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HomeMy WebLinkAbout2518 ELDEN AVE - Building Permits n w CITY OF COSTA MESA `o "4 4 BUILDING DIVISION Fk :t� 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)7544856 • www.ci.costa-mesa.ca.us l IAA FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: P10-00089 PERMIT TYPE PLUM STATUS: ISSUED • APN: 93668001 DATE ISSUED: 06/28/2010 ISSUED BY: CAC JOB ADDRESS: 2518 8001 ELDEN AV CM Suite/Unit: B001 Vicinity: SCOPE OF WORK: REPLACE WATER HEATER AT THE SAME LOACTION 2BND STORY CLOSET. OWNER: LEANNE CALBUTT Address: 2518•ELDEN AVE#B-1 PHONE: City/State/Zip: COSTA MESA,CA APPLICANT: JOE ELLIS Address: 3801 LENAWEE AVE : PHONE: 310-838-0408 X120 City/State/zZip: CULVER CITY,CA CONTRACTOR: ORANGE CO SVS INC DBA GEORGE BRAZIL PLU License No. 679898 ' 0-00089 Address: 3801 LENAWEE AVE PHONE: 310-838-0408 X120 City/State: CULVER CITY,CA ZipCode: 90232 CELL: T: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: $0.00 PERMIT FEE: $35.80 TOTAL FEES: $35.80 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit, CODE I. INSPECTION TYPE pilg INmfAL$ PORE/ INSPECTION TYPE DATE INTITIAI$ 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 7-c93-10 L � hX HM (Art) 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall _ 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site ` 204 Final Demolition _ 250 Final Building/Occupancy N n WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver a license. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Drivers License No. .Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the rmance of the work for which this permit is issued. o tI have and will maintain workers'compensation insurance, as required by to 3700 of the Labor Code,for the performance of the work for which this ' DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a CM: re: ^/��j// person is required to descend,will be made in connection with work authorized Carrier •tetr,P 6'.( /f e, Y r I/ �/S • by this permit,and that no building structure,scaffolding,falsework,a demolition ' C or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp ntr naednot be�� the permit[ .S urbredaxars(srao)rKss.) 2.An2,Sec.341,1111e 8,California Administrative Code). Poliy� r !/ J ❑ As owner-builder, I will not employ anyone to do work which would O I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compen do I.ws of -lifomia, and agree that if I should become s •'-r.t to the . .ens.tion provisions of Section 3700 of Applicants Signature Date the Lobo* I�• �omply • th these provi 'ons. •W'/ — Division of Industrial Safety Permit Number: /isi, .�.4.r/rt. i -- —S —Ap. core r D.te HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE ORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons.or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with tion 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file liven is i full force a d -I ec ,(� a registration form for acutely hazardous materials? 0 Yes 0 No • I� r. (� I (Section 25533 of the California Health and Safety Code, with some��//r�� exceptions, requires registration with the Costa Mesa Fire Department by a ie 411. each business which at any one time has on hand a quantity of acutely aT?Ti?Signature for -te hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGEN Y: temperature and pressure). O I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work fa which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the Califomia OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2fu of the nliaornia Government not Cotld requires nthe requested tl ct he or she iselr 9(cd pursuant to the provisions 000 of the Contractorsthe information be furnished on applications fa non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation. WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). i completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all slate laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Cafe for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until fin.l inspection. ,. a `e ate Signature Date9/ 14--2-15 ib 3057-46(3107) Andlar' innzed.'.IlWnt hate CITY OF COSTA MESA "` rt BUILDING DIVISION t a t°; :,lwww.ci.c,osta-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • w.ci.costa-mesa.ca.us e, -/ FOR INSPECTIONS CALL:(714)754-5626 %+.,come`° 9 PERMIT NUMBER: E08-00360 PERMIT TYPE ELECS��ra! STATUS: ISSUED APN: 93668005 9ADATE ISSUED: 09/15/2008 .• ISSUED BY: RMD JOB ADDRESS: 2518 C002 ELDEN AV CM ` , Suite/Unit:- `•, •C002 Vicinity: . SCOPE OF WORK: REVISION TO PERMIT ON99l22/08 TO INCLUDE 9 GFIS. . . - - SERVICE PANEL UPGRADE TO TO"200 A FOR UNIT C002. OKAY PER RR-PLANNING, NO CHANGES TO BOX. , OWNER: BAILEY,ANNICAMILLE • - - Address: 2518 ELDEN AVE#C2-Unit: ' PHONE: - City/State/Zip:, COSTA MESA,CA •. - - • APPLICANT: GURROLA, RICK .i.;i Address: Unit: • ,: , PHONE: 800660-8072 . City/State/zZip: CONTRACTOR: POWELL ELECTRIC CONTRACTORS License No. 631836 ' Address: 5625 W.WASHINGTON BLVD.Unit: PHONE: 800 660-8076 City/State: LOS ANGELES,CA ZipCode:_90016 CELL: ELECTRICAL PERMIT FEES . Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $63.90 - Reinspection Fee .. $0.00 - , - . TOTAL FEES . $63.90 • • • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. . INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE S ItptIwC, N Tyef, M INTIMI CODE! INSPECTION TYPE PAM INmuLS 1616 Fixed System Final Fire Prevention 208 Final Mechanical 1286 Pool Spa Final 208 Final Plumbing 200 Final Re-Ropf 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy _ I 1 WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive..license. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownershi compensation, as provided for by section 3700 of the Labor Code, for the P b Y(type of document,i.e.-property tax bill or deed); performance of the work for which this permit Is issued. . • ❑ I have and will maintain workers'compensation insurance,as required by DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ' section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers' compensation Insurance carder and policy ❑ I hereby certify that no excavation five(5)or more feet iri depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier. C♦I Al\7,S.S �N _ or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm (This section need not be competed if the permit is valued at one hundred dollars($100)a less.) 2,Art 2Sec.341,Title 8,California Administrative Code). 1 Policy:Number: 23 ocu3 36nif -ock ' ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.I to the wo -rs' compensation laws of California, and agree that if I should I become•ct to the .• e 'compensation provisions of Section 3700 of the Labo e, shal orthwith comply with these provisions. Applicant's Signature Date Division of Industrial Safety Permit Number: '-Applicant'e.gnature L le- HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE Ts SCURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greaterlthan a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons, or 200 cubic feet oflcompressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant aor future building0 occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes 0 No ILIC#' Op G-I /k.? Class#c °d —/O (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by - -- 9- 1-7,.-OK each business which al any one time has on hand a quantity of acutely Contractor's 517 .cure Date- - hazardous materials equal to or greater than a weight of 500 pounds. or a volume of 55 gallons, or 200 cubic feet of compressed gas al standard CONSTRUCTION LENDING AGENCY: temperature and pressure). o I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes 9 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 1 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes I ❑ No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occdpant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes '0 No issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors (Section 65850.2 of the California Govemment Code requires that the requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits). Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 1 ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). I ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by Califomia License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 1 0 No thereon,and who does such work himself or herself or through his or her own • 8. (If yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion. the owner-builder will have the burden of proving that he or she ' 'CERTIFICATE OF COMPLIANCE: I certify that under penalty•of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and city Ordinances regarding Hazardous Materials and Emissions. ❑ I. as owner of the property, am EXCLUSIVELY CONTRACTING WITH , LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature ' Date ' property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION•OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ am exempt under sec. the information given is correct. I agree to comply with all state,laws and city ordinances relating to building construction. and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building • authorizeedd by this permit until final inspection. • S,prtature ,Legal ar(s) •i - Signature Date z rl/�� o .- 27 �Q(/ 305]<fi(3lp]) ✓An orA honed Apperant tr-Dater • -• CITY OF COSTA MESA BUILDING DIVISION i° �y� 1 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us mr FOR INSPECTIONS CALL:(714)754.5626 PERMIT NUMBER: E08-00360 PERMIT TYPE ELEC STATUS: ISSUED APN: 93668005 _ DATE ISSUED: 09/15/2008 _ ISSUED BY: RMD rrt- JOB ADDRESS: 2518 C002 ELDEN AV CM • Suite/Unit: C002 Vicinity: - SCOPE OF WORK: SERVICE PANEL.UPGRADE TO TO 200 A FOR UNIT C002.OKAY PER RR-PLANNING, NO CHANGES TO BOX. • ,4J - OWNER: BAILEY,ANN CAMILLE' Vtddress: 2518 ELDEN AVE#C2- Uhit:• PHONE: -';,/ .:- -- - City/State/Zip: ? COSTA MESA;,CA APPLICANT: GURROLA,;RICK Address - ,: Unit PHONE: 800 660.8072 `J� t yJr- - City/State/zip: - a ,• CONTRACTOR: POWELL ELECTRIC CONTRACTORS, W ,.., .License No. 631836., Address: 5625,W.WASHINGTON"BLVD.Unit • .;`;'1,' "••--PHONE: 800 660-8076 City/State: LOS ANGELES,CA, ZipCode: 90016 - -- CELL . . • ELECTRICAL PERMIT FEES Electrical Plan Check Fee:, . ..•. $0.00 - Electrical Permit Fee: $54.00 . , Reinspection Fee TOTAL FEES • , $54.00 H • • • •• NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE INSPECTION TYPE OSTS INTMALs CODE r INSPECTION TYPE PATE INITAl$ 1816 Fixed System Final Fire Prevention 206 Final Mechanical 1286 Pool Spa Final 208 Final Plumbing ' 200 Final Re-Root 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention ' 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy • WORKERS'COMPENSATION DECLARATION: - , . - Owner ID verified by driver,.,cense. ❑Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: . 1:1 I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the , performance of the work for which this permit is Issued. ❑ I have and will maintain workers'compensation insurance,as required by DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code,for the performance of the work for which this •- . permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized Cartier: Cy T!lg S s -�� S by this permit,and that no building structure,scaffolding,falsework,a demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp - --(This section need not he comDieted ithe permit is valued at one hundred dollars(P )or less) 2,Art 2,Sec.341,Title B,California Administrative Code). Policy Number: 33 004 5 3(o O p -64K i I 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should , • becom . lett to t workers'compensation provisions of Section 3700 of Applicant's Signature Date the L.. •..e,I all fo hwith comply with these provisions. ' C-_ ^A A 9-1c-or' Division of Industrial Safety Permit Number: Appr ml's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater'than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds.or a volume of 55 gallons.or 200 cubic feet of,compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). 1 with Section 7000)of Division 3 of the Business and Professions Code. and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and/effect. /� a registration form for acutely hazardous materials? ❑Yes ❑No Lic.# ( 3 ah Class# - tom-/U (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by ti.. AL_ A A— /,/C----"'.... q-/ ) -op each business which at any one time has on hand a quantity of acutely Contrac Signature ,Date hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed 'gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affum that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 1:1Yes 0 No Lender's Address: (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation„certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date I 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes I 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No applicant forapermit the applicant to a civil penaltyof not more than PPsubjectspp (If"yes”, the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I. as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management''DisMct or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes I ❑No thereon,and who does such work himself or herself or through his or her own ' employees, provided that such improvements are not intended or offered for 8. (If"yes-, attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she' CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). - information given above is correct. I agree to comply.with all state laws and city ordinances regarding Hazardous Materials and Emissions! • ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH . LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND.AUTHORIZATION 10F ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building • authorized by this permit until final inspection. . - Signature ego^lTunez(S) Signature Date /fes (� -7 Date 3057-46(3107) (— AndlocAut ized Apperant • Dale , ,4111 'f9 CITY OF COSTA MESA . 4 BUILDING DIVISION > l- Ali DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER S PERMIT 4tbitroI • E05-00354 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2518 ELDEN AV Status: ISSUED Suite No Applied: 04/22/2005 Vicinity: Issued: 04/22/2005 Parcel Nunmber: 93668004 Applicant: HEHN, STEVEN ISSUED BY: Address: 2518 ELDEN AVE#B-1.-- �C"' _ _ -. _ . Phone: 949 720-6345 , COSTA MESA;CA - - Zip 92627-1301 / Owner HEHN, STEVEN'. . - Address 2518 ELDEN AVE#B-1 . Phone: COSTA MESA,CA Zip: 92627-1301 . Contractor: • Address: ' , '- - - Phone: Zip: License: SCOPE OF PERMIT NEW ELECT.Q EXIST.GARAGE;REMOVE 1 OUTLET,ADD.6 NEW OUTLETS&5 FIXTURES. 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(1-2 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 to 10 kva/kw _ $0.00 0- ' Lighting Fixts , $5.50 5 --- • up to 50 kva/kw $0.00 0 Recept Outlets $6.60 6 ' -up to 100 kva/kw $0.00 0 Switches ' '.$0.00 0 over 100 kva/kw $0.00 . 0 Non Res Appl $0.00 - - 0 Low Voltage Equipment'- - $0.00 0 Res Appl $0.00 0' Low Volt Wiring System/Ckt , $0.00 0 Service to 200a $0.00 ' 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 '0 Misc.Conductor $0.00 ' 0 ' Service over 1000a $0.00 0 Circus(gen or ride) . $0.00 0 Motors to 1hp $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 N, $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 $35.60 • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days,or if work is suspended or abandoned fora 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 Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2448-46(8/00) • DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: • (This section need not be completed if the permit is valued of one hundred dollars($100)or less.) i ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to'the workers' compensation laws of California,end agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. I Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($110,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: ' I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.a Class a Contractor's Signature: Date: • CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). ' Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: • I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of DMsion 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subje s the applicant toe civil penalty of not more than five hundred dollars($500).): F s owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044.Business and Professions Code:The Contractors License Law does not apply to an ownor of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). . ,jsk I,as owner of the property,am EXCLUSIV LV CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The canto ctors License Law di=s (•t .ppty to an owner of property who builds or Improves thereon,and who contracts for such project with a contractors) license pursue to the A. trr t• s L' ens; :ws.). I am exempt de,J. Business and Professions Code for this reason: si' ature: `i�7�ei/1I///1/II • Eplrsali: Verification of• nership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2:Grp 2,Art 2.Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: • Division of Industrial Safety Permit Number: • HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: ' I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions.that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds.or a volume of 55 gallons. or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No • (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application a ermit for such construction or modification 0 from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits), 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). I CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and,city ordinances regarding Hazardous Materials and Emissions. I Signature: Date: I CERTIFICATE OF COMPLIANC AND ' O• , • ON •F -Y: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply wit all st: = IY'4. J C or. nanes relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for'•�': ,r s. agr-.a oto• .py or allow occupancy of any building authorized by this permit until,final in pection. ft ifiirirligI y��ti•rrI r a gnature• ego Owner(s) at And/Or Authorized Applicant Date • CODE I INSPECTIONTYPF DAIS INTtTIALS CODE. INSPECTION TYPE QAIE tQQIAli 1618 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing (� 200 Final Re-Roof 210 Final Electrical 40'/ /a . ' K_ �'J1�FIt�w�- 201 Final Block/Retaining Wall 212 Final Fire Prevention P 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy . • CITY OF COSTA MESA - Crpoi:244:terapprola„,‘...