HomeMy WebLinkAbout444 19TH ST - Building Permits� C� _'Y OF COSTA M; �A �
� Development Services, Division of Building and Safet� �
CERTIFICATE OF OCCUPANCY
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This cerHficate is issued pursuant to the requir`ements'of the 2007 California Building Code, SecHon 110 adopted by
the City of Costa Mesa certifies that at the Hme of its issuance the builduig structure herein below described was
inspected and approved foroccupancy as follows:
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BuildingAddress 494 W,. '�l•9tM� S`tx'eetfi ���?' �� Bld`g:�Pecini't��Number BC11-00196
Use Commercial �; � � , ' �-: �,
Group B
Owner of Building
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_ Type.of Construction �-B Fire Zone Use Zone
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Lawrerice O`�Yn��"S'omers� Trust �� Tenant pret�ty ,�Kitty Beauty Shoo
Address 471 Old
>ort Bldd. !
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BUILDING OFFIC�AL-Keltll CIdTICe, C.B.�.
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By; _
� Date '
92663
REQUIRED TO BE POSTED IN A CONSPICUOUS PLACE
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CITY OF COSTA MESA
'o ""'F9 BYILDING DIVISION
F`�� 77 FAIR ORIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.wsta-mesa.ca.us
� FOR INSPECTIONS CALL: (714) 754•5626
'"�^^°"` PERMIT NUMBER: BC11-00196
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: COM_ALT DATE ISSUED: 0510412011
ISSUED BY: KJB
JOB ADDR�SS
APN: 41920515
Vicinity:
Const 7ype: V-B
444 W 19TH ST CM
SQ. FT:
Zoning: , ,
Suite/Unit:
Primary Occ:,.
Valuation: $38,000.00
SCOPE OF WORK: 600 SF INTERIOR TI FOR "PRETiY KITTY BEAUTY SHOP". WORK TO INCLUDE THE CONSTRUCTION OF
NEW CEILING, NON-LOAD BEARING WAIIS TO CREATE A NEW SALES, WAXING, STORAGE AREAS AND A NEW UNISEX
RESTROOM WITH EL, MECH AND PL WORK. ELEC TO INCLUDE: 17 LIGHT FIXTURES, 9 SWITCHES AND 18 OUTLETS.
PLUMBING TO
INCLUDE:1 TOILET AND 1 SINK. MECHANICAL TO INCLUDE: 1 REPAIR/ALT TO EXISTING SYSTEM, 1 EXHAUST FAN.
OWNER: SOMERS, LAWRENCE ORIN TR
Phone:
APPLICANT: BARAN, KATHY
Phone: 702-575-9746
CONTRAC7pR: NORTH BAY DEVELOPMENT
Phone: 702-575-9746
Cell:
ARCHITECT:
ENGINEER:
COMBINATION PERMIT FEE SUMMARY
Building Plan Check:
Building Fees:
Electrical Fees:
Mechanical Fees:
Plumbing Fees:
SMIP Residential:
SMIP Commercial:
Bldg Std Admin Fund
TOTAL FEES:
Address: 471 OLD NEWPORT BLVD #301
City/State2ip: NEWPORT BEACH, CA
Address:
CitylStatelzZip:
License No. 939014
Address: 8941 ATLANTA AVEUnit:
Ciry/State: HUNTINGTON BEACH, CA
License No.
License No.
$85.00
$523.05
$71.90
$47.85
$43.10
$0.00
$7.98
$2.00
$760.86
Un(L
Unit: :
SUITE 165
ZipCode 92646
PHONE:
PHONE:
Ra/or to foe recoipts tor all foes paitl for projett
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279
Monday ihry Friday • 7:00 am thru 7:00 pm. Saturdays• 8:00 am thru B:00 pm. PfOhibitBd ell hOu�S - Sund3y5 Bnd the following Fedefal holiday5:
NOTICE: The work authorized by this pertnit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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 inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
c oF �, ixsvecnoxTvre
1�878 Fixed System Final Fire Prevention
V12fi6 Pool Spa Final
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'200 Final ke-Roof
201 Final glock/Retaining Wall
202 Final Cactory Fire Place
203 Final Sign
204 ' Final Demolition
DAIE INPTRL LODE� INSPECTIONME
206 Final Mechanical
208 Final Plum�ing
210 Final Electn[al
' 1
212
220
Final Fire Prevention
Final Planning ApProval
222 Final Site
250 FinalBuildinglOccupancy
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WORKERS' COMPENSATION DECLARATION:
I hereDy affrm untler penalry of perjury one of the following declarations:
❑ I have and will maintain a cerliffcate of consent to sel(-Insure for workers'
compensation, as provided for by Section 3700 of Ne Labor Cotle, for the
peAormance ol the work lor vmich this pertnit is issued.
❑ I have and will maintain v.orkers' canpensation insurance, as required by
section 3700 of Ihe Labor Cotle, fa the peAormance o( the work fa which Ihis
pertnil is issued. My workers' compensation Insurance car�'1er and policy
numberare: ��
Carrier. \
(7nkseUionnevdrrornewmpletMnNepenMa ue0afonehun edtlo9ars(Si00)ale.cs.)
Policy Number:
certily thal in the performance of the work for which this permit is
' s , I shall not employ any person in any manner so as to become subject
to the workers' compensation laws of Calilomia, and agree that if I should
become subject lo lhe vrorkers' compensalion provisions o( Section 3700 of
the Lab r e, I shall 1 with wmply with lhese provisions.
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WARNING: FAILURE TO SECURE WORKERS' CAMPENSATION CAVERAGE
IS UNIAWFUL AND SHALL SU6JECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
(5100,000), IN ADOITION TO THE COST OF COMPENSATION, DAh1AGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLqRpTION:
I hereby affrm thal I am licensed untler provisions of Chapter 9(commencing
with Section 7000j of Division 3 of (he 8usiness and Professions Code, and
my license is in full force and ef(ect.
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' 8ontraCt � �S�gnalure �
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CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrm that Ihere is a consWction lending agency for the
peRortnance of the v.vrk forvfiich this permit is'ssued. (Sec. 3097, Civil Code�.
Lentler's Name:
Lender's Address:
SiB^aNre Dale
OWNER-BUILDER DECLARATION$:
I hefeby afffrtl tha� Under pBnally o( perjury that I am E%EMPT FROM THE
CONTRAC70RS LICENSE LAw tor the follovring reason (Sec. 7037.5.
Business and Professions Cotle: Any �ity or county which requires a permit to
construct, alter, improve. tlemolish, or repair any strucwre, prior to i1s
issuance, also requires the applicant (or such permil lo file a signetl slatement
ihat he or she is licensed pursuant lo the provisions of ihe Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Prolessions Code) or that he or she is ezempt therefrom and
the basis for the allegetl exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicaN to a civil penally ol not more than
five hundred dollars ($500).):
❑ I, as owner ol the praperty, or my employees with wages as their sole
compensalion, WILL DO THE WORK, and Ihe sWCNre is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does nol apply to an owner of property who builds or improves
thereon, and who dces suU vrork himself or herself or Ihrough his or her own
employees, provided that such improvements are not intended or offered lor
sale. II, hrnvever, the builtling or improvement is sold within one year of
completion, the owner-builder will have the burden of proving that he or she
did not build or improve for purpose bf sale.).
❑ I, as owner of the properry, am EXCLUSIVELY CONTRAC7ING WITH
LICENSED CONTRACTORS lo construc[ the projecl (Sec. 7044. Business and
Professions Cotle: The conlractors License Law dces not appy to an ovmer of
property who builds or impmves thereon, and who contracts fw such project with
a cont2ctor(s� license pursuant to the Contractors License Laws.�.
❑ I am exempt under sec.
Business and Professions Code for this reason:
S�gnalum Date
105].<6(3/0'!)
Owner ID venfie0 by tlriver's license. ❑ Yes ❑ No
Driver's License No. Expires:
Verification of Ownership by (lype ot tlocument, i,e. - property lax Dill or deed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby cetldy Ihat no excavation frve (5) or more (eel m deplh into wfiich a
person is required to descend, will be made in connecl'an vrith wnrk auttarized
by this permit, and that no building strucWre, scaFldding, falsewurk. a demolition
or tlismaNling thereof, will be more than thitly-soc (36) teet high. (Chap. 3.2, Grp
2, Art 2, Sec. 341, Title 8, Califomia Administrativa Cotle).
