - property terz bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATON: No. ❑ I hereby certiry thet no excavetlon five (5) or more feet In depth Into which a person is requireC to tlescentl, wlll ba made in connection wlth work aulhorizeC by Ihis pertnit, end Ihat no building strucNre, swHoltling, falsework, or demolitlon or dismantling thereoL will be more Ihan ihirry-six (38) feet high. (C�ap. 32, Gry 2, Art 2, Sec. 341, Title 8, Celifomla Atlministretive Code). ❑ As owner-builder, I wlll not employ anyone Io do work whic� would require e permit trom the Divislon oi Industnal Safery, as notetl above, unless such person hes e pertnit to tlo such work from Ihe divisian. SlgnaWre: Date: DMsion of Indusirial Sefery Permit Number: CEHTIFlCATE OF COM� IANCE AND AUfHORQATION OF ENfRY: I certity under penalry ot perjury thet I have read ihis eDPlicatlon end state ihat ihe Informetlon glven Is conect. I egree to co wlth ell state aws entl ciry ordinences relating to bullding construction, entl euthodze representetives of U) e CI ol Costa Mesa to enter upon t�e ebove-described Drop rt For InsDeclio urposes. I agree not to occupy or allow oaupancy ot eny building euihorized hy this paArm/itQ/ ntil f el inspection. /(l//Q � Sign ure Ot Legal�Ovmer s Data-�� CODE �, INSFEGTIONTYPE Qd¢, Q�Y 1878 Fixed System Flnal Flre Prevention 1266 200 201 202 203 Pod Spe Final Finel Re-Roof Finel Blak/Retaining Well Final Faclory Fire Place Final Sign 264 Final Demolllion CODE 1 INSPECTION TYPE 208 Final Mechanical 200 Finel Plumbing 210 Flnel Electdcel 212 Flnel Fire Preventlon 220 Final Planning Approval Fi�� 25 Final Site Flnel Building/Occr�pancy Q� �� (714)754=5273•• rPex'(714)'754=4856•• dob Atldress: 460 E 19TH ST Suite: Viciniry: REAR OF HOUSE ' Primary Occ: R3 Parcel Number: 42632118 � � :CIT.Y.OF.COSTA'MESA I ;BlIIL'DING;DLI/ISION � : DEVEL'OPMENT:SERVICE§' DEBARTMENT P.ERMIT .4ppliwnt: YBANEZ, RICHARD Address: 412 LAUREL AV Owner: Address ContraUor: Address Zip: Type of Construclion: V-N Zoning: BREA,CA ._ „ :_��- :.- GOODWIN, JOHN P.� `"� ' 460 E�19TN ST � = -� � ' ' � � ` '� - . �.. � �COSTA�MESA, CA � - � % . �� - %\ i i'- ,�Ja_ _ _ ,, Phone: - 714 92-'� - , i : 92821, -�� / � Pho :� -Zi : 9 627�- STRAIGHT LINE-D� ELOP ENT� 412 LAUREC AV j j . . �, ; . -��. BREA; CA.'.� 92821 � � �� } Arch : �Addre55: -, , ;, , � � . , , Zip: . , ' �'; � Ppone: ! `--,License: , _ "'� ADD 580SF TO EXISTING SF�, NEW 1 BEDROOM,CONSTRUCT2NEW 8ED THE ROOF LINE OVER AN (E) BEDRO INTERIpR REMODEL TO CONSIST OF EXISTING 2 BEDROOM, 1 BATHR00 PLANNING: � RESIDENCE = 1,608 S0. FT. GARAGE = 369 Sa. FT. DRIVEWAY = 80 SQ�FT. LOT COVERAGE = 2,057 S�. FT. 7°/ OPEN SpACE = 5,703 SQ�F . (73% ,1BA SFD TO :'- f`�' _. �.�� RCH AN 7 OOM, L 1 ( ) � ALI , _ __--�\��' Plan Check: $495.79 Pe�mit: , $762.75' . SMIp Res: $6:63 �-. = � � SMIPCom'.�, $0.00 � �� .�\ . Other. ' , � $0.00�. � , � Inspection: $0.00 , Tof� $1,265.17 �� , i' SETBACKS MAINS7RUCTURE Front 0.0 Rear-�...0-0 ACCESSORY Front 0- Rear 0-0 PARKING Existin : 0 Required: 0 71 392-' 29276 Eng: ,P,ddress: i �FERMIT NUMBER B05-01933 DRIVE; C09jA MESA, CA 92626 Status: �SSUED Applied: 10R7Y2005 Issued: 11l142005 ISSUED'BY: � Phone: License: � �vrr�mmi .� � � 9SF REAR DECK. WORK TO INCLUDE: DEMO OF (E) REAR 240SF NDRY ROOM, NEW FRONT ENTRY PORCH, A REAR DECK AND CHANGE . TO EXTEND KITCHEN, RECONFIGURE (E) CLOSET AND (E) BATHROOM. , INTO A 4 BEDROOM�, 2 BATHROOM SFD. , � �; � � . ___ -- ��_'_ _ _ .. � .. 'FEE SUMMARY � � ° _ � � � - Calc Valuation: , Sss,ais.aa � '�' . Claim Ualuation: . 5sa,000.00 f� . . , . , 1 , ,/ , /, // / , - �. '��"�� -i�' - , . .��'� A .. / ANNING & ZONING � .,i�% j _ , ._Left,,. -0-0�� ,-� � � Righl 0-0 Lek 0-0 Right 0-0 ._. r _ Pr000sed: 0 .NOTICE: �The work�authorized:by thiscpermit:shall�.compty.withaall�applicable�handicap:access-requirements,under Califomla:�statutes�and relatetl repufations. (Ord: Mo:.92-28,�§'1: 72.21=92) ;EXPIRATON:'This,permiUshalfaulomatically.expire�antl become.vaid ILxrork is�not wmmenced�wllhin'18p�days,:or if.work Is�.suspended or ebandonetl fora period of�180 days. . ��INSBECTIONS: ' In:orderfor the.work¢authorized.undecthfs:permit�to:be�considered Iegal,ssuch.work�must:compy.with�all��epplicable codes d II . rrequiredlnspeetlona:end'tlnsl:approvefmustbe�obtained'F.ailuretoobtainh�spectionsandfinafapproval�willresultinthe.expiraC aithispermit. iFOR INSiPECT10NS'CALL: � (774) 75445626 . ewwa �aw7 :rz• �v•..'r _' WORKERS' COMPENSATION DECLARA710N: !� `� � •'�'T ( �� , 1 �ereDy eMirm unGar penelry ot perjury one ot the lallawing dederetions: ' ., � ' ❑ I heve end will meintain e certilicate ol consenl to selbinsura for workq;s'_compeasatlon, es pmvldetl tor by section 3700 ot the Lebor Gode, lor t�e peAormarice of Ihe work lor which this permit is issuetl. " . ❑ I have en0 will malntain workers' compensaUon insurance, es required by sectlon 3700 of the Lebor Cotle, for the pertormance ol Ne work Por which this pertnit is issueA. My workers' compensatlon Insurance carder entl policy number ere: ' � Carrier: __" ,._ ^33.��p Policy��umher: ' , j�ls.sectlon need nof be comp/efetl il Ne permit is valued e1 one hundred tlollers (S 100) or IessS)i'""ix1! � ,.., �t '.5.�,- . "�3 .titir.:�., . �� y� i certify �hat in Ihe peAormance �t the work �or which ihis permit is'�issueQ I 5ha0 not employ any person in any manner so es to become subject to the workers' compensatlon laws ol alito �, an � ree Ihat il I shoultl �ecome suDjact to Ne workers:compensatlon pro`Wsioiisbf Section 3700 ot the Lebor Cade, 1 s�all tort�wit� compty with Ihese pr sion � � . -, x' = rtpa�i sro�a��: r` - oace: '_!1-' /Y — d� iVAqMN(3'KALTIRE TO SE pE WORKERS' ENSATON COVEMGE IS UNUW FUL AND SM�LI SUBJECf Ml EM OY�CHV.VWIL PENALTIES AND dNL FlNES UP TO ONE HUNDRED THOUSrW D OOLLARE (5100.000). IN A�dTIIXJ TO THE Cp$7 OF COMPENSATIIXJ, DAMPGES AS PFiOVIDED FIXi M SECTION 3106 OF THE IABOR �DE, INTEFEST, AND ATTORNEYS FEES. LICENSED CONTRACTORS OECLAAATON: I h' erre0y eHirm Ihet I.em licensetl untler provislons oi Chapter 9(commencing with Sectlon 7000) af force end eXect.Lc. N�-�++n A n , i, /_ Professlons Code, and my license is in tull CONSTpUCTON LENDING AGENCY: ' . ❑ I hereby eHirm thel ihere is e consWction lending egency br the performance ot t�e work for which this permit is issued. (Sec. 3097, Civil Code). Lsnders Name: Lentlers Adtlress: Signature: Date: OWNER•BUILDER OECLARATIONS: I hereby eHlrtn thet under penelry ol peQury ihet I em E%EMP7 FROM THE CONTiiACTORS UCENSE LAW for Ihe following reason (Sec. 7031.5, Business flntl Professlons Cotle: My Gry or counry which requires e permit Io consiruct, elter, Improve, tlemolish, or rapair any atructure, prior ro its Issuance, also requlres Ihe epplicant for such pertnit to tile e signed stetement Ihet he or s�e Is IlcenSeC puBuem to the pmWslons oi the Contrectors License Lew (Chaprer 9(commencing with Sectlon 7000) of Divislon 3 of the Business end Prolesslons Cotle) or ihat he or sh0 is exempt therefrom end Iha hasis lar Ihe alleped exemptlon. Any violatlon af Seclion 7031.5 by eny applicant tor e permtl sub�ects t�e epplicent to e civil penelty o1 not morp Ihan live hundred dollars ($500).): ❑ I, es owner of the properry, or my employeea with wages as thelr sole compensailon, WILL DO THE WORK, antl the siructure Is noi Intende0 or oMereO for sale (Sec. 7044, Business end Protessions Cada: The Conirectors License Lew does not flpply to an owner ot property who builds ar impmves thereon, en0 w�o tloes such work himseN or herself or through his or her own employees, provided that such imprwements ere not Intended or oftered for sale. It, however, t�e bulltling or Improvement is soltl wiihin one year of completion, ihe owner-bullder wlll have the burden oi proving that he or she did not build or improve for purpose ot sale.). � ❑ I, e5 owner ot Ihe praperry, Bm E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to con5truct the pro�ect (Sec. 7044, Business entl Protessions Cotle: The contractors License Lew tloes nat epply to an owner of propeny wha bulltls or Imprwes thereon, antl who contracts lor such pro�ect with e contractor(s) ' liconse pursuant to the Coniredors License Lews.). ❑ I em exempt under sec. Busineu antl Professions Catle lor this raeson: Signature: Date: Owner ID verilied by tlrivers license. ❑ Yes � No Oriver's License No. Vedlicetlon ol Ownership by (rype of documem, i.b. • properry tax blll or deed): DIVISION OF INDUSTRIAL SAPETV PERMIT CEpTFICATION: Expires: ❑ I hereby certity �het no excavetion five (5) or more feet In depih into which e person is required to descend, will be mada in connection wllh work euthorized by this permit, entl t�et no building structure, scaHolding, lalsework, or demolition or dismanUing �hereof, will be more than thirty-six (36) feet hig�. (Chap. 32, Grp 2, An 2, Sec. 341, Ttle B, Celifomia Adminisiretive Gode). ❑ As owner-builder, I will not employ enyone to do work which would require e permit Irom the Division ol Intlusirial Safery, es noted ebava, unless suc� person has e pertnit to tlo such work from the tlivision. Signature: Date: Division of Industnel Safery Pertnit Number: ICERTIFlCATE OF COMPLJANCE AND AUIHORqpT10N OF EMRY: I cenity untler penalry ot perjury Ihel I have read Nis eppllwUon end state Ihat the inlortnation given is I correct. I egree to compty wlt� ell stete lews end ciry ordinances relating to builtling construdion, end euthodze representatives of the Ciry of Casta Mesa to emer upon Ihe abovedescribed property tor inspectlon purposes. I agree not to occupy or allow occupency ot any building euthorized by Ws pemilt umil linel inspection. COOE 1' INSPECTION TYPE � � � � � 1816 Fixetl System Fi � 1266 PoolSp inel 200 Final Ro�Rool 201 FlnaBfock/Retaining 202 � Finel Feciory Fira ca 203 Final Sign 204 Finel Demolition . �¢ ,__��"��,.': �_ ' ' QQ7�fj 'INSPECTIONTYPE ' 206 Flnel Mechanicel �208 Final Plumbing _ 210 Fin Elect cal 2?2� Finel Sile 250 FinalBuilding/OCcupenf.y ^ O S - Date . —"�-� � � . QAIE ' Iti�Lfl _.,. (714) 754-5273 • Fex (714) 754-4856 • www.ci.costa•mesa.��sCTRICAL PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 �� .lob Address: 460 E 19TH ST Suite No Vicinity: ParcelNunmber: 42632118 Applicant: GOODWIN, JOHN P Address: 460 E 19TH ST �:'A,� � .. th - y � �T�� Y•� '�J . �I••?�.• ... d.. . y:.�. � .. V � � �f ,�;� .�, � �- _� . ... . � Address 460 E:19TH ST �,�� ` /.%�/�� A , � /�,�/ � A �,��'i:� / ,� COSTA \ SA, � / i.'��' ,/� �_ �. Contrector: �' OWNER-BUILDER .� Address: � ' - ' � � %i �" , , � ;,, , , �� ;ii ;_- Phone: 949=574-0643 ' �Zip:-� 92627 � .. Phone:' 2ip: � License: 000000 . ' , ' . , , .. • � , di�- i � �,� � i � REVISED 10-16-06: ADD 11 LIGHT HALLWAY). ' ISSUED BY: Status: ISSUED Applied: 70/05/2006 Issued: 10/O6/2006 i � - .