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Home My WebLink About342 18TH ST - Building Permits, . � . ., . � . ��ia� �sa-s2�s • Fax (714) 754-4856 • www.ci.costa-mesa.��DING PERMIT � . � Job Address: Suite: Viciniry: Primary Occ: Parcel Number: 342 E 18TH ST• • Fj1 XTENSlON iST AND2ND FLOOR R3N1 11725113 Applicant: WARD, DEE Address: 342 E 18TH ST COSTA MESA CA _ �� , Owner: WARD, DONALD D Address 342 E 18TH S7 � Type of CQ[�[�&fk9i P��, EXPIRES_ Phone: Zip: 77 FAIR DRNE, GOS I A MtSA, GA 92626 ` Slatus: ISSUED Applied: 09/08/2005 Issued: 12/292005 714-745-�' 386 CELL ISSUED BY: 92627 Phone: COSTA MESA, Cq . � - ; Zip: 92627 � , X� 1 Contractor:, �-OWNER-BUILDER� ��- � � ' � , . � _� Address[ �" � . . `� , �� , ;i,. i , . , Phone: . - . � � . � , Zip: '-' � , License: 000000 � '%."; , nrch : DENGHAUSEN HOWARD Eng: PETER G TOGHIA Address: PO BOX 11844 • .Address:� TOGHIA CONSTF2UCTION ENGINEERING ' - � � - Phone:;. 9496463667 � �-FOUNTAIN VALLEY CA �}Phone: 7143782855 . ' "Y ;- COSTA MESA, CA � , � \"' -- ', _ 18837 BROOKHURST STREET . ` "i� Zip: �' 92627' " , ,Lioense: 14281-� _ . � � 92708 License: 25297 SCOPE OF PERMIT CONSTRUCT 1843 SF,TWO STORY ADDITION TO EXISTING SFD. 1ST FLOOR ADD IS 458 SF AND NEW 2ND STORY IS 1385 SF. CONSTRUCT 63 ATTACHED GARAGE AND 215 SF COVERED DECKS AT 2ND FLOOR. ALSO INCLUDES REMODEL OF EXISTING 1208 SF SFD. , REF: ZA-OS-006 ` EXISTING 3 BEDROOM 2 BATHROOM SFD TO BE�CONVERTED TO A 4 BEDROOM WITH 5 BATHROOMS FEE SUMMARY ,- Plan Check: $1 410 34 Calc Valuation 53io 000 00 Permit: SMIP Res: `. SMIP Com: � Other: Inspection: Total: $2,169.75 $31.00 $0.00 $0.00 $0.00 $3,611.09 ' Claim Valuation: - $3io,000.00 - `��;,� � --- � _ PLANNING & ZONING - � SETBACKS ��/ . �, � ., � � � MAINSTRUCTURE�Front %0-0 � - � .Rear� 0-0 ,` Left 0-0� _Right �0-0 � � , , ACCESSORY ; � � FronC�' 0-0 � �� Rear, _ 0=0'�-. � _ , Lek 0-0 _ � Right 0.�0 � PARKING Existinq: �0 �� Reaulred: 0 Pr000sed: 0- _ . , � " .. . . . - ' NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) � EXPIRATION: This permit shall automatiqally expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for tha work authorized under this permN to be considered legal, such work must comply with all applicable codes, antl all requlred inspectlona end finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 754-5626 zasas �doo� WORKERS'COMPENSAnON DECLARAnON: . . _ I hereby ettirm under penalry ot perjury one of the following tleclareiions: � � . ❑ I �ave entl will maintein e certificete ot consent to selt-Insure tor workers' compensation, as pmvitletl for by section 3700 of Ihe Lebor Code, br the pedortnance of Ihe work for which ��is pertnit Is issue0. ❑ I have anG will maintain workers' compensa�ion insurance, as requiretl 6y section 3700 0l Ihe LeDor Cotle, lor the perlortnance ol ihe work tor whkh this pertnit is Issued. My workers' wmpensation Insurence carner antl policy number are: Cartier: Policy Numbec ,�This secfion need not be camp/efed i! fhe perm�� Is valuetl et one hundied dollars ($f00) or less.) cenity thet in �he pertortnance of the work br which this pertnit is Issue4 I shall not employ any person in any manner so as to become subject to ihe workers' � ompensatlon lews of Celifomia, end egrae that If I should become sub�ect to the workers' compensation provislons ot Section 3700 ot [he Labor COCe, I shall forthwith omply with these provisions. 4 ��^�� A�PP��9��"'` ate: WAR�TIIdCa'.�FAILURE TO SECURE WOFKERS' CAMPENSATION COVERAGE IS UNUWFUL AND SiNLL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FMES UP TOONE HUNDREO THOUSAND DOLLARE (5100,000), IN ADDITION TO THE �p$7 OF Q7MPENSATION, DPMAGES AS PROVIDED FOR IN SECiION 37080F THE UBOR CWE, INTEREST, AND ATiORNEVS FEES, LICENSED CONTRACTORS DECLARATION: I hereby aHirm that I am licensed under provisions of Chepter 9(commencing with Section 7000) of Division 3 oi Ihe Business antl Professions Code, antl my license is in full torce and eHecL Lic. k Cless x Contracrofs Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby ettirm that there is a construction lentling agency tor the performance of the work for which this permit is issued. (Sec. 3097, Civil Cotle). Lenders Name: Lender's Adtlress: Signawre: Date: OWNER-BUILDER DECLARATIONS: I hereby etflrm thet untler penelty of perjury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe tollowing reason (Sec. 7037.5, Busineu entl Professions Code: Any ciry or counry which requires a pertnil to construc6 alter, improve, tlemolish, or repair any simcture, pnor to its issuance, elso requires t�e applicant for such permil to file e signed statement ihet he or she�is Ilcenged pursuam to the provisions of the Contrectors Llcense Lew (Chepter 9(commencing with Section 7000) ot Divislon 3 ot ihe Business entl Professions Code) oi �hat he or she is exempt therefrom entl the besis tor the elleBetl e:emption. Any violation of Section 7031.5 by any epplicant lor a permit su jects ihe flpplicant to a civil penelty of not more ihan five hundred dollars ($500).): owner of Ihe property, or my employegs wiih wages as Iheir sole compensation, WILL