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Home My WebLink About467 19TH ST - Building Permits.,i�J. • y �`�',' i •.m:�.�::: ; : �� ' � + CITY OF COSTA MESA � BUILDIN6 DIVISION DEVELOPMENT SERVICES DEPARTMENT. PERMIT ��ia��sa•52�s • Fax��ia�75a-aess ,lob Address: 467 E 19TH ST Suite No Vicinity: Parcel Number: 11734127 Applicant: KEN WIANT Adtlress: MECHANICAL PERMIT Phone: 949-721-0730 Zip owner: HANSON,. FRANS RICHARD TR Address: ' 1826 COMMODORE RD � Phone: NEWPORT BEACH, CA Zip: 92860 Contractor: , - Address: Arch / Eng : Address: ' - � Phone: ,. ' ." . , . ' : � Zip: . License: Phone: Zip: License: PERMIT NUMBER ��i�fi` CJ�j �% �o 77 FAIR DRIVE, Status: ISSUED Applied: 64I27I2000 Issued: 04/27/2000 ISSUED BY: � I 1' l � , • I,r (�`i.. . � •+1 •5 , . .. .. - • . SCOPE OF PERMIT ' RESIDENTIAL ADD, SUPPLEMENTARY PERMIT FOR iFACTORY FIREPLACE AND 18ATHROOM FAN, RE:899-01998, M00-00173.'. � . . , � -.- -- -' . . • ` ' , . . FEE SUMMARY ISSUE FEE Inst FAU <700 k BTU � Inst FAU >700 k BTU Repair / Alt Cooling/Heat Inst / Rep. Recess Wall Htr Retrig Sys <100 k BTU Refrig Sys >700 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers � 10000cfrn Air Handlers > 10000cfrn Floor Furnace � Floor or Suspend Heater $7.25 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 $10.65 $0.00 $0.00 $7.25 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity Repair / All Absorbtion Unit " Repair/AltRefrigerationUnit Ventillation System Evaporative Cooler Commercial I n cinerator Domestic Incinerator Compressors / Absorotion Svstems Upto3hp/100kBTU 3To15hp/500kBTU , . 15 To 30 hp / 1,000 k 8TU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Up to 3 hp 3To15hp 15 to 30 hp 30 to 50 hp Over 50 hp ' Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Quantity $0.00 0 so.00 0 $0.00 0 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 $0.00 0 $0.00 0 $0.00 $0.00 80.00 525.15 NOTICE: The work authorized by this permit shall comply'with all applicable handirap access requirements under Califomia statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) , EXPIRATION: This permit shall automatically expire and become void if work is not�commenced within 180 d�ys, 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 legat, such work must comply with all applicable codes, and all required Inapeetlona and flnal approvel must be obtained. Failure to oblain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (71/) 7545628 �� WORKERS'COMPENSAnON DECLARAnON: � I hereby aHirtn under penalry oi perjury one of iha tollowing deGaretions: ❑ I have and will maintain a cehificate of consent lo selhlnsure tor workers' compensation, as providetl tor by sectlon 3700 of ihe Lebor Cotle, for the pertormance of the work tor which Ihis pertnit is issuetl. ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of ihe Labor Cotle, for ihe perfortnance of �he work for which Nis permit is issuetl. My workers' compensetion Insurance cartier end policy number are: . Cerrier: Policy Number. (This section need not be crompleted il fhe pemtit is valuetl at one hundretl tlW/ars ($100) ar less.) ❑ I certily ihat in the peAortnance of iha work for which this permit is iuuetl, I shall not employ eny person in eny manner so es to become sub�ect lo the woAcere' compensation laws of Celifomia, and agree thet if I should become subject to the workers' compensetion provisions ot Sec�ion 3700 of ihe Lebor Cotle, I shall forthwith comply with ihese provisions. Applicant SlgnaNra: Date: WARNING: FAILLIRE TO SECURE WORKERS' COMPENSATION COVERAOE IS UNL4WFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN�RED THOUSAND OOLLARE ($100,000), IN ADOITION TO THE COST OF COMPENSATION, DAANGES AS PROVIDED FOR IN SECTIIXJ 3'1O60F THE LABOR CODE.INfEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby aHirtn that I am licensetl untler provisions of Chapter 9(commencing with Section 7000) of Division 3 of t�e Buslness and Professions Code, and my licensa is in full force end ettect. Lic. N Class x ContractoYs Signature: Date: CONSTFUC710N LENDING AGENCY: ❑ I hereby aHirtn Ihat there Is a construction lentling egency for t�e pertortnance of ihe work lor which this pertnit Is issuetl. (Sec. 3097, Civil Code). Lentler's Name: Lenders Address: SlgnaNre: �ate: OWNER-BUILDER DECLARATIONS: I hereby atfirm that under penalry oi perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Code: My ciry or county which requires a permit to construct, alter, improve, demolish, or repair flny siructure, pnor to its iuuance, also requires tha epplicent tor such pertnit to file.e signed statemem that he or she Is licensed pursuant lo ihe provisions of Ihe CoNractors License Lew (Chepter 9(commencing wilh Section 7000) oF Division 3 of Ihe Busiriess�and Pmtessions Code) or that he or she is esempt Iherefrwn antl the Oasis for ihe allegetl e:emp0on. Any Noletion ol Sectlon 7031.5 by eny applicent for e pertnit subjects the epplicant ro a civil penalry ot not more than five huntlretl tlollare ($500).): .. �.., t t. � U �'�� ❑ I, as ownar of�iha praperry, or my employaes with wages es their sole compensetion, WILL DO TME WORK, antl the structure is not imended ar aHeretl for sala (Sec. 7044, Buslriess and�Professions Code: The Contractors License Lew does not apply to an owner oi property who huiltls or improves ihereon, end who does such work �himself or herself or,ihrough his ar her own employees, provided that such improvements ere not Intended ar aHared for sale. If, however, the building or improvement is soltl within one year of'completion, the owner-builtler wi0 hava the burden of proving that he or she did not build or improve tor purpase of sele.). ❑ I, as owner oi the properry. am EXCLUSIVELV CONTHACTING RH UCENSED CONTTiACTORS to conswct the pro�ect (Sec. 7044, Busineu antl Pmfessions Code: The coniredors.Wcense LavyGo� noj.�ap;ly to fln owner oi properry who bulltls or Improves thereon, and who comracts for such proJect with e contractoqs) licanse pursuam ro the Contrectfl(;tiC�hae K�ws. . , , ❑ I am eKeWplSmder sac. Brified by driver5liten5e. ot Ownership by (type of and Professians Cade tor t�is is ❑ No � Drivers License No. i.e. - property tav bill or tleetl): Explres: DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I hareby ceniry that no eacavation five (5) or more feet in depth Into which a person is required to descentl, will ba mede in connection with work emhorizad by this pertnit, and that no building sWcture, scaffolding, talsework, or demolition or dismantling Ihereot, will be more than thirry-sin (36) leet hlgh. (Chap. 32, Grp 2, Atl 2, Sec. 341, Ttle B, Calitornle Adminlstretive Coda). ❑ As owner-buil�er, I will not employ anyone to do work which would requira a parmit irom the Division oi Intlusirial Safety, as notetl ebove, unless such person has a pertnit to do such work from Ihe division. Signature: Date: Division of Industnal Safery Pertnit Number: CERTIFICATE OF COMPLIANCE AND AUfHORIZATION OF EN7AY: I certity under panelty of perjury that I have read this epplication and state Ihat Ihe Intorme�ion given is correct. I agree to comply with all stete lews end ciry ordinances rela�ing to building consiructlon, and authotlze representalives ot the Ciry oi Costa Mesa to enter upon Ihe ebove-described properry for inspection purposes. I egree not Io occupy or allow occupency af any bullding euthonzed by this parmit until final inspeclian. - Signature Ot Legel Owner(s) �` Date CODE t. INSPEC710NTYPE 1816 Fized System Final Fire Preventlon 1266 POoI Spa Final 200 Finel RB-Roa� 201 Finel Block/Reteining Well 202 203 204 1a4Ea6 Finel Fectory Fire Place Finel Sign Final Demalition P9IF. 1I�45 CODEI �xsvecnoxTvve 208 Finel Mechanlcal 20B Final Plumbing 210 Finel Electricel 212 Final Fire Preventlon 220 Final Plenning Approvel 222 Final Sita 250 Final Building/Occupancy PAiE ItiIIDAL$ ��ia� �sa•52�s • Fax (�ia»sa-aess Job Address: Suite No Vicinity: Parcel Nunmber: 467 E 19TH ST SIDE OF GARAGE 11734127 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT ELECTRICAL PERMIT Applicant: HANSON, FRANS RICHARD TR Address: 1826 COMMODORE RD . �Phone: (949)650-8463 NEWPORT BEACH, CA Zip: 92660 Owner: 'HANSON, FRANS