�`� _ �_ ROOM, KITCHEN, AND � �- ELECTRICAL TO ADD SBOSF TO EXISTING SFD, NEW 110SF FRONT PORCH AND 369SF REAR DECK. WORK TO INCLUDE: DEMO OF (E) REAR 240SF BEDROOM, CONSTRUCT 2 NEW BEDROOMS, 1 � BATHROOM, LAUNDRY ROOM,.NEW FRONT.ENTRY P,ROCH, A REAR DECK AND CHANGE THE ROOF LINE i� � ATBEDROOM.� �� ':�',% �/ ; ,�l• • , . .. . INTERIOR REMODEL'TO CONSIST OFDELETION OF1'(EO WALL TO EXTEND KITCHEN, RECONFIGUKRE (E) CLOSET AND (E) BEDROOM. - . „ _ , ..REF#: 805-01933 �v" "�,'.,, �-.�,_ _�-- , _. - - , . ,. � - _ , - � ' WORK TO INCUDE: 1,UPGRDE'SERVICET0�200A, 12 OUTLETS, 19 SWITCHES 10 GFI. �' � FEE SUMMARY - , � � , . , `� �,, . . Quantiry � ISSUE FEE � � 523.50 -. Temp Dist System / Lighting Temp�servicetest $0.00 .;;;.;: "��Busway/t00ft Res.'a/qpackage � $0.00 -' �� ' � Standing'Section � New Res (1-2 units) �, �$0.00 � 0 -., - Misc Eleclrical Equipment New Res (3+units) �$0.00 � , 0��' � , Transformers up to 1 kva/kw Pool / Spa� - , �� $0.00- �� ' � �� 0' ° � . " . , , :...............up to 10 kva/kw Lighting Fizts, � � / J- $33.68� „ �� 36. - �- � � .................up to 50 kva/kw RecePt Outlets` � . , j , 31320�� c. �,' 12 �- ' : �, � ..................up to 100 kva/kw Switches � � $20.90- �� 19'� � ...........:.. over 100 kva/kw Non Res Appl �� .i $0.00' 1��0� ��< �,, , � Low Voltage Equipment� Res Appl �� $0.00,' � �. r0 "� - - - Low Volt Wiring System / Ckt Service to 200a � �$30:50, �/ /- 1 � .- - - - Misc. Conduit Service to 1000a �� `�� 50.00 �� 0 i �� ; ��, i- -� . Misc..Conductor' Service over 1000a \$0.00-.� �� 0� / �-- % � � ' . � Circus ( gen or ride) Motors to ihp $0:00�-�`�� 0 ' � ' � � ,� �Circus (mech ritle or lights) Motors to 10hp $0.00�, c�0-- � � � - � � Christmas Tree Sland -. � Motors lo SOhp $0.00 ��- � 0 " - � : -, _ Fireworks Stand ' Motors to 100hp $0.00 0�� ..' - � Other Electrical Fee Motors over 100hp $0.00 0 � " ' - - �- Communication drops $0.00 0 Investigation Fee Sub panel to 200a $0.00 0 Plan Check Fee Pole Light Pkg $0.00 0 Reinspeclion Fee Quantiry 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 ' $0.00 � �� 0 , -'$0.00 ,0 � ' , $0.00 : 0 ' 50.00 0 � $0.00 0 $0.00 ' 0 $0.00 0 $0.00 . 0 $0.00 0 $11.00 $0.00 $0.00 $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $132.78 Intermed Pole $0.00 0 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiiements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) � EXPIRATION: This parmit shall automatically expire and become vold if work Is not commenced within 180 days, or if work is suspended or abandoned for a penod of 180 days. . INSPECTIONS: In order for the work authoAzed under ihis permfl to be considered legal, such work must comply with all applicable code�d all required Inspeetlona and finel epproval must be obtained. Failure to obtain inspections and final approval will result in the expirati�.W;thfs permit. FOR INSPECTIONS CALL: (714) 754-5626 �� 24G64B (8�00) WORKERS' COMPENSATION DECLARATION: � � . I hereby ettirm under penalry ot perjury one of the tollowing declaretions: ��'. ❑ I heve en0 will melnlaln e certificete ot consent to self-Insure for workers' compensailon, es pravided for by section 3700 ot tha Lebor Cotle, for the peAortnence of ihe work for which this permit is issuetl. ❑ I hava end will maintain workers' compensaGon Insurance, as requlred by section 3700 of the fabor Cotle, for the peAortnance oi the work for which this pertnit is issued. My workers' compensatlon Insurence carrier end policy number ere: Certier. Poliry Number: (Thls sectlan need nof be cnmpleted il (he permit is veluetl at one hundred dollars ($100) or less.) ihet in Ihe isatlon law with �hese TO �ence f Ih ork for which this pertnil is issue4 I shall not employ eny person in eny manner so es to became subJec� to the workers' �Iitomi en gree thet tl I should become sub�ec� to ihe workers' compensation proWsions of Se tlon 3 0 af the Lebor Code, I shall fanhwith 41ons. � M- , �oa��:��o� � � WORKER$' COA1PENSATION COVERAGE IS UNUWFUL rWD SMALI SUBJECT Ml EM%.OVEq�9'CRIMI PE TIES AND GVI� FlNES UP TOONE HUNDRED IN MDRION TO THE WST OF COMPENSATION, DAMAGES /S PROVIDED FOR IN SECTION �OB OF THE IABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: � I hereDy eNirtn the� I em licensed under provlslons of Cheptar 9(cammencing wlth Section 7000) ot DMsion 3 01 ihe Business entl Professions COGe, and my license is in full force and ettact Lic. q Class a ContrecfoYs SlgnaNre: Date: CONSTpUCTION LENDING AGENCV: ❑ I hereby aHirm Iha� Ihere is a constmction lending egency for ihe pertormence oi lhe work for which ihis permit is issuetl. (Sec. 3097, Civll Code). LenAels Name: Lendar's Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereDy aHlrm t�a� under.penalry of perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business end Professions CoGe: Any ciry or wunty which requires a pertnit to construcL alter, Improve, demolis�, or repair any structure, prior to its issuance, also requires �he epplican� for such permit to file e slgned stetement (hahhe�or sha is Ilcansetl pursuent to the proNsions ol the Contractors License Lew (Chepter 9(commencing with Sectlon 7000) at DlNsian 3 of the Business antl Professioris Codej,or'ttie( he or;she'is exempt therefrom and Ihe besis for ihe ellegad exemption. Any violation of Saction 7031.5 by eny epplicant for a pertnit sub�ect e epplicant to a civll penelry �t not,more then five huntlretl dollers ($500).): . i_: N. ,�,�I, as owner of the�properry, or my employees wrth wages as thelr sole compensation, WILL DO THE WORK, end the structure is not Intendetl or ottered tor sale (Sec. 7044, Business and Prolessions Code: The�Conirectors License Law tloes not apply to an owner of property wha builds or improves thareon, entl who does such work himself or herself or through his or her ow"n employees, provided thet such improvements are not Intended or oNered for sale. If, however, the building or improvement is soltl within one year oi completion, the ownerbuiltler will heve Ihe burden of proving that he or she did not bulltl or improve for purpose oi sele.). ❑ I, es owner ol the properry. am E%CLUSIVELV CONTRACTINC WITH LICENSED CONTHACTORS to construct the project (Sec. 7044, Business antl Protessions —✓ Co�e: The contraaors Llcense Lew tloes not apply to an owner ol property who hullds or impmves thereon, end who contracts for such project wit� e contractor(s) .�Fanse purpfi�nt tp tha ConUactore License Lews.). sec. Business and Protessions Code for this reason: Ownar ID venfie y drivefs license. ❑ Yes � No ,1p.,�,ve�s ClCense�No. �.� %�� J � � Expires: '��v(o5 Vedflcetlon of O ers�ip by (type ot tlocument, i.e. - properry tax bill or deetl)L �-�—�`� DIVISION OF INDUSTAIAL SAFEN PERMIT CER7IFICA710N: ❑ I hereby certify that no excavetlon five (5) or more teet in dapth into which e person Is required to descend, wlll be made In connection with work euthonzetl by this permi( antl Ihat no builtling siructure, scaflolding, talsework, or demolltlon or tlismantling thereot, will be more then thirty-six (36) feet hlgh. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, CaliFomia Adminisiretiva Code). ❑ As owner-bullder, I wlll not employ enyone to do work which woultl reQulre e permit from the Division of Intlustrial Setery, as notetl ebove, unless such person has e pertnit to do such work trom �he division, Signature: Date: Division of Industnal Safery Permil Number: CERTIFICATE OF COMPLJANCE AND AUTHORIZATION OF ENTHY: I certify under penalry of perjury Ihat I heve read this application end state thet tha intormetion given is cortect. I egree �o comp It� I sta�e lew nd ciry ordinances relaiing to Oulltling construction, and euthorize represantatives of the Clty of ste Mesa to enter upon the ebove-desCnbed prop or i ection p oses. I egree not to occupy or ellow occupanq of any building authonzed by this permit until finel i pecti . lo i�% $Ignet�e OI Legal Owner(s) ""?;g. D�� \ CODE�. INSPELTIONTYPE Q� II�LS 1818 Fi:etl System Final Fire Preventian 1268 Pool Spe Finel 200 Final Re-Roof 201 Final BIxWRetaining Well � 202 Final Fectory Fire Place � 203 Final Sign 204 Final Demolition - COOE I INSPELTION TYYE 206 Final Mechaniwl 20B Flnel Plumbing .� 210 Finel Elecincal 212 Final Fire Preventlon 220 Finel Planning Approval 222 Finel Site � 250 Final Building/Occupency Q� � F1�7� � ,r U Job Address: Suite No Viciniry: Parcel Nunmber: 460 E 19TH ST 42632118 ELECTRICAL PERMIT ,4pp�icant: YBANAZ, RICHARD \ Address: 412 LAUREL AV .�. ��< :' ;�,�^. ISSUED --Phone .714-392-1377 �:�. BREA, CA � �� Zip �'� 92821 - ^ - tl. - *d'� .«�d'� r � `\ Owner. GOODWIN�,`JOHN P �" ' � ,� ;�� ' Address 460 E 19TH ST, - �� '� *, � � "4 <�Phone.".. - ,.. � , . �. �:;� �;s��,.... - m;:��,� ��QOSTA MESA��CA - i� Zip: 92627 � �:_: :,r �- �� ( _ Contraaor. STRAIGHT'CINE DEVELOPMENT AND CONSTR CT •� �� Address.=: 412 LAUREL AV ��, .:.; : � � ' . r _" . Phone. -714-392-1377 � BREA CA Zip �92821 � �'' . "Lice e 2 ,61 ' . � '�. ., .»�„` " '�' ._ F i , a : � ELI �r DE �� ffr �� _�� RE � W� �� eT RE --:... � '� .. PERM�T TO ADD 57 �a�� _. ISSUE FEE $23.5 � Temp service test � $ 0 , Res. a/c package� =,' 00 New�Res (7-2 units) � ,,�� ,; _$�:BO NewRes(3+units)."' --$0.00 Pool / Spa � :� �� ' � �� $0.00 Lighting FiMs - ;E$25.65 Recept Outlets : $1320 Switches' - .9 Non Res Appl , -.$0. Res Appl �d° • .. $0. 0 Secvice to 200a � � $30. 0 ServicetoA000a ' ,r° 0 0 Service over 7000a ,` ` ' 00 Motors to 1 hp , -` $ . Motors to 10hp ��''� $0.00 Motors to 50hp ,:- $0.00 Motors to 100hp `$0.00 Motors over 100hp �- 0.00 Communication ops $ 0 Sub panel to 200a $0.0 Pole Light Pkg $0.00 5ign Circ ts $0.00 TempPwrPo 0.00 Intermed Pole 0.00 0 0 0 _s'��,: e,,,. � status: ISSUED Applied: 1 2/1 52 0 0 5 Issued: 12/15/2005 UY YCK II ) EXIS SF , NEW 1105 FRONT.PORCH AND 369SF REAR � � �yd, s, .. r :r:.� - =c --. _. -__ � _ � �i',: . , 1UPGRADE RVICEPANELT0200A120UTLETS � .., . ... . � „. . . ��!�E SUMMARY ,�k" ` , . .,. ._,.' � ._.'. � Quantity y � � Tem, p Dist System / Lighting ^��- $0 00�: ;��" 0 BuswayN00ft •� ... $0.00 0 ., Standing Seclion � $0:00 � 0 � ` - Misc Eledncal Equipment .$0.00 0 �� _ Transformers�up�to 1 kva/kw .$0:00 ` 0'.,� �� ......................uptol0kva/kw -$0.00 ,�.Op ", ,:�'� .up to 50 kva/kw �$0.00 0 - � i 12 . :,up to 100 kvalkw $0,00 .� � 0 - � , f_ .:.-.'over,100 kva/kw $O.00k' 0 0� Low Voltage Equipment �., . $0.00, 0�.-� �0_��' Low Volt Winng System / Ckt �. $0.00 0 , �1 .. i . Misc. Goodud , � " $U.00, � 0 � �, � � --0$� - � �Misc Conductor � - •��$0.00 �v0 _ � , �+�T` , . p , �,, 8p 0- 0 �.A, "' p:p: 0 0 0 Cqcus ( gen or_nde) ,,,;� $0.00� . 0 �, "�'"` � �Ci�cus (mech nde or lights) � :' �$0.00' , 0 ' `��' �� * .Ch'ristinasTrea'Stand 50.00" O,o� �� --�'FireworksStand � '�,$0.00 �.��0 O�her Electriwl=Fee 'E .: $'17,00 � , �� ,�. ., ,. .