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Home My WebLink About2533 ORANGE AVE - Building Permits (2)(714)754-5273 • Fax(714)754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Job Address: 2533 ORANGE AV Suite: D Vicinity: Parcel Nunmber: 43941115 npp�icant: BELL. GLENN Address: 2459 LEE AV BUILDING PERMIT Zoning: � Phone: 626-350-8303 SOUTH EL MONTE � ,- Zip: 91733 Ownec MEKAMBE DEVELOP: Address . � � � / - IRVINE � . , , " � �� _ ' %-�;'/ � Contractor: � AMERICQN;WRECKING INC �. � �Address: 2459 LEE AV� � ,? � ,. • . � � . SOUTH EL MONTE i Phone: 949-476-3133. Zip: Phone: 626350-8303 � Zip:��- 91733�" License: 685192 PERMIT NUMBER I B99-01258 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 08I10/1999 Issued: OB/10/1999 ISSUED 8Y: �� L �\ �\- 2':�: � � :�',' �' � Arch : - . � _ � Eng: � Address: - . � � � --, � Address: - , - . , . � �Phone: - - Phone: � i ��: . r � .ti., . �. , . . � Zip: - .- License: ��Llcense: � � ' � SCOPE OF PERMIT � � � /� DEMOLISH EXIST. SFD. ' �i (.L"/1 �'i � � � t: �� . y r �' � - . ` �' " FEE SUMMARY . � Plan Check: ,, $0.00 �,, ,= l � Calc Valuation: � $a,000.00 � Permit: , $97.25 _ _ _ _ Claim Valuation: . Sa,000.00 SMIP Res: $0.00 - - . .� ,� SMIP Com: $0.00 , Other. $0.00 - - �Inspection: � � $0.00 � � - — � - . � ToWI: $97.25 � � � � PLANNING & ZONING ' � . SETBACKS . � � • � ' .' MAIN STRUCTURE Front . 0- 0 Rear 0. 0 Left 0- 0 ' Right 0- 0 � �"� ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existin : 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by Ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 7 BO days, or if work is suspanded or abandoned for a period of 780 days. . INSPECTIONS: In order for the work authorized under thi�permit to be considered legal, such work must comply with all applicable codes, and all requlretl Inapectlona and (inel epprovel must be obtained. Failure to obtain inspections and tinal approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 � . _ . , . ,, , WORKERS' COMPENSATION DECLARATION: I heraby eflirm undar penelry oi perjury one of the lollowing tleclaratlons: � ❑ I heve and wlll melntain a cetliticate of consent to sel4lnsure for workers' compensetion, es provided for by section 3700 of ihe labor Cotle, for Ihe pertormence of the work lor which t�is permit is issuetl. ❑ I have and will maintain workers' compensation insurance, es required by seqion 3700 of Ihe Lebor Code, for ihe pertormance of Ihe work for which ihis Dermit is issuea. My workers' compensatio/n I�nsurance cartier entl poliry number ew: '� Q Carrier: �Y�� /��Z�i �1.� �; Policy Number. �'i-� �� ^—' (This secfion neeC not be comp/etetl i! lhe permit Is veluetl e( one huntlred dollers ($700J or less.) � I certi thal In lhe edormance ot e work tor which thl It is ' Q I shall not employ eny person in any manner so as to Decome subject to the workers' compensation laws of Califo a, agrea ihet if I -becom u�jec to Ihe workere' compensetion provisions of Section 3700 of tha Labor Cotle, I shall torthwith comply with these provisi � � / � �� Applicant SignaW�e� � Date: WARNING: FAILURE T SECURE WOPKEPS' COMPENSATIdJ COVEMG UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE MUNDRED THOUSAND DOLLApE ($100,000), IN ADDITION TO THE CAST OF CqMPENSFTIqJ, DAM4GE5 AS PROVIDED FOR IN SEGTION 3]O60F THE