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Home My WebLink About462 18TH ST - Building Permits(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DFiIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: 462 E 18TH ST LEFY AND REAR OF SFD Status: ISSUEO Applied: 10/24/2007 Issued: 11/15/2001 Parcel Nunmber: 11733228 Applicant: WILSON, BOB . _ ISSUEDBY: � Address: 485 E 18TH ST - ' - � � -. - - .,%`� _` �� - -Phone: (949) 646-1740 , � ' COSTA MESA; CA : -� ' Zp: 92627 - � � � � . , ' � � � ' / � ' . Owner, O'CALLAGHAN,�CASEY�J' � � ` � Address � 462 E 18TH ST �' - - " ' - . Phone: � CO$TA MESA; CA' Zip: 92827 �, � � �" Contractor: BI WILSON AND SONS Adtlress: 485 E 18TNST . / -. . C05TA,MESA,CA�- � � , . � � .�� , � . A-�� `' V, '! � �, � �, V� ' :%Phone: (949) 646�7740 ' - Zip: 92627 . ._. License: 377487 .- � , � SCOPE OFPERMIT . � , ' CONSTRUCT 635 SF'MASTER BEDROOMIBATH; GUEST BATH ADDITION/REMODEL OF AN EXISTING � SFD. 9 LIGHT FIXTURES, 14 OUTLETS;�4 SWITCHES.�REF: 801-01703 �- � � � , � �� -'� FEE�SUMMARY �- ," � � � ' � � � Quantity ' � � � ; � � ' _ Quantity ` .� , . . ISSUE FEE $23.50 Temp Dist System / Lighting $0.00 0 '' � � . � ' Temp service test $0.00 Busway /100 ft $0.00 0 - . � � . Res. a/c package $0.00 Standing Section. ' $0.00 0� , New Res (t-2 units) $0.00 0 Misc Electrical Equipment $0.00 ��0 , � - New Res (3+units) $0.00 0 .. . . Transformers up to 1 kva/kw $0.00 ,0! , �; - Pool / Spa , � $0.00 0 --':�! - �� ...........:...:up l0 10 kva/kw $0.00 , " 0 �� - - . , -.,_ , , _ . Lighting Fizts , _$9.90 . 9 , ''; ' ` � ,,,,,,,,,,;,;;�.;.up to 50 kva/kw $0.00 %', 0 ' � Recept Outlets - $15.40 14 , . .................up to 100 kva/kw - _ $0.00 0 � Switches ' , , $4�.40 . � �`4' �.- . � �- ..................over 100 kva/kw $0.00 � 0 Non ResAppl, ,. , $0.00�<`� 0 �- ' � Low Voltage Equipment . $0.00 -' � 0 , . Res Appl � 50.00��-; ��0 Low Volt Wiring System / Ckt $0.00' , � 0; Service to 200a ' " $0.00�, - �0 ` Misa Conduit - - $0.00 � � " 0 " � Service to 1000a � ,$0.00 -� , "0 � - � Misa Conductor � $0.00 0 ' � � Service over 1000a � � , , $0.00 � 0 - ,. � Circus ( gen or ride) , $0.00 � , �0, Motors fo 1 hp ' - $0.00 � � � 0 , Circus (mech ride or lights) - $0.00 "- 0 �" � Motors to 10hp , $0.00 " � 0 . - , Christmas Tree Stand � � $0.00 �' -'0 Motors to 50hp $0.00 - 0 � Fireworks Stand � .$0.00.� 0 Motors to 100hp $0.00 � � 0 � . Other Electrical Fee � "$0.00 Motors over 100hp $0.00 �` . < �0 - � � . , - � Communication drops $0.00 --0 � , � .. Investigation Fee � - $0.00 Sub panel to 200a $0.00 0 � _� Plan Check Fee � $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $53.20 Intermed Pole $0.00 0 COMMENTS ! SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and ielated regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit snall 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 authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetlons and Tinal approval mus� be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaae-ae �aroo� WORKERS'COMPENSArON DECLAFiAnON: I hereby atfirtn untler penalry of perjury one of iha following tleclaretions: ❑ I heve antl will maintaln a cetliticate ot consent to self-Insure tor workers' wmpensetion, as pmvided for by sectian 3700 oi Ihe Lebor Code, for the peAortnence of the work for which Ihis pertnit is issuetl. ❑ I hava and will maintain workers' compensatlon insurence, as required by section 3700 of the Labor Code, for Ihe perfortnence of the work for which Ihis pertnit Is Issued. My workers' wmpensation Insurance carrier end policy number ere: �7/' p 7 Carriar. c�i %/c %G F�/�� Policy NumDer. ��/ 7'+�C> /'� Cl � (This secfion need not be com0�ete0 il the permit Is velued et one hundred dollers ($100J or less.) ❑ I certify [hat in the peAormance of the work for w�ich Ihis permil I5 issued, I shall not employ eny persan in eny manner so es to become suD�ed to Ihe workers' compensation laws oi Celifomia, antl egree Ihet il I should become sub�ect to the workers' campensation proWslons of Section 3700 oi the Lebor Code, I shall forihwlth comply with Ihese prov�isio / � Q � ApplicamSignature: /�0�� !�"�✓ Date: J�/S/••200� WARNINO: FAILURE TO SECURE WORKERS' WMPENSATION COVERAGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PE TIES AND GVIL FlNES UP TOONE MUNDRED TFqUSAND OOI.LARE ($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]O60F TME LABOR CODE, INlERESi, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aXirtn that I am licensed untler Orovisions of Chapter 9(commencing with Sectlon 7000) ot Dlvlsion 3 0l ihe Business end Profeulons Code, and my Ilcense Is in full torce end ettect Lic. M 7 Cless p � Contractols Signature: Date: � � O / CONS7RUCTION LENDING AGENCV: ❑ I hereby aHirtn Ihat there is e construction lentling agency lor tha peAortnance of the work tor which this permit is iuued. (Sec. 3097, Civil Code). Lendefs Neme: Lendefs Adtlress: SlgnaNre: Date: OWNER•BUILDER DECLAFiA710NS: I hereby aNirm t�et under penalry ol perjury that I am EXEMP7 FROM THE CONTAACTORS LICENSE LAW for ihe tollowing reason (Sec. 7037.5, Business end Professions Cotle: Any ciy or counry which requires e permit to consiruct, eltar, improve, tlemolish, or repair any struqure, pnor lo its issuance, also requires Ihe epplicant for such