RICHARD TR � Address � 1826 COMMODORE RD - , , " � , Phone: (949)650-8463 NEWPORT BEACH, CA 2ip: 92660 Contractor: O W N ER-B U I LDER Address: , ISSUE FEE , Temp service test Res. alc package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts ' Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over t000a Motors to 1hp Motors l0 10hp Motors to SOhp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole .:.. �'.. . - ' � � �Phone: Zip: License: 0 REMOVE & REPLACE EXISTING $23.50 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity PERMIT NUMBER E00-00086 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: 'H NEW 200 AMP SERVICE. . FEE SUMMARY .. - � . � � - . - -- Temp Dist System / Lighting Busway /100 ft � Standing Section Misc Electrical Equipment �- � Transformers up to i kva/kw ' .. : . ................up to 10 kva/kw . .. . .................up to 50 kva/kw � � ...._...........up Jo 100 kva/kw � ..................over 100 kva/kw � Low Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit � � Misa Conductor Circus ( gen or ride) Cirws (mech ride or lights) Christmas Tree Stand , Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee �Reinspection Fee Stams: ISSUED Applied: 02/03/2000 Issued: 02/03/2000 Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 - 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES 554.00 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access raquirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all required Inepectiona end finel approval must be obtained. Failure �o obtain inspections and final approval will result in �he expiration of ihis permi�. FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSAnON DECLARATION: . I hereby aMirm under penalty of perjury one ot �he lollowing declaretionso- . . . ❑ I have end will maintain a certificete of consent to salf-Insure for workers' compensation, as O�ovidetl for by sectlon 3700 of Ihe Lebor Cotle, for the pertormance of Ihe work for whith thi5 permit i5 i55uetl. ❑ I have antl will maintain workers' compensation insuranca, as requlred by section 3700 of Ihe Labor Code, br the peAortnance of ihe work for which ihis Dermit is issuetl. My workers' compensation Insurence carner and policy number ere: Cerner. Policy Numbec (This section need not be complered I/ the permit is veluetl af one hunUretl Col/ars (S 100) ar Iess.J ❑ I cenily Ihat in Ihe performence of Ihe work tor which this permit is issued, I shell not employ eny person in eny manner so as to 6ecome subject to the workers' compensation laws ot Calitomia, antl egree thai if I s�oultl Gewme sub�ect to the workers' compensation provisions ol Section 3700 of the Labor Code, 1 shall torthwith comply with these provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CqVEBAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPIOVER TO CRIMINAL PENALTIES AND CIVIL FINE$ UP TO ONE HUNDRED THOUSAND OOLIARE ($100.000), IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 3]O60F THE LABOR CODE, IN�EREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: � I hereby aHirtn thal I am licensed undar provisions ol Chapter 9(commenqng with Section 7000) of Division 3 of Ihe Business and Professions Code, antl my license is in full torca antl eNecL Lia N Class a Conirettofs Signalure: Date: CONSTRUCTION IENDING AGENCV: �� ❑ I hereby aHirtn that there is a consiruction lentling agency tor ihe peAormence ot the work tor which this pertnit is issued. (Sec. 3097, Civil Cotle). I Lendefs Name: Lenders Atldress: Signeture: Date: OWNER•BUILDER DECLARA710NS: I hareby aNirm that under penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Co�e: Any ciry or counry which requires a pertnit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, elso requires Iha applicant for such permit to file a signetl stetemeN that he or she is licensed pursuant to Iha prodsions of Ihe Contractors License Lew (Chapter 9(commancing with Section 7000) ot Division 3 of the Business antl Professions Coda) or thei he or she is exempt Iheretrom end Ihe basis lor the alleged exemption. Any NOWtion of Section 7031.5 by any applicant for a permii suWecis iha applicant to e civil penalty ol nof more than tive huntlretl tlollars ($500).J: dI, as owner ot lhe property, or my employees with wages as their sole compensation, WILL DO THE WORK, ena the structure is not intended or offered tor sale (Sec. 7044, Business and Professions Cotle: Tha Contractors License Law does not apply to an owner of property who builds or improves ihareon, antl who tloas suc� work himself or herself or ihrough his or her own employees, providetl Ihet such improvements are not intended or oNered for sale. tl, however, ihe building or improvement is soltl wi�hin one year ot completion, the owner-builder will have the Durden of provinq Ihat he or she tlitl not builtl or improva for purpose of seleJ. ❑ I, as owner oi the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the prolect (Sec. 7044, Business end Professions Cotle: The contractors License Lew does not apply to an owner ot propeny who builds or improves thereon, end who comracis for such project with a contrectoqs) license pursuant to Ihe Contractors License Laws.). ❑ I am axempi under S. Bu5in855 antl Profe55ion5 Cotle tor Ihis reeson: Signemre: � oate: ' 3' O O Owner ID verified fs lic se. ❑ Yes ❑ No Drivers License No. � Expires: %- y- O Z Venlication of O�nersp(p ty (tyde'6f tlocument, i.e. - pmperty tax 6ill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cenity that no excavation five (5) or more teat in depih into which a person Is requlretl to tlescen4 wlll be matle in connection with work authonzetl by this permit, end ihat no builtling structure, scattolding, falsework, or tlemolition or dismantling ihereof, will be more Ihen ihirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title B, Califomia Adminisiretive Cotle). ❑ As owner-builtler, I will not employ anyone to tlo work which would require a permit from Ihe Division of Indusirial Satery. as notetl abova, unless such person has a permit ta do such work from the division. Signature: Date: Division of Industnal Safery Pertnit Number. I CERTIFICATE OF COMPLIANCE AND AUTHO ZAT10N OF EMRV: I cehify untler penalry of perjury that I have reed this application and state Ihat ihe information given is I correcL I agree to wmply with ell stat I ws tl ciry ordinances relating to building construction, end authodze representatives of Ihe City ot Costa Mesa to enter upon the abova-tlescnbed pmperty for inspeqi n u s. I agree not to occupy or allow occupancy oi any builtling authonzed by this pertnit until tinal inspection. c,,.,�e�, ib,.ni „od�� Da3 o a COpE 1. INSPECTIONTYPE `� �IE IiiI�ELS 1616 Fixed System Finai Fire Preventi 1266 200 201 202 203 Pool Spa Final Final Re-Root Final BlocklRetaining Wall Finel Fectory Fire Place Final Sign 204 Final Demolition 2666a8 CO � INSPELTONTYPE 206 Finai Mechanicel 208 Finel Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 250 Pinal Site Final Builtling/Occupancy � m;. � r., i �LpS�p M6 9 o � > _ r J ��Coqro� n � CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714)754-5273 • Fax(714)754-4856 Job Address: Suite: Vicinity: 467 E 19TH ST SIDE AND REAR OF HOUSE Parcel Number: 11734127 Applicant: KEN WIANT Address: 250 NEWPORT CENTER DR #204 BUILDING PERMIT Zoning: . r . . .Phone:- (949p21-0730 NEWPORT BEACH, CA ' � � Zip: 92660 Owner: HANSON, FRANS RICHARD TR Address 1826 COMMODORE RD , - '.�,�; ' - � , . �- � NEVJPORT BEACH, CA� - - /�.i . � , . . -_ " Contracror: `_OWNER-6UILDER Address: � -�� ' Phone ��. . � , Zip: 92660 ' � � , � �._,_... ', PERMIT NUMBER B99-01998 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 12/23/1999 Issued: 02/10I2000 ISSUED BY: �� , - Phone: � Zip:. License; , 0 . . . Arch: SAUNDERSWIANT,ARCHITECTS-�'� ` Eng: Address: 250 NEWPORT CENTER DR #204 �: ', - � . Address:- . � � ' - � ' Phone: (949)721-0730 � . Phone: � NEWPORT BEACH, CA � - . - �- Zip: 92660 � ' , License: • �License: , SCOPE OF PERMIT � � 1,160 SF.SINGLE STORY ADDITION TO EXISTING 7,048 SF SFD. � � � INCLUDES ADDING A MASTER BEDROOM AND BATHROOM, RELOCATING KITCHEN, REMODEL LIVING ROOM, AND THE ADDITION OF A fAMILY ROOM. ALL APPLICABLE CODE REQUIREMENTS TO BE SATISFIED: AND CONST A164SF FRONT PORCH AND 84SF REAR PORCH. . - �—�- , � i � a � . � . : � — . -.