L4BOR CAOE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONYRACTORS DECLARATION: I hereby attirm Iha� I am torce and eflecL Lic. q_ Contractors Signe�ure: of Chepter 9 7000) of Divis�on 3 of ihe Business and Professions Cotle, end my license is in full aass a '° / Date: CONS7RUC710N LENDING AGENCY: . ❑ I hereby aflilm that Ihere is a construction lending epency for Ihe pedortnance of the work for which this permit is issuetl. (Sec. 3097, CiNI Code). Lender'S Neme: Signature: _ OWNER-BUILDER DECIARATONS: Lendefs Adtlress: Date: I hereby attirm tha� under penalry oi perjury that I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Protessions Code: Any ciry or County which requires a permit to constmct, alter, improve, demolish, or repeir eny s�ruclure, pnor to Its issuance, elso requires the applicant for such permit to tile e slgned ste�ement ihat he or she is licensetl pursuent to the provisions of the Contractors License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 ot Ihe Business and Pro�essions Cotle) or Ihet he or she Is exempt iherefrom antl Ihe basis tor the ellegetl ezemptlon. Any violation of Section 7037.5 by eny appllcanUor a permit sub�ects the eppliGant to e civil penalry of nat more then fiva hundred tlollers ($500).): � I, as owner of the property, or my employeas with weges as their sole compensation, WILL DO 7HE WORK, and the siructure �s not intendetl or ottered for sale (Sec. 7044, BusinBss and Professions Cotle: The Contrectors License Lew tloes not epply to en owner at property who builtls or improves thereon, antl who does such work himself or he�self or thmugh his or her own employees, provitletl t�at such improvements are noi intended or oHered for sale. If, however, the building or improvement is sold within ona year of completion, the owner-builder will heve the burden of proving that he or she ditl not build or improve for purpose ot sele.). ❑ I, as ownar af the pmperty, am EXCLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS to consimct the pro�ect (Sec. 7044, Business antl Professlons Cotle: ThB Ca��/aCbrs License Law do85 no� epply to an owner of properry who builds or imprOves Ihereon, end who contrects lor such prolect with e contrecmqs) license purs�ant to the Contractors License lews.). ❑ I em exempt untler sec. Business antl Professions Cotle lor this reason: Signatura: Date: Owner ID verified by tlriver's license. ❑ Ves ❑ No Driver's License No. Expires: Veritication ol Ownership by (rype of document, i.e. - property tex bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMI7 CERTIFICATION: ❑ I hereby cenity ihat no eacavation five (5) or more feet In depth into which a person is reqWretl �o descenq will be made in connection wi�h work authorized by this permit, and �hat no building sirucWre, scattoltling, falsework, or demolition or Oismantling thereof, will be more Nan Ihirty-siz (36) �eet hig�. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Gelitornia Atlministretive Code). ❑ As owner-builder, I will not employ anyane to do work which woultl require a permit from the Oivision of Intlusirial Safery, as noted above, unless such person has a permit to do such work from the tlivision. Signature: Date: Dihsfon of induslrial5afery Pertnit Num�er. CERTIF{CATE OF COMPLIIWCE ANO AUiHORIZP.TON OF ENfRY: 1 ceM1ily undar panalry oi per�ury that 1 have read this applicatioa and state that the infarmation givea is wrtecL I agree ro comply with all state laws and ciry ordinances relating to building construction, and authorize representatives ol the Ciry oi Costa Mesa to entar upon Ihe ebove-tlescrl6ed property for inspection purposes. I agree not to occupy or allow occupancy of any buliding authorized by this pertnit untll finel inspectian. COOE N. 1ty5PESIl4N� Q97E inrmnus 1fi16 Fixetl Sys�em Finel Fire Prevention 1266 200 201 202 203 Pool Spe F�nal Final Re-R�� Finel BIocWRetaining Wall Finel Fectory Flre Place Finel Sign 204 Final Demolition 264&68 COOEN INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbinq 210 Final Electdcal 212 Finel Fire Preven�ion 220 Finel Planning Approval 222 FinalSite 250 Final Building/Occupancy j18jE IINTTIA�S .• � �� J•, SOUTH COAST AIR QUALITY MANAGEMENT DISTRtCT NOTIFICATION OF DEMOLITION OR ASBESTOS REMOVAL 21865 E. Copley Drive, Diamond Bar, CA 91765-4185 (909)396-2000 MAIL fORM AND FEE TO SCA�MD, ASBES70S NOiiFICATiONS, FILE 0 55fi41. LOS ANGElES, CA 90074-5641 AQMD USE ONLY SCREEN BY RECEIVED POSTMARK ENTERED BY NOTIFICATION � COMPLETEO BV Duarte M. COMPANY Ameriwn Wrecking, Inc. PHONE (626) 350-6303 DATE 07l30199 CHECK# FEES PROJECT# A99104D NOTIFICATIONTYPE or+i. GINny Revisror+onrEs REVISIONOiMER(tvyNghl) cnwc.��una+ PROJECTTYPE OEMOLRqN OHDEREOOEMIXffqN RENOVATtON(mncval) EMPRGENCYftEMOVAL PtANHEDRENO(arcual) SITE INFORMATION SITE NAME COMMERCIAL SITE qDDRESS 2533 D ORANGE AVENUE CROSS STREET MONTE VISTA CITY COSTA MESA STATE CA ZIP COUNTY ORANGE DESCRIBE WORK LOCATION Demoiition of SWctures alxl Site Clearirg BUILDING SfZE(SQ FTj 3696 NUMBER OF FLOORS 1 BUtLDING AGE (YEARS) 2535 NUMBER OF OWELLING UNITS BLqGPR10RlPRESENTUSE C9MMERGW_ HOSPffAL WWSTRIAL OTliER OFFICE %18LILBLDG. RESIDENCE $CHOOL SIYP UNN.COLLEGE SITE OWNER MEKAMBE �EVELPMENT GROUP LLC ADDRESS 17775 MAIN STREET SUITE B CIIY IRVINE STATE CA ZIP CONTACT BRETT ISAACMAN PHONE 949-476-3733 REQUIRED BUILDING ASBESTOS YES NO ASBESTOS YES NO A58ESTOS VES NO BUILDING TO BE YES NO INFORMATION pRESENT? YES SUftVEY? YES ftEMOVED? YES DEMOLISHED? YES PROJECT DATES START OBl13199 END 0825/99 WORK SNIFT(artJpm) AM ASBES70S AMOUNT TO BE FRIABLE CLASS t CIASS II TOTAL REMOVED (add row) REMOVED (in square fcet) ASBESTOSREMOVEDFROM SURFACES PIPES COMPONENTS DESCRIBE NP@ 8 AMOUNT ACOUSTIC CEILING LINOLEUM INSUL4TION FIRE PROOFING DUCTING STUCCO MASTIC OFASBESTOS FLOOR TILES (VA'n DRV WALL PLASTER TRANSITE ROOFING OTHER (desaibe) CpNTRACTOR INFORMATION CSBL LICENSE 3 685192 OSHA REG # AQMD IDC 97316 NAME American Wredcing, Inc. ADDRESS 2459 Lee Avenue C17Y South El Monfe STATE CA ZIP 91733 SI7E SUPVR DON COBLER PHONE (626) 350-8303 WqSTE 7RANSPORTER #1 LANDFILL ORANGE COUNTY INTERGRATED LANDFIIL ApDRESS ADDRESS P.O. BOX DRAWER 1955 CI7Y STATE ZIP CITY SANTAANA STATE CA ZIP 92702 Rub 1403 anC NESMqP ASMstpa Nahlca0on Form REV 9]p6ID ta03 FR9] pppg � p� 2 Fams. bntrUctims. uM ihe RNe 1 W3 en ba o0L'tln via FA%.94CN h' 4��9 M1Oen a la�ptqrie (909139&1250 m tl�iou9� AOMD we� Me M�'/Iwv.w.aN� W�'�M�a#ixh�tr�Y TRANSPORTER it2 SCAqAD NOTiFICATION OF DEMOlfT10N OR ASBESTOS REMOVAL WUL ORIGIANL TO SCAQlAD, ASBE5T05 NOTIFICA710N, FILE C 55661 LOS ANGELES, C0. 