„•..bmirreci BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT k. B03-00641 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesaLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2518 ELDEN AV Status: ISSUED * Suite: C001 Applied: 04/17/2003 Vicinity: Issued: 04/17/2003 Parcel Number: 93668006 Zoning: Applicant: MAROVISH, ERIC J AND KUSHNER, JULIETTE ISSUED BY: Address: 2518 ELDEN AV C001 Phone: 949466-7460 COSTA MESA,CA Zip: 92627 Owner: MAROVISH, ERIC J AND KUSHNER, JULIETTE , Address 2518 ELDEN AV _ C001- - Phone: COSTA MESA,CA Zip: 92627 eaContractor: I A Address: Phone: Zip: . License: Arch : Eng: ._Address: - Address: • s Phone: • Phone: Zip: License: License: SCOPE OF:PERMIT REMOVE TWO WALLS TO OPEN UP KITCHEN AREA AND CREATE A BAR/ISLAND AREA: FEE SUMMARY Plan Check: $54.11 • Calc Valuation: $3,000.00 Permit: $83.25 Claim Valuation: $3,000.00 SMIP Res: $0.50 ,SMIP Corn: $0.00 Other: $0.00 • Inspection: $0.00 • Total: $137.86 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existinq: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related • regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(&W) DECLARATIONS . WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty Of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to sell-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. * i ❑ I have and will maintain Workers'compen ion Insurance,as required b-y section 3700 of the Labor Code,for the performance of the wQk for which this permit is issued. My workers'fix atlon Insur e der and policy number are: 0 Carder: Policy Number: his section need net be complete if the permit Is value.at one hundred dollars($100)or less.) certify that I erformance of the wo .I• this.:. it is issued,I shall not employ any person in any manner so as to b come subject toithe workers' compensatlo ,. . ....a ,'• :gr.:. • I should ben me subject to the workers'compensation provisions of Section 3 0 of the Lep or Code,I shall forthwith i�-••• atu : _ Date: T ) WARNING:F„ RE TO SECURE WORKERS'"•• PENSAHON COVERAGE IS UNLAWFUL AND SHALL SUBJECT Mt EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND LIOLLARE($100,000),IN ADDfTION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE,INTEREST.AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Lie.ft Class A Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Buslriess and Professions Code:My city or countywhich requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement,that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions,Code)or,that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civi{`penalty of not more than five hundred dollars(5500).): ❑ I,es owner.of the property,of my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:Jhe Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or-through his or her owremployees,provided that such improvements are not Intended or offered for sale.11,however,the building or Improvement is within one year of completion;the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). I,as owner of the property,am EXCLUSIV LY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law d.: of apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors , se Laws.). ❑ I am ,.et u •:-,, ,.^ .y, �_ Business and Professions Code for this reason: / /��''� Sig...ore - Date: 54/ �/,J1 / / _ J Owner I a verified by drivers livens:. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): ri'• • DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: • — ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ) ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unlesssuch person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: I • • HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes LJ No I (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one lime during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,ore volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). F 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No I (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and'.filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication agennit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes L-I No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). i 7 if a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No I 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).— CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANC• '• AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply wi ' +- , •.d city ordinances relating to building construction,and authorize representatives of the City of Costa Masai()enter upon the .e. •w_�;- _• • .• .Dees.I agree not to occupy or allow occupancy of any building authoriz �iis permit untilfinal inspection. /~/ [/ Signature Of Legal Owner(s) • Da ' And/Or Authorized Applicant Date • PODS 1 INSPECTION TYPE PATE =AO CODE I INSPECTIQN TYPE PATE INTITIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical . 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof _ 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 9 CITY OF COSTA MESA BUILDING DIVISION :9-t DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4 PERMIT E03-00357 ilbePoRmito°c (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2518 ELDEN AV Status: ISSUED Suite No C001 Applied: 05/07/2003 Vicinity: KITCHEN Issued: 05/07/2003 Parcel Nunmber: 93668006 Applicant: MAROVISH, ERIC J - ISSUED BY: Address: 2518 ELDEN AV - - - - C001 - Phone: 949-466-7460 COSTA MESA,CA Zip: 92627 Owner: MAROVISH, ERIC J AND KUSHNER, JULIETCE Address 2518 ELDEN AV C001 - ' Phone: COSTA MESA,CA Zip: 92627 '40: oil, Contractor: OWNER-BUILDER 1, 19 ° ' Address: • _--Phone: Zip: -- . License: 000000 • . SCOPE OF PERMIT , ELEC PERMIT IN CONJUNCTION WITH REMOVAL OF TWO WALLS TO'OPENUP KITCHEN AREA AND CREATE A BAR/ISLAND AREA. - - -.. - .- - . . 7 LIGHT FIXTURES,2 OUTLETS,3 SWITCHES REF:603-00641 ' 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(1-2 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 to 10 kva/kw $0.00 0 Lighting Fixts $7.70 - 7 up to 50 kva/kw $0.00 0 Recept Outlets $2.20 2 up to 100 kva/kw $0.00 0 Switches $3.30 3 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0. Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 - Misc.Conduit $0.00 0 Service to 1000a $0.00 0 , Misc.Conductor $0.00 0 Service over 1000a $0.00 0 - Circus(gen Or ride) $0.00 0 Motors to 1hp $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 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or If work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: • I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed If the permit is valued at on:h0hUred dollars($100)or less.) I ❑ r Ify that'• = :: orman : • .: ^.rk for whic is•:•:• 'ssued,I shall not employ any person in any manner so as t ecome subject to the workers' compensation a' - - : omia,an :g • :ct to the workers'compensation provisions of Secti 3700 the Labor Code,I shall forthwith comply wi• :se pro -- `r Applicant Silo nrse Date: n 7.). WARNING:ter RE TO SECURE WORKERS'COMPENS TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO GRIM! PE TIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Uc.# Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ "I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than Live hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or thiough,his.or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or Improvement is s thin one year of'completlon;the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). yrr E, •I,as owner of Ira property, L w does'- ONTRACTINGanownerWITH LICENSED CONTRACTORS tor ,and the nt (Sec.7044,Business isand Professions Code:Thecontractorsto the License Law does :•• .. to an owner of property who builds or improves thereon, who contracts for such project with a contractor(s) license• rsuant to the Contractors Li•= ❑ I a - : / •ass and Professions Code for this reason: Sign-.• • as I Owner ID verified by driver's license ❑Ya's C7 ■ to Driver's License No. " Expires: V.241aA. Verification of Ownership by(type• document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No I (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (if"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No 8 (if"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: ICATE OF COMPLIANCE AND, ,r'•; : •s. •F ENTRY:I certify under penalty of perjury that I have read this application and st that the information given is c• I a. - . •.ly with , s••aws and city ordinance dating to building construction,and authorize representatives of the City Costa M to enter upon the - .:. . .1), for:17 • • •-:: . ee not to oc-upy or allow occupancy of any building authorized by this permit un inspectio . 5'.. ature Of Legal Owner(s) ate / And/Or Authorized Applicant Date CODE I INSPECTION TYPE PATE i imaL5 CODE! IN$PECTIONTYPF DATE Its 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention I 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 1 ) w i CITY OF COSTA MESA ' '4 ' 9 BUILDING DIVISION ). %1 c.Y r. .#440, . , % F t 4.:...., DEVELOPMENT SERVICES DEPARTMENT pERM1T NUMBER t• ' !ti PERMIT 41tb#Poom am0� B01-00664 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2518 ELDEN AV Status: ISSUED Suite: Applied: 05/10/2001 Vicinity: 3-UNIT APARTMENT BUILDING Issued: 05/10/2001 Parcel Number: 93668001 Zoning: Applicant: HANAWALT, STEVE ISSUED BY: Address: 5017 N SUNFLOWER AVE - - - Phone: (626)914-4290 COVINA,CA • Zip: 91724 ' Owner: CHEW, THOMAS J i Address 2518 ELDEN AVE#A-1 CPhone: - /) 1 COSTA MESA,CA Zip: 92627 /� Contractor: RANCHO ROOFING *ty../0) ',Address: 5017 N SUNFLOWER AVE / .11-1)4Q)2144) / Phone: (626)914-4290 Zip: 91724 COVINA,CA License: 602655 I 'EX, Ea v A 1 Arch : Eng: k, V Address: Address: -/ i Phone: - PE' .c-: Zip: License: . '[YP1DES . - SCOPE OF PERMIT. ' ' • GA f� - REROOF EXISTING 3-UNIT APARTMENT BUILDING(65 SQ).TEAR OFF EXISTING WOOD SHAKES&RESHEATH WITH . 