=' Investigation Fee��^ r� �,,$0.00 � � � � . �� Plan' Check Fee � � $0.00 ReinspectiortFee� , �, $0.00 " ' �� TOTACCALCULATEDFEES 512476 NOTICE: The work authorized by this permit shall comply wi�h all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12•21•92) E%PIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, oi if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply wi�h all applicable c es, and all requlred Inepeetlone and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration o is permlt. FOR INSPECTIONS CALL: (714) 7545828 (aoo) WORKEHS' COMPENSATION DECLARATION: , r , . � ''� . I hereby aflirm under penalty of perjury one ot ihe following declerations: �• . � �`t � ❑ I have and will maintein e certificata of consent to selt-Insure for workers' compensation, es provitletl for by section 3700 of the Labor Code, for the peAormence o( the work for which this permit Is issued. . � . ❑ I have end will maintain workers' compensatlon insurence, as requlred by seqlon 3700 of the Labor Code, for Ne peAortnance of ihe woM for which this�pertnit is issuetl. My workere' wmpensatian Insurence cerner entl policy number era: Cerrier: Policy Number. (This sectlon need nof be complefed il the permif is valued et one hundred dollaa ($f00) or less.) . . ily t�niNepertortnance ot the work �or which this Dertnit is issued, I shall not employ any person in any mannar so as to become subject to the workers' iensalion laws of Cal' mia, antl agree that if I shoultl Cecome sub�ect to the workers' compensation prwisions of Sadion 3700 ot the Labor Catle, I shell farthwlth tly with thesa provis' s. J� 7gnetu�"""F�a� � L/ L.. � are� _� —/�S' — c� 1'— ILURETOSECUREWORK S'COMPENSATIqJCOVERAGEISUNUWFULMIDSHALLSUBJECTANEMPLOVERTOCRIMINALPENALTIESrWDCIVILFlNESUPTOONEHUNDRED DOLLARE (5100,000), IN ADDRION TO THE C�ST OF COMPENSATION, DMMGES AS PROVIDED FOR IN SECTION 31O60F THE LABOR CWE, IFREREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS OECLARATION: I em licensed under provisions of Chapter 9(commencing with Section 7000) ot Division 3 of the Busin�s and Protesslons Code, antl my Ilcense Is in full CONSTRUCTON LENOING AGENCV: - ❑ I hereby aHirtn Ihat Ihere is a consiruction lentling agency for the performance ot the work for which Ihis permit is issued. (Sec. 3097, Civil Cotle). Lentlels Name: LendeYs Atldress: Signeture: Date: OWNER-BUILDER DECLARATONS: I hereby affirtn thet untler penelry of perjury that I am EXEMPT FROM THE CONTHACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business end Professlons Code: Any ciry or counry which requires a permit to construct, elter, improve, demolish, or repair any slrucNre, prior ro its Issuance, also requires Ihe applicant for such permit to tile e signed stetement that he or she is licensed pursuent to ihe provisions oi ihe Contractors License Lew (Chepter 9(commencing with Seclion 7000) of Divislon 3 of the eusiness end Protessions Cotle) or ihat he or she is ezempf ihereffom end tha besis for the elleged exemption. Any vloletion of Section 7031.5 by any epplicant for a pertnit subJects Ihe epplicent to a civil penalTy oi not more ihan five huntlred tlollars ($500).): ❑ I, es owner of iha property, or my employeeS with wages es tlieir sole compensation, WILL DO THE WORK, antl ihe structure is not intended or oflared for sele (Sec. 7044, Business and Protessions Code: The Coniractors License Law tloes not apply to an owner of property who builds or improves ihereon, and who does such work himself or herself or ihrough his or her own employees, provided that such improvements are not Intended or oHeretl for sale. If, however, ihe building or improvement Is sold within one year oi complation, the owne�-builder will have the Durden of proving that �e or she did nol build or improve tor purpose ot sale.). � ❑ I, as owner of Ihe Droperry, am EXCLUSIVELV CONTRACTING WITH LICENSEO CONTRACTORS to consiruct the project (Sec. 7044, Business and Professions Code: The comrectors License Law tloes no� epply to en owner of property who builtls or Impmves ihereon, entl who contraas for such proJed with a contracbr(s) license pursuent to the Contractors License Lews.). ❑ I am exempt untler sec. 8usiness and Professions Code for this reason: Signature: Date: Owner ID verifietl by tlnver's license. ❑ Yes ❑ No Dnvers License No. Veriticetion of Ownership by (type of document, i.e. - p�operty tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CBAnFICATION: Expires: ❑ I hereby cerlify ihat no excavation five (5) or more feet in dep�h into which a person is required to descend, will be made in connedlon with work authorized by Ihis permit, and ihat no building structure, scaffoltling, felsework, or demolition or tlismantling thereof, will be more than t�irry-si: (36) teet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, Calitornia Atlminisiretive Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit trom the Division of Industrial Sefety, es noted ebova, unless such person hes e permit to Oo suc� work from ihe division. Signa�ure: Da�e: Division of Intlustriel Safety Permit Number: CERTIFlCATE OF COMPLIANCE AND AIJTHOR17AnON OF ENTTiY: I certi(y under penalry of perjury that I have read this application and state that ihe intortnation given is correct. I egree to comply with all state laws and city ordinances relating to building construction, and authorize representetives of the Ciry of Costa Mese to enter upon Ihe ebove-descnbad property for inspedion purposes. I egree not to occupy or allow occupancy of any building authorized by this permit until Finel inspection. CODE L INSPECTION TYYE 1616 1266 200 201 202 203 FixeO Sys�e inal Fire Preventian Pool Spe Fina , Final Re-Roo� Final BIocWRataining Wel Final Factory Fire Place Final Sign 204 ' Final Demolition �F 1t�9L5 �. COOEt INSPECTIONTYPE 206 Finel Mechanical \B Elnal Plumbing . 210 Final Electricel �_ 21 Flnal F e Pre ntion 220; inalP ng proval. –4P2�Final Site ��250�� FinalBuilding/Occupancy �4\q � �� (714) 754-5273 • Fax (714) 754•4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT Job Address: 460 E 19TH ST Suite No Viciniry: Parcel Number: 42632118 ISSUED BY: App�icant GOODWIN, JOHN P_ - ' Address: 460 E 19TH ST � " `. ,: � �'._ " "" Phone: 943574-0843 COSTA MESA, CA- "�" _ Zip: , 92627 % // j// �•. � . . owner. GOODWIN, JOHN P �� - =-_ Address:�460 E 19TH ST� � �� -! ' - - � � -= � -- . ��_�,/�j' '\ j / � -:� - Phone 949-574 0643 � ' ��qqqqqq'''�� '� COSTA MESA; CA -/ Zip: 92627 � ��i� � �-.�i"///i.�.i Contrador: OWNER BUILDER Slatus: ISSUED Applied: 10I05/2006 Issued: 10I062006 �^�'� a ";; ` -� �;: w ,�,d s � Address: �, � ,, - _� " i , ��' �, �..� Phone:. . 2ip: l - ' '�% �License:000000 � � - - , , _ � ,„ _ ,.�..` � _ � � � �- ' ,� �� ; � /�� ', ��SCOPE OF PERMIT " � . ', ��MECHANICAL PERMIT TO ADD 5805F TO EXISTING SFD, NEW 710SF FORNT PORCH AND 369SF �; REAR DECK. WORK TO INCLUDE: OEMO OF (E) REAR 240SF BEDROOM, CONSTRUCT 2 NEW - BEDROOMS, 1 BATHROOM, LAUNDRY ROOM, NEW FRONT ENTRY PROCH, A REAR DECK AND CHANGE THEROOFLINE AT BEDROOM. �INTERIOR REMODEL TO CONSIST OF DELETION OF 1(EO WALL TO EXTEND KITCHEN, RECONFIGUKRE�(E) CCOSET AND (E) BEDROOM. � .-i�-�i, �� ' /^_ ,_ . . _ . . REF#:BOS-01933 �.�i;.'<. .. �i-._' . . _ . . . . � .. WORK TO INCLUDE: t INST FAU GREATER THAN 100 K BTU AND �1� GAS PIPING AND 1 VENT FAN. - � ! �' .>� •'��"�-' _ --� " - - , , �,;.: . _FEESUMMARY ,:�,`.. � - ` � � Quantity �� ISSUE�fEE �� $23.50 - Repair/AltAbsorbtionUnit Inst FAU <100 k BTU � $0.00 0 Repair I Alt Refrigeration Unit Inst FAU>100 k BTU �'� $1820 1 Ventillation System Repair)�Alt Cooling/Heaf �• $0'00 0 - . --EvaporativeCooler InstlRep:RecessWallHtr�;�-.. $0.00 0 "%^��' . Commerciallncinerator Refrig Sys <100 k BTU� '� � � � � '�" $0.00 0 :,=<", > � - Domestic Incinerator Rehig Sys,>100 k BTU ; '�� A $0.00 0 • . , . - � ' : ComoressoFs> Absomllon Svstems Gas Piping. ��, '� �$8.15 1�. � - Up to 3 hp / t00�k BTU " , Factory Fireplace � �� .$0.00 0; �� - . 3 To 15 hp / 500 k BTU Hood w/Mech Exhaust � // � $0.00 0 "'� _ � - ; � 15 To 30 hp / 1,000 k BTU � , VAV Box \�,�� _,,� "// $0.00 0,� � � . = , 30 To 50 hp / 1,750 k BTU � VentFan/SingleDuct,A �i%�$725 7��- � � - 'Over50hp/Over.1,750BTU ,. Appliance ,,�. $0.00�� 0 �"�.:;,-�= �� '- ' ' Boilers - , - Fire Dampers �� ;��_ •., �J $0:00 �;,-�0� �-�, ,,, "- -� �Up to3 hp - Smoke Dampers � � _> ,� $0.00� � 0'�' f % - � � , 3 To 15 hp Inst or Relocate A I VeN ` � � � ' ' r" � � � ` � � pp �'�, -$0;00 � 0 ,; � 1510 30 hp � AirHandlers< 10000cfm �^�,�$0:00�-� 0�'u � � � ' �- i. � 301o�50hp � � - � . AirHandlers> 10000Gfm $0.00��0� �--��_ �.�_. Over50hp - -� - Floor Furnace $0.00�0;--' ��. �- _ Olher Mechanical Fee-�' Floor or Suspend Heater $0.00 0 � - _ �'� ' � -. -- .,- Investigalion.Fee � �� - - �- Plan Check Fee o ..:...........:.... c.... Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 �$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 en nn � � � � 0 0 0 0 0 NOTICE: The work aulhorized by this parmit shall comply w0h 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 780 days,-or if work is suspended or abandoned for a period of 180 days. � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetlonc and final epprovel must be obtained. Failure to obtain inspections and tinal approval will result in the ezpiratlon of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 r<e� ._.suo,cni WORKERS'COMPENSAnON DECLARAnON: � " ' � I hereby eNirm unCer penelry of per�ury one of the following tlecleretlons: � ❑ I have and wlll meintaln e ceniticete ot wnsent to setl-Insure for workere' compensatlon, es provltletl far by secllon 3700 of the Lebor Code, for ihe perlortnence o1 ihe work for which this pertnit Is issuetl. ❑ I have arM will maintain xrorkers' campansatlon insurance, as required by secUon 3700 ot Ne Lebor Cotle, for the perfomianca ol the xro�lc for which Nis pertnit Is Issued. My workers' compensation Insurence wrrier and policy numDer are: Cartier: (Thls s} one Poliq Number: w less.) ihe work for which Ihis permit is Issuetl, I shell not employ any person in eny menner'so es to become subject lo Ihe workers' nd egree that it I shoultl become subject b t�e workers' compensetion provisions ot S ctlon� 700 of the Lebor Code, I shell forthwit� � oa�e_ fb ,/D/66 'COMPENSATIqJCOVERAGEISUNUWFUTANDSHALLSU&IECTANEMPLOVERTOCRIMI ENALTIESANDGVILFlNESUPTOONEHUNDRE� J TO THE CO6T OF COMPENSITION, DPMAGES AS PF#'MUED FOR IN SECTION 3lOfi OF THE LABOR CODE, IMERE5T, PND AITORNEYS FEES. LICENSED CONTAACTORS DECLARATON: I hereby effrtn that I am licensetl untler proNsions o1 Chapter 9(commencing with Section 7000) of Division 3 of ihe Business enO Protessions Code, antl my license Is in lull force end eflect. Lic. # Cless a Contrectors SlgneNre: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby aNirm that t�ere Is e construction