HomeMy WebLinkAbout3333 BRISTOL ST - Building Permits (2), _-._.
,.
JobAddress: 3333 BRISTOLST
Suite: 1225
Viciniry:
Parcel Nunmber: 41250107
Applitant: RANDY MANCINO
Address: 818 N GRAND AV
COVINA, CA
Owner: SOUTH COAST PLAZA
Address
COSTA MESA CA �
3315 FA�RVIEW ROAD
Contracror: ALLREADY FIRE SPRINKLER
Address: 818 N GRAND AV
Slatus: ISSUED
� � � �..- � . � Applied: 11/01/2005
Issued: 11/ 12 0
Zoning: PDC PDC ISSUED BY:
Phone: 626-913-6720
Zip: . 91724
Phone:
Zip: 92626
Phone: 626-913-6720
COVINA, CA Zip: 91724 -
� � � License: 358795 � � --- -- - � -
SCOPE OF PERMIT
� � RELOCATE 20 OVERHEAD FIRE SPRINKLERS FOR "STUART WEITZMAN" IN SPACE 1225. �
Plan Check: $63.21
Permit: $97.25
Other: $0.00
Total: $160.46
Ir ��G����h a�G:��
Iz � oq�os F`�-c� {' Ftis a�- Cc�
FEE SUMMARY
Calc Valuation: $3,soo.00
Claimed Valuation: S3,5oo.00
NOTICE: The xrork eulhorized by this permit shell comply with all applicable handicap eccess requirementa under Califomia statutes and related
raguletlons. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit ahall automatMalty e�ire en0 become vold if xrork Is not commenced withln 1 BO days, or if work (s suspernled or ebandoned
for a period ol 180 days.
� INSPECTIONS: In order lor lhe work eulhorized urMer thia pertnit to be Considered legal, such work must comply with all applicebla codes, and all
� requlred Inepaetlons and Ilnal approvel must be oDtained. Feilure lo obtein Inspectlons and final approval will resuN in the expiration of th(s pertnit.
FOR INSPECTIONS CALL: (714) 7545848 � ' T �
z++e+e �emo�
WOFiKERS' COMPENSATON DECLARATION: . � . . . . -
I hareby eflirtn untler penelry oi per�ury one of the lollowing tleGaretions: '�� - ,_, '
❑-I have and will mairitaln e ceNticete ol consent to self-Insure tor workers' compensetlon, es provided tor by sectlon 3700 0l the Labor Code, for the pertortnance of �he
wark tor whlc� INs permit is issued. .
��I �have end will maintein warkers' compensation insurexa, as required by section 3700 of lhe Lebor Code, for the pertortnance of t�e work for which this permit ls IssueO.
My w ers' wmpensallon Insurence cerrier antl poliry numDer are:
Cer�a. � LllQ � iJ�� �,/y,(J,a-��� PoIlryNumDer. �J ��- LI,3 �Gy�� a�(
(Thls secN�eedno( be comp/efed I!i-he pemti175 velued af one hundred tlollers (5100J or IessJ . .
❑ I cenify that In the pertormence of t�e work for which this pertnit is Issue4 I s�all not employ any person in any menner so as to become subject lo the workers'
wmpensetlon lawa ol Celtlomie, entl egree that If I should Eecome sub�ect to the workers' compensation provislons af Sactlon 3700 of ihe Lebor Code, I nhall farthwlth
comply vrith these prwis
Applicent Slpnat6rei� /�• G,�� Date: I I� /_6; G'
W�RNINO: FAIl.URE TO 5 CURE WORKER�' COMPENSATION COVEMGE IS UNL4W Rll. M1D SIULL SUBIEGf AN EMP�COVER TO CRI PNALMI� TIES AND CML FlNES UP N ONE HUN�RED
TNWSAND DOUARE (5100,000), IN ADDRION TO THE COST OF GOMPENSATION, �AMAGES AS PROVIDED WR IN SECTION 3]OB OF THE UBOR CODE, INTEREST, AND FTTOiWEYS FEES.
LICENSED COHTRACTORS DECLARATION:
I he�eby,eflirtn t�at I am Ilcense nAe� Wsic
tvice entl ettect.' Lic. M'
ConlfeMOf581gn9tum:"" `" �L�
_.�,,.,," _ . �
9(commendng with Sectlon 7000) of Divislon.3 oi.lhe.Buslnass end Prafessians Code, antl my license is In full
�CI999'M- - � '��
— �Dare:�—�---_. � I—� —i�4'
�
CONSTRUCTION LENDING AGENGY:
❑ I hereby aMirm ihat t�ere Is a cansiruction lending agency for the peAortnance ot ihe work lor wMth this pertnit is Issuetl. (Sec. 3097, Civil Gode).
LendefsName: _ __ .__. _. LendersAtltlress:
SigneWre:
Date:
OWNEH-BUILDER DECLARATIONS: '
I �ereDy aHirm that untler penelry ol perJury Ihet 1 em E%EMPT FROM THE CON7RACTORS LICENSE LAW tor lhe followinp reeson (Sec. 7031.5, Bu9lness entl Professlons
Cotle: Any ciry or wunty which requires e permlt to construct, alter, improve, demolish, or repalr any atmcture, prlor to its Issuence, elso reQuires Ihe epD���eN tor such pertnit
to file e signed stetemem thet he or s�e is IlcenseA pureuant to Ihe provisions ot ihe Comrectors Llcense Lew (Chapler 8(commencing wit� Sectlon 7000) of Dlvlsion 3 at the
Business entl Protessions Code) or Net he or she Is exempt Iherefrwn anA t�e basls for the elleged exemption. Any violetion oi SecUon 703L5 by flny epplicent for e permlt
sub�ects ihe epplicant to e clvil penalry of not more then five hundred dWlere ($500).):
❑ I, as owner of Ihe properry, or my employees with weges as their sole compensation, WILL DO TF1E WORK, entl the siructure Is not intentled or oHered for sale (Sec.
70a4, Business and Professions Code: The Contractors License Law tloes not eppy to en owner of properry who builds or Improves ihereon, end who does such work
himsetl ar hersetl or Ihrough hls or her own emplqrees, provided that such improvemenis ere not Intended or aflered tor ule. N, however, ihe building or Improvement Is
soltl within one year ol completion, t�e owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). '
� I, as owner oi the O�operty, em E%CWSIVELY CONTAACTING WfTH LICENSED CONTRACTORS to consWct the project (Sec. 7044, Business antl Prolessions
Code: The contractws Liwnse Lew tloes noi appry to en owner of properry who builds or Imprwes thereon, antl who wntrecLs lor suU pro�ect with e contraaor(s)
license puBuent to the Contractors License Laws.).
❑ I em exemp� under sec. Business antl Professions Code tor this raeson:
Signature: Date:
Owner ID verlfleO by Orivers license. ❑ Yes ❑ No Drivers LJcense No. Expires:
Veritication oi Ownership by (rype o1 documem, i.e. - property tae bill or deatl):
DIVISION OF INDUSTRIAL SAFETY VERMR CERTIFlCATION:
❑ I hereby cently Ihat no excavetion tive (5) or more teet in tlept� into which a person is requiretl to tlescend, wlll be mede in wnnection wit� work eui�odzetl by this
permlL antl Ihat no bulltling structure, scaMdding, telsework, or demditlon or dismentling Ihereot, will be more ihan thirty-six (38) feet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Tltla B, Celifomia AAmInISlreUve Cotle).
❑ As owner-builder, I wlll no1 employ enyone to tlo work whkh would require e permit trom iho DMslon al Industriel Sefery, as noled ehove, unleu sucl� peraon hes e
permit to tlo suc� work trom Ihe tllvision.
SlgneWre: Date:
Division af Industnel Satety Permit Number.
CER7IFlCATE Of COMPLIANCE AND AUTMORQATION OF ENTRV: 1 certily under penelry ot perjury that I �eva read t�is epplication antl state Ihet the InfortnaUon given is
correct. 1 agree to comply wlth all stete laws entl city ortlinances releting to bullding construdion, end euthodze representatives of Ihe Ciry of Coste Mese to enter upon Ihe
above-descdbed Oroperty lor InspacGon purpases. I agree not to acupy or ellow occupency ot eny building euthodzetl by INs Dermit until final ins0ection.
. � �ZA' . . / / i
COOE I, INSPECTIONTYPE � QdjE
1818 ' Fizetl System Final FIrB Preventlan
1266
201
202
203
Pool Spa Flnal
Finel Re-Roof
Finel Block/RetaininB Well
Final Fedory Fire Plece
Finel Slpn
204 Finel Demolltlon
I(��$ �iQpEj INSVECTIONTYPE
206 Final Mechenical
. � 20B Final Plumbing
210 Flnal Electdcal
� 212
220
Date
Q� 11�lLLIWf I.•
Flnal Fire Preventlon . %%" �g•�
Flnal Plenninp Apprwal ' �
222 Final Site .. � �
250 ' Final BuilAing�Occupency' '
�
(714) 754-5273 • Fax (714) �54-4856 • www.ci.costa-mesa.��gCTRICAL PERMIT %� FAIR DRNE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
3333 BRISTOL ST
1225
SUITE 1225 STUART WEITMAN
41250107
THOMAS,STEVE
;.-Phone: .Z14-861-4060--�` -
� S� . ' " `- - - �.
`� �' > . , Zip -- .
�
Owner. SOUTH COAST PL9ZA
Address - � - ° ' � � - � �
ISSUED BY:
Status:
Applied:
Issued:
ISSUED
ioi2v2o05
10/21/2005
� COSTAMESA�CA - >���Pfibne� " � .. � _ -- � '
«'.� 3315FAIRVIEW_ROAD "z�-Y-z '�� ' Zip: 92626 � � .
, ,
Confractor: HP,RBOUR ELECTRIC
^,��"�Addres's: 16321 GOTHARD ST
„ - , , STE�A '; Phone:�:714-861-0060
HUNTINGTON BEACH CA Zip: G 92647
� � License�707899
_. . 'r, .. _ ., _
� � SCOPE OF PERMIT_ , „ ° , �
�ELECTRICAL PERMIT IN CONJUNCTION WITH THE INTERIOR STORE TI FOR "STUART WEITZMAN"
�SUITE 1225'� _ � - .�
� REF: B05-00923 � - ''� � �:�
�:- �;
� 148 LIGHT FIXTURES, 35 OUTLETS, 5 SWITCHES, 1 SERVICE TO 200A .-
1
" ISSUE�FEE � E
.. Temp'seivice test --
; �Res. a/c package -
New Res (1-2 umts)
New Res (3+units) . .
Pool / Spa _"
Lighting Fi�As ,
Recept Outlets -'
Switches - .
Non Res Appl •
Res Appl �v
Service to 200a , "
Service to 1000a .
Service over'IOOOa
Motors to 1hp , .
Motors to 10hp
Motors to 50hp -
Motors to t00hp .
Motors over 100hp -
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
., � Quantity
$23 50 �
$0.00 �- .. .-
� .$0:00_��
$0:00 � 0"�' � .
.,r$0.00 �� ' 0
"-$0.00 - ' 0
$115.44 148
-:$32.95 ' 35
--- $5.50 � 5
z: $0.00 �: 0
so.00 ;y, o
.:$30''S0,", 1 . .
$000 �? 0; ��,�; ,
$0'AO '� ' �0 `��- _
$0.00 0
$0.00 0
' - $0,00�. . 0. .....
$0.00 0 :
$0 00 0
.. _. $0.00 ��.� .. 0 ..
- $0.00 .. 0 �: . . .
$000 0
$0.00.;w, . „ 0
$0.00 � � -0'�'
$0.00 0.�.-.
FEE SUMMARY � a �-` � �
� ;Quantity, - - �
Temp Dist System ) Lighting $0.00 :- 0, , H ; ,;
Busway /100 ft . � . $0.00 - 0-
,_ � �.Standing Section � , ; �$0.00 ', 0 - -
Misc Elecirical Equipment ._ $0.00� 0��
Transformers up to 1 kva/kw --� $0.00 ���• 0.,,
...............up to 10 kva/kw �-- $0.00 - 0 , ; �
......... ..;`.up to 50 kva/kw $0.00 0 .� '
.................up"to 100 kva/kw :$0.00 . 0:-�
....:.............over 100 kva/kw �$0.00 � : 0 -
. � �Low Vol�age Equipment $0'.00�.'� . 0
�"� � Low Volt Wlring System / Ckt $0.00 �_' 0
� ` � � � Misc: Conduit � -' $0.00 : - 0 �
-- �,MisaConductor • `;. $0.00� 0
� - �Circus ( gen or ride) '��$0.00 - 0 -
.. . . Circus (mech ride or lights) -' $0.00 � �0 ,
- Christmas Tree Stand - ' $0.00 �0 � �:
` ' _ '" ,' Fireworks Stand - - - . $0.00 � 0 '
", � Other Electrical Fee - , . $0.00 .
, ,- . . .. _ - . _ .
Invesiigation Fee --- - . $0.00
- Plan Check Fee ::� - - - $0.00
� �- -- �� �Reinspection Fee;- ; $0.00
� " °TOTALCALCULATEDFEES"��5207.89
rr�uueure � c.nen�w� rnue��r��uo
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis unde� California statutes and related
regulations. (Ord. No. 92-28, § 7, 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 Inspeetiona end tinel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (774) 7545fi26 ,%
x+aaee �sioo�
WORKERS'COMPENSAnON DECLARAnON: '
I hereby attirtn under penalry oi perjury one oi t�e following tleclarations: .
❑ I have and will malntein e certificate of consent to self-Insure for workers' compensetlon, es provided for by section 3700 of ihe Lebor Gotle, for Ihe peAormance of the
work for w�ich this pertnit is issuetl. ,
E�.I have and will maintain workers' compensalion insurance, as required by seMion 3700 ot the Labor CoAe, for ihe peAortnance ot �he work for which Ihis pe'mit is issuetl.
T�My workers' compensation Insurence carner and policy number era:
cam-e�:'� S�+T�F�nF� PWicy.Num ,:oao44 Oozlo�6-2o0S
(This section need nof be comp/etea ii the permit is valuetl et ane hundred tlollars ($100) or /ess.J
❑ I certify ihet in Ihe pertormanca of the work for which this permit is issued, I shall not employ eny person in eny manner so as to become subjecl to Ihe workere'
compensation laws of Celifomia, and �.e that N I should become subject to lhe workers' compensalion provisions of Sectlon 3700 ot the Labor Code, I shall fotlhwith
comptywith Ihese pmvi 's�en__''CL./(/— J
Z!'O �
���.sig�ac�re: �— co_=m.� � — S
WARNING: FAILURE TO SECURE RKER ' MPENSATION COVERAQE IS UNLAWFUL AND SHALL SUflIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO IXJE HUNDRED
hKK15AND 00LLARE (5100.000), IN A TION TO THE COST OF COMPENSFTIIXJ, �AMAOES AS PROVIDED FOR IN SECfION 31O60F iHE IABOR CODE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby aHirm ihat 1 am Ilcensed under rovision� ot Chaptar 9(commencing with Section 7000) of Division 3 ot the 8usiness antl Pmfessions Code, and my license is in full
torce and eHect. Lic..p._ �� Class� C-% 0 �i'
Gam�aaf;s Skj ehire ' � ���— `D�te;� !U � LI --0 b'�
CONSTAUCTION LENDING AGENCV:
❑ 1 here6y effirm ihat there is a wnsiruction lending agency tor the peAortnance ot the work br which ihis pertnit is issuetl. (Sec. 3097, Civil Code).
Lender's Name:
Signeture: _
OWNER•BUILDER DECLARATIONS:
Lender's Atltlress:
Date:
I hereby afllrtn ihat under penelty of perJury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires a permit to consiruct, alter, improve, damoiish, or repair any slruMure, prior to its issuance, also requires ihe epplicant for such pertnit
to tile a signetl statement lhat he or she I5 Iicensetl pursuant to the provislons oi ihe Contractore License Law (Chepter 9(commencing with Sectlon 7000) ot Division 3 of the
Business and Protessions CoCa) or that he or sha is axempt theretrom and the �asis for Ihe elleged exemption. Any violation of Sadlon 7031.5 hy any applicant for a pertnit
su6jects the applicant to e civil penelty of not more than five hundred dollars ($500).): ,
❑ 1, as owner oi the property, or my employees wi�h wages es their sole compensa�ion, WILL DO THE WORK, end Ihe siruclu�e is not intended or offeretl for sale (Sec.
7044, Business and Protessions Code: The Conirectors license Law does not apply to an owner oi property who builds or improves Ihereon, and who does such work
himself or herself or through his or her own employees, providetl Ihat such improvemenis ere not intended or oHered for sale. If, however, Ihe bulltling or improvement is
sold within ona yeer ot completion, the ownerbuilder will heve the burden of proving that ha or she did not build or improve tor puryose of sale.). '
❑ I, as owner of the propary, am E%CLUSIVELV CONTRACTiNG WITH LICENSED CONTRACTOPS to construct ihe Oroject (Sec. 7044, Business and Professions
Cotle: The contractors Llcense Law does not apply to an ownar oi pmperty who bullds or Improves thereon, antl w�o contracts tor such proJect with e contractor(s)
license pursuent to the Contractors License Lews.).
❑ I am exempt under sec. eusiness entl Professions Code tor this reason:
Signature: Date:
Owner ID ven�lad by dnvers license. ❑ Ves ❑ No Orive/s License No.
Verification of Ownership by (rype of daument. i.e. - property tau bill or tleetl):
Expires:
DIVISION OF INDUS7RIAL SAFE7V PERMIT CERTIFICATION:
❑ I hareby cehity Ihat no excavetion flve (5) or more teet in tlepth into which e person is required lo descend, will be made in connection with work euthonzed by Ihis
permit, and ihat no building structure, scattolding, talsework, or demolition or dismantling ihereof, will be more than Ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Celifomia Atlminisirative Code).
❑ As owneabuilder, I will not employ enyone to tlo work which woultl require a pertnit irom the Division ot IndusMal Sefery, as noted ebove, unless such person has e
permil to da such work from ihe division.
SignaNre: � Date:
Divislon of Intlustrial Salaty Permit Num6er:
CERTIFlCATE OF COMPLIANCE AND AIJiHORIZATION OF EMRY: I certity under penalry ot peryury that I have read this epplicetion and state ihat the intortnation given is
wrrect I egree to wmply with ell state laws entl ci�y ordinances relating to building constmctioq end authorize representetives of the Ciry oi Costa Mesa to enter upon the
ebove-descnbetl property tor inspection purposes. I agree not to occupy or ellow occupancy of any building authonzed by this permit until fnel inspection.
COOE I, INSPECiIONTYPE
1616 Fixetl System Final Fire Preven�ion
1266 Pool Spe Final �
200 Final Re-Roaf
201 � FinaFBlocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204� Final Demolition
Date
l 0 -7i/ �'J�_
� n��a—,.
Q�jf, 1 L COpE1 INSPECTIONTYGE
206 Final Mechanical
208 Final Plumbing
210 Final Elecirical
212 Final Fire Prevenilon
220 Final Planning Approval
222 Final Site
250 Finel Building/Occupancy
Qeie �*me:�
(774) 754-5273 • Fax (714) 754-4856 • www.c�.costa-mesa.q_$�LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
,lob Address: 3333 BRISTOL ST
Suite: 1225
Vicinity: STE 1225 STUART WEITZMAN
Primary Occ: M Display/Sale Merchandise Type of Construction: I-FR
Parcel Number: 41250107 Zoning: PDC
npp�icant: HURST, LYNN SCOTT
Address:
Owner. SOUTH COAST PLAZA
Address
COSTA MESA CA
3315�FAIRVIEW ROAD
- -- Phone: . 949-338-7725CELL
Zip: � _
�, �
Phone:
Zip: 92626 -
ISSUED BY:
Status: ISSUED
Applied: 06/OB/2005
Issued: 09/13/2005
Contracror: ,. HURST AND SIEBERT �
Address:j- 2377 SO EL CAMINO REAL� � � � " -.�
SUITE 103 Phone: (949) 361-0111
SAN CLEMENTE, CA ' 4
� � Zip: 92672 License: 622681 , �
Arch : JOHN L ALLEN Eng: GERALD T WYNNE
Address: 4220 RICHMOND AV . Address: 10101 SOUTHWEST FREEWAY
' SUITE 200 Phone: 713-621-7227 SUITE 600 �� Phone: 713-779-7252
HOUSTON, TX - HOUSTON, TX
Zip: 77027 License: C20290 77074-1126 License: C60346
SCOPE OF PERMIT
- INTERIOR TENANT IMPROVEMENT FOR "STUART WEITZMAN" IN SUITE 1225. �
Plan Check: $166.95
Permit: $1,027.35
SMIP Res: $0.00
SMIP Com: $22.25
Other: $0.00
Inspection: $0.00
Total: $1,216.55
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0- 0
FEE SUMMARY
Calc Valuation:
Claim Valuation:
PLANNING 8 ZONING
Rear 0- 0 Lefl 0- 0 Right 0- 0
Rear 0-0 Left 0.0 � Right 0-0
PARKING . Existina: 0 Reauired: 0 Pr000sed: 0
a
$105,966.40
So.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Orcl. No. 92-28, § 1, 12-21•92)
EXPIRATION: This permit shall automatically expire and become vold if work Is not commenced within 180 days, or ii work is suspended or abandoned
for a period of 180 days.
INSPEC710NS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
required Inapeetiona end final approval must be obtainetl. Fallure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545826 �
za+we larool
WOPKERS' COMPENSATON DECLARATION: �
1 hereby eftirtn under penalry oi perjury one of Ne tollowing tledarations:
❑ I heve entl wlll meintain a certiticate of consent to self-Insure tor workers' compensatlon, es provided for Dy sedion 3700 of ihe Lebor Cotle, tor the pertortnance ot Ihe
wonc ror wn�cn mIs vennic is issuea.
�, I have arM will mainWin workers' compensatlon insurence, es reQulred by section 3700 of Ne Lebor Code, for Ne partortnence oi the work far which Nis pertnit Is issuetl.
My wo m ensatl nsurence carrier entl policy number ere: I�
Cerrle. �'4� � PolicyNumber: O��� I— ZUv�±
(Ptls s'ectlon neetl nof be completed i/ the peimit i aluetl at one hundred tlollers ($100J or /ess.J � E
❑ I certity that In the peAormence of the t whlch Ihis pertnit is Issuetl, 1 shall not employ eny person in any manner so es to become subject to the workers'
compensetlan lews e`Ilfomia, e et (�(��h uo Id become su��ect b the workars' compensation pmvlslons of Sectlon 3700 of the Lebor CaOe, I shell forthwith
camptywit�t�e rovl (^� @
Applicent SlgnaNre: tDete:� -/ — � � — V �
�--�^--
WARNINO: FAILURE TO SECURE WORKERS' COMPENSATIqJ COVEPAOE IS UNLAWFUL AND SHHLL SUBJECT pN EMPLOVEP TO CflIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
hKKISAND DOLLARE (E100.OW�, IN ADDRION TO THE COST OF GOMPENSAiION, OAMAGES AS PROVIDED FOH IN SECiION 3]OB OF TNE LABOR �DE, INTEREST, AND ATTORNEVS FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby eNirtn the� I em II n5ed unde�r �prov�isij
force end ettect L1c. # 1� �n `/!C E
Sectlon 7000) ot DlWsion 3 of the Business antl Prolessions Cotle, antl my license is in full
c�
CONSTRUCTION LENUING AGENCV:
❑ I hereby aflirtn that there is a consiruction Ien0ing agenty for Ihe peAortnance af tho work for w�ich this pertnit is issuetl. (Sec. 3097, Civil Cotle).
Lendefs Name: __ . Lentler's Address:
Signeture:
OWNER•BUILDER DECLARATIONS:
Date:
I hereby eMirtn that under penelry ot perjury that I am EXEMPT FROM TME CONTRAC70RS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Buslness and Protesslons
Code: Any ciry or counry which requires a permit to construct, elter, Improve, tlemolish, or repair any strudure, prlor lo Its Issuance, also roquires tha epplicant for such pertnit
to Nle e signetl stetement thet he or sha Is Ilcensed pursuent to the provisions oi the Contracbrs License Lew (Chepter 9(commencing with Section 7000) of Didslon 3 of Ihe
Business and Prolessions Code) or that �e or she is ezempt thorolrom end the besis for the ellegetl exemption. Any violatlon oi Settlon �031.5 by any epplicent for e pertnit
sub�ects the ap0�icent to e civil penelry of not more than five hundred dollars ($500).): .
� I, as owner ot t�e properry, or my employees with wages es their sole campensaiion, WILL DO THE WORK, entl t�e slructure Is not intendetl or oHered for sale (Sec.
7044, Busineu flnE Professions Code: The Conirectore License Law does not apply to an owner ol property who builtls or Impmves thereon, and who does such work
himself or herself or through his or her own employees, provi0ed ihet such Improvaments are not intendad or oflerad for sale. It, howaver, the building or improvement is
sold within one year of completion, tha owner-builder will heve tha burden of proving thet he or she did not 6uild or improve for puryose of sele.). '
❑ I, es owner oi the properry, em E%CLUSIVELY CONTAACTING WITH LICENSED CONTAACTORS to construct the project (Sec. 7044, Business end Prafeuions
Cotle: The cantractors Llcense Law tloes not appy ro en owner of pmperry who bulltls or impmves t�ereon, end who contrects for such pmject with a contrector(s)
licen5e Dursuant to ihe CAntractors License LBws.).
❑ I em exempt untler sec. Busineu end Protessions Cotle for ihis reason:
Signature: Dete:
Ownar ID verified by drivefs Iicense. ❑ Yes ❑ No Dnvers License No.
Vertlication ot Ownership by (rype of documant, i.e. - property tex bill or deed)�
DIVISION OF INDUSTRIAL SAFETV PERMR CERTFILATON:
Ezpires:
❑ I hereby certlly ihat no excevation Five (5) or more feet In depth Into which a person Is required to descend, will be matle In connection with work euthonzed by this
permit, entl thel no building structure, scaHoltling, falsework, or demolition or dismemling thereof, will be more Ihan thirty-six (36) feet hlgh. (Chap. 32, Grp 2, Art 2, Sec.
341, 71t1e B, Caltlomle Atlminisiretive Code).
❑ As owner-builtler, I will not employ enyone to do work which would requlre e permlt from Ihe Division of Intlustrial Selery, es noted ebove, unless such person has e
pertnit to do such wark Irom the division.
Signeture: Date:
Division ot Intlustrial Safery Pertnit Numbar.
CERi1FlCATE OF COMPLIANCE AND A ORRATION OF EMAY: I certify under penalry of Derjury that I have reatl Ihis applicetion end state Ihat the information given is
correct. I egree to comply wlih all stale I s and city ordinances releting to hullding construction, end euthonze representetives of �he Clry ot Coste Mesa to enter upon the
ebove-descnbetl property for inspectio yr�ses. I egree not to occupy or allow occupancy of any building authorized by this pertnit until finel inspection.
GOOE I' INSPECTONtYPE - ,
1616 Fi:ed System Final Fire Preventlon
7266 Pool Spe Final
200 Final Re-Roof
201 Final 81acWRetaining Wa11
202 Final Fectory Fire Place
203 Final Sign
204 Final Demalltian
p� ��g CODE1 ixsvecnoxTrae
206 Final Mechanicel
208 Final Plumbing
210 Final Electncal
212 Finel Fira Preventlan
220 Final Planning Approval
222 FinelSite
250 Final Building/Occupenry
DeteC /
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�""Data�
QAiE It�ELfl
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
MECHANICAL PERMIT
Job Address:
Suite No
Vicinity:
3333 BRISTOL ST
1225
STUART WEITZMAN,SPACE 1225
ParcelNumber. 41250107
Applicant SANDERS, BILL,, ;. ,
Address: 1140 RED GUM`" �„ �
ANAHEIM, CA; Y �'��
� �,. ,, _
Owner. `SOUTH COAST PLAZA
Address: � ` ` � �`� ` ' "�
. . . ,r.,.: �
„ ' i COSTA MESA CA ,
- � 3315FAIRVIEW�ROAD
z: ,= � ' .?,� `-
Co`ntractor THERMALAIR INC
Stalus: ISSUED
Applied: 10/07/2005
Issued: 10/07/2005
�
_=?�"' '� � _ ISSUED BY:
� . . � � �i•.
Ptione: 714-630-3200: � ;,�,,y.,,��
Zip.•r` 92806 i-�� .
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Phone: - � ' � � -�
Zip: 92626
`.. Address'� 1140,RED GUM ST
y z.'
"�'���' � � �� Phone -:- 714-6303200
- --� ANAHEIM, CA . � Zip: � '92806 ,
, `
,�', - - License:102276 �,,
:6 - _ <_ ... ~ - . _ - .
; � � ' � SCOPE�OF PERMIT � :y � = � • �
-. �MECHANICAL PERMIT-FOR INTERIOR TENANT IMPROVEMENT FOR "STUART WEITZMAN" IN a�� . -
-� � � * "` SUITE 1225 >�"'` -- � ' _ ' - -
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' � ' ' �n�* �REF# 805-00923 � •� .
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, � . . . _ ,x .�'s�;, _
. � � . �r�. ..;-... _ .. . . .;,,.. .. .. . _ � . " ..:
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`� i° "� _- WORK TO INCLUDE 2 REPAIR/ALT COOLING/HEAT;�2 VAV BOX,,1 CIELING FAN AND t; _ '- ��
,��'? - REOISTER_�` ; _ .. �. �. — y..� . . _. , " . .'i.. .
. ;� . . - � .. . _ .
`_
. . _ . . ___, - _.._- _, ; _ .
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FEE SUMMARY ,_ � - �
� �� --. Quantity , ,. , -. Quantity��
IS�SUE FEE „$2350 ' ",Repair/AltAbsorbhon.Unit � � i$0.00 0
,`"; , ,.� ,�:" �,._: = -
'InstFAU<100'kBTU . >� , •$000 0 '�"'i� '�� "" -�-Repair/AltRefngeratiomUmt ,-�$O.00��r-O
InsCFAU >100 k BTU i, , $0.00 0 Ventillation System �:� �' $0:00 0,
Repair/AIf Cooling/HeaG'... - ,$27:40 2 EvaporativeCooler , r$0.00 0
Insl'IRep. Recess Wall Htr �...$0.00 0 � Commeicial Incinerator -'� $0.00 0' �
Refrig Sys <100 k BTU � . ---$0.00 0 Domeslic Mcinerator -$0.00 0;
Refrig�Sys>100 k BTU $0.00 0 - Comoressors /Absorotion Svstems -� "�
Gas Piping. -- �., $0.00 0 � � Up to 3 hp / 100 k BTU $0.00 0
Fac�ory Fireplace ': `$0.00 0 ,, -3 To 15 hp /500 k BTU . $0.00 0
Hood w/Mech Exhaust. t �.-- $0.00 0 � � :15 To 30 hp /.1,000 k BTU $0.00 0
VAV Box -'_� �� ,W $21 30� e,2 � �30 To 50 hp /�1 750;k BTU�. `� ' - $0.00� 0
s
Vent Fan / Single Duct �� $7 26 1 `�s �dOver 50 hp,/-Over 1;750.BTU $0.00�"" 0
Appliance + , $0 00 0 �; ` ' �? Boilers �,,, � � �
Fire Dampers . � � - $0 00 0 � � . °� Up to 3 hp `� _- � � . ' �$0.�00 0
Smoke Dampers � � , � $0 00 0 � -`+ ����' 3 To 15 hp- �$" . _ "�$0.00 0
Insl or Relocate Appl Vent �, ' $0 00 , 0'` -- ' .- 15 to 30 hp ,_ s $0.00 0
Air Handlers < 10000cfm r �` $0 00' -- - 0 ' �-. , - ' 3010�.50 hp' - - . 50.00 0
Air Handlers > 10000cfm -` $0 00 ,.„ 0, y � � Over 50 hp ,,,. _ $0.00 0
Floor Furnace - ,� $0 00 = � 0 = � � � � ���Other Mechanical Fee � � -
FloororSuspendHeater �--�$0.00 0 - , ' �. � Investigation�Fee-' � $0.00
�. � �� ".Plan��Check Fee . � � $0.00
��� "� Reinspedion.:Fee' � $0.00
� " . �� .�''^TOTALCALCULATEDFEES E6670
NOTICE: The work aulhorized by this pe,mR shall comply with all applicable handicap access requirements under Califomia statutes
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EX�IRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is
tor a perlod of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all
requlred Inapeetions and final epproval must be obtained. Failure to obtain inspections and final approval will result in the er
FOR INSPECTIONS CALL: (714) 7545626 �
zuses �eroo)
�le codes, and all I
of this permit. ` ,
WORKERS' COMPENSATION DECLARA710N: ' �` . , , - ,
I hereby atfirtn under penelry ot perjury one ot the tollowing declaratlons: � � '
❑ I �eve entl'will maintain e certllicate ot consent to selbinsure for workers' compensatlon, es provided for by sectlon 3700 0l tha Labor CoCe, far t�e peAormence oi the
�_ work for which this pertnit is issuetl. - � ' '�
and will mainlein`�warkere' compensation insurance, es reqWretl by sedion 3700 of the Lebor Cade, for the peAortnance of the work for whic� ihis pertnit is issued.
�kere' cam ensetlon Insurence carrler entl policy number ere: "
>� �'A`�SR � �}�'C� eoua.e,��,-'r33105 0 2 �.� �
i need not be canp/eted I! (he permit Is va/uetl et one huntlretl tlollars ($100) or Ie55.J . .. .. . _
❑ I certify that in tha peAortnence of the work for which this pertnit is issued, I shall not employ eny person in any menner so es to become sub�ect to the workers'
compensation lews ol Cellfomia, end egree Ihat il I hould bewme subjact ro tha workars' compensatlon provlslons of Secpon 3700 of Ihe Lebor Cotla, I s�all fo�hwith
comply with these Pro ' si
, p_ nFS an� C AI �. ��.i..-� Dete:—I. O'�" O�
WARNING: FAILURE TO SEIXIRE WORKE0.S' COMPENSAT1dJ ODVEMGE IS UMAWFUL ANO SHALL SUBJECT AN F.AW�ERTOLHIMIN�L PENPLTIES AND CML FlNES UP TO IXJE HUNDRED
TFiOUSAND DOLLARE (E100,000�, IN ADDITION TO THE WST OF �APENSATION, DAMNGES AS PROVIDED FOfi IN SECiION 3%OB OF THE UBOR CODE, INfEREST, M!D ATTOf WEYS FEES.
LICENSED CONTRACTORS OECLARATION:
I hereby aHirtn t�at I am Ilcensetl untler provislons of Chapter e(commencing with Sectlon 7000) of Division 3 of the Business antl Professions Cotle, end my license Is in full
force e �
Qt o H\G
1:cntre ors'Sgnaye: E� � �.__ [;oate: 1.0 �'7—O �
GONSTRUCTION LENDING AGENCV:
❑ 1 �ereDy eNirtn Ihat t�ere is e consiruction lentling agency for t�e peAormance of ihe work for which this pertnit is issued. (Sec. 3097, Civil Cotle).
Lenders Name: Lendefs Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aHirtn thet under penelty ol perjury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe tollowing reason (Sec. 7031.5, Business end Protession:
Cotle: Any ciry or counry which requires e pertnit ro construn, alter, improve, demolish, or repalr eny sWCWre, prior to Its issuence, elso requires the epplicant for such permii
to flle a signed stetement that he or s�e I5 Iicensed Oursuant to the provisions of the Contrectors LJcense Lew (Chapter B(commendng with Sedlon 7000) ol Divislon 3 of the
Business end Prolessions Code) or Ihet he or she is exempt Iherefrom and the basis tor t�e allegetl exemption. Any vloletlon ol Sectlon 7037.5 Dy eny epplicem br e permP�
sublecis Ihe epplicant to e cNll penelry of not more then five huntlred tlollars ($500).):
❑ I, as owner ot t�e propeny, or my employaes with wages es their sole compensation, WILL 00 THE WORK, and ihe strucWre Is not Intended or aHerad for sale (Sec.
7044, Business and Professions Coda: The Contractors License Law does not apply Io an owner ot property who Duilds or improves ihereon, and who does such work
himself or harselt ar thraugh his ar he� awn emplayees, pravided ihet such improvemenis ere not Intended or oNeretl lor sale. If, however, ihe building ar Improvement is
sold within one year of completion, the owner-builder will heve the burden of proving ihet he or she did not Ouiltl or improve for purpose o1 sele.). '
❑ I, es awner at the properly, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTNAC70RS lo construct Ihe pro�ect (Sec. 7040, Business end Pmfesslons
Code: The contrectors License Law tloes not epply to en owner oi property who bullds or improves thereon, end who conirects lor such pro�ect wlth e contrector(s)
licansa pursuant to the Contrectors License Lews.).
❑ I em exempt under sec. Business and Prolessions Code for this reason:
Signature: Dete:
Owner ID verifiad by dnvefs license. ❑ Yes ❑ No Drivers License Na.
Vetlllcation af Ownership by (type ol tlocumem, i.e. - pmperry tax bill or tleetl):
Expires:
DIVISION OF INUUSTRIAL SAFETY VERMR CERTIFICATION:
❑ I hereby cetlity thet no excavation five (5) or more feet In tlepth into which a persan is requlretl to tlescen4 will be mede In wnnectlon wlth work authodzad by this
pertnit, end that no building structure, scaHolding, lalsework, or demolition or dismantling ihereol, will be more then thirty-six (36) tee� hiph. (Chep. 32, Grp 2, Art 2, Sec.
341, Title B, Califomla ACminlsirative Cotle).
❑ As owner-builder, I will not employ enyone to do work which would require a permit from the Division ol Industriel Sefery, es noted ebove, unless such person �as e
permit to do such work Irom Ihe division.
SigneNre: Data:
Division o1 InAustrial Sefery Pertnit Number:
CERTIFlCATE OF COMPLJANCE ANU AUiHORVATION OF ENTRY: I certify under penalry ot perjury that I have read Ihis epplication end state that t�e infortnatlon given is
conect I agree Io comply with ell slete laws end Ury ortlinances relating ro building consWction, end authorize represenietives ol the Ciry oi Costa Mese to enter upon the
a6ove-descnbe0 property tor inspection puryoses. I agree not to occupy or ellow occuDancy ot eny building euthorized by this permit until finel inspection.
'COpE I, INSPECTIONTYPE _
'1618 Fizetl System Finel Fire Prevention
1266 Pool Spe Final
200 Final Re-Roof
201 FInaI BIacWRetelning Well
�202 Final Fectory Fire Plece '
203 Finel Sign
204 � Final Demol tion • ^ � ' �
10-7^05
��
. s,Qp� INSPECTONTYVE
208 Final Mec�anical
208 Final Plumbing
210 Final Electrical
212 Finel Flre Preventlon
� 220 Finel Planning Approval
222 Final Site
� 250' - � Final Building/Occupancy
� �
- -0 5 ��
