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Home My WebLink About2985 MENDOZA DR - Building Permits� CITY OF COSTA MESA ; � BUILp/N6 pMS10N : � DEVELOPMENT SERVICES DEPARTMENT � J PERMIT P MITNU BER •� � E99-00170 (714) 754-5273 • Fau (714) 754d856 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: 2985 MENDOZA DR CARPORT @ ALLEY Parcel Nunmber: 14122129 npp�icant: THORNE, DON Address: i: owner. MURADLIYAN, JACK Address 20545 OXNARD � � Contractor: Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res�(3+units) Pool / Spa� � Lighting Fizts Recept Outlets- Switches � � Non Res Appl ,-, Res Appl Service to 200a � � Service to t000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to SOhp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pol¢ Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole WOODLAND HILLS,CA ELECTRICAL PERMIT Phone: Zip: Phone: Zip: 91367 DUNHAM CONSTRUCTION, INC P.O. BOX�68 SAN CLEMENTE Phone: 949-492-7100 Zip: 92674 � - License: 450880 Status: ISSUED Applied: 03/03/1999 Issued: 03/03/1999 SCOPE OF PERMIT REPAIR FIRE DAMAGE TO CARPORT. REPAIR/REPLACE FR4MING, ROOF FRAMING & SHEETING, PLASTER, DRYVJALL & ROOF. REPLACE NVO ELECTRICAL LIGHTS INCLUDING CONDUIT 8 WIRING. $22.00 $0.00 $0.00 $0.00 $0.00 $0.00 $2.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 : $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 2 0 0 0 0' 0 0• 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY , Temp Dist System / Lighting Busway /100 ft ' Standing Section Misc Electrical �Equipment Transformers up.to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misc. Conduit Misa Conductor � - ' Circus ( gen or ride) � ,Circus (mech ride or lights) . Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantity $0.00 0 $0.00 0 $o.00 o� $0.00 0 $0.00 0 $0.00 ' 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 ` $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES E24.00 COMMENTS / SPECIAL CONDITIONS EXPIRATION: This parmit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period ot 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetione and flnel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545828 WORKERS' COMPENSA710N DECLARATION:� � I hereby eKrm untler penalry of perjury one of the follovnng declaretions: ',� -, I heve entl will meintein e certlficate ot consent to selFlnsure for workers' compensetion, es provided tor by sectian 3700 of the Lebor Code, for the peAormence oi Ihe - work for which Ihis permit is iuued. ❑ I have end will maintain workers' compensatlon insurance, as requiretl by section 3700 of Ne Labor Cotle, for ihe peAortnence of the work tor which Nis pertnit is issuetl. My workers' wmpensetion Insurence cerrier entl policy number are: Certier. Policy Number. (Th/s sectlon need not be completed tl fhe permiNs valued et one hundred dollars ($ f 00) or less.) ❑ I certify that In Ihe performance of Ihe work tor which this permit is issueC, I shall not employ any person In any manner so es to Decome sub�ect to the workers' compensation lews of Celifomia, end ag e thet if I should become subject to the workare' campensation provislons ot Sec[lon 3700 of Ihe Lebor Code, I shell torthwlth comply with these pr ions. , Applicent SlpneNre: ��47�� b. l Date: �� . � �� WARNING:FWLURETOSEWflEWORKERS'COMPENSAPIXJCOVEPAGEISUNLAWFULANDSHALLSUBJECTANEMPLOYEflTOCRIMI PNAL ENALTIESANDGVILflNESUPTOONEHUNDRED THOUSAND OOLLARE (5100.000), IN ADDITIIXJ TO THE COST OF COMPENSAiION, DAMACaES AS PROVIDED FOfl IN SEGTION 3lOfi OF THE UBOF CODE. INTEREST, AN� ATTORNEI"S FEES. UCENSED CONTRACTORS DECLARA710N: 1 hereby ettirtn ihat I em lic1n/sed under rovisions oi Chapter 9(commencing with Section 7000) of Division 3 of Ihe Busin ss and Profassions Cade, and my license is In tull force end ettect. Lic. p '7.5(� �cg�% Class q �� Contrectors Signature: � D�i i� A7 n� Date: �� . 7/ 7/ i r CONSTRUC710N LENDING AGENCV: ❑ I hereby effirtn Ihat there is a construction lending egency for ihe pertortnance ot the work tor which this permit is iuuetl. (Sec. 3097, Givil Code). Lenders Name: Lender's Atldress: SignaWre: Date: OWNER-BUILOER DECLARATIONS: I hereby ettirtn that untler penelry ol perjury t�at I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the tollowinq reason (Sec. 7031.5, Busineu entl Profeuions Code: Any ciry or wunry which requires a pertnit to construM, alter, improve, demolish, or repalr any structure, prior ta its issuence, elso requlres t�e epplicant tor such permit to flle e signetl statement Ihat he or she Is licensed pursuaN to t�e provislons oi the Contrectors Licensa Lew (Chapte� 9(commencing with Section 7000) of DlNsion 3 of the Busineu and Professions Code) or thet he or she Is eaempt therefrom end the basis tor the elleged exemption. Any violation of Seqlon 7031.5 by eny epplicant for e permit sub�ects the epplicant to a cMl penalry ot not more than five hundred dollars ($500).): ❑ I, es owner of ihe Oroperry, or my employees with wages es Iheir sole compensailon, WILL UO THE WORK, antl iha structure is not Intendetl or oHeretl for sale (Sec. 7044, Business end Professions Code: The Conirectors License Lew does not flpply to an owner at properry who builds or improves thereon, end who does such work himself or heraetl or through hls or her own employees, proNtlea ihat such improvements ere not Intentled or oRered for sele. If, however, tha builtling or impmvement is solG within one year of completion, Ihe owner-builtler wlll have the burtlen of proving ihat he or she did not build or improve far purpose of sale.). ❑ I, es owner ot Ihe property, am E%CLUSIVELY CONTRACTNG WrtH LICENSED CONTRACTORS ta construct ihe pmject (Sec. 7044, Business end Pmtessions Code: The wntwcrors Licensa Lew does not epply to an owner of propeM1y who builds or improves thereon, end who contracts for such project with a contrector(s) Ilcense pursuant to the Conirectors License Lews.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signeture: Dete: Owner ID venfied by drivers license. ❑ Yes ❑ No DnveYs License No. Expires: Vedflcetion ot Ownership by (rype of document, i.e. - pmperry ta< bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I hereby certify that no excavetion five (5) or more feet In depth Into which e person is required to descend, wlll be metle In connection with work euthorizatl by t�is permit, enC that no builtling strucNre, scaHolding, felsework, or demolition or dismentling thereof, will be more then thirry-siz (36) feet hlph. (Chep. 32, Grp 2, An 2, Sec. 341, Title B, Califomla Adminisiretive Code). ❑ As owner-builder, I will not employ enyone to tlo work which woultl require a pertnit from the Divislon oi Industnal Sefery, es noted above, unless such person has e pertnit to tlo such work irom �he tlivision. Signeture: Date: Division of Indusirial Safery Permit NumDer: CEHTIFlCATE OF COMPLIANCE AND AIIfHOROATON OF ENTRV: I certity under penalry of perjury that I have read this applicatian and state that the infortnetion given Is correct. I epree to comply with all stete laws and ciry ordinances relating to building consiruction, end authonze representatives of the Ciry of Coste Mesa to enter upon the ebove-tlescribed property for insDeclion purposes. I egree not to occupY or allow occupency ot eny building authorized by Nis pertnit until flnel inspection. e •_ ignaNreOf�LegalOwner(s) �/�/^D�te l�s.��., �• ;'Y —`AriB/Or AUNodzed Applicent � ate , cooe.�. ixsnecnoxTrve GeiE It�eLS 1616 Fixed System Finel Fire Preventlon 1288 Pool Spa Final 200 Finel RaHoof 201 Finel BIocWRetaining Wall 202 Finel Fectory Fire Plece 203 Finel Sign 204 Flnel Demoli�ion 2H8-OB cooe� ixsvernoxrne 20fi Final Mechenical 208 Finel Plumbing 210 Final Electrical 212 Final Fire PrevenGon 220 Final Plenning Approvel 222 250 Final Site Final Building/Occupency � �� :'�T/ � � CITY OF COSTA MESA ` ,t _ BI/ILDIN6 pIVISION � � DEVELOPMENT SERVICES DEPARTMENT �� PERMIT PE ITNUM R 899-00301 (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 2985 MENDOZADR Suite: Vicinity: CARPORT @ ALLEY. Parcel Nunmber: 14122129 Applicank THORNE, DON Address: BUILDING PERMIT Zoning: Phone: Zip: Owner: MURADLIYfiN, JACK Address 20545 OXNARD . . , , , � � Phone: . WOODLAND HILLS,CA � Zip: 91367 Contractor: DUNHAM CONSTRUCTION, INC Address: P.O. BOX 68 , � SAN CLEM,ENTE Zip: 92674 - � Arcli : Address: 0 Zip: Phone: License: Phone: 949-492-7100 License: 450880 � Eng: Address: Status: ISSUED Applied: 03/03/1999 Issued: 03/03/1999 Phone: License: SCOPE OF PERMIT � REPAIR FIRE DAMAGE TO CARPORT. REPAIR/REPLACE FRAMING, ROOF FRAMING & SHEETING, PLASTER, DRYWALL &' , ROOF. REPLACE NVO ELECTRICAL LIGHTS INCLUDING�CONDUIT & WIRING. � , FEE SUMMARY ; . ! Plan Check: $0.00 � -_Y Calc Valuation: � $s,000.00 Permit: $99.75 ; ,% Claim Valuation: " SS,000.00 SMIP Res: $0.50 SMIP Com: $0.00 - ` - Other: $0.00 Inspection: $0.00 Total: $100.25 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existin : 0 NOTES: Rear 0- 0 Rear 0- 0 Required: 0 PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Right 0-0 Right 0- 0 EXPIRATION: This permit shall automatically explre and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepectlona and finel approvel must be obtained. Failure to obtain inspections and tinal approval will rasult in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545828 WORKERS' COMPENSA710N DECLARATION� � ' I hereby effirtn under penalty ot perjury one of Ihe following declaretions: �� I heve and wlll meintaln e certlNcete of consent to selbinsure for workers' compensetion, es provided for by section 3700 of the Labor Code, for the pertortnence of the work for which IhiS permit is issued. ❑ I have entl will maintain workers' compensation insuranca, as required by section 3700 of the Labor Cotle, tor Ihe peAortnance of Ne work for which this pertnit is Issuetl. My workere' compensation Insuranca certier end palicy number are: Cartier. Policy Numbec (Thls secBon need not be comp/ered i/ the permit Is va/ued af one hundred dollars ($f 00J or/ess.J ❑ I certity that in the pertortnance ot the work for which this pertnit is issued, I shall not employ eny person in any manner so as to become sub�ect to the workers' compensetion lews oi alitomia, end e e[hat if I shoultl bewme subject to the workers' compensetion provisions of Section 3700 of the Lebor Catle, I shall forthwith comply wit� these v ions. �� 7 �j O O �ApplicentSlpnature: � �i�fl ��YI.�C/ Date: L7 �J �9 / WARNING: FAILUHE TO SECUFE WORNERS' GY)MPENSATION GUVEMGE IS UNIAWFUL M!D SHALL SUBJECT PN EMPLOYER TO CPIMI PE ES AND GVIL FlNES UP TO ONE HUNDRED TFIOUSAND DOILNRE (E100.000), IN ADDITION TO THE WST OF COfAPENSATIIXJ, DAMAGES AS FROVIOED FOR IN SECfION 3]O60F THE LABOR CODE, IMEREST, M!D ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirtn that I em licensed untler provislons of Chepter 9(commencing with Saction 7000) of Division 3 ot Ihe Busin and Protesslons Code, end my license is in full lorce end eNed. Lic. a � Class % Contrectors SlgnaNre: � 7 a�s ¢ti.! ) Date: CONSTRUC710N LENDING AGENCV: ❑ I hereby affirm Nat Ihere is a wnsiructlon lending agency tor the pertortnance of the work tor which this permit is issued. (Sac. 3097, Civil CoOe). LBnCefS NemB: Lendefs Adtlress: SignaWre: Date: OWNER-BUILDER DECLARATIONS: 1 hereby ettirm that untler penely ot perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reeson (Sec. 7031.5, Business and Protesslons CoCe: Any ciry or counry which requires a permit to consiruct, alter. Impmve, Cemolish, or repair any siructure, pnor to its issuance, elso raquires the applicant tor such partnit to flle a sipned atatement thet he or sha is licensad pursuant to ihe prodsions of the Contrecrors License Lew (Chepter 9(wmmencing with Sedlon 7000) af Divisian 3 oi t�e Business end Professians Code) or that he or she is exempt iherefrom end the basis for the elleged exemption. Any violatlon of Sedion 7031.5 by eny epplicant for e pertnit sub�ects the epplicant to a clNl penalry oi not more than five hundred dollars ($500).): ❑ I, as owner of Ihe properry, or my employees wit� wages as thair sole compensatlon, WILL DO THE WORK, entl iha structure is not intended or otteretl for sale (Sec. 7044, Busineu antl Professions Code: The Contrectors License Lew does nat epply ta an owner of properry who builtls or improves thereon, end who does suc� work hlmseN or hersetl or through his or her own employees, provldetl ihet such improvements are not intended or offered for sale. If, however, the bulltling or Improvement Is sold within one year of completion, the owner-builder will have Ihe burden of proving that he or she tlitl not builtl or improve for purposa of sale.). ❑ I, as owner of the D�operty, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sea 7044, Business and Professions Code: The contractors LJcense Law daes not epply to en awner of pmperty who builds or improves thereon, and wha conirects for such project wiih a contractor(s) license pursuant to the Comrecmrs License Lews.). � I am ezempt under sec. Business and Professions Code tor Ihis reeson: Signetura: Date: Owner ID verified by dnvefs license. ❑ Yes ❑ No Dnvefs License No. Expires: Vedticatlon of Ownership by (rype ot document, I.e. - property taz bill or deed): DIVISION OF INDUSTRIAL SAFETV VEHMR CERTIFICATION: ❑ I hereby certly that no excavetlon five (5) or more teet In depth Into which a person is required to descend, will be made in connection wit� work euthodzed by ihis permlt, end t�et no builtling siruciure, scettolding, falsework, or demolition or dismentling thereof, will be more then thirry-siz (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Tltle 8, Celifomla Atlministretive Code). � ❑ As owner-builder, I wlll not employ anyone to ao work which woultl require a pertnit trom t�e Division of Intlusinal Sefery, as noted a6ove, unleu such person hes a pertnit to tla such work irom Ihe division. Signature: Date: Division of Industrial Sefery Permit Number: CEHTIFlCATE OF COMPLUWCE AND AUTHOR¢ATION OF EMAV: I certify under penelry of perjury that I heve read this applicetion and slate thet the intormatlon qiven is corred. I epree to CAmpty with all state law9 end ciry ordinances relaiing to building construction, and authorize representetives of Ihe Clry of Costa Mesa to enter upon ihe ebove-tlescribed property for inspection purposes. I egree not to occupy or allow occupency of eny building authorized by this permit until final inspeclion. � igneture Of Legal Owner(s) � MNOr�A ih rizetl Applicant . �J, INSiECTIONTYVE 1818 Flzed System Finel Fire Preventlan 7268 Pool Spa Final 200 Finel Re�Roof 201 Final BIocWRetaining Wall 202 Finel Fectory Fire Place 203 Finel Sign 204 Flnel DemoliUon PMB�aB �g ��$ �QpEj INSVECTIONTYPE 206 Finel Mec�anical 20B Finel Plumbing 210 Final Electrical 212 Final Fire Preventlon 220 Final Plenning Approval 222 Final Site 250 FinalBuilding/Occupancy �� . � � �tTNI��II CONSTRUCTION "c/ose doesn'f count" Slate CoNracbrs Liccn,c dd50000 DUNHAM CONSTRUCTION, INC. Po:t 011icc Oox 60 $an GcmeNq CJ� 92G7n ' (714) ��J2J100 J��k ��u�� I,ya�, 5'��-3K�-`-13�� 2�°S 1'1'��,�'�za l�r �os�(a ?��•1-E:,scr 0 � , � /y �l 1 c�.w, ,5 , � � � —� � �C. E. l� �5 h�s z o' Ho� �oo F am / �I . � i � : � �DSf - i -� i 35 � — — — -- —}�e�(ac,� I-o�-�,Jays-E� + u/a 1( �r�vva�� Gei�i>�G ,�n �.-au��cPr`-rS-I�ora�G �/� v / '�✓ � V l/�,�j�� w �� " G ti �»a� �ea-sz�s • Fax (714) 754-4856 Job Address: Suite: Vicinity: CITY OF COSTA MESA BI/ILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 2985 MEND02A DR WHOLE BUILDING Parcel Number: 14122129 BUILDING PERMIT ZOning: � PERMIyNUMBER / �/B99-01435 77 FAIR DRIVE, COSTA MESA, CA 92626 Applicant MAC NEIL, TOM � ISSUED eY: Address: 1835 WHITTIER AVE. _ _ _ _. COSTA MESA, CA —'�-�__�P._hone'= (949).6453917��-� SUITE F10 ��-f`.' r— �Zip:--92627 r--� ` �� /ii .-� � , � : i I �� Y�..'�. Owner: MU Address 205� 1835 WHITTIER�A\ i iiiui COSTA�MESA;CA i�ir/ SUITE"F10 /,�'Arch_: � ��ir�� , � ��%/! / Address f = ��1(' I ;_�%l I��7 � � r�� ' i„i �i f; �{1� �'P� i��'; /' � t '� ��iYI�: 2i' �' ��`— � ; �� _REROO� EXISTWG � � SHEATHING-WITH 7/16" � � � � � ASPHALT SHINGLES. 1 � h� , �' , � ll �'-__— ��1t:� 1�'� Plan CFieck:��s�, $0.00 ' ��`, l� Permitl�',�„S;$125.25 ��SMIP�Res:�\��° $0.60 tiSMIP'Com: A`��+� $0.00 � ,. '��Other-: � �•$0.00 �� Inspection�� $0.00 ` ,�, � /` ��:� ` \_ �i�To4al: , $125:85 .�_� , , �� ;:�, ACCESSORY PARKING NOTES: Status: ISSUED Applied: 09/OB/1999 Issued: 09/OB/1999 L � � �. � 1 '� �``��'�� \ 1`�� Y y � -I- - - ` jn,�' " '� i � �\�,Z� i /__=Phone:_ _�� ., i. �� /�,\� \\ j-/ ;=� �..,-y�"5,"'�,�.`-.: � \`� t � '�� :7x- 'Zip. 91367--��.�,..,�� \ � i " L-��'�.\� �� )FING � � � Phone: (949) 645-3917 �� l License}� 750385 �,l �. �Phone� Y "'� '_ T z'�.-- License: j' sco PARTMENTBUIL"DI NG' (28;.SZ � INSTALL'd=L'AYER OF_30# A u J `_�� _ .. .. . : "' Eng i i �``-�Address � \/� ' t � ;�'i�' �� , .,.n �� . _ `__ _ �.� _ V '' FEE SUMMARY � ,-�1�'--�#s'��=T-�•-' 1% _� `—�1��irV- 5'��3 c,= w __' . — - _ - —., `-S '� � _ _ ; i� �"'_" _ , ��:� _ . � � " ��'�� ; , , .i. " _ �� '�`h. , , �. . ,`tr _. i,r_a � ��'��o; �;i; � � � : '� 4 \ \� � � a�� , � "� �'�'"� . n?�\ ( •� ��\ \� � \ ; /"-`. �t1`.�� `/� �. � �\ � �� ., �. - �� ;1 �� t � \ �n �� ' �\l�\i r� 1, Fhone:' .t \Lif`n`e U , 1 i �� l k ,�r., � _ .. i � 7 ;OOFING B�REPLACE ^ WITH 20 YEAR � l � }(:' ._ I �lil � . Valuation: i Valuation `,� j� .` i �.'i �i �� `=A�, � �i �� ' PLANNING & ZONING {� �:,� � ' �_ 't�� v �� j / � �� -'. `_i ,.,,`r r.�� - i " �� i �`�r Front �� 0;� Rear 0 0� -� �t--Lek 0 0 �� : ` Right �0 0 � �� ' � � ,� / 'j_ ', _ `.� w . -' : � ` ;� r ��,<� ,�y'�/ Front 0=0�'j >,�-Rear 0-0 - __Lek�. -0-0"� , Right��'0-0 �;'�� . � � , ci' /��i/ �. � r � � �'_ ' ; �'� ��. i7r/ � Exis4ng ��0_ ( Requireil: � ;0 � � �Proposed:. - �0 '� ?' � ;�G� �` _, � �� `�. , _ - �_ ir/,. . — - .:. . , � j��,. %% -- _ ,..?'_ f�. / l . � �. � NOTICE: The work authorized by this 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 if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 180 days. � � . INSPEC710NS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, ana au requlred Inspectlons end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � WORKERS' COMPENSATION OECLARA710N: I hereby aflirtn under penalry of perjury one of the following declarations: ❑ I have entl will maintein a certificate ot consent to setl-Insure for workers' compensation, es provitletl lor by section 3700 of the Lebor Gode, for ihe pertortnanca ot the work for whlch this permit Is issued. �I have entl will mainiain workere' compensation insurance, as required by section 3700 of the Lebor Code, for the pedortnance of Ihe work For which this pertnit Is issued. My worker/s�' compensation Insur nce carrier end pollcy number are: Carner. K EZ I A'71! L� Polity Number: Nu%•4 �/. i y nls 3 � D� (This secHon need no( be campleted il the peimit Is velued af one hundred dollars ($100) ar less.J ❑ I certity thet in Ihe pertortnence of ihe work for which this permit is issued, I shall not employ any person in eny menner so as 10 become subject to ihe workers' compensation laws oi Califomia, end egree that if I shoultl become subject to the workers' compensation provisions of Sedion 3700 of Ihe Labor Cotla, I shell totlhwith comply with Ihese�ns. -� ^ , .--r�/]� �9 �J % Applicant Signature: OZLI y��L� Dete: !— II �r � WARNINO: FAILURE TO SECUflE WORKERS' COMPENSATION COVERAOE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVI� FINES UP TOONE HUNDRED THOUSAND OOLLARE (5100.000). IN ADDITION TO THE CQST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3'/W OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) ot Division 3 of Ihe Business and Protessions Cotle, and my licansa is In full torce and eNect. lic. a D 6' c�ass a � G 3 9 Contractofs Signature: � ��y �4 � � � Date: — _'_ � CONS7RUCTION LENDING AGENCY: ❑ I hereDy aHirtn ihat there is a consiruction lending agency for the pertortnance of the work for which this pertnit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lendefs Address: Signature: OWNER-BUILDER DECLARA710N5: Date: I hereby attirtn that under penalry of perjury tha� I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which reQuires a pertnii to construci, alter, improve, tlemolish, or repair any strucNre, prior to its issuance, also requires the epplicant for such pertnit to tile a slgned statement thet he or she Is licensetl pursuant to ihe provlsions of the Contractors License Law (Chapter 9(commencing with Section 7000) ot Divlsion 3 oi the Business and Pmfessions Code) or that he or she is eaempt therefmm end the basis for the alleged eaemption. Any violaiion of Sectlon 7031.5 by any epplicam for a permit sub�ects the applicant to e civil penelry of not more than five huntlreC tlollars ($500).): ❑ I, as owner oi ihe properry, or my employees with weges as their sole compensation, WILL DO THE WORK, end Ihe siructure is not intended or oHeretl for sale (Sec. 7044, Business end Professions Code: The Coniractors License Lew does not apply to an owner of property who builtls or improves ihereon, and who does such work �imself or hersetl or thmugh his or her own employees, providetl that such improvemenis are not intended or oXered for sale. If, however, the builtling or improvement is soltl wi�hin one year oi completion, the owner-builder will have the burden of proving that he or she ditl not build or impwva tor purpose of sale.). ❑ 1, as owner of Ihe propeRy, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to conSWM the project (Sec. 7044, Business antl Pmfessions Code: The contrectors License Lew does not epply to an owner of proparty who builds or improves thereon, and who coniracis tor such projed with a coniractor(s) license pursuam to the Coniractors License LawsJ. ' ❑ I am ezempt undar sec. Signawre: Owner ID ventietl 6y ariveYs license. ❑ Ves ❑ No Business antl Professions Code for t�is reason: Verification of Ownership by (rype ol document, i.e. - pmperry tax bill or deed): OIVISION OF INDUSTRIAL SAFETY PERMIT CER7IFICA710N: Dnver's License No. Dare: Expires: ❑ I hereby certity ihat no excavation tive (5) or more teet in dapth into which a person is requiretl to descenq will be matle in connection with work authorizetl by �his permit, and Ihat no builtling siructura, scattoltling, talsework, or demolition or tlismanNing thereoi, will be more than thirty-six (36) feet high. (Chap. 3.2, Cary 2, Atl 2, Sec. 341, Tile B, California Adminisirative Cotle). ❑ As owner-builder, I will not employ anyone to do work which would require a permit fmm ihe Division of Indusirial Safery, as noted above, unless such person has e permit to do such work from tha tlivision. Signature: Date: Division ol Indusinal Safery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AU7TiORIZATION OF ENTRV: I cenity under penalty of perjury that I hava read ihis application and state Ihat Ihe infortnation given is correct. I agree to compy with all state laws and ciry ordinances relating to building construction, and authorize representatives ot ihe Ciry of Costa Mesa to enter upon tha above-tlescribed property for inspeclion purposes. I egree not to occupy or allow occupancy oi eny building euthorizetl by this permit until final inspeciion. �—Sig wre Of Le er(s) te^ fn,,� � °�'N n � - � - t�' r A orized Ap c'ant Dat � ' CODE t. INSVELTIONTYVE 1676 Fixetl Syslem Final Fire Prevention 1268 Pool Spa Final 200 Final Re-Roof 201 Final Block/Rataining Wall 202 Final Fectary Fire Place 203 Final Sign 204 Final Demolition 2MB dfi Dpre I[R�ALS � � CODE� INSPECTIONiYPE 206 Final Mechenicel 208 Final Plumbinq 270 Final Electrical . 212 Final Fire Prevention 220 222 250 Final Planning Approval Final Site Final BuildingiOccupancy OATE INTITIFLS ;� 9. " ". � , � , � COSTA MESA BUILDIN�G- AFE11 _=PARTMENT F E ��ECEIVED . P.O.BO%917 COHTAMEBA.CALIFORNIA � i� � ';� .f116'3 Y 1� For Appllcanf to Fill In Completely APPLI�A dT�11WOR�PE�Nfl' T� TYPE OR PRwT � �l11rA�6Gc COSiA MESA BpILDIN6 � % en za_ �,�e � � �For Office'Use Only ADORE53 . pEce1PT rv0. P[y�*-�; O. COSTA MESA, CALIFORNIA ' I Q�7 (% . xecerv o er � xqr,erv�� o�fa;i eueo OWNER Dillman-Bruinmell Enter rises �� ' BUILDINO AO RES9 12OH1 BllBI'O� � ' AODRE58 [ FIRE � CITV Garden Grove NO. Q�ZZVQ ZONE TYPE GROUP � APPROYE� ' OR ENGI ER Walters 8C SO[1 ND QR 3-2�� BY DATH zoNrNa aooaessL Del Mar ZO NO.OF U6EOPNEW • • � PLANB Z I lUILOIN6.1 CONTRACTOR SEIS� ��v � LEOAL' � y , ,� � . ADDRESS '-�� DE9CPIPTION .ic.� , CITY �'- • . A. P. NO. � . NOTE: NO EAVE OVERHANG SHALL BE LE58 THAN 6TATE - TEL. 90' TO SIOE 8 REAR P. L.� � . LIC: NO. NO. '--� •SIZE �J [ ll(� f� No.aFeLD08. ALLOWED (U.B.C.REQUIREMENT) OF LOT ( • J� XX117• �" I NOW ON LOT O, . YAR�SAPPROVED YARDSAPPROVED USEOF —� MAIN BUILDING ACCESSORYBUILOIN6 . EXISTIN� BLD6. (FROMC/ STREET eeTencrc urve FwoM (�,S � REAR YARD �S � FRONT t�'. Ff. ' CENTER OF BTRELT SIDEYARDI LEFT ��,�11 I R16HT �, R.SIOE Ff. Ff. DESCRIPTION OF WORK �. s�oe 3�%S Fr. F-r. /'/ /y / . NEW X ALTERATION AODITION �REAR � FT. DISTANCE BET. BET. MAIIJ @ . REPAIR MOVING DEMOLISH MAIN BLDGS. ACGESS. BLD65. BOILDING. r�I� � r� � NO.OF 1' � V'°'R.${' . �ATE C l4� X/H Rflf1MN �'Y RT1'1P�FH Z l' 11 P SI APPR(]VFIS . ' I /J yg3o « � � % � 6Q. FP. � 1 XEREBY ACKNOWLE�G6 TXAT 1 HI�VH flEAD THIB APPLICpTION '�E AMOUNT BHOWN ON�Ep VAWATION IB FOR TH8 � ANO 8TAT6 THAT THS ABOV6 18 CORRECT AND AOREE TO COM. � PURP09E OF EBTABLI6NIN0- A� PEflMIT FEE ONLY.' Q , PLY WITH ALL CITY ORDI NC AN � T6 LAW9 H80ULATINO VALUATION BUILDINOCONBTNUQI . /�� m PERMITFEE $'� SIGNATURB OP '/ / y/' � PERMITfE a y� (Y/ LA HECK �� O / AUTHORIZEO AGENT � ' � - . 4 ' TOTAL FEE $ ?O 'J 11 