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Home My WebLink About2557 OXFORD LN - Building PermitsJob Address: Suite: Vicinity: Primary Occ: Parcel Number. 2557 OXFORD LN THROUGH OUT HOUSE R3 14137411 Applicant: BRADY, TIM Address: 17740 CRUSADER AVENUE CERRITOS, CA Type of Construction: V-N Zoning: Owner. PACKER, MARILYN KATZ;TR Address 2557 OXFORD LN - � � -�_ � , " Phone: 800-204-3854 Zip: 90703 Status: ISSUED Applied: 11/28/2005 Issued: 11/282005 ISSUED BY: � Phone. COSTAMESA,CA . . _tZip ,92626 Contractor. WEST COAST VINYL WINDOWS . � � � Address: ��,17740CRUSADERAVENUE�. �"-'-�� - - �� Phone: 800� CERRITOS, CA Zip: 90703 ' ,. - Arch : Address: ' - Zip: � Phone: �icense:. License: 826970 Eng: Address: ;.. .. � � Phone: License: `� SCOPE OF PERMIT RETRO FIT 7 WINDOWS AND LOWER 7 BEDROOM WINDOW 10" (SAME WIDTH, NO CHANGE IN HEADER). ALL WINDOWS SFiALL MEED 1997 UBC EGRESS REQUIREMENTS. � . ' , Plan Check: $0.00 Permit: t. $9725 SMIP Res: $0.50 SMIP Com: 50.00 Other: $0.00 Inspection: $0.00 Tofal: $97.75 "FEESUMMARY.. Calc Valuation: {. Claim Valuation � � �-F PLANNING&�ZONING � � SETBACKS � -�" . MAINSTRUCTURE Fronl 0-0 � � " "`�Rear� 0-0 �� , _LeR , .0-0 - � " Right.�� 0-0 ACCESSORY Front � 0.0 _Rear -0-0 � �'-left` ��0-0 � -Righl ,0-0 ' PARKWG �`Exis�ina'` -0 . '�,�Reauired�. 0�' ��Pr000sed'��0� " "' � ` ,' � ' .... - . ,�R. � . " _ . . , ' _ a.. '�� . . - — . -�_, - . . � � .�.. -.�y�, _ „.:" . . ...- .. _ sa,oao'oa sa,000:oo NO710E: 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: Thls permit shall automatically expire and become void if work is not commenced withln 180 days, or ii work is suspended or ebandoned for a period of 180 days. INSPECTIONS: In order tor the work eulhorized under this permit to be considerad legal, such work must comply with all applicable codes, and all requlred Inspeetiona and final approvel must be obtained. Failure to obtain inspections and final approval will rasult in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 zaaae �sroo� WORKERS'COMPENSAnON DECLARAnON: � i � I hereby affirm under penalry ol perjury one oi the tollowing tlecleretions: �:• ❑ I heve end will maimain e certificate of consent to seli-Insure br workere' compensatlon, es provitled for by sedion 3700 of ihe LeDor Code, for Ihe pertortnance of ihe wark tor which �his permit Is issuetl. ��avaaad wlll malntain workers' compensatlon insurance, a5 requiretl by sectlon 3700 oi ihe Labor Cade, for ihe peAortnance ot ihe work br which Ihls pertnit is issued. My workers' compensatlon Insurance wrrier�2 policy number ere: o� �.�Yl �o vr�2s 1 J� 2�0-� �„� �vo- 4q �( -o cl is section need�te i1 the permit i valUed ef one M1undred dollars ($100) or less.) ❑ I canity thet in Ihe pertarmance of the work for w�ich this pertnit Is issued, I s�all not employ any person in any manner so as lo become sublect to the workers' compensatlon laws of Callfor ' end egree thet If I shoultl become subJect to ihe workers' compensation provislons of Sectlon 3700 oi Ihe Labor Coda, I shell forthwith complY with these provisi � " APPI.a�s��e--�'re: _ Date: ��,— p� g— U' � WARMN�: FAILURE TO SECURE WORK RS' COMPENSATION CAVERAOE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOV'rER TO CRI��+INAL PENALTIES AND CIVII FINES 11P TOONE HUNDRED THOUSAND DOLLARE (5100,000), IN ADDRION TO THE COSi OF COMPENSATION, DAMAGES AS PROVIDED WR IN SECTION 31060F THE UBOR CADE, INiEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS DECLARATION: ot Cnapier 9(commencing with Section 7000) of DiNsion 3 ot Ihe BuSiness an Pmfeuio s Code, antl my license is in full Cfass# '��H-�f'l �n i� CONSTAUCTION LENDING AGENCY: ❑ I hereby eNirtn that t�ere is a consiruction lending agency lor ihe pertormance ot t�e work tor