DO THE WORK, ena ihe sWqure Is no� Inlended or oflered tor sale (Sac. ♦ 7044, Business and Pmfessions Code: Th0 Contractors License Law does not appty to en owner of property who builds or improves thereon, and who does such work himself or herselt or through his or her own employees, provitled that such improvements are not intende0 or offeretl for sale. If, however, the building or improvement is sold within one year of completion, the ownar�builder will have ihe burden ot proving ihat he or she tlid noI builtl or improve for purpose of sala.). ' ❑ 1, as owner of f�e pmperty, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct iha project (SecJ044, 8usiness entl Professions Cotle: The contracrore License Lew tloes not epply to en owner oi pmperty who builds or Improves Ihereon, end who coniracls br such project with a contractor(s) license pursuant to the Contractors License Lews.). � F3:Zal Owner ID verifie0 by tlnvers license. Veritication ot Ownership hy (type of and Professions Code tor lhis reason: YeS ❑ No nt, i,e. - prapeny taz bill or tlaetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenity thal no excavetion tive (5) or more feet in tlepih into w�ich a person is requiretl Io descen4 will Ge made in connection with work authonzed by Ihis permii, and Ihat no builtling structure, scafloltling, lalsework, or demoli0on or dismantling ihereoi, will be more than ihirly-siz (36) leet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tlle 8, Calitomia Atlminisiretive Code), ❑ As owner�builder, I will not employ anyonq to tlo work which woultl require e permit trom Ihe Division of Indusirial Setety, es notetl above, unless such person Aas e permit to do such work irom tha tlivision. Signature: Date: Division of Industnel Safery Permit Number: CERTIFICATE OF COMPLIANCE AND AUTHORIZq710N OF EMRY: I certity under penalry ot perjury ihat 1 �ave reatl this eppliwtion and stefe �hat Ihe inFormation given is correct. I agree to comply with all state lews en ity ordinances relating t building consWction, and authorize representatives ot ihe City of Costa Mesa to enter upon the above-descn6ed pr e for inspe �io urp , e� e no occupy o Ilow occupancy ot any building authorized by ihis permit until tinal ins ectio / � -- � S��S'_ Signalur� eg�r er(s)� /� � And/Or Authorized Applicant ' Date CQOE �, INSPECTIONTVPE' 1616 Fixetl SyStem Final Fire Prevention 1266 200 207 202 203 204 Pool Spa Final Finel Re-Raot Finel BtocWReteining Well Final Factory Fire Place . Final Sign Finel Demolition �jf iMrti"�$ � COpE1 INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing � 210 Final Electrical 272 Final Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final Buildina�Occupanc e �,��,.,�.,�,,. - .....�.._,._. .'-- ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: 342 E 18TH ST 11725113 Applicant: WARD, DONALD D Address: 342 E 18TH ST COSTA MESA, CA Owner: WARD, DONALD D Adtlress 342 E 18TH ST � , .COSTA MESA, CA = i " - _ Contractor. OW N ER-BUI LD ER . Address: � i � ;'... .'� _ ., : . �' ��i�� : y'i"d ��a' � h_d PER E�XPIRES_ hone: 714-7� Zip 92627 Phone: � Zip: 92627 Phone: Zip: � � � � License:000000 ' ✓ �-.--� ISSUED BY: t6 . Slatus: ISSUED Applied: 12/292005 �ssued: 12292005 � � /' �• � •' SCOPE OF PERMIT CONSTRUCT 1843 SF TWO STORY ADDITION TO EXISTING SFD AND REMODEL OF EXISTING 1208 SF SFD. CONSTRUCT 636 SF ATTACHED GARAGE. � � REF: BOS-01549 � . . 1 RES AIC PKG, 69 LIGHT FIXTURES, 63 OUTLETS, 62 SWITCHES, 1 SERVICE TO 200A, 7 MOTORS TO 1 HP, 1 SUB PANEL TO 200A, 1 TEMP PWR POLE, ' � ISSUE FEE $23.50 , � Temp service test $0.00 Res. a/c package 554.50 New Res (1-2 units) $0.00 New Res (3+units) $0.00 Pool I Spa . � , $0.00 Lighting Fixts $57.77 Recept Outlets � 553.39 Switches $52.66 Non Res Appl $0.00 Res Appl ., $0.00 Service to 200a - $30.50 Service to 1000a � � j , $0.00� Service over 1000a � , 50.00 Molors to 1hp � . , $33.25 otors to 10hp � - $0.00 Motore to 50hp � , $0.00� Motors to t00hp �, $0.00 � Motors over 100hp � � � $0.00 Communicationdrops �.,$0.00- Sub panel to 200a $30.50 Pole Light Pkg $0.00 Sign Circuits 50.00 7emp Pwr Pole $23.50 Intermed Pole $0.00 Ouantity , , 0 0 0 69 63 62 0 0 1 0 0 7 0 0 0 0 0 1 0 0 1 0 FEE SUMMARY • Temp Dist Syslem I Lighting Busway/100ft , . Standing,Sedion Misc Eleclrical Equipment Trans(ormers up to 1 kvalkw .......'........up l0 10 kvalkw .................up l0 50 kvalkw :................up to 100 kva/kw ..................over 100 kva/kw low Vollage Equipmenl Low Volt Wiring System /,Ckt Misc Conduit � Misc. Condudor Circus ( gen or dde) Cirws (mech ride or lights) Christmas Tree Stand Fireworks Stand " Other Electrical Fee �Investi9ation Fee Plan Check'Fee Reinspeclion Fee Quantiry $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 - 0 $0.00 0 $0.00 0 , $0.00 0 $0.00 0 $0.00 $0.00' so.00 $0.00 TOTAL CALCULATED FEES 5359.57 NOTICE: The work authorized by lhis permit shall comply with all applicable handicap access requirements unde� Califomia statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire antl become void Ii work Is not commenced wlthin 180 days, or if work is