pertnit to file a signed statement ihet ha or ahe is Iicensatl pursuent to Ihe praWsions of the Contrectors License faw (Chepter 8(commenGng wlth Secflan 7000) of Dlvlslon 3 of the Business end Protessions Cotle) or that he or she is ezempt therelrom end the basis tor the elleged exemption. Any vidation ol Sectlon 7031.5 by eny epplicant for e perrt+. subjects the applicant ta e dvil penelry of not more Ihan tive hundrad dallers ($500) J: ❑ I, as owner of the properry, or my employaes wl�h wages as thelr sole wmpensailon, WILL DO 7HE WORK, en0 the siructure Is not Intendetl or oHeretl for sale (Sec. 7044, Business anE Professions Code: The Coniractors License Lew does not appty to an owner ol property who builds or improves thereon, end who tloes such work himsell or herselt or ihrough his or har own employees, providad ihat suc� Improvements are no� Intentled or ofleretl tor sala. If, howevar, the building or improvement Is soltl within one year of completion, the ownar-6uilder will heve ihe burden of proving ihat he or she tlid not build or imD�ove for purpose of sale.). ❑ 1, as owner ot Ihe properry. em E7(CLUSIVELV COMRACTNG WITH LICENSED CONTRACTORS lo construct lhe prol�� (Sec. 7044, Business anA Profeuions Cotle: The contractoro License Lew tloes not epDly to en owner ot property w�a builtls or Improves Ihereon, antl who contrects tor such pro�ea wlih a conirectoqs) license pursuent to ihe Cantractors License Laws.). ❑ I em exempt under sec. Business and Professlons Cotle lor this reeson: SignaNre: Date: Owner ID verified by drivefs license. ❑ Ves ❑ No Drivefs License No. Vedfiwtion ot Ownership by (rype oi tlacumem, i.e. - pmperty ten bill or deetl): DIVISION OF INDUS7FilAL SAFETY PERMR CERTIFICA710N: Expires: ❑ I herehy certity thet no excavation five (5) or more feet in tlepth into which e person is required to descend, will be mada in connection with work authoAzeC by Ihis permit and that no builtling strudure, scattolding, falsework, or demdition or dismantling thereot, will be mora than t�Irry-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title B, Califomia Administretive Cotle). ❑ As owner-builder, 1 will not employ anyone to do work whic� would require e pertnit trom the DlNsion of Intlustnel Setery, es notetl ebove, unless such person hes e pertnit to do such work fmm the tlivision. Signature: Date: DiviSion ot Intlusirial Satery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORVJITION OF ENTFiY: I certity under penalry of perjury lhat I have reatl t�is applicetion entl state that the infortne�ion given is correci. I agree to compty with ell stete laws and ciry ordinances relating to building construction, end euthodze representalive9 0l lhe Ciry oi Costa Mesa to enter upon Ihe ebove-described property tor inspection purposes. I agree noI to occupy or ellow occupanty ot any building euthonzed by Ihis pertnil until final inspeciion. SignatureQ� LegalOwner{s) Date —�.o-G, VJ. //.�a�e,•� //� 5�2 0 o J AnNOr Authodzetl Applicant Date CO�E I, INSPELTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Rooi 201 Final BIocWRetelning Well 202 Final Fectory Fira Place 203 Finel Si9n 20< Finel Demolition �[E J({f�{� �j INSPECiIONTYPE 206 Finel Machanical 208 Finel PlumDing 210 Finel Elec�riCal 212 Finel Fire Prevention 220 Finel Planning Approval 222 Finel Site 250 Finel Bulltling/Occupancy � It� (714) 754-5273 • Fez (714) 754-4856 • wwVGCI.COSfe-meSe.Ce.U3 77 FAIH UHIVt, GUS 1 A MtSA, GA'J1ti2ti ,lob nddress: 462 E 18TH ST Suite No Vicinity: LEFT AND REAR OF SFD Parcel Number: 11733228 Applicant: Address: Owner: Address: MECHANICAL PERMIT WILSON, BOB .; �i-� ' �" 485 E 18TH.ST„ �%�. � : � � '.' " COSTA MESA, CA ._ � ,. . � '., " - � . � O'CALCAGWAN, CASEY J � 462 E 18TH.ST - " " � �. COSTA MESA, CA Phone: (949) 6464740 -' Zip: 92627 ' Phone: Zip: 92627 Status: ISSUED Applied: 10/24/2001 Issued: 11/15I2001 ISSUED BY: ' � Contractor. BI WILSON AND SONS \. ; Address: 485 E 18TH ST ' ' - - �, � ' � , ' Fhone: (949) 646-1740 �' � COSTA MESA, CA "- - � Zip: 92627 ." ' ; , ,. . - License:377487 . ' � ; '. SCOPE OF PERMIT � CONSTRUCT 635 SF MASTER BEDROOM/BATH, GUEST BATH ADDITION/REMODEL OF AN . EXISTING SFD. 11NST; FAU < 100K BTU, 1�GAS FIPING SYS, 2 VENT FAN/SINGLE DUCT. � REF: BOt-01703'� � � � � ' . ISSUE FEE InsCFAU <t00�k BTU Inst FAU >700 k BTU RepaiilAlt Cooling/Heat Inst I Rep. Recess Wall Htr Refrig Sys <700 k BTU Refrig Sys >100 R 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 > 10000cfm FloorFurnace Floor or Suspend Heater FEE SUMMARY Quantity�-, , " -� � �- � -_ .. $23.50 -" - '- � - - " Repair / Alt Absorbtion Unit $14.80 1� � ' ` Repair/'AltRefrigeretionUnit $0.00 0 Ventillation System $0.00 0 Eyaporative Cooler � $0.00 0 ' Commerciai lncinerator $0.00 0 Domestic Incinerator $0.00 0 - "- ' Compressors / Absorption Systems $6.15 1 ,"� � Up ro 3,hp I 100 k BTU $0.00 0 . 3 To 15 hp % 500 k BTU . $0.00, ;. 0 '� � , 15 To 30 hp /.�7,000 k.BTU � , � $0.00 0 30 To 50 hp I 1,750 k BTU $14.50 , 2 " Over 50 hp I Over 1,750 BTU $0.00 � � :0 , � Boilers � - $0.00 0 ` - Up to'3 hp ; � $0.00- . 0 � 3 To 15 hp� $0.00 -0� , 15to30hp . � � $0.00 0�� 30 to 50 hp . $0.00 � 0 ' Over 50 hp $0.00 0 � Other Mechanical Fee � � � $0.00 0 , Investigation Fee , , - " Plan Check Fee � Reinspedion Fee $0.00 ; $0.00 $0.00 50.00 50.00 $0.00 Quantity 0 0 0 0 0 0 . $0.00 . 