which this permit is issued. (Sea 3097, Civil Code). Lendefs Name: Signature: _ Lenders Address: Daie: OWNER-BUILOER DECLARA710N5: I hereby ettlrm ihet untler penelty ot perjury thet I am EXEMPT FROM TME CONTRACTORS LICENSE LAW tor Ihe following reeson (Sec. 7031.5, Business end Professions Code: Any ciry or coumy which'requires a permit to construct, eller, improve, demolish, or repeir eny stmcWre, prior to its issuance, elso requires the epplicant for such permit to ille e signed sletement Ihat he or she is licensed pursuent to the provislons of the Contractore License Law (Chepter H(commencing with Sectlon 7000) ot Didslon 3 of the Business entl Professions Cotle) or thaPhe or she is ezempt Ihereirom end ihe basis lor Ihe elleged exemption. Any violatlon o� Sectlon 7031.5 by eny applicant for e pertnit sublects ihe epplicent to e civil penalry ot not more then five hundred dollers ($500).): ❑ I, as owner oi Ihe property, or my employees wlth wages,es Iheir sole compensatlon, WILL DO THE WORK, end Ihe structure Is not IntentleC or oltered for sale (Sec. 7044, Business antl Professions Cotle: Tha Conirectors'Lieense Lew does not epply to an owner of property who builds or improves ihereon, antl who does such work himself ar harsatl ar through his or her own employees, ooCvitled ihat such improvements ere not intended ar oHered br sale. tl, however, Ihe 6uilaing or improvement is sold within one year of completion, Ihe owner-builder will he4a the burtlen ot Droving ihet ha or she tlid not build or improve lor purpose of sele.). ' ❑ I, as owner ot ihe properry, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTOPS to construct Ihe project (Sec. 700d, Business and Professions Cotle: The comrectors License Lew does not appry to an owner of pmperty who builds or Improves ihereon, antl w�o contraas for such projec[ with e comraqor(s) license pursueM lo the Coniractors License Lews.). ❑ I am exempt under sec. Business enA Professions Code lor this reason: Signeture: Data: Owner ID venfied by drivafs liCenSe. ❑ Ves ❑ No Drlvefs liCense No. Expire5: Vedticalion of OwnerShlp Dy (rype of document, i.e. - properry Iex bill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certify Ihel no e:cavation five (5) or more feet in dep�h into which a person Is required to descend, will be made In connection wlth work authorized by Ihis pertni6 end ihat no building structure, scaftolding, falsework, or tlemolition or dismantling thereof, will be more then Ihirry-six (38) feet �igh. (Chap. 32, Grp 2, Atl 2, Sec. 341, Tltle 8, Cellfomla Adminislrative Code). ❑ As owner-builtler, I will no� employ anyone to do work which would requlre e pertnit irom the Division ol Industnal Satery, es noted ebove, unless such person hes e permit to tlo such work trom Ihe division. Signeture: Dete: Division of Intlustnal Sefery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTTIORIZATION OF ENTRY: I certify under penalry ot perjury �hat I heve read this application and state Ihat the informalion given is correct. l egree to compry with ell state laws end clry ordinances relating to Eulltling construction, and authorize reDresentetives of ihe Ciry ol Costa Mesa to enter upon the above-dascribed property tor inspectioo puryoses. I egree not to acupy or allow occupancy ot any 6uilding auUorized by Nis permit uoGl fi�el i�spectioo. Si na Le al Own - �tl`ApPHeen1=�-- SODE t. INSPECTONTYPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Finel 200 Finel Re-Roo� 201 FInaI8locWRetaining Well 202 Final Feciory Fire Place 203 FinalSign 204 Final Demolition P9IE It�le65 COUE I INSPECTION TYVE 206 Final Mechanical 208 Final Plumbing 210 Final Elearical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy G9IE Ui�IdL$ Job Name �fl-R-�l ��-N�� , J�� .