suspended or abandoned for a period of 1 BO 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 Inspectlone end final epproval must be obtained. Failure to obtain inspections and finel approval will result in the expiretion of this permi� FOR INSPECTIONS CALL: (714) 7545628 / 2M&a8 (8qp) WORKERS' COMPENSATION DECLARA710N: I hereby aHirm under penalry oi perjury one of the bllowing tledarations: ' . ❑ I heva antl w��l maintain e certificate of consent to selFlnsure for workers' compensetlon, es provided Por by section 3700 0l the Lebor Code, for Ne pertortnance of the I� wark lor whiCh thi5 pertnit i5155uetl. ❑ I heve antl wlll maintain workers' compqn5ati0n insurance, as requiretl by section 3700 0l Ne Lebor Code, tor Iha pertortnence af t�e work br whkh Ihis pertnit is iswetl. My workers' compensation Insurance carrier and policy number are: Carrier: policy Num�er. ,((hls seclbn neeA no! be oampleted i( Ne pertnit is ve7uetl et me huntlretl ddlars ($700) a IessJ �certily Ihat In the pertormence of Ihe wark tor which ihis permit Is issueE, I shell not employ eny person in eny manner so es to become subject to ihe workers' compensation �aws ot Calitomia, end agree t�at ii I should become subiect to the workers' compensation pro�islons ol Sectlon 3700 0l Ihe Lebor Cotle, I shall foMwith c�ompl with t�hese Wsions. '� �l n p Ap I nEa I SlpnaWr9'�' �� I1 . �.U�a � �8t9.^1 �o( �� /'� � v WA INO: FAILURE TO SEIXIRE WORKERS' COMPENSATON COVERAGE IS UNLHWFUL M1D SNALL SUBIECT AN EMPLOVEF TO CRIMINAL PENALTIES AND dVIL FlNES UP TOONE HUN�RED T110USPND OOLURE (5100,OW�, IN AUIXTION TO THE WST OF COMPENSlT1IXJ, OAAMGES �5 PFOVIDED PoR IN SECTION 37060F THE LABOR CODE, IMEREST, ANO ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: � I hereby eHirm Ihat I am licensed under Drovisions ol C�apter 9(commencinp wlth Sectlon 7000) of Division 3 0l Ihe Business end Professions Code, end my license Lq In full force antl eNecl. LiC. N Class M ContrectoYs SlpnaWre: Daie: CONSTRUC710N LENDING AGENCY: ❑ I hereby eflim'i ��at there is a cnnsiructlon lending epenty tor the peAormance of the work tor which this permit is issued. (Sec. 3097, Civil Code). Lender's Neme: Lenders Address: SlgnaWre: Dete: OWNER-BUILDER DECLARATIONS: I hereby efflrtn Ihat untler penalry of perjury thel 1 am E%EMPT FROM 7HE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Buslness entl Protesslons Code: Any ciry or counry which repuires a pertnit t0 construct, alter, improve, demolis�, or repair any slructure, prior to its issuanca, also requires tne epplicanl lor such permit to tile e signetl statement that he or she is licensed pursuant to the provisions af t�e Contrectors ticense Lew (Chapler 9(commencing with Secuon 7000j ot Dlvision 3 at the Business entl Pmfessfons Code) or thai he or she is ezempt therefram anOlhe besis for the ellegetl exemption. Any violetion of Section 7031.5 by any applicant for a pertnit s �ects Ihe ep0��nt to e civil penalry oi not more Ihan tive hundred Collars ($500).): as owner ai the properry, or my employees with wages as thelr sole compensellon, WILL DO THE WORK, antl the structure is not Imentled or oHeretl for sale (Sec. 7044, Busine55 and Protessions Cotle: The Gontractors License Lew tloes not epplY to en owner of properry who builtls or improves ihereon, anC who tloes such work hlmself or herselt or ihrough his or �er own emDloyees, pmvitletl �hat such impmvemems ere not intenAetl or otteretl lor sale. If, �owever, the building or improvement is sold within one year of completion, the ownerbuilder will have the burdan oi proving that he or she did not build or improve br purpose of sale.j. � ❑ I, es owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to wnsiruct the pro�ect (Sac. 7044, Bus��ess and Pmfeulons 'Cotle: 7Te coniracbrs License Lavi does not apply to an owner ot pmpeny who Duilds or Improves thereon, and who contracis for such projeGt with a contractor(s) license pucsu2nt to lhe Contrflctor5 Ucense Lflws.). ❑ lem Owner ID veniied by tlnvefs license. Venficetion oi Owne�ship Dy (type of antl Pmfessions Code for ihis reason: Ves ❑ No i.e. - properry ta�c bill or deetl): � DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby certity Ihat no exwvation INe (5) or more leet in Eepth imo whic� a person is requiretl to descend, will be mede in conneaion with wo�k authodzetl by t�is permit, and tha� �o builEing structure, scaMdding, falsework, or tlemolition or tlismantling Ihereoi, will be more than Ihirty-si: (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle 8, Celifomia AtlministratNe Cotle). � As owner-builder, I will not employ enyone to tlo work which would requlre e pertnit Irom the Division of Indus�rial Sefery, es notetl aDove, unless suc� person has e pertnil to do sVch work from the tlivision. Signawre: Dale: Dlvislon of Intlustrial Safey Pertnit Number: CEHTIFlCATE OF COMPLIANCE AND AUTHORVJITION OF ENTAY: I certify untler penaly of perjury that I have read this application and state tbat the Infortnation given is wrrect. I egree to ply with ell stete I nd ciry or nances rei ng Io builtling wnswction, and authorize representetives ot the Giry ol Costa Mesa to enter upon t�e ebove-tlescnbe� ro ior ins e ion se I gr yno� �o� p^Y or ellow occupency at eny building authonzed by this Dermit until tinel inspection. /`�� -�o� !�-�.9-�� —w�- s� -n,9 a` �re o,:�e0a�.ovme��s>— �Oa�e— AndOr Aut�odzed Applicant Date 400E �. INSPECTIONTYPE 1616 Flzed System Final Fire PrevenUon 1266 Pool Spe Final 200 Finel Re-Rooi 201 FIneI BIaWRetaining Well 202 203 204 Finel Factory Fire Place Final Sign Final Demoftion Q�� $ CODE 1 IN59ECTION iV9E 206 Final Mechanical 20B Finel Plumbing 210 Final Elecirical 212 Finel Fire Preventian 220 Final Planning Appravel 222 Final Site 250 Finel Builtling/Occupancy PAIE ItIIIDE�S (714) 754•5273 • Fa�c (714) 754-4856 • v+ww.ci.costa-mesa.ca.us dob nddress: 342 E 18TH ST Suite No Vcinity: Parcel Number: 11725113 npp�icant WARD, DONALD D Address: 342 E 18TH ST - Owner: Address: ContraGor. Address: WSTA MESA, CA • - WARD, DONALD D -342 E�18TH ST- - - COSTA MESA, OA �` � OWNER-BUILDER MECHANICAL PERMIT i i rnin univo, a.va � n rv�wn, ..n acvcv �l�rg �l\►7��1\ �L�� PER � EXPIRES `� 7� �SSUEDBY: Phone: 71a-745-8386 , �2ip> 92627 � . Phone: Zip: 92627 Status: ISSUED Applied: 72/29/2005 Issued: 12/29f2005 ' Phone: EXr � � z�P: . DA� �O � � -�. � � ' License� 000000 � • ' � � � � • . „ � , \ � SCOPE OF PERMIT CONSTRUCT 1843 SF TWO STORY ADDITION TO EXISTING SFD AND REMODEL OF EXISTING 1208 SF SFD. CONSTRUCT 636 SF ATTACHED GARAGE. REF: BOS-01549 . 2 INST FAU < t00K BTU, 2 FACOTRY FIREPLACES, 1 HOOD W/MECH EXHAUST, 6 VENT FANSISINGLE DUCT- � - - - , . � . � . ISSUE FEE Inst FAU <100 k BTU Ins� FAU�>100 k BTU Repair I Alt CoolingMeat Inst I Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU � Gas Piping �� Fadory Fireplace Hood w/Mech F�chaust . VAV Box Vent Fan / Single DuG � Appliance Fire Dampers � � / � i SmokeDampers`'�V `� - Inst or Relocate Appl Venl � Air Handlers < 10000cfm AirHandlers> 10000dm- . Floor Furnace � � Floor or Suspend Healer . FEE SUMMARY Quantiry $23.50 - � ' ' 529.60 2 - " . _ -_ . $0.00� �0 � - $0.00 0 $0.00 D $0.00 0 $0.00 0 $0.00 0 $21.30 2 $10.65 1 � $0.00 0 , 543.50. - 6, � $0.00 0 �$0.00��,0, . ' $0.00 ,. 0 . � � $0.00�- 0� � � $0.00 , 0 - - � . $0.00 0 $0.00 0 $0.00 0 Repair / Alt Absorbtion Unit � �Repair./Alt Refri'geretion Unit Ventillation System Evaporative Cooler Commercia l I ncineretor Domestic Incinerator Comoressors / Absomtion Svslems , Upto3hp/100k8TU 3To15hp/500kBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers ��Uplo3hp ' 3To15hp 15 to 30 hp _ � 30 to 50 hp Over 50 hp Other Mechanical Fee � Investigation Fee Plan Check Fee , Reinspedion Fee TOTALCALCULATEDFEES Quantiry 50.00 0 so.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 50.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 _ , , 5126.55 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremanis 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 780 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with ell epplicable codes, and all required Inapeetiona end flnel approvel must 6e oCtainetl. Fallure to obtaln inspectlons end final approval will result in the ezpfration ot this permit. FOR INSPECTIONS CALL: (714) 7545828 / zaases(emo) / / WOHKERS'COMPENSATON DECLApATON: 1 t�ereby atfum under pertalty of pe�ury ofre ot the tollowi� tleclacallons: d I heve entl wi�l meintain a cenificate of consent lo sell-Insure tor warkers' compensation, es provitled lor by section 3700 0l ihe lahor CpEe, tor Ne peAortnance oi the work for whk� this permit is issuetl. [] I tievg gM will makfiain xroflcers' compensatlon insurence, as required by section 3700 of t�e Lebor Cotle, for Ne perfortnaiue ol Ne wwk Iw wNch ihiy permit I5 Iswetl. My workers' mmpensatlon Insurance cartler and policy num0er are: Carder. � ' : ! ; . , Policy Number: (Yhis secNon need not be cvrnp/efed i/ t�e pBrmit /s vslued ef wre huntlrBd dollen'($106j oi /ess,j � �I�e�nity Ihat in the pertottnance of the work for which t�is pertnit is �ssueq I shall not employ eny person in any manner so es to become sublec� �a the workers' compensetlon laws at Calilomie, entl eg�ee Ihat If I ahoula Decome sub�ect to Ihe workers' compansatlon provisions at SecNon 3700 at the Lebor Catle, I shell Iorihwllh comply with these provi ' S. . � n gna � - j�g jdl }� . t�c�r � �\�p_��5 i �. - �9 -o.� WPANINO: FNLURE TO SECUPE WORKERS' COMPENSATIdJ CpVEMGE IS UMAWRIL ANO SHp115U8JEGT AN EMPLOYEF:T6 CFIMINqL PENALTIES AND CML FlNES UP TO ONE HUN�RED T/10USMlD DOLLARE (5100,OW�, IN ADDI710N TO THE O0.ST OF GUlAPENSATION, DAMAGES A$ PROVIDED FOR IN SECfION 37060F THE LFBOA CODE, INiEREST, PND ATTORNENS FEES. LICENSED CONTFiACTORS DECLARATION: I hereby aHirtn that 1 am licensetl under provisions of Chepter 9(commendng with Seaion 7000) of Division 3 0l the Businass and Professions Cotle, and my license is in tull fo«e end aHect. Lic. q Class N Ctl��ractors Signeture: Date: CONS7RUCTON LENDING AGENCY: ❑ I �ereby eHirtn that ihere is e consiruction lending egency for the peAormence of t�e work tor which this permit is issued. (Sec. 3097, Civil Cotle). Lentlefs Name: Lendels Atldress: Slgnature: Date: OWNER-BUILDER DECLARATIONS: 1 hereby afllrtn Ihat under penelry ot perjury thet I em E%EMPT FROM THE CONTAACTORS LICENSE LAW for ihe tollowing reeson (Sec. 7031.5, Business entl Protesslons Code: Any ciry or counry whic� requires e pertnit to conswct, alter, impro�e, tlemdish, or re0eir eny s�mcture, prior to Its issuancB, elso reqWres I�e applicant lor such perm�t to lile a slgnetl statement that he ar s�e Is Iicensetl pursuent to Iha provuions oi Ue Contraqoro Llcense Lew (Chapter 9(comme�dng wlih Sectlon 7000) ot OlWsion 3 ot tne Business end Pro�essions Cotle) or Ihat he or she is e:empt therelrom antl the basLv lor the elleged exemption. Any vidation ot Section 7031.5 by eny epplicant for e permit �u lects Ihe epplicant to a civil penalry at not more then five huntlred dallars (3500J.): �1, es owner ot the property, or my employees wlih weges as iheir sde wmpensatlon, WILL DO THE WORK, and Ihe structure Is no� intended or oflered for sala (Sec. 7044, Business erM Protessions Coda: The CoMrectors Licensa Law does not apply to an ownar ot properry who builds or knprwes ihereon, antl who does such work hlmself or hersell w Ihrough his or �er own em0�oyaes, providetl that such improvements ere not Intended or oHered lor sale. If, hawever, Ihe huiltling or improvement is 5old within one year of completion, lhe owner�builder wiil have the burdan ol proving Ihat he or she did not build or improve lor purpose oi sale.). ' ❑ I, as owner of the property, am EXCIUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Businass and Professions Code: The contractors Licanse Lew tloes not epply to an owner of property who bullds or Improves Ihereon, antl who contrects tor such project with a coniractor(s) license pursuant to t�e Contractors Licensa Laws.). ❑ I em exemQt untler sec. �r ID verifietl by drivers lice�se. Ver��catlon ol Ownership by (rype of Business and Professions Code br this reason: Yes ❑ No I.e. - properry tax bill or tleetl): � DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby cenity that no excavetion Ilve (5) or more feet in depth into which a person is required to descentl, will be metle in connectlon with work authodzed by this permit, entl that no builCing structure, scaHolCing, lelsework, or demolition or tlismamling ihereoi, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Ar12, Set. 341. Title 8, Celifomia Atlminisiretive Cotle). ❑ As owner-builder, I will not employ enyone to tlo work w�ich would require a permit Irom Ihe �ivision ol Industrial Safery, as note0 above, unless such person hes e permit to tlo such work fmm Ihe division. Signeture: Dale: Division of Industrial Safery Pertni� Number: CERTFlCATE OF COMPLUWCE AND AUfHORIZATION OF EHTRY: I ceM1iy under penally of perjury lhat I heve read Nis applicatlon and state I�at the informetlon given Is corrB��. I agree to compty with ell state lews end ciry ordinences relating ro builtling constructlon, end euthodze representetives of the Clry ot Costa Mesa ro enter upon the ebove-desc9'�fQ� O,��operry tor ins �on pu�rpo9ses. I egr�° not to occupy or allax occupancy ol eny building euthorized by t�is permcit u.ntil final ins ection. V�'"__� `�'i�d�l�11s= �,�"a`/ 't%� Signalµ�e.Ol�Legal"Owner(s) Oate .s AndOr Authonzed Applicant COUEl, INSPECTIONT7PE 1616 Fixed System Final Fire Preventlon 1286 Pool Spa Final 200 Final Re-Foof 201 Final BIocWRetaining Well F��'L� 203 204 Final Factory Fire Place Final Sign Final Demdition PAIE 1l�LS COOEI �SPECTIONiYPE 206 Final Mechanical 20B Final Plumbing 210 Flnel Electdcal 212 Final Fire Preventlon 220 Final Planning Apprwal 222 Final Site 250 Finel Building/Occupanq PdT� IIiI�L$ (774) 754-5273 • FeX (714) 754-4856 • wvnv.Ci.coste•mesa.Ca.Us � ii rHin univ�, i.w in mwi., a.r. acoco P M IN . � , ,: .lob Address: 342 E 18TH ST ��\�QJ�j',� Status: ISSUED Suite No d' �j' Applied: 12292005 ,�� Issued: 12/29I2005 Viciniry: P [..f� Parcel Nunmber: 11725113 Applicant: WARD, DONALD D Address: 342 E 18TH ST COSTA MESA; CA"-�� Owner: WARD, DONALD D Address 342 E 18TH ST � „ , " ' COSTA MESA, CA . , i , � -, � C o ntra do r: O W N E R-B U I L D E R Address: EXPIRES ° ° - Phone: 714-745-8386 � � ' � Zip: 92627 . . � Phone: � Zip: 92627 ' Phone: Zip: ,` , License: 000000 ISSUED 8Y: � � � SCOPE OF PERMIT � � CONSTRUCT 1&43 SF TWO STORY ADDITION TO EXISTING SFD AND REMODEL OF EXISTING 1208 SF � ' SFD. CONSTRUCT 636 SF ATTACHED GARAGE. . REF: BOS-01549 � � 4 BATHTUBS, 7 ICE CONNECT, 1 DISHWASHER, 1 RAINWATER DRAIN, 4 ROOF DRAINS, 1 GAS OUTLET (1-4), 2 GAS OUTLETS OVER 4, 1 LAUNDRY TUB/WASHER, 1 LANDSCAPE IRRIGATION 1 SEWER CONNECT, 4 SHOWERS, 1 KITCHEN SINK, 1 SERVICE, SINK, 6 WASH BASINS, 5 WATER CLOSETS, 1 WATER HEATER, 1 WATER REPIPE . � .. . , , � /, . AMT ISSUE FEE $23.50 Backtlow irrigation $0.00 Backflow Preventer E0.00 Bathtub ' $39.20 Clarifier Syslem 50.00 Connect (Ice,Soda,etc) $9.80 Dantal Units $0.00 Dishwasher $9.80 Drain, Floor 50.00 � Drein, Rainwater� � 89.80 � Drain, Root �� 539.20 Drinking Fountain , � � , 50.00�. Expansion Tank � 50.00 Gas Earthquake Valve � $0.00 � Gas (1-4 outlets) � $6.15 � Gas (Over 4 outlets) �� $2.20 Gas Repipe $0.00 Gas Service $0.00 Interceptors (Grease, Oil) $0.00 Interceptors (Sand Auto ) 50.00 aTv 0 0 4 0 1 0 1 0 1 . 4 \. 0 0 0 1 z 0 0 0, 0 FEE SUMMARY , AMT Laundry Tub / Washer $9.80 Landscape Irrigation $14.80 P-Trep � $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 SepticTank -� $0.00 . Sewer Cap for Demo $0.00 SewerConneU � $24.65 Sewer Private Line 50.00 , � Shower � , - $3920 Sink, bar - $0.00 � Sink; commercial � $0.00 SinR, Floor � $0.00 - � Sink, kitchen $9.80 Sink, service/mop $9.80 . , Spa (privatej " $0.00 Spa (public) $0.00 � 1 � 0 0 0 0 0 0 1 0 4 0 0 0 1 1 0 0 !:(�MMFhITC / CDF(`.IAI rnunirinue 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 W ater Heater / vent Wa�er Piping (Inst or Rep.) Water Re-pipe Water Service Water Sokener OTHER VIOLATION PIAN CHECK REINSPECTION AMT 30.00 $0.00 50.00 $0.00 50.00 $0.00 $58.80 50.00 50.00 549.00 512.30 50.00 59.80 50.00 $0.00 $0.00 $0.00 50.00 30.00 TOTAL CALCULATED FEES: 5377.60 � 0 0 0 0 0 0 6 0 0 5 1 0 1 0 0 0 NOTICE: The work authonzed by this permit shall comply vnth all appllcable handicap access requirements under California statutes and related regulatlons. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expira and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order lor the work euthorized under thls permit to be considered legal, such work must comply with ell epplicable codes, and ell �equlred Inepectlone end finel epproval must be ohtained. Failure to obtain Inspections and final epprovel wlll result In the ezplratlon ot this permit. FOR INSPECTIONS CALL: (714) 7545628 � zaae-ae �eroo� WpRKERS'COMPENSAnON DECLARAnON: . _ I hereby eHirm under penelry of peRury one of Ue fallowing tleGarations: ❑ I heve entl will meintein a cenilicate ol consent ro selFlnsure Por workers' compensation, es prodtled for by section 3700 oi �he Lebor Cotle, for Ine pertortnance oi the Work tor which thi9 pertnii (5 issued. ❑ I have end wlll malntein workers' compensetion insurence, as required by secUon 3700 of Ihe Lebor Code, for the perto�ance of Ihe work tor wNch Ihis pertnit is issued. My workers' campensation Insurence carcler and pdity numDer ere: Ca��ec notbe Poficy Number: orless.J �/i cenity t�at In Ihe peAortnance of the work �or whic� this permit is iuueQ I shall not employ eny person in eny manner so as to become subject to the workers' r� compensatlon laws of Califomia, and agree thet il I s�ould become sublect to Ihe workers' compensation provisions of Section 3700 ot the Labor Co0e,1 shall foMwith compty with these OroNs' ns. ,�,�� ne��a: �f1m(�1)_ /.c%a �v, oa,a: I 1-- J�9 —O .S� WqRNINO: FFILURE TO SECURE WORKERS' COMPFJ�ISATION pWEqAGE IS UNUWFUL ANO SNM.L SUBJECf AN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNORED TYIOUSAND DOl1ARE (5100,000), IN ADDRION TO THE 005T OF NMPEN54TKXy DAANGES AS PROVIDED FOR IN SECfION 3)OB OF THE LABOq OOOE. INTEFEST, PND ATTORNEI"5 FEES. LICENSED CONTRACTORS DECLARATON: I h9�eby aflirm that I em licensetl under provlsions ot Chapler 8(commencing with Sec�ion 7000) o� Division 3 0l the 8uslness antl Prolessions Cotle, entl my Ilcense is in full force ena enect. uc. a cless a Con��ectofs Signeture: Date: CONSTRUCTION LENDING AGENCV: ❑ I �ereby aflirm that ihere is a construction lentling agency lor ihe pertormanCe ol �ha work lor which this pertnit is issued. (Sec. 3097, Civil Cotle). Lentlefs Name: Lenders Atltlress: � SigPeture: Date: OWNER-BUILDEfl DECLARATIONS: I he�eby eHirtn Ihet under penalry ot perjury Ihat I am E%EMP7 FROM TME CONTFiACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business entl Professions Code: Any ciry or counry whic� requires a pertnit to wnsWct, alter, improve, demolis�, or repair any siruciure, O�or to its issuence, elso requires the epplicant for such permit to flle a signed statemant Ihat he or she Is IicenSed pursuant to the pmvisions ol tha Contrectars License Law (Chapter 9(commencing with Sectlon 7�OOJ of Oivisfon 3 ot Ne Business and Professions Catle) or Ihet ha or sha Is exempt lherefmm and Ihe Desis for the alleged exemption. Any violation ol Sectian 7031.5 by eny appliwnt Por a pertnit u jecis the appllcant to e civil penalry of not more Ihan live hundrad dollars ($500).): �I, es owner ot tha property, or my employees with wages as t�eir sole compensation, WILL DO THE WORK, and the slructure Is not iniendetl or otteratl for sale (Sec. 7044, Business antl Pmfessions Code: The Contractors �cense Lew does not apply Io an owner ol properry who builds or improves Iharean, entl who does such work himselt or herself or �hrough his or �er own employees, provided that such improvemenis are not Intendetl or oflered for sale. If, however, Ihe huilding or improvement is soltl within one year ot completion, Ihe owne�-builder vrill have the burden ot provinq ihat he or s�e did nm build or improve for purpose ot sale.). ' ❑ I, as owner of Iha pmperty, am E%CWSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct ihe pmject (Sec. 7044, Busine55 and Professions Code: The comractars License Law does not eppty to an owner ol pwperry who builds or impmves ihereon, entl who wntracts