9007456N STA7E ZIP SITE OLS: DESCRI6E WORK PRACTICES AND CONTROLS TO BE USED AT7HE DEMOLITION AND RENOVATION SITE, FOR ASBESTOS REMOVAL INDICATE RULE t403 PROCE�URE!! i, 2, 3, 4 Oft 5 OR COMBWA710MS OF PROCEDURES USED. FOR PROCFDUF2ES 4 AND 3 SUBMIT AiANS IMb PRIOR APPROVAL. PROCEDURE k: FSBESTOS DETECTION PROCEDURE: DESCRIBE THE METHODS AND PROCEDURES USED TO DEiERMINE WHEfHER ASBESTOS IS PRESEM ATTHE SITE, INC�UDING lHE ANALYTICAL METHODS (wrvey, Wlk semplinp, inspedron, aSsu�MC ACWM, elC.): FOR OEMpLRONS GNE iHE COAIPANV NAME AND DATES OF THE ASBE5T05 RENOVAL: FOR ORDERED �EMOLITION SEND A COPV OF iHE ORDER AN GNE THE AGENCY NAME: AUTHOR17jNG PERSON: DATE Of ORDER: TITLE: DATE ORDERED TO BEGIN: POR EMERGEMCY ASBE5T05 RENOVAL GIVE 1HE NM1E AND PHONE NUMOER OF THE PERSON DECLARING/AUTNORILNG THE EMERGENCV, DATE P.ND HOUR OF EMERGENCV AND DESCRIBE THE SUDDEN, UNEXPECTEO EVENT: � EXPLAIN HOW THE EVEM WOULD CAUSE UNSAF[ CONDITIONS, E�UIPMENT DAMAGE OR UNREASONABLE FINANCIAL BURDEN: CONTINGENCY PLAN: DESCRIBE AC710NS AND PROCEDURES TO BE FOLIOWED IF UNEXPEC7ED A59ESTOS IS FOUNO DURING DEMOLRION OR NONFRIACiLE ASBESTqS MATERIAL BECOME CRUMBLED, PULVERIZED, OR REDUCED TO POWDER. STOP D�YOLITION WORK AND NOTFY AOMD. TRAINING GERTiFICATION: I rertity Uat an i�MiviCual treineA in ihe provisass of mpulatirn A�MD Rule 1103 md NESFNP will be m siie Grirg Vre renwval aM ¢Ntlence Nat Ne mpuimU VaininB �s been accanplisAed by Uiis person will Ae availde la iMpetlion Curirq rwrmal dsiness hqrts. MFORMqT10N CERTIFICATtON: I certify Ihat Ihe above iMoimalio is cortcU a�tl I have mdosed am/ AdERICqN WRECKING, INC. PR0.IECT COORDINATOR CONPANy NAYE pp�NT NANE OF OWNER/OPERATOR M'� E OF OWNER/OPERATOR nnE OF OWNERIOPERA" Notl(ra�iq�.s aie rrot acceple0 wiU�w'1 the required asDestos �ee (AQMD Rule 301). Removals ol le � 100 squaie feet me exemp� Gwn Iroteficatiai tees. Piease rtWke dmck payable to'SCA�MD'. Fees ere per notifiration, nol rehuMaWe, arM vary acroNvW to the asCestos amaml Io De remwetl. Fees are az IOIMws. FROM1001pt.0005WIMEFEET i28.i0 FRdI1.00t TO 6.000 SpUARE FEEf i90.10 vaou s,00� �ro io,oao wunrse �r sia�.+o NOPETHqMt0,0005Q1111REFEET f2W.00 RESIDENTqI REMOVILLS RENSqM OF NOTIRCATKIM GMCELLATON OF NOIiFlUTOM PROCFDURE l OR 5 PlANS RETUftNED CHECN CHRRGE KceP a cWY of yqa �aotlmbon. State lew rapivet l�at Y^� puviGe a mPY d Te tlenq4Gon rotifimtm b Bu1Gv5 dM S�M' Defore rsvarirn d a�pdm pemv� 62336. FaYav comc�ienm deme maY Ta brm arM tee eM Eo rot nane ram m A�M�. YAIL FOkN AND FEE TO: SCAQMD, ASBESTOS NOTIFICATIONS, FILE 0 55661, LOS ANGElES CA 9007�.5661 TELEPHONE :(909) 3%-2336 FAX :(909) 3%J1lY AsOeslw DertroldioNRerrovstion Notifiq�iM Form REV 9906p1 Fortns, ins�n�pions, arW Ihe Rule 1403 can �e o��ainetl AOMD weG sile. http:!/W W W.iqmd.90Y t36.10 510.l0 i O.aO ttYa.00 f2B.00 f26.00 Pape y ol 2 SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT NOTIFICATION OF DEMOLITION OR ASBESTOS REMOVAL 21865 E. Copley Drive, Diamond Bar, CA 91765,4185 (9D9)396-2000 MAII FORM AND FEE TO SCAQMD, ASBESTOS NOTiFICAT10N5, FILE 0 55641, LOS ANGELES, C0. 