0 so.00 o' $0.00 0 $0.00 0 $0.00� 0 $0.00 0 $0.00 0 � $0.00 0 $0.00 0 50.00 0 $0.00 SD.00 $0.00 TOTAL CALCULATED FEES 558.95 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) � EXPIRATION: This permfl shall automatically e�ire 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 authorized under this permit lo be considered legal, such work must comply with all applicable codes, and all ' requlred inspeetlons end flnel epproval must be obtainetl. Failure to obtain inspections and final approval will result in the ezpiration of this permit. IFOR INSPECTIONS CALL: (714) 754-5626 zaaaaa �doo) WORKERS'COMPENSAPON DECLARAnON: � I hereby aflirtn under penalty of perjury one ol the following declarations: ❑ I hava and will maimain a certificate oi consent to salf-Insure tor workers' compensation, es provided for by section 3700 oi the lebor Code, for iha pedormence of the work for which ihis permit is issued. ❑ I have antl will maintain workers' compensation insurance, as required by section 3700 of the Lalwr Code, for ihe pertortnance of the work for which this pertnit is issued. My workers' compensation Insurenca carrier end policy number ere: f Cartier: �� i��.✓,I PolicyNumber: OJ��I�S7`� � (This section neetl no! be Eomplefed il the permit is veluea at one hundretl dollars ($100) or less.) ❑ I certiy that in the peAortnenca of the work for which this pertnit is issued, I shell not employ any person in eny manner so as to become subject to the workers' compensa[ion laws of Calltomia, end egree thet If I should become subject to t�e workers' compensetlon provlsions of Section 3700 of the Lebor Gode, I shell forthwlth comply with these provisions. �. � L^, �%f ApplicantSlgnaWre: '��o'�� !��'t' Date: ��.5 U/ WARNINO: FAI�URE TO $ECURE WORKERS' CAMPENSATION CAVERAQE IS UNL4WFUL AND SHALL SUflIECT AN EMP�OVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED T/qUSAND DIXLARE �E1 W,000). IN ADOITION TO THE COST OF fAMPENSATION, DAMAGES PS PROVIDED f-0R IN SECTIdJ 3]O6 OF THE IABOR CADE, IMEREST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm Ihat I am Iicensed under provisions of Chapter 9(commencing with Section 7000) of Divislon 3 ot Ihe Business and Professions Code, and my license is in tull force end eHecL Lic. M Class % Contractar's Signalure: s -� Dete: /� O/ CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirtn that there is e construction lending agency for the peAormance ot the work for which Ihis pertnit is issued. (Sea 3097, Civil Code). Lender's Name: Lender's Atltlress: SignaWre: Dare: OWNER-BUILDER DECLARA710NS: I herehy eHirtn Ihet under penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Buslness and Protessions Coda: Any city or wunry which requires a pertnit to consiruct, elter, improve, demollsh, or repair eny structure, Orior to its issuance, also requires Ihe apD�icant tor such permit to file a siqnetl statement ihat he or she Is Iicensed pursuant to ihe provisions oi �he Contractore License Law (Chaptei 9(wmmencing with Section 7000) ot DlNslon 3 of the Business and Professions Code) oi that he or she is axempt therefrom and tha besis for the alleged exemption. Any violation of Section 7031.5 by flny epplicant for a pem+. subjecis the epplicant to a civil penalty of not more than five hundred dollers ($500).): ❑ I, as owner of Ihe proper�y, or my employees wlih wages es their sole compen5aiion, WILL DO TME WORK, antl Ihe siructure is not intended or ottered for sale (Sec. 7044, Business end Professions Cotle: The Coniractors License Lew dces not apply to an owner of properry who builds or improves ihereon, and who does such work himself or hereelf or ihrough his or her own employees, provided ihat such improvements are not Intended or aHered tor sale. If, however, Ihe building or improvemant is sold within one year of completion, ihe owner-bulltler will heve ihe burden ot proving that ha or she did not build or improve tor purpose oi sele.). ❑ I, as owner of the properry, am EXCLUSIVELV CONTRACTING WITH UCENSED CONTRACTORS to constmct the projea (Sec. 7044, Business and Professions Cotle: The conirectors License Lew tloes not epplY to an owner of pmperty who builds or Improves thereon, end who contracts tor such projec[ with a contractor(s) license pursuant to ihe Contradors License Laws.). ❑ I am exempt undar sec. Business and Professions CoOe for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Dnver's License No. Vedtication of Ownership by (rype oi tlocument, i.e. - property te�c bill or deed): DIVISION OF INDUSTHIAL SAFE7Y PERMIT CERTIFICATION: Expires: ❑ I hereby certify that no excevation five (5) or more feet in depth into which a person is required to descend, will be made in connection wilh work autharizetl by this pertnit, entl that no building siructure, scaHolding, lalsework, or tlemolition or tlismantling ihereot, will be more than ihirty-six (36) feet high. (Ghap. 32, Grp 2, Art 2, Sec. 341, Title 8, Calitornia Adminisiretive Code). ❑ As owner-builder, I will not employ anyone to do work whic� woultl requira e pertnit trom Iha Division of Industnal Safery, es noted above, unless such person has e pertnit to tlo such work from the division. Signature: Date� Division of Intlusirial Salery Permit Numher: CERTIFlCATE OF COMPLIANCE AND AUfNORVATION OF ENTAY: I cenity untler penalry ot perjury that I have reatl this epplication and state Ihat the infortnation given is correct. I agree to comply wilh ell state laws end ciry ordinences relating to building construction, end euthonze representatives of t�e Ciry of Costa Mesa ro enter upon the ebove-described property for inspection puryoses. I egree no� to occupy or allow occupancy of eny building euthorizetl by this pertnit until final inspection. Signature Of Legal Owny r(sy Date �� nf� L9 /./,t�/.