lending agency tor the pertortnance of ihe work tor which this pertnit is issuad. (Sec. 3097, Civil Cotle). Lentlefs Neme: Lendefs Address: SlpnaNre: Oate: OWNER-BUILDER DECLARATIONS: I hereby aflirm that under penelry ot per�ury that I am EXEMPT FROM THE CONTRACTORS LICENSE lAW tor Ihe following reason (Sec. 7031.5, Business end Protesslons Code: Any ciry or counry which repuires e permit to canstruct, elter, improve, demolish, or repair any strucNre, prior ro its Issuence, elm requires the appliwnt for such pertnit to flle e signetl statement thet he or she Is Ilcensed pureuant to t�e provlslons ot t�e Contrectors License Lew (Chapler 9(commencing wit� Section 7000) of DlWsion 3 of ihe Business nd Professions Cotle) or ihet ha or she is ezempt therefrom end Ihe basis for the alleged exemption. Any vialation oi Sectlon 7031.5 by eny epplicent for e permit 6�e he applicant ta e civil penelry M not more ihen five hundretl tlollers ($500)J: - �I; as'owner of t�e property, or my employees with wages es Ihelr sola compensation, WILL DO T1E WORK, end the structura Is not inten0etl or otlered for sale (Sec. -� 7044, Business end Pmfessions Code: The Contradors License Lew does not apply to an owner of property who builds or Improves thereon, and who does such work himsell or herself or through his or her own employees, provided ihet such improvaments ere not Intended or otteretl lor sele. If, however, the building or Improvement Is sold within'o�e yeer o1 complation, the owner-huilder will heve Ihe burden oi proving thet ha or she tlid not build or imprwe for purpose of saleJ. ❑ I, es owner of ihe property, em EACLUSIVELY CONTRACTING WITH LICENSED CONTAACTORS to construct the project (Sec. 7044, Business antl Professions Code: Th contiad s Gcense�LeW,does nm apply m en owner oi propeny who �uiltls or improves thereon, and who contrects br such project with e contrector(s) license rs ant to e ConVecto s`Cicense Laws.). ❑ I am e unde ec. Businass aiM Protessions Coda tor this reeson: �Signeture:��' � ' � `'�f�f� �ate: Owner ID ver ed by tldvefs Ilcense. ❑ Ves ❑ No rD�Iver:s�Licensa No. /!� ~" Expire's:` - Vedficetion Ownership by (type ot document, i.e. - property te�c bill ar deed): �`"'� DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I heraby certify thet no excavetion live (5) or more ieet in tlepih Into which a person is required to descend, will be metle In connection vrith work euthonzeE by this permit, entl that no building structura, scaHolding, falsework, or tlemolition or dismantling ihereoi, will be more than ihirty-six (38) feet high. (Chap. 32, Grp 2, Atl 2, Sec. 341, Title 8, Calitomia Atlministrative Code). ❑ As owner-builder, I wi0 not employ enyone �o do work which would requira e pertnit trom the Division ot Indusirial Sefery, es noted above, unless such person hes e permit to do such work from the divisian. Signeture: Data: Division of Industrial Setety Pertnit Number: CERTIFlCATE OF COM[P ANCE AND AUTHORVATION OF ENfSiY: I carti(y under penalty oi perjury Ihe� I have read ihis epplication end siate �hat t�e information given is correct I egrae lo co �pi w ell ste lews end city ordinances releting to b�ilding consiructfon, and authorize representetive5 W the City ot osta Mesa to eMar upon the ebove-descnbed pro i inspect' n purposes. I egree not to occupy or allow accupency of eny building authorized by this pe��nlil'i� I��tion. L �Si! aNre Of Lagel Owner(s) .. �e _��_ _ _ ... . . COOE 1. INSPECTIONTYiE t61fi Fixed System Pinal Fire Preventlon 7288 Pool Spa Final 200 Final Re-Raol 201 Finel8lock/Reteining Well 202 Final Factory Flre Place 203 Final Sign 204 Final Demolitlon � �g � � �� INSPECTIONTYFE 206 Final Mechanical 208 Flnal Plumbing � 210 Final Electrical 212 Finel Fire Preventlon 220 Final Planning Apprwal 222 Final Site 250 Final Building/Occupancy Date i � ' / . i� ,� � „ ; , 1 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 �obAddress: 460 E 19TH ST Suile No Vicinity: ADDITION Parcel Number: 42632118 App�icant: YBANAZ, RICHARD. Address: 412 LAUREL AV BREA, CA owner: GOODWIN, JOHN P Address: � 460 E 19TH ST . . COSTA MESA, CA MECHANICAL PERMIT Phone: 714-392-1377 2ip: _92821 , Phone: Zip: Contradoc STRAIGHT LINE DEVELOPMENT AND C� Address: 412 LAUREL AV � � Phone: 7143'� � BREA, CA Zip: 92821 . .. ...... �� ---- MECHAN�CAL PERMIT TO REAR DECK. REF#: BOS-01933 WORK TO INCLUDE: � 7 �INST FAN ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU � Repair/All CoolingMeat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Re(rig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Boz Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers � 10000cfm AirHandlers> 10000cfm Floor Furnace Floor or Suspend Heater �uantiy 523.50 � $0.00 ' 0 \ $18.20 1 50.00 0 $0.00 50.00 0 so.00 0 ss.� i S0. 0 $0 0 0 $ .00 0 5 1 0.0 0.00 0 $0.00 0' so.00 0 � $0.00 -0- , $0.00 0 $0.00 0 00 0 \ Status: ISSUED Applied: 12I152005 Issued: 12/152005 V V� SFD, NEW 110SF FRONT PORCH AND 369SF K BUT AND 1 GAS PIPING ANO 1 VENT Repair I Alt Absorbtion Unit Repair I Alt Refrigeration Unit Ventillation System Evaporetive Cooler Com mercial I ncinerator Domestic Incineretor Comoressors / Absorotion Svstems Up to 3 hp I 100 k BTU 3 To 15 hp / 500 k BTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp! 1,750 k BTU , Over 50 hp I Over 1,750 BTU Boilers Upto3�hp �� - 3To15hp-a`�� .. 15to30hp�-� � 30 to 50 hp � � Over 50 hp Other Mechanica� Fee Investigation Fee ' Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES �uanliy $0.00 0 50.00 0 50.00 0 so.00 0 30.00 0 50.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 so.00 0 50.00 0 $0.00 0 50.00 $0.00 $0.00 555.10 NOTICE: The work authorized by this partnit shall compty with all applicable handicap access requlrements under Califomia statutes and related regulatlons. (Ord.�No. 92-28, § 1, 12-21-92) EXPIRATION: This permlt shall automatically expire and bacome void II work is not wmmenced wlthin 180 days, or if work Is suspended or abandoned- br e period ol 180 days. � INSPECTIONS: In order for the work euthorized under thia permit to be consldered legal, such woik must comply with ell epplicable , end ell requlred Inepeelione end flnal approval must be obleined. Failure to obtain Inepeetions and final epproval wlll result in the ezpirelion o„�M permit. FOR INSPECTIONS CALL: (714) 7545828 hEerEpit•'i{tll WORKERS' COMPENSATION DECLARATON: � � . � � • � I hereby aflirtn under penalry of perjury one ot tha tdbwing tledaraGons: � - ❑ I �ave entl wlll maimain a ceRificate of mnsent to selt-Insura tor workers' campenseHon; es providetl tor by section 3700 oi the Lebar COAe, for the pertormance of Ihe work fOr which Ihls pertnit is issuetl. ., . - ❑ I have aM will maintain woAcere' compensetion Nsurence, es required by sectlon 3700 ot the Letwr Code, lor �he pertortnance ol Ne xrork for which tNs pgrtNt is IsweE. My workers' compensation Insurence carrler end poliq number ere: � Cerriar: Policy Number. (7hls section need not be campleted ll (he pemut ls velve0 ef one hundretl dol/ars ($100) or Iess.) � I.ceNy�iheTJmttle peAormance oi Ihe work for which Ihis permit is iuued, I shall not employ any person in any manner sa es to become subject to Ihe warkera' compeneation laws of Ca mla, e/M' //egree thet II I ahould Cecome suD�ect to the workare' compensatlon provislons o1 Section 3700 oi Ihe Lebor Code, I shell foMwlt� �wl�.IheseDrovis . Ap0licent �ure: ��c —� ete: /� — / [�� n r3� INO: FAILURE TO SECURE WORKEgS` COMPENSATION WVERAGE IS UNUW Fl/L M1D SlULL SUBIECT PN �9YEHY0 CRIMINAL PEN�LTIES AND CML FlNES UP TOONE HUNDRED TNOUSMID DOLLARE (5100,000), IN ADDfiION TO THE WSi OF COMPENSIITION, DAA41GE5 PS PROVI�ED FOR IN SECfION 31080F THE UBOR CODE.IMEREST, AND FTTOFNEYS FEES. LICENSED CONTRACTORS DECLARA710N: I I I flm IMan ed under provisions oi Chepter 9(commenGng wit� Sectlon 7000) ol Divlsion usiness antl Prolesslons Cotle, e� my Iicense is In full lorc� aM eHel�e+� � _ ./ � � �}- '7 G � Con4eatolYSlgnamre: 6rt�--� � , ., _ , ,�_ _„ _�- _ CONSTRUCTION LENDING AGENCV: ❑ I hereby eHirm that there is a wnstruction lending epency lor the peAormence oi the work tor whic� this pertnit Is issued. (Sec. 3097, Civll Cotle). Lentlefs Neme: Lender's AOtlreu: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby efllrtn Ihet under penalry ol perjury ihat I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Businass end Professlons Code: My ciry or caunry which requiras a permit to construct, elter, improve, demolis�, or repair eny structure, prior to its issuance, elso requlres ihe applicant tor such pertnit to tila a signed stetement that he ar she Is Iicensetl Oursuflnt to the provisions o1 the Conirectora Llcensa Lew (Chepter 8(commencing wllh Sectlon 7000) of DlNsion 3 of Me Business end Professions Code) or that he or she Is exemp� Neretrom and Ihe besls tor t�e allegetl exemption. My vidatlon of Sectlon 7031.5 by eny appOcant fw e pertnit sub�ects Ihe applicent to e civil penalry af nm more Nan tive �undred ddlars ($500).): ❑ I, es awner af the property. or my employees wl�h wages es their sole compensation, WILL DO THE WORK, antl the structure Ls not intentletl or ottered for sale (Sec. 7044, Business and Professions CaGa: The Contractore License Law does not aOPly to en owner of properry who builds or impmves thereon, entl who does 5uch work himself or herself or ihrough hls or her own employees, providad thai such improvemems ere not Intendetl or oHeretl tor sale. If, however, the building or impmvement Is sold withln one year ot completion, the owner-buildar will have the burtlen oi proving thet he or she did no� builtl or Improve lar purpose of sale.). ' ❑ I, es owner oi the properry, am E%CLUSIVELY CON7RAC71NG WI7H LICENSED CONTRACTORS to construct the proiect (Sec. 7044, Business and Professions Code: The contrectors License Law does not apply to en owner of property who bulids or Improves Ihereon, end w�o coniracis for such project with a contrector(s) license pursuant to the Contractors License Lews.). , . ❑ I em exempt under sea .' Business and Professions Code lor this reason: Signature: Date: Owner ID veritietl by Grivers license. ❑ Yes ❑ No Drivefs License No. Venllcation of Ownership by (rype oi document, I.e. - properry lac blll or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CER7IFlCATION: Expires: ❑ I hereby cenify that no excevation live (5) or more teet in tlepih into which e person is required lo tlescentl, will De maAe in connedion wlth work authorized by this pertnit, end tha� no building sirudure, scaNdding, falsework, or tlemdition or Alsmentling Ihereof, will be more than thlrry-slx (38) tee� hiph. (Chap. 32, Grp 2, Art 2, Sec. 341, Tlile 8, Celltomia Administretive Code). ❑ As owner•bulider, I will not employ enyone to do work which wauld require e pertnit trom the Dlvision of Indusidal Sefery, es noted ebove, unless such person �as e pertnit to do such work trom the tllWslon. SignaNre: Date: Divislon ol Indusirial Sefery Pertnit Number: CERTFlCATE OF COMPLIANCE AND AUfHORIZA710N OF EMAY: I certify untler penelty ol parjury that I have read this epplicetion end state Ihat Ihe Informatlon gNen is correcL I egree to wmpty with ell state laws enA city oMinences relating to builGing constructlon, end euthodze representetives of Ihe qry of Coste Mesa to enter upon Ihe ebove-described properry tor inspection purposes. I egree not to ocwpy or ellow accupenry ol eny building authorized by this pertnit until final inspectlon. { ure e Date �----�_ COUE �, INSPEMIONTYVE 1618 Fixed System Final Fi� 1288 ,Pool Spe Finel 200 Final Re-Rool 201 Final BIocWRetaining Wall 202 Final Faciory Flre PWce 203 Finel Sign 204 Final DemdWon � • QAg . ItIIID�LS nme GOUE� INSPEC710NTYPE 208 Finel Mechenicel 20B Finel PIum6ing 210 Finel Electdwl , 212, Fine en 220 elPlanninp �. � mi. : y� / • I% � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa��MBING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 �ob aadress: 4&0 E 19TH ST Suite No Viciniry: Parcel Nunmber: 42632y18 Status: ISSUED Applied: 10/OS/2006 Issued: 10/O6I2006 npplicant: GOODWIN, JOHN P ISSUEDBY: Address: 460 E 1gTH ST -- � -- �'�. ��-.'