7/16"OSB. INSTALL 30#ASTM FELT UNDERLAYMENT&REROOF WITH ELK 30 YEAR COMPOSITION SHINGLES. ' _. .FEESUMMARY, _ Plan Check: $0.00 -Calc Valuation: I sio,0oo.o0 Permit: $181.25 Claim Valuation: sio,00o.00 SMIP Res: $1.00 SMIP Com: $0.00 Other , $0.00 = ' Inspection: $0.00 x' , ' Total: $182.25 i ,. Jam • /%; _ �-- ' PLANNING'S ZONING -r ' %' /, SETBACKS , ' - ��_ MAIN STRUCTURE Front' 0-0' Rear 0-0 Left 06-0 Right 0-'0-- - _ . _. ACCESSORY Front' _0.0 , Rear 0-0 'left • 0-0- "))i Right 50+0 �� -, % . PARKING Existinq: 0 -Required: �0 �- Proposed:✓ 0 "---"!. NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 . 2448-48(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: 41. I hereby affirmtinder penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the ork for which this permit Is Issued. I have and will maintain w rkers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which This permit is Issued. ' -My workerr$�',�c,�oo/fJ�Ipensa n Insu rice carrier and policy number are: Carrier_ /1/1( Policy iJuinber. VOQJ7c3 '-(This section need not be ompleted if the permit is valued at one hundred dollars($100)or less.) • ❑ I certify that in the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California end agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisi Applicant Signature: .— '--fin (-Date: -- S— ' O— b e (WARNING:.FAILURE SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(St W,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.,Licra-� 4702 Co Sr- Class s C" -3 / Conue otoYsSignature:-` - 'Date: - j--. O —CSR CONSTRUCTION LENDING AGENCY: i ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that underpenelty,of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement thet'he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of DMsion 3 of the Business and Professions Code)-or that ho orrshe Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more Ulan five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors license Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her Own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant'to the Contractors license Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: DMsion of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 WIII the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every - business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .._ _ _._ il..._...r_._ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). I 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No I 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? IQI Yes ❑No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No � 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa[Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. gnature Of Legal Owner(s) Date _ e— o ! And/Or uthodzed Applicant (Date- I J CODE A INSPECTION TYPE PdIE INTITIALS yODEI IBSPECTION TYPF p9IE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof .10 ate- 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention I 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy ' CITY OF COSTA MESA Orae , . ^- BUILDING DIVISION e r- 1 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT ° E01-00984 , (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2518 ELDEN AV Status: ISSUED Suite No B002 Applied: 11/21/2001 Vicinity: RIGHT SIDE OF DWELLING Issued: 11/21/2001 Parcel Nunmber: 93668003 Applicant: CHRISTIANSEN, KATHRYN A ISSUED BY: Address: 2518 ELDEN AVE B-2 "„.:,712(.../ - Phone:. 949-646-0442 7- '7> ; COSTA MESA;.CA - Zip: 92627 _ - .. - r i N Owner /CHRISTIANSEN' KATHRYN A Address -2518 ELDEN AVE-" -•- - - - ' , . - - i ' B-2� �,.= Phone: � . . . . COSTA MESA,CA" Zip: 92627 s di ioD ,, ii,610,5 Contractor OWNER-BUILDER . DA JArs , Address: � - - --Phone: . - / - Zip: - . License: 0 - , ' SCOPE OF PERMIT ELEC PERMIT FOR AN ABOVE GROUND SPA INSTALLATION(1 ELEC OUTLET:REF: P01-00648 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 ,1 • Res. a/c package• $0.00 Standing Section . $0.00 0 New Res(1-2 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 to 10 kva/kw $0.00 0 • ' Lighting Fixts • - $0.00 0 - ' , ' - up to 50 kva/kw $0.00 " 0 Recept Outlets • , $1.10 1 up to 100 kva/kw $0.00 0 Switches • -• `.$0.00 0 over 100 kva/kw,. $0.00- ' 0 . Non Res Appl -, $0.00 - 0' " Low Voltage Equipment - $0.00' 0 Res Appl $0.00*, 0 - Low Volt Wiring System/Ckt $0.00 , 0 , Service to 200a. - x$0.00 -,0 ' Misc.Conduit $0.00 , , 0 Service to 1000av '- Y' . $0.00. N *-.'0 Misc.Conductor - ' ' $0.00 - 0 ' Service over 1000a- ' \ /$0.00,, -0 - Circus(gen or ride) ,- $0.00 0 '- - Motors to 1 hp 'N $0.00 -, 0 Circus(mach 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 $24.60 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 related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-08(&00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: • . , I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carder and policy number are: Cartier: Policy Number: (This section need not be completed it the permit Is valued at one hundred dollars($100)or less.) • ❑ I certify thai in the performance the ek Fort if I s this permit u Issued.I shall not ke s'C any n person in any manner a as to becOme subject abo to e I shall f compensationlyh es rofo California,o ,and agree that 11 I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith Comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(SI C0,000).IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Lic.ft Class u Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors license Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement Is sold within one year of completion",the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). NV& I,as owner of the property,m EXCLUSIVELVCONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply tb an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am ex d s . Business and Professions Code for this reason: Signature: Date: II /9'1 (n1 I Owner ID v filed by driver's en e. 0 Yes 0 No Driver's License No. Expires: I/a3/o-x Verification of Ownership by(type of document,i.e.-property tax bill or deed): • DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap)3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file end certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does r will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yeo ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Flre Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the California Health end Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application apermit for such construction or modification from the South Coad Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the California Govemment Cale requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No I (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cate). —If . _..._ .__...Dist.__ _ _ 7 a icpamhav tae South iscst s p Quality cri edManagement District or other airtpollution ooncontrol district3 or agency is required tort the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF •MPUANCE ORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that)the information given is correct. I a•.:. o com• with . and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-d -.••�••rop: y for ses.I agree not to occupy or allow occupancy of any building authorized by this pe mit until final inspection. /i/lji;; , ti`? �1 71 /O (1�� Sig a•": • .:I Owner(s) Date And/Or Authorized Applicant Date CODE I INSPECTION TYPE O6IE NImAL9 CODE( IySPEC110NTYPE GAM MAU 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final BIock/Retalning Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition - 250 Final Building/Occupancy ir t CITY OF COSTA MESA 0 @@ BUILDING DIVISION - > .� DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER �thil . PERMIT .tbJ #. IP01-00648 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2518 ELDEN AV Status: ISSUED Suite No 6002 Applied: 11/02/2001 Issued: 11/02/2001 Vicinity: UNIT B002 Parcel Nunmber: 93668003 ISSUED BY: f21' - Applicant: MOSIER, DAVID/7.2. - - Address: 2518 ELDENAVE ',-_ B002,- ,',-- , '- Phone: 949-696-0442 - - �N COSTA MESA,CA Zip: 92627 - ', � v. Owner:/ CHRISTIANSEN, KATHRYN A '� Address v 2518 ELDEN AVE- 1 - �,`' B 2 ' " ' . Phone: - - . COSTA MESA,CA Zip: 92627 " , Contractor: -'OWNER-BUILDER Address: : - Phone: - - �; �. Zip: . - - - License: 0 , Arch / Eng : Address: Phone: Zip: . License: - SCOPE OF PERMIT • PLUMBING PERMIT TO RUN GAS LINE FROM MAIN AT THE REAR OF A CONDO TO HOT TUB IN THE FRONT YARD. • - ' ' FEE SUMMARY ' AMT QTY-- -. - AMT QTY -H.; 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 Clarifier System \ $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc). , -$0.00 -. 