— � -- .. � FEE SUMMARY' 'Plan Check: $685.98 Permit: $1,055.35 SMIP Res: $11.07 SMIP Com: $0.00 ' Other: . $0.00 Inspection: $0.00 ' Totalr $1,752.40 SETBACKS MAINSTRUCTURE Front 25-0 ACCESSORY Front 0- 0 Rear 34-0 Rear 0-0 Calc Valuation: - Claim Valuation: PLANNING & ZONING Left 11-0 Left 0- 0 � . . Right 6- 0. � Right 0- 0 $i i o,�ao.00 $o.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspectione and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permi� FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSAnOND�CLARATION: I hereby ettirm under penalty of perjury one of the following tleclerations: ❑ 1 have and will maintain a certificate of consent to selt-Insure for workers' compensation, as provided for by section 3700 of ihe Labor Cotle, tor the pertormance of the work for which this pertnii is issuetl. � ❑ I have and will maintain workers' compensation insurence, as required by section 3700 of the Labor Code, for Ihe peAortnance of the work tor which this permlt is iuued. My workers' compensation Insurance carner and policy number are: Cerrier: Policy Number: (This sec(ion need not be completyd il the permit is velued et one hundred dollers ($100J or less.) ❑ I certiy that in Ihe pertorm�nce of ihe work tor which this pertnit is issued, I shall not employ eny person in any manner so as to become suDject to tha workers' compensation laws of Celifomia, and egree that if I should become subject to the workers' compensation provisions ot Section 3700 of the Lebor Code, I shall torthwith comply with ihese provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' CAMPENSATION CAVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND OOLLARE (5100.000). IN Aq01TIQV TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]W OF THE LABOR CODE, IIJ�EREST, AND ATTORNEYS FEES. LICENSED CON7RACTORS DECLARATION: I hereby aNirm that I am licensed Under provisions of Chapter 9(commencing wi�h Section 7000) of Division 3 ot ihe Business and Protessions Code, and my license is in full force and eNect Lic. # Class # Contractors Signature: Da�e: CONSTRUCTION LENOING AGENCV: ❑ I hereby attirm that there is a cons�ruction lentling agency for the pedormance of the work for which this pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Adtlress: Signature: Date: OWNER-BUILDER DECLAFATIQNS: I hereby aNirm ihat under penalry Of perjury ihat I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (SecJ031.5, Business and Pmfessions Coda: Any city or counry which requires a permit to cons�mct, al�er, improve, demolish, or repair any stmcture, prior to its issuance, also requires ihe applican� for such permi� to tile a signetl statement thet he or she is licensetl pursuant m the provisions of the Contraciors License Law (Chepter 9(commencing with Section 7000) ot Division 3 ot Ihe Business and Professions Cotle) or ihat he or she is exempt theretrom end ihe basis for the allagetl ezemption. Any violetion of Section 7031.5 by any applicant for a permit sublects the applicaN ro a civil penalty of not more than tive hundred dollars ($500).): ❑ I, es owner of the pwperty. pr my employees with wages as their sole compensation, WILL DO THE WORK, antl the siructure is not intended or oHered for sale (Sec. 7044, Business and Professions Cotle: The Contracmrs License Law does not epply to en owner of propeny who builds or improves Ihereon, and who does such work himseH or herself or Ihrough his or her own employaes, provitled ihat such improvements are not intended or oHered for sale. It however, ihe building or improvement is � sold within one year of completion, ihe owner-builder wiil have the burden oi pmving Ihat he or she did not build or improve for puryose of sale.). Ipp I, es owner of iha properry, am EXCLUSIVELV CONTR�7ING WI7M LICENSED CON7RACTORS to constmct the project (Sec. 7044, Business antl Protessions '� Code: The coniracbrs License Law does not appty to a owner of property who builds or improves ihereon, and who con(rects for such project with a coniractor(s) license pursuant to ihe Conirac]prs,qice�(se�laws.). � ❑ lam ezem� �unpersec. SignaNre: ��f--i"'�" Owner ID venfied by tlriver's I Verifica�ion of Ownership by ( Busir�ess and Proiessions Code loi this reason: Yes ❑ i.e. - propehy tax bill or deed): DIVISION OF INDUSTRIAL SAF�TV PERMI7 CERTIFICATION: Dnver's License No. Expires: ❑ I hereby certiy that no excavation fiva (5) or more feet in depth into which a person Is required to descend, will be made in connection with work authorizetl hy this permit, and ihat no builtling gtmcNre, scaflolding, falsework, or tlemolition or dismantling ihereot, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industnal Safery, as noted above, unless such person has a permit to do such work from the division. Siqnature: Date: Division o( Industrial Safety Permif Number: I CERTIFICA7E OF COMPLIANCE qND AUTHORIZATION OF ENTRV: I certify under penalty of perjury that I have read this application and state that the intormation given is I � correct I agree ro comply wifh all stafe faws and ciry ordinances relating to buitdinq wnstrucfion, and authodze representatives ot the C'iry of Costa Mesa ro enrer upon the � above-described Droperty tor inspe,�tion�purposes. I agree not to oc�i y or allow occupancy of any building authorized by ihis permit until linal inspection. COpE M. INSGECTIONTYPE �ATE INTRI 1616 Fized System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign�' 204 Final Demolition 2A46-46 �OOEN INSPECTONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy Date oATE IN RR (714)754-5273 • Fax(714)754-4856 .lob nddress: 467 E 19TH ST Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner. Address Contractor: Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fi#s � Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over t000a Motors to thp Motors to tOhp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits 11734127 HOPF,JEFFERY 8 CARLBAD LANE CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT ELECTRICAL PERMIT . Phone: 714-023-2516 ALISO VIEJO, AC Zip: 92656 . HANSON, FRANS RICHARD TR' 1826 COMMODORE RD � � Phone: NEWPORT BEACH, CA Zip: 92660 � Phone: Zip: License: � SCOPE OF PERMIT REF 899-01996; 30 LIGHTS, �48 OUttETS , 24 SWITCHES AND 1�SUB PANEL. $23.50 $0.00 50.00 $0.00 $0.00 $0.00 $27.30 $40.44 $22.92 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.50 $0.00 $0.00 Quantiry 0 0 0 30 48 24 0 0 0 0 0 0 0 0 0 0 0 7 0 0 , FEE SUMMARY � Temp Dist Systein I Lighting Busway/t00ft Standing Section Misc Eleclrical Equipment Transformers up to 1 kva/kw ................up to 10 kvalkw ........:........up to 50 kvalkw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misc. Conduil Misc. Conductor Cirws ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee �� NUMBER �0159 77 FAIR DRIVE. COSTA MESA, CA 92626 Status: ISSUED Applied: 02/28I2000 Issued: 02/28/2000 ISSUED BY: 4-s- Quantiry $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a poriod of 1 BO days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all epplicable codes, and all raquired Inapeetiona end final epproval must be obtained. Failure to obtain inspections and final epproval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSA710N DECLAfiATION: � I herehy eHirm under penelty of perjury one of the tollowing tleclarations: � z-�" ❑ I heve antl will maintein a certificate of consent to self-Insure tor workere' compensation, es providetl tor by section 3700 of the Labor Code, for the pertortnence of the wark for which this permit is issued. � ❑ 1 have antl will maintain workers' compensation Insurence, as required by section 3700 of Uia Lebor Code, for the performance of the work for which this permit Is issued. My workers' compensation Insurance wrrier and polity number are: Carner: Policy Number. (Thls sectlon need nof be comp/eretl il the permit is valued af one hundred dollers ($100J or /ess.) ❑ I certity that in the performance oF the work lor which this pertnit is Issued, I shall not employ eny person in any