�'Phone:�.�949-574•0843 - . _ . COSTq MESA, CA � , �j � " _ " Zip: 92627 - . /,';--� ` i Owner. GOODWIN, JOHN�P e. � �h _. Address /460�E.19TH�ST � - - /�� i 1�[' /i��,� � � - . - e.a _r . ' � - Phone,' '�"L,, � ". � � - .COSTq N1ESA„6A .�� ip': 92827 - � , /.�:,/� �/;;;�.-� "� /�%,% � Contractor: OW N ER=BU I LDE R „��/ / �'Address:J ;; .,, �-� . ! , � ! � ", �'i%� Phone:'- . i- ' - ,,� �i' Zip: - . , , � �� %,/ - � _ . , �� ; �. ,� . � �,�License:, 000000 , ��. � � . - i , "! �� - . , ". ;��'�, . . � � . ., - SCOPE OF PERMIT � ADD 580SFTO.EXISTING�SFD, NEW 110SF FORNT PORCH AND 369SF REAR DECK. WORK TO , INCLUDE: DEMO OF (E) REAR 240SF BEDROOM, CONSTRUCT 2 NEW BEDROOMS, 1 BATHROOM, � LAUNbRY ROOM�, NEW FRONT ENTRY PROCH, A REAR DECK AND CHANGE THE ROOF LINE AT `•�BEDROOM. � � - � INTERIOR REMODEL-TO CONSIST OF DELETION OF,1 (EO WALL TO EXTEND KITCHEN, RECONFIGURE (E) CLOSET AND (E).BEDROOM. - .� . � .t . . _ . . . . . . . REF#: 805-01933 �' � � -WORK TO INCLUDE: 1'BATHTUB„t`LAUNDRY_TUBNJASHER, t SHOWER, 1 WASH BASIN, 1 WATER � ' � '� CLOSET AND 1 WATER HEATER.= - - � � � . ' � ' ` ` � PEE SUMMARY � � � � � � MT � ' � AMT aN AMT � ISSUE'FEE - � � `'� �$23.50 �� Laundry Tub / Washer � ' $9.80 - t Sump Pump $0.00 0 BackOow irrigation� ��;�$0.00 0�, Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow�Preventeri \'$0.00 0' P-Trap _•.�J:''�yt' ' �" � ., $0.00 0 Trap Primer � � $0.00 0 Bathtub. �, ,�� '$9.80 1' Pressure"Regulator $0.00 0 Urinal 50.00 0 Clarifier System � $0;00 �� 0 Proceas Piping (per 10 ft) $0.00 '� 0 Vacuum Brkr BkOow(1 �) $0.00 0 Connectpce,Soda,etc) �' $O.00��;�,.O�j: ;-, �-'�Receptors - $0.00 �0., .� � VacuumBrkrBkflow(5+) $0.00 0 DentalUnits ' 50.00A`-0� SepticTank � $0.00 0 WashBasin $9.80 1 Dishwasher V'� '� % 50.00 �' �0 :` =�Sewer Cap for Demo ,. $0.00 0 Wash Basin Set $0.00 0 Drain, Floor �" i50.00 0�� Sewer Conned � $0.00 0 � Waste and Vent System 50.00 0 Drain, Rainwate�� 50.00�/ ��0 ��Se�der Private Line.� �- ,. $0.00 . 0 , Water Closet (Toilet) $9.80 1 Drain,Roof � �50.00/ �0^. �-Shov:�er=��,` $9.80 1 � WaterHeaterlvent $12.30 1 Drinking Fountain ��` 50.00 -�• -0� � -. Sink, bar ' . $0.00 0 Water Piping pnst or Rep.) 50.00 0 ExpansionTank ��$0.00 � ��0-�✓ ii ;�, �Sink,.commercial- ' $0.00 0 WaterRe-pipe $0.00 0 Gas Eadhquake Valve �50.00 �� 0'�U ��'Sink, Floor_ ,, $0.00 0 Water Service $0.00 0 Gas (1-4 outlets) 50.00, ��.:=0;�, ;,> �Sink, kitchen , . .. , $0.00 0 . Water Softener $0.00 0 Gas (Over 4 oullets) $0.00 �0��- _ Sink, seryice/mop, �' � $0.00 0 � , OTHER $0.00 Gas Repipe 50.00 0\\�; `Spa (pnvatej � ' `- �- - ' $0.00 0 VIOLATION $0.00 � Gas Service $0.00 0 �, Spa (public}r � -$0.00- 0�� PLAN CHECK 50.00 Interceptors (Grease, Oiq 50.00 0 " - _ __ " " REINSPECTION $0.00 0 Interceptors (Sand Auto ) $0.00 0 � - - NOTICE: The work authorized by this permit shall comply with all applicable handlcap access requirertients'"under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-g2) �./ � \/ EXPIRATION: This permit shall automatically expire and become void it work Is no� commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered lagal, such work must comply with all applicable codes, and all requlred Inapectlons and final approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 2d4&48(&00) WORKERS' COMPENSATION DECLA(iATION: ; I hereby eHirtn unCer penalry o1 per�ury one of iha following deGaretlons: � � ❑ I heve end will meinteln a certlflcete of wnsent to setl-Insure for workers' com�ensa�� n, es provided far by section 3700 0l tha Lebor CaAe, for Iha peAormance of the work for which this permit Is issued. ❑ I heve and will mainialn workers' compenselion Insurence, as required by sectlon 3700 of Ne tebor Code, tor I�e perfortnence of I�e work for w�ic� Ihis pertnit is issuetl. My workers' compensatlon Insurance carrier entl policy number ere: Certier: (7hi5 ss t�e� in �he WMNINO: FAILURE THOUSAND DOILAF Policy Number: or less.) m ce o� ihe work tor wNch t�is pertnit is IssueO, I shall not employ eny person in any manner so as ta be�ome subjact to iha workers' el' mia, C agreB Ihet ii I should 6ecome su�Ject to the workers' compensation provisions of Sec� (bn 3700 oi Ihe Lebor Cotle, I shall forthwil� � �5.�_— /D//I��1� ,. �,e:�__ � �_, , WORKERS' COMPENS�1T10N COVEMGE IS UNLAWFUL AND SIULL SUBJECT AN EMPLOVER TO CRIMII AL P ALTIES AND pVIL FINES UP TOONE HUNORED IN ADDITION TO THE �T OF COMPENSATIIXJ, DAhNGES AS PROVIDED FOR IN SEGTON 3IW OF TME Lr1BOR COOE, IMEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirtn thet I em Ilcensetl under proNslons of C�epter 9(cammencing with Section 7000) ot DlWsion 3 oi fhe Business and Prafessions Code, entl my license is in lull force end eflect. Lic. q Class p ContracroYs Signature: Date: CONSTRUC710N LENDING AGENCY: ❑ I hereby eRirm.thet the`e�is a co�struction lending agency for the pedormence ot the work for which this permil is issued. (Sec. 3097, Civil Code). w Lender'sName;� rrlr . `.i C +,i' LentlersAddress: n Signeture:, -. ' V�"'��"" Date: OWNER-BUILDER DECLARATIONS: I hereby aHirtn that under penalry of Derjury that I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, 8usineu and ProFessions Code: Any city or county whic� requires e permil �o construct, altar, improve, demolish, or repair eny structure, prior to its issuance, also requires ihe epplicent for such permit to tile e signed statement thet �e or she is Iicensed pursuent to ihe pravislons oi 1he Contractors License Law (C�apter 9(wmmencing with Sec�lon 7000) of Division 3 0} t�e Busine s and Protessions Code) or t�et he or sl+e Is exemp� therefrom end tha 6esis for ihe elleged exemption. Any violetion of Section 7031.5 by eny applicant for e pertnit s�the epplicant to e civil penalty M nol mole than five �untlretl tlollars ($500).): ' � I, es owner of the properry, or my employees with wages as their sole compensation, WILI DO THE WORK, and ihe structure Is not intendetl or ottered for sale (SeC. 7041, Business antl Prolessions Code: The Contrectors License Law tloes not appty to an owner of properry who builds or improves Ihereon, and who does such work himselt or herselt or through his or her own employees, provlded Ihat such improvements ere not intentled or offered tor sale. If, however, the builtling or improvement is sWd wi�hin one yeer oi wmpletion, ihe owner-builder wi11 have Ihe burden ol proving Ihat �e or she did not bulld or Impwve for puryose ot sale.). ❑ I, es owner of ihe praPerty, am El(CLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to construct tha pro�ett (Sec. 7044, BuSines9 and Profeuions Code: The qqnirectors Icense Lew does not epply to en owner of proparty who bulitls or Improves Ihereon, and who comrecis tor such project with e comractor(s) license pu�SJant to t Conirectors License Lews.). // _ /� � ❑ lami SlgnaNre: � OWner ID v Verilicatlan eusiness and Profassions Code for this reeson: 6y tlrivers license. ❑ Ves ❑ No by (type ot document, i e. - pmperry taz bill or deetl): No. DIVISION OF INDUSTRIAL SAFETY PERMIT CER7�FICA710N: ❑ I hereby cerlity ihat no excevation Five (5) o! mora teet in depih into which e person Is required Io descend, wlll be mede In connection with work euthorized by ihis permit, and ihat no bulltling simcture, scattolding, falsework, or demolltion or dismantling ihereof, will be more than ihirty-six (38) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Celllomla Atlministrative Code). ❑ As owner-6uilder, I will no� employ anyone to do work which would require e permit trom ihe Division of Industrlel Sefety, as noted above, unleu such person has e pertnit to do such work trom the division. Signature: Date: Division of Industrial Selety Pertnit Number: CEHTIFlCATE OF COMPLIANCE M D A ORIZI�TON OF ENffiY: I certity under penalty oi perjury thet I have read this epplication and state Ihat the intortnation given is correct. I egree to comply with el te la entl clry ortlinences rela�ing to building conslructian, end eutharize representetives of ih¢ Ciry qt Casta Mesa to entar upon the ebove-descdbed property tor in e tion rpa5es. I egree not to occupy or ellow occupancy ot any building authonzed by ihis pertnit (�til fin (mspectlon. 8 �,�� Si ewreOf�Le a er(s). :Date4 � : �. ;.�;,,..,:.n�,=�-:-a.. . -..,� �din. e�nti�d�ed eoollcan� Date COOE 1. INSiECTIONTYVE 1616 Fi�ced System Final Fire Prevention 7266 Pool Spa Finel 200 Final Re-Rool 201 Finel BIocWRetaining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolltion -PdIE II�dLi CO�E I INSVECTION TYPE 206 Final Mechanical 208 Finel Plumbing 210 Finel ElecMcal 212 Final Fire Prevantlon . 220 Flnal Planning Approval 222 Final Sita 250 Finfll Building/Occupency � 1�� / � � �� /�• � �� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 460 E 19TH ST Suile No Viciniry: Parcel Nunmber: 42632118 Appiicant: YBANEZ, RICHARD Address: 412 LAUREL AV �r� � BREA, CA A, Zip 92821... ;„ ....�.. ... . � �:re_T� r^-; �sr-,,.= -.:h-..«. Owner. GOODWIN, J�OHN�P� � � � . � , � ''� t; Address 460�E,19TH, ST- � ,.'� _ ,=� 'r • �Phone � - "'`� . �COSTA�MESA, CA � .��: ' Zip: 92627 '-�`�. ,'<.; , �: ' ' �, . " � '- Comractoc STRAIGHT LINE DEVELOPMENT AND CONSTRUCTION Address: �r;; 412 LAUREL �AV �=, � . ' ; . Phone:`".714392��77� . . .. Status: ISSUED Applied: 12/072005 .. . Issued: 12/07R005 ISSUED BY: , BREA,CA Zip: -92821 i a,-,P- � --�r:, . . - � " �- • � � LicenSe:�.292767,'. : ,� . � - . . . � � � e . . Y �, , . ' , , � ' � � (_ � . SCOPE OF PERMIT , "`� � ADD�580SF TO EXISTING SFD, NEW 710SF FRONT PORCH AND 369SF REAR DECK. WORK TO; ,' - ;'�INCLUDE:,DEMO OF (E).REAR 240SF BEDROOM, CONSTRUCT 2 NEW BEDftOOMS, 1 BATHROOM, �� '- LAUNDRYROOM, NEW FRONT ENTRY PORCH, A REAR DECK AND CHANGE THE ROOF LME OVER AN �, (E)_BEDROOM.. INTERIOR REMODEC TO CONSIST OF DECETION OF 1(E) WALL TO-EXTEND �i . : KITCHEN,.RECONFIGURE'(E)�CLOSET,AND (E) BATHROOM.