0 Receptors $0.00 0 Vacuum Brkr Bkflow(54-) $0.00 0 Dental Units '10.00 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 $0.00 0, - Sewer Private Line, $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0. " - Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar - - $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 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 Gas(1-4 outlets) $6.15 1 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $29.65 COMMFNTS I SPFCIAI Cf1NflTIn?S • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. . INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(WOO) w 'DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the'pertormance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. My workers'compensation Insurance carrier and policy number are: Carrier: i Policy Number: (This section need not be completed if the permit Is valued et one hundred dollars($100)or less.) ❑ I certifythat in theperformance of the work for which this permit is issued,I shall not employ any p p y person in any manner a as to becomef subject to theI haf compensationh laws rofo California,oand agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,an6 my license is in full force and effect.LIc.M Class A Contractor's Signature: Date: ' CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lenders Address: • Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions to Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,odor to Its issuance,also requiresuiresthe applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business end Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a perry<' subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business end Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is Void within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). as owner of the property,em XCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors Lice aw does not apply to en owner of properly who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant t C• •rs License Laws.). ❑ I am exempt der c / Business and Professions Code for this reason: Signature: Date: I/ — Z—C� Owner ID v by driver's license. [0'(ies b No Driver's License No. . ( Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safely Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 WIII the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater then a weight of 500 pounds,oris volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). _ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 r will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yeo ❑No (Section 25534 of the California Health and Safety Cale provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire beparment of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? II Yes L]No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 WIII any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 if a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the Information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE IND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all la s and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described properly for ins•:ction• ryoses.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. J 1Ce 060gal(Tuners Date And/Or Authorized Applicant Date ;ODE# INSPEC110N TYPE DAIS INTMAL$ CODES INSPECTION TYPE PATE IIBEIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical (''� 1266 Pool Spa Final 208 Final Plumbing —1 9 c i RE- 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Flre Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy PROJECT ADDRESS:AMS: 2518 ELDEN AV l \`� UNIT: OWNER'SB1 CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 062647 ADDRESS:HOWARD PERKINS �- 2518 ELDEN AV #B1 I. PERMIT NO: B 062647 PLAN CHECK NO; 02160-93 S GOVT: SPP:' N COSTA MESA . CONSTRUCTION TYPE; 5—N PERMIT TYPE: STR / PURPOSE; OTH ;I rAflLMIENDRESS: (714 )65CA " "'•`�y� REG.ND.: UNIT: JOB DESCRIPTION : 180 LIN FT OF RCMU WALL @ 6 ' HIGH SQ FT: 180 Il ADDRESS: PERMITTEE: CLAIM VALUE; CALL VALUE; 3, 600. 00 GROUP OCC; R-3 / ADDREss:HOWARD PERKINS ( 714 ) 650-6389 (`25'1}`8� ELDENN� SAV B1 COMMENTS. * IIR�ECLAFII'r IM:Fi'K'�bv. CA 92626 ********iP********************************************************************** LICENSED CONTRACT ere affirm that I am licensed under provisions o a ter 9(commencingwith Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. CITY LIC.: STATE LIC.: CLASS: SETBACKS Dale: Signature:. MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN Compensation Insurance.or a certified copy thereof($ tion 3800.Lab.C). LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN POLICY NO.: . . EXP.DATE: COMPANY: - PARKING REQ• PROV; PARCEL: 43916157 ZNE: R2 REF NO: ' 7 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> PROPOSED 180LI .FT. , 6FT.HI .BLK. WALL ALONG THE WEST WALL OF T > HE SIDE PROP. LINE. Date: Applicant: • ******************************* ***** ****************************8E.*ik********** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is or one hundred(5100)or less). DEVELOPMENT SERVICES R E Q U I R E M E N_ T .S I certify That in the performance of the work for which this permit i issued,I shall not employ person in any manner so as to become •p • ! subject to the/�yo�rk7eri /o�mpensation Laws of CaSignature: et O� ZONING APPROVED BY C-•E; DATE: (CJ l c7/ 93 Date'./1 after m-{ Signature 1' �A NOTICE.If,after making this declaration,you should,b come subject to the Workers'Compensation pro cions of the Labor BUILDING APPROVED BY : 1`V , DATE; 6./17 (93 Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm thaDtM1¢re is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; �� C� DATE; (px' ! J which this permit is issued(Section 3097.Civ.Cl *.****.*.**.******.*.********{E *.{(•*{Eft 1E iE iF 3f lE #if 3E if if**TE iE iF iF iE iE iE iF****iE iE iE it 3F iFiF�ER*iF iE 1E iE iE LENDER: ********************************************** ******************************* ADDRESS: LEGALIZATION;N F E E S U) M M A R•Y` .. STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State license Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter,improve,demolish.or BLDG PMT PLUMBING ELECTRIC ;/MECHANIC e _ FIRE SMTP/RES GRADING repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 63. 00 �. _• .'1✓ - . 50 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business Y' /S .. SMIP/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any Halation of Section 7031.5 by PLAN 40 . 95 - - LL(• •n .- any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE I. as owner of the propeny or my employees with wages as their sole compensation, wit do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK _ TOTAL PAID DUE structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 63. 50 0. 00 ' 40195 -:.:7-) 104 . 45 104 . 45 . 00 does not apply to an owner of a propeny who builds or improves thereon,and who does such work himself/herself or through , r his or her own employees,provided That such improvements are not intended or offered for sale. If,however the building or I , 104 . 45 OVER/SHORT: . 00 improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED; = uf-" for the purpose of sate). BLDG PMT PLUMBING ELECTRIC MECHANIC_ •- FIRE ' SMIP/TOT GRADING PLAN-CHECK I.as owner of the properly.am exclusive) contracting with licensed contractors to construct the project(section 7044.Business 63 . 00 Ark.- i 1 . 50 40. 95 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon • L' 'r• -.,7-1 and who contracts for such with a contractor(s)license pursuant to the Contractors'State License Law). am aware that proof of their Worker's Compensationcts insurance should be provided to me. ,****************************************!C,***,iF,********************************,* ❑ I am exempt under Section: B.8 P.C. INDIVIDUAL FEE 41- BREAKDOWNN cormsreason: / �/j TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ^— Dale:kin `Q Owneta 4, W,/7�l c ' ' I do hereby certify that I am aware of and understand the requirements of Califor a Health and Safety Code Sections 25505. 5533,and SFR 180 RES-CONCRETE BLACK-"WALL' ...1,1 / FT. 20. 0 0 3, 600. 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES ' permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from (- these provisions. • - Date: Applicant: a '' ` I hereby certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county '' �%/ ordinances and stale laws relating to building construction and hereby uthorize representatives of city to enter upon the above.mentioned '; ,. property Jur in eclion purposes, l vl y i Dale:ID Cy1 _ signawre/ I Q 4_, 4'--,...7 D01 ATE:14116r00141167 06/17/93 1403 104.45 Driver's License or Social Security ' 1641-46 White-Building:Green-Code Enforcement:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING POC SPA APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole „' 52. Pool & Equipment Location /' 2. Soil Pipe-Undrgrnd. `� 53. Steel Reinforcement 4 J • • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms -J -4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding , 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test l // 57. APPROVAL TO COVER-GUNITE 6, Electrical LIFER Grnd.�j��¢a�(� ��///� 7. Footings, ` -y1rF58. Electrical Conduit-Undrgrnd. \ . 8. Foundation Vim'`. 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. t 60. Backwash Lines,P-Trap, 0 Undrgrnd. ,, 10. Structural Floor System 61. APPROVAL TO DECK ,• 11. Property Sewer Line & House Connection • - 62. Backwash & Receptor-Final - 'n 12. Sewer Cap J 63. Heater & Vent-Final ,`�' 13. Roof Drains . , - 64. Plumbing System - Final - 5 s 14. Rough Plumbing -' - 65. Electrical-Final '•, 7 '", 15. Rough Electricaj.Conduit 66. Solar System-Final 16. Rough.Electric Wiring 67. Fencing & Access Approval i% 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING' 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning _FIRE DEPT. REQUIREMENT 20. dough Factor.' Fireplace • ; - • - _- APPR&VAL-S' Perrgix# 21. Ducts,in Structure 's " " .- : 70. Underground-Hydro - 22,.Dugts, Ventilating' . _ t - 71. Product Ping 0 Gs OOiI 1 23. "Gee Pipe-Rough & Test - r • , - 72. Underground Flush,. - 24. 'Roof Framin - ` 9 . 73. Undergrnd.StorageTa.Pk Q Gas 0 Oil 25. Roof Sheathing .- 74. Overhead Hydro . 26.,T-Bar Ceiling (Structural) & Monocoat " . ' 75. Dry Chemical 27. Frame and Flashing •_ - - -� - 76. Dry Standpipe • 7 . 28. Lathing& Siding ) 77. FIXED SYSTEM FINAL 29. Insulation - J - I _ - •�� :78, .FIREPREY. FINAL - '30. Drywall Nailing I ` HEALTH,DEPT:REQUIREMENT 31. Plaster Brown-Coat , -- • 79. FINAL INSPECTION J 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric- ( {, Notes: 9J , r�/Y/W//p/� 34. Final Heating_& Air Conditioning I _• /� 35.,Final Gas-Pipe-Test I 36. Hood or Canopy .) 