Por such prqect with a contractoqs) license pursuam to ihe Conirectore License LewsJ. , ❑ lem Owner ID veniied by driver's license, Verifcalion ot Owners�ip by (rype ot eusiness and Professions Coda tor this reason: Yes ❑ No i.e. - property ta: bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICAtiON: ❑ I hereby canity that no axcevetlon tive (5) or more leet in depth imo whiGh e pereon Is requiretl to tlescend, will be made in connectlon wlih work euthorized by Ihis permit, end Ihat no Duilding strucWre, scaHoldinp, falsework, or demolition or dismantl�ng thereof, will be more ihan �hirty-si: (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle B, Calllornia Adminlstretive Cotle). ❑ As owner�builtler, I will not employ enyane to tlo work which would requira e permit Irom the Dlvision ot Intlus�riel Selety, es noted ebove, unless such person has e permit to do such work irom Iha division. SigneNre: Date: Divis�� ol Industrial Selery Pertnil Number: CERY1FlCAiE OF C M LUWCE AND AUfHORIZA710N OF ENfFiY: I ertity untler penalty ol per�ury that I heve read this epplication end staie Net the infortnation given is correFt. I egree t� omp with all state la antl dry orCinances rel g to Euiltling constructlon, end euthodza representatives ot Ihe Ciry of Coste Mesa to enter upon the ebovU-describe r pa for ins se . �o 0 oc � y or alfow occupam.y ot eny buildifg sulhorixetl 6y this rmit until linel Ins / �--�9-0� �-✓��;�a<<s, � And/OrAuthorized Applicent Date GOOE 6 INSPECTONTYPE 1616 FIxeO Sysiem Final Fire Preventian 12fi6 200 201 202 203 204 Pool Spa Final Flnal Re-ROof Final Block/ReWining Well Final Fectory Fire Place Final Sign Final DemdiUon pAg ItIIID�LS FODE� INSPECTIONTYPE 208 � Final Mechanical 20B Finel Plumbing 210 Finel Electricel 212 Finel F�re Preventlon 220 Final P�anning Approval 222 Final S�ta 250 Final Builtling/Occupency QAIE I[�Lfl ��a� �sa-s2�s . Fax ��ia»sa-aess CITY OF COSTA MESA - BUILpING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT Job ndaress: 342 E 18TH ST 5uite: ViCinity: WHOLE HOUSE 8 ATT. GARAGE ParcelNunmber: 11725773 Applicant: MCEUEN, DAVID Adtlress: 2428 NEWPORT BLVD 5 COSTA MESA,CA Owner: LOESER, PHILIP J TR Address' 342 E 18TH ST i, � - � � i , . " � �-' COSTA MESA, CA � /, Cont�acror. THE ROOFING SPECIALISTS ; „Adtlress: 2428 NEWPORT BLVD . 5, : " � � COSTA MESA,CA Zoning: Phone: 949-722-8846 Zip: 92672 Phone: Zip: 92627 Phone: 949-722-8846 NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: O611417999 Issued: 06/74/7999 � ISSUED BY: ' "� , . Zip: '92672 � � ' License: 734068 Arch : , , � Eng: � Address: , . Address: ' Phone: ' - Phone: � � � \ �Zip � � License: Zip: License: � , SCOPE OF PERMIT � TEAR OFF EXISTING SHAKE ROOF. INSTALL 1-LAYER OF 30# FELT & 25 YEAR COMP. SHINGLES (16 S�). � Plan Check: P�rmit: � � SMIP Res: SMIP Com: � Other:. Inspection: � �'•Total: $0.00 $87.25 $0.50 $0.00 $0.00 $0.00 $87.75 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: o NOTES: Rear 0-0 Rear 0- 0 Required: 0 FEE SUMMARY , PLANNING 8 ZONING Lefl 0- 0 Lett 0• 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0• 0 $3,600A0 $3,600.00 NOTICE: Th0 work authorized by this permit shall compty with ell epplirabie handicap access requirements under Califomia statutes am1 related regulations. (Ord. No. 92-28, § 1, 12-21•92) EXPIRATION: This pertnit shall aWomatically expire and become void if work is not commenced within 180 deys, or if work is suspanded or abandoned for e period of 180 deys. INSPECTIONS: In order for the work aulhorized under this pemiit to be cronsidered legel, such work musi comply with all epplicable codes, and ell requlred Insppctlons and finel epproval must be obtained. Failure to obtain inspections end flnal epproval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 i WORKERS' COMPENSA710N DECLARATION: � _ I hereby ettirtn under penalry ot peQury one of Ihe tdlowing tledaretions: ❑ I heve enC wlll maintain e cenificate of consent to seli-Insure tor workers' campensation, as D�oNdetl tor by sectlon 3700 of ihe Labor Code, lor the pertormance oi ihe ` woAc for which Ihis pertnil i5 issued. , ¢ I heve antl will malntain workers' compensatim insurance, as required by section 3700 ot the Lebor Code, lor the peAormance ot the wwk far w�ich Ihis pertnit is issued. � .workers' compensation Insurencep� er endP�{icy number are: ca r ^� q Gerrier. �Z Yt_.�/�/ Pol_cyNumOer'_^�..�—/ "7��^ � OL / (�Rils secfion need not be mp d 1! fhe permltls ve/ueU ef one huntlred dollers (5700) or less.) ❑ I cenity ihat in the eAorm of Ihe rk for ich this permit is Issued, I shall not employ any person in eny mann�l so es t��/// became suD�ect to the workers' compensetlon laws 1 Califo i, and egr a th I oultl become s' t to Ihe workers' compensatlon provisions o�e�Qon 370p Qt ihe Lebor Code, 1 shall torthwith comply with these p 'slon / ( ApplicenlSlgnature: Date: I� I l� � WARNINO:FAILURETOSECUR ^MpEISU WFULANDSWHLSUBIECTANEMPLOVEfiTOCRIMINA�PENALTESAN�GVILFINESUPTOONEHUNORED TIqUSAND00LLARE(5100,0OO�,INADDITIONTOTHECOSTOFCOMPENSATI , AMAGES�jPROVIDEDFORINSECTION37080FTHELABORCODE,IMEREST,ANDATfORNE1^SFEES. LICENSED CONTRACTORS DECLARATION: I hereby eNirtn am Ike unde p sl� torce entl eHec�� wim secuon 7000) or enA Prytess}pns Cotle, antl my Iicense is in full CONSTRUCTION LENDING AGENCV: L. ❑ I hereby ettirtn thet there is a conswction Iending egenry tor Ihe peAormence of the work tor w�ich I�Is Oermit Is issued. (Sec. 3097, Civil Cotle). Lender's Neme: Lenders Adtlreu: SignaNre: OWNER-BUILDER DECLARA710NS: Date: I hereDy aXirtn Ihat under penalry ot perjury Ihai l em EXEMPT FROM TME CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business end Professlons Code: Any ciry or counry which requires e permit to consWct, elter, improve, demolish, or repelr any 5tructure, pdor �o its Issuanca, also requlres Ihe applicant for such permil to lile a slgned stetement �he� he or she is Iicensed pursuent to the provisions oi ihe Conirectore LJcense Lew (Chepter 9(commencing with Seqion 7000) of Dlvislon 3 ot Ihe Business and Proteulons Cotle) or ihet he or s�e Is exempt thereirom enA Ihe besis tor Ihe alleged ezempiion. Any vloleUon ol Sectlon 7031.5 by eny appllcant for e pertnit sub�ects Ihe applicant ta e civil penalry of not more than Ilve hundred dollars (5500).j: ❑ I, es or.ner ot Ihe pmperty, or my employees wiU wages as iheir sde compensation, WILL DO 7HE WORK, end Ihe struccure is not intentletl or ottered for sale (Sec. 7044, Business entl.Professions Code: TTe Coniractors Llcense Lew tloes not eppty to an owner ol property who builds or improves thereon, anA w�o tloes such work himself or hersetl ar through his or her own employees, prodded Nat such improvements are not intentletl or oNered for sele. If, however, the building or improvement is soltl wit�in one year ot completion, the owneo-6uiltler will have ihe burtlen of pmving thet he or she did not builtl or Impmve for purpase of sale.). � I, es owner of the property, am EXCLUSIVELV CON7RAC71NG WI7H LICENSED CONTHACTORS to construct the project (Sec. 7044, Business anG Protesslons Cotle: 71ie wntrectors License Ww does not appty m an owner ot properry who builds or Improves ihareon, end who wntraqs for such project with e contrectoqs) license pursuent to Ihe Contractors License Laws.). ❑ I em exempi under sec. Business and Professions Code for this reason: Signeture: Data: Owner ID verified by drivefs license. ❑ Ves ❑ No Dnvars License No, Ezplres: Venfication af Ownership by (rype oi documeN, i.e. - property tex bill or deed): DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFICATION: ❑ 1 hereDy certly t�at no excavetion tive (5) or more teei In tlepth Into whlch a person Is requlred to descend, wlll be matle In connection wIN work authodzed by Ihis permlt, antl Ihat no DUIICing structure, acaHolding, telsework, or demditlan ar dlsmantlinp thereoi, wlll Oe more than ihirry-six (36) feet high. (Chep. 3.2, Grp 2, An 2, Sec. 341, Title B, Celtlomia Administretive Cade). ❑ As owner-builder, I will not employ anyone Io do work which would require e permit Irom Iha Division ol IntlusMel Sefery, es noted ebove, unless such persan has e permit to do such work Irom Iha division. Signature: Date: Dlvision oi InOusirial Safery Permil Number: CERTIFlCATE OF COMPLJANCE AND AUTHOHVJITION OF EMAV: I ceRily under penalry of per�ury that I have read this application and state that Na Intortnatlon given is conect I egree ply with all state laws end dry ordlnances reletlng ro building consWctlon, entl authodze representatives ol Ihe Clry ot Costa Mesa to enter upon tha ebove-tlescA prope for Insqnellorypurposes. I egree irot lo occupy or allow occupancy of any builtling authorizetl by Nls pertnit until tinal Inspectlon. COOE I. INSPECTIONTYPE 1618 FisBtl Syslem Flnel Flre PrevenNon 1268 Pool Spa Finel 200 Final Re-Roof 201 Flnel 81ak/Reteining Well 202 Final Fectory Flre Place 203 Flnal Sipn 204 Final Demdition 2u&ae QejE ` I�L$ �4�f,! IN9PECTIONTYPE 208 Flnel Mechanicel 208 Flnal Plumbing 210 Final Elecldcel 212 Finel Flre Prevenibn 220 Finel Plenninp Appravel 222 Finel Site 250 Finel Builtling/Occupancy GAIE Itil�Li ' 25683 lOSTA MESA 9UILDING-SAFETY DEPARTMENT P.O. BOl[ 91] GOSTA M69A. CALIPORNIA For Applicanf to Fill In Completely TYP OR PRINT � BUILDINO ADDRESS i I COSTA MESA. CALIFORNIA ■ MAIL Oo SV cirr L o s LIC. NO. �Z� �� NO. SIZE O'Z f 1'\ // I NO.ORBLDO9. � BETBACK LINB PPOM �� q � � R�a� .3�6 0' DESCRIPTION OF WORK B ZE�1N6 I l? X�L� ROOMS STORIE9 � E%TERIORWALLSTIJC COVERINOSIsl� G COVERING USH OF BU ILDING ANo WefRK T[� wF OePFnPurn CITY 0� C;�S i A ME MAY 6 1966 Office Usa Only 2. Z� ( I iuHa1/ I eu��n�e+o� � � k:e�:,..,,,..lj'aR � � t 9 � /�-� .�/- / 3 OVHRNAN6 SHALL BE LESS THAN YARO9APPROVED MAIN BUILDINf3 � DISTANCE BET. MAIN BLDGB. VAR. SF U.B.C.REQUIREMENT) �� VAR�SAPPROVED ACCESSORYBUILDINO DATE 1 HEqEBY �CRNOWLBDpe TN�T 1 XAV6 RBAD TM19 APPLIC�TION TM8 �MOUM eNOWN UNOBR V�LUATION 19 ROp TNC AND BiAiE THAT iN8 ABOVB IB CORRECT AND AQRHE i0 COM. P�AP08! OP 69TABlI8HIN0� A PBHMIT F88 ONLY. PLY WITH �LL CITY OqDINANCBB AND BTATB LAWB R80UU1TIN0 BU�LOINOCON9THUGT14N. VALUATION .R7 o SIONATURE OP PERMIT FEE $ � O PERMI7TE $ � � Q� C/ � � AUTHORIZED AOENT �/NJ/1 ' _ /� .7 