❑ As ownerbuilder, I will not employ anyone to do work which vrould
require a permit from the Division of IntlusMal Safety, as noted above, unless
such person has a permit to do such vrork from the division.
Appliwnfs SignaWre Dale
Division o! Induslnal Safety Permit Number.
MAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe applicant or preseN or fuWre builtling occupant need to fle and
certily a Business Plan for emergency response to release or threatened
release of a hazardous material? � Yes ❑ No
(Section 25505 of Ihe Califomia Health antl Safely CoOe requires, with some
exceptions. thal a Business Plan be filea with the Cosla Mesa Fire
Department Dy every business which has at any one time during a reportetl
year a QuaMiry of hazardous materials equal to or greater lhan a weight of
500 pountls, or a volume of 55 gallons. or 200 cubic teet of compressed gas
at standard temperaNre antl pressure).
2. Does or will the applicant or present or future building occupant neetl to file
a reqistration form for awtely hazardous materials? ❑ Ves � No
(Section 25533 of lhe Califomia Health antl Safety Code. with some
exceptions, requires registration vnth the Cosla Mesa Fire Department by
each business which at any one time has on hand a quantity ol acutey
hazardous materials equal to or greater than a weight of 500 pounds. or a
volume o! 55 gallons, or 200 cubic feet of compressed gas at stantlartl
tempereture and pressure�.
3. Does or will the applicant or present or future building occupant need to
prepare an RMPP (Risk Managemeni antl Prevenlion Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of Ihe Califomia Health and Safery Code provides that the
Costa Mesa Fire Department may require the preparation, certifw6on and
filing with the Fire DepaAment of an RMPP by businesses which are required
to register acutely hazardous matenals wi1� lhe Fire Department.
4. If an RMPP is presently requiretl, has Section 25534 of Ihe Cali(omia
Health and Safety Cotle been fully complied with? ❑ Yes ❑ No
5. Does or vnll the applicant or present or tuture builtling occupant require for
Ihe work v+hich is Ihe suDject of this applicalion a pertnit fOr such cOnStruGtiOn
or mo0ification from the South Coast Air Quality Management DisMct ar from
any other air polWtion control disMct or agency? � Yes ❑ No
(Sectbn 65850.2 of Ihe Califamia Govemment Cotle requires that the requested
intortnation be fumishe0 on applications fa rarrresidential buiiding pertnits�.
6. Will any part of the taciliry to be constructed under t�is permit be within
1000 feet Irom the outer boundaries of a schoolY ❑ Yes ❑ No
(If "yes", the lacilily musl meet the requiremen[ of Sections 25594 and 42303
of the Calilornia Health and Safety Cotle�.
7. If a permit from the Soulh Coast Air Qualiry Management Oistricl or other
air polWtion control dislrict or agency is required for the work which is the
subjecl ot this application, have all of Ihe disclosures prescnbetl by Califomia
Health and Safety Code Section 42303 been matle? ❑ Yes ❑ No
8. (II'yes", attach certificate of compliance from tha appropriate air pollution
control oKcer�.
CERTIFICATE OF COMPLIANCE: I certify lhat untler penalty of perjury the
iniormation given above is correct I agree to Comply vrith all slate laws and
city orCinances regar0ing Hazardous Materials and Emissions.
SignaWre
CERTIFICATE OF COMPLIANCE AND AUTMORIZATION OF ENTRY: I
certify under penalry of perjury that I have read this application and slate lhat
the information given is correcL I agree to comply with all state laws and city
ordinances relating to building construction, antl authorize representatives of
the City of Costa Mesa 10 enrer upon Ihe above-described property for
inspection purposes. I agree not to occupy or allow occuDancy of any 6uilding
authonzetl by lhis permit until final inspection.
giawreolLeg,a/lO.merls) Dat
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CITY OF COSTA MESA
B!/ILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Faz (714) 7Si-4856 • www.d.costa-mesa.ca.us
FOR INSPECTIONS CQLL: (714) 754-5626
PERMIT NUMBER: BC07-00492
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: COM_ALT DATE ISSUED: 05114/2008
ISSUED BY: RMD
J4B ADDRESS: 444 W 19TH ST CM:�, �" SUlte/Unit:...