1 1114 - 37. FinaLFactory Fireplace .• . • - , .-�' Le ,/- r - - 38, Final Plumbing t - I I / 39. Water Service•Final ) ' 0_0 Q�Qa �, bKl40. Gas Service-Final • -- -41, Solar Domestic-Final - i , 42. Backflow Preventer- . _• • - - 43. Backflow Irrigation - . - . . 44. Landscape Irrigation System . • - - - . . - - ' . 45. Sound Attenuation - -46. Handicap-Regulations I I- - _ - _ 47. FINAL STRUCTURE & BUILDING t� q704,•• _ .• `I 48. FINAL PLANNING I '" - - -49. Electric Release to Edison ! '1 - I • r 50. Gas Release to Southern California Gas Co r t • 51. CERTIFICATE OF OCCUPANCY ' No. Date • ADDRESS OF BUILDING: WIT 2518 ELDEN AV A2 CITY OF COSTA MESA — BUILDING PERMIT OWNERS NAYEIr(OuIPE st ROSALIND MUNRO PPRM Nfl• P OR400E1 must 2518 ELDEN AV PERMIT NO: P 084006 PLAN CHECK NO: N GOVT: N SUPP : N APPL wAim DORESS: COSTA MESA, CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: ALT ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION ; REPLACE 40 GAL WATER HEATER SQ FT: ARCH.OR EMI S ADDRESS: WIT: � p.wa. CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / caNrfucT NAILING BRAZIL PLUMBING ( 714 ) 535-7905 3022 N. HESPERIAN WY COMMENTS: WATER HEATER ADDRESt SANTA ANA CA LIKE: 6 . ******if#E****iF****aEiFiEiFiE********ik******* Ear*****if+rif+EiFikik*SE**#if*ikiFatikif****ifxa ****1F*** 9 06 ! 1 ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby SF... -:. d• - •ander -d Chep (manenci g whh ]000)d Division 3 d Uhs ad Pra...:. .. •( m . . end SETBACKS T B A C K S /". CRY UC.NO.: LIC.CLASS: LIC.N0. 9 •0 " 1 • 2 /jam! 08)• MAIN BUILDING ACCESSORY BUILDING Dale, / c. �_ {,//'� /� FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN OWNER BUI DERD LARATION:Ihereb affi 'Perely.P.;ayJtha`f.. .-00111a11.1111...—....- LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN E Lew la itch ucture pnieve end nceadas Arty cry. ••..ply . .o a perms td sono •Ma.ao she eolith.or puuani theprov:isbm issuance.tactors •. -- the=••pt (such.- •lofileection •..)ot KMetMaehe PARKING REQ: PROV; PARCEL: 43916157 INE; REF NO: licensed id Prole to the provisions h a he Contractors pt. . Law hep 9( • • - • ed Seder •)vi Division 3 e the PLANNING NOTES> Bu31.5 b an Professions l Code)or that he or ore u exempt her.,.. ad t .Nan 1. the alleged dreg••... vislatcn d Soden ]031.5 by any applicant la a pemd subjects IM applicant to: - penalty a nee hundred..�.. RsroU. > �' 0 I.noweeralheproleny ormyempbyees with wages as their sole corn ,,do the work. •the•6uclum is not mlelded ********************!f************************1F********************************* altered for sale(Section TOM,Business ed Profession Code:The Con! 'LI.. ..slew••.-not appy tom owner apnpedy DEVELOPMENT S E R V I C E S ' R E Q U I R E M E N T S who butes a inproves thereon.end who does such work himself or hersel or through :- . own emplgws.Provided Mal such l." improvement,are M intended or offered for sale.I,however.the budding or improvement S sod within one year a completion,the owwedaer will have the leaden a proving Mothe did not lead o improve to the papoee a..e). ZONING APPROVED BY . -__-_ - - _ . DATE: ❑ I.as owed a the property.am n dmeay corvrading with licenM oonbedas to consaud IM project(Seaton TOM,Business and !. Professions code:TM Contractors License Law don not appy to an owner a property*to build a improves thereon and who BUILDING APPROVED BY : / DATE: contracts la suds projects with a contractor(s)licensed pulses to the Contractors License Law). ❑ Iamexempt udeSwim: B.AP.c..Ice this reason: APPLICATION ISSUED BY: r ,I Ati �1 DATE: �( in Date: r. * Owne *********************************** * *********************** **I sr* ** I dohereby candy Oat lam aweea end understand the requirements of California Health and Safety Code Section 25505.25533.ed LEGALIZATION:N FEE nS U M M A R Y STRUCTURAL SEGMENT:N 25534.and that I or any(Mire building oc spent will/wit not(circle one)need 10 comply with said date codes and Me requirements for eParrb torcmntrwisnamodification from the Ai-D SyMaaneD.m«d District.Residential mnmrwgrn.ppkr+tbwere exempt Mangles. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 11 . 00 i Dale: . App'cam: 2 St :-.• SMIP/NON RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty a perfidy one a the following dedaatbs: PLAN . ❑ I have andad maiaeinecaNcaeaconsent tosefinunfor welters'om cation,asprwkedfobySection3T00atheLabor ISSUE FEE 22 . 00 Code, performancemkis issued. BUILDING—DIV—> PERMIT ISSUE PL the TOTAL PAID DUE ❑ Ihave end will maintain warkerscompensation insurance,aarequired byRealm 370Oalhe Labor Code.for!he performance ofthe TOTALS----> 11 . 00 22 . 00 7 0 . 00 33 . 00 33 . 00 . 00 -- work for which this permit Is issued.My wan'compensation carrier insurancecarrier and naiad number ore: t 1 - Caner Number: EAGLE EX• S REVENUE DIVISION TOTALS--> COLLECTED: 33 . 00 OVER/SHORT: . 00 P(This section need nor be completed f ilie perishs • of..Iii "• iv.IT:. ' I i. t /01 -'8 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ❑ I centy that in a ped. • :nee a Ihe work ch this permit la , "non In y to 33 . 00 become su•'•• to Ihe •rkes'coo laws d Cele 1,. become can _ r .� s700athe n:. I 1 1•r Icy,•er i ****************************************************************************** Date. / APO I �__, i .sir ` � INDIVIDUAL F E E BREAKDOWN hWarning:Path, lo sec re worker?compenn •-coy' W is• a-�� •• ' ' ' Ier 0100,ale�- 1 Civil fines up .ash.. dead thousand dollars(SI r ii i),Madfllb•'tO, �• compesation • as provided for TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Section 3706'.r the -••r Co*,Interest,and alto • is fan. j • CONSTRUCTION LENDING AGENCY: I hereby alfi . u •.nehy a •. that there isa cont. 'ion landing agency la the PLU 1 WATER HEATER AND/OR PENT 11 . 00 11 . 00 performance of the work for which this pami is issued(Section 3097,Cit C). END,? OF FEES LENDER'S NAME: LENDER'S ADDRESS: ' I certify that I have read this application and dale t • .idamation -. •.I...twe to comply with al countycity and ordinances 1 end store owe nlel'np Ip• ad •a represent• . .. . o• b enter upon IM above-memiaed properly f«masectien puns. htflAIMMP // 87-31-1997/82:12 PN/$33.89 ? R i ` �.. � RCPT8:91 8319933 � � + —�� Date: 1 PERMIT:QJ84@146 Rr� �IX (5151-46.WP) . ' PO 1 SPA CONSTRUCTION AND PLANNING ' , APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd, - - 53. Steel Reinforcement 1 _.1 3. Ele;ctricai Conduit Utility-Undrgrnd. 54. Forms ! - - t, _ - . • - -4: Electrical Conduit:Undrgrnd. - 55. Electrical Bonding 5.' - Steel Reinforcement 56. Rough Plumbing & Pressure Test - - 6:-,Electrical LIFER-Grnd: 57. APPROVAL TO COVER-GUNITE .7.,Footings 58. Electrical ConduitUndrgrnd. • 8. Foundation 1 59. Gas Pipe; 0 Undtgrnd., Test' e' 9. Water Pipe-Undrgrnd. 60. Backwash Lines;P-Trap, 0 Undrgrnd. 10. Structural FloorSvstem ' - 61. APPROVALTO.DECK i i , 11. Property Sewer Cine& House Connection - 62. Backwash &.Receptor-Final - , I ' 12. Sewer Cap _ 63. Heater & Vent-Final I 13. Roof Drains64. Plumbing System - Final • 14. Rough Plumbing'. yr, _ '65. Electrical-Final 15. Rough Electrical-Conduit - 66. Soler System-Final " 16. Rough Electric Wiring , , • 67. Fencing & Access'Approval 1 _ 17. Rough Wiring Sign , '68. APPROVED FOR PLASTERING 18. Rough Electrical=T BarzCeiling' ' -'' 69. POOL/SPA SYSTEMS-FINAL 19. Rough Heating & Air Conditioning _ - FIRE DEPT. REQUIREMENT • r - .t. 20. Rough Fau.torcrFirjplace t =:'l .t 7; " - J ''APPROVQ.LS� ,Permit# ' • 21. Ducti^in Structure%I. •• -• << i ^ r.' )- t X70. Underg'rbund Hydro t • • r _ 22. Ducts;Vetltilatti g��'l •u ''t 7 `- '4 271. ProducvPiping ❑Gas D'Oil 23. Gas Pipe-Rough& Test T a 1 TI „ X ^ 72. Undergrouhd Flush) ± . 24. Roof:Framing 41_4; `'i" "t' e - ?' 73: Under rnd.Stora eTank Gas ❑til t.l , 9 'ig: p 25. Roof Sheathing Y'.+ .- • v f T. Ft x-11_ 74.-'Overhead Hydro- l 26. T':Bar)Ceiling (StruoftlraI) & Moctoat• -, t. 75-Dry Chemical _ , ' r r 27. Frame.and-•Flashing`' _ = #: r r -. a 76. Dry Standpipe Fr, 28. Lathing&Siding t' v. '.•;:r- !t "rt " -� 77:e FIXED SYSTEM;FINAL* X29. Insulations. •• i i Yr 78;:FIRE P-REV. FINAL . . -. 30. Drywall Nailing F k HEALTH:DEP-rREQUIREMENT ''-31. Plaster Brown Coat . y ;ort ti r79•'FIN'AL INSEECTIDN r. - ¢ -32. Electrical Power Meter-Final r r'; i "80P:iFOOD CERTIFICATE ISSUED , I -33. Final lec is -. a -r t :1., ;j. q ri - F ,t _ r r Nojt-esr:�J4 ' 34. Final.Heating &Air Conditioning_ . + is ,v4/Q97 ^,/t, :,iit-ccp s 35. Final Gas Pipe:Test a -, - `1 .1 c • 36. Hood or GtanopY * )� •� r-. i ' X 5: ) :. , -1 r - _.37. Final Factory Fireplace Sr' ! .� w' J -) --38. Final Plumbing :9J •'s .* ' 3!7 'asp 1: =, :39. Water-Service•Final ` :40. Gas Service-Final -1 r t 7, i `i _ - + D• it ?41. Solar Domestic-Finals - _ U 42. Backflow Preventer r '-' > , - -43. Backflow Irrigation -. r •, - , 44. Landscape irrigation System i - - - ±. - XI - - ..tt -. r � ) - S - 4. 45. Sound Attenuation - .. '' -- 46. Handicap Regulations `, -- - " • .. . . - r 47. FINAL STRUCTURE& BUILDING ) l i - - ' 48. FINAL PLANNING : -- - -1 , • • 1 49. Electric Release to Edison _ ix ' .. .. 1 . l4 St. Gas Release to Southern California Gas GD -' - - - - 51. CERTIFICATE OF OCCUPANCY '- No. _ Date .y � i / r r;_ 641 Y �� � COSTA MESA BUILDING DEPARTMENT �- NA-..6.- ti P.O.BOX 317 Mat gilt COSTA MESA, CALIFORNIA WV c C.51A Ira FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING�,j-/kms _�oF� 42�� BUILDING ADDRESS COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. PERMIT NOS/ OWNER Dean Warren . Pope- 6 y/ MAIL RECEIVED BY DATE RECEIVED D E ISS CL. ADDRESS 2150 Newport Blvd. ,�/ 5° ) ---r---70 a_/5e-e 2- y- 5 CITY Costa Mesa NO.L1: 8-9388 UILDING ADDRESS a5/S Ii Lab/ ' LTA/ !T ' C. OR EH -CTLI NO. COSTA MESA, CALIFORNIA FIRE ZONE 3 ADDRESS CITY LIC. O ZONE NO.OF TYPE j GROUP, CONTRACTOR Romer Builders NO. 73 _F' V �x .� . o. LI 8-9386 PPR0 � � �ADDRESS 0 New•ort BlvdI LEGAL DESCRIPTION OT 81 BLOCK TRACT 300 CORRECTIONS A.P.NO. f I7 _ 0 70 "-. a c) i SIZE C NO.OF BLOCS. (j` {I jr R Ov 11 N O OF LOT 66 x 305 NOW ON LOT L 1 LL II VVV� r CJ./ USE OF CITY Y 01' r- ,.,T,k. MESA EXISTING BLDG. -) �. •AP . • G SETBACK LINE FROM � J I• . / CENTER OF STREET -. REAR YARD�LL r�.33/ SUGIECT TO E , G. DEPT: REG. ' SIDE YARD (RIGHT 1 g/ LEFT /T// BY 9T2�n�'fDTF'2 t1f -r DESCRIPTION OF WORK C NEW 4 X ALTERATION ADDITION V '�//�YY��✓/ CV/i REPAIR MOVING DEMOLISH BUILDING GING IO^� S^. i�tNO.OF ShOOMS 6 STORIES 1 EXTERIOR WALL `S 1 ROOF COVERING COVERING USE OF NEW / BUILDING IPhree Bedroom Dwelling ,Q17- 6712 // / 7 - .." „2560 ,a - _409... HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND �/ STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND ST TE LAWS REGULATING BUILDING CONSTRUC. TION. VALUATION Crp//� PERMIT FEE $ a 6."--- SIGNATURE PERMITTEE bG- '/ 1 .� j� -. PLAN CHECK 5 %a - $ J /SG AUTHORIZED AGENT TOTAL FEE 5 3 r Nmr ` ` 6416 � � ', , : • COSTA MESA BUILDING DEPARTMENT D ' ,4._s-s v `` P.O. BOX 317 tp .,a OLQ‘ COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL INSA. CAL •IFORNF OR PERMIT ADDRENG•/.J YSRC2�� /iA2//C BUILDING ADDRESS / O �/ COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. PERMIT NO. OWNER Dean Warren Pope ‘ Cl/5v , RECEIVED BY DATE RECEIVED D E ISS Dr ADDRESS 2150 Newport Blvd. �/ �- i fl � y S /, TEL. BUILDING 2 y / r 13 CI CITY Cost$ Mesa NO.LI 8-1303 ADDRESS 1-� P/✓ 9/. • ARC4LIC. OR E E LEER COSTA MESA. CALIFORNIA ENC. FIRE 3 ADDRESS ZONE CITY LIC. L� ZONE NO.OF TYPE GROUT >) Builders NO. 738 G J7 ADDRES2LL 3O Newport Blvd.. TN O. LI 87317 L)BYPRO Derrir DATE 2 (7 } LEGAL I7 p 3 CORRECTIONS DESCRIPTION)) NOT Vl /..BLOCK TRACT 00 A.P.NO. /I'f.._.B -YV — •� c) pl�� . SIZE ` JNO`.OF BLOCS. A Pp R OV t. . ■ OF LOT 66 X 305 NOW ON LOT •L9a Y 11J USE OF • CITY OF ii)STA MESA EXISTING BLDG. j sr a. / _ _. C^J • 1I.1•► ... . .'.,NNE., IGS SETBACK LINE FROM CENTER OF STREETEE. *St; / REAR YARD 25fffy . SUBJECT TO . UG. DEPT. REG. SIDE YARD • LIGHT !O'h `LEFT /ere.'" � ,,,� �� ,/ c/ DESCRIPTION OF WORK gy� DA•fE "" S /J v PLAN TiCF4t7,j NEW,' A II ALTERATION ADDITION REPAIR MOVING 6 DEMOLISHBU '1 SIZE 109h- 109h. sY.ftNOMSSTORIES 1 EXTERIOR WALL ROOF COVERING COVERING USE OF NEV BUILDING 11Th111111..ree Bedroom Dwell're ?Rrr la en?"' // / 7 •-...1 . d I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AN ST LAWS REGULATING BUILDING CONSTRUC• TION. VALUATION PERMIT FEE S pZ V- SEGRNMTUERO .e. $ y3 )._.' PLAN CHECK $ / aI AUTHORIZED AGENT TOTAL FEE S 3 c — 'B.x/ • i 45860 • 9505 4/19/7836,50 TL COSTA MESA BUILDING-SAFETY DEPARTMENT ill— P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant tto Fill in Completely {—��Use Ink Only RECEI V /U,/®1V DATE RECEIVED //�r- ADDRESS BUILDING asig ales kg, — �l/�1./`I /} —!-IISSf- A.P. Pelt A.P. NO. —/ 39 , , PERMIT NO. OWNER I-CIGI� /LSO}? ( P MAIL BUILDING c 5/& SI 4 Q ADDRESS ADDRESS (O �—( j' TEL. CITY NO.ETRACT I LOT 3) BLOCK ( T CONSTRUCTION NEW I ADD I ALTER REPAIR MOVING DEMO!ISH LENDER CA,- '4(D. • BRANCH PO_ /007_....6:0--..ADDRESS OWNER VALUE ARCHITECT TEL. S / $ OR ENGINEER NO. FIRE ADDRESS ZONE TYPE / GROUP CONTRACTOR fie II COPS / . ByPROVED /� DATE ADDRESS Iati E. I84h — TEL. ZONA /� NO.OF-j USE OF NEW ,, (� CITY C P ,( / �p ( NO. t'�q(/ PLAN [�, BUILDING 1f„ /_,.i MQ u)&J I- TN 14,1 Sy I z6✓$T C1 id STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. 'MAIN BUILDING ACCESSORY BUILDING W SIZE NO.OF BLDGS. (FROM Ch.STREET) (3.• OF LOT NOW ON LOT FRONT FT. FT. a USE OF �t� � 4 EXISTING BLDG. R.SIDF FT. „xi, 1 p ill...FT. V) F Separate permits are required for L.SIDE 9f7. FT. . C electric,plumbing and heating work. REAR FT. t/ u FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& a A p -T5 I MAIN BLDGS. ACCESS.BLDGS. G i-4 { DATE ""1 t�J.e 1 l&' I- n (/ 7b /{L ialp /,.n C.U.P. y. APPROVED a I ! VAR.# / >. I 0 '}-O/ ned I 'v as-e F9 e , RO j 2 J LYI&1 DATE V/ /42 C4 w 0 I hereby acknowledge that I have read this application and state N $$ that the above Information Is correct and agree to comply with m nx all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of the State of California. m I hereby certify that I am properly licensed as a contractor under SQ. FT. a D the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR al Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE NLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ 2 Y and Professions Code, Division 3,Chapter 9. �i n 0012. 00 n Signature of _ �O PLAN CHECK $ O, �S l o Permittee $ 3 8l7 TAX E y �'10 f � 5 _ u Authorized Agent 112--rtt o 'V✓WvY�7 TOTAL PAID $ 7‘r60 /.. : ll . 45510 Ain n 5843 2/14/78 153.81 TI • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only* RECEIVED BY DATER C V ig /Ne 4042 ) DATE ISSUED ADDRESS . / �K//11� se r/�� a///-OS /— PERMIT NO. t OWNER .fAIL /�/n//�/r /�-�y/,1/�//�/l/OL yam' �j A.P.NO. /'�/(J�b( f/,J��JJ�j // `Q A / //✓Y�f T t �/L //(/ ADIDRIES)��-J/ Q /Cs C"if /it. i , ADDRESS (� CITY N .C3• NO /9 yo TRAC'�l Ap LOT BLOCK CONSTRUCTION { i/� �y��� NEW ADO ALTER REPAIR MOVING DEMOI ISH LENDER (///_ Zj/IL BRANCH IN li � I V RCC ' �j. OWNER V./ //��' kin J �/y ARCCHITECT /17-,-... TELY�,/ /� US Egli/s�Ir- CM" 17 Al / D� —OR ENGINES O A NO, % Y/L� ,f/ - .. �,.y/,/t/ y c(�//[�/,(�(+(J�}��FIRE 't,�//�' ADDRESS / /J/( r l_/JI/ ��' �/ ZONE TYPE .�.ROUPy LL /s-7r7 APPROVED / CONTRACTOR -�! BY DATE ADDRESS/ �/ /A-- 7/ // TEL. ZON, NO.OF USE OF NEW CITY �/ = fie.....-_,..5.4 NO. f� PLANS' BUILDING „Q• F STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING SIZE y/ �y�r^/ NO.OF BLDGS (FROM C/ S RVET) (114. OF LOT//� x IW NOW ON LO FRONT FT. FT. a USE OF � // � DE ` -, EXISTING BLDG. R.SIDE ETC FT. E Separate permits are required for L.SIDE3c? F7( !/ FT. Gelectric,plumbing and heating work. REAR oag F'1( J ye' FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& MAIN BLDGS. AINBLDGS. ACCESS. BLOCS. / oNr Ea Wa ✓O �MAam/ VAR. CUPBL�L /� DATE APPROVED/3'C ROVED77 r / t,7 ,JDATF6(- 7 EY iu 0 I hereby acknowledge that I have read this application and state n N Q' that the above information is correct and agree to comply with m L all laws regulating building construction, and I shall not employ s Z any person in violation of the workman's compensation laws of [�0 FOR SPECIAL REQUIFLLIZI: ti Ia the State of California. t/'T (Jp• - I hereby certify that I am properly licensed as a contractor under SO. FT. �� 66 H the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro Chapter 9, and that such licenses are in full force and effect,or I THE PURPCGE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ and Professions Division 3,Chapter 9. �, Signature of 2 PLAN CHECK $1v 5 0 Permittee $ win V TAX E Jj9(,/ /p=�`7 Authorized Agent TOTAL PAID s/5' ' s/ O �Pi ( • , '3693f/9:6206/08,78 229§Op. • COSTA MESA BUILDING-SAFETY DEPARTMENT +$�93 b/0Air8 : 229.001 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 pp��a��g �j�� For Applicant to Fill in Completely APPLICATION FOR ST YL'��"fiTO • P y- Use Ink Only I A RECEIVED BY DATE RECEIVED DATE ISSUED ABUILDING 2 O 2 ^n /C OWNER Y BUILDING(W:2. k / Newt _[; A.P.NO. 5I39—�{/b(moi- PERMIT NO. MAILADDRESS /D/ o VSR. OIC , sµ(fs ///Q ADDRESS `a eligoJ TECITY Aywpoar goiter NO. 1t. TRACT les (&y LOT BLOCK CONSTRUCTION( (f /^� � NEW ADD ALTER REPAIR MOVING f1FMOLISH LENDER ll J1�- rr //J � BRANCH JNT• fHe/lz-✓ OWNER et,ag. t1/4kNevlese. ADDRESS xxALUE ARCHITECT /G{7�S CRlJCETE L. 9 IS 2— w P vi-t $ /- OR ENGI EER (�I, y ,tC� ,, NCO.-., ♦ C l+ J T T N , tstLw K T/ / /1L�c� FIRE ADDRESS /V/ �_ ZONE TVP GROUP APPROVED CONTRACTOR 8 e.-2z r,(Q„/ �SGr� BY DATE E—ADDRESS IO sr /G n--, ZONE NO.OF USE OF NEW CITY CritJ—('v$.o e C TEL PLANS BUILDING qJ' y NO. 37 F STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDINGACCESSORY BUILDING (FROM C/L STREET) W SIZE •I �a NOW ON LOTNO.OF O - - FRONT FT. C. LOT 6 4'1 Q USE OF 4 EXISTING BLDG. • FT. h 5 Separate permits are required for FT. C electric,plumbing and heating work. -EAR FT. FT. : I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& BLOCS.MAIN ACCESS. BLOCS. G // (N DATE a D— LI Ali-r- Cr..") n..4 APPROVED J J.1 DATE .] Ik W 0 I hereby acknowledge that I have read this application and state 'n N (X that the above information is correct and agree to comply with m 61 all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of La the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. w the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR w Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: id am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ �`/ q and Professions Code,Division 3,Chapter 9. G•S� K/ 'a m PLAN CHECK § G Permittee ty' r it 2 Permittee •'X� $ ��` TAX $ F `^ U Authorized Agent TOTAL PAID $ !i 44,111 t - 45511 8-02- . COSTA — COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 5844 2/14/76 157a 93 TL A IC TION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RE I E BY DATE/Ifni a BUILDISN G/�- E/IP„ /, / DATE ISSUED ADDRES /j✓V�_ Fri / g1t�prgrry A. OWNER ar�` � A 7 �� A.P.NO. ._ (J —# � P155t 1 MAILF• ri�= 5'1,'j // BULDING ADIDRESAl• in• ADDRESS (l /s' !i' / -� �i CITY 44-/ø4 NOL 1 TRACT AP LOT BLOCK CONSTRUCTION/ / y'T ��/ _ NEW ADD ALTER REPAIR MOVING OFMOI ISH LENDER ( Zij:; ,jz BRANCH 174- M��d / OWNER , GTL�/Z—' 1p2„.F ADDRESS is0 ARCHITECT y,�J�7 ��L[y L./yyy/�"Ids../ S - I : / / I 4 40 OR ENGINEE /�ri(/Ji/`/�y(L17�f0.!/✓/ -�I `I�h.. l/ / / //A Mty ase FIRE • ADDRESS /AI / , Lar"//�/G ZONE TYPE GROUP Z , / APPROVED CONTRACTOR en:, r BY DATE ADDRESS G• �{.-� ��s ZON NO OF USE OF NEWTE �/ CITY47 /4$°r, NOL. . J iC OC PLANS BUILDINNGG2 iii) �6_ ` F. o- STATE CITY YARDS APPROVED YARDS APPROVED -T F. LIC.NO. ! LIC. NO. MAIN BUILDING ACCESSORY BUILDING W SIZECLI OF LOT /�/y�/��t },,,.9 I NO.OF BLDGS (FROM C/LrTREEj)FRONT T. //I// FT Q EXISTING Leri `�G � �/e� NLO R_SIDE .7 /FTd 4 �/i/'L/C//� FT. �. UXISTING BLDG. // F. Separate permits are required for L.SIDE/S1 FT. FT. C electric,plumbing and heating work. REAR FT.(9 A (J .FT. • USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAI & +: MAIN SLOGS. ACCESS. BLDGS. A �V /-- a/ / Uc?-•yY VAR.ak DATE CU.P.' 7172 APPROVED /ai2 7 Q 7 APPROV D �7 -a RY �/ i DATE fat? . c r a ., , ,, . .. - . . . . in Q I hereby acknowledge that I have read this application and statea r. a4 HOLD FOR SPECI�f. RFntrr^T-t*—,.-. C2 that the above Inform Ion Is correct and agree to comply with . ._.. .- m .+ all laws regulating building construction, and I shall not employ S Z any person in violation of the workman's compensation laws of �.(1/yI //�)�/} �(�/ u the State of California. V ✓ ✓Yb0 FT. �� s+(v N I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force end effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ 7 and Professions C d 'vision 3,Chapter 9. •/✓��/ T m Signatureermof • $ / TAX CHECK $/„lei" e ��f Permittee j U Authorized Agent TOTAL PAID fh7� 3 y COSTA MESA BUILDING-SAFETY DEPARTMENT 3694 6/09178 1835.pp TL P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 _q3CCGa91�; ��6�/O�fiB/��78r, 13_B5PICKY APPLICATION FOR'3CR 4.11916 PI!1 MIT 1 Q ^ For Applicant to Fill in Completely — Use Ink Only RECEIVED BY DATE RECEIVED DATE ISSUED BUILDING L^1!//IE� ADDRESS / Q G Com /j'YF_ Pa / ,/ PERMIT NO. OWNER )t/tc W/ // othaAr' A.P. NO.MAIL �p BUILDING ADDRESS 9c ( rid-7-^ r(1�j • 0 . tea ADDRESS 3'x70 �O iv.. CITY /d/6 . NO.TEL TRACT LOT BLOCK CONSTRUCTION NEW I ADO ALTER I REPAIR I MOVING OFMOLEH LENDER BRANCH OWNER Peft" )tC. /1j. "/ eW/�o cd C ADDRESS �/ V LVE ARCHITECT TEL. USE 14V " Ce'thl 1 M$ OR ENGINEER NO. FIRE ADDRESS ZONE TYPE GROUP g ^ , ` .Jr APPROVED CONTRACTOR /3�Z-.L- (� / BY DATE ADDRESS TEL. ZONE INO.OF USE OF NEW CITY NO. PLANS BUILDING F STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING 1.51 SIZE NO.OF BLOCS. (FROM C/L STREET) C. OF LOT NOW ON LOT . FRONT FT. FT. Q USE OF VI EXISTING BLDG. R SIDE FT. FT. VI FSeparate permits are required for L.SIDE FT, FT. C electric,plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& MAIN BUMS. ACCESS BLDGS. O VAR.IP DATE Q � {J/ C-( G� C.U.P.qp APPROVED 7 APPROVED >-. .BY DATE ..1 lY Izt Q I hereby acknowledge that I have read this application and state N lY that the above Information is correct and agree to comply with -. a. all laws regulating building construction, and I shall not employ Z any person In violation of the workman's compensation laws of 2 Sthe State of California. . 3 I hereby certify that I ern properly licensed as a contractor under SO. FT. w the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business I to VALUATION PERMIT FEE $ a and Professions Co Ion 3,Chapter 9. •� n PLAN CHECK $ "l Signature ofc Permittee $ u. TAX $ qq //y 2 ✓...�.r// mJ U Authorized Agent TOTAL PAID 5 -- 45512 C 5845 2/14/78 177x11 TL - COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 AP LI A ION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only ��/j /y///� �/ //y. RE 1 D Y DgTE RFyEIyn DATE ISSUED BUILDING "( 4 f-x . '(/ ' v/`) -//7/ I7 OWNERS Naa,� — OWNER ,'/s % y/- }s /' // A.P. NO.yJ (-y / J'J���/ PERMITpNO. ADD I# aye, !//` %� //L�• ADORESJI/,/rS 6....- Ffi'6(.i�( i.'7 ✓ ADDRESS ✓ /// ��' CITY $ anal. NO• L _ s I` TRACT/6/1g LOT 1 BLOCK CONSTRUCTION /4 j>C f j tj ^_ NEW ADD ALTER REPAIR MOVING DFMOI ISH LENDER l� L� /� L�1iC•-/1// �!%'/ BRANCH !fl / / 9 c/^iE OWNER• /1 �`/t,C Al/v M1! ARDRESS CHITECT �/ /����y�j�' 997 US�1 UNIT De CIS'$ _OR ENGINEE$/ ///[GV Nom' /'�iY✓� � FIRE ADDRESS 4Z / if 4112.% 1 4 -ZONE TYPE :-.14-• GROUP •/� APPROVED CONTRACTOR /, E1L �jT/NUt�/ . nV nn DATE //_+ J/ ADDRESS6. / Mt 4 NE�� � ZONE/(r1 PIANS BUILDIN7? USE OFG an 1' lTnc/; EH STATEITY K/_//_'/.7/_ ej- L� /17�� CITY YARDS/ DS/APPROVED YARDSAPPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING /�f� (FROM C/LSTR ET) NO.OF BLOG 0.. SOF �>LOT GAi NOW ON LOT"('J FRONT 30 FT. 74, Peg9 t FT. sC USE OF / . /I / EXISTING BLDG. R.SIflF S �__ FT( / FT, 9 Separate permits are required for L.SIDE _5 / FTA- `/ FT. F. electric,plumbing and heating work. O - REAR.926 FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& nQ COM) /�/r MAIN BLDGS. ACCESS. BLDGS. ''J a.UNLT l SFJM)0 F- RP:� "��-�71/3 DAAPPROVE/D I/R-753" -1 } RY raft .4.-^ DATE/n - R-/ . -1 \ VV VV/ ill%%% t4 , ..: , o ..: HOLD FOR SPECIAL I hereby acknowledge that I have read this application and state REgU1R ?,1[; n X that the above Information Is correct and agree to comply with m n• all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of k^4 E W the State of California, T .: L+•� I hereby certify that I am properly licensed as a contractor under 3 3n�(,/I _SQ. FT. , / . 727 _ the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: lD am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ a�lt� and Professions on 3,Chapter 9. -1 '^ M C"....--PLAN CHECK E/70.73 SI nature Of pG � Permittee $ OD d no TAX $ to•/U7/ Ear 1 U`�1t Authorized Agent TOTAL PAID $ / / b'^ COSTA MESA BUILDING-SAFETY DEPARTMENT B/7 3695 6/QB P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626263.00 T! APPLICATION FOR STRUCTURAL PERMIT , - ' For Applicant to Fill in Completely—Use Ink Only D4,--/ ,�'J I �.r / RECEIVED BY DATE RECEIVED DATE ISSUED BU I LD I NG ADDRESS � v��/`,�elJ "V(�� OWNER 1 e ' "2 tm..N ®(J 2d'eC A.P. NO. � (� I� n PERMIT NO. MAIL BUILDING ADDRESS /a E1V 71 ✓� • ADDRESS rj TEL. TRACT /D�A CITY NO. LOT BLOCK CONSTRUCTION NEW ADD ALTER REPAIR (MOVING DEMO(ISH LENDER • III BRANCH QrCIOWNER PETTQ Al , QV, ADDRESS ARCHITECT TEL. U _)--C ^�–j/tee iflyALU$ OR ENGINEER NO. FIRE ' ADDRESS ZONE TYPE GROUP �� /'. N APPROVED CONTRACTOR (_A f BY DATE • ADDRESS • TEL. ZONE NO.OF USE OF NEW PLANS BUILDING CITY NO. F STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W -S SIZE NO.OF BLD . /^ . (FROM C/L STREET) e OF LOT NOW ON LOT^5J , FRONT FT. FT. Q USE OF V/ EXISTING BLDG. R,SLOE FT. FT. z FSeparate permits are required for L.SIDE FT. FT. mr electric,plumbing and heating work. REAR FT. FT. - USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0 ,_ /. MAIN BLDGS. ACCESS. BLOCS. �, �(//' J �/'_ VAR.# DATE J cacti Ci ..to (TAS C.U.P.# APPROVED Q APPROVED _BY DATE W a W 0 I hereby acknowledge that I have read this application and state N N a that the above information is correct and agree to comply with m 0-' all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of xthe State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. Cl the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business $ /_� y VALUATION PERMIT FEE 4/ Sig Professions Cod i 'Mon 3,Chapter 9. m n�'' " � � ' PLAN CHECK $ "l Signature of yL,w�.�_ o Permittee $ • TAX $ IL2 U U Authorized Agent TOTAL PAID $.i &4 O Vrt r 43284 6.8.95 6/27178 "25.25 7L` • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 ' API CA' ION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only REC:i 'is i DATE RECEIVED BUILDING vv /�( ; D iED /, ADDRESS ��I Cj `GLf�i=A1 Itl6�I� �3-0V N) �/3 14 .#: :";a/ P' -MIT O. OWNER �—f32. W, bUl1.r...0 A.P. NO. `Y' MAIL ADDRESS ���� t_✓/7 BUILDING Atte- ADDRESS TEL. CITY NO. TRACT ` I LOT BLOCK -CONSTRUCTIONC ASS, `= NEW IA D ALTER REPAIR (MOVING DEMOLISH LENDERt]1�V_13.4_ _BRANCH OWNER 'V 02/S1 ppp///{{{ F _ARCHESS z�/Li ALOE /O,) I ARCHITECT TEL. iJ$E GG N $/ (� OR ENGINEER N FIRE ,yl+ ADDRESS (� / / ZONE ,(I///�/T/�LPE GR/O/,�1P//�' _ CONTRACTOR \ ev �(` • C I • BYAPPROV ED (/__ DATE(( -{i�• W W/-v..4.4 C:v/.5i L ADDRESS 72,2, Nn/. 5 CiiAP i.e.,i.e., V `rTE�. _ ZONEf_ LANS BUILDING2440.OF USE OF NEW l..,r�'tTEL. CITY _lati=0t>; CY., k,• NO. Vi/-e•FgF� .F. STATE ��'1r� CITY YARDS APPROVED YARDS APPROVED g -LIC.NO. .y-(�-�1'a LIC.NO. JO�q f, MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLOCS. (FRO C/L STREET) OW. OF LOT I NOW ON LOT FRONT FT. FT. a USE OF / .N. EXISTING BLDG. Cr 00-3 (T Ca to S>'Yt S , R.SIDE FT. FT. V1 — F Separate permits are required for L.SIDE FT. FT. G electric,plumbing and heating work. _REAR FT. P r LUSE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BLD BET. AEC.MAIN& MAIN BLDGS. ACCESS.BLDGS. L VAR.# DATE Q _�i�:-s lT=.- �11 1 J�Y 1'It7 ,LIKE-. C.U.P.qW APPROVED APPROVED ,., - , BY DATE ..l ed 0. ■ O I hereby acknowledge that I have read this application and state n rg that the above Information Is correct and agree to comply with m 0.. all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of o the State of California. re 3 I hereby certify that I am properly licensed as a contractor under SQ.FT. a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR rD Chapter 9, and that such licenses are in full force and effect,or ITHE PURPOSE OF ESTABLISHING A PERMIT r3— am exempt from the provisions of the State of California Business T VALUATION PERMIT FEE $ and Professions Code,Division 3,Chapter 9. / n PLAN CHECK $ m 0 Signature //''��( LL 1 Permittee i 0 •- �='-..'-� $Ali TAX $ i; Authorized Agent TOTAL PAID $ 2-15