HomeMy WebLinkAbout2445 MARSEILLES WAY - Building Permits� . .
� CITY OF COSTA MESA
o "'F BUILDING DIV/SION
> � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
�.�` �. FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER�M07-00551
PERMIT TYPE MECH � � ��'y '
�rp.
JOB ADDRESS: 2445 MARSEILLES WY CM
Vicinity: 2ND FLR HALLWAY CLOSET
SQ. Fi: 0
SCOPE OF WORK: REPLACE FURNACE �
OWNER: MADENLIAN, ARAM -
PHONE:
APPLICANT: MADENLIAN, ARPIE
PHONE: 714-319-6216 �
CONTRACTOR: OWNER-BU�LDER
Address: Unit: -, �
City/State: �
PHONE:
ZipCode:
MECHANICAL PERMIT FEE SUMMARY
MECH ITEM FEE: $38.30
PLAN CHECK FEE: $0.00
INVESTIGATION FEE: � $Q.QO
REINSPECTIpN FEE: - � $0.00
TOTAL FEES: $38.30
STATUS:
DATE ISSUED:
ISSUED BY:
Su ie/Unit:
�
Address:
City/StatelZip:
Address:
City/State/zZip:
ISSUED
11/26/2007
SOK
2445 MARSEILLES Unit:
COSTA MESA, CA ��-
2445 MARSEILLES Unit:
COSTA MESA, CA .
License No. D00000
CELL:
NOTICE: Th@ work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 7, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order (or 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 fnal approval will result in the expiration of this permil.
C D�E�. INSPEGTIONTYPE O�T IN7171R15 C UEf INSPEC710NTYGE n rOpT� IN�
1618 Fized Sys�ym Final Fire Prevention 206 Final Mechanical �et' ,7 -07
7266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final ElectriCal
201 Final Blppp/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Si9n - 222 Final Site
204 Final D@molilion - 250 Final Building/OCcupancy
W
WORKERS' COMPENSATION DECLARA710N:�
I hereby affrm under penalry of perjury one of t�e following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'
compensation, as pmvided for by section 3700 ot the Labor Code, for the
performance o( �he wnrk for which Ihis permit is issued.
❑ I have and will maintain workers' compensation insurance, as required by
seclion 3700 of the Labor Code, ta Ihe peAormance of the work for which this
permit is issued. My workers' wmpensation Insurance cartier antl policy
number are:
Carrier.
/This sed.on neetl rrol6e cwndete0 Af�e peimR is valuedaf wre �untlrtN �llars (St00) w less J
��Polic Number:
,certify [hat in Ihe pertormance o( lhe work for which ihis permi[ is
issued, I shall not employ any person in any manner so as to become subject
lo Ihe workers' compensation laws of Califomia, and agree that it I should
become subjec� to the workers' compensation provisions of Seclion 3700 0(
the Labor od I hall fortpwith comply with these provisions
_ � 1,�,�,� ' --[��
� , AOW����'s ignawre r 'Date
l�—
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAF2S
�($100,000), IN A�DITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affrtn lhat I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business antl Professions Code, and
my license is in full force and eflect.
Lic. # Class #
Gonvactw's SignaWre Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrtn that there is a constmction lending agency fa the
peAormance of Ihe work fa which Ihis permil is issuetl. (Sec. 3097, Civil Cotle).
Lender s Name:
Lender's Atltlress:
SignaWre Da�e
OWNER-BUILDER DECLARATIONS:
I hereby affirtn that under penalty o( perjury [hat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for ihe 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 slructure, pnor lo its
issuance, also requires the applicant tor such pertnit to fle a signetl statement
thal he or she is licensed pursuant to the provisions of [he Contractors
License Law (Chapter 9(commencing vnth Section 7000) of Division 3 of the
Business and Professions Code) or ihal he or she is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a pertnit subjects the applicant to a civil penalry of not more than
five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with v2ges as [heir sole
compensation, WILL DO THE WORK, and the strucWre is not intended or
oBeretl for sale (Sec. 7044, Business an0 Professions Code: The Contractors
License Law does not appiy to an owner of property who builds or improves
ihereon, and who does such vrork himself or herself or through his or her own
employees, provided that such improvements are not iniended or oftered for
sale. If, however, ihe building or improvement is sold within one year of
completion, the owner-builder will have the burtlen of proving that he or she
d—id /not build or improve for purpose of sale.).
CL4' I, as ovmer of the property, am EXCLUSIVELY CON7RACTING WITH
GCENSED CONTRAC70RS to conswct the project (Sec. 7044, Business antl
Pm(essbns CoCe: The contractors License Law dces not appty to an owner of
property who builds or improves thereon, and who contracts for such project with
a contractor�s) license pursuant to Ihe Contractors Ucense Laws.).
❑ I am exempt under sec.
Business and Professions Code for Ihis reason:
���a�� _�/���—
305] 6�31 ])"-
� 1
Owner ID venfietl by driv � e Ves ❑ No /
CDriver's"License No. rExpires:
Verifwtion of Ownership by (rype of document, i.e. property lax bill or deed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby certify lhat no excavation frve (5) or more (eet in depth inro which a
person is required to descend. will be made in connection vrith work authorizetl
by this permit, and that no building stmcNre, scaffdding, false�wrk, or demolitbn
or dismantling lhere�N, will he more than thirty-six (36) feet high. (Chap. 32, Grp
2. M 2, Sec. 341, Title 8, Califomia Administralive Cotle).
❑ As ovmeo-builder, I will not employ anyone to tlo vrork which woultl
require a permit from ihe Division o( Industrial Safery, as noted above, unless
such person has a permit to do such vrork from the tlivision.
Appliuwnl's Sgnalure Dale
Division o( Industrial Safety Pertnit Number: _
MAZARDOUS MATc'RIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fuNre building occupant neetl lo file and
certify a Business Plan for emergency response to release or threatene0
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 ot the Califomia Health and Safery Code requires, wilh some
exceptions, that a Business Plan be fled vrith lhe Cosla Mesa Fire
Oepartment by every business wtiich has at any one time during a reported
year a quantity of hazardous materials equal to or greater Ihan a weighl of
500 pountls, or a volume o( 55 gallons, or 200 cubic fee[ of compressetl gas
a� s�antlard temperaWre and pressure).
2. Does or will the applicant or present or fuNre huilding occupant neetl to f le
a registration tortn for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Calilomia Health and Safety Code, with some
exceptions, requires registration with ihe Costa Mesa Fire Depanment by
each business which a[ any one lime has on hand a quantity of acutely
hazartlous 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 slantlar0
temperature antl pressure).
3. Does or vnll Ihe applicant or present or future building occupant need to
prepare an RMPP (Risk Managemenl and Prevention Program for acutely
hazardous matenals)? ❑ Yes ❑ No
(Section 25534 0/ the Calilornia Healih and Safety Cotle provides thal the
Costa Mesa Fire Department may require Ihe preparation, ceRifcation and
filing with the Fire Dcpariment of an RMPP by businesses which are required
to register acutely hazardous matenals with the Fire Department.
4. If an RMPP is presently required, has Section 25534 o( [he Cali(ornia
Health and Safety Code heen fully complied vAth? ❑ Yes ❑ No
5. DOes or will the applicanl or present or (uNre building occupanl require for
the work whiCh i5 the 5ubjeCt of lhi5 applicalion a peRni[ for SUGh wnSlNction
or modifitation from the South Coast Air Qualiry Management DisUict or Irom
any olher air pollu[ion control district or agency? ❑ Yes � No
(Sectqn 65850.2 of the Calitomia GovemmeN Code requires Ihat the requested
in(ortnation be tumished on applications for non-residential building pertnits).
6. Will any part of the (aciliry to be conslructed under Ihis permit be vnlhin
1000 feet from lhe ouler boundaries o! a school? ❑ Yes ❑ No
Qf'yes", lhe facility musl meet the requiremenl of Sections 25534 and 42303
of the Calitomia Health and Safety Code).
7. If a permit from the SouN Coast Air Qualiry Management District or olher
air polN[ion control disUict or agency is required for [he work which is the
subject of [his application, have all of the tlisclosures prescnbetl by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes", attach cr.rtificate of compliance from the appropriate air pollution
control oKcer).
CERTIFICATE OF COMPLIANCE: I certi(y that under penalry of perjury the
information given above is correcl. I agree to comply with all state laws and
city ortlinances regarAing Hazardous Materials and Emissions.
SionaWre Oa�e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify untler penalty uf perjury that I have reatl this applicalion antl state that
the information given is cortecl I agree to comply with all state lavrs and city
ordinances relating to building wnslruction, antl authorize representatives of
the Ciry of Costa Mesa to enter upon the above-described property for
inspection puiposes. I agree not to occupy or allow occupancy o( any builtling
authoriz y tti p � until fi I inspection. ,
i
C_ � 9g�tu W Legai er(s) `— a
AnNo�AulhnnzeCA001imn1 �dle
GAddress: _
/ / ♦ / 'I / • // / ' I I
/
OWNER-BU[LDER
VERIFICATION
Permit #:
A city or county, which is required to give notice pursuan[ to Section 19830, shall attach to such notice, and, as
a condition precedent to issuing a building permit, require the completion and require the retum of, an owner-
builder verification.
Attention Property Owner:
An `ownervbuilder' building permit has been applied for in your name and bearing your signature.
Please complete and retum this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No buildingpermit will be issued un[il [his
verification is received.
�1� I personally plan to provide the major 1 or and materials for constmc[ion of the proposed
property improvement. ❑ Yes o
�27 I(have/have not) signed an application for a building permit for
the proposed work.
C3 = I have contracted with the following person (firm) to provide the proposed construction:
Name �,n 1�1 %l r.A) �l r C�DIr�
Address
Phone(
Ciry
Contractor's Lic. No.
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address
Phone (
City _
Contractor's Lia No.
5. I will provide some of the work but I have contracted (hired) [he following persons to
provide the work indicated:
Name
1042-<6 �Rev.1VO4)
Address
Phone Type of Work
�
I hereby affirm that 1 have received a copy of the information set forth in Section 19830 of the State of
Califorrtia Health and Safety Code and have completed the above inFormation to the best of my personal
knowledge, in compliance with this State law.
�Date: �'� 0 "'
..--- � /I (. -
l� /
GName:' �'�ii I�( � a r1,2,y� %i a l'1
1 (Printed or Typca)
V .-_# _ -
For more information call City of Costa Mesa Building Division at (714) 754-5273.
1�2-46 (Rev. NN6)
CITY OF COSTA MESA
o BYILDING DIVIS/ON
F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • �wvw.ci.costa-mesa.ca.us
°. � \FOR INSPECTIONS CALL: (714) 754-5626 ��
�'"'"�� � �J PERMIT NUMBERi�P07-00598
/ ��'
PERMIT TYPE
JOB ADDRESS:
Vicinity:
PLUM �O STATUS: ISSUED
�DATE ISSUED: 1112612007
C ISSUED BY: SOK
2445 MARSEILlES WY CM Suite/Unit:
- ��
SCOPE OF WORK: REPAIR/REPLACE PIPES
OWNER:
PHONE:
APPLICANT:
PHONE:
MAbENLIAN, ARAM
MADENLIAN, ARPIE
714-319-6216
CONTRACTOR: OWNER-BUILDER
Address:
Ciry/State: ZipCode:
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE:
PERMIT FEE: $33.30
TOTAL FEES: $33.30
$0.00
Address: 2445 MARSEILLES
City/State/Zip: COSTA MESA, CA
Address: 2445 MARSEILLES
Ciry/State/zZip: COS7A MESA, CA
License No. 000000
PHONE:
CELL:
NOTICE: The vrork authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for lhe work authorized under this permit to be considered legal, such work must wmply 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 expirelion of this permit.
CODE1, INSPEC710NTPE lqTE IN11110.5 GODEI INSPEC710NTYPE ORT� INPTIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical n
1266 Pool Spa Final 208 Final Plumbing I n( '�-O� �p�
200 Final Re-Roof 210 Final Electncal
207 Final BIocWRQ�ai�i�g Wall 212 Final Fire Prevention
202 Final Factory Fire Placa � 220 Final Planning Approval
203 Final Sign 222 FinalSite
204 Final Demolition ' 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby affirm untler penalty of perjury one of Ihe (ollowinq tleclaralions:
❑ I have and will mainlain a certifcate of consent to self-Insure (or workers'
compensation. as provided for by section 3700 of the Labor Cotle, for the
pedormance of the work for which this pertnit is issued.
❑ I have and will maintain workers' compensation insurance, as required by
sectbn 3700 0( the Labor Code: (or Me peAormance of the work for which this
permit is issued. My workers' compensation Insurance carrier antl policy
number are:
Carrier.
(Tha section neetl not Ge comde(etl AMe peimd is valued at one h�Mietl tlollars (SI00) orless )
Policy Number:
❑ I certify thal in the peAormance of the wark for which this pertnit is
issued, I shall not employ any person in any manner so as to become subject
to the workers' compensation laws of Califomia, and agree lhal if I should
6ecome subject to the vrorkers' compensation provisions of Seclion 3700 0!
the Labor Cotle, I shall foAhwith comply vnth these provisions.
ApplifanCs 9gnawre oa�e
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIAIINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affrm Ihal I am licensed under provisions o( Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Prolessions Cotle, and
my license is in full force and effect.
Lic. # Class #
Comro<tor's Signawre Da�e
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrtn that there is a constmctbn lentling agency for [he
per(ormance o( Ihe v.ork ta wfiich this pertnit is issued. (Sec. 3097. Civil Code).
Lender's Name:
Lender's Address:
OWNER-BUILDER DECLARATIONS:
I hereby affvm that under penally of perjury that I am E7(EMPT FROM THE
CONTRALTORS LICENSE LAW tor 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 fle a signetl statement
that he or she is licensed pursuant lo the provisions of Ihe Contractors
License Law (Chapler 9(commencing with Section 7000) of Division 3 of the
Business anC Pro(essions Cotle) or ihat he or she is exempt �heretrom and
the basis (or lhe alleged exemption. Any violation of Section 7031.5 by any
applicant for a pertnit subjects lhe appliwnt to a civil penalry of not more than
five hundred dollars ($500�.�:
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO 7HE WORK, and the structure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Coniractors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own
employees, provided that such improvements are not intentled or offered for
sale. If, however, Ihe building or improvement is sold within one year of
completion, the ovmer-builder will have the burden of proving that he or she
d�id/ not build or improve for purpose of sale.).
�L1d�l,.as�owner of the pmperty, am EXCLUSIVELY CONTRACTING WITH
UCENSED CONTRACTORS ro consWct [he project (Sec. 7044, Business and
Professbns Code: The contractors License Law dces not apply to an owner of
property who builds or improves thereon, and who contracls for such project with
a conlractor(s) license pursuant to lhe Contrac[as License Lav+s.�.
❑ I am exempt under sec.
Business antl Pmfessions Code for ihis reason:
— -/n ` � _/'C^
Srgnamre � LD Ic
30 �.—a (3/0)) �
Owner ID verifed by driver's h. a. ❑ Yes ❑ No
�(�� �
�river's-License No. _ lExpires: �'
Venfication of Ovmership by (lype of document, i.e. - properry tax bill or eed):
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION:
❑ I hereby ceR'rfy �hat no excavation frve (5) or more feet in depth inb which a
person is required to descend, vnll be made in connectbn with wotic authonzed
by Ihis pertnit, and Ihat no building structure, scaffdding, falsework, or demoli[ion
or tlismantling thereof, will be more lhan Ihirty-six (36) feet high (Chap. 32, Grp
2, Art 2. Sec. 341, Ttle 8, Califomia Administra[ive Code�.
❑ As owner-builder, I will not employ anyone to do vrork which would
require a permit from the Division of Intlustrial Safery, as note0 above, unless
such person has a permit to do such work from the division.
Applicanl's Signalure Dale
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file antl
certify a Business Plan for emergency response to release or threatened
release of a hazardeus material? ❑ Yes ❑ No
(Section 25505 of the California Health antl Safery Code requires, with some
exceptions, Ihat a Business Plan be fled with the Costa Mesa Fire
Department by every business whic� has at any one time duiing a reportetl
year a quantity of hazardous materials equal to or greater lhan a weight of
500 pounds, or a velume of 55 gallons, or 200 cubic (eet of compresse0 gas
at standard tempereture and pressure�.
2. Does or will the applicant or present or fuNre building occupant need to file
a registration form for acutely hazardous matenals? ❑ Yes ❑ No
(Section 25533 of the Califomia Health antl Safety Code, with some
ezceptions. requires regislration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantily of acutely
hazardous materials equal ro or greater Ihan a weight o! 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressetl gas at standard
temperature and pressure).
3. Does or will the applicanl or present or future building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazartlous materialsl? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Safery Code provides that [he
Costa Mesa Fire Department may require the preparation, certifcation antl
filing with the Fire Depatlment of an RMPP by businesses which are requiretl
ro register acutely hazardous matenals with the Fire DepartmeN.
4. IF an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicanl or presenl or future 6uiltling occupant require (or
the work which is the subject of this application a permit for such construction
or modification from the Soulh Coast Air Quality Managemenl Dislrict or from
any other air polWtion control disMct or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Code requires that Ihe requested
information be fumished on appliwCwns fa non-resitlential Duiltlirg pertnits).
6. Will any part of the facilily lo be consWctetl untler this permit be within
1000 fee� fmm [he outer boundaries of a school? ❑ Yes ❑ No
(I( yes", the facility must meet the requirement of Seclions 25534 and 42303
of the Califomia Health and Salety Code).
7. If a permit from the Soulh Coast Air Quality Managemenl District or other
air polWtion control district or aqency is required for the wnrk which is the
subject of this application, have all o( the disclosures prescribed by Califomia
Health and Safery Code Section 42303 been matle? ❑ Yes ❑ No
8. (If'yes", attach certificate of compliance from the appmpnate air pollution
control oKcer).
CERTIFICATE OF COMPLIANCE: I certify ihat under penalty of perjury Ihe
information given a6ove is correct. I agree to comply with all state laws and
city ordinances regarding Hazartlous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify untler penalty of perjury that I have read Ihis application and state that
the information given is covect. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
ihe Ciry of CosW Mesa to enter upon the above-described properry for
inspection purposes. I agree not to occupy or allow occupanc o( an huilding
authoriz i er it until f al inspection.
L�igna e egal Ovm� L. Da�� O'
AnG/or Au�honzeE Appli�int Dale
(774) 754-5273 • Fgx (714) 754-4856 • �wvw.ci.costa-mesa.ca.us 77 FAIR DFIVE, COSTA MESA, CA 9Z626
BUILDING PERMIT
,Jobnddress: 2445 MARSEILLES WY
Suite:
. ,;���Vicinity:
Primary Occ:
_� ;
Parcel Num6er: 43914222
Applicane HIRSCHMAN,ROBERT
Address: 9582 HAMILTON AVE
#281
HUNTINGTON BEACH, CA
Owner: MADENLIAN, AR.4M
AddreSs 2445 MARSEILLES -
COSTA MESA, CA
Type of Construction:
Zoning:
Contractor: HIRSCHMAN, RP & SONS INC
Address: 9582 HAMILTON AVE
#281
HUNTINGTON BEACH, CA
Zip: 92646
Arch :
Address:
Phone:
Phone: 714-960-8329
Zip: 92646
Phone:
Zip: 92627-1417
Phone: 714-960-8329
License: 781923
Eng:
Address:
ISSUED 8Y:
Status: ISSUED
Applied: 03/14/2005
Issued: 03/74/2005
Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF: TEqR OFF EXISTING BUR & COMP ROOF & INSTALL 4 PLY BUILT UP AND 30 YR. COMP. SHINLGES. TOTAL ROOFING S�UARES
IS APPROX. 16.5.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$0.00
$125.25
$0.51
$0.00
$0.00
$0.00
$125.76
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Existinq: o
Rear 0-0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Lek 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
S5,iio.ao
$5,110.80
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 780 tlays.
WSPEC710NS: tn order for the vrork authorized under fhis permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspectlona end finel epprovel musl be ob�ained. Failure to obtain inspections and tinal approval will result in the expiration oi this permit.
FOR INSPECTION$ CALL: (714) 7545626
2148-48(N00)
WORKERS' COMPENSATON DELLAfiATION:
I hereby aHirm under penalry o� perjury one of the following declarations: ' � . � � • � ' � ��. � . ' �
❑ I heve end will malntain e cenificate of conseni to selGlnsure for workers' compensetion, as provitletl for by section 3700 oi the,Lebor Code, for t�e peAo�ence o�the
work /or which Ihis permi� Is Issued. � ,,
❑ 1 have end will maintain workers' compensation insurence, es reQuiretl by sectlon 3700 0l Ihe Lebor Code, for �he peRortnance of �he work for whlch this pertnit Is IssueO.
/�.Ay workars' com ensatlo� yI surance�c rner antl policy number are:
c,emer: �'�,Q�2 F-�CNO—� .F;dicyNumber. �D 27 — 7'c=1'� C
�(This secfion need nof be complefed i! the permit is veluetl at ane huntlretl tlollers (3/00) or less.)
❑ I certity Ihat in t�e peAormenca of the work for which Ihis permit is Issuetl, I shell not employ eny person in any manner so as to become sub�ect to the workers'
compensetlon I fomia, and egree thet if I should become sublect b the workers' compensation pmvislons o� Section 3700 af the Labor Catle, I shell fanhwith
�apmplY with ese pr '
.�P�cant Signeiw � pAe� � � / � � � . . .
WARNING FAILURE TO SECURE WORKERS' WMPENSATION COVERAGE IS UNLAW FUL PND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED
TFIOUSAND DOLLARE (5100.00p), IN ADDITION TO THE COST OF COMPENSATION, DMAAGES r1S PROVIOED FOR IN SECIION 31080F THE IABOfl CqpE, IMEREST, MID ATTORNEI^5 FEES.
LICENSEU CONTRACTORS DECLARATION:
m ihat I am Iicensed,�nder provisions of Chapter 9(commencing wit� Sectlon 7000) of DiWsion 3 ci
ect. Lic. a �� ( S' Z3 �
�
SigneWre: D
and Professions Coae, end my license is in tull
CONSTRUCTION LENOING AGENCY:
❑ I hereby aRirm Ihet lhere is e constmction lentling agency for the pertormence of the work for which this permit Is Issued. (Sec. 3097, Civll Code).
Lendefs Name: Lentler'S AAdress:
Signeture: Date:
OWNER-BUILDER DECLARAT10N5:
I �ereby aNirm thet untler penalty of perjury ihat I am E%EMPT FROM THE CON7RAC70RS LICENSE LAW 1or ihe following reason (Sec. 7031.5, Business entl Protessions
Cotle: Any ciry or counly which requires a pertnit to construct, elter, improve, demolish, or repair any strucWre, pnor to its iuuance, elso requires the applicant for such permit
lo lile e signetl statement that he or she is Iicensetl pursuant to t�e provisions ol the Contrectors License Lew (C�apter 9(commencing with Section 7000) of DlWsion 3 of Ihe
Business and Professlons Cotle) or that he or she is e:ampt therefrom antl the besls for ihe ellegad exempticn. Any violatlon of Section 7031.5 by eny epplicant for a pertnit
subjects the epplicant to e civll penelry of not more than five hundred dollars ($500).): .
❑ I, as owner ol the properry, or my employees wilh wages as Iheir sole wmpensation, WILL DO THE WONK, and ihe struc�ure Is not intentlad or ottered tor sale (Sec.
7044, eusineu entl Professions Code: The Coniractors Licensa Lew tloes not apply to en owner oi proparty who builtls or improves thereon, and who does such work
himself or �erself or ihrough his or her own employees, pmvided that such improvements ere not intended or ottered for sale. If, however, Ihe building or impmvement is
soltl wil�in one year of completion, the owner-builder will have tho burdon of proving that he or she tlid nut �uild or improve tor purpose ol sale.). �
❑ I, as owner oi the pmperty, am EXCLUSNELY CONTRACTING WITN LICENSED CONTRACTORS to construct the project (Sec. 704A, Business and Pmfessions
Code: The coniractors Llcense Ww does not apply to an awner ot propeny who builds or Improves thereon, end who contrects lor such pm�ect with e contractor(s)
license pur5uant lo Ihe Contrac�ors License Lews.).
❑ I em exempt under sec. Business entl Professions Code for ihis reason:
Signeture: Date:
Owner ID venfietl hy tlrlvef5liten50. ❑ Ves ❑ No DriveYs License No.
Verificetion oi Ownership by (type of daument, i.e. - property tex bill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certify that no excevation five (5) or more feet In depth into which a person is reQuired to descend, will 6e made in connection wlth work eu�honzed by Ihis
pertnit, and that no building sWcture, scattolding, falsework, or tlemollUon or tlismantling theraoL will be more ihan thirty-six (36) leet high. (Chap. 32, Gry 2, Art 2, Sac.
341, Tltle 8, Celifornia Adminis�retive Code).
❑ A5 ownar�builder, I wlll not Bmploy any0ne to do work whlth would require a pertnit �rom Ihe DiNsion ot Indus�rial Sefery, e5 noted ebove. unless such person hes a
pertnit ta do such work from the division.
Signeture: Dete:
Division of Intlustrial Sefary Pertnit Number:
CER71flCATE OF COMPLIANCE AND AUTHORIZATON OP ENTHV: I certity under penalty ol perjury ihat I have read this epplication end state that the information given is
correct. I a compty with ell state laws end ciry ordinances relating to builtling constructlon, antl authonze represematives of the Ciry of Costa Mesa to eNer upon the
ab - escnbed inspection puryoses. I egree not to acupy or ullow occupency of eny buildinq authorized by this permit unlil finel inspection.
3 . �- �-' �
SignaWre OI Legal Owner(s) �^�ate
GOUE �. INSPECTIONTYPE
1616 Fi:ed System Final Fire Prevention
1266
200
201
202
203
204
Pool Spa Finel
Final Re-Rool
Final Block/Retaining Wall
Final Factory Fire Place
Final Sign
Final Demolition
PAIE
COpEt INSPECTIONTYPE
206 FinallAec�anical
208 Final f'lumbing
210 Final Flectrical
212 Flnal Fire Prevention
220 Final Planning Approval
222 FinelSite
250 Final3uiltling/OccuDancy
p7.\I�I:iuil.l4i
Applicant lo fill In all spaces within
CITY OF COSTA MESA aegf.ai�o. ,��
CONSTRUCTION PERMIT I���- ����
Arch/Eng. License No.
Address
1 hereby af(Irm that I am Iicensetl untler provislons ot Charter 9(com-
mancln9 wi[h sectlon ]000) ot Divlsion 3 Of Ihe Business antl
Professlons Cotle, antl my Iicense is In full force antl effect.
ucense aass e� 3 L' � Lltense No. ^'�'/ �G �7
Date ���'��'F�'"' Signature ������ - l�� _
WORKERS' COMPENSATION OECLARATION
I hereby a(tirm that I have a certificale of <onsent to self-Insure or a
cerl7fiwte of Work¢r5' COTpensation InSurdnce, or a certifietl copy
thereof (Section 3800, tab. CJ.
'cyNo. �«�w� Company�'9��f.^ Z./S
:ertifietl copy is hereby furnishetl.
�� CertifieG capy is tiletl with the city Builtling Division.
EXEMPTION FROM WORKERS• COMPENSATION DECLARATION
(This 5action neetl not be completetl if the permit I5 for one hunGred
�51001 or less).
cartffy tnat in the pertormante ot the work for whicM1 this permit is
issued, � shau not emP�oy any person In any manner so as to become
subject [o the Workers Compensation Laws ot Ullfornia.
Date Siqnature
NOTICE: If after making this tleclaraUon, you shoultl become subject
to the Workers' Compensation provisions ot the Labor Cotle, you must
forthwith comply wlth such provi5ion5 or this permit shall be tleemed
revokatl.
CONSTRUCTION LENDING AGENCV
I hereby affirm that there is a construcUon Ientling agency for tne per-
tormance of tha work tor which this permit IS ISSuetl (Section 309]
Civ. C.). -
Lentler's Name
LentlerY Atltlress
OWNER BUILDER DECLARATION
I hereby atfirm that 1 am exempt from the Contractor'S License Law tor
the Pollowin9 reason (Section �031.5 BuSiness ana Professions Cotle:
Any tlty or rounty which requires a permit to construct, alter,
improve, tlemolish or repair any structure, prlor to Its Issuance, also re-
quires the appliCant fo� Such permit to file a signetl statem¢nt that he
Is Iicansetl pursuant to the provisions of the Contractor'S License Lzw
(Chapter 9(commencin9 with Sectlon �000) ot Division 3 of the
Business and .Professions Cotle) or that he Is exempt [herefrom antl the
-- for the allegetl exemption. Any violatlon of Section 7031.5 by
applicant for a permit subjects the applicant to a civil penalty
at mOr¢ Ihan five hundretl tlollars ($500).
�J I, a5 own¢r Of tne p�operty, or my employees wltM1 wages a5 their
sole tompensation, will tlo the work, antl the strutture is not intentletl
or offeretl for sale. (Section 7044, Business antl Rofessions Cotle: The
Cont�aGtO�'s LlcenSe Law tloes nof apply to an owne� of a property
who builCs or improves thereon, antl who tloes such work himself or
throu9n his own employees, provitletl that such improvements are not
intentletl or oneretl for sale. It, howeveq the builtling or Improvement
is soltl within one year of completion, the owner will have the buraen
of provin9 he tlitl not builtl or improve tor the purpose of sale).
❑ I, as owner ot the property, am exclu5ively contracting with
IiC¢nsetl con[raclors [o conitruct tlte proj¢Cf (SectlOn ]044, Busine55
ana Professions Cotle: The Contractor'S License law tloes not appty to
an owner of property who builds or improves thereon, antl who con-
tracts from sucn projects with a mntractor(5) Iltesnetl pursuant to
the Contractor's License Law).
❑ I am exempt untler Section B. & P. C. tor thi5
reason
Date Owner
I.hereby certify that I have reatl tnis application antl sta[e that the above
informatlon is torrect. I agree to comply wlth all city antl county
ortlinances antl state laws relating to construction, antl hereby authorize
representative5 of this <ity to enter upon the above mentionetl
p�operty f0/ IfSpection pU/poses� /�
[t�//�i1 / / /1 /%�/t�l.x�i / —�.� -! �
Signature � Da[e
Drivers'�icenseor55,� �
borOer lines antl sign all appropriate tleclarations.
TRACT NO. LOT NO. �BLDG. NO.
TVPE OF CONSTHUCTION
❑ NEW ❑ ADD ❑ ALTERATION
❑ REPAIR ❑ CONVERSION ❑DEMOLISH
❑ OTHER
DESCRIPTION OF WORK
TYPE OF PERMIT
❑ GRADING ❑ FOUN�AT�IO�N ❑ STRUCTURAL
❑ TENANT ❑ ELECTRICAL VdVLUMBING ❑MECHAN
❑ OTHER
PROJECT DESCRIPTION
50. FT.
OCCVPANCV_CONSTRUCTION TVPE
VALVATION ZONE
GRADING CU. VDS. ACRES
PLUMBING
BATHTVBS
TOILETS
LAVATORIES
KIT. SINKS
SERVICE SINKS
FLOOR SINKS
PLAN CHECK
SHOWERS
VRINALS
DOUBLE LAVS
DISHWASHERS
SUMPS
FLOOR DRAIN$
DRINKING FOUNTAINS -
INTERCEPTORS CLARIFIERS
SWIMMINGPOOI PTRAP
WATERSERVICE� ALTERATION
GASSERVICE OUTLETS
WATER HEATERS � BTV OUTPVT
SEWERCONNECTIONS
SOLAR TANK COLLECTQRS
SOLAR PIPING SYS.
ISSUE FEE
MECHANICAL P�AN CHEGic
HEATING SVSTEM 0-300,000 BTU
AND DUCTING 300,000 + BTU
REFRIGERATION 0-300,000 BTU
SVSTEM 100,000+gTV
BOILEftS BTU
SVSTEM REPAIR,ALTERATION
EXHAVSTSVSTEM MULTIPLE
ISSUE FEE
CMF 0865-46 White-Builtling; Canary-Applicant; Pink-Accountin9: Goltlenrotl-Assessor'�i9� j, �j ����,p�C
O
5762 8/09/82
REAR VARD (TO P/L)
PKG.SPACE RE�.
STREET WIOTH
20NING APPROVED BV
SPECIAL CONDITIONS:
R
PLNG.REF.
PROVIDED
PARK FEE
ELECTFICAL PLAN CHECK
5(]. FT.
GENERATOR 0-1 KW_1-10 KW
TRANSFORMER
APPLIANCE - 30-50 KW_50 + KW
MOTORS 0-1 HP_1-10 HP
(INC. SOLAR) 30-SO HP SO + HP
FIXTURES OVTLETS SWITCHES
GAS TVBE SIGNS
POLE LIGHTS
POLES METERED SUB
PANELS MAIN SUB
SERVICE - AMP
ISSUE FEE
APPLIGATION APPROVED BV OATE
SUMMARY OF FEES .
BUILDING
PERMIT $
PLAN CHECK $
PLUMBING $�
PLAN CHECK y
ELEGTRICAL $
PLAN CHECK $
MECHANICAL $
PLAN CHECK $
5.OQ TI.'
SMIP $
PERMIT �
ISSUANCE $
GRADING $
$
MICROFILM $� , ,,��
TOTAL FEE $ -+ � ��
1E55 AD-
VANCEPC $_
FINAL FEE § S G`�
CONSTRUCTION AND PLANNIN� ' POOL & SPA . .
APPROVALS Permit #-�_ Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location
2. Soil Pipe-Undrgrn 44. Steel Feinforcement
.. 3. Electrical Conduit Utility-Undrgrn 45. Forms
4. Electrical Conduit-Undrgrn 46. Electrical Bonding
. tee ein orce 47. Rough Plumbin & Pressure Test
6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE �
7. Footings 49. Electrical Conduit-Undr rn
8. Foundation 50. Gas Pipe, ❑ Undr rn, Test
9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ Undr rn
10. Structural Floor System 52. APPROVAL TO DECK
11 . Property Sewer Line & House Connection ' 53. Backwash & Rece tor-Final
12. Street Sewer Connection � - 54. Heater & Vent-Final
13. Rough Plumbing � -
14. Rough Electric-Conduit �56. Electrical-Final
15. Rough Electric-Wiring 57. Solar System-Final ' �
16. Rough Heating & Air Conditioning � encing & Access Approval
17. Ducts, in Structure APPROVED FOR PLASTERING
18. Ducts, Ventilating �
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing
21. Roof Sheathin
' 22. Frameand Flashin NOTES:
23. Insulation
24. Lathing & Siding
25. Drywall Nailing '
26. Plaster Brown Coat
G%. CleCifiCEi fuWei iv�eiei-�iiidi
28. Final Electric � �
29. Final Heating & Air Conditioning �
30. Final Gas Pipe-Test
31. Final Plumbing
32. � Water Service-Final
33. Gas Service-Final
34. Solar pomestic-Final
35. Landsca e S rinklin S stem �
36. Sound Attenuation
37. Handicap Regulations '
38. FINAL STRUCTURE & BUILDING
39. Special Requirements Completed
40. Electric Release to Edison -
41. Gas Release to Southern California Gas Co.
42. CERTIFICATEOFOCCUPANCY �
No Date
JOB ADDRESS 2445
GENERAL CONTRACTOR
DATE 6-3-63
BUILDING PERMIT NO.
VALUE S 19.417.00
b'IRE ZONE DLSCRIPTION OP WORK
�,�jfIGROUP I&J TYPE V ZON
5�1 SUBCONT1tACTOlt ,,.PE�
REOUIRF.M^NT9 _
.�''
� �g���
COSTA MESA BUILDINGSAFETY DEPARTMENT
P.O. BO%]t] CO3Tp MEBA, Cp{,�FORNIA
For Applicant fo Fill In Completely
TYPE OR PRINT
� MAIL
COSTA MESA, CALIF4RNIA
s 4100 West Commonwealth
CTOR `Same '
e Same
Same
151-250-B-1 No' PR 28020
44 X 56 I no. or e�oo �,_
NOW ON LAT
6 BL�O.
�'a�."c."' ZO_SO o�.ev.en —
DESCRIPTION OF WORK
� a�I�LDINr�4 x 56 o°;,M� 6
�
Model 32-C
a
FEE RECEIVED
JUN 3 -1963
lNANCE OEPT.
APPL��'IQ� I(�T�Ef��A
BUILDING
For Office Use Only
RECEIPT NO. PGHMIT NO.
�
Y DATBRHCHIVBD GAT8189fIB[
a
ZONING '
NO. OI UB[ O� N8
rune em�oina � A a
NOTE: NO EAVE OVERHANG SHALL BE LE9S THAN
90' TO 81OH $ REAR P. L.
HAVE6
ALLOW6D (U.B.G.REQUIREMENT
YARUSAPPROVED YARDSAPPROVED
MAIN BUILDIN6 ACCESSOFY BUILDIN6
VAR. 3C
' 1824 eo. F
I HHPBBY ACNNOWL8O0H TH�T 1 H�V[ RHAD THI� �PPLIGTION THe �MOUNT BI
AND BTAT2 THAT TH8 ABOV[ IB CONP6CT ANO AOp88 TO COM� PUHPO88 O!� 8
VLY WITH ALL CITY ORDINANC60 AND YTATp y�WO p6OULATING yALUATION
OUILDINO CONBTRIlCT10N. n
S16NATURE OP /1.... �O , C /� ,/
PERMITTE / +�eV lI,/ s/// / � (/�
AUTHORIZBD AQ6NT � (./ ��.41i I.LLN
BET. MAIN Q
ACCE95. BLI
DATE
{'D q �
VALUATION 19 FOH TH8
A PEHMIT P68 ONLY.
_ �.7 V •