+REF.^. B05-01933;, "^"'a "'"""`•'�:" 'bF' ` ,.; . - . .._ . ,. . �. �. - •, �� i 1 �.PLUMBING SO.INCLUDE. 1 BATHTUB, 1 LAUNDRY TUBM/ASHER;.1 SHOWER, � WA$H BASIN 1�.:�. � T WATER CLOSET� AND 1 WATER HEATER �� -� � � �.. ' , � -'��,� :y'�. '� �, , '_� � .,.� + ' �F'� . , �• � ' . � FEE SUMMARY � °� � . "SM_T � 9MT � 9L • ISSUE FEE�, ' , ` $23:50�� " ' Laundry Tub / Washer ° $9.80'• 1 . Sump Pump- � . . Backflowirrigation. - `.50,00; 0 . Landscapelrtigation :,$0.00;; �0 Swimming?ool � . Backilow PreJenle� _ � $0.00�� 0 P-Trep $O.W � �- -0 Trap Primep � Bathtub � � $9.80 1 . Pressure Regulator -,:�.. $0.00 0 Urinal � - Clarifier System -e `��- $0.00 �.- 0 ; Process Piping (per.10 ft)�e;;.�$0,00-0'-��-- Vacuum Bikr Bkflow(1-0) � Connect(Ice,Soda,etc) .?�-$000'��.�-�,0' � Receptors<�"'.,, �� $0.00��„��_0 VacuumlBrkrBkflow(5+)�' Dental Units -� � 50.00 ` 0, , ,Septic Tank �:. SO 00 " 0 , Wash Basin . Dishwasher .-�- $0.00. 0� � -"_ ��'SewerCapforDemo � ��:�y�,$000�`�=�0 „ °�,:_WashBasinSet Drain, Floor ` �-- $0.00 ` 0 � � Sewer Connect � -- $0 00 , '0 �. Waste and VeN System� Drain, Rainwater , 50.00�.., , 0 ' � �Sewer Privateime . " $OAO , .0 .- Water Closet (Toilet) - Drain,Roof - �-•�$0.00--..�0` . ;��Shower'� � = _ ,.�' $9.80' --1'� � WaterHeater/vent DrinkingFountain � � $0.00�� 0 ," �Snk�tiar.,�.,.,, , .. $O.OQ.,=:O-"'- �.�WaterPiping(InstorRep.) EzpansionTank �� $0.00, `�0 �- : �Sink,commercial �--N-..;e"'�'$O:OOt��"-0 t� •�---.WaterRe-pipe� GasEaAhquakeValve 50.00`, 0' , -.Sink,Floor ��- -g- $0.00 �0 . >�WaterService Gas(1-4outlets) $0.00-, �_,�OL � �,; .,Sink kitchen��; - -::_-., $0.00��",�0 � . � - � WaterSoflener Gas(Over4outlets) $0.00 �-0='�•, -�Sink,senrice/mop !' -i� $O.00��k'0-,' ,.rOTHER GasRepipe 50.00 0� , � Spa(private); - � �$000"'=0 ""� •.VIOLATION " Gas Service 50.00 0 '^'�"' -: Spa.(publiy � ` $0 00 • -,0 * - � PLAN CHECK Interceptors (Grease, Oil) $0.00 0 "� =�::. - '- � REINSPECTION Interceptors(SandAuto) y0.00 0 ^ --=. ......_._-....��-�"'"�" TOTAL CALCULATED FEES: COMMENTS I SPECIAL CONDITIONS � ..--.. _��r ,� �;r,,. . _ �_'._ ._._ ..... f r`<� AMT� $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $9.80 $0.00 so.00 $9.80 $12.30 50.00 $0.00 $0.00 50.00 50.00 $0.00 $0.00 $0.00 E64.80 � 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statNes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) � EJ(PIRATION: This permit shall automatically 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 tor the work authorized under thls permit to'be'consiqe7g`�3f��a „l s�i "CF'w'ork must 2oin`ply'7w iFi'all applibable codes, arn1 all requlred Inspections and flnal epproval musl be obtained. FaiWre to obtain inspedio'ns and final appmval will result In Ne eapiration of thls�permR' � FOR �NSPECTIONS CALL: (714) 754-5626 . , �g�� «o-,o �nw� WORKERS'COMPENSAnON DECLARAnON: I hereby eHirm under penalty oi perlury ona of tM1e following declaratlons: � � � ❑ I have end will meinteln a certiticete of consent to self-Insura tor workers' compenseaon, es proWded Por by section 3700 ot Ihe Lebor Cotle, for the pedortnence o� iha 1_work fa which this oermit is issued. /� l\ � � ,. MII �Pceitify thet in t�e pertormance c`ompensetlon laws of C ifoml[ compty with these pr�ons. � (E100.00O�.IN ADDITION LICENSED CONTHACTORS DECLAFiAT10N: es reqyy4tl by sedtjon 3700 0} Ne L�lfor Codp, for the entl Number: this pem�it la issued. tor999wttthich this pertnil is issued, I shall not employ any person In eny menner so es to become suD�ect to t�e workers' �h If I should become sub�ect to the workers' campensetlon provislons of Sectlon 3700 ot Ne LeDor Code, I shell tort�wit� / � oate: '2a'=� - [9.S ISATION COVERAGE IS UNUWFUL �VlD SWLLL SUBIECT AN EMPLOYER TO CRIAUNAL PENALTIES AND CML FlNES UP TO ONE HUNORED COST OF COMPENSATIpN, DAMAGES PS PROVIUED FOR IN SECTIIXJ 3'1O80F THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. oi Chapter 9(commencing with Sectlon 7000) oi Division � Professions CoAe, and my license is in full O 7 — CONSTRUCTION LENDING AGENCY: � ❑ I hereby ettirm Ihet ihere is a consiructlon lending agency tor ihe pedormanca of the work for which this permit is issued. (Sac. 3097, Civil Cotle). Lender's Nama: Lendefs Atldress: •. SlgnaNre: OWNER-BUILDER DECLARATIONS: Date: I hereby aHirtn that untler penalry ot perjury Ihet � em EXEMP7 FROM THE CONTRACTORS LICENSE lAW tor the following reason (Sec. 7031.5, Business antl Professions Code: Any ciry or county which requires e pertnit to construct, elter, improve, demolish, or repair any structure, prior to its issuence, elso requires the epplicant for such pertnit to fila e signed stetement Ihet he or she Is Ilcensed pursuant Po t�e provislons af ihe Comrectore License Law (Chepter 9(commencing wlih Sectlon 7000) of Dlvislon 3 of the Business and Professions Cade) or thet he or she Is exempt Iherefrom and Ihe basis for che alleged exemptlan. Any violation oi Sectlon 7031.5 by eny epplicant far a pertnit subjecis ihe appllcen� to a civil penalry oi not more ihan five hundred dollars ($500).): ❑ I, as owner ot Ihe property, or my employaes with weges es iheir sole compensation, WILL DO THE WORK, end the siructure Is not intended or ottere0 for sele (Sec. 7044, Business and Professions Code: Tha Coniractors Licensa lew does no� apply to fln owner ot properry who builds or improves Ihereon, end who tloes such work himsalf or hersalf or through his or her ov.•n employees, provided Ihat such improvemants are not Intended or oflered for sala. Ii, hov.•ever, iha builtlinp or improvement Is sold wifhin one year oi wmpletion, the owner-builder will heve Ihe burden oi proving that he or she did not build or imprwe lor purpose ot sale.J. � ❑ I, es owner of the property, am EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to conSlruM the project (Sec. 7041, 8usiness entl Professions Code: The con�rectors Llcense Lew does not apply to en owner of property who bultds or Improves ihereon, antl who comracls tor such pmject with e contractor(s) licensa pursuant to the Contractors Licanse Laws.). ❑ I am e:empt untler sea Business and Prolessions CoAe for Ihis reason: Signature: Date: Owner ID verified by drivefs license. ❑ Ye5 ❑ No Drivefs lJcense No. VatlFlcation at Ownarship by (rype oi tlaument, I.e. - properry ta: bill or deetl): Espires: OIVISION OF INDUS7RIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity thet no eawvation five (5) o� more feet in depth into which a person Is required to descentl, will be matle in connection with work euthonzed by ihis pertnit, end Ihet no building structure, scaHolding, talsework, or demolition or dismentling thereof, will ba more than thirty-six (36) leet high. (Chap. 32, Gry 2, Art 2, Sac. 341, Title 8, Celitomia AdministratNe COde). ❑ As owner-Duilder, I will not employ anyone to do work which would raquire e permit from ihe Division ol Intlusinal Sefary, as noted ebove, unless such person has e permil to do such work fmm ihe division. Signatura: Date: Division of Indusirial Setery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORW710N OF EHTRY: I certiry under penalry ol perjury that I have reed this epplicatlon and state thet the information given is wrtect I agree to comply with ell stete lews and ciry ortlinances releting to builtling consWctlon, an0 euthodze representatives ol tne Ciry of Costa Mesa to enter upon the ebove-descnbed property tor inspection purpose8. � egree not to xcupy or allow occupency ol eny building authonzed by ihis permi� until final inspection. CODE �. INSPEC710NTYVE PAIE 1616 Fixed Syslem Final Fire Preventlon 1266 200 Pool Spa Final Final Re-Root � / 207 Finel BIocWRetaining NTall 202 Final Fectory Fire Place 203 Final Sign � 204 Final Demolition / �Y" CODEt INSPEGTIONTYPE 206 Finel Mechanical 200 Final Plumbing 210 I Electrical 212 al re e on 220 ' I enni A proval 2 i� 250 Final Builtling/Occupan�y Date �— O nu.� �,�4rob w1_- (��a) �sa-52�s • Fax (714) 754-4856 • www.c�.costa-mesa.�WlLDING PERMIT Job Address: 460 E 19TH $T Suite: Viciniry: ROOF PrimaryOcc: R3 Parcel Number: 42632118 npp�icant: GOODWIN, JOHN P Address: 460 E 19TH ST COS7A MESA, CA Ownec GOODWIN, JOHN P Address 460 E 19TH ST COSTA MESA, CA / - -, , Contractor. OWNER-6UILDER ' Address; � ZIP Arch : Address: Type of Construdion: V-N Zoning: Phone: 949-574-0643 Zip: 92627 Phone: 949-574-0643 Zip: 92627 , ., ` . � .� Phone: License: 00 � 0 Eng: Address: 77 FAIP DRNE, COS I A MtSA, GA 92626 Status: ISSUED Applied: 10/OS/2006 Issued: 10/O6Q006 ISSUED � Phone: � ' Phone: Zip: � License: , "- � � � License: SCOPE OF PERMIT REROOF 1,100SF REMqINDER OF RESIDENCE, NOT PART OF ADDITION (BOS-01933) WITH COMP SHINGLES. FEE SUMMARY ` � Plan Check: $0.00 - �. Calc Valuation: Permit $0.00 � � Claim Valuation: SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 � ' � � _�' - � , � ' - _ Inspection: $0.00 � . : , � _ . . _ , . .� Total: , $0.50 � ' � , PLANNING & ZONING SETBACKS � � � � � � � �. ' � MAINSTRUCTURE Front 0-0 � Rear . 0-0 Left 0=0r - Right - 0-0 -, ACCESSORY Front 0-0 � '� Rear � 0-0 Left 0-0 "�" '��Right �� 0-0 � PARKING Exi tin : 0�� Reauired: 0 Pr000sed: 0 � ` � � ' ' � � so,00 So.