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Home My WebLink About228 DEL MAR AVE - Building Permits • " CITY OF COSTA MESA ' 4 BUILDING DIVISION j _ DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER � or ' PERMIT B05-01903 do' (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cB.1hLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 228 DEL MAR AV Status: ISSUED Suite: Applied: 10/21/2005 Vicinity: GARAGE Issued: 12/21/2005 Primary Occ: U/1 Type of Construction: V-N Parcel Number: 43921106 Zoning: Applicant: CEFALIA, JOE S Address: ' Phone: 714-321-6302 ISSUED BY: ,'/ Zip: / Owner CEFALIA, JARED • ' z Address 228 DEL MAR AVENUE?".<�- l ,,-,, ';�� _- Phone 949 307-9309 4;; , ^.v_ COSTA MESA,�CA . m • "• Contractor: OWNER-BUILDER 1 e, Address �++, i0, '' ' �,�,� Phone: • ., _ 6-i 1 V ! 7 Zip � _ License: 000000 r � Arch ; PETEVOLBEDAARCHITECTUREPLANNING Eng: : Address:; 615 N BENSON AVNEUE Address: ••,i, :,, 1.10' STE C` s Phone: 909373-,1150 -.iv`� Phone:. ✓ ., i Zip: 91786 /,' �' Lic4.ense: �,<,.- - "`-mo` o,; '' SCOPE OF PERMIT . k." NEW DETACHED 2 STORY,GARAGE W/2ND FLOOR HABITABLE SPACE.WORK TO INCLUDE GAME'ROOM,OFFICE CLOSET AND BATHE FLOOR:'978 SF / : t . t'E" ' Sy TOTAL 1ST FLOOR:'1,225 SF -1.2.!„.„,,,__,„,,,, .. - x sxi, p WORK TO INLCUDE=762 SF GARAGE AREA 358 SF/TOOL STORAGE AREA AND WORK AREA AND 59 SF STAIR WAY AREA r PLNG.#ZA 0531 ; %� ,: S r._. FEE SUMMARY' kiw S , Plan Check: $722.38 '° ••*` ,,_ ,," ,. _. Calc Valuation $120,134.70 Permit: ," $1,111.35 , Claim Valuation °;; ,,$0.00 SMIP �" "$1201 _;f 4 x,' '',?.`' SMIPPCorn: '$000 ,-,..— Other $0.00 " Inspection $0 00 ti s s. Total: $1,845 746-" ; • . , } s' a '�''Z. s °r '*� PLANNING;&ZONING SETBACKS '• • > " ti, MAIN STRUCTURE Front 0 0 : Rear 0 0 -=*&x Left; 4-'0;. 0 Right )�0 0 ,T, ACCESSORY Front w 0-0 .Rear 0'0 4. Left. 0 0t Right 0- PARKING Existing: 0 Required: 0 ' Pr posed:-' 0` ,,,,,,,ops �._ em' • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1,12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit, FOR INSPECTIONS CALL: (714)754-5626 ..,,,,-, 2446-46 WOO) �r DECLARATIONS WORKERS'COMPENSATION DECLARATION: . I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed it the permit Is valued at one hundred dollars($100)or less.) • 10.. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I ould ome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these rovisions. r ApPI> t Signature: i EOvaree. / 2-- Z/ -03_ WARNING:FNLUR CURE WORK 'COMPEN COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLAR ($100,000),IN AD TION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Lic.# Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued.(Sec.3097,Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of pgrjl jllhat 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).): 12r�,as owner of the roe. or no" employees with wa es as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. p. P P, -1 my9 P hams'7044,Business through sionssCode:The pyeLicense Law does not apovely ta is owner of property who buildsdor improves, e thereon,h,and who does such work hams��$$r hers through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is I sold�Yn 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 . I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business end Professions "'ft_ 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 der sec. r 40P. Business and Professions Code for this reason: / ganaNre:,^^� R—C.1 -ii ��_i / 1Expip rel s:A Verification of Ownership by(type of document,i.e.-property tax bill or deed):- "'-�""a-----sz-' - / 1� DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 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 California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a_aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes L-I No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Ignature Of Legafirer( t Date -yep NOgAuthdri AppLcan ,�„� Wats' EOPE I INSPECTION TYPE Pam INrITIALS CODES INSPECTION TYPE PATE 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 Site 204 Final Demolition . . 250. Final Building/Occupancy ' artyCITY OF COSTA MESA 40 ,L4 @ BUILDING DIVISION -•1. r.; al DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT '4�.00.�orrww 505-01335 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa f�IsCTRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 228 DEL MAR AV Status: ISSUED Suite No Applied: 12/21/2005 Vicinity: Issued: 12/21/2005 Parcel Nunmber: 43921106 ' Applicant: CEFALIA, JOE � Address: ISSUED BY: Ai/ Phone: 714-321-6302 Zip - 92627:r Owner CEFALIA, JARED A _; .z Address 228 DEL MAR AV" ' .` Phone:_ COSTA MESA,CA 1 Zip 92,,627 Contractor: , OWNER BUILDER ' it Address:" �„ Phone: Zip: ,' -License:000000 t - ,µ ' '' a f„( ', :. SCOPE-OF PERMIT? _` - NEW 4203 DETACHED 2-STORY GARAGE W/2ND FLOOR HABITABLE SPACE WORK INCLUDE GAME ROOM,OFFICE;CLOSET AND BATHROOM.2ND FLOOR:978 SF , . REF:B05-01903; , y^ 12 LIGHT FIXTURES,20 OUTLETS,10 SWITCHES,2:MOTORS TO 1 HP,1 SUB PANEL TO 200A 3 ” FEE SUMMARY N,i> k. } i' Quantity. .,...... . Quantity ISSUE FEE $23.50 Temp Dist System%Lighting ; $0.00 0=` Temp service test , $0.00 - .L >>,: >:. ,,'Busway/100 ft p $0.00 0 3 " - Res.a/c package - .$0.00. 1 ws , s. Standing Section-- `_ $0.00;,,, 03.;:', '. New Res-(1-2 units) • ' ` $0.00= 0 � ''' Misc'Electrical Equipment $0.00 0j,2, / New Res-(3+units) '. $0.00 '' ' 0 Transfomiers up to 1 kva/kw $0.00 0 - . Pool/Spa " s $0.00 - 0 up to 10 kva/kw -. $0.00 .3'0 Lighting nits_ `, < r$13.20>-, • 12 ' up to 50 kva/kw $0.00" : 0` - Recept Outlets ....,-,,, `H x$22.00 20 up to 100 kva/kw $0.00 0 ;• . ' Switches : •$11.00_ E 10 „,,,L .....1 - ”. . over 100 kva/kw $0.00-- r.' 0` Non Res Appl $0:00 0 •t LoVoltage Equipment $0'.00: '' 0 ' Res Appl ti;- $0:00', 0 fr 'Low Volt Wiring System/Ckt : $0.00. „0 Service to 200a $0:00' „0 - , Mist.Conduit '3,..-,, _,.x„ ,. .$0.00 0 .- Service to 1000a $0.00 :- 0 %., ., „Mist.Conductor ' $0.00 0 Service over 1000a ',$0.00 0 ' Circus(gen or ride) Motors to lhp ,• ',-$9.50 , '23--'"^ .Circus'meth rlde'.or Ii ht $000.” Motors to 10h ( g ) �^ ,f; O . p "�-"'"„ $0.00' _ 0•.�- -�,Christmas Tree=Stznd;. � $0 00 0„ „ Motors to 50hp $0.00 _ -0 •- -<Fireworks Stand's $0.00 -0 ' Motors to 100hp $0.00'; :;0`7 r; Other Electrical Fee -$0:00 ' Motors over 100hp Communication drops $0.00"' "013, •,..,r ` Investigation Fee $"000 Sub panel to 200a $30.50`., ''�...1 „ f__ ' r- ` •PIanCheck Fees $0:00 Pole Light Pkg $0.00 „0t ,, , • - -.i >' Reinspection'Fee ',..,..-'3,6. $0.00 • Sign Circuits $0.00 Temp Pwr Pole $0.00 0 '" ;!-TOTAL CALCULATED FEES $109.70 Intermed Pole $0.00 0 e•^1114111,11=•11'0 I onersa I rnunsrsnuc NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 / ,:7`-,-( ....r24464t taw) 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 to which this permit is issued. My workers'compensation Insurance carrier and policy number are: Cartier: Policy Number: ��(TT''his section need not be completed if the permit is valued at one hundred dollars($100)or less.) I certify that In the performance of the work for which this permit is issued,I shall not employ any person In any manner so as to become subject to the workers' compensation laws• California,and agree that If I shou• b=.. e subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these p I,visions. Applkam'Slgnetu V' �.� `� .N • -/ Date: 4 2 -2/ -or WARNING:FAILURE T n�a URE WORKERS' ••MPENSATI 0^••VERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TfptjSANO DOLLAR=fRR: . 000),IN AD' TO THE COS • COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and effect.Lic.it Class a Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I•am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions 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,.ppuyBBcant 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 sffe:!?exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit acts the applicant to a civil penalty of not mote:than five hundred dollars($500).): t -3I,as owner of the property;ormy employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not Intended or offered for sale(Sec. v 7044,Business and Professions Code:The C,giitractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself fr through'Iiis'or.her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement Is so within one bar of compleylonYthe owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • O Crater ater of the property,aril EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Cgde:q ?ie 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 pktsuant to the Contractors License Laws.). o I am.exem,r nder sec. / t Business and Professions Code for this reason: Signature:-r'Jt a.. a �� 7Date:_`-- /2 —L I Owner IDiii,d by driver's l'•::rise. ries 0 No Drivers License No: Expi s:/ /,.-, Verification of Ownership by(type of docu ent,i.e.-property tax bill or deed):\----- `•� DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Ej 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). a As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or.present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 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 ere required to register acutely hazardous materials with the Fire Department. 4 if an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No S Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 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 Wilt 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 Safely Cale). 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"yet,attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is Correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. gnature Of Legal r(sDate P /2 — Z,.0 7 d "Aulhori Applicant ( Dots----- G CODED IIISPECTION TYPE MI INTMALS EOMI IdSPECTION TYPE an IMEL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final _ 208 Final Plumbing 200 Final Re-Root 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place _ 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy kTh- - CITY OF COSTA MESA /re�� BUILDING DIVISION F ",,,, ,I DEVELOPMENT SERVICES DEPARTMENT RMIT NUMBER 4Irra PERMIT MOS-00746 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT • Job Address: 228 DEL MAR AV Status: ISSUED Suite No Applied: 12/21/2005 Issued: 12/21/2005 Vicinity: Parcel Number: 43921106 '� ISSUED BY: Ii/r Applicant: CEFALIA, JOE � Address: • - ' • Phone:- 714-321-6302 - - Zip: 92627 - ' Owner: CEFALIA, JARED A Address: 228 DEL MAR AV - . COSTA MESA,CA - Zip: 92627 - Contractor.. OWNER-BUILDER Address: ,. Zip: Phone: License:000000 , _ r SCOPE OF PERMIT ,c - - NEW 2,203 DETACHED2-STORY GARAGE W/2ND FLOOR HABITABLE SPACE.WORK TO INCLUDE:` . 'GAME ROOM,OFFICE CLOSET AND BATHROOM.2ND FLOOR:978 SF - REF:805-01903 • - 1 INST FAU<100K BTU,1 VENT FAN/SINGLE DUCT . ' • ' FEE SUMMARY - Quantity _ Quantity ISSUE FEE - $23.50 "- Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $14.80 1 , Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 -0 -- . - - -Ventillation System _ ' • $0.00 0 Repair/Alt Cooling/Heat $0.00 0 • -- -- • ' Evaporative Cooler - $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems ' Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $0.00 0 , - 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box - -$0.00 0 - 30 To 50 hp,/1,750 k BTU $0.00 0 Vent Fan/Single Duct ' $7.25 1 • Over 50 hp/.Over-.1,750 BTU $0.00 0 Appliance $0.00,' "0 ;'J" t . . Boilers - Fire Dampers $0.00 0 - Up to 3 hp _ " $0.00 0 Smoke Dampers $0.00 0'. 3 To 15 hp - r - " $0.00 0 Inst or Relocate Appl Vent 7 $0.00 •0, - 15 to 30 hp - - $0.00 0 Air Handlers< 10000cfm $0.00 0 . ' 30 to 50 hp -.," % DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to sell-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I 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: Cartier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) Ar>I certify that In the performance of the work for which this permit is issued,I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California,and agree that if I should be e subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these p Bions. .ApplIc .�1 `5"- WARNING: ARNING:FAILURE T:?'E URE WORK �C P iYE� /2- '2/ V THri ANi DOLLARE URE T�I_N�a ,000),WORK ��///CO THE g{nO.COVERAGEmPENS TS UNLAWFULAND SHALL PROVIDED SUBJECT I N EMPSECTION R TO THE AL PR CODE,ITER CML o A UP TO ONE HUNDRED. TFlrx IU1ND D 000),IN ON TO THE OF CUAIPENSATION,DAMAGES AS PROVIDED FOR IN SECTION OF3706THE LABOR CODE,(MEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Uc.a Class 1t Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to Its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed :nt to the provisions of the Contractors Ucense Law(Chapter 9(commenting with Section 7000)of Division 3 of the Business and Professions Code)or that he or - lf: ;l pt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit e$biects the applicant to a cMl pen not • .- e hundred dollars(5500).): s .'l,as owner of the prope mployees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. J 7044,Busines$Apd Prole ions Cala:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or hersb�lff 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 complletjon,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(loan to the Contractors License Laws.). ❑ I em exam under sec. Business and Professions Code for this reason: SreL -Date:-- /L -L/(?3 DOwned by driver's ense. Yes 0 No IDn• eratacense No�� Ezpiies//-,/- 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,fatsework,or demolition or dismantling thereof,will be more than thirty-six(38)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 W III the applicant or present or future building occupant need to lila 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 end Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No tpesen._..arturebui ._ _ _ . _ i_ _ - 5 Does or willo the applicant Air or Quality t ar Management District o from at require air toe work ontch is the district or age of this a pistion ap No for such ConSWction or modification - from the South Coast Air Ouelity District or from any other air pollution control or agency? �Yes 0 No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the fadlity to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes',the fadlity 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 COMPUANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. S•�-lure . L:...l •. l-rls) Date _. � - t .:..: -r _ / 7 - 7/ -o.c %•nd/OrA f ,•,Applicant-. /Da_.> CODE. INSPECTION TYPF SAIF. RIal CODE I INSPECTION TYPE / gg_AIE // Irl. : 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical Co'3C -CD(O us k 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof210 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 ' CITY OF COSTA MESA : BUILDING BUILDING DIVISION Y • r:..4 DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER F 1 r...itr4. ISI PERMIT OPP " P05-00966 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesapvMBI NG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 228 DEL MAR AV Status: ISSUED Suite No Applied: 12/21/2005 Issued: 1221/2005 Vicinity: Parcel Nunmber: 43921106 4/ Applicant: CEFALIA, JOE ISSUED BY: Art i Address: i/ Phone: 714-321-6302 'Zip: 92627 :. Owner: CEFALIA, JARED A, Address 228 DEL MAR AV . •, , - � � .Phone: . .. ....- - .1 -COSTA MESA,CA : . - Zip: 92627 , • Contractor: OWNER-BUILDER - it Address: e Phone: p Zip: • License: 000000 •^ -! - 7-. SCOPE OF PERMIT -• • fi.0."' %` NEW 2,203 DETACHED 2-STORY GARAGE W/2ND FLOOR HABITABLE SPACE:WORK TO INCLUDE:GAME ROOM,OFFICE,CLOSET AND BATHROOM.2ND FLOOR:978 SF . f2EF:.B05-01903 _ , - • 1 GAS OUTLET(1-4), 1 SERVICE/MOP SINK,1 WASH BASIN,1 WATER CLOSET,1 WATER ' HEATERNENT - `t r -; ' FEE SUMMARY , ' AMT QTY - - AMT QTY (1114-T QTY ISSUE FEE . $23.50 - - Laundry Tub/Washer $0.00 .. . .. Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer - $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 - Process Piping(per 10 ft) " $0.00 ' 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank . $0.00 0 Wash Basin $9.80 1 Dishwasher - $0.00 0 Sewer Cap'forDemo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $0.00 '.0 ' Sewer Connect $0.00. - 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 „• - -Sewer Private Line - " $0.00 ''. 0- ' , Water Closet(Toilet) $9.80 1 Drain,Roof $0.00 0. :. Shower . $0.00 0 -. - -Water Heater/vent $12.30 1 Drinking Fountain $0.00• 0 Sink,bar ,, $0.00 0 . . .Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00;' '0 -- Water Re-pipe $0.00 0 Gas Earthquake Valve - $0.00 0 ^ 'Sink,Floor . - - $0.00-, i3O ; Water Service, $0.00 0 Gas(1-4 outlets) $6.15 1 .' Sink,kitchen •�'s $0.00 '`':0 ,`,,Water Softener ` $0.00 0 Gas(Over 4 outlets) $0.00, 0 Sink,service/mop M- -, r.$980 1„ % OTHER,- $0.00 Gas Repipe $0.00 0 `-Spa(private) WOO ::0 '" VIOLATION $0.00 Gas Service $0.00 ",0 Spa(public) $0.00-.'•0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $000 ''-0' "-REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 R",-.7.--> - - '=,TOTAL CALCULATED FEES: $71.35 COMMENTS/SPECIAL CONDITIONS • • • y NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days,or If work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 ./--- . 2 2448-46(MO) \/ 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: Cartier: Policy Number: (This section need not be completed if the permit Is valued et one hundred dollars($100)or less) �J certify that in the performance of the work for which this permit is Issued,I shall not employ any person In any manner so as to become subject to the workers' (`_compensation laws of California,and agree th t if I should beco subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these proal ns. Applicant Signature: ' r-Date: /2 -R/4 r KI WARNING:FAILURE TO S E WORKERS' ENSATN ERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AMID CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S100,000),IN ADDRI TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Llc.it Class N Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions 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(commendng with Section 7000)of Division 3 of the Business and Professions Code)or that he or she zihsaexempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjerlts the applicant to a dull penalty of not more hundred dollars($500).): ,I,as owner of the prope ployees s as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Busines d Profe The rectors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or he throug r er own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement Ls s in one r of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ .,as Owner of the property,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 exe pt under sec. Business and Professions Code for this reason: Signature:"'"`' rData:-� 2 /-2/ Owner I led by driver cense. es 0 No Drivers License N_o. <' ) Expires:'-/!_//_� Verification of Ownership by(type of document,i.e.-property tax bill or deed):L"� `- - 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 pemlit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to filo 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 et 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 Celifomia Health and Safety Code been fully complied with? 0 Yes ❑No -- 5—Does or will the applicant or present or future building occupant require for the work which Is the subject of this application a eermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LI Yes IJ No (Section 65850.2 of the California Govemment Code requires that the requested information be fumished on applications for non-residential building permits). 8 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 ❑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 Alr Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final Inspection. Sig tare Legal s) ^ /t eL -z _S-- �A---- A Author' pllcanTrDat - _ _ CODE I INSPECTION TYPE PATE IMI CODEC INSPECTION TYPE Rg0IF PALS 1618 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing L --3(11-O(n11 V 200 Final Re-Roof 210 Final Electrical 201 Final BIocWRetalning 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 Applicant to fill in all soaees except tnose witnin heavY OorGer lines ana sign all aDD�opriate tleclarations. CITV OF COSTA MESA CONSTRUCTION PE�RJMnIT O.. 9 �_ PERMIT N. / TRACT NO. LOT NO. UNIT NO. _.Projec< Addiess �ZZQ� � �iL i�:�:� � V- \ 1 c-E.,Z% � � � " � � � . � � � . MQ TVPE OF CONSTRUC710N NEW ADD ALTERATION REPAIR ApplicanYsMailil�ddress �� I/ � � � Owner'sName ��--T�SfL V• A'N!F Phone.�q�-CL�LL�� SQcN� 9 Address Arch/Eng: License No. Address Contractor's Name � Phone Address Imailing) ��j City License No. � v LICENSED CONTRACTOR DECLARATION I hereby affirm thab I am licensetl untler p�ovisions of Charte� 9(commencing with section ]000) o� Division 3 of tne eusiness antl Protessions Cotle, antl my license is in tull torce antl effect. Licenze Class License No. Date Signature 'RKERS' COMPENSATION DECLARATION reby affirm tM1at I have a certiticate ot conseM to selt-insure or a certificate JJorkers' Compensation Insurance, or a certifietl copy thereof (Section �800, Lab. C.) PoliGy No. Company BCertifietl copy is he�eby fumishetl. Certitietl copy is tileG with tM1e city Builtling Oivision. Date Applicant EXEMPTION FROM WOFKERS' COMPENSATION DECLARATION (This section neetl not be tompletetl if the Oermi a r ne huntlretl ($100) o� I255�. I certify that in Ihe performance of ttte wo� ch this p rm�t is issuetl, I sM1all no mp y any person In any ma s s to bec e subject to the Work ation Laws ot Calitor Date Signature ' ^ NOTICE: I, atte� making'tM1is tleclaration, you shoultl become Subject to the Workers' Compensation provisions of [he Labor Cotle, you mus[ forthwith comply with such p�ovisions o� tnis pe�mit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I nereby aifirm tnat there is a construction lentling agency for tne performance of tM1e work tor which this permit' is issuetl (Section 309] Civ. C.) Lentler's Name 'Lentler's Atltlress OWNER BUILOEN GECLARATION I nereby aftirm that I am exempt from the ConVactor's License Law for tne following reason (Section 7031.5 Business antl Professional Cotle: Any city or county wnich requires a permit to canstruct, alter, improve, tlemolish or repalr any structure, prior to its issuance, also requires ihe ap0licant tor-such pe�mit to file a signetl statement that he/she is licensetl pursuant to the orovisions ot Contractor's License Law (Chapter 9(commencinq with Section ]000) of sion 3 of tM1e Business antl Professions Cotle) or that he/she is exemp[ efrom antl tbe basis for the allegetl exemption. Any violation of Sec[ion //[ �l1.5 by any ap licant (or a permit subjects the applicant to a civil �'�`}' �alty of not mo than tive huntlretl tlollars ($500). /i6l I, as owner f the propertX � /coE� ill tlo the work, antl the structure is not intentletl or offeretl for sale (Sectwn �044, Business and Gwtessional Cotle: The Conbactor's License Law tloes not apply to an owner of a properly who builtls or improves thereon, antl who tloes such work himself/herseli or Ihrou9h his or her own 2mplOyees, p�ovitl2tl tM1at SUCM1 improvemenis are not intentletl o� offered tor -sale. If, however, the builtling or improvement is soltl within one year of com- pletion, the owner will have the burtlen of proving he/she tlitl not builtl or im- prove for the purpase of sale). ❑ I, as owner Of [he property, am exclu5ively tont�acting wi[h licensetl con- tractors to mnstruct the project (Section 7044, eusiness antl Professions Code: The ConVactor's License Law tloes not appty to an owner of prooerty who builtls or impwves thereon, antl who contracts for such projects with a con- tractor(s) Imense pursuant to the Contractor'S Licen � Law). I am aware that proof of their Worker'S Compensation insuranc � prOvitletl to me. ❑ 1 am exe{npt untler Section P. C. for Ihis reason Oate a I orivers' License or 55 � the above �rtlinances rize repre- Iperty,for CONVERSION DEMOLISH OTHER Ap # DESCRIPTION OF WORK/USE OF BLOG. � 5 Main Building: TVPE OF PERMIT ❑ GRADING FOUNDATION ❑ STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear ❑ OTHER . . PROJECT DESCRIPTION Sq. FT. � oCCucarvcv C Ri9ht K CONSTRUCTIONTVPE VAWATION$ g Left ZONE GRADINGCU.YDS. ACRES ping.Ref.# Remarks: ' Planning Notes: Bar Sink Backflow Preventer 8ackflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service � � Outiets Sink P—Trap Roof Draini ReinspeMion Fee $15 Boiler Duct - Under Ground Duct - Sttuccural Duct - Ventilating � Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. IC80 # Heating System & Ductin9 ❑0-700,000 BTU O 100,000 BT Rainspec[ian Fee � $15 CMF 0865-46, �ev. 30/84 White - Builtlin9; Canary - Applicant; Pink - Accounting; Goltl¢nrOtl - A55e55or Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimmin9 Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Issue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System ❑0-100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers Issue Fee FEES $ 3 FEES $ 3 9092 4/20/88 2one Accessory Building:' Parking Req./Provided . , ELECTRICAL � Automatic Washer" - Transformer �� 15-50 KW ConstructionPoleSub. ❑ SO+KW - Cooking Unit Meter ❑up ro 100 amps Dishwasher Meter ❑over'100amps � Dryers �Gas ❑ElecCric Suh Panel ' Fan ' Motors DO-1 HP �1 %� 8 F.A.U. ' Inc. Solar �9-15 HP 016-15+ F,ixtures Microwave Device Boxes Pole Light Outlets Range Switches � Sign � ' ' Garhage Disposal Standing Sections Generator �0-5 KW �5-15 KW Trash.Compactor I Reinspection Fee I$15 ' I luue DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By Building Approved By � ApOIItBLlOf1 Issued Bv Fee . 39050 7L FEES $ - SUMMARV OF FEES . BUILDING PERMIT $ SMIP $. PLAN CHECK $ PEFMIT , PLUMBING $ ISSUANCE $ PLAN CHECK 25q $ �� . ENERGY P.C. $ ELECTRICAL $��.�V GRADING $ PLAN CHECK 50% $ MICROFILM $ %� MECHANICAL $ TOTAL FEE $ ��Sv PLAN CHECK 25% $ Z O N I N G R E Q M T S CONSTRUCTION ANDPLANNING .-.� �-a ;'�. POOL & SPA � r.� •" Date Inspector " Date Inspector APPROVALS Permit�# 1:• � APPRQVALS Permit # � 1' Temporary ElectricalrService or Pole � 52. Pool & Equipment Location � .� 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' � • 3. Electrical Conduit Utility-Undrgmil. , 54. Forms , 4. Electrical Conduii-Undrgrnd. �" 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. 57.. APPROVAL TO COVER-GUNITE � 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation �•�� 59. Gas Pipe, O Undrgrnd., Test .._, 1,_• 9. Water �Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 70. Structural Floor System 61. APPROVAL TO DECK 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. �Fen� g& 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 � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing . 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 PREV. FINAL � 30. Drywall Nailing HEALTH DEPT. REQUIREMENT �_�- 31. Plaster Brown�Coat 79. FINAL INSPECTION - ✓� i 32. Electrical Power Meter-Final 55�� . FOOD CERTIFICATE ISSUED (,�� 33. Final Electric �-, otes: i� 34. Final Heating & Air Conditioning 1 � j 35. Final Gas Pipe�Test 36. Hood or Canopy � � ',� � . 37.' Final Factory Fireplace � �� , � i 38:'Final Plumbing ' ` � ' 39.' Water Service-Final � � �� 40. Gas Ser,vice-Final ' ' % . 41. Solar C�om�stic-Final - . �' . I ' , i ,i . i �' 42� Backflow P�eventer ; �� 43.�Bac!(floW Irrigation ; � :� - _ • 44�. ,L'andscape Irrigation System ! � .. ��45 Soun`d Attenuation � '- � � � : � 46 � Fl-andicap Regulations � � � i� c r . 47�FI�NALSTRUCTURE&BUILDING � � . "' •�• �,i I 48„Specia�F�equirementsCompleted , ' - `' �: - 49:� Electri�c�Release to Edison � ' � 50. Gas Release to Southern Califorrva Gas Co � y��'' .a. 51. CERTIFICATE OF OCCUPANC�' : ' ' . . � 'y;�5 - , • No. � Date '�� .. AOPlicant to fill in all soaees except tnose within heavY bortler Iines antl sign all approoriate aeclarations. ' ! -CITX OF COSTA MESA� -- - - � � , � '" � � ' PERMIT NO: � TRACT NO. ' " LOTNO�. BLDG. . • �' ' , ' � - � — - - � -�� - ._C�NSTRUCTION PERMIT ; , , i.. . � ' { � '� � ' ' ' = � 9231 �3%�d-3�/85 ^ �A•. �_ , �Z'. ' ,'.' S �, . _ ... . , . . PrOjeCt Addre55 ' ` e a r , - . '- , TYPE OF CONSTRUCTION NEW P.DD �ALTERATION .REPAIR ApplicanYsMailingAddress. ��2 0 N. Van,.Buren ❑CONVERSION ❑DEMOLISH ❑OTHER ' '� q,p,# � � ZOne � . � i Owner'sName VI Ui01' �VOfI_VBf1C0 Phone �797�� .DESCRIPTIONOFWORK ' ' . . , • � - • S o 1 a r pomes t i H r� f a s Ma�� Building: c Accessory Building'� Z � nadress, . . s a m e - : . e e . , _ . . o , � r. TVPEOFPERMIT ; GRADWG '�FOUNDATI N STRUCTURAL� - T Front ' N M A�Ch/Eng.� � � Licen52 No. - ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL . ` , 8 ' � , ' - 1. ' ' � y�� _ Rear . N �Address ❑ �OTHER � � � � ' ' A 6G6-IO3� ,PROJECTDESCRIPTION SQ.FT. � OCCVPANCY C Right � � � , - � ' � - ' C+ coni�aciors rvamr—�y c o r p E'n g i n e e'r i n anone , , K ' ; Left R ° � Addresslmailingl. 12�0� Van Blll'Ell �AllaI701R1 � ' CONSTRUCTIONTVPE VALUATION$ � � S � ' � • - � E , �\ " ' ' � � . � 20NE � GRADING CU. VDS. 'ACRES Ping. Ref. # ' � ' Park.Fees $ � � � � n City Licvnse No. • � ' � • _ ' ' ' . '. U ' LICENSED CONTRACTOR DECLARATION � Remarks: . � � S � ' Pa�king Req./Provided � r ' � - �,' �` ' 1'hereby aRirm that Pam licensetl untler provisions ot Gharter 9(commencing , ._ R with'section 7000) of Divlsion 3'o e usiness antl Professions Cotle, antl � , - ' . Useof Building: . . - E my license is in full forc na eftect ' - . � � . - ' _4O%S�S�' . . . PLUMBING � � FEES PlanningNotes: ' • � •- M ' � License Class ¢ se No. ' E Date : ��]Tc� Ji9natur , u. ' ' , i � . � • ' ' , N .;AORKERS' COMPENSATION DECL•A'RATION.� ;, • Ba� Sink ShOwe15 , . T '`,neveby�affirm that I have a certiticate oi consent t insure or a certlficate ' - ' " i ' • � � ' ' � � � • I ; �f Workers' Compensatiom Insurance; or a=certi tl• opy,thereof (Section _BackflowPrevente� . ServiceSink. S 380q �Sb. C ) � ' � Backflow Irrigation ' � Sewer Cap -� � �� ` ELECTRICAL � � � ' FEES � PolicYNo. 682375 � � PanYst �Ulid. . - . . ' ' i ❑ certifiea copy is nereby tumishetl. '� � ; ' Bathtutis � i � Sewer Connection � • Automatic Washer � �Transformer 0 15-50 KW jl.Cer[ifietl copy is filea with the' it g61 M w' � ' ' ' ' ' • . � � � 50+ KW � i oate '��_�.,_ �.,4��At App�ican C ,• Clarifiers olarCollecrors _ � ConstructionPoleSub. i ' .� EXEMPTION FROM-WORKERS'',COMPENSATIO ECLARATION - ��- - -^' DiShwashef "" "" "' ' �"' "SolaY Pi in '. ' P 9 - � � " "Z Oi� � Cookm UniY'' � 's"' ' Meter�Oupto�100,amps-• (This sectiomneetl not be completetl if the'permit is r one huntlretl ($100) or ' � 9 � . i� � f less). � : � - ' � '� Drinkin Fountains � � � - . I.certi(y that �in the performance of th¢ work fonwhich this pe�mR isiissuetl, I� 9 ' SOIa� T2nk � �, i 3 QO . Dishwa5her � .Meter �Ovef 1008Tp5 � shalG nof emplOy any person in any manne� so as to become subject to the . . � - , ' ' , � Workers' Compensatiom Laws of California.� . , . , } Floor Drains ' � Swimming Pool w/Spa - Dryers ❑Gas' DElectric. ' �Sub Panel •� . � j Date � �� Si9nature � - ' . — . ' ' . � ' NOTICE: It; afte� makin9 this tlecla�atiOn, you Shoultl become subjeCt to the FI00� SinkS 7 � - U�indl . Fan� � � •MOt0�5 -1' HP �1 �fi- 8 ,_ Workers' Compensation' provisions ot Ihe Ldbor•Cotle, y0u must farthwith � � ^ - - � � -- �- - - - � compty'with such ,provisions•.or this�permit sM1all�.be tleemetl revoketl. ' GaSService t - � ' 1 ' ' - WaterCloset '� 'Z p ;�F.A:U. � Inc.Solan�9-15 HP 016-15+ CONSTRUCTIONI LENDING'AGENCV . ' '{` " � '� � . � - " ' " ' ' ' ' � fhe�eby affbm that there is a con5t�uctlon lentling a9ency�for tne peFtormance Interceptors ' Water Heater, � � �� .�Fixtures � �Microwave . ' � o( the work tor which this permit.iz issuetlt(Section 309] Civ. C:) � - �� Lentler's Name ' _ Kitchen Sirik °' � Water Service � - + f_ Device Boxes ' POIe Light � � l.enaer's Atlaress� ' ' Lavatories' - OWNER BUILDER DECLARATION ' ' - � OUtlets � ' Range t • I hereby affirm thzt 1 am ¢xempt from the Contractor'S.License Law tor the � - _ � , � __ � - . ' following reason (Section 7031.5 Businessantl Professional'Cotle:.Any ciry or F-Trep . � � -� �� Switches• Sign ' � munty whith requires a permitto construct, alter, improve, tlemolish or repair ' _ . ` any structure, prior to its.issuance, also requires the applicant tor such permit 'Roof D�ains �` . -�'� ' I '-' �" ; Garbage Dispos2l � • Standing Sections ' • � 'o file a signetl statement-[hat he/she is licensetl pursuant to the provisions o!', _ _ � Contractor's License Law (Chao�er 9(commencing,with SecUon ]000) of - - ' ' Generator �0.5 KW 05-15 KW Tresh Com actor � � ' ision 3 0( the'Business antl Professions Cotle).or tnat he/she is exemp[ �� - % ' '�'� P �' refrom antl the basis (or ttie allegetl ezemption: Any'violation of Section - �; � ,J31.5 by any applican[ to�� a' permit Subjects _the� applicant to a civil ' ' ' � � . � �' � j� _ , , � ' � � enalty of not more tnan five huntlretl tlollars (g50o). � • - - Reinspection Fee ,$25 _ � Issue Fee� ' $�3 � I, as owner of the property ror my employee's with wa9es. as their sole : - ,'MECHANICAL ''`� Reinspection Fee f $25 � Issue Fee $� 3 mmpensation will tlo the work, ana the structure is not intentled or ofieretl ' �. ' FEES _ tor sale (SecFion 7044, Business antl Professional Cotle: The Conhactor's ,PUBIICSERVICESREQUIREMENTS: ' ' � ' ' License Law tloes not appty to an owner ot a property'wM1o'builds or improves � gpj�er �� ' Hood or Type I• ❑ _ ' � 1 ' • � thereon,.antl �wM10 tloes such work.himselt/herself or through his or M1er own ZOOIOg ApprovBd By Ddte ' ' employe¢5, p�ovitletl that such'im0�ovements a�e not intentletl o� otteretl fo� � C2nOpy TypC II ❑ ' , - � � ; sale. If, however, Ihe b W Itlin9 or improvement is zoltl within one year of com- . Duct�- Under GrDund . ' • Applicatioa Approved By Date pletion, tne owner will have the burtlen of Drovinq he/she tlitl not builtl or im- - � . , ; �rove'tor the purpose of sale). { , � , � Duct - Strucmrel q¢frigeration Sys[em � , , /� � Appliption Issued By �� Date . .�1 � 1, a5 owne� ot the property, am exclusively [ontracting wi[h licensetl con- - � tractorsto ronstruct the project (Section 7044, eusiness antl Protessions Cotla: Duct - Ventilating ❑��100,000'BTU ❑100,000 BTU � ��„✓ �r''• � , , •SUMMARV OF FEES . .The Contractor's License Law.tloes not apply to an owner of.property who ' builtls or improves tnereon„antl who contracts tor such projects with a con- Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING�PERMIT $� SMIP '$ tractor(s) license pursuant to the Gontractor's License Law). '� . PLAN CHECK $- ' PERMIT ' � ❑�I_am exempt untler Section B. & P. C. for this reason Pirepl/Fact. Blt. IC80 # � � PLUMBING $- ��O ��d '.ISSUANCE •$ � oate ownen � Heating System & Ducting � � � pLqN CHECK � ,$ ENERGV P.C. $� I hereby certify tl I have reatl this application antl stata mat the above , ❑0.100,OOOBTU �700,OOOBT � � GRADING $ � ' iniormation is cor ct. gree to mmply with a11 city antl countY ortlinances � -' --- - .P. ��j� ELECTFICAL f$ . antl state laws rel ting bui c nstruction; antl hereby authorize repre- ' � ��%:�' p��qN CHECK $ M�CROFILM $ ' sentatives o( thi •ci r� t dbove-mentionetl �roperty ►u� , � • , inspection r os n /G/�(�p/� /�� ' �• � _��'�_!, • ' I� MECHANICAL � $ TOTAL FEE . $ ZU. SO Sigwture Date � , � . (p�i. ' • . Orivers' License or 55 #` � � Reinspec[ion Fee $�5' Issue Fee � $ 3 S- PLAN CHECK �$ /� 'CMF 0865-46 rev. 7/83 White - Builtling; Canary - Applitant: Pink - Accountinq; Goltlenrotl-- Assessor - ' � � . . _ .. .. _ _ .. _ ' ` __— _—_/' -^. � , � , i - - � - BO � SPA � � • '� .CONSTRUCTION AND PLANNING � - - ' „� - , - � ' ,� Date� Inspector_ � - ` ' - . 'Date Inspector , APPROVALS.- �Permit # � -� -APPROVALS • � Permit # � �. - ��,11?emporary Electrical Serviceor Pole-; � � , � , 52:-Pool & Equipment Location � :'2: Soil Pipe-Undrgrnd. - • . ' '" � '. � . ' 53. Steel Reinforcement - - " �:3: Electrical Conduit Utility-Undrgrnd. � � . � , ` 54.: Fo}ms � . •- ' . . - '•4: ElectricalConduit-Undrgrnd�� _ � . � 55.,ElectricelBonding - 5. Steel Reinforcement � - � . . � 56: Rough Plumbing & Pressure:Test '��6. Electrical UFER Grnd. , ' "� � ' � ' 57.-APPROVAL TO COVER-GUNITE � �.y . 7.,Footings ' �;� �" ' � �: � 58. Electrical Conduit�Undrgmd�.- -, � �y i 8! Foundation ' f, � ''j'J '.59.. Gas Pipe, O:Undrgrnd., Test 9. Water Pipe-Undrgrnd. ' " �'�',� 7 � . �j`, � •i 'v �,- ��60. �Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System � +` � �' 67.- APPROVAL'TO DECK . ' 11. Property Sewer Line & House Connection �. ' 62. � Backwash & ReceptorFinal 12. Sewer Cap _ � � ' . 63. � Heater & Vent-Final � - _ � 13: floof Drains � �� ,- 64. P.lumbing System - Final '• 14. Rough Plumbing . . - 65. Electrical-Final '� ' ' "15: Rough Electrical-Conduit - " ' ,- ' + �� , ' ' _66. Solar System-Final � - " � ' �'16. .Rough Electric�Wiring � . , , . �-'i - � '67:-Fencing & Access Approval � ' � 17i Rough Wiring Sign �� 68. APP,ROVED FOR PLASTERING 18: `Rough Electrical-T Bar Ceiling � � , 69. �POOL/$PA.SYSTEMS FINAL � 19. Rough Heating &�Air Conditioning � � � � � FIRE DEPT. REQUIREMEN'f � . �� 20•..Rough Factory Fireplace. � • � , APPROVALS Permit# 21: Ducts, in Structure . ' � , , J0. Underground Hydro � . 22. Ducts, Ventilating � ; � 77. Product Piping OGas ❑Oil . , � - � 23. Ga4 Pipe-Rough & Test � . • 'E{ �. � � j 72. Underground Flush ' 24._Roof Framing . - � „ � � � ; - I ' 93.• Undergrnd. Storage Tank,O Gas ❑ Oil 25�. Roof Sheathing � � � - ' � � 74. Oveihead Hydro � �� 26. T-Bar Ceiling (Structural) & Monocoat ' • . � � 75. Dry�Chemical � ' ' � 27�� Frame and Flashing , �� . � 76. Dry Stand'pipe - 28.:Lathing & Siding � � � � � ' � 77. ,FIXED SYSTEM FINAL, ' 29. Insulation ' � - . � � 78. FIRE PREV. 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. F,inal Factory Fireplace �. • � , �� • � � � . . ' _ 38. Final Plumbing . � - . � - . " ' � 39. Water Service-Final � � � , � , 40. Gas Service-Final � ' � � ' � � , . � . � � i i 41. Solar pomesticFinal � � � - � .. . - - - - - - ' i 42. Backflow Preventer � ` � � � • � � � 43. Backflow Irrigation . � ' - , , � - � ,. � -� 44. Landscape Irrigation System . � - � ,� �` ' � � � � 45. Sourid Attenuation � ' � � � • 46. Flandicap Regulations ' , � _ . � � � �. 47. FINALSTRUCTURE & BUILDING � ! `� • � � � 48. Special Requirements Completed � . � , ' • � • ' ' - ' � � . , � r -aA. E`I�trie Release to Edison , � - --- - .-��*- -' -- - ^+ - , � , ; • ��=lease to�Southern California�Gas Co , � � � " _O i . T� IIFICATE OF OCCUPANCY . . , ' .. , . _. _ � Date ' - � i �_ r- -' - - - J � s �(, Y c� Va� �_z�a �..1 n� �e�-�—c. (�� o �iir� t � �Xr� �v(�`9�.� z iZ��-,� � � ��i � �� P��-5 . c�-i� STRUCTt�`kkL ;aFPR SEPAAq7E PEP,��;TS A FCR �:L�t;�RiCAI, F kF.ATii�:;, i�i:F:��'tA !iEFF,:;E�sA�':( ;"J t. � �l L'i rEGUIRF.O �;�ni�+!G. �,P:!D ��,��;°, •�._._. � �� i�?�5,,,,...�G,. , � :.u�,,; A!,l. t,,•;,:..., - . 5 � "�, z:"„ . . . f�- . ------_ i,ee;�I.+:Y;:, � , . �... ; .. :..: t �� :.:%.Utuht:�,,. :7 .:u^; � : : ...;� ; ...• 8:: CU'iSLii;L . . , : •tiY ucmuu�.«..... `�:N �._�tTIOPlAI .• , r �� a,��rp � � �u �Y� P�L�er �� ,tv��. �- 5-* - ��ti. � J �fLX W� �� w�Y 1�-!'�' ��`:,.��I C��Y �F ��.s`;T�1 ��_ Mechcnicul Division Buiiding Decar'rrent ppproved __c��at ,xiD, (tir�z 5�-�-STI /�OO��eant to fi11 in all spaces except tnose within heavy Oortler Iinez anE si9��all appropriate tleclarations. , . , I�cJ � 2/'��/83 °E'e @c� TL CIT� OF COSTA MESA• � �� . � � � � PERMIT NO. ' ` , �TRACT NO. � LOT NO. . BLD . . , � � �� ' � � - �� -� � -, � � `:,CC�NSTRUCTIONPERMIT c ' . . ` i 8F1�� I �a4- �IILD�3 '; / - '' - : � : - ., y.. r. . ., _ :. , • . �p F Pfoject Aildre55- : � �' - U - � TYPE OF CONSTRUCTION ' �- NEW • ADD ALTERATION REPAIR - � " ' ' ' � ApplicanYsMailingAddre55. - 5�� 1 - ❑ CONVERSION :❑ DEMOLISH ❑ OTHER ' p " ` n-( ��p" ' � _ ' `t DESCRIPTION OF WORK �'S 'P�Ci � L��' I�OmM /X�'DI'j�/ A P ��" �I'� — "_ Zone Owner's Name U�� M i(' }�� ho� e7o_7�'/ . g,' , �oK� �,d�G�� . - S Main Building: � - _. Accessory Building:- -- ' Z Address� Z� ��--� � Mf?�- �'��%'�' ; L� T�VPE OF PERMIT - G.aaoING ; �FOUNDnTiory SrRUCTURA�' � , T Front'� (��' , � - • ' � � N . AfCh/Eng. , � � LiCenSe No. � ❑ TENANT B ELECTRICAL ❑ PWMBING � MECHANICAL - B REar � - ' ' �� ' � Address �—' ' . • • - • O �OTHER � . . ., � . %� . N PROJECT DESCRIPTION 5�. FT. •ocCUPANCV � C Right - - - . - �- ? � �� Contractoi's Nam � � Phone � . ' ��ppOO - � Address (mailing) - ,- , - CONSTRUCTION TVPE � VALUATION $ -�/v — )$ Left ' r � ' � " ' ' ' E � ' T ' . . 20NE GRADINGCV.YOS. ACRES — � � Q Gry�License No. ' �—' � � � Ping. Ref. # � Park.Fees $ - LICENSED GONTRACTOR DECLARATION � Remarks: ^ �^�� _$�` � • � • � - Parking Req./P�ovid¢d r+ u 1=nereby aftirm Ih5t.1. am licensetl untler provisions of Charter 9(com'mencing ' , , wiro section 7000) of Dlvislon 3 ot the Business antl Professions.Cotle, antl � ' ' � -� , . Use of Building: I � , '' my license is in f W I force antl effecL ' ' � License Class `�' ' License No. � � PLUMBING • 'FEES P�anning Notes: Date ' ' Si9nature ' � ' . . - Bar Sink � ' � Showers � � r - N WORKERS' COMPENSATION DECLARATION � ' -. • �/y�, T ' I hereby_affi�m thdt I have a certificate of consent to self-Inmre o� a ce�tlficate � BdCkfIOW P�Evfnt2f .� . _S¢� i 2 j� � � . X..C-I(J � ' $ ot Workers' Compensation InSurance, Or a certifieC COpy thereot �(Se<fion 3800, �ab. CJ � , - ' ' Backflow trrigation. � Se e ap , � � . ' LECTRICAL ' � � � FEES Policy No. ' � Company � ' ' � � ecertiflea copy is hereby fumishetl. � �. � � � Bathcubs ' er nne n 1 Automatic Washer � �Transformer ❑ 15�50 KW � � Certifietl copy is filetl with the city Builtling Division. � 0 5�+ KW oate ' Applicant � , Clarifiers ' Solar C lectors Construction PoleSub. ; EXEMPTION FROM-WORKERS';COMPENSATION��ECLARATION ' ��" . i u - � -- --- Dishwasher Solar g, Cookin Unit � ��Meter �u to100am s (This seciion neetl not be completetl if the permit is for one buntlretl (5100) or .. 9 P _ P less) , . � ' ' Drinkin Fountains � ' ' I c2rtiTy tha[ �in the per/Ormdnce of th2 work fo}�which thls perrti�t is� uetl, I 9 Td�k Dishwasher ' � Meter ❑OVCf 10� dR1p5; shall not employ any person in any m� er iq gs�tp-p¢� ome sub)'fct�to,the ' ' Worker�.,Copipen5a�onl Laws of Calit��p I 1 l�l 1\ �/ ' Floor Drains � Swimming Po I / Dryers ❑Gas ❑Electric �Suh Panel ' . Date 1 C_ CO Y Si9nature 1 V V Y 4Y�_I••\ vGl.� � � " NOTICE: If;'after.making t�is tleclar�n, you shoultl_become.subject to the Floo� Sinks U�i Fan . . _ �. . Moto�s �0.1 NP 01'/z_�8 Workers' Compensation provisions of the Labor Cod¢, y0u mu5t (orthwith : �� . • � comply with' suc�'provisions or� tnis��permit shall Ce tleemetl revokea: GasService Outlets atecCloset• J : F.A:U. � InaSolar��9-15 HP �i6-15+ � CONSTRUCTION'LENDING AGENCV � ' ' ' - I hereby affirm that there is a construction lentling agency tor the performance InterceptOfs . WateR Hea[C� - p- � Fixtures + � ' ' • t of the �work ror, which ph� permit.'is issuetl_(SetHon 3097 Civ. CJ _ . � � ' �% � Lentler's � Namv.� ' �1 A�� _ ' Microwave � Kitchen Sink Watei Service � �=; Device Boxes � -< 4 Pole Light ' ' . LentlePs Atltlresr ��' Lavatories OWNER BUILDER DECLARATION - � � Outlets � Range OO � I hereby affirm.that I am exemp[ irom Ihe Contractor's License Law for.tbe � p_Tra � � ' tollowing reason (Section 7031.5 Business antl'Protessional'Cotle: Any city or P, . ' �, 'i . `� �Switches � � - Siy�� p rounty which requires a permit to construct, alter, improve, tlemolisn or repair • - � ' ,any structure; prioryto ics.issuance,.also requires the applicant tor such permit '. !Roof Diains � S - � - - � to file a;signetl statement(that he/she is Iicensetl�pursuant to the provisions of '�� - ��Garbage Disposal ' � Standing Section5 ' i �S'�.�.�e Contractor's License Law (Chapter 9(commencing with Section 7000) of ' � p, � . � �4;,viwom 3 0( the� eusinezs antl Professions Cotle). or �that he/she is exempt -� � i, -- ' � � . :�' � Generatoi �a5 KW �5-15 KW � Trash Compacmr ' , il�4erefrom.antl the basis tor the alle9etl exemption. Any violation of Section �. �' � � , , � - _� 031.5 by any applicant for a' permit subjects tne�applicant to a civil - : . • ' ��enalty of not more than five huntlretl tlollars ($500). �-� Reinspection Fee $25, '' . Issue e- '$� 1;-as owner ot the property �or my employees with wages as [helr sole . ,�?, Reinspection Fee f � $25 . �uue Feet � �$� 3 compensation will tlo the work, antl the stru<ture is not intenGetl or offeretl ' � -• . ��_ MECHANICAL � ; ', FEES tor sale� (Sec�ion J044, Business antl Professional Cotle: The� Contractor's � PUBLIC SERVICES REQUIREME ITS � ' � ' .License law tloes not apply to an�owner ot a property who builtls o� improves � B��y� .,-� : � Hood or Type I: � � [hereon, antl-who tloes such work.M1imself/herselt or through his or her own � -+ � V G ' � employees, provitletl tnat such•imorovements are not Intentletl or ofieretl•for Canopy Type II; [ri� Zu�ing APP�a�ed By__._(�. —Date�� sale. If, however, the buimin9 or improvament is'soltl wlthin one year of com- Duct = Under Ground , �1/ �' �% qpp�ication Approved By ' Date ��0 '$3 pletioq the owner will have the burtlen ot proving he/she tlitl not builtl�or im- . . � � � . �rove,tor the purpose of sale). • . � � , Duct - Structural : i � Refrigeretion Sys[em �./ � {� yApplication Issued By ' ' Dat �'Z'�4 ��l P51 I, as owner of the property, am exclusively contractlng with licensetl con- � , bactorsto construct tne project (Section 7044, Business antl Protesslons Cotle: ; Duct - Ventilating _ ❑�-100,000 BTU ❑100,00 TU � . ' SUMMARV OF FEES The C6ntractor'S"Cicense Law tloes'not apply to an pwner of property who'�' � ' , - �Y7 builtls or improves thereon, antl who contracts for such projects wich a com � - BUI�DING PERMIT $' SO.� SMIP '$ •� �• , Exhaust System ❑ Multiple ❑ System Repair/Alteration � tractor(s) license pursuant to the Contractor's License taw). � ' PLAN CHECK � $ �� PERMIT ❑�Cam exempt untler Section B. & P. C. r his reason Firepl/FacL BIL ICBO # ' � "' �$: iISSUANCE ,$ I � '� . . ' ' ' : � � ty PWMBING . Date • • � � owner ' " . Heating System & Ducting . � • � PLAN CHECK ' $ " ENERGV�P.C. , $ .1_hereby- certlfv that.l have.reatl this applicatibn. antl state that the above_ .l:. ❑P100,OOO.BTU 0100,0006T . . ,_. _ _ -� ELECTRICAL ✓�'�� GRADING �$ ' Information Is correct. I agree to "comply wkh all city antl�county ortlinances � $ � . antl'state laws rela'ng. to builtlin9 consVuction, antl�hereby authorize repre- i � , � , CO � MICROFILM �$ sent s of this t. to'e r upoi tf2�above-mentlonetl'Oroperty tor + PL3�NCHECK ' $ �'� Inspe tio rpose . ' ' ' � � m? ' ' �.Q Ss.�� S�qn� � � o ci2 20'�3 ' , , � MECHANICAL $ 7 , TOTALFEE $ _�1� Drivers' License or 55 �� - I Reinspection Fee ,$25 , laue Fee , $ 3 PLAN CHECK , '$ �'0O �CMFO865-46}ad.'7/83 White-Builiiinq;Canary-Applicant;Pink-Accounting(Goltlenrotl-Assessor� `"'�"� ' ' '-" ' �' ' � "-- '-- """ - ' ' �� - -- - -� -• -- •� - � :� � CONSTRUCTION AND PLANNIIVG . � . � . . POG SPA . ;. 1 ' � -Date Inspectoi ' ' � Date Inspector �',. APPROVALS Permit # - � APPROVALS Permit # � �1�. �Temporary Electrical Service or Pole � - : - 52. Pool & Equipment Location- � . ' . � 2. Soil�Pipe-�Undrgrnd. � ' � `-'� � �53. SteelReinforcement _, � • 3. Electrical.Conduit Utility-Undrgrnd. � � ' � 54. Forms . � � � -� 4.'Electrical Conduit-Undrgrnd. � - 55. �Electrical Bonding � `5. �Sfeeh Reinforcement ' ' • - � 56. Rough. Plumbing & Pressure Test ' � 6. Electrical UFER Grnd. . � � � 57. �APPROVAL TO,,COVER-GUNITE ' � 7. Footings , ' , � . 58. Electrical.Conduit-Undrgrnd. . 8. Fouridation . . -, � , - 59. Gas Pipe, 0 Undrgrnd., Tesr , � 9.'Water Pipe-Undrgmd. � �- � 60. -Backwash�Lines, P-Trap, O Undrgrnd. ' - 10. Strucwral'Floor System ' ' � � � ' '61. APPROVAL TO DECK - it. Properfy 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. ElectricabFinal � • � 15. Rough Electrical-Conduit � � � ' " - 66. Solar System-Final ' '� 16.� Rough, Electric Wiring .. ' i . . ' - 67. Fencing & Access Approval " , � � 17.' Rough Wiring Sign- �' 68. APPROVED FOR PLASTERING 18. Rougli Electrical-T Bar Ceiling : , , � 69. POOL/SPA SYSTEMS FINAL -- 19. Rough Heating &,4ir Conditioning � �� ,� FIRE.DEPT. REQUIREMENT 20. Rough Factory Fireplace �� ' � APPROVALS . -�Permit # - _ .� 21. Ducts, in Structure . . -_,,, �� 70. � Unde�g�ound Hydro , � 22. Ducts, Ventilating � ' � 71. Product Piping �Gas OOiI 23. Gas Pipe-Rough & Test ; � .`�;� 72,_,Underground Flush ' , 24. Roof Framing ; • - f �� ' 73. Undergrnd.StorageTank OGar OOiI �� :� � 25. Roof Sheathing :. ' �� ' 74. Overhead Hydro , 26.�T-Bar Ceiling (Structuraq & Monocoat�' �. � � 75. Dry Chemical � '27.' Frame and Flashing � � �� _; 76. Dry Standpipe� �- 28. Lathing&�Siding . .� - .'��V�� j77. FIXEDSYST,EMFINAL"�. ♦., r.,._ : 29.. Insulation • , � - �` � � �;.� -78` FIRE PREV. F�INAL � -' � � ,� , ' �"C 1" 30. Drywall Nailing � � ' �.:y,f '� - � a HEALT:H DEPT: REQUIREMENT .` • - .31: Plaster� Brown Coat � �"j� . - - 79.rFINAL�INS_P,'ECTION' ' ' �� 32.� Electrical Power Meter-Pinal • ' � 80. FOOD.CERTIF.ICATE-ISSUED � � , 33. Final`Electric 7 � Notes: -� � � ` % ' 34. Final'Heating.& Air Conditioning � " � [. / � Y' . eB1.0 p 35. Fina� Gas Pipe-Test - - . � ' � � � � 36. Hood or Canopy , , � �. . � , - • � _ . 37. Final Factory Fireplace � i ' ' '-� � � . � ' � 38. Final,Plumbing . � . � _ . � . - ' 39. Water Service-Final ' • ' � 40. Gas Service-Final � . • ' � . . 41. Solar pomestic-Final , � . __ , ' �, . ' . , 42. Backflow Prevehter � . � ' � � � . � 43. Backflow Iriigation , � � , - ' ' - � • • 44. ,Landscape Irrigation System' �. . � � � 45. Sound� Attenuation ' � . , . . ' � , . ' 46. Handicap Regulations � - � , , � � 47. FINAL STRUCTURE'& BUILDING ` �- � � . ; � . • - � . � 48. Special Requirements Completed ' � , � � 49. Electric Release to Edison ' ' •- � � ' - • � - - � . � 50. Gas Release to Southem Califomia Gas,Co � ' • � � ' � � � � 51. 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