�-.rr,/ �� And/Or Authonzed Applicant Date COOE I, INSPECTIONTYPE 7616 Fixea System Final Fire Prevention 1266 Pool Spe Final 200 Final Re-Rooi 201 Finel Block/Reteining Wall 202 203 204 Final Fectory Fire Place Finel Sign Finel Demolition J�T� UL COpEt INSVEC710NTYPE PAff. 206 Final Mechanical � Z— 208 Final Plumbing 210 Finel Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 FinelBuilding/Occupancy (714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ea.us // rnm unrvt, cw i N mw�+, i.M azozo �ob Address: 462 E 18TH ST Suite No Vicinity: LEFT AND REAR OF SFD Parcel Nunmber: 11733228 Applicant: WILSON, BOB Address: 485 E 18TH ST' �� , COSTA MESA, CA � PLUMBING PERMIT ' Phone: (949) 648-1740� Zip: 92627 �. Owner. O'CALLAGHAN, CASEY J Address � 462 E 18TH ST ' Phone: ,", COSTA MESA, CA Zip: 92627 Contractoi: Bf WILSON AND SONS Address: 485 E iBTH ST � COSTA MESA, CA Arch / Eng : � � Address: Status: ISSUED Applied: 70/24/2007 Issued: NI752001 ISSUED BY: ' Phone: (949) 646-1740 - � Zip: 92627 License: 377487 . . Phone: � Zip License: SCOPE OF PERMIT CONSTRUCT 635 SF MASTER BEDROOMIBATH, GUEST BATH ADDITION/REMODEL OF AN EXISTING SFD. 1 BATHTUB, 1 LAUNDRY TUB/WASHER, 1 SHOWER, 2 WASH BASIN, 2 WATER CLOSETS. REF: B07-01703 " . - � . ISSUE FEE BackFlow irrigation Backflow Preventer Bathtub Clarifier System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT 523.50 50.00 � $0.00 $9.80 50.00 „ $0.00 $0.00 50.00 50.00 50.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 50.00 50.00 $0.00 $0.00 aTr FEE SUMMARY AMT Laundry Tub / Washer $9.80 ,. Landscapelrrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0:00 Receptors $0.00 8eptic Tank � ' $0.00 Sewer Cap for Demo 50.00 Sewer Connect 50.00 .Sewer Private Line $0.00 Shower , 59.80 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop 50.00 Spa (private) $0.00 Spa (public) $0.00 Qrv 1 0 0 0 0 0 0 0 0 � � .- � '. 0 0 0 0 0 0 0 SumpFump Swimming Pool � . Trap Primer i Urinal , � Vacuum Brkr Bkflow(1-4) ,Vacuum Brkr BkAow(5+) Wash Basin Wasn Basin Set Waste and Vent System Water qoset (Toilet) Water Heater / vent WalerPiping (inst or Rep.) Watei Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 519.60 50.00 50.00 519.60 $0,00 50.00 $0.00 $0.00 50.00 50.00 $0.00 $0.00 50.00 TOTAL CALCULATED FEES: E92.10 QTY 0 0 0 0 0 0 2 0 0 2 0 0 0 0 0 0 NOTICE: The work authorized by ihis permit s a comp y vn a app ica e an aep access requiremen�s under Calitomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This pertnit shall automaticalty expire and become void if work is not commencad within 180 days, or if work is suspended or abandoned lor a period of 180 days. � . INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicabla codes, and eil requlred inspectlone and final approvel must be obtained. Failure to obtain inspectlons and final approval will result in the explration of this pertnit. FOR INSPECTIONS CALI: (714) 754-5628 zuaae �e�oo� . . _ ._. Y.'..y_ WORKERS'COMPENSAnON DECLARAnON: I hereDy aHirm untler penalry of perjury one of Ihe lollowing declarations: ❑ I heve end will maintaln e certitiwie of consent to sell-Insure tor workere' compensaUan, es proWtletl for by sectlon 3700 af the Lebor Code, br Ne pertortnance of the work far w�iC� thi9 Oermit i5 issuetl. ❑ I hava end will meinlain workers' compensation insurence, az required by sectim 3700 of Ne Labor Code, tor Ihe peAortnence ot Ne work lor whkh this pertnit is Lswed. My woAcers' compensation Insurence= rrier antl policy number are: r Certier. .�%2� � !i/�[� PolicyNumber. OJ9yylPT--O � (Th/s secNon need nof 6e oompleted /I Ne permlf fs valued et one huntlretl dd/eB (5100) or less.) � I certify t�et In t�e pedormence ot Ne work for which Ihls permlt b issue4 I shell not employ eny person in eny menner so es ro become subject ro Ne woAcers' campensetlon lawa ot Celifomia, end egree Ihat it I shauld became su��ect to t�e workers' compensatlon provisians of Sectlon 3700 ot t�e Lebor Code, I shall forthwlth cnmply with these prw��isi / � Q � �� ApplicenlSigneture: /l�t `-�• G:lf�6GdYV Date: /�s O / WAPNINO: FAIIURE TO SECURE WORKERS' CpAPENSATION COVEMOE IS UMAWFUL M'� $HALL $UBIECT AN EMPLOYER TO CRIMINAL PEIJ�LTIE$ AND CML FlNES UP TOONE HUNORED TKKISAND DOl1ARE (E100.000�, IN ADOrt10N TOTHE O�ST OF C�OMPENS�TION, DAMAGES ti5 PRWIDED FOH IN SECTION 3]OB OF THE UBOR CODE, INfERE5T. M1D ATTOHNEYS FEES. LICENSED CONTRACTORS DECLARATON: I hereby eXlrm ihat I em Ilcensed under provislo s at Chepter 9(commencing wil� Sectlon 7000) oi Division 3 ot the Business end Professlons Code, end my Ilcense Is In tull rorce ena enea. uc. a .� 7 7=f�7 c�ess a /.�i � Comrenors Signature: r/t Dete: // o/ CONSTRUCTION LENDING AGENCY: ❑ 1 �oreDy eMirm Ihat t�ere Is a conslruction lending egenq for Ue Dedormence ot the work lor w�ich ihis permit Is luuetl. (Sec. 3097, Civil Cotle). Lentlefs Neme: Lentlers Atltlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby effirtn t�et urMer penalry ot perjury that I em EXEMPT FROM 7ME CONTRACTORS LICENSE LAW for the lollowing reason (Sec. 7031.5, Bustneu entl Prolessions Code: Any dry or counry which requires e pertnit to construct, alter, ImO�we, Oemdlsh, or repair eny structure, prior to its issuance, elso requires the appliwnt fw suU pertnit b tile e signed statement ihet he or she Is Iicensed pursuent to the provlsions o1 ihe Coniradors License Lew (Chepter 9(commendnp with Section 7000) of DlNslon 3 of Ne Busineu end Professions Cotle) or that he or she is ezempt theretrom enA t�e besis tor ihe elleged exemptlon. Any vloletion of SecUon 7031.5 by any epplicant for e pem+: suD)ects the epplicant to e civil penalry ol nat more than live hundred dollers (5500).): ❑ I, es owner of ihe proPerly, or my employees wilh wages as their sole compensation, WILL DO THE WORK, entl Ihe siructure Is nat InientleC or ottered far sale (Sec. 7044, Business entl Protesslans Code: The Contrectors License Lew does nat appty �o an owner of properly who bullds or improves Ihereon, antl who does such work himsetl or herselt or through his or her own employees, provi0etl ihat such improvements are not Intentled or oXered br sale. It, however, the building or improvement is so10 within one yeer of completion, the owner-builtler will heva the burden of proving tha� he or she did not build or improve for purpose of sale.). ❑ I, es owner of the property, am EXCLUSIVELV CONTAACTING WITH LICENSED CONTIiACTOBS ro wnstruct the project (Sec. 7044, Busineu and Professions GOCe: The camrecrors Llcense Law does noi appy to an owner ol property who builds or Impmves ihereon, and who contrects tor such project wlth a conirectoqs) license pursuant to the Coniractors License Laws.). � 1 em exempt untler sec. Business end Professions Code for this reeson: Slgnature: Date: Owner ID veritietl by tlrivels license. ❑ Yes ❑ No Drivers License No. Vedficatlon ot Ownershlp by (rype ot tlocument, i.e. - property tex blll or deed): Ecpires: DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFlCATION: ❑ I hereDy certlly that no eacavation Me (5) or more leet in depth Into which e pereon Is required lo descend, wlll be mede in conneclion wit� work authorized by ihis permlt, end that no building strudure, sceNdding, lalsework, or demdition or dismantling Ihereof, will be more Ihen Ihir�y-sf: (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, T1Ue 8, Calilamia Adminisirative Cotle). � As owner•bullder, I will not employ enyone to tlo work which woultl require e permit from the Division oi Intlustrial Setely, es noted ebove, unless such person hea a permlt to do such wark from Ine division. Signature: Date: Dlvlslon ot Industrlel Sefery Permil Number: CERTIFlCATE OF COMPLIANCE AND AUTHOR¢A710N OF EMAY: I certiy under penalry oi per�ury ihat I have reatl this applicetion and stata Ihat �he inlortnation given is correct. I agree to compty with all state laws en0 ciry ordinences relating to builtling wnstruction, antl authodze represematNes ol the Ciry of Costa Mesa to enter upon Ne ebove-0escribetl property for inspection purposes. I aprea not to occupy ar ellow occupancy ol eny building authonzed by this pertnit until final inspecUon. ��eiur`O�Legel Own r(s - /S/ % ate Y �.J �� / O AnNOr Authorized Applicant �-� Date 40pE �, INSPECTIONTYPE Qe¢ II�LS t818 Ficed System Finel Fire Prevention 1268 200 201 202 203 204 Pool Spa Final Flnel Re-Root Final BIocWRetaining Well Finel Fectory Fire Placa Finel Sign Flnel Demolitlon y00E� INSPECTIONTYYE 208 Finel Mochenlcal 208 Flnal Plumbinp 210 Flnal Elecidcal 212 Flnel Fire Prevention 220 Finel Planning Apprrnal 222 Final Site 250 Final Builtling�Occupency �.1 IPI.: C , I%�i% 1/ � (714) 75M1-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us // YAIH UMI VC, GV51 N MC,A� cR yzozo BUILDING PERMIT Job Address: 462 E 18TH $T Suite: Vicinity: LEFT SIDE AND REAR OF SFD Parcel Number: 11733228 Applicant: WILSON, BOB Address: 485 E 18TH ST COSTA MESA, CA - Owner. O'CALLAGHAN, CASEY J Address 462 E 18TH ST . ' � ' , COSTA MESA, CA � Convac}or. BI WILSON�AND SONS Address: 485 E 18TH ST � COSTA MESA, CA Zip: 92627 Zoning: � Phone: 949-646-1740 Zip: 92627 Phone: Zip: 92627 Status: ISSUED Applied: 1024/2001 Issued: 11/14/2001 ISSUED BY: ' Phone:� " (949) 646-1740 License: 377487 Arch : - Eng: KENNETH CLARK Address: . , ,� �. Address:, xxx porl nelson st � - . � ' Phone: ' � Phone: 949-759-1767 ! �"„ � NEWPORT BEACH, CA� � � � Zip: . License: 92660 , License: C7899 SCOPE OF PERMIT CONSTRUCT 600 SF ADDITION TO AN EXISTING SINGLE-STORY SFD TO INCLUDE A NEW MASTER BEDROOM/BATH, GUEST BATHROOM, ADDITION TO AN EXISTING BEDROOM AND REMODEL OF AN�EXISTING SFD. PROJECT ALSO ' INCLUDES CONSTRUCTION OF 275 SF COVERED PORCHES. � Plan Check: $454.84 Permit: $699.75 SMIP Res: $5.77 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $1,160.36 SETBACKS MAINSTRUCTURE Front 26-0 ACCESSORY Front� 0-0 PARKING Existinq: z ` NOTES: Rear SS 0 Rear Re uired: � � FEE SUMMARY. Calc Valuation: 5s�,�ss.00 Claim Valuation: bo.00 PLANNING & ZONING Left 5-0 Right '� 0-0 " � Left 0- 0 , Right � 0- 0 a . ` - Proposed: 4 NOTICE: The work authorized by this permit shall comply with all epplicable handicap access requlrements under California statutes and related regulations. (Ortl. No. 92-28, § t, 72-21-92) EXPIRATION: Thls permit shall automatically explre and become void if work Is not commenced within 180 days, or if work Is suspended or abandoned tor a period of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be consitlered legal, such work must comply wi�h all applicable codes, and all requlred Inspeetiona and final approvel must be obtalned. Failure to obtain inspections and final approval wilt result in the expiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 zasae �aroo� WORKERS'COMPENSAnON DECLARAnON: I hereby ettirm unAer penalry of perjury one of Ne followNg declaratians: ❑ I have end will malntein a cenificate of consent ro sell-Insure tor workers' compensetlon, es pmWtleA for by section 3700 0l the Lebor Code, for Ihe perfortnarxe of the work tor whlch Ihi9 Dertnit is issuetl. ❑ I heve end wW malntaln workers' compensatbn insurance, es requlreE by section 3700 ot Ihe Lebor Code, tor tha pertortnarxe ot ihe woAc for whkh Nls pertnit is issuetl. My workers' compensation Insurenc�e car/rier antl pdky number ere: • .. _.. Carner: �7�ir/� �?� PolltyNumber: OS'�/�✓�IPJ—O/ (Th1s sectlon need nof be complefed i! tlie pertnll ls velued et one huntlretl ddlers (5100) or Iess.J ❑ I cetlity that In Ihe pertortnanca of the work for which Ihis permlt is issueQ i shell not employ any person in any menner so es to become suDject to the workers' compensatlon lews of Calitomia, end egree Ihat II I s�oultl become sub�ea to Ihe workers' compensatlon provlslons o1 Secllon 3700 oi the Lehor Code, I shell forthwith com0ly wlth these provisions./� /� g � � AppllcentSipneWre: `7J.'�� . �/�(_IJA3-/ Dete: �/�J�/ � WARNINO: PAILURE i0 SECURE WORKERS' COMPENSATION COVEMOE IS UNUW FUL M1D SHALL SUBIEGT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED THOUSANO DOLURE (f100,000�, IN MDIiION TO iHE ODST OF COlAPENSATION, DAMRGES AS PHOVIOED WR IN SECTION 3]OB OF THE IABOR CODE, IMEREST, AND ATTORNEV'S iEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm thet I em Ilcensetl untler provisions ol Chepter 9(commencinp wilh Sectlon 7000) oi Divlslon 3 of the Buslness entl Prolessions Code, entl my Ilcense Is In tull torce entl etlect. LJc. a :� 7'7 �/ �'1 7 Class p � ConirectoYsSigneture: �.L+-z r-w, i�v�rz�_ Dete: //.S o/ CONSTRUC710N LENDINO AGENCV: ❑ I hereDy aNirtn thet there is a consiruction Iending egency tor Ihe peAormance ot iha work for which ihis permit IS issuad. (Sec. 3097, Civil Cotle). Lentlefs Neme: Lendefs Address: SlgnaNre: Date: OWNER•BUILDER DECLARATIONS: I hereby etfirtn thet under penalry ot perJury ihat I am EXEMPT FROM THE CONTRACTOHS LICENSE LAW tor Ihe following reeson (Sec. 7031.5, Business entl Professlons Code: Any city or county which requires a permit to consWcl, alter, ImD�ove, demolish, or repair any sirucWre, prior to its issuance, elso requlres ihe applir2nt tor such pertnit lo file a aigned statemem thet he or she is licensed pursuent to Ihe prodsions ol the Contractors Llcense Law (Chapter 9(commencing with Section 7000) of DhAsion 3 oi t�e Business end Pmteulons Cotle) or ihet he or she is ezempt therefrom antl t�e besis tor the alleged eaemptlan. Any violetlon of Section 7031.5 by any applicant for e pertr+: subJects the appllcaN to e GWI penelry of not more then flve hundrad tlollero ($500).): ❑ I, es owner ol the pmperry, or my employees wit� wages es Nelr sole compensatlon, WILL DO TME WORK, antl the stmcture Is not Intentled or otFerad tor ule (Sec. 7044, Business end Professions CoOe: The Conirectors License Lew does not appty to an owner of properry who builtls or improves t�ereon, and who does such work himself or herself or through his or her awn employees, proviAed ihat such imprwements era not Intendatl or oNered lor sala. If, however, Ihe building or improvemen� Is sold withln one year of wmpletion, ihe owner-builder will heve the burden of proving that he or she ditl not Duiltl or improve lor purpose ot sale.). ❑ I, es owner of the D�operty, am EXCLUSIVELY CONTRACTING WITFi LICENSED CONTRACTOBS to construct the proJect (Sec. 7044, Business antl Professions Code: The contrectors License Lew does not appy ro en owner ol proparty who Dullds or improves thereon, and who comracts for such projact with a contractor(s) license Dursuant ro t�e Contraaws Licensa Laws.). ❑ 1 em exempt untler sec. Business erW Professions Cotle for this reeson: Slgnature: Da;e: Owner ID veAfietl by Crivers Iicense. ❑ Yes ❑ No Drivefs LJcense No. Expires: Verillcatlon ai Ownerehip by (rype ol tlaumenL i.e. - praperty tex 6ill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFlCATION: ❑ I hereby certity Ihet no excavation frve (5) or more feet In dept� Into which e person Is required to descend, wlll be mede In connectlon wlth work eufhonzeC by Ihis pertnit, entl t�at no building sWcture, swNdtling, lalsawork, or Oemditlon or tlismantling thereof, wlll De more than thlrly-six (36) faet hign. (Chap. 32, Grp 2, An 2, Sec. 347, Tltle 8, Calllornla Adminislretive Code). ❑ As owner-bullder, I will not employ enyone ro da wark which would require e permit from the Divisian