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremanis _underCalifomia statutes and related regulations. (Ord. No. 92-28, § 1, 1241•g2) � / EXPIRATION: This permit shall automatirally expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. , INSPECTIONS: In order tor the work authorizetl under ihis permit to be cansidered legal, such work must comply with all applicable codes, and all requlred inepectlone and Iinal epprovel must be obtained. Failure to oDtain inspections and final approval will result in the expiratlon of this permit. FOH INSPECTIONS CALL: (714j 754-5826 zuaas �a�oo� WORKERS' COMPENSATION DECLARATION: � � � � ��. I hereby ettirm under penelty ot peryury one of the following declaratlons: ❑ I have entl wlll meintaln e ceniticate of consent to self-Insure for workers' compensetlon, es provided tor by sectlon 3700 of the Lebor Code, for Ihe pertortnence ot Ihe work for whiCh �hi5 pertnit is issued. ❑ I have an0 will maintain workers' compensation insurflnce, es requiretl by sectlon 3700 oF the Labor Cotle, for the peAormance of the work 1or which this pertnit is issued. My workers' compenselion Insurance cerner end policy number ere: Policy Number: :fion need not be cromp/eted il the peimitl5 ve/ued ef one hundied dollars ($100J or /eSsJ . tity:lhatin the pedortnence of ihe work for which this permit is issued, I shall not employ eny person In eny manner so as to become subject ro the workers' pensation law f Iifomia, tl agree that if I should becoma subject to the workere' compensation provision'`i S� tio 37Q0 of ihe Labor Cotle, I shall fort�with ply,wilh ihes o 5ion5. � Slgnature:. (,�D le's= ��li1L FAILURE TO S URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES FND CIVIL FINES UP TOONE HUNDRED �DOLLARE(E ,000),INADDRIIXJTOTHEWSTOFCQ`APENSATION,DAMhGESASPROVIDEDFIXiINSELT10N3]O60FTHELABORCODE,INTEREST,ANDATTORNEI"SFEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm that I am licensetl under provisions of Chepter 9(commencing with Sectlon 7000) of Division 3 oi the Business and Protessions Code, end my license is in full brca and eHect Lic. A Class A Contractofs Signatwe: Date: CONSTRUC710N LENDING AGENCY: ❑ I hereby attirm ihat there is e constmction lending egency for the pertormance of ihe work for which Ihis permit is issued. (Sac. 3097, Civil Code). Lendets Name: Lendels Address: Signatura: Date: OWNER�BUILDER DECLARATIONS: I hereby eHirtn that under penalry of perjury �hel I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sac. 7031.5, Buslness and Professions Code: Any ciry or counry which requires a pertnit to construct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires ihe epplicant for such permit to tile a signed statement ihat he or she is licensed pureuent ro the provislons of the Coniractors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of the Business d Protessions Gotle) or t�et he or she is e:empt therefrom and the basis for the elleged e:emption. Any violation of Section 7031.5 Dy any epplicent for e permit subj �ihe epplicant to a civil penalry ei not more Ihan five hundred dollers ($500).): - ��I, as owner of ihe properry, or my employees with wages as iheir sole compensatlon, WILL DO THE WORK, antl �he siructure is not intended or oHerad tor sale (Sec. ' 7044, Business and Professions Code: The Contractors License Law does noi apply to en owner of property who builds or improves thereon, antl who does such work himself or herself or ihrough his or her own employees, provided that such improvemenis are not intended or oHered tor sale. It, however, tha building or improvament Is sold within one year ol completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose ot sale.). ❑ I, es owner ot the property, em EXCLUSIVELV CONTRACTING WITN LICENSED CONTRACTORS to consiruct the prqect (Sec. 7044, Business and Professions Cotle: The contractors License Law tloes not epply to an owner of propeny who builds or Improves thereon, antl who contracis for suc� pmject with a contracror(s) license pqsuant ty Ihe Conirectors License Laws.). sec. Business antl Professions Code For ihis reason: ID ve ietl by tlrivefs license. ❑ Ves ❑ No tion Ownership Dy (type of tlocument, i.e. - propeey ta:6iil or DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I heraby certify that no excevetlon five (5) or more teet in depih into which e person is requi�ed to descend, will be ma0e in connection with work authonzetl by ihis permi�, and ihat no builtling structure, scaHolding, falsework, or demolition or dismantling thereot, will be more than thiny-six (36) teet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Tltle 8, Celifornla Atlminisirative Cotle). ❑ As owner-builder, I wlll not employ anyone to tlo work whic� woultl require a permit irom Ihe Division ot Industnal Safery, as notetl above, unless such pereon has e permit to do such work irom the division. Signature: Date: Division af Industnal Safery Permit Number: CERTIFICATE OF COMPLI E AND AllTHO�IZA710N OF ENTFiY: I certify under penalty of perjury ihat 1 have read this epplication antl state Ihal the infortnation given is correct I agree �o comply w al stete laws tl ciry ordinances releting to building consiruction, and authodze representetives of ihe Ciry Cos�a Mesa to enter upon ihe ebove-described property 1 s ction pur es. I agree not to acupy or allow occupancy of any building aulhorized by this permit u fin inspection. faron6 i� t Rf0 Legal Owner(s)f�:'�"=:.` .�...� n,.: ate `-,.,. �,�._...-_�_ ...-- t--"=��+:.:" COUE �. INSPECTIONTYPE 1616 Fized System Final Fire Prevention 1266 200 Pool Spa Final Final Re-Roof 207 �� Finel BIocWReteining Well . 202 Final Factory Fire Place 203 Finel Sign 204 Finel Demolition ' UATE I A §Qp�k INSYECTIONTYPE , 206 Finel Mechanical 208 Final Plumbing �n�,�.�� n � 210 Finel Eleciricel � W✓�212 Finel Fire Prevention v 220 Final Planning Approval 222 250 Final Site Final Building/Occupancy �n1I.1S9 (714) 754-5273 • Fan (714) 754-4856 • www.ci.coste•mesa�DING PERMIT 77 FAIR DRIVE, COSIA MESA, cA 92626 Job Address: 460 E 19TH ST Suite: Vicinity: Primary Occ: R-3 Dwellings/ C6ng Res <10 Parcel Number: 42632118 Appliwnt: YBANEZ, RICHARD Address: Type of Constmclion: V-N Zoning: Phone: 714392-1377 Zip: owner. GOODWIN, JOHN P � Address 460 E 19TH ST � � ' _ � . � ' � Phone: COSTA MESA, Cq ", _ � Zip: 92627 Contractor. STRAIGHT LINE.DEVELOPMENT AND CONSTRUCTION Address: 412 LAUREL AV- =� ' � , ' �,� � Phone: 774-392-1377 , BREA; CA'� � � ' Zip: 92821 %��' � .License: 282761 Arch : � , Eng: Address: � . , Address: Phone: Zip: ' ' � . License: � � Status: ISSUED Applied: iZ30l2005 Issued: 12l30I2005 ISSUED BY: �( J - 0 Phone: License: a�.vrc vr r�rtnu � REROOF 1100SF REMAINDER OF R�SIDENCE, NOT PART OF ADDITION RE; b05-01933) wlcomp shingles. � , _, FEE SUMMARY � Plan Check: $0.00 r,� � � - -, Calc Valuation: a3,soo.00 Permit: $97.25 Claim Valuation: 53,soo.00 SMIP Res: $0.50 SMIP Com: $0.00 � Other. � $0.00 - _—_ ; � � � � . Inspection: $0.00 Total: $97.75 SETBACKS MAINSTRUCTURE Front � 0-0 Rear 0-0 . - �� _:;.-,.; .� . ACCESSORY Front 0=0� � Rear 0.0 �` i , i ,� �,�, PARKING '`� Existina:-; o -Reauiied: o / PLANNING & ZONING Lefl 0- 0 Left 0- 0 , Pr000sed: 0 9� Right 0. 0 Right 0-0 , NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ottf. No. 92-28, § 7, 12-21-92) EXPIRA710N: 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 for Ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and ell required Inepectlona end flnel approval must be obtained. Failure to obtain Inspec�ions and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 w� WORKERS' COMPEN^aAT10N DECLARATION: � ,� I hereby aHir,m�untler penalry oi perjury one of iha tollowing tleclaratlons: ' \, ,;' ❑ I heve end will meintain e certificate ot consant to self-Insure lor workers' compensation, es providetl lor by section 3700 0l lhe Lebor Code, tor Ihe pertormance ai ihe work Por whic� t�is pertnit is issuetl. ❑ 1 have and will maintain workers' compensation insurance, as requlretl by sectipn 3700 of the Lebor Cotle, tor tho pertortnence ot Iho work tw wNU this pertnit Is issuetl. My workers' compensatlon Insurence cerrler entl policy number are: / Cerrier. PWicy Number: i (This section need nof be oompletetl i! (he perml! fs velued et one huntlretl dWfars (S7 ) or loss.) �— I certity that in Ihe peAorm nce ol the work I Jwhich t Is permlt is Issueq I shall not employ any person In any manner eo as to become sub�act to the workerg' compensation laws ol Ca mia, en0�egre !at it oultl become sub�ect to the workors' compensetion provisions ol Sedlon 3700 of tha Lebor Catle, I shell torthwith compty with these pro TW%� ns. a Applicant SigneWre: /C�� {��.�� / Date: � �- - ?, O — b •7 / � W ARNING: FnI�URE TO SECURE WORKEfiS' COMPENSA#ION CpVEMGE IS UMAWFUL rW D SHAL� SUBIECT AN EMPLOYER TO CRIMINAL PENALPES AND CMl FlNES UP TO ONE HUNDRED i11C%1SAND �OLLARE (5100,000). IN ADOfTION TO THE COST OF COMPENSATIpN, D0.NAGES AS PRU�DED FOR IN SECf10N 3]O60F TME IABOR COOE. INTEREST, M1D ATTORNEY'S FEES. IICENSED CONTRACTORS DECLARATON: I hereby attirtn Na� I am licensed under provisions ot Chapter 9(wmmencing with Sectian 7f100) ol Divisian 3 0l Ihe Business antl Professions Cotle, end my license is in full forca and ettect Lic, # / Class N f3 - 19 ��- 7/ % ComractorsSignamre: 71�.._ � Date: �� _ -�p — �� CONSTRUCTON LENDING AGENCV: ❑ I �ereDy aNirtn Ihat Ihere is a construction lending agency for Ihe peAortnance ol Ihe work for w�ich I�Is pertnil is issueU. (Sec. 3097, Civil Cotle). Lentlers Neme: Lendels Atltlress: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirm Ihat unOer penelry ot perjury that I em E%EMPT FROM THE CONTRAC70RS LICENSE LAW lor Ihe tollowing reawn (Sec. 7031.5, 8uslness entl Professions Catle: Any dry or counry which requires e permit to construct, alter, improve, tlemolish, ar mpair eny sWcture, pdar m IU issuance, elso requires the epplicant lar such pertnit m lile e signed statement ihat he or she Is Iicensetl pursuant to Ihe provisions ot ihe Contrectors License Lew (C�epter 8(commendnp with Sectlon 7000) ol DMslon 3 0l the Business and Pmfessions Cotle) or Ihat ha or she is exempt t�erefmm end t�e besls for the elleged ezemption. Any violation o1 Sectbn 7031.5 by eny applicant for a permit subjecis Ihe applicant to e civil penalry ol not more than tive �untlretl Oollars (3500).): ❑ I, as owner of the pmperry, or my employees with wages es �heir sde compensatlon, WILL DO THE WORK, and the structura Is not inteiWeO or otteretl for ule (Sac. 7044, Business and Professions Code: The Contractors Licensa Lew does not apDN �o en owner of properry who builds or impraves thereon. and who does such work himself or herself or through his ar her own employees, prodded that such improvemenis are not Imended or ofleretl for sele. If, however, Ihe bullding ar improvement is soltl wit�in one year ot completion, the owner-builtler will have the burden ot pmving iha� he or she did not build or imprrne lor purpose oi sale.). ' ❑ I, as owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTHACTORS to canstruct t�e project (Sec. 704d, Business antl Prolesslons Cotle: The coniractors Licensa Law tloes not appty to en owner ol propeny who huiltls or impmves ihereon, and who contracts Por such pmject with a contractor(s) license pursuam to the Contractors Licanse Laws.). ❑ I am exempt under sec. Business antl Prolessions Cotle for �his reason: Signaiure: Date: Owner ID veritietl 6y tlrivefs license. ❑ Ves ❑ No Drivets License No. Vadflcation ot Ownership by (type of document, i.e. - pmperry te�c blll or deetl�: DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICA710N: Expires: ❑ I hereby certify that no excevation five (5) or more teet in tlepih into which e parson is requiretl to tlescentl, will be mede in connection with work authodzed by ihis permit, and that no builtling structure, scalloltling, falsework, or demolitlon or dismaniling t�ereol, will bo more than thirry-six (38) teet high. (ChaO� 32, Gry 2, Art 2, Sec. 341, Tltla 8, Celitomia Atlminisirative Cotle). ❑ As owner-builder, I will not employ enyone ta tlo wark which would