menner so es to become subject to Ihe workers' compensation lews of Celifomie, antl egree t�et If I should become subject to the workers' compensation pmvisions of Section 3700 oi the Labor Code, I s�ell forlhwith comply with Ihese provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' CW�APENSATION COVERAGE IS UNLAWFUL WJD SHlLLL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE HUNDRED THOUSAND Dq1ARE (5100.000). IN ADORION TO iME COST OF COMPENSATION, DAhNGES AS PqOVIDED WR IN SECTION 31O60F THE Lr1BOR COOE, INrEREST, AND ATTORNEI"5 FEES. LICENSED CONTRALTORS UECLARATION: �, I hereby aflirtn that I am licensed under pmvisions of Chapter 9(commencinq with Section 7000) of Division 3 of the Business antl Professions Code, antl my license is in full I brce and ettect Lia x Class N ContractoYs Signature: Date: CONS7RUCTION LENDING AGENCV: ❑ I hereby afrirm ihat ihere is a consiruction lentling agancy tor the peAormance of 1he work tor which t�is pertnit is issued. (Sec. 3097, CiNI Code). Lentlers Name: �endefs Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirm ihat under penalty of perjury that I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or counry which requires a permit to construct, alter, impmve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to tile a signed siatemeni Ihat he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9(commencing with Section 7000) of DiNsion 3 of ihe Busineu end Professions Code) or that he or she is exempt therefrom and the basis for the allegetl e:emption. Any Wolation of Section 7031.5 by any applicant tor a permit s ts ihe applicant to a civll penalry of not more then tive hundred dollars ($500).): I, as owner oi tha pmperry, or my employees with wages as their sole compensalion, WILL DO TME WORK, and Ihe SWclura is not intentletl or ottered for sale (Sec. 7044, Business and Prolessions Code: The Contrectors License Law tloes not apply to an owner of property who builtls or improves lhereon, antl who does such work himself or herself or through his or her own employees, provided Ihat such improvemenis ere not intentled or oNered tor sale. If, however, the buildinq or improvement is solG within one year of completioq the owner-builder will have the Durtlen of proving that he or she did not builtl or improve tor purpose of sale.). ❑ I, es awner of ihe prapeny, em EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to consiruct ihe project (Sec. 7044, Business end Pratessions Code: The contractors Licanse Law tloes no� apply �o an owner of proparty who builds or improves thereon, and who coniracis for such project with e contrector(s) liCenSe pur5uant l0 ihe Contrattors license LewS.). ❑ I a xempt untler sec. Business antl Professions Code for ihis reason: . � ewr . _Date: ' Z "0 0 'OwnBrlDverifieab tl'er' se. � ❑No Dn s ce eNo. _�( � �5: (7i'O�/—�, Verification of Owne hip by (type of docum , i.e. � property taz bill or deed): DIVISION OF INDUSTRIAL SAFEN PERMIT CER7IFICATION: ❑ I hereby cetlity ihat no excavation five (5) or more feet in depth into which a person is requlred to descend, will be mede in wnnection wiN work authonzed by this pertnit, and that no building structure, scaflolding, falsework, or tlemolitlon or tlismantling thereof, wlll be more ihan thirty-sis (36) leet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Celifomia Adminisirative Cotle). ❑ As owner-builder, 1 will not employ anyone to tlo work which woultl require a pertnit from the Division of Intlustrial Safely, as noted ebove, unless such person has a permit to tlo such work from the division. Signature: Date: Division of Indusinal Safery Permit Number: CERTIFICATE OF COMPLIANCE AND AUTTIORIZATION OF ENTRV: I certity under penalry of parjury that I have read this application entl state ihat the inlortnation given is correct. I agree to comply with all state laws and uty ordinances relating to building construction, and authorize representa�ives of the City ot Costa Mesa to enter upon the above-descnbetl pmperty for inspection purpases. I egree not to wcupy or allow occupancy ot any bullding aut�orizetl by t�is pertnit until linal inspection. CODEY, INSPECTIONTYPE v � y�E INTITIALS t616 Fized System Final Fire Prevention 1266 200 201 202 203 Pool Spa Final final Re-Roof Final BIocWReteining Wall Final Factory Fire Placa Final Sign 204 Final Demolition 2a48�46 CQOE 1 INSPELTION TYYE 206 Final Mechanical 20B Final Plumbing 210 Finel Electrical 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final euiltling/Occupancy CITY OF COSTA MESA BUILDIN6 DIVISION DEVELOPMENT SERVICES DEPARTMENT. PERMIT. (714)754•5273 • Fau(714)754-4856 Job Address: 467 E 19TH ST Suite No Vicinity: � Parcel Number: 11734127 Applicant: Address: DON DEANGELIS 14 SANTA CATALINA RANCHO SANTA MARGERITA 77 FAIR DRIVE, MECHANICAL PERMIT ISSUED BY: Phone: (949)589-6592 Zip: 92688 owner: , HANSON; FRANS RICHARD TR Address: 1826 COMMODORE RD ' �� Phone: Contractor. Address: Arch / Eng : Address: REF:B99-01998 NEWPORT BEACH, CA COAST TECH SERVICES 14 SANTA CATALINA RANCHO SANTA MARGERITA INSTALL 100K BTU FURNACE. ISSUE FEE Inst fAU <100 k BTU Inst FAU >700 k BTU Repair I Alt Cooling/Heat Inst / Rep. Recess Wall Hlr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > t0000cfm Floor Fumace Floor or Suspend Heater $23.50 $14.80 50.00 $13.70 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 Quantity Zip: 92660 ��Phone: (949)589-6592 " Zip: 92688 License: 355425 Phone: Zip: License: SCOPE OF PERMIT FEESUMMARY Repair I Alt Absorbtion Unit � Repair I Alt Re(rigeration Unit Ventillation System Evaporative Cooler Commerciallncinerator � Domestic Incinerator Compressors / Absomtion Svstems Upto3hpl100kBTU 3To15hp/SOOkBTU � � 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 Upto3hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS NUMBER - ��1�3 Status: ISSUED Applied: 04/26/2000 Issued: 04/26/2000 Quantity $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 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 552.00 NOTICE: The work authorized by ihis permit shall comply with all applicabie handicap access requirements under Califomia statutes end related regulations. (Ord. No. 92-28, § 1, 12-27-92) 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 e period of 180 days. INSPECTIONS: In order tor the work aulhorized under this permit to be considered legal, such work must comply with all epplicable codes, and all requlred Inspectlona end final epproval must be obtained. Failure to obtain inspections and final epproval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545828 WORKERS' COMPENSATION DECLARA710N: - I hereby eMirm untler penelty of pehury one of the following decleretlons: ' _ ❑ I have end will melntain a certificate ot canseni to selbinsure for workers' compensatlon, as provitled for by section 3700 of the Lebar Cotle, for the peAortnance oi the work for which this permit Is issuetl. - -� ❑ I have anC will mainteln workers' compensation insurance, as requiretl by sectlon 3700 of Ne Labor Code, for �he peAortnance ot the work for which this pertnit is issued. My workers' compensation Insurance cerrier antl policy number ere: . Carrier: (mis sec6'on ❑ I cBrtity Ihat in Ihe compensation laws comply with these { Applicant Signature: _ WARNING: FAILURE TO SEQ THOUSAND DOLLAFiE (5100. one or less.) Palicy Number: 1 the wotl Po hic� this permit is issueQ I shall not employ any person in any manner so as) o become sybject to the workers' n2tl agree 1 tl I shoultl Decome subject to ihe workers' compensation provisions of Section 37 Q oi ihe Lab Code, I shall fotlhwith i Date: l7GL!' COMPENSATION OOVERAGE IS UNLAWFUL AND SHALL Sl1BlECT AN EMPLOYER TO CRIMINAL NALTIES GVIL FlNES UP TO IXJE HUNDRED I TO TME COST OF COMPENSATIpN, OPhNGES AS PROVIOED FOq IN SECTION 31O60F THE LABOR COOE. INiEREST, AND ATTOflNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that I am licensed undar provisic �a«B e�d ena��. �,�. � r Contrectors Signature: 9(commencing with Sectian 7000) of Division 3 of tha I Class a _. __ Date: Code, antl my license is in tull CONSTRUC710N LENDING AGENCV: ❑ I hereby aHirtn that there is e construction lentling egency for the pertortnance of tha work lor which ihis permit is issuetl. (Sec. 3097, Civil Cotle). Lendefs Name: Lendels Adtlress: Signalure: OWNER-BUILDER DECLARATIONS: Date: I hereby aftirm �hat under penalry of per�ury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for �he following reason (Sec. 7031.5, Business and Protessions Code: Any ciry or counry which requires a pertnit �o consiruct, elter, improve, tlemolish, or repair any structure, prior lo ils issuance, elso requires Iha epplicant for such pertnit to file a signed statement that ha or she Is licensed pursuant to the provisions of the Contraclors License Law (Chepter 9(commencing with Sectlon 7000) of Division 3 of Ihe Business antl Protessions Cotle) or ihet he or she is ezempt therefrom and the basis for I�e elleged exemption. Any violation of Section 7031.5 by eny epplicem for a permlt sub�ecis the epplicant ta e civil penalry of not more than tive huntlretl tlollars ($500).): ❑ I, es owner ot the properry, or my employees with weges as their sole compensetion, WILL DO 7HE WORK, end the siructure is not intended or oHered tor sale (Sac. 7044, Business and Professions Cotle: The Contrectors License Lew tloes not epplY to en owner of praperty who builds or improves thereon, end wha does such work himselt or herself or through his or her own employees, provided that such improvements are not intended or oHered for sale. If, however, the Duiltling or improvement is sold within one yeer ot completion, the owner-builtler w10 heva the burden of proving Ihat he or she did not build or Improve tor puryase ot sele.). ❑ I, as owner of the property, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmd the project (Sec. 7044, Busineu end Pwfessions Cotle: The contractors License law tloes not appty to an ownar of property who builds or improves ihareon, antl who contracis for such prolect wlth e cantracmr(s) license pursuant to ihe Contrectors License Lews.). ❑ I em e:empt untler sec. Business and Professions Cotle for Ihis reason: SignaWra: Date: Owner ID verified by drivefs license. ❑ Yes ❑ No Dnvels License No. Verification of Ownership by (rype of document, i.e. - properry tan bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMI7 CERTIFICATION: Expires: ❑ I hereby certify thet no excavation fiva (5) or more feet in depih into which a person is required to tlescend, will be made in connection wlth work authorized by tMs pertnit, antl that no bulltling strucWre, scaHolding, telsework, or tlemolition or tllsmentling thereot, will be more Ihen thirty-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sac. 341, Ttle B, Califomla Atlministra0ve Code). ❑ As owner-builder, I will not employ anyone to do work which woultl reQuire a permit from the Division of Industrial Setery, es noted above, unless such person has a pertnit ta do such work irom ihe division. SignaWre: Date: Division ol Industrial Safery Pertnit Num6er: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTAN certify under penelty of perjury that I have reatl this application antl state that the intortnation given is correct. I egree to comply with all stale laws and ciry ordinanc ela' g to 6uilding constructlon, antl authonze representatives of the Ciry oi Costa M a to enter upon the above-tlescribed propehy for inspection purposesJ�ree n o oc y or allow occupancy of any 6ullding euthorized by ihis permit until final inspect� IQQQf�� INSPECTONTYVE 1616 Fixed System Flnal Fire Prevention 1266 I200 201 202 203 204 2496d6 Pool Spa Final Finel Re-Root Final Block/Retaining Wall Finel Fanory Fire Plece Final Sign Final Demolition PAIE INTITIALS GOOE� INSPECTONttGE 206 Final Mechanical 20B Finel Plumbing 210 Final Electricel 212 Finfll Fire Preventlon 220 Final Planninp Approval 222 Final Site 250 Final BuildinglOaupancy (� -�-tt� �J1— (714) 754-5273 • Fe�c (714) 754-4856 Job Address: 467 E 19TH ST Suite No Vicinity: ADDITION Parcel Nunmber: 11734127 Applicant: Address: JAY PAMER 24265 TAMA LN LAGUNA NIGUE�, CA CITY OF COSTA MESA BIIILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT PLUMBING PERMIT Phone: (949)831-0761 Zip: 92677 - ,. . ownec HANSON; FRANS RICHARD TR Address � 1828 COMMODORE RD Contrador: Address: Arch I Eng : Address: NEWPORT BEACH, CA H P PLUMBING 24265 TAMA LN LAGUNA NIGUE�, CA Phone: Zip: 92660 Phone: (949)831-4761 Zip: 92677 License: 626907 NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 07J29I2000 Issued: 02/29/2000 ISSUED BY: �� Phone: Zip: - - - - �Licenae:- �' � - i � . SCOPE OF PERMIT � ' 7 BATHTUB, 1 DISHWASHER, 4 GAS OUTLETS, 1 KITCHEN SINK, 1 WASH BASIN, 1 WATER HEATER AND 1 WATER CLOSET FOR NEW ADDITION. REF:B99-01998 ISSUE FEE Backflow irrigalion Backflow Preventer Bathtub Clarifier System Connect pce,Soda,etc) Dental Units DisFiwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank AMT $23.50 50.00 $0.00 $9.80 $0.00 $0.00 $0.00 $9.80 80.00 $0.00 50.00 $0.00 $0.00 Q7Y FEE SUMMARY AMT Laundry Tub I Washer $0.00 Landswpe Irrigation $0.00 P-Trep $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Private Line � ` $0.00 ShOwer $0.00 Sink, bar - $0.00. Sink, commercial $0.00 An 0 0 0 0 0 0 0 0 0 0 0 0 0 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toileq Water Heater I vent Water Piping (Inst or Rep.) Water Re-pipe AMT so.-oo 50.00 $0.00 $0.00 $0.00 $0.00 $9.80 $0.00 $0.00 59.80 572.30 50.00 50.00 Qn 0 0 0 0 0 0 1 0 0 1 1 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period ot 180 days. INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, antl all requlred Inapectlone and finel approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 WORKERS' COMPENSATION DECLARATION: , I here6y attirm under penalry of perjury one of tha following decleretians: ❑ I heve entl will maintain e certiticete of conseni to selt-Insure tor workers' compensation, es provitled for by section 3700 oi lhe Lsbor Code, tor Ihe pertormance of Ihe work lor which ihis permit Is issued. ❑ I have and will maintain wwkers' compeissation irtwrance, as requlretl by secGon 3700 of Ne Lelwr Cade, tor the peAortnance of ihe work fw which thLs pemtii is isweA. My workere' compensation Insurance cerriar and policy number ere: Cerrier: Policy Number: (fhls section need not be cample(ed I/ the pemut is valued et one huntlretl tlW/ars ($ ]00) or less.) �� I certity that in t�e pertormance ol the v�ork for which this permit is I55ueQ I s�all not employ any person in eny manner so es to become subject to t�e workers' compensation laws ol C lilom e, comply with these prov ns. Applicent Signeture: __ �� WARNINO:FAILURETOSEC EWO R' THIXISAND DOLLARE 1510p, I, IN F� ( LICENSEO CONTAACTORS DECLARATION: Ihat if I shoultl become sub�ect ro t�e workers compense6on pro�sions oi Secuon 3700 of the Labor Code, I shell lonhwith � — oe,a: z— Z9— 2��v �ATIIXJ COVEMGE IS UNLAW FUL AND SNALL SU&IELT AN EMPLOYER TO CRIMINAL PENALTIES AND GVII FINES UP TO ONE HUNDRED �5T OF GUAIPENS�TION, OAMAGES PS PROVIDED f-0R IN SECfIIXJ 3'1O60F THE 1A80R CODE, ItJrERESi, AND ATTORNEYS FEES. I hereby attirm that I am Iicensed under provisirns ol Chapter 9(commendng with Section 7000) of Dlvision 3 of the Business antl Professions Code, and my license is In full force and eNea. Lic. x � Z Cless �- 3�0 comrectors Signature: � n..,_ oate: 2— l,i — Z�l70 CONSTRUC710N LENDING AGENCY: ❑ I hereby aHirtn that Ihere is a construction lending egenty tor Ihe peAortnance oi the work tor wNch this pertnit is luuetl. (Sec. 3097, Civil Cade). Lendefs Neme: Lendefs Adtlress: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby aHirm that under penalry of perjury t�ai I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions CoCe: Any ciry or counry which requires e permit to wnsiruci, alter, improve, demolish, or repair eny siructura, pnor to its issuance, elso requires the applicani tor such permit to tile e signed siatemen� �hat ha or she is licensed pursuent to ihe pmvisions of tha Comracrors License Lew (Chepter 9(commencing wlth Section 7000) ot Division 3 ot the Business and Professions Code) or thet he or she is exempt therefrom entl t�e basis for Me allegetl ezemption. Any vlolatlon ol Section 7031.5 by eny appllcani for a pertnit sub�ects Ihe epplicant to a civll penalry ol not more than five huntlretl tlollers ($500).): ❑ I, es owner of the propeny. or my employaes with wages as Iheir sole campensatian, WILL DO THE WORK, antl the structure is not intended or oMered lar sele (Sec. 70a4, Busineu antl Professions Catle: The Coniractors License Law'dces not appty to en owner ol property who builds or improves thereon, and who does such work himselt or herself or through his or her own employees, pmvided that such improvemeNs are not intended or oflered for sale. If, however, tha 6uiltling or impmvemeni is soltl within one year of completion, the owneo-builder vrill �ave the burtlen of pmving Ihat he or s�e did noI build or improve tor purposa ot sale.). ❑ I, as owner oF the properry, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contrectors License Law does not apply to en owner of pmperty who builtls or improves thereon, and who comracts tor such project with a wniractor(s) license Oursuant to the Contractors License laws.). ❑ I em exempt under sec. Business end ProFessions Code for t�is reason: SignaWra: Date: Owner ID veritietl by drivar's license. ❑ Yes � No Dnver's Licensa No. Expires: Venfication of Ownership by (rype of documem, i.e. - pmperry tex bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATON: ❑ I hereby certity that no excavation tive (5) or mora leet In depth into which a person Is raqulred to descend, wlll be matle In connection with work authorizetl by Ihis pertnit, end that no builtling siructure, scaHWding, lalsework, or tlemUiUon or tlismantlinp �hereot, will be more than thirty-Sis (36) feei high. (Chep. 32, Gry 2, Atl 2, Sec. 341, Title B, Califomia Administrelive Cotle). ❑ As owner-builder, I will nal employ anyone to do work which woultl repuire e permit irom the Division oi IndusMal Salery, as noted ahove, unless such person has a permit to do such work Irom Ihe division. Signature: � Date: Division of Industnal Sefory Permit NumDer. ICERTFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRY: I cenify under penalry ot perjury Ihet I have read this application entl state that t�e informetion given is I correcL I agree to comply with all state laws antl city ortlinances relating to building constmction, and euthorize representatives ol the Ciry oi Costa Mesa to enter upon ihe ebove-tlescnbed pmperty for inspeclion purposes. I agree not to occupy or ellow occupancy of any �ullding euthorized by this permit untll final inspection. COOE�. INSPECTIONTYPE � � / 1618 Fized System Final Fire Prevention 1286 Pool Spe Final 200 Final Re-Rooi 201 Flnal Block/Reteining Well 202 Final Factory Fire Plece 203 Finel5i9n 204 Final Demolition ^ 2aa&a8 ` QA1E INTff1AL5 COOE I INSPECTION TYVE 206 Final Mechanical 200 Final Plumbing 210 Final Electdcal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency Date Z.. �G��'�L1G� Date � �I L��I`uiiillF9 - .. : �. Gi►� � .1 'P�0.IECTADOHE55: QCJ% E 19TH ST OWNFB'S-4AME: HANSON FRANS R . ADOflE55: A G% E � 9 TH ST COSTA MESA,CA AXCHIENGINEEfl: ROUPE55: � UNIT: 92627 flEG.NO.: UNIT: PENMITTEE: KEITH HANSON ( 714 ) 548-5095 aoon[ss: 4 6 � E 1 9 TH S T C.M. CA 92626 UCENSE� CONiflPCTOfl OECLABATIDN: I here0y alurm mai I am licensed un0er pmvisions af C�apter 9(commencinB wiin Section 7000) ol Division 3 of ihe Business antl P�ofessions Co6e, aiM my liceme is in furi tome an0 e�fect. CITY LIC.: STRTE LIC.: CIASS: Date: _ Signamre: WOBNEBS' COMPENSATION OECLABRTION: I nereby alfirm �nat I nave a cenilicate of cansent ta sel4insure or a cenilicate ot Workers' Compensalion Insurance, or a ceniheU copy Ihereoi (Sedion 3800. LaO. C). POLICY NO.: E%P. DRTE: COMPANY: J Ceniliea coOY is hereby Iumisne0. ❑ Cenifie0 coDY �s file0 with ine city Builtling Division. Oale: AppliCanl: EXEMPTION FHOM WOflNEPS' LOMPENSATION �ECIABRTION: �This section nee� noi be comple�etl il �he p� i or one �unaretl �$100) ar less�. I certily thal in Ihe pedormance of �he wofk lor whi�h Ihis permil is' , e0. shall no e Ihy any fs ' any manner so as �o become SUEIe e rk¢rs' Compensaii n L9K's ol Catilomia. , - '� � Signaiure' � ' E: 1�. atl¢t making I�is detlar9�ion. you 511 Id DeC➢ te Su lett lo t�e ork Cy �Vensa(ion pro rsi ns o� �he Labor o0e. you must 7o��vnID compN'+n�h suc� p� siorvs� Ihk pe�mil sTaN �e de meNfevok¢d. CONSTBOCTION LENUING RGENCY: I Aereby affirm iha� tllert is a consimction len ' aAency for ihe pedormance al t�e work lar w�ic� �Ois Oe�mn a issued (Setlion 3W7. Civ. C�. LENOEP: ' ADOflESS: OwNEP BUI�OER DEClABp710N: I nereby aflirm iha� I am exempl Imm ihe Comractors' State �icense Law lor ine foliowing reason �Seaion 7031,5 eusiness anA Profession9l Code: Nny citV ol counly which requires a De�mil �o consimct, aller, impmve, demolis�, or r¢pair any Slmc�ure, prior lo iis issuance. also repuires Ihe applitani for Suc� permii Io tile a S�qned 5�alemenl �Aa� he/S�e is litensetl pursuanllo ��e provisions of I�e ConVaclo�s' S1a�e License Law (Chapier 9lcommencing with Seclion 7000) o� Oivision 3 0� �he Business and Pmtessions Cotle) or ihat he/she is Cxemp� Iherefmm an0 I�e �asis lor t�e allegetl exemD�ion. Any violation ol Seclion 7031.5 �y any appliWnl for a permit sublects ihe aPPlicant to a civil Oenalty of not more than live hunAretl tlollars �5500). � I, as owner oi the Dmveny a� my employees wiln waAes as their sole campensation, will do ihe work, an0 �ne slmclure is nol intenAed or oflered lor sale (Sec�ion 704a, Business anG Pmlessional CaOe: 7he Contractors' State License Law Ooes nol appN to an owner ol a P�openy wno �vilOs or impmves thereon, and who does sucA work himseltltlerself ar tAmupA �is or her ovm em0loyees, pmvitlea IAai suc� impmvemenls are not imenaeE or o��ered �or 5ale. II, Aowever the building or �. imo�ovement is sole witnin one year ol completion. Ine owner vnll have the bureen ol provinp he/sne tlia not buila or impmve ' lor I�e Ourpose ol Sale). I, as owner a� �Ae pmDeRy, am exclusively conlraciing wi�� licensed coniractors m cons�mct ��e prole�� (Sec�ion 7044. Business ❑ antl Pmlessions CoAe: T�e Contfac�ors' Siate License law Goes not appty to an owner o� 7roperty who OwIQs or improves I�ereon anA who conVacts tor such projC��s wilA a coniractoqs�license pursuan�to Ihe Canlraciors' State License Law),I am aware I�a� pmo� ot IOei� Worker'S CorriP¢nsati0n insurance shoultl be pmvitletl �o m¢. � 1 a emp� under Seciion: B. 8 P. C. �his r as : [� c 7 � :�� oaie: — �� Ownec� �'y� I Qo y cetlify Iha11 am aware ol and unAers�and Ihe repuiremenls oi Calilomia Healt� ana Saleiy COJe Seclians 25505, 25533, antl and t�at Iaranyfuiure Duilding oc�upanlwilUwiil nol (circle ane� neealo comply vn�� SaiA s�ale cotles antl��e reQuiremenlstora permil lor conslmc�ion ar mo�ilica�ion Irom Ihe Air Oualily Managemen� �iSVicL Fesitlen�ial conslmciion apDlicaiions are eaempi �mm I�ese provisions. Oate: pPP6can1: I �ereGy cetlily t�at I have reatl Ihis appli[alion and slale IAat IAe aGOv¢ orainances antl siale laws relating to bmlain9 conslmclion antl �ere6y aut� �r Oy 'nspeqion pmpoSes. � ��/ 7�7 % — SignaWre: l� I or Social Seamy x: � wrrect. 1 agree ta compy KitA all ciry anA caunty ilives of inj5 cil ei eu40on �he above-mentione0 16aLa6 Whne—Builaing: Green—Code EnlorwMEnl: Canary—Applicanl: Pink—Revenue: GOI4enroC—Assessor . � _ ... • .CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO; E 065736 PLAN CHECK NO: N CONSTRUCTION TYPE: PERMIT TYPE: ELE JOB DESCRIPTION : RELOCATE SERVICE CLAIM VALUE: CALC—VALUE: PERM NO: E 06573 GOVT: N SUPP; N PURPOSE: OTH SQ FT: GROUP OCC: R-3 / COMMENTS: X �**+t+r�r�rxxx��rx*�r�+t*x*�r�r�+r�ir�*��***�r+tit�r*�r*ir*x��+t�**�r�r*+��***ir*�*��+t+a��r**+�*x��*�* Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAA; FT IN FRNT; FT IN REAR; FT IN LEFT; FT ZN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV; PARCEL: 11734127 ZNE; REF NO; PLANNING NOTES> '. � . i! 1E j!!f ik 1f 1f i! 1f iE i!!E 1F 1f ik if if M!t it if iE 1F if ik iE 1f 1E 1f 1f if 1E fE if 1E it 1E 1f 1t if ik 1E 1f iE ik fE ff if iF iE fE iE 3E iE M 1k f! fE �E if iF iElE iE fE iE 1E iF iE �/E �E iE if 1ElElE 1E iF iF D E V E L O P M E N T S E R V I C E S �R E Q 0 I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED HY : DATE: APPLICATION ISSIIED HY: . DATE: � �r*�r***�r+�*x�r�x��r+t+t�r*x�r�r� ****�r�r�r�** �.'* iEiE�tiElEitiEiEiF1E�FltifiEiflEiflfiEifitifffikMitifiEifitifiEiEfEiFikiE�FlEifitiFitiFiElEiE3fiElEKif9fifiPlElEMifkiFifiElEiFffififiF if*iflEif iFiF�f LEGALIZATION;N F E E S U M M A R Y STROCTURAL SEGMENT:N HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMZT 18.50 502 SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 18.50 15.00 0,00 33,50 33,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 33.50 OVER/SHORT: .00 BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 33.50 iE iE if ff ff iE if iF iF it iElf iE iE if iE aE fE iF aE jf iE it k if if 1f iE if k iE iF iE iE iE jE iE 3E iE if iE iE iF iE iE iE iF if if if iE iE iE iF ib iE if iE iF ib iE iE K if if iF iE it if iE iE iF 1E iE ik iF iE if iE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 SERVICES BELOW 60 V& BELOW 201 AMP 18,50 18,50 �' �iEND OF FEES EXPIRED �11COff1(�8 �f1S�ECt10i1G . �. uace �� •F _�. =•,> a1� '1 0015?�33-OD.S38'3 T �'T JJ.JV UriiEC tji/17/G1� TIIiE: 11�51 ... _ � �ONSTRUCTION AND PLANNING ( , APPROVALS Permit �r '� •1. Temp��ary Electrical Service or Poie 2. Soi Pfpe-Uadrgrnd. I3; EiccViw'Con¢ui2Utihty�Undrgrr,d. 'S�. Electr�cal Cond��t-Undrqrnd. �. Steal Reinforcament 6• Electntat Uf ER Gmd. �. rooi�ngs 8. Fou�.d.,i�on 9. t`ater P�pe�Und�gmd. ' 70. 5:-c:;�rc� Floor System �--- 11. ��pc�•y Scrrer Li�r E Nc��qConnection ' 12 5��.:;ar Cap r- --- �73. Roof Orains � '4. Fuugh Piumbing � r-- � te a��ot Eiectr�ca:�Conyurt L. "c..y•. El2ttriC�.l�i�ing t- - -- I 17. ko�(h!'J.ring$tgn 18. Rouch Elect�ic�i�T Bar Ceibnp 19 Rouyh Heating & A4 Conditipning 20. � Roi�gh Factory Fjreplace � � , 21. Ducts, i� Structure . . 7.2. Durts, Ven�l�ating �- , 23. G : Piu��r7o�;gh & Test al 2<. Roof �r3m��ng --- 7S. Rn.�S!,4�.��9 26. T-��]r Ceil�ng ISiruc.u�all � A-0Onoeoat 27. F�amN zr.d Fiashing . �-r'- -��Lath�h?�Sid�ng _ ; . 7.° InsulthAn - �3�-^•.,v.a :_�.aiiir _ 3i. ?a;te- 3rv.:n Coat � 32: �_'cri'i¢. P�:�-e. ."�:ete� Fir.a� �_� -� �3.�� .;u� :�zct��c � '---- i�------ - - ��. '3^.�F,r+l +.caLny L Av ConditCning_T- F' � _.,_,..�_ 35. P�nal Ges Pipe�Test , ) �„ 36. Hovd �r Canopy --� i � s7:��na� Factory Firepface ' �� ----- I38. Fina� P umbin.� �� ..�.+r '...crr=�Fin�I � �... , �' _ -" -' - �., �;0�. Gas Svrucz�F�nai " ,� �� 41 Saiar pom¢stio-Fi�al �- B.id<Nqnr Preventer �-�--- 43. Dackflo�v Irvigation . � - - I�d4. Landscaoe frripation SVstem,. � � _ 45. Sou��d Attenuation , 40'. .Har,tlir.ap Regulauons ' 47. F:P3Ai. STRllCTURE & BU!LDING �'.b F';dqL PIANNING 4£. EI�_tric Relcase to Etlison 5C. Ga:-Release to Southem California Gas �o Date Date a I rpspector POv� & SPA APPROVALS Permit'� 52. Poo� & Equ�pmenc Locatlon 53. Steel Relniorcrment 54. Fo�ms 55. Electrical Bondmg 56. Rough Plumbing & Pressure Test 57. APPROVIii_'fOCOVER�GUNITE 56. Electrical Condwt�Undrgrntl. 59. Gas P�Fe, u Und�grnd., Test 60. E:ck�.-ash L�.nes, P�Trcp, -' Und�crrd 61 APPROVAL TO DECK 62. Bac:cy^as�� L4 ReceNtor�Final 63. Heater & Vent-Final 64. Plumbing Syscem � Finai 65. Electrical�Final 66. Sotar System�Finai 67. Fencing & Access Anpro.al 68. APPROVED FOR PLASTEFiiRG 69. PODUSPA SYSTEf,1S FINAL Flfl[ DEPT. HEQUIREMEN7 APPR�}VALS ^ JPermit � ' - . 70. Underc�rourtd HyUra ' � 77. Product PiPing I J G.�s U Oil 72. Undcrgro�rad F'u_'4 73. Ur.dergrnd. Storo,e Ta�k =- G�; � J: 74 O�r.nc�aC H';d�c %5_ Dry Ciiemicdl -- -�� - ` 76. Dry Standp�t�e � 77;� FIXED SYSTEh4 FINAI. _ Date --.� Inspector � I -- - - -! '_ ______I --- - -- i I 7£i.� FIRE PREV. FINF,i_ . � 1 I �N �-i � 4 ' - ~i , . . - HEALTI-.; D�Pi. REQUI �F.;.�E�:? . -- --=- -- ----- -'-- --t-- -- ' 1 � �� 79. F;',AL I"•:SC�ECTip'� � � � -� ' 60. FOOD CtFTi'tf',�r�: ISSUEiJ " ' � J i __- ., 1 _�____ _1 - • �lote�; ' � - . - �----- ----'Y-7 - - -� - ^_-- i -------- - - - � � �� -D _ . . r' --. .---- ---- - - --- y ---- � ------ -- - I --- ----1 �.� PXOJECT RDOflE55: Q 6% E 1 9 TH JCT OWNEX'S NAME: HANSON FRANS R' '� aoosess: q 67 E � 9 TH ST COSTA MESA,CA �PCHIENGINEER: AODNESS: UNIT: 92627 PEG.NO.: UNR: � PEflMITTEF: FRANS HANSON ( 714 ) 645-8008 ' nooness: 467 E 19TH STR C.M. CA 92626 IICENSEO CONTBACTOP UECIAPATION: I nereby affirm ihat I am ticenseA unee� V�ovisions of Chapter 9lcommencinp witn Section 7000� of �iv,sion 3 0l t�e Business and Prolessions CaOe, anA my license is in lull lorce an0 eltect. CITY LIC.: STRTE LIC.: CLASS: Date� Signamre: IWOflNEBS' COMPENSATION �ECLABATION: I h¢reby allirm Ihal I have a certi�iCate o� ConSenl lo sel4insure or a tehilitale oi Workers' ICompensation Insu�ance, or a cerUlieU coOY Ihereof (Seciion 3800. Lab. C). POLICY NO.: E%P. OATE: ^.OMPANY: CertilieE rApy i5 �ereGy �umis�eE. ❑ CeM1ilieE copy is �iletl vni� t�e ciry BuilUing Division. Date: ApPlicam: E%EMPTION FPOM WOBNENS' COMPENSATION �ECL4BRTION: (This section need noi b¢ complele0 i� the permit is for one �unAred ($100) of IeSs�. I ceriity iha� in Ihe �etlormance ot Ihe woB for which t�is permi� is issuea, I shall noi emDloy any person in any manner so as �o become soblect to the Worke�5' Compensation Laws ot Cal�tomia. Date: Signature: NOTILE: It, at�er making ihis Ceclaralion, you s�ou10 �ewme subiect ta tAe Wofkers' Comp¢n5ati0n provisio45 of tAe LaUor Coee. }rou must lotlhvnt� compN m�� such O�otisions or Ihis p¢rmi� shall be 4eemeA r¢voke0. CONSTFUCTION LENOING AGENCY: I here�y aifirm thal t�ere i5 a constmction IenEing agency lor the pedormance at IAe wOrk br w�ic� Ihis permil is issued (Seclion 3097, Civ. C), IENOEA: aooaess: OWNEB BtlILOEP �ECIAMTIDN: 1 �ertUy aflirm ihat 1 am exempt from Ihe Co2iatlors Sute License Law to� tlre toNowing reason (Seclion 703L5 Busin¢55 antl Pm�e55i0nal Cotle: Any city ol coun�y which requir¢5 a OQrmii Io cons[mct, alter, impwve, tlemoli50. ar repair any slmUure. p�ior Io its issuance, also requires �he aDP�icam for sucA permit to file a signe0 statemenl t�at Ae/sAe is licensetl pursuan� to �he pm�isions o� the Camracmrs' S�ale License Law (C�apter 9(commencing wilh Seclian 7000) ot Division 3 0l lhe Business antl Pmtessions COtle) or Iha� he/she is exempt �M1erelmm an0 Ihe 6asis �or �he allegetl exemp�ion. Nny violaiion 0� Section 7031.5 by any applicant lor a permit subietls Ihe aoolicanl lo a civil oenalty ol not more ihan five hundretl eollars (3a`00�. �y, 1. as owner ol lhe pwp¢tlY or my employees vnih wapes as their Sole campensation, will Ao rt1e wark, and ihe U stmcture is noi intentle0 or olleretl lor ule (Secuon 70aa, Business anE Pmtessional Cotle: T�e Caniracmrs' State License law � does not apP�Y lo an owner ol a property who OmIGs or impmves Ihereon, and who tloes such work Ilimse��/�erself or i�rouAh nis ar tler own employees, pmnaea tlwt such improvemenis are not intentlee or offeretl for sale. If, however Ihe OuilOing or impmvemeN is soltl wiinin one y¢ar al completion, Ihe owner will �ave ibe Eurden ol pmving Ae/s�e tlitl not Duiltl or improve for �he purpose ol sale�. I. as owner ol the pmperty. am erciusively contractinB wi�h licensetl contracrors to consimct ihe omlect �Section 7044, Business '❑ an0 Prol¢SS�onS Code: The Cqnirat�ors' Slate LiCense Law Qoes nai apply lo an owner oi pmperty wh0 UuA05 ar impmv¢5 (hereon anA w�o [Onlrati5 �or Suth prOi2tl5 wiih a coniratlOr(5�license OurSuanlio Ihe ConVatlOrs' $Ia�e LiCenSe Law�.l am aware ihal pro01 of iheir Worker's Compen5alion insurance sMula ee pr EO to me. � I am exemP� under Section: B. E P. C. lor t 's reason: Daie: r f � Owner. � r � I tla Aereby cerlily Ihai I am aware ol anA under5lan0 Ne reQuir¢meni5 0� alibmia Heal� antl Salely CoUe Sections 25505, 25533, and 2553d an4 i�a1 I or any iNur¢ �Vilding ocCupanl wAVvntl nat �nrCle One) nee0 to COmWy wilh 5ai0 Slale COdes an0 tlie re0uirem¢nls tor a Oermn �or consVuc�ion or modilic ion Imm Ihe Nu Ouahty Managemen� OisMct. Pesi4ential wnsimc�ion aDO�iw�ions are exempt imm IAeSe pr visions. �y ' �ate: � ✓ � � AOPIi t � I h y cetlAy Iha� I have read l�is appliCalio nd S�aie Iha� ihe ahove ordinanc and slalelawsrela�i gto builtling n5iruclion antl hereby au�h� D�ope ai inspec�ion purpo s Date' �/ SignaWre: _� oriver s �icense o� sociai secudiy x: } is correcl. I agree to comply with all city an0 niatives of ihis ci�y �o