�_ Address: � 5S '7 �) X,�Zj�1 L/U West Coast Vinyl Windows CSL# i43509 800-204-3854 C _C � . �Cf}-r_��6 Phone Number (�_)�[.�-� X O X Sl.�{Z Floor plans have �o have wi tl w/door loca�ions, approxamite sizes, rype antl rooms need to be identified. 9a x a� 5� �oQ La� J,� %os�o,� �a 3,� xoX S�m� , _ _.. , - ---...- - -- - ; �-�_ �_+--�-, �-�i _ . .-. ._ ... -1 ' _. _ L. . . : � � _- � • r, � M Si72 _ I r - -' '- --- ' � , - = � - - - .��:�k' __ __-- �'_- —� ' ' - � _ . . .. .._ -= ,- T �- , ' ': � - �, . . .. � � .-- _ " ,- �. f- , -- C� �� ' � � . 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'-� - - __ , i-- - _ - �_ -- - ---.�- -'= _ _= _— _ --- l-- — - - '- � L% - � -- _ - -- � - � � Q�i � 3`7 _ � :_ ,_ , N � _ _ _ - - , � " - -- ; ;- -- - - �� 5 - - -- - -- _ _ . . -- - - - � -- _ : ,.. a. ,-- - -- . - -- - x - ---- � x `7 �- -- -- . . _._ -� � ,. � , _. _ _ . __ _._ . . - -- . _ _._ -- � T.__ . ._�_ , _ � � _ � _. , . __ . .. _ . - - ------ ._ _ __ _ �.: . , . . _. � . _ . _. . . _�__ . . . _ , , 0 . , _ . . . : . ._ --- - � - - - - - -- -D -- - . . .. _ _ _;_ . . . . . . _ _ - - - . --. . ._. . _ ._ - -- . _ , ._ _ _ _ ._ . _. . . ._ .. , . . , � _ , ,, _ ,_._ .. . ._ _ . - --- , - -- __ - . ._ . - , , i, , , _-- . ._.__ —_:.T--- � � - - - -....__ , � ------ ----�-- -- - -- _._ . . - -- - --- --------- - -- - ..---- - -- -_ _, - � - - -------- - - �- --- - � ----- _. . : , - -- --- -- - - -- - - --- � --- - - �� . , :_ , ._..-- - -_ - ,------;:_ . . . . , �--- - - - - -... ,_ - --- - . . _ __-- � � ;. ' . . __ ___ ._ _.. _ ..... . . �_. ..� . . ` ._ . .T _. . � . . .. ..__... ,.............. �' . �'l . ..._ � � . . .___ ___ . . . ' .... _______ _______ ___ j _ . __ ___ ._________ _______ __ _______ __ . ' ... � .. _ .. . _ _ .__ __ . ..._ . ._ . . . .. . . . ._� .._... .. . .. . . . . . . .. . . . . . . . . - � - . - . . . .. . .. .__.!. . . _ ..___ __ . �' .. _ ...-.. _..._ .. .. . 1st Floor 2nd Floor �� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT �� FAIR DRIVE, GOSTA MESA, GA 92626 Jobnddress: 2557 OXFORDLN Suite: Vicinity: Parcel Number: 14137411 Applicant HUSSNI, KEN Address: 4502 W ROOSEVELT AV SANTA ANA, CA Ownec PACKER; MARILYN KATZ TR Address 25570XFORD LN . COSTA MESA, CA Contractor: OWNER-BU ILDER Address: Zip: Arch : Address: Phone: Zoning: Phone: 714-554-1900 Zip: 92703 Phone: Zip: 92626 Phone: License: 0 Eng: Address: Status: ISSUED Applied: 10/17/2000 Issued: 10/18/2000 ISSUED BY: �G� Phone: Zip: License: License: SCOPE OF PERMIT ENCLOSE EXISTING BREEZEWAY TO EXTEND THE DINING NOOK AND�KITCHEN AREA OF A SINGLE FAMILY RESIDENCE. APPROX.100SQ.FT. � - � Plan Check: $54.11 Permit: $83.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $137.86 SETBACKS MAIN STRUCTURE � Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: o NOTES: FEE SUMMARY PLANNING & ZONING Rear 0- 0 Left 0- 0 Rear 0- 0 LeR � 0- 0 Required: 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0-0 $3,000.00 $3,000:00 NOTICE: The work authorized by this 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 180 days, or if work is suspended or abandoned for a period of 780 days. INSPECTIONS: In order tor the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 t446-46 (6/00) - WORKERS' COMPENSATION DECLARA710N: I hereby aFlirm under penalty of perjury one of the following declarations: � ❑ I have and will maintain a ceniticate oi consent to self-Insure tor workers' compensation, as pmvided for by section 3�00 of the Labor Code, for the pedormanca of ihe work tor which lhis permit 15 i55ued. ❑ I have and will maintain workers' compensation insurance, as required by section 3700 ot Ihe Labor Cotle, for the pedortnance ot ihe work tor which this pertnit is issued. My workere' compensation Insurance carner and policy number are: Carner: Policy Number: (This section need not be compleretl il the permif is valued at one hundred dollars ($100J or less.) ❑ I certiy ihat in the pedormance of the work for which this permit is issued, I shall not employ any person in any manner so as to bewme subject to ihe workers' compensation laws oi Califomia, end agree Iha[ it I s�ouitl bacoma subject to Ihe workers' compensation provislons of Section 3700 of the Labor Code, I shall forthwith comply with ihese provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKEPS' COMPENSATION CAVERAGE IS UNLAWFUL AND SHQL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TOONE NUNDRED THOUSAND DOLLARE ($100,00pJ, IN ADDITION TO THE CAST OF CAMPENSATION, DAMAGES AS PqOVIDED FOR IN SECTION 3]OS OF THE LABOR CADE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn that I am licensed untler provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business antl Professions Cotle, antl my license is in tull force antl ettect Lic. a Class �t Coniraaors Signa[ure: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby aflirm that lhere is a constmction lentling agency For the pedormance of Ihe work for which this pertnit is issued. (Sec. 3097, Civil Code). Lentlefs Name: Lender's Address: SignaWre: Date: OWNER•BUILDER DECLARATIONS: I hereby aHirm �ha� under penalty of parjury thet I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for ihe toliowing reason (Sec. 7031.5, Business antl Protessions Cotle: Any ciry or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant tor such permil to file a signed statement that he or she ISlicensed pursuant to the provisions of �he Contractors Licanse Law (Chapter 9(commencing with Section 7000) of Division 3 oi the Business end Professions Code) or ihat he or she is exempt thereirom and ihe besis for the alleged ezemption. Any violation of Section 7031.5 by any applicant for e permit subjects Ihe applicant to a civil penalty of not more ihan tive huntlretl dollars ($500)J: � I as owner of Ihe pmpeny, or my employees with wages as their sole compensation, WILL DO THE WORK, antl Ihe struc�ure is not intantled or oHeretl tor sale (Sec. r'C 7044, Business and Professions Code: The Contractors License Law dces not apply to an owner of properry who builds or impmves thereon, and who does such work himself or herself or Ihrough his or her own employees, provided ihat such improvements ara not intended or oHered tor sale. If, however, ihe building or improvement is sold within one year of completion, the owner-builder will have ihe burden of proving that he or she did not build or improve for purpose ot sale.). ❑ I, as owner of the D�oPerty, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business antl Profeuions Code: The contracmrs License Law does not apply to an owner of pmpetly who builtls or improves thereon, and who contracts for such pmject with a contractor(s) license pursuant to ihe Con�rectors License Laws.). ❑ I am ex ui Signature: i O Owner ID verifietl 6y sec. ` license. ❑ Ves ❑ No Business and Professions Code for ihis reason: Date: / /�' Driver's License No. Expires: Verifiwtion oi Ownership 6y (type of document, i.e. - pmpetly tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMI7 CER7IFICA710N: ❑ I hereby certify ihat no excavetion five (5) or more teet in tlepih into which a person is required to descenq will be mede in connec�ion wilh work euthorized by thls permit, and ihat no building stmcture, scaHolding, talsework, or demolition or dismantling thereot, will be more Man ihirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Adminisirative Coda). ❑ As owner-builder, I will not employ anyone to tlo work which would require e permit fmm the Division ot Intlustnal Sefety, as notetl above, unleu such person hes a permit to tlo such work from �he tlivision. Signature: Date: Division of Indusirial Safety Permit Numbec CER7IFlCATE OF COMPLIANCE AND AUTHORIZATION OF EN7RY: I cenify untler penalry of perjury ihat I have read this application and state that the intortnation given is correct. I agree to comply with all state laws and ciry ordinances relating to builtling consimction, and authonze representalives of Ihe City of Costa Mesa to emer upon the above-described property for inspection purposes. I agree not to occupy or ellow occupancy oi any building auihorized by this permit until final inspection. Signature Ot Legal Owner(s) Date �,, ��,.��. _ �olL/� And/Or Authonzetl Applicant Date COOE �. INSGELTIONTYPE 1676 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 207 Final Block/Petaining Well 202 Final Factory Fire Place 203 Final Sign 204 Pinal Demolition , 1[Z¢, �yjQ�$ �Qp�F1 INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency P� € II�1dL$ DECLARATION OF ..�THORITY FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMITS dldg. Permit # This Permit # a-�-�� o� -��-- l.h . C��, %�/-3 7��-/� reet Ad ess AP Number I(we), �a'r�l � , declare that I am the Owner of Title of the above referenced real property and that I(we) hereby authorize: ,-�ev� r�Uss�', �.kan� `��l�l ' Name � � � �� / trD � Telephone No. to obtain permits in my behalf, as owner/builder, for �� J(�'Dr(�, �` at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I(we) shall im- mediately provide Worker's Compensation Insurance coverage and cause a certificate 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 per- son, 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 '�� ay of 1��b , at California. NOTE: This authorization does not grant authorization to perform the work as owner, it solely provides for limited power of attorney to secure this permit in any behalf. r��,� ��! „ , O119�a6 (Rev. 2191) C� � L''oQta �Zleda su�r�di y Du�io�o� OWNER-BUILDER VERIFICAT[ON A city or counry, which is required to give notice pursuant to Section 1983Q 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 v�rification. Attention Propeny Owner. An bwner-builder' building perrttit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building pernut. No buildine permit will be issued until this verification is received. 1. 1 personally plan to pro ide [he major labor and materials for conswction of the proposed property improvement. � Yes ❑ No 2. 1(have/have not) //Q signed an applica[ion for a building permit for the proposed work. 3. 1 have convacted with the fotlowing erson ( rm) to provide the proposed construction: Name C 55 R —) �'D �I Address � � . City Yl. Phone � �i') �5 -1 - � G1 �_� Contractor's Lic. No. ��-�i 4. I plan to provide portions of the work, but 1 have hired the following person ro coordinate, supervise and provide the major work: Name Address City Phone ( ) Con[rac[or's Lia No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide [he work indicated: Name Address Phone Type of Work 1002-46 (REV.9198) � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIF UHNh, GUS I A MtSA, l:A BZtiLti ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: 2557 OXFORD LN 14137411 HUSSNI. KEN Address: 4502 W ROOSEVELTAV SANTA ANA, CA Ownec PACKER, MARILYN KATZ TR Address 2557 OXFORD lN COSTA MESA,CA Contractor: OWN ER-B U I LDER Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool I 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 Motars to 100hp Motors over t00hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole Status: I SS U E D Applied: 1 011 7/2 0 0 0 Issued: 10/18/2000 ISSUED BY: s � Phone: 714-554-1900 Zip: 92703 Phone: Zip: 92626 Phone: Zip: License: 0 SCOPE OF PERMIT MISC. ELECTRICA� FOR BREEZEWAY ENCLOSURE. ADD 4 OUTLETS AND ONE SWITCH. REF: B00-01682 " � " � - � - � $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $1.10 $4.40 $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 Quantiry 0 0 0 1 4 0" 0 0 0 0 0 0 0 0 0 0 Q 0 0 0 0 0 FEE SUMMARY Temp Dist�System / Lighting Busway /100 ft . Standing Section Misc Electrical Equipment Transformers up to i kva/kw ............�...:up to 10 kva/kw .............:::.up to 50 kva/kw .................up to 100 kva/kw�= ..................over 100 kva/kw Low Voltage Equipment �ow Volt Wiring System / Ckt Misc Conduit � Misc. 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 Quantiry $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 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $29.00 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned for a period of 180 days. � INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2446�46 (W00) WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of t�e following declarations: � ❑ I have and will maintain a cetliticate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Lebor Code, for the pertormance of the work tor which ihis permit is issuetl. ❑ I have antl will mainlain worKers' compensation insurance, as required by section 3700 oi Ihe Labor Cotle, for ihe Oedormance of Ihe work for which ihis pertnit is issuetl. My workers' compensation Insuranca carner and policy number are: Carrier. Policy Number. (This section need not be campletetl i/ the permit is valuetl af one hundred dollars ($f00) or less.) ❑ I certify Ihat in the pertormance ot ihe work for which this pertnit is issued, I shall not employ any person in any manner so as to become subject to the workars' compensation laws of Calitornia, antl agree that it I shoultl become sublect ro the workars' compensatlon provisions oi Section 3700 oi the Labor Cotla, I shell forthwith comply with Ihese provisions. Appllcam Signalure: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FWES UP TO ONE HUNDRED THOUSAND DOLI.ARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3�W OF THE LABOq (YJDE, INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRAC70RS DECLARATION: I hereby aHirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full foroe antl ettect Lic. k qass B Coniractor's Signature: Data: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that ihere is a constmction lentling agency for ihe pertormance of Ihe work for which Ihis permit is issUed. (Sec. 3097, Civil Code). LentleYs Name: SignaNre: _ Lender's Adtlress: Date: OWNER-BUILDER DECLARATIONS: I hereby attirm ihat untler penalry ot perjury ihat I am EXEMPT FROM THE CON7RACTORS LICENSE LAW tor the following reason (Sec. 7037.5, 8usiness and Protessions Code: Any city or counry which requires a permit to construct, alter, improve, tlemolish, or repair any stmcture, prior to its issuance, also requires the applicant for such permit m file a signed statement ihat he or she is licensed pursuant b the provisions of ihe Contractors License Law (Chapter 9(commencing with Section 7000) ot Division 3 of the Business and Professions Code) o� that he or she is exempt therefrom and the basis for the aileged ezemption. Any violation of Section 7031.5 by any applicant for a pertnit sublecis ihe applicant to a civil penalty of not more than five hundred dollare ($500).): �I, as owner of the property, or my employees with wages es their sola compensation, WILL DO THE WORK, antl ihe stmcture is not intended or ofleretl tor sale (Sec. �� 7044, Business and Professions Code: The Conirectors License Law does not apply to an owner of propetly who builds or improves thereon, and who does such work himself or herself or