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Home My WebLink About2381 ELDEN AVE - Building Permits CITY OF COSTA MESA •• _ • ,, C BUILDING DIVISION . • :40111*r y; 'w,` 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca,us ,..„ r ga. FOR INSPECTIONS CALL:(714)754-5626 % . ft. N PERMIT NUMBER: BX08-00261 PERMIT TYPE B_MISC STATUS: ISSUED APN: 43927215 DATE ISSUED: 10/01/2008 Zoning: ISSUED BY: RMD JOB ADDRESS: 2381 A ELDEN AV CM Suite/Unit: A Vicinity: ROOF TOP Primary Occ: , ' �.,^„ Const Type :?? SO. FT: 0 .. Valuation: $16,200.00 - SCOPE OF WORK: INSTALLATION OF A 1.6 KW ROOF MOUNTED PHOTOVOLTAIC SOLAR PANEL SYSTEM WITH 1 INVERTER, DC DISCONNECT, CONDUIT FOR CONDO UNIT A. . . .. OWNER: ELDEN STREET PARTNERS Address:: PO BOX 15126 Unit City/State: NEWPORT BEACH, CA , Zip Code: - 92659 Phone: 949-230-5426 • . APPLICANT: MICHAELS,ABEL , Address: 393 VINTAGE PARK DRIVE STE'140 ' Unit: City/State: FOSTER CITY,CA ' Zip Code:: : 94404.•-• Phone: (650)638-1028. . .. '_ CONTRACTOR: SOLARCITY CORPORATION' ' - License No. 888104 Address: 393 VINTAGE PARK DRIVE STE 140 Unit: City/State: FOSTER CITY;CA - Zip Code: 94404 - _ -__ Phone .(650)638-1028 -. 'Cell: . ARCHITECT: - - - - . License No. ` ' Phone - - ENGINEER: SOLARCITY INC ' - License No. C67059 Phone 888-765-2489 . FEE SUMMARY - . Building Plan Check:-- ' - Building Permit: - :$279.25 . Electrical Permit: ' - $59.90 - -, SMIP Residential $1.62 . . SMIP Commercial - . ' $0.00 ' TOTAL FEES $522.28 GREEN 2 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. . INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable nodes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval wilIresult in the expiration of this permit. Com i INSPECTION TYPE oag INTMAL$ . c00EI INSPECTION TYPE mg DWI' ALS 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 BuildinglOccupancy Z II Pk iPit-- WORKERS'COMPENSATION DECLARATIONS - Owner ID verified by driv nse. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: . Driver's License No. —• '- Expires: . • ❑ 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 ' section 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 ❑ 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 , LUP. Lk yn 2^t Ca✓1 by this permit,and that no building structure,scaffolding,falsework,a demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gry --(This-seam need not be cwnplet the pemrt is vahled al one hundred dollars($103)of less) 2,Art 2,Sec.341,Title 8,California Administrative Code). P tot cy Number: W G d{A 7 3 Y G 70 U 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 become subject to the workers'compensa on provisions of Section 3700 of / Applicant's Signature Dale the Labo Code,I s all forthwith co •ly iky these provisions. eAl /sr o g Division of Industrial Safety Permit Number: / .(ranfs Si 1B 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 same 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 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 0E1-7.3, l0%� Class# ,/g/c-to(ccIL (Section 25533 of the California Health and Safety Code, with some 1 �r OC f-6!"S exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Oontdes 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 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)? ❑Yes ❑ 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 California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑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 65850.2 of the California Govemment 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 forRaged exe p' i A 10 'rot t.:{(a•n „liar ui tt am .000 feet from the outer boundaries of a school? ❑Yes- 0 No applicant for ermit subje 3C:p•li civ .e IA •rife 7/-- I an five hundrede. tl ($500).); -"� 'Q es the facility must meet the requirement of Sections 25534 and 42303 .3. e California Health and Safely Code). ❑ I, as os he pr•p-rty, .' m • is t'n4 sol: • r. 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 ❑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 p p rty,am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. . ' ❑ 'I, as owner of the roe . - - ' 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 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. . - igna -re of Legal Owner(s) Date Signature Date ��d ,SrDL p c7 3057-46(3/07) ,_�- y.rA ori .A,cant' Dote u i \Y c CITY OF COSTA MESA • • BUILDING DIVISION y ,o - . 77 FAIR DRIVE.COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us f1 I °. 1. FOR INSPECTIONS CALL: (714)754-5626 • PERMIT NUMBER: BX07-00124 PERMIT TYPE B_MISC STATUS: ISSUED APN: DATE ISSUED: 09114/2007 Zoning: , ISSUED BY: BJK JOB ADDRESS: 2381 E ELDEN AV CM Suite/Unit: E Vicinity: DUPLEX UNITS E AND F . Primary Occ,. Const Type :?? SQ. FT: 1600 Valuation - $2 000.00 %.. - SCOPE OF WORK: UNIT.E"AND F INTERIOR DEMOLITION OF A 1600SFDUPLEX"IN PREPARATION FOR A FUTURE CONDO CONVERSION, REF: 806-00060 OWNER: Address:: Unit • City/State: Zip Code: `i Phone: - APPLICANT: ZEHNDER,IPETE _ ' - Address: PO BOX 15126 Unit: City/State: NEWPORT BEACH,CA- Zip Code: 92659 Phone: 949-230-5426 CONTRACTOR: OWNER-BUILDER - - " • License No. 000000 Address: .Unit: • City/State: • - . - . Zip Code: Phone Cell: ARCHITECT: . . . - . - - - - -`�'License No. - Phone , • ENGINEER: - - 'License No. - , Phone - °+" "• . " FEE SUMMARY - Building Plan Check: $0.00 "... Building Permit: - -• $69.25 ..S. ' Electrical Permit. $0.00 - SMIP Residential - $0.00 �'�- SMIP Commercial • $0.00 3 $O.00TOTAL FEES , , .. , ."" NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE/ INSPECTION TYPE la IN11MLS CODE# IN$PECDON TYPE, DATE INTIIUL$ 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 L 204 Final Demolition 3-16"-en at- 250 Final Building/Occupancy 3-Ar egT WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive se. t Yes ❑No /� I hereby affirm under penalty of perjury one of the following declarations: Expires: '�Q ❑ 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' section 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 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,a demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Thus section need not be competed dlhe permit is valuer)of one hundred abears($100)or less) 2 Art 2.Sec.341,Title 8,California Administrative Code). Policy Number: 0 As owner-builder, I will not employ anyone to do work which would I certify at in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless sued,I shall) .1 employ any person in any manner so as to become subject such person has a permit to do such work from the division. 1 to the workeis' compensa ion laws of California, and agree that if I should become subjec'to the wa ers'compensation provisions of S tion 3700 of the Labor•S.•e,I s II fort 'th comply with these provisions. Applicant's Signature Date I Division of Industrial Safety Permit Number: A Firanrs Si. .rr. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: 1AIL RE TO SE, URE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAW'UL 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 ATTORNEYS 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 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? 0 Yes 0 No Lic.# Class# (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 Contractor's 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 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 0 No (Section 25534 of the Califomia 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 California OWNER-BUILDER DECLARATIONS: Health and Safely 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 65850.2 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 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? ❑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 Califomia 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 ❑ 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 oKcer). t , completion, the owner-builder will have the burden of proving that he'or stie 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' 01ty ordinances regarding Hazardous Materials and Emissions. ENSED CONTRACTORS to construct the project(Sec.7044,.Business and Professions Cade: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 CERTIFICA' OF'COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s) 'cense pursuant to the Contractors License Laws.). certify under •enalty of perjury that I have read this application and state that ❑ I am ex; pt under sec. - the informati• given is correct. I agree to comply with all state laws and city ordinances)re ating to building construction, and authorize representatives of Business an: "rofessions Cede for this reason: the City •f eosta Mesa t. enter upon the above-described property for inspection pur•oses. I agree of to occupy or allow occu anc of any building ' authorize. by ' is •-rmit until mal inspection. ��\ 0®G1 /�- e'e'r-) j y G to '• 5:5'.tui' late 3051-06(3107 Andlor Authorized Apptront Date ` CITY OF COSTA MESA BUILDING DIVISION Fi`,,,��,.,, A( 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us a, FOR INSPECTIONS CALL:(714)754-5626 as if PERMIT NUMBER: BC07-00418 ttiirsPERMIT TYPE: B_COMBO S,,e•a;:.'ig A STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 0111012008 ISSUED BY: BJK JOB ADDRESS: 2381 A ELDEN AV C11/11:1- ' Suite/Unit:. A APN: 43927215 _ Vicinity: UNIT A . - : : Primary Occ:, Const Type: V-N : $Q: FT: 0 Valuation: $60,000.00 SCOPE OF WORK: UNIT A:'RENOVATION/OF THE CONDO CONVERTED UNIT. REPLACE WINDOWS(TO MEET PRESENT EGRESS REQUIREMENTS),.ENTRY DOOR AND SLIDER. NEW INSULATION, DRYWALL& FINISHES. MISC GARAGE REPAIRS. ELEC: 16 LIGHTS, 29 OUTLETS,21 SWITCHES; MECH: 1 FAU <100K BTU, 1 APPL VENT. PLUMBING: P07-00511. REF: BX07-00122, .. . B06-00060 OWNER: ELDEN STREET PARTNERS Address: PO BOX 15126 -•• - ••— -• - . - - Unit: . I„i,;( Phone: 949-230-5426 - City/State/Zip: NEWPORT BEACH,CA ' 4• -UC S. ` APPLICANT: ZEHNDER, PETER . . ' Address: - " _. .- . Unit: : Phone: 949-230-5426- • � City/State/zZip: - CONTRACTOR: OWNER-BUILDER - - --- - H License No: 000000 . ' Phone: .. Address: Unit: - - Cell: , - City/State: - ZipCode ARCHITECT: License No.• . PHONE: ENGINEER: LicenseNo. - . PHONE: COMBINTATION PERMIT FEE SUMMARY Building Plan Check: - $463.94 . Building Fees: . $713.75 - : • Electrical Fees: . $92:40 Mechanical Fees: • • - $49.15 Plumbing Fees: $0.00 SMIP Residential: $6.00- - . - SMIP Commercial: $0.00 - - .. TOTAL FEES: $1,325.24 ' :•I: '` :; --Refer to fee receipts for all fees paid for project NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE A. INSPECTION TYPE DATE IN1WALS CODES INSPECTION TYPE DATE INTITIALS 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 Sit 204 Final Demolition 250 Final Building/Occupancy • WORKERS'COMPENSATION DECLARATION: Owner ID verified bydcccri��ivver's.❑Yes ❑No ' I hereby affirm under penalty of perjury one of the following declarations: Drivers License No. Expires: � Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Owners Ip 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 section 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 , ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: person i#'required to descend,will be made in connection with work authorized — by this permil,,aridlhaf no building structure,scaffolding.falsework,or demolition Carrier: 'or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Tris seolbn need not be completed tithe permit is valued al one hundred dollars($500)or less 2,Art 2,Sec.341;Title 8,California Administrative Code). Policy Number: . - r i CO 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 ed, I s all not employ any person in any manner so as to become subject such person has a permit to do such work from the division. Is . to the wo ers' compensation laws of California, and agree that if I should become eject to the •rkers'compensation provisions o Secti n 3700 of --- - the Labo pA ee,Ishall f.rthwith comply with these provision Appuwnl's Signature Date I \ h Division of Industrial Safety Permit Number: IV*PIA vri. . e D to HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNIN : FAILURE • 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? 0 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 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 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.# Class# (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 Contractors 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 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)? 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 California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑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 ❑ No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment 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? 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). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penally 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 fessions 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 contra tor(s)license pursuant to the Contractors License Laws.), certify and-r penalty of perjury that I have read this application and state that 0 I .m xemp[under sec. the info - ion given is correct. I agree to comply with all state laws and city ordinances elating to building construction, and authorize representatives of Businesss a d Profe •'.. •de for this reason: the City of Costa Mesa to enter upon the above-described property for inspecti•n p rposes. I agree not to occupy or allow occupancy of any building A. \ ' /��/�'/ authori a-d b this permit u it final inspection. tt }��j �, V/t 'Eru •of Legal , •-r(s) \ pte OU -,gna Oae (l ' 1� 3057-46 3/07) And/or Authorized Applicant Date • . CITY OF COSTA MESA 1111) cam F., BUILDING DIVISION Feu' 'Ii) 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us F PECTIO L: (714)754-5626 mom I. 1 :;t..8'# PERMIT NUMBER: P07-00511 -: . PERMIT TYPE PLUM 44 STATUS: ISSUED DATE ISSUED: 09/0412007 ISSUED BY: SOK • JOB ADDRESS: 2381 A ELDEN AV CM SuitefUnit: A Vicinity: • • • SCOPE OF WORK: PLUMBING WORK FOR UNIT A OF DUPLEX. INCLUDES: 1 BATHTUB, 1 DISHWASHER, 1 GAS(1-4 OUTLETS), 1 GAS REPIPE, 1 LAUNDRY-TUB/WASHER, 1 SHOWER, 1 KITCHEN SINK, 1'WATER HEATER AND 1 WATER REPIPE. OWNER: ELDEN STREET PARTNERS Address: PO BOX 15126 PHONE: 949-230-5426 - City/State/Zip: NEWPORT BEACH, CA APPLICANT: PETE ZEHNDER Address: PO BOX 15126 : PHONE: 949.230-5426 City/State/zZip: NEWPORT BEACH, CA CONTRACTOR: OWNER-BUILDER License No. 000000 Address: PHONE: City/State: ZipCode: - CELL: PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: $0.00 PERMIT FEE: $110.55 • TOTAL FEES: $110.55 • 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 IATE INTITIAL CODE INSPECTION mgpn� INOTIALS 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 4111 WORKERS'COMPENSATION DECLARATION: : :., Owner ID verified by 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 section 3700 of the Labor Code,for the performance of the work(or 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 number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,lalsework,or demolition Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp (This sailor need not be completed tine permf is valued al one hundred dollars MOO)cvtess.) 2,Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: 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 become subject to the workers'compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,I shall forthwith comply with these provisions. Division of Industrial Safety Permit Number: Applicant'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? 0 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 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 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? 0 Yes 0 No Lic.# Class# (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 contractors 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 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 Itris permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? IDYes 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 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 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 Government Code requires that the requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for rpm-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 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 undyed 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 •erisation, 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 control officer). sale. If, however, the building or improvement is sold within one year of completion, the ovmer-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 am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. property,❑ I, as owner of the 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 tractors)license pwsuant to the Contraclas License Laws.), certify under penalty of perjury that I have read this application and state that i la exempt under sec. - the informs'on given is correct. I agree to comply with all state laws and city gordinances •lating to •uilding construction, and authorize representatives of ness- d Professions ••e for this reason: • the City • osta Me.a to enter upon the above-described property for inspectio • •oses. I .•ree not to occupy or allow occu ncy of 6ny building I authorize, h' permi • ' '- -'pection. O I 1/ ! _• - • aweatb'fhalOweer(s) J• sl•natue _3057-46( /OkLLOJatm __- A 1, l . t! CA IF AVz • •int-_ la—Vi-L---- • r• CITY OF COSTA MESA a ` • BUILDING DIVISION 44ellta• �) 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • wwN.ci.costa-mesa.ca.us 4. FOR INSPECTIONS CALL:(714)754.5626 PERMIT NUMBER: BC07-00419 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 01/10/2008 ISSUED BY: BJK JOB ADDRESS: 2381 B ELDEN AV CM Suite/Unit: B APN: 43927215 Zoning: , , Vicinity: UNIT B - Primary Occ: Const Type: V-N ' SQ. FT: - 0 - Valuation: $60,000.00 SCOPE OF WORK: UNIT B: RENOVATION OF THE CONDO CONVERTED UNIT. REPLACE WINDOWS(TO MEET PRESENT EGRESS REQUIREMENTS), ENTRY DOOR AND SLIDER. NEW INSULATION, DRYWALL&FINISHES. MISC GARAGE REPAIRS. ELEC: 19 LIGHTS, 25 OUTLETS, 17 SWITCHES; MECH: 1 FAU <100K BTU, 1 APPL VENT. PLUMBING: P07-00564. REF: BX07-00122, B06-00060 OWNER: ELDEN STREET PARTNERS Address: PO BOX 15126 • Unit;DT-004i , I}r Phone: 949-230-5426 City/State/Zip: NEWPORT BEACH,CA • APPLICANT: ZEHNDER, PETER • • Address: Unit: : Phone: 949.230.5426 City/State/zZip: CONTRACTOR: OWNER-BUILDER - - License No. 000000 Phone: Address: Unit: Cell: City/State: ZipCode ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: COMBINTATION PERMIT FEE SUMMARY • ' Building Plan Check: -• • $463.94 l - Building Fees: - $713.75 . '`c'Et` Electrical Fees: $88.75 P.F.PAIRS. Mechanical Fees: $49.15 Plumbing Fees: $0.00 SMIP Residential: $6.00 SMIP Commercial: $0.00 TOTAL FEES: $1,321.59 '- • t.•00,41 ti` —Refer to fee receipts for all fees paid for project 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. ODE r INSPECTIONTYPE CSU INTn1AL5 CODES INSPEC110N1YPE DATE IN1n1AL5 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 ' -IL 7; 204 Final Demolition 250 Final Building/Occupancy (—Z/—(D / /7 • .., .. • WORKERS'COMPENSATION DECLARATION: Owner ID verified by d' errs � ' Expires: YD ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Owners up 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 section 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 ❑ I hereby certify that no excavation five(5)or more feet m 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 Carder: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Thissecton need nal be completed L thepmnt isvalued at one hundred cSars(5100)of less.) 2,Art 2,Sec.341,The 8,California Administrative Code). Policy Number: 0 As owner-builder, I will not employ anyone to do work which would I certify hat in the performance Of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless ued, I she)l 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 worker' compensation laws of California, and agree that if I should becomes bje't to the workers compensation provisions of Section 3700 of Applicant's Signature Date the Labor I ori: I s : forthwith comply with these provisio s - U Number Division of Industrial Safety Permit A•nc�anrS Signal e/ 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? 0 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 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 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.# Class# (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 Contractor's 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 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)? IDYes 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 California OWNER-BUILDER DECLARATIONS: Health and Safely 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 65650.2 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 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). 0 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 ❑ 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 control officer). 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 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. ENSED CONTRACTORS to construct the project(Sec.7044,Business and rofessions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves(hereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractors)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 I am exehpt under sec. the information given is correct. I agree to comply with all state laws and city ordinances rel.ting to building construction, and authorize representatives of Business an Professions Code for this reason: the City of sista Mesa to enter upon the above-described property for r inspection pu •.ses. I agre• not to occupy or allow occupancy of any building 1 /,/(�( authorized by t is permit un•1 final inspection. 1///�\` ^ (/\� \ ( " p e. t.egai• Dat �1 Signatuh J Date �� 1 't 4 305746(3/07 '•ndlor Authorized Applicant Date CITY OF COSTA MESA , fir' BUILDING DIVISION • r �l� 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us ts. pic FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: P07-00564 PERMIT TYPE PLUM STATUS: ISSUED DATE ISSUED: 10/30/2007 ISSUED BY: BJK JOB ADDRESS: 2381 B ELDEN,AV CM .Suite/Unit:, - B Vicinity: UNIT B . . • SCOPE OF WORK: PLUMBING WORK FOR•UNIT B OF DUPLEX. INCLUDES: 1 BATHTUB, 1 DISHWASHER, 1 GAS (1-4 OUTLETS), 1 GAS REPIPE, 1,LAUNDRY TUB/WASHER, 1 SHOWER, 1 KITCHEN SINK 1 WATER HEATER AND 1 WATER REPIPE. OWNER: ELDEN STREET PARTNERS - Address: PO'BOX 15126 PHONE: 949-230-5426' - City/State/Zip: NEWPORT BEACH,CA". APPLICANT: PETE ZEHNDER . • Address: PO BOX 15126 : PHONE: 949-230-5426 ' City/State/zZip: NEWPORT BEACH,CA . CONTRACTOR: OWNER-BUILDER License No. 0000.00 Address: PHONE: • City/State: ZipCode: - - CELL: • • PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: $0.00 PERMIT FEE: $110.55 ' TOTAL FEES: $110.55 - • • • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. OOOE 11 INSPECTION TYPE, g1ET INTr1AL$ COPE/ INSPECTION MF• DATE INTmAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing -te-cc L6._ 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 WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers. .e. Yes ❑No / I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: 16/01 O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership"by( pe 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 section 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 ❑ 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 by this permit,and that no building structure,scaffolding,falsework,a demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gry (Teo sect.",need not be completedtthe pem*B valued at one hundred dolars($IW)orless.) 2.M 2,Sec.341,Title 8,California Administrative Code). XP icy Number: ❑ As owner-builder, I will not employ anyone to do work which would I cert' 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 ued,I sal-II 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 •Ac'rs' compensation laws of California. and agree that if I should become Lb ect to the worke 'compensation provision of Section 3700 of Applicant's Signature Dale the Lab,r C..e.I shall forth 't comply with these pr I A pr 716") Division of Industrial Safety Permit Number: ,'!'r' 51g.u 7 le HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARN! G: F•LURE TO SE RE 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 CML 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 ATTORNEYS 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 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? 0 Yes ❑No Lic.# Class# (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 Contractor's 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 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.CMI 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 California OWNER-BUILDER DECLARATIONS: ,tet- d:.' Health and Safety Code been fully complied with? ❑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.requiresa 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 65850.2 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 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 ❑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? ❑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). 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 of build or improve for purpose of sale.). I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH information given above is cored. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. U NSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature pate property who builds or improves thereon,and who contracts for such project with CERTIFICA E OF COMPLIANCE AND.AUTHORIZATION OF ENTRY: I a contract• s)license pursuant to the Contractus License Laws.). certify unde penalty of perjury that I have read this application and state that ❑ I am a opt under sec. the informa'on given is correct. I agree to comply with all state laws and city ordinance elating to building construction, and authorize representatives of Business an. Professions Code .r this reason: the City .f Costa Mesa to enter upon the above-described property for inspectio .urposes. I .gree.not to occupy or allow occupancy of any building I �r authorize•i y this per it until final inspection. /D ?A • `"' V� i azure of sal Owner(s) ' 6/ tsV'0Th 3059<6(3l,') V ' n'ure V Dale ¶Ii I 1 ndlor Aute.iz .Applicant Date r CITY OF COSTA MESA a BUILDING DIVISION F0 n-t.,l 77 FAIR-DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)7544856 • www.ci.costa-mesa.ca.us 4. FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: BC07-00420 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 01/10/2008 ISSUED BY: BJK JOB ADDRESS: 2381 C ELDEN AV CM Suite/Unit: C APN: 43927215 Zoning: , Vicinity: UNIT C - ' . . , Primary 0cc: Const Type: V-N - SQ'. FT: - 0 Valuation: $60,000.00 SCOPE OF WORK: UNIT C: RENOVATION OF THE CONDO CONVERTED UNIT. REPLACE WINDOWS (TO MEET PRESENT EGRESS REQUIREMENTS), ENTRY DOOR AND SLIDER. NEW INSULATION, DRYWALL& FINISHES. MISC GARAGE REPAIRS. ELEC: 17 LIGHTS, 31 OUTLETS,20 SWITCHES; MECH: 1 FAU,<100K BTU, 1 APPL VENT. PLUMBING: P07-00565. REF: BX07-00123, B06-00060 OWNER: ELDEN STREET PARTNERS Address: PO BOX 15126 .. Unit: 7 i,,: Phone: 949-230-5426 City/State/Zip: NEWPORT BEACH, CA -'r''6`i APPLICANT: ZEHNDER, PETER Address: Unit: Phone: 949-230-5426 . City/State/zZip: _ CONTRACTOR: OWNER-BUILDER ' License No. 000000 Phone: Address: Unit: Cell: City/State: ZipCode ARCHITECT: License No.- . PHONE: ENGINEER: License No. PHONE: COMBINTATION PERMIT FEE SUMMARY - Building Plan Check: - • '$463.94 Building Fees: $713.75 - lk 5 -NT Electrical Fees: ' $94.23 -1:c IRE,aAIRS. Mechanical Fees: $49.15 - • ' liFF• Plumbing Fees: $0.00 SMIP Residential: ' $6.00 - SMIP Commercial: $0.00 TOTAL FEES: $1,327.07 "Refer to foo receipts for all foes paid for project 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. - §ODES INSPECTION TYPE QATF INTTALS CODES INSPECTION TYPE DRF INTmALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical - i-'I'j 1286 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 6—Zilfe WORKERS'COMPENSATION DECLARATION: S Owner ID verified by driv �/ Yes 0 No I (ay hereby affirm under penalty of perjury one of the following declarations: Driver's License No. / -property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the wait 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, wilt be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,a demolition Carrier: a dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Thisseclion need nor be completed if lhepermd 6 valued al one hundred dNrars(4r00)or less) 2 Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would I certify hat in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless is ued,I shal 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 worker ' compensation laws of California, and agree that if I should become subje 1 to the wo ers'compensation provisions f S tion 3700 of Applicant's Signature Date the Labor pd: I shall forth 'th comply with these provisi s. // , i) Division of Industrial Safety Permit Number: A•T S roar re 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? 0 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 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 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 forte and effect. a registration form for acutely hazardous materials? ❑Yes 0 No Lic.# Class# (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 Contractor's 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 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)? 0 Yes 0 No (Section 25534 of the Califomia 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 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 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? 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? ❑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). 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 NigI, 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 a exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances r:ating to building construction, and authorize representatives of Business • d Professions Code for this reason: the City of osta Mesa to enter upon the above-described property for l inspection pJ-•oses. I agree not to occupy or allow occupancy of any building authorized b. his permit un 1 final inspection. AL,.. ( IIIA ±11 sigma '7 I Date err 3051-06‘•]) And!'AuthMzed ApYirant Dale CITY OF COSTA MESA s•C't i� BUILDING DIVISION F`: ',^,.,,,,.,,,' tI 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us u. /"� FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: P07-00565 PERMIT TYPE PLUM STATUS: ISSUED DATE ISSUED: 10130/2007 ISSUED BY: BJK JOB ADDRESS: 2381 C ELDEN-AV CM' - _ !Su' C Vicinity: UNIT C SCOPE OF WORK: PLUMBING WORK FOR UNIT C OF DUPLEX. INCLUDES: 1 BATHTUB,1 DISHWASHER, 1 GAS(1-4 OUTLETS), 1 GAS REPIPE, 1 LAUNDRY TUBM/ASHER, 1 SHOWER, 1 KITCHEN SINK; 1,WATER HEATER AND 1 WATER • REPIPE. -�P rt - .r ' • OWNER: ELDEN STREET PARTNERS Address: 'PO BOX 15126 - ' PHONE: 949-230.5426' I - r - City/State/Zip: NEWPORT BEACH,CA , '' APPLICANT: PETE ZEHNDER Address: PO BOX 15126 ' : t 1' PHONE: 949-230.5426 . . City/State/zZip: NEWPORT BEACH,CA ' • CONTRACTOR: OWNER-BUILDER License No. 000000 Address: - PHONE: City/State: ZipCode:• - � - CELL: PLUMBING PERMIT FEE SUMMARY ' • • PLAN CHECK FEE: $0.00 PERMIT FEE: $110.55 -410.- TOTAL FEES: $110.55 '4 fp . . . . . 3 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. alai INSPECTION TYPE DATE IN1I11AL$ CODE I INSPECTION TYPE DA INT111AL$ 1816 Fixed System Final Fire Prevention . 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing• A3'/6^t 200 Final Re-Roof 210 Final Electrical j3E- 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Piro Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Buildingloccupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by driversc^ '� ,e. t.L�1Yes 0 No / 1�ox I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: 0U O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of docum nL 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 section 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 ❑ 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 by this permit,and that no building structure,scaffolding,falsework,or demolition Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm (This se n',need not bemmplefed/the permit is valued at one hundred claaars(Elle)or less.) 2,Art 2.Sec.341,Ttle 8,California Administrative Code). Policy Number: 0 As owner-builder, I will not employ anyone to do work which would SI c��fy 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 I all 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 -:Ts' compensation laws of California, and agree that if I should become)' •'ect to the wo' ers'compensation provisions of Section 3700 of the Labe ••.e,I shal fort Th comply with these provi;iql)� 1 Apclir�ni's 5;gnawre Date L. • 1.... [(v 30 Division of Industrial Safety Permit Number: Appli;it's Sign re Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNI : 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? 0 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 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 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? 0 Yes 0 No Lic.# Class# (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 Contractor's signature Dale 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). 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)? 0 Yes 0 No (Section 25534 of the Califomia 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. Sgnature Dater, 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: •fC"-t.',. w''V,: 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 LICENSECLA.W 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 consuuctC.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 65850.2 of the California Government Code requires that the requested that he Pr,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 0 No applicant for a permit subjects the applicant tea 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 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 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 taws and XcityI, as owner of the property, am EXCLUSIVELY CONTRACTING WITH ordinances regarding Hazardous Materials and Emissions. ENSED CONTRACTORS to construct the project(Sec.7044,Business and X Professions Code:The contractors License Law does not applyowner an of Sgnawre Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contracta(s)license pursuant to the Contractc's License Laws.). certify under penalty of perjury that I have read this application and state that �.. 0 I exempt under sec. the inform- ion given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business nd Professions Code for this reason: the City 0 Costa Mesa to enter upon the above-described property for ` inspection r rposes. I agree not to occupy or allow occupancy of any building A/,I authorized ., this permit until final inspection. �o� oate •gnature of L:rat• er(s) e 5 to ata �� L O al Q 3057 1300 ) /F/� • A d... vire' Applicant 0 to i' • CITY OF COSTA MESA 0-.1:011i. BUILDING DIVISION )•• . `l 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 3. pia - FOR INSPECTIONS CALL: (714)754-5626 `gym PERMIT NUMBER: BX07-00123 PERMIT TYPE B_MISC STATUS: ISSUED APN: DATE ISSUED: 09/14/2007 Zoning: , ISSUED BY: BJK JOB ADDRESS: 2381 C ELDEN AV CM- .:; -, Suite/Unit: C Vicinity: DUPLEX UNITS C AND D . • Primary Océ: Const Type :?? SQ. FT: 1600 Valuation: • $2,000.00, , SCOPE OF WORK: UNIT C'AND D INTERIOR DEMOLITION OF A-1600SF DUPLEX IN PREPARATION FOR A FUTURE.CONDO'CONVERSION. REF: 806-00060 OWNER: Address:: Unit City/State: ''Zip Code: Phone: - APPLICANT: ZEHNDER,•,PETE -, -Address: ' PO BOX 15126 • ''Unit: City/State: NEWPORTBEACH, CA - Zip Code: 92659 • - Phone: 949-230-5426 CONTRACTOR: OWNER-BUILDER - - - License No.,- •000000 j Address: • Unit: • , - City/State: Zip Code: _ Phone Cell: ARCHITECT: - • License No. Phone ENGINEER: --- - - ,License No. _ • Phone '. - . FEE SUMMARY - • Building Plan Check: $0.00 Building Permit: $69.25 4. . . Electrical Permit:' $0.00 - SMIP Residential _ -:•':,...:;$0:00:r- SMCommercial 69.20 $O.00TOTAOTAL FEES $69.25 3. . _ . _ . . . ... NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE r INSPECTION TYPE DATE INTnIALQ CODE r INSPECTION TYPE DATE INTITUL$ 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 Demolition3 250 Final Building/Occupancy ,3 i'(V' WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive. The. Yes ❑No ' j I I hereby affirm under penally of perjury one of the following declarations: 7 Driver's License No. Expires: fit6`� 16 ❑ I have and will maintain a certificate of consent to self-Insure forworkers' Verification of Ownership by(type of docum nt,i.e.•properly 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 by this permit,and that no building structure,scaffolding.falsework,a demolition Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm Min section need not be completed rt the penny is rowed al one hundred dinars(S100)a'less) 2,Art 2.Sec.341,Title B,California Administrative Code). Policy Number: ❑ 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 ued, I sh-II of 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 workers compensation laws of California, and agree that if I should become sdbjec to the workers'compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code I shall forth 'th comply with these provision{ • 0 (41 •,._ / 'T1 Division of Industrial Safety Permit Number: nrs '.oat f11f /Dat / HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNIN ' ARE TO •�I RE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNIA UL AND SHAL 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 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one lime during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lic.1$ Class It (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 Contractors Signature Dam 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 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,Ovil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑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 California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑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 65850.2 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 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 safe(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). 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 CONTRACTORS to construct the project(Sec.7044,Business and EXCLUSIVELY CONTRACTING WITH ' ' city ordinances regarding Hazardous Materials and Emissions, yLt(CENSED f Professions Code:The contractors License Law does not apply to an owner of Signature Dale 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 unde •enalty of perjury that I have read this application and state that 0 I am e rapt under sec. the informa i• given is correct. I agree to comply with all state laws and city ordinances re-ting to building construction, and authorize representatives of Business a d •rofessions Code for this reason: the City o •••stn Mes. to enter upon the above-described roperty for inspection lur.oses.I ag.-e not to occupy or allow occupy cy f ny building authorized .y ' i. permit ntil final inspection. • 1 e . at ` - I*g tiff er D to •r T_ at e Date `` 3057-46(3/0 And/or Authorized pplicant Date CITY OF COSTA MESA o w 14s. a BUILDING DIVISION A .AI 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 etcv;ft:ito le PERMIT NUMBER: BC07-00421 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 01/10/2008 „----71-.—- ISSUED BY: BJK JOB ADDRESS: 2381 D ELDEN AV CM Suite/Unit: D APN: 43927215 ' 'Zoning: , , . Vicinity: UNIT D - , , Primary Occ: Const Type: V-NSQ. FT: 0 - Valuation: $60,000.00 SCOPE OF WORK: UNIT D: RENOVATION OF THE CONDO CONVERTED UNIT. REPLACE WINDOWS (TO MEET PRESENT EGRESS REQUIREMENTS), ENTRY DOOR AND SLIDER. NEW INSULATION, DRYWALL&FINISHES. MISC GARAGE REPAIRS. ELEC: 17 LIGHTS, 31 OUTLETS, 20 SWITCHES; MECH: 1 FAU <100K BTU, 1 APPL VENT. PLUMBING: P07-00566. REF: BX07-00123, - - B06-00060 OWNER: ELDEN STREET PARTNERS Address: PO BOX 15126 '• Unit: Phone: 949-230-5426 City/State/Zip: NEWPORT BEACH,CA • - ''*= APPLICANT: ZEHNDER, PETER • --Address:, - : . - Unit: Phone: 949-230-5426 City/State/zZip: • CONTRACTOR: OWNER-BUILDER -' _ - License No. 000000 Phone: _ Address: -Unit: Cell: City/State: - ZipCode ARCHITECT: . License No.--: - ' PHONE: ENGINEER: License'No. PHONE: COMBINTATION PERMIT FEE SUMMARY' ' Building Plan Check: $463:94 - .. . . . Building Fees: $713.75 Electrical Fees: $94.23 Mechanical Fees: $49.15. - - Plumbing Fees: ' -. $0.00 . SMIP Residential: SMIP Commercial: $0.00 TOTAL FEES: $1,327.07 • "Refer to fee receipts for all fees paid for project 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 t INSPECTION TYPE DATE IN1111ALS CODES INSPECTION TYPE DATE IN1111ALS 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 WORKERS'COMPENSATION DECLARATION: S Owner ID verified by drive ..?;YesAA // Expires: V 0 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. O 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance canier and policy ❑ 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 by this permit,and that no building structure,scaffdding,falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp (This sectonneetl not be completed 3the permit is valued at one hundred dollars(SIM or less.) 2 Art 2.Sec 341,Title B,California Administrative Code). Policy Number: 0 As owner-builder, I will not employ anyone to do work which would �ry5 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 Nued,I s all 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 wor ers' compensation laws of California. and agree that if I should become st.ject to the workers' compensation provisions o Se tion 3700 of Applicants Signature Date the Labors.de.I shall f• hwith comply with these provision . A ) (‘ Division of Industrial Safety Permit Number: gn�+ ate HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNINS: F•!LURE TiECUS RE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLA FUL AND HALL 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 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 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 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? 0 Yes ❑No Lic.# Class# (Section 25533 of the Califomia 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 Contractors Signature Dale 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 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 ❑ 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 Dale 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 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 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 Safely 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 control . 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 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 El I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances rel ing to building construction, and authorize representatives of Business an rofessions Cod' for this reason: the City of C.-ta Mesa to enter upon the above-described property for inspection pup.ses. I agr e not to occupy or allow occupancy of any building authorized by thi. permit til final inspection. Signawr • Date 16‘9" 0057-46 mon - • - ndlor Authorized Applicant Date sir CITY OF COSTA MESA . - r . BUILDING DIVISION f ��tn�''' ,,,'-Ig$ . 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 www.ci.costa-mesa.ca.us 4. l • FOR INSPECTIONS CALL:(714)754-5626 PERMIT NUMBER: P07-00566 PERMIT TYPE PLUM STATUS: • ISSUED • DATE ISSUED: • 10/30/2007 ' , • , . ISSUED BY: BJK ' JOB ADDRESS: 2381 D ELDEN>"AV CM ' . ' _ -Suite/Unit:, -` D, Vicinity: UNIT D , , - - SCOPE OF WORK: PLUMBINGWORK FOR UNIT D OF DUPLEX. INCLUDES: 1 BATHTUB, 1 DISHWASHER, 1 GAS(1-4 OUTLETS), 1 GAS REPIPE, 1 LAUNDRY TUB/1NASHER, 1 SHOWER, 1 KITCHEN SINK;1 WATER HEATER AND 1 WATER REPIPE. "��._ a, , . OWNER: ELDEN STREET PARTNERS ' ' Addless: PO BOX15 • 126 - ' , PHONE: 949-230-5426 - . - City/State/Zip: NEWPORT BEACH;-CA- . APPLICANT: PETE ZEHNDER , - - Address: PO BOX 15126' - ' PHONE: 949-230-5426 - .City/State/zZip: NEWPORT BEACH,CA. CONTRACTOR: OWNER-BUILDER • - ' License No. 000000 - Address: - PHONE: •City/State: • • . - ZipCode:—_' - • CELL: • PLUMBING PERMIT FEE SUMMARY ,•,.;.' ;;;,, A. 0 `' PLAN CHECK FEE: $0.00 PERMIT FEE: $110.55 •, TOTAL FEES , 3 . : $110.55 • . .. .. . . •,. .. . .. . , . . • . • . . . . . . . . , . . . . .• 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 1. INSPECTION TYPE DATE INnnALS CODES INSPECTION TYPE DATE glmALS 1616 Fixed System Final Fire Prevention • 206 Final Mechanical 1266. Pool Spa Final • 208 Final Plumbing 3 1 "O7 a 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 I 204 Final Demolition • 250 Final Building/Occupancy ' WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers e. l/ ❑ 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 section 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 ElI 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 by this permit,and that no building structure,scaffolding,falsework,or demolition Cartier: or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp alas section need not be completed the permg is valued at one hundred dollars(S100)or/ess.) 2,Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would I cert' 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 %sued, I s - 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 . .': compe sation laws of Califomia, and agree that if I should become - t to the •rkers'compensation provision of Section 3700 of Applicant's Signature Date the Labor r•••.,I shall f• hwith comply with these pr 0'-1 Division of Industrial Safety Permit Number: A 1 pelican S!nature oat 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? 0 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 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 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 Lit.# Class# (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 Contractor's 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 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)? 0 Yes ❑ 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. Signaturet..,`t Date `t,'• 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'afftrm 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 65850.2 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 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? ❑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 control ofs , cer). 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 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 A I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. ENSED CONTRACTORS to construct the project(Sec.7044,Business andessions 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 CERTIFIC• 4 OF COMPLIANCE AND AUTHORIZATION OF ENTRY: a contract )license pursuant to the Contractors License Laws.). certify un.-r •enalty of perjurythat I have read this application and stale that ❑ I a ex:met uncle c. the info ati•n given is correct. I agree to comply with all state laws and city ordinan•es mating to building construction, and authorize representatives of Busine enc Professions C for this reason: - the Ci of osta Mesa• o enter upon the above-described property for inspec in pu •oses. I agr>- not to occupy or allow occupancy of any building J///L1�` 11j�1 Z/1I authori.-d by this permit u til final inspection. �1 f v( U V O.—) 'ar• •or Legal• 'er(s) i 6 17b(r) Sig afore Date 1 3057A6(3le7) And/or Authorized Applicant Date Er a CITY OF COSTA MESA �� > BUILDING DIVISION ).i4,4",.. . ---''iii 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FI 4 :kt I 1e- FOR INSPECTIONS CALL:(714)754-5626 ot 11' PERMIT NUMBER: BC07-00422 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 0111012008 ISSUED BY: BJK JOB ADDRESS: 2381 E ELDEN AV.CM " ' • Suite/Unit: E APN: 43927215 Zoning: Vicinity: UNITE .. - . -Primary Occ: • Const Type: V-N SQ. FT: 0 Valuation: $60,000.00 SCOPE OF WORK: UNIT E: RENOVATION OF THE CONDO CONVERTED UNIT. REPLACE WINDOWS (TO MEET PRESENT EGRESS REQUIREMENTS),-ENTRY DOOR AND SLIDER. NEW INSULATION, DRYWALL& FINISHES. MISC GARAGE REPAIRS. ELEC: 17 LIGHTS, 29 OUTLETS,21 SWITCHES: MECH: 1 FAU.<100K BTU, 1 APPL VENT. PLUMBING: P07-00567. REF: BX07-00124,B06-00060 OWNER: ELDEN STREET PARTNERS Address: PO BOX 15126 - " ' Unit: , fl.l•y� Phone: 949-230-5426 City/State/Zip: NEWPORT BEACH,CA APPLICANT: ZEHNDER, PETER ' "-Address:- - Unit: : Phone: 949-230-5426 City/State/zZip: CONTRACTOR: OWNER-BUILDER - - - - . License No. 000000 Phone: _. -. Address: . Unit: / — - Cell: • City/State: . ZipCode • ARCHITECT: . . • License No.- PHONE: ENGINEER: License No. - PHONE: COMBINTATION PERMIT FEE SUMMARY . Building Plan Check: . - $463.94 " _ _ Building Fees: $713.75 . - - - Electrical Fees: $93.50 . Mechanical Fees: . " $49.15 Plumbing Fees: $0.00 SMIP Residential: . $6.00 . - SMIP Commercial: $0.00 TOTAL FEES: $1,326.34 • .r•f',4 22 -'Refer to fee receipts for all fees paid for project 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. INSPECTION TYPE DATE ix-rains CODE/ INSPECTION TYPE DATE INTnIALS 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 mo//�// 204 Final Demolition 250 Final Building/Occupancy 7 - /gtC • WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's lice..__. ❑Yes• ❑No �f I hereby affirm under penalty of perjury one of the following declarations: 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 performance of the work for which this permit is issued. O 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 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 number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffdding,falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(35)feet high.(Chap.3.2,Grp (This sedan need not be competed if the permit is valued at one hundred dollars($)00)or less.) 2,Afl 2Sec.341,Ttle 8,California Administrative Code). Policy Number: 0 As owner-builder, I will not employ anyone to do work which would I certify at 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 shal .t 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 wo Is' ompensation laws of California, and agree that if I should become su.'ect to the wo :rs' compensation provisions of ecti n 3700 of Applicant's Signature Date the Labor C•.e. shall forth h comply with these provisions. a I Ii tic Division of Industrial Safety Permit Number: IAp•V.nt S. .wr D to HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: IAILURE TO SECi.RE 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? 0 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 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 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 lull force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lic.# Class# (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 Contractor's 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 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)? 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 ❑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 65850.2 of the California Govemment 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 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). 0 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 control officer). 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 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 yrEA'_ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. /LTCeENSED 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 0 I am exe 'd under sec. the information •iven is correct. I agree to comply with all state laws and city ordinances rela ..g to building construction, and authorize representatives of Business and • •fessions rode for this reason: the City of Ctrs : Mesa to enter upon the above-described property for f inspection purpos'5. I agree n.t to occupy or allow occupancy of any building authorized bylthis sermit until f al inspection. • / ( li Siis ® / v. .— -a ( Date 3057-06(3/07) I An.or i thonzed Applicant Da e • CITY OF COSTA MESA . Ar BUILDING DIVISION f N ' BUILDING 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273'. Fax(714)754-4856 • www.ci.costa-mesa.ca.us Te. fl FOR INSPECTIONS CALL:(714)754.5626 , , 4 PERMIT NUMBER: P07-00567 • • PERMIT TYPE PLUM STATUS: ISSUED DATE ISSUED: 10/30/2007 ' ISSUED BY: BJK JOB ADDRESS: 2381 E ELDEN,AV CM Suite/Unit:. . E Vicinity: UNITE - - , SCOPE OF WORK: PLUMBING:WORK FORUNIT E OF DUPLEX. INCLUDES: 1 BATHTUB,:1 DISHWASHER, 1 GAS(1-4 OUTLETS), 1 GAS REPIPE, 1 LAUNDRY-TUB/VV..ASHER, 1 SHOWER, 1 KITCHEN SINK;,1,WATER HEATER AND 1 WATER REPIPE. '%%> < `` ,,; a;. OWNER: ELDEN STREET PARTNERS ` .. -. 'Address: . PQBOX 15126 • - PHONE: 949-230-5426 - City/State/Zip: 'NEWPORT BEACH;CA„ . APPLICANT: PETE ZEHNDER •" Address: PO BOX 15126' ,: - - '.,` PHONE: 949-230-5426 , . - - . City/State/zZip: NEWPORT BEACH;CA CONTRACTOR: OWNER-BUILDER - . - License No. 000000 - - Address: �' . PHONE: -- ' City/State: ZipCode:'"- - ' - — CELL: - PLUMBING PERMIT FEE SUMMARY . PLAN CHECK FEE: $0:00 H '. PERMIT FEE: $110.55 lk/ , TOTAL FEES: $110.55 - . p . ..... .. 3 . NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE I. INSPECTION TYPE DATE MODALS CODFI INSPECTION TYPE DATE INTITIAL$ 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1286 Pool Spa Final 208 Final Plumbing (('Of IC • 200 Final Re-Roof 210 Final Electrical !l/��------------ 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's ,e. Yes ❑No N)d[� I hereby affirm under penalty of perjury one of the following declarations: •Driver's License No. e.-propertytax 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 section 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 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 Carder: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This section need not 0e completed nine permit is valued at one hundred dollars(S 700)or less) 2.Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: 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 i ued, I all 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 theerecome=nsation laws of California. and agree that if I should becom= - eject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date the Lab' lode,I shall .rthwith comply with these provision . I , u Division of Industrial Safety Permit Number: m's gnat . Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARN(G: FAILURE TiI,SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND HALL 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 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 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 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? 0 Yes 0 No Lic.# Class 4 (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 Contractor's 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). 0 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)? 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 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 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 License 1.1.-;(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? ❑Yes ❑No applicant fora 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 fiv 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 c pensation, 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 s License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑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 control officer). 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 CERTIFICATE OF COMPLIANCE: I certify that under penally 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 contracto(s)license pursuant to the Contractors License Laws.). certify under penalty of perj • that I have read this application and state that - • the informatio given is corre't. I agree to comply with all state laws and city ❑ �I a exempt under sec, ordinances rel.ting to building construction, and authorize representatives of Busine.s nd Profes .ns Code for this reason: • the City of C.•ta Mesa to •nter upon the above-described property for inspection •ur{7.ses. I agree n.t to occupy or allow occupancy of any building /`� authorized ./th. permit until fi al inspection. I b 3V O • r(s) ,t .i9nalf Dat I� 3057-4'(3/07)• I I 1 •nd/or Authorized Applicant Date . CITY OF COSTA MESA - BUILDING DIVISION f a .A; 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • 1wwv.ci.costa-mesa.ca.us - FOR INSPECTIONS CALL: (714)754-5626 41mA' PERMIT NUMBER: P07-00568 PERMIT TYPE PLUM STATUS:. ISSUED DATE ISSUED: 10/30/2007 ISSUED BY: BJK JOB ADDRESS: 2381 F ELDEN'AV CM:— ''Suite/Unit: , ;:•F., Vicinity: UNIT F _ _ SCOPE OF WORK: PLUMBING WORK FOR UNIT F OF DUPLEX. INCLUDES: 1 BATHTUB, 1 DISHWASHER, 1 GAS(1-4 OUTLETS), 1 GAS REPIPE, 1 LAUNDRY TUBAVASHER, 1 SHOWER, 1 KITCHEN SINK;1;WATER HEATER AND 1 WATER REPIPE. OWNER: ELDEN STREET PARTNERS, - Address: PO BOX 15126 - PHONE: 949-230-5426 I City/State/Zip: � NEWPORT BEACH;CA_ APPLICANT: PETE ZEHNDER . ' Address: PO BOX 15126 ,: PHONE: 949-230-5426 ,City/State/zZip: NEWPORT BEACH,CA, CONTRACTOR: OWNER-BUILDER - - - License No. 000000 Address: _ PHONE: • City/State: ' - - ZipCode:r' . _ . CELL: - • , . . - ,l PLUMBING PERMIT FEE SUMMARY it . • PLAN CHECK FEE: $0.00 - PERMIT FEE: $110.55 TOTAL FEES: $110.55 3 _. _. , . • . . . • 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. POE I. INSPECTION TYPE DATE INTMALS CODE I INSPECOON TYPE WI INTTALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical ' 1266 Pool Spa Final 206 Final Plumbing 3 ig-vl 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 I 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy . • WORKERS'COMPENSATION DECLARATION: • Owner ID verified by driver's. .e. 4Yes ❑No /�/ I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. 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 by this permit,and that no building structure,scaffolding,falsework,art demolition Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This sectim need not be completed the pend is valued al one hundred dollars(5100)or less.) 2,Art 2.Sec 341,Titles.California Administrative Code). Policy Number: 0 As owner-builder, I will not employ anyone to do work which would I certify :t in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless ued, I sha I no employ any person in any manner so as to become subject such person has a permit to do such work from the division. ft to the work: s' 'ompensation laws of California, and agree that if I should become sub-ct o the worker 'compensation provisions o Secti n 3700 of the Labor C•de,I shall forthwit comply with these pro i 0 Applicant's Signature Dale I A r 3 0 Division of Industrial Safety Permit Number: App`l:nr'ien ure r - Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: AILURE TO SECU"E 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? 0 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 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 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? 0 Yes ❑No Lic.# Class# (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 Contractors 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 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 Lenders Name: hazardous materials)? ❑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 i"et ^, f.,`.. _' .--r/..1 . 4. If an RMPP is presently required, has Section 25534 of the California • OWNER-BUILDER DECLARATIONS: =' ..�.• ....'41:‘ 7 : ' Health and Safety Code been fully complied with? 0 Yes 0 No 1. I hereby affirm that under penalty of peijury.that I arri.,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 theapplicant 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 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 control officer). 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 CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the - didof 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. U ENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Dale property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contract. (s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 1 a 'xempt under s-c. the inform. ion given is correct. I agree to comply with all state laws and city ordinance,- relating to building construction, and authorize representatives of Busin-.. . tl Professions ode for this reason: the City I, Costa Mesa to enter upon the above-described property for inspecti• •urposes. '•ree not to occupy or allow occupancy of any building authori by this permit ntil final inspection. 1 (Date 1111191141 (=) ( d(3 f a-) gnat e Date 3057.46(3/07) ' ( And/or Aut • zed '•plirant Date ------...OD a CITY OF COSTA MESA r CC BUILDING DIVISION F 4,11111* d .t i. 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us e- FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: BC07-00423 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 01/10/2008 ISSUED BY: BJK JOB ADDRESS: 2381 F ELDEN AV CM Suite/Unit: F APN: 43927215 • - Zoning: Vicinity: UNIT F • Primary Occ: Const Type: V-N SQ. FT: 0 Valuation: $60,000.00 SCOPE OF WORK: UNIT F: RENOVATION OF THE CONDO CONVERTED UNIT. REPLACE WINDOWS (TO MEET PRESENT EGRESS REQUIREMENTS), ENTRY DOOR AND SLIDER. NEW INSULATION, DRYWALL& FINISHES. MISC GARAGE REPAIRS. ELEC: 19 LIGHTS, 25 OUTLETS, 17 SWITCHES; MECH: 1 FAU <100K BTU, 1 APPL VENT. PLUMBING: P07-00568. REF: BX07-00124, . : B06-00060 • OWNER: ELDEN STREET PARTNERS Address: PO BOX 15126 - Unit: , ,– `t��c Phone: 949-230-5426 ., City/State/Zip: NEWPORT BEACH, CA 3 APPLICANT: ZEHNDER. PETER "Address: - Unit: : Phone: 949-230-5426 City/State/±Zip: ' CONTRACTOR: OWNER-BUILDER • - - - - License No. 000000 Phone: Address: . Unit: • Cell: _ City/State: .ZipCode • ARCHITECT: License No:----. . PHONE: ENGINEER: License No. . PHONE: COMBINTATION PERMIT FEE SUMMARY. Building Plan Check: $463.94 Building Fees: - $713.75 - - . _• ENT • `,E-1. ,p.I``, Electrical Fees: - - -.$88.75 - - . Mechanical Fees: - $49.15• ' Plumbing Fees: $0.00 SMIP Residential: $6.00_ . SMIP Commercial: $0.00 - - . TOTAL FEES: $1,321.59 ,-7-03423 ^Refer to fee receipts for an fees paid for project 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 DA1F, INTPALS CODER INSPECTION TYPE DATE INIITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical ' 1266 Pool Spa Final 208 Final Plumbing r'I, 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 R'I I)/l..t�' 204 Final Demolition _ 250 Final Building/Occupancy ', Com(�� / ,1�(y_�/J`—/ WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's c ❑Yes ❑ No I dl/ I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownershi S 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. O 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ 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 by this permit,and that no building structure,scaffolding,falsework,or demolition Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This section need nol be ovnpleted a the perm/is valued at one hundred dollars($100)or less) 2,Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: ❑ 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 is ued,I shal 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 worke .' compensation laws of California, and agree that if I should become subj= t to th- -ers'compensation provisions of Section 3700 of the Labor cid-,I shall forth 'th comply with these provision Applicant's Signature Dare ii /y Division of Industrial Safety Permit Number: A'p Signa Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: AILURE T• SES RE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLA UL AND SHAY 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 (3100,000). 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 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? 0 Yes 0 No Lic.# Class# (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 Contractor's 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 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 hazardous materials)? 0 Yes ❑No Lender's Name: (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 California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑ 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? ❑Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia 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? 0 Yes ❑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(3500).): 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? ❑Yes ❑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 control officer). 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 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. \L LENSED 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 ellempt under sec. the information .iven is correct. I agree to comply with all state laws and city (' ordinances relate g to building construction, and authorize representatives of Business an. Professions Code for this reason: the City of Co-ta Mesa to enter upon the above-described property for inspection purge.es. I agre: not to occupy or allow occupancy of any building r authorized by/lhi• permit un I final inspection. i .� Ad__ Lege er(s) I`aL�' n natu'' te 3057-46(3 r7) ' A d/or Al thonzed A•pLtant Dal- AOCITY OF COSTA MESA • •�, BUILDING DIVISION >. am'' 1 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us it -- 1 4.in FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: BX07-00122 PERMIT TYPE B_MISC STATUS: ISSUED APN: 43927215 DATE ISSUED: 09/14/2007 Zoning: ISSUED BY: BJK JOB ADDRESS: 2381 A ELDEN AV CM • Suite /Unit: A Vicinity: DUPLEX UNITS A AND B - ' PrimaryOcc: Const Type :?? SQ. FT: 1600Valuation: : - $2,000.00, • • SCOPE OF WORK: UNIT A AND B _ INTERTOR-DEVRXMOid'OREPARATION FOR A FUTURE'CONDO CONVERSION. REF: 606-00060 OWNER: ELDEN STREET.PARTNERS:. .- Address:: PO BOX 15126 '- ' Unit City/State: NEWPORT BEACH, CA Zip Code: 92659 Phone: 949-230-5426' ' " - • ' .. - APPLICANT: ZEHNDER;PETE' '':•7- 'Address: PO BOX 15126 - ;Unit: . City/State: NEWPORT BEACH,CA: - _ . ' Zip Code: 92659 , , • Phone: 949-230-5426 CONTRACTOR: OWNER-BUILDER - . ' License No. 000000 ' Address: Unit - " City/State: Zip Code: Phone Cell: ARCHITECT: - - -"` - - License No. Phone - - ' ENGINEER: - License No. •Phone FEE SUMMARY Building Plan Check:- $0.00 . . Building Permit: $6925 Electrical Permit:' • _ - $0:00 SMIP Residential '$0.00 SMIP Commercial - •, - 69.25 ®� $O.00TOTAL FEES $69:25 -.,' ,1,'. - .k' .... ', 3 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92.28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OFISSUE OR DATE OF LAST INSPECTION. • INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE I. INSPECTION'Mg D)A;F INTInAL$ CODE; INSPECTION TYPE E1 Th INnnAL$ 1816 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 r..,! 222 Final Site 204 Final Demolition ( 7 ZCi-C £ 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION. ' - ' Owner ID verified by drib ,p/ ? Expires: ❑ 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' section 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 ❑ 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 by this permit,and that no building structure,scaffolding,falsework,or demolition Carder: or dismantling thereof,will be more than thirty-six(36)feel high.(Chap.3.2,Grp (This section need not be competed a the permrt is valued at one hundred dollars(5100)or less) 2.Art 2Sec.341.Title8,California Administrative Code). Policy Number: 0 As owner-builder, I will not employ anyone to do work which would I certif 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 Is ued,I s .I not employ any .erson in any manner so as to become subject such person has a permit to do such work from the division. to the wog - compensatio laws of California, and agree that if I should become s • -ct to the worke compensation provisions of Section 3700 of Applicant's Signature Date the Labor 4• e,I s -II forthwi' comply with these provisio . A U'1 Division of Industrial Safety Permit Number: S',�1 u" HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING FA •RE TO C IRE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLA FUL 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 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 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 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? 0 Yes 0 No Lic.# Class# (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 Contractors signature Dale 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 affirm that there is'fa 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)? 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 - Dale 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 ❑ 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 ❑ No issuance,also requires the applicant for such permit to file a signed statement (Sect• ion 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 0 No applicant for a permit subjects the applicant to a civil penalty of not more than Of 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 employees, provided that such improvements are not intended or offered for 8. (If'ye. '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 safe.). . information given above is correct. I agree to comply with all state taws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. UCENSED 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 contracto(s)license pursuant to the Contractors License Laws.), certify under penalty of perjury that I have read this application and state that I am exe 1 under sec. the informatio given is correct. I agree to comply with all state laws and city ordinances re(sta ling to •uilding construction, and authorize representatives of B iness •an r fessions Cal r[his reason: the City of M . to enter upon the above-described property for inspection p •ses. Iag -e not to occupy or allow Occup ncy f any building authorized b' is permit u til final inspection. r U . VA 04 G .I r coo Dal 5 nature , Dal � T I 3057-46(3/07) 1 q'd/or AUIM1onze4 'pelirant Date 'iJr CITY OF COSTA MESA :y _ BUILDING DIVISION / 1' t' -. .; ' DEVELOPMENT SERVICES DEPARTMENT / 1' • PERMIT PERMIT NUMBED `* engrl.et B98-01572 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2381 ELDEN AV Status: ISSUED Suite: Applied: 08/31/1998 Vicinity: UNITS A AND B Issued: 08/31/1998 Parcel Nunmber: 43927215 Zoning: • . Applicant: SWORD, LARRY Address: - .- - j r i,-_Phorie:=-7-14=751=7663%, - % - -' \ Owner: EVANS„BEVERLY A / Address 4709 SEASHORE DR �/ ' _ I -/1 , �J /,, ('\\ / yam--Phone - c` 4.2: / \ \\ NEWPORT BEACH,CA j '- Zip: 92663 - - �`� 4N /\\^�\ Contractor: \\N / ;1;4-- Address: / it �� - /„.17 Phone: Ny� / \\\�` License Al,A� j” 'i a '. 'Arch/Eng : ' i/ l r ; \ - • \'. Address /_ - 1, fr ' - r 1' r ' - -_ , ' ' Zip: / „A dr\, /. ' v -c 4./ N , A ii „� License: •� �� y' < -V V / /� j SCOPE OF PERMIT _ N v ' ,- , 30#FELT NEW PIPE:FLASHING;.ELK PRESTIGE 2 SHINGLE ON iT/O EXIST AND INST 7/16 OSB C / UNITS A ANDBONLY OF-2381.EL'DEN. 1:1,...113';'‘,.i../. ;,.v� � � J : ,Kc,:i-l: V ‘ a - r ..,/ 'vt',;i'n-�✓ FEE SUMMARY srY q ;i'; Plan Check: , , $0.00 - :''''''t.Calc Valuation: 7, _ $6,889.00 Permit • ' '$124.75 `., - "-- Cm.—-Claim Valuation:", ' $6,889.00 SMIP Res: .,$0.69 SMIP Com>,; $0.00 �.- - �� ,�Other: ;;'•v \.$0.00 %%/L/ ,-N / —/', / Inspection: $0:00 i „ ��'2 j v,' r Total: $125.44 �. r /'�'., , . �: - , . / /. N \, i 'PLANNING%S ZONING 'ice •-//,,,, 7'. ` /.- \� �t SETBACKS 1 / MAIN STRUCTURE Front 0-0�'' ,'Rear 0-0 - Left 0 0 Right �-0 0!:// t// ACCESSORY Front 0-0 `- Rear -'0-0` -''Left, ' 0 0'i' Right ';0-O PARKING Existing: 0 Required:_ 0. Proposed:. 0 ��/ , -5-!- _ NOTES: - '-�_A"'`_ - • 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 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: Carder: ./ - Policy Number (This s ' need not be completed l/the permit Is valued at one hundred dollars($100)or less.) I certify that in the performance of the work for which this pe 't is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of alifomia,and agree that i I should be a subject to the workers'compensation provisions of Section 3700 of the Labor Applicant I shall forthwith •ase p �C%god Applicant Signal :: �/n `,,9 Data: _ C LURE TO SECURE WOPNERS COMPEN TION COVERAGE IS UNLAWFUL AND SHAH SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(Si 00.000).IN ADDRION 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 pnndQ�provi ns pter 9(corn ncing with Section 7000)of Division 3 of the Business and Professions Code,end my license is in full force and effect.Lk.4 /r O /((re'r ` Class a �-C s Signature. e.,4/�2 y 4 Date: � /e- 2 2 - vill""` f . 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 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 Cale for this reason: Signature: Date: Owner ID verified by driver's license. El 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,1 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 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 ❑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 Califomia Health and Safety Code been fully compiled 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 gency? Utes 0 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 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 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 p rposes.I agree .t to occupy or allow occupancy of any building authorized by this permit until final Inspection. inr ignat'/Of Legal Ow--) a Date .9F( / An:,7211% •- ' ri plicant Date cams gISPFCTIfN TYPF DATE 9RMML4 CDDLI INSPELTIONTYPE DAB gift$ 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 Anal Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Anal Sign 222 Final Site a 204 Final Demolition 250 Final Building/Occupancy l_q'7f accii 2446-A6 ADDRESS w WILMS 2381 ELDEN AV u,Ar: E & F CITY OF COSTA MESA — BUILDING PERMIT 0%WiEwSNuiEIv02awN:MIKE EVANS PERM NO: B 077825 ADDRES5:1720 WHITTIER AV COSTA MESA PERMIT NO: B 077825 PLAN CHECK NO: N GOVT: N SUPP : N CA 92627 ( 714 )646-1185 APPL.MMIBC ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE; STR PURPOSE: OTH ARCHITECT OR MINER: LIC NO.: JOB DESCRIPTION : T/O SHAKES, RESHEATH, INSTALL NEW FIBRGLS SQ FT: 6, 350 ...11 ARCH.OR ENO'S ADDRESS: WIT: CLAIM VALUE: 6, 350 .00 CALC—VALUE: 6, 350 .00 GROUP OCC: R-3 / ca+mACTarstamESENTRY ROOFING COMPANY ( 714 ) 751-7663 cumikCronwil NG 3364 NEVADA AV COMMENTS: RESHEATH AND REROOF DUPLEX ADDREss:COSTA MESA CA ucND.: 678801 *****************+L* '*** '*rtititit****itatst**+titiEititrtit*at**x**it*RrRt*****Rtatjtatatit*****atx**its* 92626 WIT: Z ONING REQUIREMENTS • I LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter SETBACKS (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. cmuc.Na060429 uc.ams:C 39 uc80k EX . 10/9 MAIN BUILDING ACCESSORY BUILDING nn fs� CC FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: �'/Pt' 7l/! centred«: �� LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that mp.from the tractors License Law for the following reason(Section 7031.5 Business end Professions Code:Any city or ern requite*a panne to construct.alter.improve, PARKING REQ: P ROV: PARCEL: 43927215 Z N E: REF NO: demolish,or repair any structure,prior to is issuance.also repu'ves the applicant l«such permit to fib a signed statement that he or she PLANNING NOTE , ,n.,-L.... ( 'a licensed pursuant to the provisions d the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 d the Justness end Profatiord Code)or that he or she is exempt therefrom and the basis for the ateged exemption.My violation of Section > 7031.5 by any appfirantfor a Tarred subjects the applicant to a civil penalty ty of atmore than five hundred dollars(550DU. **************4.******************************************************3E********* ❑ I.as°Wrier of the property or MY employees with wages as thei sole compareation.will do the work.end the structure is nc4 intended DEVEIOPMENT SERVICES R E Q U I R E M E N 'T S or offered for sale(Section 7044,Business end Professions Code:TheCuuadon License Law does not apply loan owner of property — who butes or improves thereon.and who does such work limited or herset or through he or her own employes,provided the,such r . improvements are not intended acifered for sob.g.however.the building or inroownere is sold Whit,onsYear doomplelion,the ZONING APPROVED BYDATE: ownerbuider will lures the burden of proving he Or she did riot build or improve for the purpose of sable). ❑ I.asowner dthe aoperry.amexdueivelycomractipwithlansad°nvedontownsrwtheprgw(SwiTh aa'8uairreeM � BUILDING APPROVED BY • DATE: ^ Professions Code:The Contrectanot s License Law does apply to an owner of progeny who builds or improves thereon and.....and / contracts for such projects with a contractor(*)licensed pursuant to the Comradors License Law). 7 C/ ❑ Iamexemplunder Sedcn: B.AP.c.. «Nereeeon: APPLICATION ISSUED BY; DATE: .5"—F: = / /G **********************7t **** * *# ** * ***** ***************** ** * Date: Owner: LEGALIZATION;N F E E SUMM R Y STRUCTURAL SEGMENT:Y I do hereby unify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and 2553m,adoetl«any r mod Widingomthemwill/whlno(drment Direct ResidenplywihsaboMeoodpadlheregptfromhsr BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a penmen«thattrudian f modlhnlionlranthant u�y enepemeo District. to oomph/ construction apMrelsnsenexemglmm Nps pranaions. PERMIT 124 . 75 . 64 Date: Applicant: S M I P/NON—RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the blowing dedaratons: ISSUE FEE ❑ IhaysendWmaintaivacediTcebofconsentloseainsunlorworkericompesation.asprovidedforbySection3700oftheLebor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Cada for the performance dthe work for which this permit is issued. TOTALS----> 125. 39 0 .00 0 . 00 125 . 39 125 . 39 . 00 ❑ I have and wit maintain workers'compensation insurance.a nqured by Section 3700 d the Labor Code.for the performance of the work for which this permit is issued.My workers'compensation insurance center and policy number are: Carrier: REVENUE DIVISION TOTALS--> COLLECTED: 125 . 39 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK t� (This-rsection need nor be completed if the permit Is for one hundred dollars MOO)or less.) 124 . 75 . 64 ND 'caddy that In the performance d Ihe work ler which this permh is issued,I shall not employ any person In y manner so as become subject to the compensation laws of CaliforniaC , end /th/at h I should ed to the *************************************************************** **************** ° ppy °°d the Code.t shed! v° with IND IVIDUAL F E E BREAKDOWN Date: Appl'cem: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Num to unwidt✓s'umpauetloncoarp.ISuniawN(and ap1alett aneine tocriminal penalties and civil tines rig to one hundred Thousand dollen(sf04000),In addition to the c of compensation,damages as prodded for In secdon 375 of the Labor Code,Interest,and attorney's lees. SFR 6350 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 6, 350 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under pantry of peiary that there Is a oonanoWn lending agency for dor END OF F EES performance of the work for which this perm*'n issued(Section 3097,Civ.C). LENDER'S NAME LENDER'S ADDRESS: I certify that I have read this application and pate that the above information S cared.t agree to comply with all city and county ordinances and stale laws relating to building consbudcn and hereby authorize representatives of the city to enter upon the above-mentioned property for inspection ..If .SWORD, LARRY Name �� ./ • �.....Le., Dena: �� h�Ii r. ice;r ' v !NI-. (,r gnature d Owner/ .-..ApplcanVContractor N .St wS.WP) Whha-Suidiq&Safety:Green-Al :Caary-ADPEunt:Pink-Reams;Goldenrod-Musty a- - CONSTRUCTION AND PLANNING POOL a SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector ' r : 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • t 2. Soil Pipe-Undrgrnd. . ,;.' 53. Steel Reinforcement , -3: Electrical ConduitlUtility-Undrgrnd. 54. Forms .• 4. Electrical Conduit-Undrgrnd. ; 55. Electrical Bonding '(- ,' 5. Steel Reinforcemen( 56. Rough Plumbing & Pressure Test _ - . :6. Electrical LIFER Grad. 57. APPROVAL TO COVER-GUNITE 'I 7.. Footings 58. Electrical Conduit-Undrgrnd. - 1 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Und,grnd. 60. Backwash Lines, P-Trap, 0 Updrgrnd. 10. Structural Floor^System ' 61. APPROVAL TO DECK t j_' 11. Property Sewer.Line& House-Connection 62. Backwash & Receptor-Final , 12. Sewer Cap • 63. Heater& Vent-Final , 13. Roof Drains -- ' 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical-Final ). 15. Rough Electrical-Conduit . '' 66. Solar System-Final 16. Rough Electric Wiring _ 67. Fencing & Access Approval' 17. Rough Wiring Sign c • 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS'FINAL ' 19. ;,Rough Heating & Air Conditioning ,_ - r. t - F1REtEPT'REQUIREMENT 20. Rough Factory Fireplace - ?.r r _ _ APPROVALS' Permit# - 21. Ducts, inStructure - - i - 70. Underground Hydro 22. put-is, Ventilating .,-• 4 '- - a 71. Product`Piping OGas 0Oil - 23. Gas Pipe!-Rough& Test •- - , . s. ; 72. Underground Flush 24. Roof Framing - F _ '- y ,. 73:,Undergrnd.Storage.Tank 0 Gas 0 Oil 25. Roof.Sheathing , 'N'.-% 404174. Overhead Hydrd- 26 .T-Bar Ceiling (Structural) & Monocoat v C - - 75;rj9ry Cheimical `" - ' 27. Frame and FIXShir>gr, ° ' .- . 76. Dry Staidpipe•c- 28. Lathing& Siding - s. _ ' i 771 FIXED`SYSTEM FINAL n 29. Insulatidh r, i` • _ _. 44 78. FIRE PREV. FINAL • 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT ' 31. Plaster Brown Coat . `_ I' 4�. 79. FINAL INSPECTION ' , • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED - 33. .Final`.Electric , r.,,- r -- '. I'Jotes: -.• 34. Final Heating& Air Conditioning- _ ^ - c __ r 35. Final Gas Pipe•Test - - 3fi Hood or Canopy :-.r K - _ rt 37. Final Factory Fireplace - - > ,4 `: 7 38. Final Plumbing - • - _ 39. Water Service-Final ' r•. ' 40. Gas Serv(ce-Final - - y: 41. Solar Domestic-Final . T _ ' 42. Backflow Preventer t -' •- - -- - '• , 43. Backflow Irrigation, 44. ,Landscape Irrigation System - 5 r 45. Sound Attenuation _ ' - - 46. Handicap Regulations - "n ,.'9-- . - - 47. FINAL STRUCTURE & BUILDING frig-tic 6 48. FINAL PLANNING V - ;, - _ 49. Electric Release to Edison - ' 50. Gas Release to Southern California-Gas Co 4 - T - 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OFSuIUNND: 2381 ELDEN AV wit C & D CITY OF COSTA MESA — BUILDING PERMIT aytnxs'ruliEwmmm: MIKE EVANS PERM NO: B 079068 ADDRESS: 1720 WHITTIER AV COSTA MESA PERMIT NO: B 079068 PLAN CHECK NO: N GOVT: N SUPP: N 2A 92627 ( 714 ) 646-1185 APPL.MAIlp1G ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH ARCNNECT OREI NEER: UC.NO.: JOB DESCRIPTION : T/O SHAKES, RESHEATH, INSTALL NEW FIBRGLS SQ FT : 6, 900 ARCH OR ENG.'S ADDRESS: LINT: CLAIM VALUE: 6, 900 . 00 CALC—VALUE: 6, 900 . 00 GROUP OCC: R-3 / OONIRACTORseum SENTRY ROOFING COMPANY ( 714 ) 751-7663 CONTRACTDWSMAIUNO 3364 NEVADA AV COMMENTS: RESHEATH AND REROOF DUPLEX ADDRESS: COSTA MESA CA uC.NO.: 678801 +t***it*ttatat**ieatit+ta ********+tie** KStStxStStSESEK*** **it*********Ksr*+t*rt*x*iF****>E******Sf>E** 92626 INT: Z ONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby airim under penalty of perjury that I am licensed u of Chaplet SETBACKS (commenting with Section 7000)of DMaion 3 d the Business and Professions Code.and my license is in h and effect CITY UC.NO.:060429 uc.mmm C 39 UC.NM: 6788 1 P: 10/96 MAIN BUILDING ACCESSORY BUILDING --- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN g . c«mado ! LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OW., :UILDER DECLARATION:I hereby affirm under pereky of peryry that I am exempt from the Contractors License Lew 1«the 'no reason(Section 7031.5 Business and Professions Code:Any city or County whkh nquivea a permit to construct,after.improve, PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: demolish,«repai any structure.prior to as issuance,also requires the applicant for such permit to fib a signed statement that he or she PLANNING NOT E S> / ',licensed pursuant to the prowwom of the Contractors license Law(Chapter a(commencing with Section 7000)d Divhion 3 of the - uemss and Professions Code]or that he or she is exempt therefrom and the basis for the ageged exe pion.Am/violation of Section > /031.5 by any applicant for a permit subjects the applicant to a civil penalty of net more than fire hundred dollar,MGM*. ***************************************iE*************************************** ❑ I.as owner of the properly or my employees wkh wages as their sole compensation,eV do the work.and the structure is nol intended D E V E •L O P M E N T SERVICES R E Q U I R E M E N '.T S or attend for sale(Section 7044,Business and Professions Code:The Contractors licensee Law does not apply to an owner of popery .. who bolds or improves thereon.end who does such work hinted'or herself or through his or her own employees.provided that such improvements are nos intended or dtsedfor sal.If.however.the building or imprevermerd is sold*thin con yen el completion.the ZONING APPROVED' BY DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose d sale). ❑ L as owner of the properly.am exduaiwey mnvadkg wish licensed contractors tocondrud Me praled(Sedion 70ats 44. nirsand BUILDING APPROVED BY : DATE: / 4 buid Professions Code:The Contractors License Law does notapply to an owner d properly wino s«inecess thereon and c m ; connects for such projects with a contractor(s)licensed pursuant to the Contractors License law). ❑ lamexempt under Section: B.AP.C.,for this reason: APPLICATION ISSUED BY: *� DATE: A ************************************** * *******************...,. .r. . . . . .* D81e: Owner LEGALIZATION:Ny F E E SUMMARY STRUCTURAL 'EGMENT:Y I do hereby caddy that I am aware of end understand the requirements of CaMomia Health and Satety Code Sections 25505,25533.and 25534.and ran l«any future building oCdrpam_Mil R /wnd(dtclooe)needtecomplywihsadm s aecodadthenldrementkn BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING 'permmttfafor ms°n`tionor modification from the Ai Dankly Management District.Residential construction'PVNwliro are exempt from pas PERMIT 124 . 75 . 69 Date: Applicant: PLAN SMIP/NON RES WORKER'S COMPENSATION DECLARATION:I hereby Stun under pesiy of perjury one of the following declarations: ISSUE FEE ❑ Ihave and will maintain acertificate dconsent tosell-insure tor workers'compesaton.spro compensation. on Section BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE de ca .f«the pad«manaedM.w«kf« ith this wpen*li.eued. TOTALS----> 125 . 44 0 . 00 0 . 00 125 . 44 125 . 44 . 00 ❑ I have and will meintaal workers'compensation insurance,as required by Section 3700 of the Labor Code.for the performance d the work for which Me pamd®®r"d.Myw«kit"ompenem"n insurance carrier end policy number are: REVENUE DIVISION TOTALS--> COLLECTED : 125 . 44 OVER/SHORT: . 00 Carrier _-- Policy Number. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ' di section need not be completed I tame pme is the one hundred din «hs ars/Stool ./ 124 . 75 . 69 u I amity that in the performance ol the work for which this perma is issued. shall not any s I t employ aany manner so to rme subjecttothe beswlarssdon jaws Caitartua.and agree the' 1 shoed subject to the wean. ******************************************************************************* compensation proal d/y//�� 3700 d m.1 f the Labor Cow/5y'hh campy those INDIVIDUAL F E E BREAKDOWN APpficant rig, acorn m secure compensation Cowlings unlawfl end subject an employer n criminal p«nlsw aTYPE QTY DESCRIPTIO N UNIT COST TOTAL COST • nig to os hurrdred thousand dollars($1OR000A In addition to the rot of conpsestiory damages as provided for In Seed on 3706 or the Labor Com,Incest,and artomey'a fest SFR 6900 REROOF BY VALUE, RESIDENTIAL NOZONE 1 . 00 6, 900 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that then is a cendmdion lending agency for the END OF FEES performance of the work for which this perms is issued(Section 3097.Ci,.C). LENDER'S NAME LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct.I agree to comply with all city end county ordinances - and state laws slating to building construction and hereby authorize representatives at this city to enter upon the aboyememioned property _• . for inspection purposes. SWORD, LARRY - - . /// / r m4(1/01./14. 47q; J - .nature el Owher//gem/.•^err- // y (5151-b.WP) White-Suidig 8 Safety,Greemfe;n- . peaerd:Pink-eyenue Oddwod-Asaesor(/ -I. _ CONSTRUCTION AND PLANNING POOL 'A 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 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure lest 6. Electrical UFER Grnd. - 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 1' • 7 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 1 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Lindrgrnd. ,. 10. Structural Floor System 61. APPROVAL TO DECK ' • 11. Property Sewer Line & House Confection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final -• 13. Roof Drains • 64. Plumbing System - Final 14. Rough Plumbin 9 65: Electrical-Final 15. Rough Electrical-Conduit- 66. Solar System-Finals 16. Rough Electric Wiring - 67. Fencing & Access Approval 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. Rough Factory Fireplace APPROVALS Permit#. 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23- Gas Pipe-Rough & Test 72. Underground Flush 24, Roof Framing 73. Undergrnd.Storage Tank 0 Gas D Oil 25. Roof Sheathing '_'77_-14- a. 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test . 36. Hood or Canopy 37. Final Factory Fireplace - 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation • 46. Handicap Regulations 47,. FINAL STRUCTURE & BUILDING A?��-�.a 48. FINAL PLANNING vt _ . 49. Electric Release to Edison 'a 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No Date 17990 EE% RECEIVED COStA MESA BUILDING-SAFETY DEPARTMENT OCT.1 1 1962 P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. Applicant to Fill In Completely PITS' Pt CESTA MESA For P Y APPLICATION FOR RM TYPE OR PRINT _ BUILDING BUILDING 2 rt U ( ` �{ ADDRESS 1 j v J �- f FV COSTA MESA. -CAL 1/nrORNIIAf Y For Office Use Only OWNER P/460,v Ci ( • tie I I RECEIPT NO. PERMIT LnNO. ADDRESS/ ) () ) J ��_ I L Pu J/�+MAIL RECEIV D BY I 71,777-34.,I J / p CITY /1 (/�f� //2 /-/I NOd!-�y7' BUILDING / 3 ADDRESS • • ARCHITECT I / - TEL. — COSTA MESA. CALIFORNIA OR ENGINEER % I roc",�1 thAljp INO. �) ADDRESS /OJT Y�(y/.I �JU 14 htf FIRE (/Y0 /' �T / { ZONE TYPE V GROUP V// CONTRACTOR PAI 0co . APPROVED BY DATE ADDRESS ZONING P0--f Z4 NO.OF USE OP NEWEI" ,d CITY T- lTrfl/-I PUNS ISI BUILDING /./!i q STATE 4i/�e/ TEL. LEG L -A I� Yp LIC.NO., Y/ `/ NO. DESCRIPTION 1 Of- 3 L tie U -0 --- SOI. /L aJ I NO. OF NOW ON OTB I / ii-oi a - iII OI. LOT /3 A.P.NO. USE OF .1 1 n YARDS EVES EXISTING BLDG. LL1.�a.k�CJ APPROVED ALLOWED SETBACK LINE FROM /5 i (CENTER LINE ST.) L/ CENTER OF STREET REAR YARD - FRONT [] FT. IN. SIDE YARD I LEFT C>7 I RIGHT S . R.SIDE S FT. IN. DESCRIPTION OF WORK L.SIDE ) FT. IN. 1111, NEW I II ALTERATION I II ADDITION I REAR .$ {j�n FT. ecOi- IN. REPAIR II MOVING I II DEMOLISH I APPROVED ( / // E /'�F ^ 5-,(n 1) BUILDING NO. OF . i A/ �I//�l L-// ) l Y SIZE 7 d 7j ROOMS STORIES EXTERIOR WALL ROOF //// COVERING S"QO CCCOVERING SNA /1 �, USE OF BUILDING AND WORK TO BE PERFORMED D(..) nLA(-I- AI I . G44/ TREK. THIS PPLIGTION L — /1;21l g(fe 7 H 4 / // I HEREBY ACKNOWLEDGE HAT 1 HAVE THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE VE IS CORRECT,AND A E TO CO • PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY 0 2çGTJ, �BUILDING CONSTRUVALUATION SIGNATURE //_/tel //� J PERMIT FEE $ N PERMITTEE &L.57 .) ` R J/ I I ,,\I $ )&L 7 — PLAN CHECK $ 8_3 — ': AUTHORIZED AGENT ` • ¢ TOTAL FEE 0 5, REcEllwED • 17991 T , i lss COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DM P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA 'For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE LORJ PRINT E-1/ /1 BUILDING BUILDING M \A I GFQC - EL/J7= NAO r'/'CC�OSS{TA MESA.6-7,14..i �CALIFgyaNIA For Office Use Only y" Aaa Q C X77( -Lex- ' RECEIPT NO. PERMIT NO. OWNER ((�� ll-- /f MAIL l 8 Si' ( ,� . /.frL� C REC81V8S/ BY ( DATB�PiCB�e �TOIB&- €?- ADDRESS 1. (, E CA-M-,.... TELit41 BUILDING CITY /t?'to- 4-Cr ......l. NO.64en-) ADDRESS • ARCHITECT / TEL. COSTA MESA. CALIFORNIA ' OR ENGINEER I � f��1 `•GIAMQNO. L Q ADDRESS if OI I Z N V A 1 ( �1 Clen . ZONE TYPE GROUP N ��` APPROVED CONTRACTOR BY DATE / ADDRESS ZONING {�pv��'��.!J '-- Z I •-yl PLANE 7.-------.1 1 BU LDING r USE OP aW VJ l (�r✓ CITY 1111 STATE ^� TEL. LEGAL / . ( -. LIC.NO. J/�J f/Q C� NO. DESCRIPTION ^� 3�}- OF LOT (, 6 J� s O,J--- I NOWGF ON LOTS' p p NO. i t -O ( D - i USE OF GG � jYARDS EVES EXISTING BLDG, APPROVED ALLOWED .�..JJ SETBACK LINE FROMSi REAR YARD-/ / FRONTR LINE QT .6n(1 .4 / IN. SETTER OF STREETE /�T7 1(/( SIDE YARD I LEFT / 3 I RIGHT .5 ,_ R.SIDE 5-FT. IN. DESCRIPTION OF WORK L.SIDE I .. / FT. IN. NEW I SII ALTERATION I II ADDITION I REARL,-f/ S IAAPPROVED ) 1 �FT, OTE ppp IN. REPAIR II MOVING I II DEMOLISHLt) / p 9 (— BUILDING ftJ G NO. OF t/ / i e � eL� SIZE 9'‘ 7 ROOMS STORIE /V.Y�IV/ EXTERIOR WA --- ROOF COVERING 5j ()CODI COVERING _cite- USE OF BUILDING AND WORK TO BE PERFORMED �f� I -/�/y L'/ p _ ye02 .0- I HEREBY CKNOWLE THAT 14 E REAL•THIS APPLIFTION THE AMOUNT SHOWN DER VALUATION IS FOR THE AND STATE THAT T ABOVE IB CORRECT/AND AGREE/ 0 COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CI INANCE9 AND STATE LAWS REGULATING BUILDING CONSTR N. / / / I VALUATION /J SIGNATUR / �,(y7 .( : > I PERMIT FEE S 1/ ..�._ PERMITTEF ��' ._a - H _ ,/I 1y�D�\_ S /7 PLAN CHECK S %SO o 4 1 X AUTHORIZED AGENT � y�c�� U TOTAL FEE 5 2/iJ y 19202 FEE RECEIVED '� MAR 2 7 1963 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 917 COSTA MESA,CALIFORNIA �j (�F r(�eD For Applicant to Fill In Completely APPLICATI8l FGR PEW MESA TYPE OR PRINT BUILDING BUILDING 3 /• I �I '/L For Office Use Only ADDRESS .�. get G i-/'SA/ 4' Vii. RECEIPT NO. PERMIT NO. COSTA MESA. CALIFORNIA 6/',A',/',/, RECEI eY RECEIVED 9L_27-4 .3--2 7— R OWNER PitGGO '- aO/N6TMAIL r , -T_ BUILDING ADDRESS ,//y�" 6^�.1 /'r/� ,Ein y/ . ADDRESS /!// CITY Jry/T h 121-7A4 TTE -^ ZONE TYPE GROUP APPROVED -- ARCHITECT G T-L-----_, BY DATE /� OR ENGINEER NO. 1&11)) (/ TSR p ZONING L.1/-0�� ' ADDRESS ,,// • / r /� al^^ -I^ puNOj/ I BUUILDINo W CONTRACTOR Al ,T p/s b F/� - {' '] n DESCRIPTION, to k? 1- 3 4 dI1 R 304) ADDRESS 9.515- 9ss-a >77 y:5 r�c NF CITY /.//] Pl.L-7/Y• A.P.NO. _ /r n NOTE: NO EAVE O ERHANG SHALL BE LE STHAN STATE •1 ` 3 /OI NO /]/{ y'�an j 9 30*TO SIDE @REAR P.L. LIC.NO -(.1 -7 �J,�(�/`� G 6 SIZE / Z. �L' I NOW NLOT3 AIA.LOWED (U.B.C.REQUIREMENT) OF LOT o Is USE OF YARDS APPROVED YARDS APPROVED EXISTING BLDG. MAIN BUILDING ACCESSORY UILDING I FROM C/L STREET) SETBACK LINE FROM FRONT FT. • CENTER OP°TREE`, HEAR YARD Th SIDE YARD If LEFT I RIGHT R.SIDE FT. FT. DESCRIPTION OF WORK L.SIDE Fr. NEW -x ALTERATION _ ADDITION REAR FT. FT. DISTANCE BET. BET.MAIN @ REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS.BLDOS. BUILDING NO.OF VAR'# DATE SIZE • -11 - - - -S- C.U.P.# I�'l/�_/•/,///{ APPROVEDEX •//� COVER F \ BYPROV ETI/ D TE / / COVERIN USE OF BUI/WA CWOT(K TO BE �R7 ED ��%y //// �iYY//// GC / N SQ.FT. Y I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION 10 FOR THE i AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION OJ r O BUILDING CONSTRU ION. « n SIGNATURE OF �(/�/ / PERMIT FEE S j PERMITTEF Lr�.(R•C4! ' die 7 G $ 5i-.. 0 AUTHORIZED AGENT c '• T•TAL FEE 17%9 (tE R[CE vE1) COSTA MESA BUILDING-SAFETY DEPARTMENT [ per' [j LQ/jj� P. O. BOX 317 COSTA MESA. CALIFORNIA FINM E 6Cl 1. For Applicant to Fill In Completely APPLICATION ITFORFPERMIT\ MESA TYPE OR PRINT _ BUILDING ADD EISS �) \(1 1 -A 4 4 ELI LE N ////��/ COSTA MESA CALF RNIA For Office Use Only OWNER 94cici RECEIPT NO. I Pre7' . MAIL • REcY I DA// �/ PAI' Dw! a�eB�� ADDRESS / S ' STEL. h( / BUILDING CITY /1):106/.-2/S4-4.-4-/ � ✓wL NO.LS/o7..3 ADDRESS • ORCHITECE cC/ /C( I TEL. .__ COSTA MESA. CALIFORNIA OR ENGINEER Ilil /( NO. ADDRESS titG'/ ! S.ik [TA 4 el N _ 'G- 4 FIRE � ZONERTYPE !// GROUP Q CONTRACTOR C;a'>GC--C, APBYPROVED DATE ADDRESS ZONING" _ 7 NO.OF U88 OF NEW bit, �T. ,I' CITY I D h ( yJ + �/I nPL,AjN-B 1/ I BUItnINO LIC.STATE NO. / / qL/ NO. /JLC--'2� LDEaGcRIPTiod_0 /0 3)Li f A n o SIZE 7/ X 3 r (NO, OF NOW ON LOTS� . A.P.NO. / l / - U1 3 —/V OF LOT USE OFYARDS EVES EXISTING BLDG. }von.--2--_ APPROVED ALLOWED SETBACK LINE PROM --/� (CENTER LINE ST.157) /� CENTER OF STREET `' REAR YARD FRONT FT.` /`/ IN. I LL SIDE YARD I LEFT / 3 RIGHT J� R.SIDE FT. IN. DESCRIPTION OF WORK L.SIDE ,) lb NEW I X /�7 FT. 1(2.71- IN.II ALTERATION I II ADDITION I REAR �1 REPAIR I I MOVING I II DEMOLISH I APPROVED 1----- -- DATE '� - BUILDINGc'i) Z NO. OF � ✓ 1 SIZE CTA Z- ROOMS 4/'3�STORIES I Get -- SIZE WALL.. ROOF / ILR/lwL_ COVERING 5/ LXLC/ I COVERING ..51/4 USE OF BUILDINGDIAND WORK TO BE PERFORMED �.�--�/ =A6-t- A77- C . I HEREBY ACKNOW /THAT I H VE R IPMI8 APP ION THE AMOUNT SHOWN'NDBR VALUATION IS FOR THE AND STATE THAT ,cr�ABOVB IS RAND AGREE TO •• - PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CI.• ORDINANCES NO'S'? EILAWS REOU TING BUILDING CONS - ON. lly I ' VALUATION / ,� SI GNATUR • 1 ��, H7.7. PERMIT FEE $ 6 —� N PERMITTEE ,�// �J�j� ? R_ '( �\ S / // PLAN CHECK $ 9 /-...3—G AUTHORIZED AGENT �Q Q TOTAL FEE $ • n