enier upon Ihe above�mE 16at�a6 Wbne—Bmltling: Green—Coda EnlorcemenL Canary—Applicam; Pink—Revenue; Goldenme—Assesso� CZTY OF COSTA MESA — BUILDING PERMIT PERM NO: H PERMIT NO: H 052588 PLAN CHECK NO: N GOVT: N UP : CONSTRUCTION TYPE; PERMIT TYPE: 5TR PURPOSE: DEM JOB DESCRIPTION : DEMO GARAGE CONVERSION TO ORIGINAL SQ FT; CLAIM VALUE: 1,000.00 CALC—VALUE; 1,000,00 GROUP OCC: R-3 / COMMENTS: X +��**�t*�****�t*�t*�t**r*+t*�t�t�t***�r*+t*�t***�t�t*�r*�t**�r*******�t***+t*�r*********�r*******�t*�t Z O N I N GS ERTEB�A�CIKRSE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN PARKING RE�• PROV: PARCEL: 11739127 ZNE: REF NO; PLANNING N TES> ) 1t iF iF if i! 1F �f if i! M it if if k iF iE k k if if iF iE iF �E 1f iF if if ik ff 1f 1E M 1f if 1E if 1FiE if 1F �f �F iE iE iF �t if �f M if iF IE 1f iF k M if M�E if �Ejf �E iF iE 1f if iE iF %K if iF M �F if iF If 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 APFROVED BY DATE: BUILDING APPROVED HY : DATE: APPLICATION ISSUED BY; DATE; � � M�fkifiFk�fikkiFMiflFiFkiflF*iEakMiF {FiFififlFafiEiFiFlf iFit �f 1F if iFiF 1F �f �F M �f if �E iF M M if 1F fF IE �lE iE iE if iF If �F �f k aF i1 it if iE ii IF iF �E 1F if if M iflf �k M iE iF if �f �F M if iF iF if iF if �f �f if iF±F�E �f �f if �E If if if fE iF iF if 3f IF iP IE �f LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 25.00 SM I P'/T10N—R ES PLAN ISSUE FEE � ��:90 HUILDING—DIV—> PERMZT ISSUE PLAN—CHECK TOTAL PAID•• DUE TOTALS----> 25,50 0.00 0.00 25,50 25;50� ,00 REVENUE DIVISION TOTALS--> COLLECTED: 25.50 OVER/SHORT• 00 BLD25P00 pLUMBING ELECTRIC MECHANIC FIRE SMIP/TOO GRADING PLAN—CHECK i}aF�flflfif�kMkkMitiEiFiFiFiFiEMkiflFiEflft�fiFkkiElfifkitMMif�1l3filKMifMlE�EifiFMifkkiflfiliF�FlFk�fifiFifiF�E�F'{fiFiF�FiFif Ik3tjfkiFiFiF � I N D I V I D U A L F E E B R E A K D O W N ;� TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST � NO FEES W�� SELECTED FOR THIS PERMIT , �. f ��'.,, � � i� G+.� incamflete i��oection5 Osi� 6-- - �-- $Ig .Y.--==_".'-- \� 1 /� kp � 9 \ ai oao�os�a-oao9Qa4a �� zs.5o iIATE: 06/18/91 TFPiE= f.^.:5� � CONSTRI;,r.TION AND PLANNIN� * P��P'�' ApPROVALS Permit# - Date Inspector APPRQVALS Permit# Date � Inspector 1. 7emporary Electrical Service or Pole 52. Pool & Equipment Location . � . 2. $oil Pipe-Undrgrnd. 53. Steel Reinfortemeni ' . � � ,i g�ctrical Cond�it U.iility-Undrgrnd. 54. Forms � ui • ;..� fgctrical Conc�Utt,•Undrgrnd. ' 55. Electrical Bonding � n� S.:�eel Reinforcg��'nt � 56. Rough Plum6ing & Pressure Test , '� :�`r�i�„�.Jgctrical UF �rnd. 57. APPROVAL TO COVEP�GUNITE �y �S��ootings Sx 58. Electrical Cqnduit•Undrgrnd. o �, �".Q. Foundation � 59. Gas Pipe, O Undrgrnd., Test , fz �9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK • 11, RGoperty Sewer Lirte{& House Connection 62. Backwash & ReceptorFinal ' 12. $e�.ver Cap 63. Heater & Vent-Final ' . :J 13. Roof Drains rc - 64. Plumbing System � Final ' 14. Rough PlumbiF� � 65. Electrical-Final ` - 15. Rough Electric,�l-Conduit 66. Solar SYstem�Final 16. Rough ElectriGWiring 67. Fencing & Access Approval 77. Rough Wiring�ign 68. APPROVED FOR PLASTERING ' 18. Rough ElectriEal-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT C i7 �-:Dr tT, , = F 20;r,Roaqh cto[y 'aplace i�Xtn v,�7 > C� tr'w *� PFR�V.41.B�OPetmit #�* v rn r+ � c e�' ' c. � v 21�D "5 iaSty ct � Fh T.S �� :-+ �7 `::r. x SD^7 C �' Ih �-I �' v a� 1• i-�S * S O r-+W � 70. �der9{�n� Hy,'�iro �. 22. DtSIs, �(Entjfatin9�. i �S k ✓ 5 v^;:t �c �71, ProdudF�ping f7t5`as �•Oil 23L.Ga�Pip�Ro�qh Si�esi � �S *,n � a �x � 72. Underg�i�n�i F�c�N � '�,�,' 24�-,Ro¢f Ffaming '�� ,-.F• �� x 7 r :� rF � 73yUndergrrd.Stonmk'TankxOGasTOOiI 25. Ro�,f Sf�athing � � ;� t+�'� � � N� F� 7r��pverhead�Hydr�'"� �* �- 2fn_�T�, r Ceiling (Strusturall &5{`QuFocoat x m .,n�. * 75rp�y �hemical �� r. :-+ q 27�Frame �nd Flashin� � � �„ -� m* „ 7�8ry Stani�ae .�� z `'� � n a �+fn� U x :a, x • r-+ a' �.• < ..�28° Lathint�,,& �,igling * ;,, .��, tr, .� S.' •• •.� fi 7h±• FIXED Sa`9TE �,'INA� 29. InsulaY�n Q ��: � ~"" > '»` M `� y 7� FIRE PREV. FIN�L F� � t* �o * r f I M _. � x �30. Drywa� a�ting � � I '� x r� �I�EAL�F{jDEPTK.&,E011IR�EMENT � .,31. Plaster o�n CoaC � rr n ��; � �' � .»�fINAL I�ECT ^N * ~ � k *1 ��3�.; Electriqel Po�Ler M4te5-Fina� �`� x: n; � � �.aQ�F00D C�Ri�IF�Cf1TE I,�'iiYED� u; � �33�Fi�l E,k"ctrii � rn � c w' i*7 � � , N�S: � �;� * v � N \ �. _ ��. �� .\: x Fa,-a � x cC x F � [+1� * ^ [n ' �34.yFir�i Hg"�., cic� & F.�t. ��tibn�+�g � � I ¢� x s nx s� 3�=1Firiel Gas Pi�-TesV. Yz+ "' t^ ` :?- :'� :1 n7S '� ^ C^. ., . .., •^o -� r f.. 3B�H¢� o�CanoPY y �� .ry .- � r� I � �. 7 ' � C�'10 � � � O 37GFi�a1 F�Ttory FireClarx i Fi� ! W!T� � � �� ' n M t" :i CT. I•• •• 6 � �lJ %'R ' T S 38. Fir;n�l P`ambin9 :x N � '� � � . K S `� �� 39. W�er SyvicaFinat _ .� '� ' � h- �z f'• :.+M > bc � f s �- 40. Gas Ser�ce�inal �* Y � k "', f: '. `'' °' � � Fr rL[rir c .* n7 ' I � x� Or.� vN a� � . .. :,r- v, r .... .... .. =41. Sola� Dome„-yirFiFle�j- �^, .. »' � 1 1 f: s: �S^� � � � c=7 :A `i -42�Backflow Prevente� E" N � a I �� %� Q ��^- � . § t, ' �'' 43. Backflow Iraigatioq nS5 x ��+ - �� :Fc M C �:�� .-, a� r �x x (" �44. Landsc�pe �iqatiY�� Syster�m� ;� w, �r r'��;. x: r,� �ty E n F Nl�� `� � _4�Sound�A[tpuation iatx',�'-. Lr �� F Fx� * c �-+ i. CO Qtei,i�pecfwns ` .. . .� . r. � t 45-Handica-n Re9ulati�ns 7 . . s * t`� .. ..* �` � � � 3 "�� 'r' �` ' o� p �. a� Y atE ry. ��47r,FI�L STf3�y;1CTl1;RE & BI�LDING �� * , � ' .� x � �v �c �� n� c.. t� . r � �-- '4&tiFl[�P,L PLA'I�1NIN.. t [r�'� � . : ) � i � � .�.' 1 Fe- .r- Cu �:i - th � F '{ �q9=El�etric Relpase to�Edison i r � x= t� �V i " �''50 G �.Aelease to So hem Ca1'iornia Gas Co ' ' .* " "` � � � 5`i., � � �.,-, .•k - t-+ C+ . ptn, .e O 51. C�HTIFICATE OF OCCUP CY x ;� ;; r � j� T * �, No. Date Y�, �j�- . �7 , `�' ' • �J�� COSTA MESA BUILDING DEPARTMENT P.O.BO% 31] COSTA MESA. CALIFORNIA - FOR APPLICANT TO FILL IN AODRE55 46� E. 19th.St.Costa Mesa COSTA MESA. CALIFORNIA OWNER �lilliam A. Sachs MAIL 46 E 1 t. nooRess . �,rv Costa Mesa ARCHITECT Self OR ENGINEER ADDRE55 �EGRL L�} oescaivnoN NO. BLOCK A.P. NO. ZZT�3�Y�� s'ZE 60 x 130 OF LOT USE OF p EXISTING BLDG.laIDll� SET9RCK LINE FPOM CENTER OF STREET costc374a �.Q�**4.00 )AN 24-58�OtlE5A APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY TNO. LZ 86890 ADD EI LIC. NO. FIRE 20NE CITV LIC. �oNE NO. TEL. APPRO' NO. BY TRA��T rvo.or e�ocs. 2 NOW ON LOT SI�E YARD RIGl7�i� LEFT rl" // DESCRIPTION OF WORK NEW h q�TERATION ADDITION REPAIR I MOVING DEMOLISH 6UILDING 12�X 2Ot FOOMS � STORIES � SIZE t'T E%TERIOR WALL R yy ROOF Shake COVERING COVERING USE OF NEW �__��.� Tl�� . � / 2. y�> � I Y6 � i�+� COSTA MESA. CALIFORNIA � �'^� DATE CORRECTIONS �CIT�Y Or� STA Iv1ESA 1'1.�^��t� SUBJECT TO DG. DEPT. REG. STRTE TN1T TNE RBOVE I$ CORRECT ANp AGREE TO COMPLV WITM Att CITV OROINPNCES AND ST4TE L1W5 REGUL/�TING BUILOING CONSTNUC- norv. yp�UATION SIGNATURE OF PERMITTEE AUTHORIZEO AGENT g y`�� — zYo J � PERMIT FEE S PLAN CHECK S � TOTAL FEE S �°M� . . —� f � , 1��0 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BO% 817 C08TA M66A. CALIFORNIA For Applicanf +o Fill In Complefely TYp6 OR PRINT BUILDING /// � �' /� ADDRH88 /t (/ COSTA MESA CALIFORNIA owNeR �✓��1/a)�l � S/�L/IS ADDRE65 C9 / h I `u� � � TEL. pC cin i No. o ARCHITLCf G w N e 2 TEL. C� OR ENf:INEER NO. , SIZE /� �� /��r v � NO. OP BLD6l. BBTBACK LIN[ FltoN J!� � REAR YARD' � C[NTBR OP 9TR6T 61DE YARD LEFT I O/ I RIGHT �� r DESCRIPTION OF WORK EXTLRIOR WALL COVERING UBE OP BUILDING AND FEE RECEIVED �.�f'H�-196 n APPLI�� G��P�� BUILDING For Office Use Only ae�.,� �o. 1c��Q leY I �� R��H'�!!%�I I //7�[;6Su¢�Y u �� /9 � COSTA MESA. CALIFORNIA FIRE ZONE APPROVED NO. OP PLAN9 LBOAL 1 � A. P. NO. � YARDS APPROVED � ICeNTBp LINC 9TJ _. 1 H6R30Y ACKNOWL{DO6 THAT 1 NAVB R[AD TXIB AIPLIGTION AND 6TAT8 TNAT TM6 AGOVB IB CORRHGT AND ApR6H TO COM• PLY WITH ALL CITY ORDINAf�C68 AND HTATH UW8 PBOVLATNO eU1LO1NG CON9TRUCTION. � � eicruruae or �� ' ,i/„A,� PERMITTE� 13rc=��=�- AUTNORIZED AGHNT APPPOVED YB8 OP MHW BUILDINO � FT. 2, TH8 AMOUNi 6NOWN UN�eR VALUATION IB POH TH! PYI�096 OP BBTABLI6HIN0 A PBRMIT F8H ONLY. VAIUAT{ON � � PERMIT FEE $ / f'� � S/�., / / PLAN CMECK $ Y� �� i x LL