APN: �y �' �` , , Zoning: , ,' . � . +
,(:�r�'.-, . . . _ . :, � , +� ..
Viciniry: '.�' i : Primary Occ: � g' ,
ConstType: V-N '�', �� `SQrFT:- 0 � �Valuation: $8,500.00
SCOPE OF WORK: EXTERIOR REMODELING TO REPLACE EXISTING CANOPY WITH TILE CANORY. REPLACE HVAC SYSTEM
AND GLAZING. DEMOLISH P,LL'tJON-LOAD BEARING INTERIOR WALLS AND RESTROONIS WITH 2 LIGHT FIXTS, 1 OUTLETS, 1
SWITCH, 1 MOTOR TO 10HP, 1 COMPRESSOR 3-15 HP, 1 WATER PIPE, 1 WATER SVC:. NO FLOOR AREA ADDED. REF:
BC07•00490 ' �
OWNER: � � f� + .;� �� . � �' , Address: - ' �� - Unih
Phone: �`,I' � r;;l��" �'_,,..,. ' Cily/State/Zip: � ��� :.-� ` . . �
;�: -� . . , . . '• ' ,
APPLICANT: MOORE, JEFF.- ' � "�! Address: , ' . , - ' � Unit: :
Phone: �� . . City/$tate/zZip: . .. .. ,
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CONTRACTOR: ROSEEN BUILDERS INC License No. 813939
Phone: 949-716-7900 �� Address: 23011 MOULTON PARKWAYUnit: �
Cell: , � CitylState: LAGUNA HILLS, CA � � ZipCode 92653
ARCHITECT: EHDAIE, BEHROUZE �'�, License No.C14284 �� � � PHONE:949-497-1935
ENGINEER: . , , , Litense No. _ . PHONE:
COMBINTATION PERMIT FEE SUMMARY
Building Plan Check: $108.�1
Building Fees: � , - $167.25
Electrical Fees: $40.20
Mechanical Fees: � - $50.65
Plumbing Fees: $43:10
SMIP Residential: ' $0.00
SMIP Commercial: $1.�g , .
TOTAL FEES: $411.69
"Refor to fee receipts tor all fees paltl for project
NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for lhe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expi2tion of this permit.
cooe � ixsrEcnoNTrae
1878 Fixed 5ystem Fina1 Fire P�evention
7268 Pool Spa Final .
200 Final Re-Roof
2o1 Final Block/Retaining Wall
20p Final Factory Fire Place
203 FinalSign
20a Final Demdicfon
o� iN 4QO�y1 INSPEC7IONTYVE
208 Final A/echanical
208 Final Plumbing
210 Final Eleclrical
212 Final Fire Prevention
220 Final Planning Approval
_ 222 Final Si�e
250 Final Building/Occupancy
� IN7I71A15
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WORKERS' COMPENSATION DECLARATION:
I hereby aHirm under penalty of perjury one of the following declarations:
❑ I �ave antl will maintain a certifcate of consent to self-Insure for vrorkers'
compensation, as provided for by seclion 3700 of the Labor Code, for the
pedormance of the work tor which this permit is issued.
❑ I �ave antl will maintain workers' compensation insurance, as required by
section 3700 0l the Labor Code, fw the peAormance o� tha work for which this
pertni[ i5 i55ue0. My workers' compensation Insurance rrier and policy
number are: � �� �� f '�,^/�
�Ci arrie_r. /Kl
(TlibseclmrqeHndEawnqlefN/��/g)pa��p�y(uvalu�e0/nf}w�e/l`vdrtdAYars(f100)akssl
Policy_Number. v " � J�'1( l
❑ I cerlify lhat in Ihe pertortnance of the vrork for which this pertnit is
issued, I shall not employ any person in any manner so as to bewme subject
to ihe workers' wmpensation laws of California, and agree that if I shoul0
become subject to ihe warkers' wmpensation provisions of Section 3700 of
ihe La ; Code. I s�all forthvni� th these provisions.
f �S� 08
/� � Appliranfz5iy�aWre Dzte
WARNING: FPJLURE T— O 3ECU WORKERS' COMPEN�TION COVER4GE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of ihe Business and Professions Coda, and
my license is in f(u�ll jforce and eqflect.
Lic. #--1 "✓ �� � 3- 1 Class il �
��i��_ ••y o
�' Canva�s5ipnaWre Date ��
CONSTRUCTION LENDING AGENCV:
❑ I hereby affum ihat there is a consUuction lentling agency (w lhe
performance of Ne v.ork for wfiich tlus pertnit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lentler's ACtlress:
SipnaNre Date
OWNER-BUILDER OECLARATIONS:
I here�y aKrm thal under penaly of perjury iha[ I am EXEMPT FROM TME
CONTRACTORS LICENSE LAW tor the following reason (Sec. 7037.5,
Business and Professions Coda: Any city or county vmich requires a permit to
construct, alter, improve, demolish, or repair any structure, prior ta its
issuance, also requires the applicant tor such permit to file a signed sWtement
lhat he or she is licensetl pursuant to ihe provisions of the Contraclors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of ihe
Business and Professions Code) or that he or she is exempt Nerefrom antl
the basis tor the alleged exemption. Any violation of Section 7037.5 by any
applicant for a pertnil subjects the applicant to a civil penalty of not more than
fve huntlretl tlollars ($500).):
❑ I, as ovmer of lhe property, or my employees vnth wages as their sola
compensation, WILL DO THE WORK, and Ihe sWcture is not imended or
oflered for sale (Sec. 7044, Business and Professions Code: The Coniraclors
License Law dces not apPly lo an owner of property who builds or improves
thereon, and who dces such work himself or herself or thmugh his or her own
employees, provided that such improvemants are not intended or oftered for
sale. II, however, Ne building or improvement is sold vrithin one year of
completion, Ihe owner-builder will have the burden of proving ihat he or she
did nol build or improve lor purpose of sale.).
❑ I, as ovmer of the property, am E%CLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to consWct the project (Sec. 7040. Business and
Professions Cotle: The cont2ctors License Law tices not appy lo an owner of
property who builds or impioves thereon, and who contracts fa such project with
a coniracla(s) ticense pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
Sig�Wre Date
]O5]�4813I0))
Ovmer ID verifetl by driver's lia ❑ Yes ❑ No
Driver's License No. Expires:
Venfication of Ownership by (type ol document, i.e. - property lax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify lhat no ezcavation frve (5) w more feet in depih into which a
person is required to descentl, will be made in connection vrith work authonzed
by this pertnit, antl Ihat no building swcwre, scaffdtling, falsework, v demWition
or dismantling thereol, will be more than thiny-six (36) feet high. (Chap. 3.2, Grp
2, fvt 2. Set. 341, Tille 8, Cali(omia Administ2live Code�.
❑ As owner-builtler, I will not employ anyone to do work which would
require a permit from the Division of Intlustrial Satery, as noted above, unless
such person has a pertnit to Co such work from the tlivision.
Ap0lit�an�'s SiB��ure Date
Division of Industrial Safery Pertnit Numbec _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to fle and
certify a Business Plan tor emergency response to releasa or threalened
release of a hazardous matenal7 ❑ Yes ❑ No
(Section 25505 of the California Health antl Safery Code requires, with some
exceptions, that a Business Plan be filed with Ne Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantity ol haurdous materials equal to or greater than a vreight of
500 pountls, or a volume ol 55 gallons, or 200 cubic feet o1 compressea qas
at stantlard lemperature and pressure�.
2. Does or will the appliwnt or present or fulure builtling occupant need to file
a regiSlration (Ortn for acutely hazarCous malerials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Safety Cotle, with some
exceptions, requires re9istration with the Cosla Mesa Fire DepartmeM by
each business which al any one time has on hand a quanlity of acu[ely
hazardous malerials equal to or qreater than a weight of 500 pountls, or a
volume of 55 gallons, or 200 cubic feet of wmpressed gas at stanCard
tempereture and pressure�.
3. Does or will Ihe applicant or present or (uture building occupant neetl lo
prepare an RMPP (Risk Managemen[ and Prevention Program for acutely
hazartlous materials)7 ❑ Yes ❑ No
(Section 25534 of Ihe Califomia Health antl Safery Code provides Ihat lhe
Costa Mesa Fire Department may require Ihe prepa2tion, certification and
filing with ihe Fire Department of an RMPP by businesses which are requiretl
to register aculely hazardous materials with lhe Fire Department.
4. I( an RMPP is presenty required, has Section 25534 of lhe Califomia
Heallh antl Safety Code been fully complied wilh? ❑ Yes ❑ No
5. Dces or vnll the applicant or present or (uture building occupanl require lor
ihe work which is ihe subjett of I�iS applica�on a pertnit lor such construclion
or motlification from Uie Sou�h Coast Air Quality Management District or from
any other air pollulion control Cis�rict or agency? ❑ Yes ❑ No
(Sectbn 65850.2 of tlie Califomia Govemment Code fequires ihat the requested
informatbn ba fumished on applications for ron-residential buildirg permits).
6. Will any part ot the faciliry to be wnslructetl unCer this permil be vrithin
1000 feet from the outer boundanes of a school7 ❑ Yes ❑ No
(If yes", 1he facility must meet the requirement o� Sections 25534 and 42303
of the Cali(omia Health and Safety Code�.
7. If a permit (rom the South Coasl Air Quality Management DisMct or olher
air polWlion control districl or agency is require0 for lhe work which is Ihe
subjecl of Ihis application, have all of the disclosures prescn6ed by Califomia
Health and Safely Code Section 42303 been made7 ❑ Yes ❑ No
B. (If yes', attach certifiwte of wmpliance from lhe appropriate air pollution
control ot(cer�. � .
CERTIFICATE OF COMPLIANCE: I certify lhal under penalty of perjury the
information given above is covect. I agree to wmply with all sfate lavrs and
city ordinances regarding Hazartlous Materials and Emissions.
SignaWre Da�e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury l�at I have reatl lhis application and Slate that
the inlormation qiven is cortect. I agree to wmply wi[h all sWte laws antl city
ordinances relating to builtling construction, antl authorize representatives of
the City of Cosla Mesa lo enter upon the above-0escribed property far
inspection purposes. I aqree not to occupy or allow occupancy of any building
aulhonzed by Ihis pertnit until final inspection.
SignaWr oiL alOwner(s) Da�e
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AODPESSOiBNLWlG: 444 W 19TH ST
�pYNERSN41E1FqqWN: LARRY SOMMERS
� 'ip°"�' NEWPORT HLVD
�P� ��,�p� NEWPORT HEACH, CA 92660
APLNRECT ON FNOINFEP:
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LENOER'S NAME:
LENOEP'S �ODflE34:
� cenih �ne� � neve reae uJs ecp� w m�a �nm �na eew. Wmmron e cmw. � epma io mmoN wnn eu tltr ena muny ordle�encea
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�IXIMPOtl1011 Ufp09l9.
HOLLI HOMAS
. .. �.
Dme: j,� .1�9. � '
Spre�uro d mer/Aperu/�p
(5151 de W P) '��ildiq 8 Se1My: O�earFb: Ce�y-�ppirant: Pink-Pmenw: GdEevoE-A+aeaev
CITY OF COSTA MESA - SIGN PERMIT
PERMIT NO: SB 075634 PLAN CHECK NO: 05163-95 S
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR SIG
JOH DESCRIPTION : 15 SQ FT NON ILLUMINATED WALL SIGN
CLAIM VALUE; 200.00 CALC-VALUE: 200.00
PERM NO: SB 075634
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT:
GROQP OCC: B-2 /
COMMENTS: WALL SIGN EXTERNALLY ILLUMINATED HY BLDG LIGHT
****at��**�r****�rat�it�r�rft**�it��it�rx�+r*it����t�t�itit�tit�*at�x��t*it*x�*�+r��*+r�t�r+�*�*�it�+�+r�*� **�x �
S I G N I N F O R M A T I O N
DISTRICT; 1 TYPE: STORE FRONT ILLUMINATION: NON CATEGORY: NEW
DIMENSIONS: 3FT OOIN X 3FT OOIN AREA: 15,OOSQFT LETTER HT: 24 INCH
STREET FRONTAGE 1: 130.00 STREET 1: 4I 19TH
STREET £RONTAGE 2: 0.00 STREET 2:
PARCEL: 41920515 ZONE: C2 LOCATION > FRONT: X REAR:
BUSINESS NAME: DECOR DELUX > LEFT: AIGHT:
O T H E R T O T A L S G R O U N D S I G N
THIS ACTIVITY . 15.00SQFT OVERALL HEIGHT: OFT OIN
THIS SITE . 115.00S(�FT GROUND CLEARANCE; OFT .OIN
ITEMS OF INFO 1. PLANTER AREA: O.00SQFT
ITEMS FOR ACTIVITY: 1 BLDG SET BACK: 20FT .