ol Industriel Setety, es notetl abova, unless such pereon �as e pertnit lo tlo such work Irom Ihe tliNsion. Signature: Date: DlWsion af IndusMel Sefery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND Al7fHOR¢ATION OF ENRiY: I cenity untler penalry of perjury Ihat I have read ihis epplication end state Ihat the intormation given is correct. I agree to comply with ell stete laws end Gry ordinences relatinq to bulltling constructlon, an0 euthoAze represenietives ot Iha Ciry of Costa Mesa to enter upon the ebove-descnbed property tor inspecGon purposes. I egree noi Io ocapy or ellow occupanry of eny bulltling euthorized by this pertnit until finel inspectlon. �Signature � Lggel Ow�r(s) ,� D te �� i� / 7�M / IS O / i� Antl/Or Authorize0 Applicam Date CODE /. INSGECTIONTYPE �818 Flxed System Final Fire Prevention 7288 200 Paol Spe Final Final Re-Roof 201 Finel BIacWRetaining Wall 202 Final Fectory Fire Place 203 Finel Sign 204 Flnel Demdltlon �jF, � �$,( INSPECTIONTYPE 206 Finel Mechenicel 20B Finel Plumbinp 270 Final Electdcal 212 Flnal Fire Prevenilon 220 Finel Planning Approval 222 Finel Slte 250 Flnel BuIl0ing/Occupenty QAIE It�ELB , CITY OF COSTA MESA avao�N� �ms�oN DEVELOPMENT SERVICES DEPARTMENT PERMIT E98-00627 � PERMIT NUMBER (714) 754-5273 • Fex (714) 754-0856 77 FAIfl DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Percel Nunmber. Applicant: Address: I ,. r i �� Owner: Address 462 E 18TFI ST 11733228 WILSON,'BOB Address: OC 'ti}� �% ,r� � a �� / J� `� r �, � : �__J '' �, � I �AI �A ��. � �-� % 'i �i N.ANI ST CA ' � stams: ISSUED � , /y, �Wr� Applied: O6/25I1998 Issued: O6/251t998 Phone: - �j � ,Zip:,, , _. . - __ �j_�_ . ---�--- -;- _�� ; �.-- -, �" _J � � ;1 � /,,, j`.`'`. �,,\ i '� i. �, ASEYJ i !� �� A�.-� �� , �, � �� =- ' �� Ji ,�� ,�-,� i\ 1 � �� l'� � � � = � // .,, ,Phone,_� - �' �'� C� ��\ � �-,`,'- "Zip:" 92627�� ';A\, �� i �\�A i� �_ - _ SONS �i . uc�enae. - �l� �- .t,.Y - � " ' i ' �• � �S.>� : �-�-, i . '� ` . �.^� � {'�� SCOPE C i TION- )'� �. � - � �� i � i � �- � ��A � / �� \:� ��/ /��\�� \- � � �/ \V�� \ �/\ \ �� \��\�� `� �; � �.: �� , ��,� , ,•, ��_�� ; , ��. � 1; _- � � \'��V`� . . . � � , i � V�� . .. . . � �, i � ��. .. �"�.%�. _ , . � \:. .'� � �. _,- �d�... �_/, • �. _ '�' `�, '`>;,�/ . �, ^ � r -,\ . ` \ . � �� ..��-` - -'- � � / . , � ; �-fEE SUMMARY-� �• � - �� '�. � ' / �� r , � , �. , , . � L.� , Quenii�y _ ..':�..� i�" .� •, a �., Quentl[y ; � i � ISSUE�FEE ,',�� $22.00 TempDistSystem/�Cighting � $0.00 0� , Temp service test' '� 50.00 � r^ ` Busway I100 ft � $0.00 0 � � � Res: a/c package $0.00 � ' � �;�,�� 4-'� ; Sta,nding.Section�,:� � - . 30.00 0 � ' � ` New Res (1-2 units) �• , � •, 50.00 , � 0 -� � Misc�Eletlrieal.Equipment� ` � 50.00 0 �� _ � � Poo�Res(3+units)-� `, , ( $0.00 0'-" � � �'=--"- Transformers'up=to tkva/kw " $0.00 0� �,, � New I Spa �� ', $0.00 , 0 ................up to�10 kva/kw $0.00 0 - `-; , � Lighting Fixts � � ' ^� •� $13.00 ! 13 ....... ;^up.to 50 kva/kw - , $0.00 0 " , " �� ' Recept Ouflats � � ��= � $20.65 , 21 ............-..:.:up,to:100 kva/kw $0.00 �0 �� % �, " / i� �' Switches��. � �. � ��A:�v\ $7.00 7 .......... �......over 100 kva/kw ' $0.00 , �p� ,� � � „ �� Non Res Appl, �,�� .��E4.25 , 1 �' Low,Voltage Equipment �$0.00 %��0 �� /„� Res Appl `� : � A � � � � $0.00 0 ; L'ow VOIt Wiring System / Ckt $O.00i��O ��% �' Service to 200a;� Service to t000a�� Service over 1000a �� Motors to 1 hp � �� Motors to 70hp Motors l0 50hp Motors to 100hp Motors over 100hp Communiwtion drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole ,.c -. - i�, 527.?5 � 1 . � � Misc.�Canduit 30.00i% 0 � . � � 30.00�, 0 �c �,� � Misc. ConduCoi , $0.00� 0 - ,��% � ' ,30.00��=, - 0� r -�, ; �; v �Circus (•gen or,ride) � � �; � -�50.00 , � 0 � � ` ��30.00 ��`��0 ; , �� Circus(mechride;orlights)-.,�' $O.00i--O /�/� � \ �A,- '�. i. �� , r,; ✓�,$000 � 0� � K" >��+ =ChristmaSTreeStand " $0,00 �/ 0 �. , � - � 50.00�� 0; '�� Fireworlis` Stand-� �� -�$0.00 �' � 0�'� . , 50.00 „�0 �� Z-�.�` ,Other_Eledrical�Fee- � =E0.00' � � � �50.00 �/i 0��. -' - _-__ _ . . . � //i'� 50.00 � �0 � / . Investigation Fea ; �- $0 00 �: % $27.25� �7� �/ � �i��- --PIan�Check�Pee a � � $0.00.-' $0.00; � � 0 ��' -: � ,-�Reinspection Fee .`- �� --:;: �$0.00 $0.00 � - 0. _� `-i�.��.,_- _. ., � " ,�i/-; . 30.00 � ' 0 ,; '. ,: -- - * - .,TOTAL CALCUCATED�EEES 5121.40 $0_00 0 � - " .,-_ � ,- ,' -. - COMMENTS / SPECIAL CONDITIONS � EXPIRATION: This perrnit shali automatically expire end become vold if xrork Is not commenced wfthin 180 days, or If woAc is suspended or ebandoned I for a pedod of 180 days. ' INSPECTIONS: In order lor the work aNhorized under lhis permil t0 be Considered legal, such work must comply wlth ell appilcable codes, and all requlred Inepettlons end flnal epprovel must be obtelned. Fellure to obtein inspeclions and final flpproval wlll result In the expiratlon of this permit. FOR INSPECTIONS CALL: (714) 7545828 WOHKERS' COMPENSATION DECLARATION: ' � , , . , I hereby aHirm under penalry o1 pe�jury one ot the lollowing deGaretlons: ' ' � ❑ I �ave entl wlll meintaln e ceNllcete of consent to seN-Insure br workere' compensetlon, as provldeG for by sectlan 3700 of the Lebor Code, lor Ihe peAortnence of �he work br which this pertnil Is issued. 