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Home My WebLink About3108 MCKINLEY WAY - Building Permits(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3108 MC KINLEY WY Suite: Vicinity: BATHROOM PrimaryOcc: R1 Parcel Number: 14165250 Applicant: MICHAEL HU ' Address: Owner: Address Coniractor Address . Type of Constmction: V-N Zoning: R1 Status: ISSUED Applied: 09/02/2005 Issued: 09/02/2005 Y✓ Phone: ISSUED BY: Zip: � � FIREBAUGH, KAZUKO�_KAY.,TR -� " � �� - �, 3108 MC KINLEY WAY " " � ;��« - � � �-"� ` . � . Phone - �"-v - �. � � .* �,,, COSTA MESA; CA :�.� r. �" F�`� �� Zip 92626 ;�� , �, _ �; a; sy �` ° � 'di �' � .4- _ � � � ��. ROVICS'CONSTRUCTIONINC�Y� � �;�� ' �,�� 8501 MARTINI�UE DR 4-� ;;;��"'� x-��; ' FF; `� � ^�• `«�;;�i' ' Phone: 714375 0722 +<.�,;� �ba � HUNTINGTON BEACH, CA ��a �' �'., �: } � . � R ., x. �.vi `'� �£`q„�,, 92646, ;�.�.-�� License: 800996 '4 _, Arch,.: ` . . . ,a Address: � �'s.:"- Plan Check: ,� Permit: ^'SMIP,, Res: SM I P„Com: " ;- Other: Inspection:- ,: �;Total: �a Phone: ��. . �License: ��. ..�4f. � YER VALVE INSTALATION. Eng: t�°�a Address: #%.; �z'i,, " �+ �- , C :4 SCOPE OF PERMIT �' i� z"< :�. , ,FEE SUMMARY ,;. � � ;�` ; �.. � x _ �" � t -:`•C � "�s,.� _ .._�...o-, �- '.0 � � . � �, , �Y r °�. �, . ;E Front 0-0 . Rear 0 0;�;: , � a� : Front�,0-0 �`��,�` �°Rear�.��-0 0;'. Right �0 0�'��: � ;� PARKING �� Existin' ` 0:% Required � 0 � Pi000sed 0 � "� ' --.�q E �. ,� .�,�� ,�. � � �� ' �-. �.-. z`� � Y , � <.. ° ,,?� �.". . ,�,'" � at...,�, . �.,.,. 8. �. t � �.F� r.�; .g''� , .�r'�I' �• i ',Y��` ;16�. ' �b-' :F� _ f, 3.; t . ; 7 '` vi, �..= ��v:,.: ,.. _ &.. .. " ". ... '� „,� ," g �,,,.`-"`,.. .,.,,�� =�` ° _ '� s3oo:o0 � � ssoo 00 , �. ^t> � 1 �°,, � +F t � - r�' . NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) � EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended.or�doned for a period of 180 days. � INSPECTIONS: In order for the work authorized under this permit to be consldered legal, such work must comply with ell appliceble codes, and all requlred Inepectlons and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaaaae�aroo� WORKERS'COMPENSAnON DECLARAnON: I hereby affirtn under penalry of perjury one of Ihe tollowing tleclarations: ❑ 1 heve antl will maintein e certificete of consent to self-Insure for workers' wmpensation, as provided tor by section 3700 ot the Labor Cotla, for Ihe pertormance of Ihe _ wark for whic� this pertnit is issued. be n Insurance, as requirad by section 3700 ot the Labor Cotle, for ihe pertortnance of the work for which this permit is Issuetl. antl policy number are: ^7�7 �j ? �_ PotICy:Numbe -� /7 >� 7�''%• u`^�l > velued et one hundred dallers ($100) ar /essJ � ❑ I certity Ihel in the peAortnance of Ihe work for which Ihis pertnit is issued, I shall not employ any parson in any manner so es to become subject to the workers' compensation laws of Celifomle, end egree ihet If I s�oultl b e subject to the workers' campansation Dmvisians at Sectlon 3700 af ihe Lebor Code, I shall forihwit� compN with t� provisio - , � ��Z� �-- r�'att�' emre � oa,a:�- �n WARNINO: FAILURE T SECURE WORKERS COMPEN T1IXJ COVE GE IS UNLAWFUL SHALL SUBIE EMPLOVER TO CRIMINAL PENALTIE$ RND GVIL FlNES UP TO IXJE HUNDRED TIIOUSAND DOLLARE (5100,000). IN PDDRIIXJ TO TME COST OF COAIPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 3�O60F THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS UECLARATION: I hereby ettirtn.lhet�l:am Iicensetl untlerpravisio s ol Chapter 9(cammencing with Section 7000) of Division 3 oi Ihe Business antl�rofessions Cotle, and my license is in full fo a�M�eNectl�N ��i� t�G�esq� /S Cra�n't o,�Slg�re��.�+ �� , ��` C� // z�G�— � C. CONSTRUCTION LENDING AGENCV: ❑ I hereby ettirtn that there is a conswction lending agency for the pedortnance of tha work tor which this permit is issued. (Sac. 3097, Givil Cotle). Lendefs Name: LentleYs Atltlress: Signeture: Da�e: OWNER-BUILDER DECLARATIONS: I hereby atfirtn that untler penalty of perjury thet I am E%EMPT FROM TME CONTRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, Business end Professions Code: Any ciry or county whic� requires e permit to construct, alter, improve, demolish, or repair any strucWre, prior to its issuence, also requlres the applicant For such permit to flle a signed statement that he or she Is licensed pursuent to the proNsions of the Contractors License Law (Chapter 9(commencing with Sedion 7000) of Divislon 3 ot the Business antl Protessions Coda) or that he or she Is e:empt thereirom and Ihe basis for tha ellegetl exemption. Any violetion oF Saction 7031.5 by eny applicant for e pertnit subjecis ihe epplicant to e civil penalry of not more than five hundretl tlollers ($500).): ❑ I, as owner ot t�e properry, or my employees with weges as their sole compensation, WILL DO 71iE WORK, end Iha structure Is noI intentletl or offeretl tor sele (Sec. 7044, Business and Professions Code: The Contractors License Ww does not apply to an owner of properry who 6uilds or improves Ihareon, and who does such work himsetl or hereelf ar through his or her ov.•n employees, proviCed that such improvemenis are not iniendetl or oXered for sale. If, however, the building or Improvement is sold within one year of completion, the owner-builtler will have the �urden of pmving that he or she did not build or improve tor puryase oi sale.). ' ❑ 1, es owner of the property, em E%CLUSIVELY CON7RACTING WITH LICENSED CONTRACTORS to consiruct Ihe pmject (Sec. 7044, Business end Profeuions COEe: The contractors License Law tloes not apply to an owner of property who bulltls or improves thereon, and who coniracts for such project with a contractoQs) license pursuant to the Coniradors License Laws.). ❑ I am ezempt under sec. Signatura: Owner ID venfied by dnvers Ilcense. ❑ Ves ❑ No Business and Protessions Code for Ihis reason: Vatlfication ot Ownarship 6y (type oi documem, i.e. - properry tax bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Driver's License No. Date: Evpire5: ❑ I hereby certify that no excavation tive (5) or more feet in depth into which a person is required to dascend, will be mede in connection wlth work authorized by t�is pertnit, and thai no building strudure, scaNdtling, falsework, or tlemolition or dismantling thereof, will ba more Ihan t�irry-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Titla 8, Calitornia Administrative Cotle). ❑ As owner-builder, 1 will not employ anyone to tlo work which would require e permit from the Division of Indusirial Satery, es noted above, unless such person has e pertnit to do such work trom the division. Signature: Date: Division of Industrial Satery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AIfTHORIZATON OF ENTAY: I ceM1ity under penalty of perjury that I have reatl this epplication antl state ihat Ihe informatlon given is correct. I agree to comply with all state laws and ciry ordinences relating to buil0ing construction, and authorize representatives ot the Ciry ot Costa Mesa to enter upon t�e above-describetl properry for inspection purposes. I agree not to acupy or allow occupancy oi any building euthorized 6y �his permit until final inspection. CQOE 1. INSPECTONTYGE 1816 Fixed System Final Fire Prevention 1286 Pool SOa Final 200 Final Ra-Rooi 201 Flnal elock/Retaining Wall 202 203 204 Final Factory Fire Place Final Sign Final Demolition QA� INfITIRLS CODEt INSPECTONTYPE 206 Final Mechanical 20B Final Plumbing 270 Finel Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Oaupency Z �� 1 �1 �� b (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: Suite No Vicinity: 3108 MC KINLEY WY BATHROOM Parcel Nunmber: 14165250 �: � 'S SSUED Ap li 9/01/2005 Is u d: 09/01/2005 � Applicant MICHAEL HU ISSUED BV: Address: 8501 MARTINIQUE DR - . . - ' _ _, . � -_� " Phone:�714-375-0722 ; � � � HUNTINGTON B�ACH, CA Zip_" 92846 i ;�� _ � � _ .; , , _ . ' - _ , - �� /`. � � _ j Owner � �FIREBAUGH, KAZUKO KAYTR� � `_ _ � � . . - � Address 3108 MC KINLEY WAY �,i% - . � � V'- . �A -.. . ��'' . , � � . Phone: ;��` _ � i-� �, � COSTA MESA, CA �- Zip: 92626 � �'�� %� .. . �, , , , � , ' _ �� V.. . � � . Contrector.' - ROVICS CONSTRUCTION INC � `' \ ,�. ,, -�Address: ; 8501'MARTINIDUE DR - � "� � � � � ' - --- `>\ ..,:Phone: '��7-14375-0722 � � ' �.': � � ' ' HUNTINGTON B�ACH, CA -"� �� Zip:�.92646��\,� . - ��,�' . . . _. . 1 �' �' r. � " ' - �' � . . , . _ , ;�,- . '�Cicense: 800996 �� , '� , . . , _ . : _-. - . r ' ' , - i.. �,� , �t', �, � � . � - .. � � - ._,��_,� �._ - � � SCOPE OF PERMIT _ �' ", ' ; . ' � ; REPLACE SHOWER VAWE. �� , � : � "� ' -.r � ;rFEESUMMARY �; "` . '' �' ' ,� '' - �. . �, �� , � � � � . , , AMT � � - � .. ....� .' .'( 1? �? �'-�.`_I� -- � � �,+�. . AMT� . 9TY ISSUE FEE $23.50 Laundry Tub / Washer � � $0.00 ' ,0� ;Sump Pump ; � : $0.00 - 0 BackBow irrigation . $0.00 0 Landscape Irrigation $0:00 0., Swimming Pool ,��j �. �,=$0.00 0 BackflowPreventer . $0.00 0 -P-Trap�.*,. + $0.00> i'0,�� TrapPrimer ' f �. � $0.00 0 Baihtuli $0.00 0 PressureRegulator� _ `� ,�$0.00, j 0; "_ r;� Urinal ��1 ' �$0.00 � ��0 Clarifer System. . � - $0.00 0 � �� „ � Process Piping�(per 10 N) $0.00 � .. 0. � Vacuum Brkr Bkflow(1=4) � $0.00 ,� � � 0 Connect,Qce,Soda,etc) $0.00 0 Receptors $0.00 . 0 � Vacuum Brkr Bkflow(5+). -$0:00 ' 0 Dental Units - 50.00 0 SepticTank $0.00 ' 0 � Wash Basin '%' i, � , ; �$0.00 � �0 Dishwasher •$0.00 0" Sewer Cap for Demo -$0.00 �� .0 Wash Basin Se(!j! � $0.00" - 0 Drein,�Floor � ._ ;$0.00 0. Sewer Connect - "$0.00 �� 0� Waste and VenCSystem �� $0.00' ; 0 Drain; Rainwater ��`� ��. �,50.00 0 Sewer Private Line�,._.� $0.00 0 Water Closet (Toilet)" „_ .$OAO 0 Drain, Roof. �.$0.00 0 Shower '"' T��'��'�':.� �' ; .,i:.��, , $9.80 1 WaterHeater`/veM�� $0.00� 0 DrinkingFountain"� $0.00 0 Sink,bar;?4�' .'.� � ^�-$0.00 0 WaterP,iping�(InstorRep.f �$0.00 0 ExpansionTank �$0�.00,��, 0 Sink,:commercial' •$0.00'�':,0 Water.Re-'pipe !$0.00 0 Gas Earthquake Valve - `. $0 00�� 0 �Sink, Floor' ��' $0.00., ��0_�_' W�:,,i_-+i-Wate�,Service j � � /; � $0.00 0 Gas(1-4outlets)'� $000��0 � ''��"x�`.-Sink,kitchen �� '-°� .$0.00 0 �S,.Watei�Softener � �j�'�$0.00 0 Gas (Over 4 outlets). , $0.00 `0 " '"� Sink, ser`vice/mop � '� -,� $0.00 �0 _=��OTHER�j;'� j �.� �; $0.00 Gas Repipe _ � ��$0.00.' � 0 �A�� Spa (private)t- � ,. $0.00 - 0� �%NIOLATION � � /-� �.` $Q00 Gas Service � -- � `$0 00. �' '0 � � Spa.(public) � � . $0.00 0- �' PLAN.CHECK /�, �, $0.00 Interceptors(Grease�0il)�`�$0.00-�� 0 � , ,,,�_ � - �� iREINSPECTION� � $0.00 0 Interceptors (Sand Auto )_`�: $0.00 � 0� � ' -. " � _ - - � _ � - : "� '�`�', : �-�) � ' '�� " �- • ` � � - � TOTAL CALCULATED FEES: E33.30 " fi " � // `,. -.;.�. � � , ; �-� - --, ,-,� - . , A � _ �i /� COMMENTS/ SPEGIAL GONDITIONS _ -- '� ' \ \�,.._ i.s -� _ -'; _. _ _ _ �:jr�% - _ - - _ - �is%`�- _ � >.�. . NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor the vrork authorized under this permit to be considered legal, such work must comply with a71 epplicable codes, antl all requlred Inspections and flnal epproval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (774) 754-5626 2146d6 (fJW) WORKEPS' COMPENSATION DECLARATON: � � I hereby ettirm untler penalry ot perjury one of ihe tollowing declaratlons: ❑ I heve antl wlll meintain e ceNfiwte oi consent to selt-Insure tor workers' compensatlon, es provitletl tor hy section 3700 of the Lebor Cotle, for the peAormance of t�e work tor which this pertnii is issuetl. ❑ I have and witl maintain wwkers' campensatlon insurance, es required by section 3700 of Ne Labor CoOe, for the perfortnance of the work for wh1U NIs pertnit is issuetl. My workers' compensatlon Insurance cartier entl poliry number ere: Cerrier: Policy Number: (Th/s secNwr need nof be completed i/ the permlf is velued e! one hundred dWlars ($100) or less.) I certity Ihat in the Dedormance of Ne work tor which thls pertnit is issued, I shell not employ eny person in any manner so as to become subjact ro t�e workers' compensatlon laws of Calitomia, end egree ihet if I should become subjact to t�e workere' compansetion provisions of Section 3700 of the Lebor Code, I shell torthwith wmply with these provis . � , G/ �an`�.i��Sipnewe"�'_-. '�`- r�. � ////�� KAIL R TO SECURE WORKERS' COI PENSATION CWERAGE IS UMAW UBJECT AN EMPLOVER TO CRIMINAL PENALTIES M1D CML FlNES UP TO ONE HUNDRED iAND DOl1ARE (5100,000�. IN ADDRION TO THE COST OF COMPENSATION, DAMAGES AS PROVI �q IN SECTIIXJ 3]W OF THE IABOR CODE, IMEREST, AND ATTORNE`fS FEES. LICENSED COHTAACTORS DECLARATON: `'� I �ereby attirtn that I em licensed under provlsions of Chapter 9(wmmencing with Section 7000) of Division 3 oi ihe Buslness and Protessions Cotle, end my Ilcense is In full force flna ettect Lic. p qass p Comrectors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby eHirtn that there is e construction lending agency for Ihe peAortnance of ihe work tor which ihis permit is issued. (Sec. 3097, Civil Cotla). Lenders Name: Lender'S Adtlress: Signature: Data: OWNER-BUILDER DECLARATIONS: I hereby eHirtn that under penelry of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reeson (Sec. 7031.5, Business antl Protessions Cotle: My ciry or counry which requires e permit to consiruct, alter, improve, demolish, or reDair any sirucNre, pnor to its issuance, also requires Ihe epplicant tor such pertnit to flle a signed statement ihat he or she is Iicansed pursuent ro the provisions of the Contredors IJcense Law (Chapter 9(commencing w0h Sectlon 7000) of Division 3 of the Business entl Professions Code) or that he or she is eaempt iherefrom and ihe basis for tha alleged exemption. My Wolation of Section 7031.5 by eny epplicent for e pertnit sub�ects the epplicant to a civil penalry oi not more Ihan five hundred tlollars ($500).): ❑ I, as ov.•ner of ihe properry, or my employees with weges as ihelr sole compensatlon, WILL DO THE WORK, and Ne structure Is not Intended or otterea 1or sale (Sac. 7044, Business and Professions Cotle: TTe Contractors License Law does not apply to an owner of properry who 6uilds or improves �hereon, end who tloes such work himself or hersetl or Ihrough his or har ov.•n employees, provideO ihat such Improvements ere not intended or ofleretl for sele. If, however, Ihe building or improvement is sold within one year of completion, lhe owner-builtler will have the burtlen ot proving t�at he or she did not build or improve lor purpose of sele.). � ❑ I, es owner of ihe proparry, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRAC70RS m construct the project (Sec. 7044, Business end Pwfessions Cotla: The coniractors License Lew Coes not eppty ro en ownar o1 property who builds or Improves Ihereon, and who wntracts for such project wlth a contracroQs) license pursuant to the Contractors Licensa Lews.). ❑ I em eaemp� under sec. Business and Professions Code tor Ihis reason: Signature: Date: Owner ID verified by tlrivef5license. ❑ Yes ❑ No Drivefs License No. Vedticatian of Ownership by (type ol document, i.e. - properry tas 6ill or tleea): Eapire5: DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I hereby cenify that no excavatlon tive (5) or more feet in depth into whic� a person Is required to descend, will be made in connectlon with work euthodzetl by Ihls pertnit, and that no building sirudure, scattolding, falsework, or demolilion or dismantling t�ereot, will be more �hen thirry-six (36) faet high. (Chep. 32, Grp 2, Atl 2, Sec. 341, Title 8, Celitomia Atlminisiretive Code). ' ❑ As owner-Duiltler, I will nat employ enyone to do work which would require a pertnit tram tha Division of Intlusiriel Safery, as noted ebove, unless such person hes e pertnit to do such work from Ihe Civision. Signature: Date: Division of Industnal Sefery Partnit Number: CERTIFlCA7E OF COMPIIANCE AND AUTHORIZATON OF EMAV: I certity under penalry of perjury that I hava read this epplication entl state that the infortnation given is wnect. I egree to compry with all stete laws end dry ordlnances rela6ng to bulltling construction, antl authodze representaGves ot Ihe Ciry of Coste Mesa to enter upon t�e ebove-0escnbed propeAy for inspection purposes. I egree not to occupy or allow accupancy af any building euthorized by this permit until fnal inspection. CODE t. INSPEC710NTYPE 1816 Fi:ed System Final Fire Prevention 1266 Pool Spa Final 200 Finel Re-Roof 201 FInaI Block/Retainlnp Wall 202 Final Fedory Fire Place 203 Final Slpn 204 Finel Demolltlon Qd¢. Q� �QQf,l INSPECTIONT'GE 206 Finel Mechanical 208 Finel Plumbing 210 Finel Eleclrical 212 Final Fire Prevention 220 Final Planning Approvel 222 Flnel Site 250 Flnal Bullding/OccupenCy � D U� PA1E Iti�lS �' � i DECLARATION OF AUTHORITY FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMITS a ;s r�� K�',� lp 1. I(we):—�� 7�.C( �i oCa z o� /c [. j� I✓ Py��t't � referenced real property, and that I(we) hereby authorize: Bldg. Permit # This Permit # AP Number: declare that I am the Owner of Title of the above Name: (�'v�C� �o NS lf�t�- I l0%J INC � Telephone Number: �I �'I�'lN�I-� �oN� Street Address: I�'"I `o S� /U C W T 10��= ST �} � Ciry: �Uh% /�(/v V�� State: C� Zip; �� to obtain permits in my behalf, as owner/builder, for at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I(we) shall immediately provide Workers Compensation Insurance coverage and cause a ceRificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. 3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or corporation. 4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the penalty of perjury that the foregoing is true and correct. Executed this �_ day of 7� I/�✓v1 iS Ei2� 20 �, at �DS'�Fj- M ES Fl— , Califomia. o]]9-a6 (rev.1 V00) Print Name: ko igna"5 ture: � fi� GU� �, � o�— Note: This authorization does not grant authorization to perform the work as owner, it soley provides for limded power of attomey to secure this permit in any behalf. ewiarn: 3108 MC KINLEY WY ��r �F�+:FIREBAUGH, KAZUKO KAY FLOOD: X 47 �� 3108 MC KINLEY WAY COSTA MESA,CA 92626 �vr�. �,uiwc �oo�ss: AXCNRECT OF ENtlNEFA: flCX.ON Fl1fi.Y ADONE55: ue No.: UNT: CMI11ifCT01Y5NAME:D P PLUMBING AND INSTALLA (714)991-9477 CpRNACfOWS YYlR10 15 8 8 S ANAH E I M B L wu�ss ANAHEIM CA uc.xo.: 563793 92805 urr: 3 LICENSED CONTP�CTOflS OECUflATON: I hereby eflim uMw penely d perjury ihel I em licenaed uMm pwia'vo d CMpx B (mmmerciip Mil� Seclion 1000) d Divrsion 3 d Ma Buaineas eM Pmlestiona CaEe, anJ my liianro w in lull brce eM Metl. cmuc.r+o.: g�7z uacuss: C 36 ��c.No��7� EXP: 00/00 ome. comrea«: �� W N BUILDEN DECLAHATION: I Mreby elfi�m under panepy of per'W�Y �� I em e�emq tmm iM Conlredan Lirorue lew In ihe ' reeoon (�� ]031.5 Buanese vM Prdwbm Cade: Riry c'ry a couMY �� 9uiree a parmG to wnbud. Ms.'vnpon. demdmh, or repei mry Meuciu�e. pebr io in 6weMe, ebo reQuiiee Ihe eppliant la euch pertnB to fib e sgneE etelement Net he a�M IicenasA pu�auenl to IM pari5ions d Ne Conlredwe lioanse law �Cheqer 9(mmmervi�p xil� Setlon 1000) d Diveion 3 ot Ilr usinm vM Profeaeiona Gode� or thet he w ehe ia eRamq �herehom enE ihe Eaz's ta IM elbpeE axempion. My videlion M SeUion rai�.5 by eny epplireni la e perm� wbjecve iha epd�� m a dvil penelry d na mora �hen fva huMred ddlen �Ssoop. � I.naxmrdihepapanyamYemdW��hwepaaec�M1usdacompemetbn.willEotMwok.eMNeebucluncm�mteiWsA «ollereE M veb (5eclion'loN. eusiiwm erd Prolenabns COJe: The Camraewa Limnae Lew doee mt WWYtoen owmr a piape�y who buida a inprovee iMreon, erd who doee auch wvrk himeaM w heneY a ihrouph �c ar har own employaee, qovided �hel wch impovemenH ue not imeMad a oHered lor ede. II. hawever. tM buikirp a inqovemeM o edd within pnY� d canWNion. ihe �.e��u« �;n ne�a in� w� a o��e ne « mb ew oa w�u a�mw� i« ine wmo� w�). ❑ L m ovmx d iM popeny. em azdi�may mnirecinB �h licenae! mnVaclas ro connrua Ns popd (Ssqun ]ou. &ni�se eM a�m�o�a coee: rna com,eao� �tia�» �. a� oa wdv �o � ow� d ww«ir ..no n,�aa « imwa+e. �ne�.o� .�a wno comrecp M wM O�e wnh e oonlredor�s) IkenseE Ounuanl to �he CanUepore Liceme faw). ❑ 1 em ezemq uMv Seclion: B. 8 P.C.. Ip ihia reeam: Dete: Owner I do Aneby ronJy thet I em ewera d arM wderstarM iM requiramania d Celipnia Heellh eM Selely CaEe SeUioro?SSOS. T5533. end 2553s. vM ihm I a ury Mum buiNmp ocwpam xill / wil rw� (a�cb mal neeA lo canply tih eaid mma mdes aM tho iepuirsmaN kr e pertnn IamnsWclion w moEififetbnhomiMAirauTty .{Tanepement Dipria. RpideMiel conq�upion eppf�bm e�e exempimm Ihaea prpvisqns. Dma: RpqicaN: WOPKER'S COMiENSATION OECLAPATION: I Mreby elfirm uMer panelry d perjuy wro d iM lallowiip Aedvmiom: ❑ IheveeMxilmeintanettnAratadmnxntioeaX�inaunMwaken'canpmwian,apovidediwbySamon3]OOd�Mlebv Cotle, la IM pMamaica d Ne wak lor wNch Nie pamn u muad. �l I heve enE xil meinlan �wMii mmpnaation ineurence. m rpuireE by Seuim J]00 M the lebor Cada. br tM peAormema d IM �i woA la which ihie permil ie imuaE. My waka�e oompensetbn insurarice cemer eM pdiq number are: c�,: FARMERS EXPIRES aa� t+�mng 0 2/ O 1/ 9 7 ❑� eecYion neeE nIN be eanpbfeC I fhe peimt ie M one hVMm! dWlen (S10J) w bea.) I oMdy Net in N'perlamercw d Ihe wak for xfi'rh thia pem�il o baueA, I ahdl eM amplo�y erry {aem in ury menw � n lo �— I b�ec9mqw�w �e(yd o the wAas' compemelion bwe d Celibmie, en ii}e��t}�et i'I' bouM�• aEptl 10 IM wa'bn' Dma: 1 V �() ��d Saeion 3]OD d tha labor Cade. I dWI ton '/` �6N Q� rO�� •od�em: I Waml�p: F�llurs ro sscun worken'rorryeiwtlon eovorps li unbNNl, mtl alWl alb/ect �n x�ployer ro MMIuI pxWtlp uM elrll llnu up ro om hintlretl thouse�q tlollen ftt00,000A M�AUfbn ro N� cwt ol rompxuefron, Evnpu n poHtlM ror In Sectlon ]lflb o/ Ms LeborCOM, /nterest, erW attomsy's /ess. CONSTqUCiION LENOIN6 110ENCY: I Mreby elfirm uMx penelly d parjury thet tMn o e mmleWion bnE'vp q�en.y far iM panamence d �n. wax ror wnl A �n's wmJ ia :suee (seeun xs�. cw. cl. - LENUEH'S NAME: LENDER'S ADDPESS: i�un inm i n.�re �.e mn m�w�, �e am, inm in� mo� ��i�m�, 4��a. i�u� �o �w.mn.n w.m �,�m aa��. end etete lexs rele�inB �a �iltlin0 ��ruabn eM heraby aulhorae �apresenletivee oi ihie cny to enter �pon �M ebove�meMbned poparry IwinapeGion Wrposea. P T PADILLA Pom Neme M� �� ome: �_..a�.._ .v.,. .,,��^c (5151-1fi.WP) Whib-BuiIE'up 8 Sdaty: Green-Fle: Cenary-AppYranl; Fnk-Revenue: Gddenro�b�mmr CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 079835 PERMIT NO; P 079835 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH JOH DESCRIPTION : REPLACE WATER HEATER SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: REPLACE WATER HEATER +�**************+��**x��**********� x�*�t��t * �t ***� ***�t*�t*�t**�***��t****�**��+�*x **�x ***�r Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 14165250 ZNE: REF NO: PLANNING NOTES> � i iF iF 1E iE iE iE �E iF iflE �E iE aE iE iE iE iE it iE iE iE ft iF iE 1E 1E iE iE 1k iE iE fk iF iE 3E iE fE fE iF iE ik k iE IE if ik iE iE iE iE iE iE ik iE iE iE iF fE It rt iE iE 1E 1E if 1E iE iE if it iE �E iE �E 1E iE 1f IE jE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED HY DATE; BUILDING APPROVED BY : DATE; APPLICATION ISSUED BY; �� DATE: �_----�� 1E'IEiE'1E1E1E�EiE'IE1E�E1E1liE�ElEiEiFifififiF3F�3Fi�f�F�F3f3F�3F�F�F iE ��F3f�f3f��3F3F�F�iiFTf�3F3f�fIt�E1E1E1f4E1Eikib�E 1E LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING 'ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 11.00 258 SMIP/NON—RES PLAN ISSUE FEE 22.00 HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 11.00 22.00 0.00 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 33.00 TOTAL PAID DUE 33.00 33.00 ,00 33.00 OVER/SHORT: .00 FIRE SMIP/TOT GRADING PLAN—CHECK 1k �k 1E �E �f fE iE �E k iE iE iE iE if 1E 3E iE 1E iE 1E iE ff IE 1F 1E iE �E iE If iE iE iE IE �F iE IE i! 4 if iF dF if if 1k 1E fE IE 16 ik if 1E iF 3f IE iE fE IE iE iF fF 1E 1E 1ElE 1E iE iElt i! 1E if iE iE iE 1E 1E �)E iE iE I N D I V I D U A L F E E H R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 WATER HEATER AND/OR VENT 11.00 11,pp END OF FEES EXPIRED L� DAT� r � 01 00216595-00216545 TO T 33.0� DATE: SD/�8/95 .TIt1E: 1I:07 PN0.IECT PODXESS: 'j ], O H MC KINLEY WY OWNEN'SNRME: FIREBAUvH RODRESS: SAME AS ABOVE UNIT: � 714/662-2120 ' �RflCWENGINEER: . • flEG.NO.: � •AOUBESS: � ' � UNIT: PEHMIREE: NOCK PI�UMBING � (714)895-1246 eooeess: 11610 SEABOARD CIRCLE - ' , STANTON CA 90680 UCENSEU CONTMCTON DECUMTION: I here�y affirm t�at I am licensetl unUer provisions of ChaD�er 9(wmmencinp with Section 7000) ol Division 3 oi t�e Business an0 Protessions Cotle, an0 my lice e is in full torce antl eHect. anuc.:050386 sT�reuc.:511971 �Ss C-36�,,, _ Q � Oate: �_ _�=5 — �� SipnaNre: "�� V V ��1 OBNENS' COMPENSATION OECUMTIOX: I here6y attirm ihat I �ave a cetlificate ot cansent ta sell-insure ar a cerli(cate af WOBers imDensition Insurance or a certifietl copy tAereoi (Section 3800, Lab. C). voucr Ho.: 116 7 9 9"l - 9 0 E%P. ORTE: O 3 I O 1 I 9 1 wrnr�Hr: STATE FUND �� Cetlifiea copy is �ere0y furnisheO. � Ceriifietl coDY�is fileU Ih [he ciry Builtling Didsion. _� �ate: �� S —�� Applicant: �-�� FXEMPTION FlIOM VIOBNEIIS' COMPENSRTION DECIAMTION: (This secuon need not De mmDleted if ihe Oe�mit is for one �uiMreE (5700) or less). I certity t�at in the Oe�ormance of the work for which this De�mit is issueA, I shall not emDloy any person in any manner so az to hecome ' suEject m Ihe Workers' Compensation Laws oi Califomia. Date: - ' SignaNre: NOTICE: II, alter makinp @is Oeclaaiion, you should Oecome subjeci to IAe Workers' Compensation Drovi5ion5 of the LabOr Cotle, you mu5i fotlhwi�h wmply wiih such provisions or Ihis permit shall he OeemeE revokeA. CONSTHUCfION LENUING �GENCY: I here�y aifrm I�at tAere is a consimction lentlinp a0ency for the perlormance ol Ihe work for which this Oermi� is issuetl (Seclion 31197, Civ. C). lFNOEH: nooxess: OWNEP BUIWEH DECUMTION: I.here�y aifrm IAat I am exempt from [he Coniractors' S[ate License Law for Ihe tollowinp reasan (Section 7031.5 Business and Pmfessional Cotle: My ciry ol wunry w�ic� repuires a permit to conslruct, alter, imD�ove, Oemolish, or reDair any stmcWre, Drior ro its issuance, atsa requires ihe apD�icant for such parmit to tile a siqnea statement [hat he/she is IicenseE pursuam to tAe D�oNsions ot Ihe Cantracrors' State License Law (Chapter 9(commencing wit� Section 7000) at Division 3 of t�e Business ' anE Professions COAe) or that he/sha is exempt therefmm antl tha basis lar ihe alleye0 exemption. My Nolatian oi Section 7031.5 by � applicant toj a permh sublects tha apDlicant to a civil penalry of not more than five Aun4reE Oollars (5500). I, as owner of Ne properry or my employees with wapes as their sole compensation, will Oo Ihe wark, an0 [he L7 simcture is not intenAeE or oflereU lor sale (Section 7044, Business and Protessional CoUe: Tha Controctors' Stata License Law I Aoes not aDPly lo an ownerol a proDerty who builds orimproves Ihereon, antl who does suc� work himsetl/herseli orthmuph his ar Aer own employees, provitle0 that such im0�a�ements are not intentleU or atlere0 far sale. If, �owever IAa buildinp or impmvement is soltl witAin one year oi com0letian, tAe owner vnll have ihe OurOen of Draving he/she tli0 nat Ouild or improve lor ihe purpose of ule). I, ss owner at t�e properry, am exclusively coniractinq vnih licensetl contractars ta mns[rucl tAe Dmjact {Section 7094, Business ' � ' and Professions Cotle: ihe Coniractors' SGte Licensa Law Uoes not apDly to an owner of pmperry who Cwlds or impraves thereon I antl wtio contracts br such pmlects cith e comradm�s) license pursuant to ihe Contractors' State Lmense Law),I am aware that pmaf of their Worker's Campens:tlon insurance s�oultl be pmvitled ro me. � I am exempt unAer Section: B. 8 P. C. for tAis reason: . ; CITY OF COSTA MESA - bUILDING PEkMIT PERM NO: P. 047976 PEAMIT NO; P 047976 PLAN CHECK NO: N GOVT: N,SUPP:,N CONSTRUCTION TYPE; PERMIT TYPE; PLU PURPOSE; OTH JOB DESCRIPTION : WATER HEATER REPLACEMENT SQ FTc' - � CLAIM VALUE: CALC-VALL'E: GROUP OCC: '/ ", COMMENTS: * jE iE it it iE iE jE it iE 1t iE jE jF iE iE if it ik iE iE it iE iE iE iE it iE iE iE iE it it iE iE it it iE jE it+t it if iE rt iE iE iE if 1E iE jE iE it 3F 3E jE �E 3E it 3E iE it iE it iE at if 3E it iE if if�iE iF it iE iE * 1E Z O N I N G R E Q U I R E M E N T S S E T b A C K S ------------ MAIN BOILDING ---------- FRNT: FT IN REAR: FT IN LE£T: FT IN RGHT; FT IN ------- ACCESSORY HUILDING --------= FRNT; FT IN REAR:• FT IN LEFT: FT IN RGHT: FT IN PARKZNG REQ: PROV: PARCEL: 11910302 2NE: REF NO; PLANNING NOTES> � ' > '. " jE 1P iF iE aE jE jE if iE k if iE iE if iE iE iE iE iE iF iF iE it if if iE iE if iE if 1f 3E iE if it 9E i(� jE iE iE jE �E 1E iE it if iE'jf.it iE iF jE * �f iE jE iE iElE iE it ik it 3E �E iE iE iE iE iE iE iE iE 1E jE {F jE iE ik D E V E L O P M E N T S E R V I C E S�� R E Q U I R E M E N T S ZONING APPROVED BY �� DATE: BUILDING APPROVED bY : 1 DATE: APPLICATION ISSUED bY;� DATE: �,�F�� iFititiEiFfkiEiEiFiEiEiEitiEiEitit'lE±E?tiEfE irx� itikiEjEjtiliEifiEiE r iEiE if !F 3f iE if 3f if if iE jE iE iE iE iE iE iE iE iE if iE iE iF iE jE iE ik iE iE iE iE 1E iE if iE iE jE iE iE iE 1E iE iE iE iE if iE 1E iElE ik iE iF iE iE �E jE ik 3F iE iE iE jE if iE if iE %9f iE iE iE iE iF iE if iE iE fE 3E LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENTcN BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRAD,ING PERMIT 2.00- � ' 25� SMIP/NON-RES PLAN - ISSUE FEE 3.00 , BUILDING-DIV-> PERMIT ISSUE YLAN-CHECK TOTAL PAID DUE TOTALS----> , 2.00 3:00 0,00 5,00 5.00 ,00 REVENUE DIVISSON TOTALS--> COLLECTED: 5.00 OVER/SHORT: .00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK J,OO , *'� �t'x� *'x� * �r'� * �'� * �' * i�'�'x�'�'x�'x� *'�'x-x- x�'� *'ia x' �' �t �' * x' * * ae �' � x�'x-*'�t'x'� �c- *'�+e x'x� �t * �t �"� * �' *'� * �r * �-*'x'x� * *'rt'�'x' � * T *'� �t I N D I C' I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST oate: � ��e�: I PLU I Oo hereby certity t�a[ I am aware af an0 untlerstanE the requiremen[s o/ Calitornia Health and Satery Cade Sectians 25505, 25533, antl 25534 anA t�at I or any luture buildinp occupant will/will not (circle one) nea0 ro compN ��h saitl state codes an0 tha reduiremanis for a permit for constmctwn or mo0itication imm Ihe Nr Uualiry ManaOement Distncl HesiOential consimction aDDlications are exempt imm thesa pmvisions. � Date: Appliwnt - I hereGy certity ihat I have rea0 this apDliwtion antl state ihat tAe a6ave information is or0inances anE sGte laxs alatinp to EuilOinA ��struction anE �eaEy nza re0�sent propBM ��orinspe�ct^i0n purposes./� �� Oate: / � 7 � �(l $ipnaWre: Driver's License or Sociai Security x: com0ly vnth all ciry anC wunry enier upon [he abovEmBntlone0 1601i6 W�i�e—BuilOing: Grean—Cotle Enlorcement; Canery—ApPlicem; Vink—Revenue; GaltlenroC—Aueasor 1 WATEft HEATER AND/OR VENT END OF FEES 0 r �� 2.00 O1 t]QQoc572-OQQbbS]2 T�i�T 9fiTE: 07/31/9p T2fIE: 1.5:;0? 7.VV CONSTRUCTION AND PLANNING � TOOL �, oPA � APPROVALS Permit # Date Inspector pppROVALS - Permit # : Date -Inspector� 7. Temporary Electrical Service or Pole - 52.' Pool & Equipment Location 2. Soil Pipe-Undrgrnd. , . 53. Steel Reinforcement � � � 3. Electrical Conduit Utility-Undrgrnd. - 54. Forms . � 4. Electrical Conduit�Undrgrnd. f � 55. �Electrical Bonding 5. Steel Reinforcement = � 56. Rough-Plumbing.& Pressure Test 6. Electrical UFER Grnd. � ' 57. APPROVAL TO COVER•GUNITE • 7. Footings � � � 58. Electrical Conduit�Undrgrnd. � - 8. Foundation �_ " 59. Gas Pipe, O Undrgmd., 7est . _ 9. Water Pipe�Undrgrnd. � . 60. Backwash Cines, P-Trap, � Undrgrnd. 10. Structural Floor Svstem- ' � - � 61. APPROVAL TO DECK " 11. PropertY Sewer Line & House Connection � 62. Backwash & Receptor-Final 12. Sewer Cap . 63.• Heater'& Vent-Final � 13. Roof Drains � 64. Plumbing System - Final �' 14. Rough Plumbing - 65. Electrical-Finaf , 15. Rough Electrical-Conduit � . 66. Solar System-Final 16. Rough Electric Wiring' ^ . 67. Fencing & Access Approval �� , 17. Rough Wiring Sign . , 68.�.APPR�OVED FOR.PLASTERING � 18. Rough Electrical�T Bar Ceiling � 69. POOL/SPA SYSTEMS FiNAL 19. Rough 4eating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure '. 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe�Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceilin9 (Su�cturap & Monocoat 75. Dry Chemlcal - ' 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulat�on ;r 78, FIRE PREV. FINAL 30. Drywall Nailing -.\ � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. ElectriCal Power Meter�Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ' . 34. Final Heating & Air Conditioning � . 35. Final Gas Pipe-Test - 36. Hood or Canopy . 37. Final Factory Fireplace . 38. Final Plumbing ' � �j0 (�� 39. Water 5ervice-Final , 40. Gas Service�Final ' . 41. Solar pomestic-Final . � 42. Backflow Preventer , 43. Backf�oW Irrigation� 44. Landscape Irripation System ' 45. Sound Attenuation � 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING 'r 46. FINAL PLANNING .% 49. Electric Release to Edison - � 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOFOCCUPANCY No. Date . � 18774 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 C087A MEBA. CALIFORNIA For Applicanf io Fill In Compleiely TYPE OR PRINT B��L�DING �'�nS� M_!/ �'[: /.,.t /ll.... ' i � COSTA MESA. ■ MAIL OF LOT U.� X �OY'% ' I Now ox oTe USE OF EXISTING BLDG. OHTBACK YNC PflOM � [� ' 7A DESCRIPTION OF WORK I X II ALTERA710N I II ADDITIO c.�y AND 1 HEREBY ACKNOWLEDOE TXAT � XAVE FEAD THIB APPLAGTION AND BTATE THAT THE ABOVE 19 CORRER AN� AGPEE TO COM- BUILOINO CON9TftURlOq./�CEB� o�TATpiLJIWB JtC6}I}ATIN CL /%/ ■ AUTHORIZED BUILDING � '_ LEOAL E R�C�{VED FEs _� s iss3 FIN�NCE DEPT. � CITY OF COSTA MESA APPLICATION FOR PERMIT euac�w� For Office Use Only FECEIPT NO. I P9Rl.P�J1( l 1 ! BY I DATE RECEIVED I �ATE IBSf1F COSTA MESA, CALIFORNIA TVPE � GROUP� ZONING NO.OF" U6E OP NEW PUNe� em4A�Nc (CENi6R LINE BT.) '� /�/.�b � �5�% DlK /��i THE AMOUNT BHOWN UNOER VALIIATION 16 POR THE PURPOBE OF EBTABLIBHING A PERMIT FEE ONLV. VALUATION PERMIT FEE $ ��ll � $ �(/' ��/_� PLAN CHECK $ NU � i