require e permit from the Division ol Industnel Sefery, es noted ebove, unless such person hes e permi� t0 tlo 5uU work tmm the divi5ion. Signature: Date: Division oi Industrial Safery Permil Number: CERTIFlCATE OF COMPLIANCE AND AUTMORVJITON OF ENTRV: I certity untler penalry of per�ury that I heve reatl lhis flpplicatlon entl state t�et the Inlortnation givan is I wrrect. I egree to compy with all state lews end ciry ordinances relating to GuilCing construction, antl euthoriza representatives ot �he Ciry ol Coste Mesa to enter upon Ihe above-describetl property tor inspeciion purpa5es. I egree not to acupy a ellow occupanty of any building euthorized hy thu pertnit un61 Mel inspecfi0n. I / / ,6ignature Of Legal Owner(s) � Cil.v �- � � AnNO ut onz t COOE �. INSVECTIONTYPE ifi16 Fixed Sys�em Final Fire Prevention 1266 200 Paol Spa Final � Flnal Re-Raol 201 Finel BIacWRetaining Well 202 Final Factory Fire Plece f /^ — CODE� INSPECTIONTYPE 20� Final Mechanical 20B F' IumDing 121 F� I Elec 'cal 1 Q12 Final Fire ven 203 Final Sign �[ ��« � rinai ana 204 Finel Demditlon 250 Finel Building/Occupenq PAg It�ki �oonessaFewtoua: q 6 0 E 1 9 TH S T ONNERSNAYEIFqqWN: JOHN GOODWIN - ��p� 460 E 19TH ST COSTA MESA,CA 895-1246 �vv�. �.uuxo �ooness: �qCNRECTOPENtlNEEX: dPCX.OP ENO.'4 �DUHESS: coam�crarswu�: NOCK PLUMBING CONiPACTOH'SYYUNG 11610 SEABOARD CIR 92627 uc. no.: �� CITY OF COSTA MESA — BUILDING PERMIT t\ PERM�IT NO: P 076083 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU JOHyDESCRIPTION ; C/O DISHWASHER UNT; � (714)895-1246 aoonesx STANTON CA ucra, 511971 90680 uNr: LICENSEO CONTN�CTOHS DECLAN�TION: I MraEy eflim uMw paialy d parjury thet I em licanaad uMer potieiona d Cheqer 9 (mmmer�arq vm� SMbn ]000) d Onieion 3 W i�e Buzroa ud PMeascm Code. vd mY lioenro u in htl lorce vW e%od. cmuc.ao.:050386 uc.cuss: C-36 uc.No.: 11971 EXP: 02/96 o��,,: �- zy - 9� �«�« �c PGv�rJ4.NG , � �uc, �OR'NER BUILUEfl UECLANATON: I MmEy efirm �ndm penery W perN�Y �� I em exemq Imm ihe ContreGaa I.iceree lew la iM Idbw.q imton (�� ]W1.5 &n'vima aed Rdeseiau Code: Atry ety n eouMy M�"rl� reQuiiaa e pe�me lo OoneVu�t. ellar. imqove. 'vndsh, a rapeir eny eVudure, p'v io us eauance. abo mpu'ves �M epplimiv fa such pertnE lo fib e agneE NelemeM Net M a eM 'mnsed q�m�ent to tM povisiona d Me Contreaon lirome lew �Cheqer 9(mmmerrnp xilh Setlion ]OW) ot D'vbian 3 d ihe einm arM Prdwbm Godel «�hm ha a ahe n uamq Ih>ohvm uM IM Eve la Ne eAaped ezemqion. Nry violation d Seaion /031.5 b'/ BIIY �1 M� IIX 9�IBITY =U�BC! ��1! B�' If8f010 9 fIV� pMB��)' O� M 111O10 ��1BII iMB M1Il1ldfBd I��BA �i�M�. � 1. ae ovmar d tM yopeity ar my empbyeav wYh we�m m �M1ei sde mmpeenetion. w21do Ihe v.vk, eM Ne e4ueturo e na imendeA or ollerad fa seb I�� a<. Biui�wsa eM PMeaaona CaCa: TM Conlredon Licanse lew does rot epplyto an ownerd propaM wM buids a inprwea iMraon, ard Wa doee suM v.a�k NmsNl ar MnN or tivaqh M ar her own empbyaee. pmvidad thm euc� impvmnema ere nd iMenEeE a Wsad tor seb, tl. however. �M buYtl'uq n inpasnem e eotl wn�in arY� d mmpbtun. tM owner-0uiker xill heva tM bueden W pmieq M w ehs d'd m� buJd a improvs la �M WTaa d eeb). � I. ea o�mer W Ihe propeM. v* ezdueively ooniretliq xiN 4tttneE canUactm lo oonfV W Ihe pmjetl (Setlon ]OIA. Buainme eM Protesdone Code: Ths ConiMwe licens Lew dou M npply b an owner d pivpe�ly wM Euiks a impwm Ihereon eM w1w coniAn. w.uM waietla ,.Vh e m+,m«c.) �icemea w�.uva m �he cun.eda, umme lewl. � I em eaemq urder Senion: B. A P.C.. br Nu �sam: Deb: Ownar. CLAIM VALUE: CALC—VALUE: PERM NO: P 076083 GOVT: N SUPP: N PURPOSE: OTH SQ FT: GROUP OCC: R-3 / COMMENTS: X **x ��r�r*+��*�r�r��***�r*+r�r*��r*�*+�**+�*�x x�*x *�x�****��*� *******�r�+r�r� ��r��**** Z O N I N G R E(] U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING -------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT ZN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 92632118 ZNE: REF NO: PLANNING NOTES> i *�'�'**'***'�'�'*'�'�'*'*****�'*�'*�'�'*'�'*�'*'�'**�'******�'�'*�"�'**'*'*'j{'�'*�'�'****�'*X'**'�"�*'*�'�'*'**'****'*�'*' 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: HUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: �� iE1E1fIF1E�FiE1ElffEififlFfEifiEiFififififif MifiE1E1E1FiElEifif if LEGALIZATION:N F E E S U M M A R Y STRUCTUAAL SEGMENT:N I Eo Mieby wnily Ntl 1 em ewue d end w�daeeieM iM repu'vammn d Cdiomu VkeXh ud Sdaty Code 9aqbm 25505.25533. aM I P5530, entl iM1tl I m eny Mun buiMirp amipant wiA / wil mi (arcb aa� meE b wmply wIh aeid etete cotlm eM IM reQuiromenb /a apmmnlmm�at�uctionamodlficmionhamtMAi u�ty anepamanlD'mtria.fiaeidruWmnqwioneppirmioroene�emptromtMee a°�^"°^° P ERM I T Dela: �pd'�: WOPKEP'S COMPENS�TION DECLANATION: 1 heroW eM uMa pandly d pajury wa d Ms blbxirp dedue�bn�: � 1 heva enE wil meinten a cenAiwa d mnaenl to �eXimvra for v.aMeri canperoelian, n pwitlaE /a by Sadim �100 W the Lebor COG. Iw �M pMormer¢a d Na wak Ia wlich Nu pamu o bsusd. C_l I havs uM wil meimen worken' oomD«iwion imwenw. n nwine M Swaion a)oo d �M lab« Coee. ror �M wnormerca ot tM )� wak /a whid� thn O+�N b'vsusd. M' waYen' mmPmaaion imuranu mrriar W odM.Y numbor en: c.m.�: STATE EXPIRES VdiryNumber: UW('iii i �i�- 09/30/96 ia eMion nasd rrot bs canpNfad / Ns pwmt u b ans hundnd dtlW �S�OJ) w Ns.1 � I canLy ihel in IM pMormerce d iha wak la whi� ihu pwmA i� eweE. I tlutl m� empby ury p«son In uy menrw M e010 Eecane vubl� �o Ihe xurken' compemtlfon 4we d CeGlmue. uM epiae I�y4LMwM Exome wbpo lo IM Moikars' ,�n� penatbn pwuom d Seqian JNO d tM Lebor Cods. I h mmp6• �+ P n pauioro b6'.:1 /- v�/ — 9G .oa��:� c�c_>> Wem/rp: F�llun ro Meun woM1'�n'ro�owwtlon eo✓�rp� l� unNwN( antl �IWI ubNet �n xr�vlayx to�TMivl paull/u�" nvn nMs w ro m. nunersa rnouw�a ewan ls�at000A �n semnan ro m. co.r o� rnmoxu,rron, e.m.os. n pov�e.e ror a s.cuon s)a ur m. l�ne, cne., �nNn.c .�a.�rom.r. �w. CONSTPIICTION LENDIN� pOENCY: I Mreby elfirm uMm perWy d parjury ihm tAwa ie e mn�ivaion IeMi�q eparKy br �M peAormar�m o11M xak M whiM th6 pami u eaad (Seaion 30g1. C'v. G). LENOEN'S NM1E: LENUEX'S �ODRE59: I canM �� 1 heve ned Ihb applwim eM qata �lim Me ebwa iNvmelion b conetl. I ep'ee lo compy wilh ell tlry erd couMy ordineMee eM etme lawe iebliq io buik'vp ommueian end hereby einlncs �sasvetrvae d Ih"v Wy m emr upon tM abv.e�mantioried pmpeny fainspedan Durpoaes. �, RON NOCK o�,: 1—'�'f —�, (515116.WP) Whne-BuiNiq d Safely: GreeMFib: Ceneey-Appira�: Fnk-Rewnue: GddmmFAsrva BLDG PMT PLUMHING ELECTRIC MECHANIC 7 , � � PLAN z5t � ISSUE FEE 20.00 ' BUILDING—DIV—> PERMIT ISSUE PL�AN—CHECK TOTALS----> 7.00 20.00 , 0.00 REVENUE DIVISION TOTALS--> COLL'ECTED: HLDG PMT PLUMBING ELECTRIC MECHANIC 27.00 "' FIRE SMIP/RES GRADING SMIP/NON—RES TOTAL PAID DUE 27.00 27,00 .00 27.00 OVER/SHORT: .00 FIRE SMIP/TOT GRADING PLAN—CHECK iFlF 1E 1f 1f If 1f� 1i K 1(� 7f 1E 1k 1t iE ik 1E 1k 1E 1E 1E 1E 1k 1E il� 1f 1f'!E iE 1f 1E 1E'k 1E 1(�,if iP 1f 1E �k iF if iE �E 1(� 1E 1E 1E 1E 1E 1E 1E 1F 1F iE �E 1F iflF IE 1E iE 1k 1E 1E iE 1F if IE 1E 1E 1F iE!(� IE 1E �!!E fE I N D I V I D U A L7 F E E B R E A K D O W N TYPE QTY D E S C R I P T Z O�N UNIT COST TOTAL COST PLU 1 DISHWASHER n 7,00 7,00 END OF FEES /V t''1 ��i9aGo�-.. ��YiL'JU �'�u'T ii �. n.:��: ot,.. -r�;.• -��:i� \ CONSTRUCTION AND PIANNiNG _ POOI � ,PA APPROVALS Permit# Date Inspector APpROVALS Permit# Date inspector t. Temporery Electrical Service or Pole 52. Pooi & Equipment Location 2. Soil Pipe-Undrgrnd. � .� 53. Steel Reinforcement �..« _ - � _ � � -3cEiectrica� ConduTt�tility-Undrgrnd. 54. Forms � � =�4��EfectricalCondinc=C1`+�drgrnd.f 55. ElectricalBonding �, ��-5.: $jeel Reinforcem;pt� 56. Rough Plumbing & Pressure Test ' ;;x'FdiectricalUFE�Grnd. 57. APPROVALTOCOVER-GUNITE - -7i�Footings �� 58. Electrical Cond,'ui�Undrgr�d. � �' 8. Foundation � C' = �= 59. Gas Pipe, O Uridrgrnd., Test - m ., 9. Water Pipe•Undrgr'p�l. ,:, . 6p. Backwash �ines, e�Trap, O Undrgrnd. � 10. Structural Floor SYstem „ 67. APPROVAL TO QECK �� 1 t. �operty Sewer �ine�& House�Connection 62. Backwash & Receptor�Final r 12. Sewer Cap ' 63. Heater & Vent-Final � . � 73. floof Droins 64. Plumbing System � Final 74. flough Plumbing- n 65. Electrica6Final 75. (iough Elactrical_Conduit �� 66. Solar SYstem�Final 16. Rough Electric Wjri g. � 67. Fencing & AccesS-Approvai 17. flough Wiring Siqn � - � 68. APPROVED FOR PLASTERING 18. RoughElectrica,�BarCeiling" � 69. POOUSPASYSTEMSFINAL 19. Rough Heating & Air Conditioning ,_, F�{� E DEPT. EQUIREMENT � + -� 7 + ^r! �r, 7`�•.� r• � n 20. �ou hi F�aor�Fice ace �' s � �'' - - _ � 9 �. � _P'� � <. ,� r,: ,'APP(�`OVAy'L�ytiF. Pe`_�rnit # µ � _ 21. 6uct§; in�SZruEture:': .. . � + S � � i 70. ;Tlnder�I�pcl FL�drU ' -. c- c 22. Ducts,,Veiftila2ing, � " r 7 � ' r,� ° 7�, p�odueq pingLJ�Cas �70i1 _ ; _> . .. .. _ :. . 23. Gas Ripe-Ftough & Test � _ + * ^ c " - 72, UndergroulA F�usM '" - 24. Fi'oof Fraining" '�` "_ .r � ;' _, _,x �. 73ro Undergrrd.Stor��TanluOGas OOiI 25. Roof•Sheaihing i� ,' �. �� a� y D � [.; r� � 74i pverhead Hydro�,. ` 26. ��Bai Ceiling (StructGrep & Nfdnt�coat � C j, ' ."'.# 7� Dry Chernical c, ,� `� - u x; " �, . 27. �reme and.Flashin9 � �w c; � e� ��z= `76. Dry Starf�(pipe E � � _ � _. 28. lathing &"Siding � � „�,",F C ;, �- ",� 7'L� FIXED S�ST FINAl �� ,- �,. 29. Insulation r�' S •• +. �� 78'r FIRE �REV. FI AL �: % " �'30. Drywa�l Nailing :. ,, "; _ ' ,�. ��;' ;';k,}EAIT�i�DEP�. REQUIREMEN7 �31. Plaster Brpwn•Coat ,,- � r• t*� + a. �9.` FINAL I[sISGECTlrJN w - ... '32. �lecirical,i�owe� Met�?�Fi�tal ' " • r' � SO � fOOD CERTIFiC�TE I�S�UED� • , 33. Fjna(-�.Electric� � ;.; . ^ x: �� , �# � Ndtes: � '* - _ � �_-S�r�� ti'a �c�s_t�� tn_� "34. Fina�Fieatingr& Air Eonditionin`g=' �1 K� � a r;=� > _ 7' 'L ;-� - s : � �-� � E- <.: � , . 35. Finat Gas Pip�:Test X_ .'. y;- ��o Or- - , ,' � ?'36. Hood�or CanoPY � '= -'-� " ,. .� . -'� � : �G ' : - x � - '1, r. � .�+ T.G Y- p; - � r.' 1' = � P --37. F.'�na(f.actory Fireplate � : �_ ,., r" ' ,r * � / k -'38. Fina�Plumbing * � � ' ' =� ' � � i t• x ' 39. Water'Service-Final t £ � `� � C. y :. ' ' ,_ � w� " -40. Gas Service-Final . . �t�^t :� M i�7 � O� �N ' ~ ., c. t ' r r. . x c; �41, Solar pomesticFinal, -- " "" , _ �,j � � � r _ ? . > .- ° 42. Beckflow Prevencer - > I ,* a' ' '' � e . r,� . .-. > i•:c *.. t � 43. Backflow Irrigation K ��'S Y� - � F" �• p4. Landscapa�irriCatio YiSystem ""�� K r �, � Gy , �" � � '�� ' S _ '= s (i;, i 4b. Sdund Attenu�tion� ��`� � ` , • -� r� ' _ - '�' =� �K � "r] . _ . �,✓ , • i 46. Handicap Regulations � ' � � �• -� � ' tv� � ,r . , 47. �INRi STRUCTUR€ & BUILDING w f, � •, '" '��' � F 48. F.INAL PIANNING x F r '• ' �� ' - "4 ` E" + � �', .ro .. 49. ETectihcReleasetoE�ison .'�� ,.�, -� '� .�- ;; ' 50. Gas Release to Southern CaliforrriaGas Co + t �'" � �' ' =' ' `_-� ' . � � M - 51. CERTIFICATE OF OCCUPANCYc F �' '�'- ` - No. Date