0 I heve entl will mainfaln workers' compensetion inwrar�ce, es requlred by sectiwi 3700 M the Lebor Code, lor Ne pertortnance oi ttre work for whkh this pertrtit iv iawed. My workers' compensetlon Inwrenca mrtler end policy number ere: Certier. ' Policy Number. (ll�ls sectlar neetl nof be oompleted U the permlt ls velued af one hunOredOollers (5100) or less.) ❑ I ceNty Ihet in Ne peAortnance af Ihe work tor wNch this pertnit Is ltwed, 1 ehall not empby eny pereon In eny manner so as to Decane sub�ect to �he workers' compensetion laws o1 Celtlomle, entl epree Uet tl 1 shoultl become suD�ecl to Ne workers' campensetlon proNslons of Section 3700 of the LnEor Code. I shell fanhwlth comD�Y wlth Ihese provisions. � (� � ) AppllceniSlgneture: � lY. /.U� Dele: �L...�/� WARNINO: FN�URE TO SECURE WORKERS' COMPENSATIIXJ ODVEMOE IS UNUWFUL M10 SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENqLTIES M!D GVIL FlNES UP TO ONE HUNORED TIKK1SrWD OOLURE (5100,000), IN AODRION TO TME CW'T OP COMPENSAT1dJ, OMUOES AS PROVI�ED FOR IN SECfION 3108 OF THE L/BOR CODE, INiEREST, AND ATiORNE`fS FEES. UCENSED COMRACTORS OECLARATION: I hereby effirm that I em Iicensed under provisiore of Chepier 9(commendng wlth SecUrn 7000) ot Dlvlslon 3 of the Business and Protessions Code, erW my Ikense Is in tull force entl eRen. LJc. N Class a ConlredofaSigneture: _ _ Dete:_ __ � 1S Q CONSTRUCTION LENDING AGENCY: ❑ I hereby ettirtn Ihat there is e construcUon IenGing egency for tne peAortnance ot the work tor which thls permit is Issued. (Sec. 3097, Civil Code). Lentlefs Neme: LenAefs Atltlress: Signature: Date: OWNER•BUILDER DECLARATIONS: I hereDy aftlrtn �het under penalty o1 per�ury t�at I em EXEMPT FROM THE CONTiiACTORS LICENSE LAW for t�e tollowing reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or counry whic� requlres e permit lo construd, alter, Imprwe, demollsh, or repeir any siructure, prlor to Its iuuance, elso requires ihe applicant tor such pertni� to Ille e signed stetement Nat �e or she Is Ilcensetl pursuant lo iha proWsbru ot 1he Contranors License Lew (C�epter 9(commendng wlih Sectlon 7000) of DMsbn 3 of ihe Business end Professions Cade) or that he or she is exempt tharetrom arM Ne besis tor tha elleged exemptlon. My WdaGon of SecNan 7031.5 by any epplicant for a pertrtit sub�ecLv Ihe epplicent to e Uvll penfllry ot not more than frve hundred ddlara ($500).j: ❑ I, es owner ot Ne D�operty, or my employees wIN wages es Nelr sWe compensetion, WILL DO THE WORK, end the structure Is not Intentled or oHereC fw sale (Sec. 7044, Business and Professions Cotle: Tha Contredors License Lew tloes not appy to en owner of property who bulds ar improves thereon, entl who does such work hlmsett or herself or through hls or �er own employees, proNded thet such impravements ere not IntentleA or ottered tor sale. I1, haweveq t�e building or Improvemen� Is solC within one year of comple�lon, Ihe owner-builder will have the burden ol proving that he or she did not build or improve for purpose of sele.). ❑ I, es owner M the properry. am E%CWSIVELY CONTRACTNC WIiH LICENSED CONTRACTORS lo construct Ne pro�ect (Sec. 7044, Business and Pmtessions Code: The contredors LJcense Lew does not eppy to an owner o1 properry wno bullQs or improves ihereon, end who contrac4s tor such pro�ect wlth e coniraclor(s) Ilcense pursuant to Ne Contrectors IJcense Lsws.). ❑ 1 am exempt under sec. Business end Professlons Catle br Nis reason: Slgneture: Date: O.vner ID verified by drivers license. ❑ Yes ❑ No Drlvefs LJcense No. Expires: Verlticatlon af Owrrership by (rype of tlowmem, i.e. - pmperry tex bill or deeO): DIVISION OF INDUSTRIAL SAFETV PERMR CEHTIFlCATON: ❑ I hereby ceNfy thet no ezcavetion fNe (5) or more teet In depth Into w�lch a person is requlretl to tlescentl, wlll be metle In connection with work euthorized by thb pertnN, end thet no bullding strucNre, ecaXoldinp, tfllsework, or tlemolltlon or dlsmantling Ihereof, wlll be more ihen thirry-six (36) teet hlg�. (C�ap. 32, Grp 2, Art 2, Sec. 341, Title 8, Celifomie Atlminlstretive Code). ❑ As owner-bulider, I will not employ anyone to do work which woultl require e partnil trom Ne Dlvislon of InEustrlel Safery, as notetl above, unless such person hes a permil to do suU work trom the divislon. Slpneture: Dete: DWISion of Intlustrlal Satery Pertni� Number. CERTIFlCATE OF CAMPLUWCE AND AllTHORVJITON OF ENTRV: I certify untler penalty ot per�ury thet I �eve read Uis epplicetion end stete ihet the inlartnetion gfven Is cortect I agree to comply with all stete laws end ciry ordinences releting to building construdion, end euthodze representatives of Ihe Ciry ol Coste Mesa to enter upon t�e ebove-dexAbed properry for Inspection purposes. I egrea not to occupy or ellow occupency oi any bulldinq euthorized by Nis pertnit until linel Inspection. Slgnetur OI Legal Or ne ) Da a �-C_ � . �� 2��4�' AnNOr AUNOAzed Applkant Date CppE I. IMSVEETONTYPE 7878 Fixed System Final Fire Prevenilon 1268 Pool Spe Flnal 200 � Final Re-Roof 201 Flnal Block/Reteining Well 202 Finel Factory Flre Rece 203 Finel Sign 204 , Flnal DemdlUon 241N8 Ddg ItiiID�tS � p00E1 ixsveenoxnve 208 Finel Mochenlcel 20B Flnal Plumbinp 210 Finel Eleddcal 212 Flnel Fire Preventlon 220 Flnel PlanninB Approval >_y� Flnel Site Flnel Bulltling�Occupancy �. i i.uu. .' ♦ � !�': /_��'�: