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Home My WebLink About391 18TH ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 lob Address: 391 E 18TH ST Suite No Vicinity: Parcel Nunmber: 425022�9 Applicant: Address: Owner: ALAN YOUNG 2085 P�.4CENTIA AV STE 4 COSTA MESA, CA LO MENZO, ANTHONY R Address 391 E 18TH ST COSTA MESA, CA PLUMBING PERMIT Phone: (949) 631-3344 Zip: 92627 Phone: - Zip: 92627 Contrector: MICHAEL RAY CLEAVINGER Address: 2085 PLACENTIA AV STE 4 � COSTA MESA, CA Arch / Eng : Address: CHANGE OUT WATER HEATER. Phone: (949) 631-3344 Zip: 92627 License: 594924 Phone: Zip: , . License: i SCOPE OF PERMIT Status: ISSUED Applied: OS/13/2003 Issued: 05/13/2003 - FEE SUMMARY AMT QTY •- � AMT " QTY � AMT QTY ISSUE FEE' � $23.50 - . - Laundry Tub! Washer $0.00 �0 - � � � Sump Pump $0.00 0 BackFlow irrigation $0.00 � 0 Landscape Irrigation $0.00 0' Swimming Pool $0.00 0 BackFlow Preventer� ,$0.00 0� , P-Trap "-$0.00 0 Trap Primer $0.00 0 Bathtub � $0.00 � 0 . � Pressure Regulator � $0.00 0 � Urinal $0.00 0 Clari(er System � � $0.00 0 � Process Piping (per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-0) 50.00 0 Connect pce,Soda,etc) $0.00 0 _ Receptors�� $0.00 0 Vacuum Brkr BkFlow(5+) $0.00 0 DenWl Units $0.00 � 0� � Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher .$0.00 0 - Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer.Connect � $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater 50.00 - 0 Sewer Private Line $0.00 0 Water Closet (Toilet) $0.00 0 Drain, Roof 50.00 0' Shower � $0.00 �0 � � Water Heater / vent $12.30 1 Orinking Fountain $0.00 0 . � Sink, bar $0.00 0� Water Piping (Inst or Rep.) $0.00 0 Expansion Tank 50.00 0 Sink, commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 NO710E: The work aulhorized by this pertnit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 7241-92) EXPIRATION: This pertnfl shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 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 ell required Inspeetlona end final epproval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. POR INSPECTIONS CALL: (714) 7545626 zaaaea la�oo� WpRKERS' COMPENSA710N DECLARATION: � `� I hereby eMirm u�tler penalry of perjury one of ihe tollowing declarations: � � � ❑ I heve antl will maintain a cerlificete of Gonsent to selt-Insure for workers' compensation, es providad for by sactlon 3700 0l the Labor Cotle, for t�e peAormanca of 1he work tor which this pertnit is issued. ❑.. (heve end will maintain workare' compensa0on insurenCe, as requi�ed 6y section 3700 of the Labor Code, for the peAortnence of Iha work for which Ihis permit i5 �ssued. My workers' compensation Insurence carrlerantl policy number are: C�I �'J_ �7 Cerrier: �� C.� 1J � 1� SUR.%.S�i� � Policy Number. (T[]� �i Z� 77 GL"JO \ (Thls section neetl not be compleretl il the pe�mit /s veluetl ef one huntlred dallero ($100) or less.) ' ❑ I certity Ihat in the peAortnance of the work tor which this pertnit is issued, I s�all not amploy any person In eny mannar so es to become subject ta the worke�s' campenseUon laws of Celitoml entl egrae thet Ii I shoultl become suD�ect to the workars' wmpensetion provislons of Sectlon 3700 of Ihe Lebor CoAe, I shall forthwit� comply with these provisi s. h Applicant Signature: Date: � �—' �� ' l / � WpRNING: FNIURE TO SEWR ERS' COMP S ION COVEMG UMAWFUL AND SHAl1 SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND qNl FlNES UP TO ONE HUNDRED THpUSANODOLURE�$t00,000�,INA�DfTIIXJTOTME TOFCOMPEN ION,�AMAGESASPROVIDEDFORINSECTION3]O60PTMELABORCODE,IMEREST,ANDATTORNE`fSFEES. LICENSED CONTRACTORS DECLARATION: I �Breby aflirtn that I am licensed under provisia ioroa e�c anaoc u�. s SG u G'Z.t Con�redofs SlgnaNre: of Chapter 9(commencinq with Sectlon 7000) of Division 3 ot ihe Business an ofessions� tl�ny licens ��ull cless a �� Date: �_�2�=Q CONSTRUCTON LENDING AGENCV: � ` ❑ I �ereDy attirtn that there is a constructio� lending agenty for the peAormence of the work tor which this pertnit is issued. (Sec. 3097, Civil Code). Lendels Neme: Signature: _ Lentlers Address: Date: OWNER-BUILOER DECLARATIONS: � I hereby eHirm that under Oenelty of parjury ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the lollowing reeson (Sec. 7031.5, Business entl Prafesslons Code: Any ciry or counry which requires a pertnit to construct, alter, imDrove, demolish, or repair any structure, prior to its issuance, elso requires the appliwnllor such pertnit to file e signed stetemeN thet he or s�e Is Iicensetl pursuent to tha provislons ol the Contrectors License Lew (Chepter 8(cammencing with Sectlon 7000) ot DIvl5lon 3 oi Ihe Business end Proiessions Code) or thet he or she is exempt tharafrom and the hesis for the alle9ed exemption. Any vloletion of Section 7031.5 �y any epplicant for e pertnit subjects Ihe epplicant to e civil penalry oi not more than five hundred tlollers ($500).); ❑ I, as owner of the properry, or my employees wlth wages as thelr sole compensetion, WILL DO THE WORK, antl ihe siruciura Is not intendetl or oflered tor sela (Sec. 7044, Businass and Prota55ions Code: The Contractor5 Uce�sa law doas nol apph/ to an ow�r oi propeRy who buitds or improves lhereon, afW wtro does such woAc himsell or hersetl or ihmugh his or her own employees, pmvidetl that such improvemenis are not intendetl or oflered tor sala. If, however, t�e building or improvament is sold wit�in one year of completion, the owner�builder will have ihe hurtlen of proving ihat he or she did not build or imprwe for puryose oi sale.). � ❑ 1, as owner of the pwperty, am E%CWSIVELV CON7fiACT1NG WI7H LICENSED CONTRACTORS ta construct the project (Sec. 7044, Business end Professions Code: The Contractors Ucense Lew OoeS nol apply m an owner ol proDetly who �ullds or improves Ihereon, end who contracts for such project with a contractor(s) license pureuant to ihe Coniraciors License Lews.). ❑ I am exempt under sec. Business and Professions Code for this reason: SignaWre: Data: Owner ID verified by tlriver's lice�se. ❑ Y85 ❑ No Driver's License No. Venf�cation of Ownership by (rype oi document, i.e. - property taa bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMITCERTIFICATION: Explres: ❑ I hereby ceAify that no excavation five (5) or more feet in depih into which e person Is required to descend, will be made in connection with work euthorized by this permit, and that no building structure, sceHolding, falsework, or demolition or tlismantling thereof, will be more �hen thirry-si: (36) teet high. (Chap.3.2, Grp 2, Atl 2, Sec. 34t, Title B, Catifomla Adminisiretive CoUe). ❑ As owneo-buildar, I will not employ enyone to da wark which would require a permit from Ihe Division ot Indusirial Sefery, es noted ebave, unless such pereon has a permit to do such work from ihe divisian. SigneWre: Date: DivlS�on of Industnal Safery Permit Numbar: CER7IFlCATE OF COMPLIANCE AND AUTHORIZATON OF ENTAY: I cenity under penalry of perjury ihet I heve read this application end state ihat t�e information given is corr6ct. I agree Io �mply with ell stale laws an0 ciry ortlinances relating to building conswction, entl euthodze represenia�ives ot �he Clry of Costa Mesa to enter upon the ebove-descnbed property for inspection purpases. I egree not to acupy or a�low occupency ot any building authonzed by Ihis pertnit until final inspection. f�Qpj�, INSPECTIO�LTVPE 1616 Fixetl System Final Fire Preven�ion 1266 Pool Spe Final ppp Final Re-floof 207 Final BIxk7Re[eining W 611 ppp Final Facrory Fire Place pp3 Final Sign 204 Final Demolition aeie u�.S �- � � rD Date� CODEI INSPECTIONTYGE � 206 Final Mechenical 208 Finel Plumbing 210 Fine� Electncal 272 Fina1 Flre Pravention 220 Final Planning Approval 222 Final Site 250 Finel Building/Occupency �7.11�IIIu17149 -1�1-C�3 