COPY VERHIAGE : DECOR DELUX __.
PLANNING NOTES:
1f iE ii 1E �f' iE 1F 1E ik iE 1E 1E if 1E 1E if 1E IE IE 1ElF iF 1E iE K 1E if IE 1E 1E 1E iE 1E IE If 1E iF 1E 1E iE 1E iE iE if If 1F 1F iF 1F Ik 1F if 1E 1Fi4 iF iE 1FlE %1F 1(� 1F iF iE if�.1E iE iE iE IE 1E iE If� 1E �E i! IE 1f
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 APPAOVED HY �� �--.. DATE: - (2-��-9b'
BUILDING APPROVED BY : W3B DATE;' �Z-�g-�
APPLICATION ISSUED BY: DATE: ?s! - -
iEifitiElElEiFiliEliiEiElElEftlEiEiElEifiFlf iEiEiEiFitiEiEikiEM ifM
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING
PERMIT 15.00 15.00
PLAN 9.75
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 30.50 0.00 9.75
SMIP/NON-RES
.50
TOTAL PAID DUE
40.25 40.25 .00
REVENUE DIVISION TOTALS--> COLLECTED: 40.25 OVER/SHOAT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN-CHECK
15.00 15.00 .50 9.75
1E iE 1F 1k iE iE 1E 1f' K iE 1E iE iF IE 1E IE IF 1f iE if IE 1f 1E k iE 1E iE if iE 1E 1E M if 1f 1E iF iE if 1f 1h 1f if 1f if iE 1E IE iF 1f K 1f iE if iE If iF iF 1i if 1E IE iE iE 1E 1F iE iE 1E if ik iE 1E 1E iF iE if iE 1ElE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
NO FEES WERE SELECTED FOR THIS PERMIT
' 1 L'U29:�n;?-n^14;fi70 TCtY' SJ ��
DAT= 13/' , _ �_Tf�� i�?":i
; CONSTRUCTION ANO PLANNING . POOL �A
qPPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector
t. TemOorery Eiectrical Service or Pole � 52. Pool & Equipment Location•_ --- 1"-
�1
p. $pil Pipe-Undrgmd. 53. Steel Reinforcement ; '
�3:�.EIeC[rical Conduit Utility-Undrgrnd. . 54. Forms .- ' �
�'4.' Elec`Irical ConduibUndrqmd. 55. Electrical Bond�ng ,__
-; 5�. �Ste@I Reinforcement 56. flough Plumbing & Pressure Test �' L
�,�'"Electrical UFER Grnd. - 57. APPROVAL TO COVER�GUNITE �
, `7:' Foofings 58. Electrical Conduit-Undrgrnd. - �
8. Foundation � 59. Gas Pipe, O Undrgrnd., Test �
, . r
9. WaCer Pipe-Undrgrnd. ' 60. Backwash Lines, P�Trap, Ef �nargrnd. .
10. StrJctural Floor Svstem - 61. APPROVAL TO DECK -
11. Prof��tY Sewer Line & House Connection 62. Backwash & R¢ceptor�Final
J
12. Sewer Cap "; 63. Heater & Vent-Final �.
13. Roof Drains � - 64. Plumbin� System • Pinal -
14. Rough Plumbing � 65. Electrical�Final •-
15. Rough Elec(ricabConduit 66. Soiar SYstem-Final -' �
% -.
76. Rough Electric4Viring 67. Fencing & Access Approval _' ,
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING %���
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rou9h Heating & Air Conditioning - .FIR� DEPT „REQ�JIR�tv1EfVT
- n - -�r�c� �.-.- :.7 r; . �� �.:. . •
20. Rough:Facibry�ir{�it�ce „";FF Q= x~ r� �� RO.I(ALS '��,'. Per dk '.TT
.7 Gr. .;:�r. S �P .I'�1X
2L �uGtsjinSirucBuet:f ' '��•^r• `;.' �� �+� - 70. UriBe��robRd Hydro�� �
22. DuCu. Ventifa�7ng `„� F.� '�''`: -'�` �. >.x• d 7i. Pioduct Piping G1G;as. ❑0+'% .
23. Gas P�Pe•Rough.& Test �� �;�_ `y -���r-, _'* .- �+ 7�y, �nder�round Flush - x
^t M \ Y.
24. f�p''of �FranSing - � _ �,:, y� �G'. � , • :,. � -' �• �deY��d. Storag�Tank �Fas �Oil
25. RoOf 5heafh��9 � � •* _.f � ' 70. O'vethead.Nydro ' �
26. T-Bar!Ceiling (Struc,turel� �`Y✓16noco3t � ` � " 75. D�' ChEmical � � � ' - �
� � > - < . �y ,--- .
27. �ramaand_Flashing , - ''� `- - 7.6. D�+VStandpipe c::: z
28. Lathia"'ij & $idi Y � ��� ' �':�'' "`.�' r � • 7Y: FlG Etl:SYSTEM p'�tNAL: " F
^� �u c� r-�� w �� C � .R f' _ �i,� .- •
~29. Insulation" o;�: r.:r• �'7 �^., r? �� � 7$� FIRE PREV. F�NAL .�� -
� 30. DrywallN�ling y� J� f �- J � �,_ . �� �;� �HEALTFLDEPT.REQUIREMENT -
31. Ptaster Brogrrt ¢pat>x �� ��- ;;, � 79: FINttL�INSPECTIO1d:�
�-�32. Efectrical Pow€��M�ttl�Fina� - *`� 80. FOOD EERT�FICATE ISSIiED °,' �;
., .� f, r ;, i,� . .. . �+ - � .
33. �inal,E.iectxlc � �, � , ^ r= Y Notes: ;K r, _ - � : ' : .
'-34. Ftnsl Neattdg &:AiREonHitioning �-' '� � �` �' -• � ' -• �
�., .,, . a r � .s ' c c
35. F,mel Gas PiPe-1'est� � ' � -' . _ ' + �` x., -�y � -
36. Hoodbr (Snopy " • r r• ' �'- ' _ -'
- <- - h �r
37. Fipal Factory PireP�aGe �:F. G r.,,- = - `�: � �� `� -
� 38. Fin�l PluniGing ' . "�"?;`- �- * � � tt �S '^'Y. -
�. �i ^ � .�"^ �
Q,39. Wa'ter�ServJce-Finaicf`. � �_^_ x ..�.�i��.''s� * � i�!';i : � _ - � r
,�40. Gas Service�-Finai . �'ti " '� . � "� � _
_��� - - ,�`
r y -. � � --i r �: �r „ � . : -, �
41. Solzr pomestir'Final._ _ �t -.; � „ .. ; ,_ ,, , � _ .
. � ,
42. Backflow Preventer F .. � - '� :� � = - ' �- � �- '-
�` 1"'1 >, i-i S j'� M1' L q. l i'
43. Backflow Irrig#J�'on � -��; �::� � *- J � �
44. Landscape irrigation System' ��� � •• ^ •"' Y "' = � ' =��'' �� �� �
:� c - '7 . f: � '� r•
. �. F > ' . I- � t. , . �i r , a� _
45�. SQ,Und At�enubfion ' F, r:';, ,. , - ,-, .- �. p �r - '
�
46. Handicap Regulationse .. -.. .•� � . '" - • r'
t i ,�
47r F�INAL STRUCTURE;& fl'l�hL'DING y � .. � • � � � ': '
. /L-i.t: y- r- � �* t.
48. FJNAL'PIANNING t -'n; ;'% -'� r. '; _ } r'
�.� 1� �. �.
49. Ei�ttri6 Release ro Edison..?^ ; C'; �y ;,;,'. .�, '
5Q. Ges Release to Southun Califomia Gas Co • � '= `' -' -
x. .
51. CEpTIFICATE0F0ECUPANCY "'��- �- • - ' �
No Da[e