90071-5647 AQMD USE ONLY SCREEN BY RECEIVED POSTMARK ENTERED BY NOTIFICATION �t COMPLETED BY Duarte M. COMPANY American Wrecking, Inc. PHONE (626) 350-8303 DATE 07I3Ql99 CHECK# FEES PROJECT# A99704D NOTIFfCATIONTYPE oaicovai ftEY1SIONOATES ftEVfS�ONOniER(NgMg�ry caacEiunav PkOJECTTYPE DEMOULION IXtOEREDDEMOLITION RENOVnTIDN(ranovap EMERGENCYREMOVAL PIANNEDRENO(anmial) SITE INFORMAT�ON SITE NAME COMMERCIAL SITE ADDRESS 2533 E ORANGE AVENUE CROSS STREET MONTE VISTA CITY COSTA MESA STATE CA ZIP COUNTY ORAN6E OESCRIBE WORK LOCATION Demolition of SWctures and Site Clearing 6UILDING SIZE(S� F� 4000 NUMBER OF FLOORS 1 BUIL�ING AGE (YEARS) 2535 NUMBER OF OWELLING UNITS BLDG PRIOR/PRESEN7 USE coµMFR�iu �+osarrry wousrnw� on+Ea o�cE PU&JC BLDCa. RESIOENCE scHoo� sH�v UNN�COl1EGE SITE OWNER MEKAMBE DEVELPMENT GROUP LLC ADDRESS 17775 MAIN STREEf SURE B CITV IRVINE S7ATE CA ZIP CONTACT BRETT ISAACMAN PHONE 949-4�&3133 F2E�UIRED BUILDING ASBESTOS VES NO ASBESTOS VES NO ASBESTOS� YES NO BUILDING TO BE YES NO �NFORMATION PRESEN77 YES SURVEY? VES FEMOVED9 YES oEMOLtSHED? YES PROJECT DATES START 08/13199 END 08f25l99 WORK SHIFT(am/pm) AM ASBESTOS AMOUNT TO BE FRIABLE CLP,SS I CLASS II TOTA� REMOVED (atld row) REMDVED (in squaro fec�) ASBESTOS REMOVED FROM SURFACES PIPES COMPONENTS DESCRIBE TYPE 8 AMOUNT ACOUSTIC CEILING IINOLEUM INSULATION FIRE PROOFING DUCTING STUCCO MASTIC OFASBESTOS FLOOR TILES (VAT) DRY WALL PIASTER TRANSITE ROOFING OTHER (tlescribe) CONTRACTOR INFORMATION CSBL LICEMSE # 685192 OSHA REG A AQMD ID7 97376 NAME Amcrican Wtecking, Inc. ADORESS 2459 Lee Avenue CITY South EI Mon[e STATE CA ZIP 97733 SITE SUPVR DON C09LER PHONE (628) 350-8303 WASTE TRANSPORTER iFi LANDFILL ORANGE COUNTY INTERGRATED LANDFILL ADDRESS ADDRESS P.O. BOX DRAWER 1955 CITY STATE ZIP GTY SANTAANA STATE CA ZIP 92702 Rule t4pJ eM NESMAP Aebesloa NotrtcaUon Form REV 9JOb20 �d03 FR9'! pape � ot Z Forms. mstnxfrons. arplRe RNa i403 tan Gr oda+via FA%.BAGN py @abp hpn a fa�,tar�e (90913%2230 aVvagM1 AOMD web sitalM1�:/Mkav.eanq.govprrrtaM¢cic.hpiy TqqNSPORiER42 AbORESS SCAOMD NOTIFIGATION OF DEMOLITIDN OR ASBE5T05 REMOVAL MAIL ORIGUW L TO SCAQMO, A56E5T05 NOTIFICATION, FlLE i 55641 LOS ANGELES, CA 9007�-5641 STAiE ZIP SITE TROLS: �ESCRIBE WORK PRACTICES AND CONTROLS 70 BE USED AT THE DEMOLRION AN� RENOVATION SITE, FOR ASeESTOS REMOVAL :K, INDICA7E RULE 1407 PROCE�URE tl 1, 2, 3, 4 OR S OR COM6INATIONS OF PROCEOURES USED, FOR PROCEqURES a AND 5 SUBMIT PLANS AQMD PRIOR APPROVAL. PROCEDURE C: STOS DE7ECTION PROCEDURE DESCRBE THE METHODS AND PROCEDURES USED TO DETERMINE Nhi�THER ASBESTOS IS PRESENT AT THE INCWDING THE ANALVTICAL METHOD6 (survey, Wlk smnplinp, itSpeUion, azwrtied ACWM, etc,): DEMOLITONS GNE THE CONPANY NAME AND DATES OF TME ASBESTOS REMOVAL: FOR ORDERED DEMOLITION SEND A COPY OF TNE ORDER AN GIVE THE AGENCV NAME: AUTHORVJNG PERSON: DATE Of ORDER: TITLE: DATE ORDERED TO BEGIN: EYERGENCY ASHESTOS REMOVAL GNE THE NAME AND PHONE NUMBFR OF THE PERSON DECLARING/AURiORILNG THE EMERGENCY, DATE HOUROFEMERGENCVANDOESCRIBETHESUDDEN,UNEXPECTEDEVF.NT: HOW THE EVENT WOULD CAUSE UNSAFE CONDITIONS, E�UIPMENT DAMAGE OR UNREASONABLE FINANqAL BURDEN: GOMINGENCV PLpN: DESCRIBEACiIONS AND PROCEDURES TO BE FOLLOVJED IF UNE%PECTED AS9ESTOS IS FOUND DURING DEMOIJTION OR NONFRIABLE A59ESTOS MATERL4L BECOMF CRUMBIED, PULVERIZED, OR REDUGED TO POWDER. STOP DEMOL�710N WORK AND NO71FY AOND. TRAINING C�RTIFICATION: I certify Ihal an i�dividual tramed m ttre provisims ol regula0on AQMD Rule 7403 aM NESFIAP will Oe on site dunrp Ihe rerrqval arM eviUerce �hat Ne require0 trainirig las Eea� accomPlis�etl �Y Nis person will Ee availWe for irtpe<Yion duri�g nmral business �ours. MFORMATION CERTIFICATION: 1�ity Nffi the above'udortnalio is cwred and I �ave erxAosed INC. OF OWNER/OPERATOR PRQIECTCOORDINATOR 0717099 are noi eccepled wiUoul Ihe required asbestos fee (AoM� ftWe 301). Removals o�ss ihan 700 squere feef are emnpf from imfl�calion (ees. r fticrk paya�le to'SCAQMD'. Fees are per rpttliqtim, rrot rehrtMa�le, arM vary a¢atlirq Io tl�e asDestos amount to �e rertwveC. Fees are es idlvxs. 10oTOt,00p50UMEFEET S]!70 t,0pt TO S,OW SUUIIRE FEET SBO.10 6,001 TO 10,000 $OUqqE FEET i18].�0 1NnNto,aooS�VAREFEET tS➢A.oO RESIOEMTNL RELWRL9 REYISlOM OF NOTiFCRT10N fJWCELLATION OF NOTIFIGTION PROCEDURE 9 OR 6 PLAl15 FEiURNED CHECK CNMGE SP[LUL XANOLING FEE KxP a mpy d Y� mtfvom. SWe la« tN�� vat Yau WUMe a�WY W me aamhliw� mmimGon b BUAdI^9 arM $afeh eelom issuarKs ol e narulCon permt. MAIL FORM AND FEE TO: SGA�IIb, ASBE5T05 NOTIFICATONS, FILE # S:d�t1, l05 ANGELES CA 90074-SWt TFt cPHONE :(909) �%-2336 FAX :(909j 3%�1]42 AsEestas DenrolttioM2enavalion Noiificatan Fam REV 990Gp7 Fams, inswaions, ana me au�e iao7 can ee omained a�Mo weE sile. http:lhvww.aqmd.gov fi02u S10.Eo { 0.00 i]9�.00 51d00 Page 2 of 2 (714) 754-5273 • Fan (714) 754-4856 �� CIN OF COSTA MESA _ BI/ILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Job Address: 2533 ORANGE AV Suite No D Vicinity: Parcel Nunmber: 4394'1115 l, : PLUMBING PERMIT PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 08/11/1999 Issued: 08/11/1999 ISSUED BY: � npp�icant: BELL, GLENN �, . ., ` r � ` ' ' _= Address: 2459 LEE AV ;� �' " � - � - .,"� �- - � Phone: 628350-8303 , . � - SOUTH.EL MONTE� � - , . Zip: 91733 ' � ' - Owner�`''MEKAMBEDEVELOP." = . Y �~ ,'� � ; �\� , �� Addre s,��,� ^ �% "�'�.� ./ � \\�\ ��. IRVINE /� � Phone: 949A763133 �� ,� % �,} `� � ��,�� .,�..� ��/ � / A��; 1.�_� � ��-� ��P� ��.. . � �. ,':�.�' j� „ /,�i.,,' � �`� . � .i. '�� ' . . ii.- . Contractor. ; AMER�CAN WRECKING INC ��' � ' � �\ �, f � Address: 2459 LEE AV � � � � � � - - , , - • � " � . - ' , , ,�Plione: � 626350-8303 - - , .. - , ,� SOUTH EL MONTE � ` � - ' �Zlp: 91733 ' , , , , � � � , _- License: 685192' � ' � . ' .� �" ` , , :ArchlEng:'r" %. `�� , � V,- '`. '� � . , Address:�i� , - � r � l � � �. � ":. . . _ Phone: � . -, ' ,"" ` . i ` ' . . � , _ . . .. . �Zip: . .. ... , . . .. � � . . � • � License: � - ' � � =' SCOPE OFPERMIT' . � �� " � � � " � ,�. ,� �,1 SEWERCAP.REF89-01258. _-- , j, i.� � . .. � � � • - � - FEE SUMMARY _:1 . AMT QTY ' --AMT ISSUE �FEE� � � �. $23.50 -• Laundry Tub / Washer . $0.00 Backflow irrigation , ��, $0.00 0 `-�` Landscape Irrigation � . $0.00 Backflow Preventer �$0.00 0 P-Trap ' � � � $0.00 Bathtub � �� ' - � � $0.00 , 0 Pressure Regulator �' $0.00` � Clarifier System � $0.00,,. 0 � .- Process Piping (per 10 H) ., $0.00�� Connea(Ice,Soda,etcj $0.00 ,0 � ��Receptors $0.00 Dental Units �', � j�� $0.00 ��0-� � . Septic Tank - � � i -$0.00 - Dishwasher A �, � , %$0.00 � 0 � . - . Sewer Cap for Demo • $9.80 Drain, Floor `$0.00 ; � 0; � Sewer Connect " ` $0.00 Drain, Rainwater � ' =' $0.00 � 0 SewerPrivate Line . : . � $0.00 Drain, Roof � � �$0.00 _ 0 � " Shower $0.00 Drinking Fountain �$0:00� 0 Sink, bar $0.00 Expansion Tank $0.00 0 Sink, commercial $0.00 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 Gas (1-0 outlets) $0.00 0 - Sink, kitchen � � ' $0.00 Gas (over 4 outlets) So.00 o Sink, service/mop $0.00 Gas Repipe $0.00 0 Spa (private) _ . - � .$0.00' Gas Service $0.00 0 Spa (public) . $0.00 � Interceptors (Grease, Oil) $0.00 0 Interceprors (Sand Auto ) $0.00 0 QTY 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0, �0 0 COMMENTS / SPECIAL CONDITIONS , /. �SumpPump., ,� � Swimming Pool � Trap Primer Urinal ' , Vacuum Brkr BkFlow(1-4) �. Vacuum Brkr Bkflow(5+), _ - Wash Basin, � -„ � " Wash Basin Set Waste and. Vent System - Water Closet (Toiletj Water Heater I vent Water Piping (Inst or Rep.) Water Re-pipe Water Service . ' Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION TOTAL CALCULATED FEES: AMT' $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 $0.00 $33.30 � QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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, 72-21-g2) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a penod of 1 BO days. � . INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspectlona end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. . FOR INSPECTIONS CALL: (714) 7545626 � WOAKERS'COMPENSAnONDECLAFAnON: ` • I hareby attirm under penalry of per�ury one o� lhe following tleclaretions: ❑ I have antl will malntain a certificate of consent to salf-Insure for workers' compensation, as providetl for by section 3700 oi �he Labor Cotle, for ihe peAormance ot ihe work for which this permit is issued. ❑ I have and wiil maintain workers' comp9nsation insurance, as reQuiretl by section �3700 of the Labor Code, for Ihe peAormance oi the work for which this permit is issued. My workers' c.o-m,pTensation Insurance cerner and policy number are: ! / / Carrier. .�i—�/ � �«-� �i . PolicyNumber: �� / �61�/ (This section need not be campletetl i/ the pe�� Is velued et one huntlred dollars ($100) or less.) � ❑ I certify that in the pedormance of the work for whi this per ' is issued, I shall not employ eny person in any manner so as to become subject to the workers' compensetion laws of Celif �and agree that if uld be subject to the workers' compensation provisions of Section 3700 ot the Labor Code, I shall forthwith compty with ihese provi '��,��' �� q /� r�+ G� Applicant Signeture� �L�^�=-=�' "��-=-c.. � c ' �� Date: // �—� � ! / WARNING FAILURE SECUFE1b WOFKERS' CAMPENSATION CAVE GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL NES UP TO ONE HUNDRED THOUSAN� DOLL4RE ($100,000), IN AODITION TO T�1E CQST OF COMPENSATIQV, �AN.AGES AS PROVIDE� F9R IN SEGTIIXJ 3]O6 OF THE LABOR CO�E, IMEREST, AND ATTORNEV'S FEES. LICENSEO CONTRACTORS DECLARATION: I hereby aNirtn tha� I am force and eHecL Lic. N ContrectoYs Signawre Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, antl my license is in full — Class # Date: � �/ -1' CONSTRUCTION LENDING AGENCV: � ❑ I hereby ettirm lhat Ihere is a constmction lending egency tor tha peAormance of ihe work for which [his permit is issuetl. (Sec. 3097, Civil Coda). �� Lentler's Name: Lentler's Address: Signature: Date: OWNER-BUILOER DECLARATIONS: I hereby attirm ihat under penalty of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor �he tollowing reason (SecJ031.5, Business antl Pmfessions Code: Any ciry or counry which requires a pefmit to construct, alter, impmve, demolish, or repair any structure, pnor to its issuance, also requires the applicant for such permit to file a signed statement ihat he or she is licansetl pursuant to ihe provisions ot the Contraclors Licensa Law (Chapter 9(commencing with Section 7000) ot Division 3 of the Business antl Professions Code) or ihat he o� she is axempt thereFrom and Ihe basis tor the alleged exemption. Any violation of Section 7037.5 by any applicem for a permit subjecis ihe applicant to a civil penalty of not more ihan five hundretl dollars ($500).): ❑ 1, as owner of ihe properry, or my employees with wages es their sole compensation, WILL DO THE WORK, and the structure is not intentled or oHered for sale (Sec. 7044, Business and Professions Code: The Contracmrs License Law tloes not appiy to an owner of propeey who builds or improves Ihereon, and who does such work himself or herself or Ihrough his or her own employees, provitled ihat such improvements are not intendetl or oflered for sale. If, however, Ihe building or improvement is sold within one year oi completion, ihe owner-builder will have the burden of proving that he or she did not builtl or improve tor puryose of sale.). ❑ I, as owner of the pmperty, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consimct the prolect (Sec. 7044, Business antl Professions Code: The contrectors License Law tloes no� appty to en owner of property who builds or improves thereon, and who contrac�s for such project with a comractor(s) license pursuant to ihe Contractors License Laws.). ❑ I am ezempt under sec. Business and Professions Cotle for ihis reason: SignaWre: Date: Owner ID verifiatl by tlriveYs license. ❑ Yes ❑ No Driver's License No. Expires: Venfication of Ownership by (type of documeN, i.a. - pmpetly tau bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more teet in depth into which a person is required to descentl, will be made in connedion with work authorized by this pertni�, and tha� no builtling slmcNre, sGenoiding, talsework, or tlemolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title e, Celifornia Atlministrative Code). ❑ As owner-buiider, I will not employ anyone to do work which woultl require a permit from the Division of Indusirial Safety, as notetl above, unless such parson has a permit to da such work from the tlivision. Signature: Date: Division of Indusirial Satery Permit Number: CERTFICATE OF COMPLIANCE AND AUTHOAIZA710N OF ENTRY: I certily under penairy of perjury Ihat I have reatl �his application and stata ihat the inlormation givan is correct. I agree to comply with all state laws antl ciry ordinances relating to building constmction, and authorize representatives of the Ciry of Costa Mesa m entar upon the a6ove-descnbed property for inspection purposes. I egree not to occupy or atlow occupancy oi any bullding authonzed 6y this partnit until final inspection. Oi Le ner s � G-' ate � O � �� Rhorized Appl nt Date COOE 1. INSPELTIONTYPE IILE 1[fIIDAL@ 1616 Fixed System Final Pire Prevantion 1266 200 201 202 203 Pool Spa Finel Finai Re-Roof Final Block/Retaining Wall Final Factory Pire Place Final Sign 204 Final Demolition zaaws COOEt INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 272 Final Fire Prevention 220 . Final Planning Approval 222 Final Site 250 Final Building/Occupancy � � INTI7IALS