ihrougB his or her own employees, providetl ihat such impmvemenis are not intendad or oHeretl tor sale. If, however, ihe building or improvement is sold within one year oi completion, ihe owner-builtler will have Ihe burden of proving that he or she did not 6uild or improve for purpose ot sala.). ❑ I, as owner of the property, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consimct the project (Sec. 7044, Business and Protessions Cotle: The coNradors License Law tloes not appty to an owner of property who builds or improves thereon, and who coniracts for such project with e contrador(s) licensa pursuant to the Con�ractors License Laws.). ❑ I am axe i SignaWre: � Owner 10 verifietl by license. ❑ Ves ❑ No Business antl Protessions Code for this reason: Verification of Ownership 6y (type of document, i.e. - pmperty tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMI7 CERTIFICATION: Driver's License No. pate: /G��B�GI'7 Expires: ❑ I hereby certify ihat no exca�ation five (5) or more teet in depih into which a person is required to descen4 will be made in connection with work authonzed by ihis permit, and that no building siructure, scaHolding, talsework, or demolition or tlismantling ihereot, will be more than ihitly-six (36) feet hiqh. (Chap. 32, Gry 2, Art 2. Sec. 341, Title 8, California Atlministretive Code). ❑ As owner-builtler, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such parson has e permit to do such work from ihe tlivision. SignaNre: Date: Division of Industrial Satery Permit Numbar: CERTIFICATE OF COMPIAANCE �1ND AUiHORIZA710N OF ENTRY: I certify under penalty of perjury that I have read fhis application and state ihat ihe information given is correct I agree to comply with all state laws and city ordinances relating to building constmction, and authonze represenfatives ot ihe Ciry of Costa Mesa to enter upon ihe above-describetl propeny for inspection puryoses. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. C// Signaiure Of Legal Owner(s) Date r f C ��Lc�� /G�f�� -� AndiOr Authorized Applicant � Date CODE t. INSPECTIONTYPE 1616 Fixetl Sys�em Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining W811 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition . OpTE I Tlp � COpEI'� INSPECTIONTYPE 206 Final MechaniCal 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy �ATE V �, �NTff1�L5 owNeR COLLEJGE PARK C0. DATE g_1},_56 JOBADDRESS �' S�7 Q FoTd IanR. BUILDING PERMIT NO. #j(y9O GENERALCONTRACTOR Harbor COI]St. CO• VALUE $ ZZ�ZOO.00 t 74 s�ocK TRACT p7p7 Residence w�det� gar, GROUP I St �T TVPE V ZONE Rj.� FIRE DISTRICT �ri13 INSPECTIONS Footing Trench Foundation Forms and Grade to Rough Framing � Plumbing, Rough to Slab � Plumbing, Rough Compiete Temporary Pole Wiring, Rough Heating, Rough Heatinq. Final SUBCONTRACTOR PERMITSISSUED DATE �.]�A�/� �/_n� .� House /O.(� Sewer. St�/i7 P`� I C1/1N/5b IG/J%rA Y�V. �_.1'.rt.� I 9— /// - f'LI S f/1 9— Septic Tank or Cesspool t ng, In Out Piastering Plumbing, Final, Fixtures Coi Plumbing, Fin.al GasTest/3 Wiring, Final Occupancy FONM 310 3M 10�•vi ` ,�sia, ivae�a nuua�ng LeparLmenL aYYi.11�a'livlv r vn rr.nirui 111 EAST 20th STREET ��j��-' �3 g U 1 L D� PI G � �� . ti COSTA MESA, CAUFORNIA FOR O�'FICE USE ONLY . FOR APPLICANT TO FILL IN I Receipt No. I Permit No. B��d��s 3 S� 9 c Address Costa, Mesa, California Received by Date Rec'd./ Date Issued r�earest I�� — S,� AUG 1 4 19� c�osss�. Greenbriar Lane B��idi�a Address Owner o e e ark C o. Costa Mesa, California Mail Address `zl.ls �.5.' . j1�81Il .5't. . acy Santa Ana, Cal if nTio��?ff 51139 Arohitect of Lic. Engineer No. Address CitY Lic„,761 trectorHaTbOI` Const.Co.No. J Z1� i Metes and Bounds) No. of Bldgs. Lot 6� X Z��J Nowon Lot � No.of No.of � 7 Bldg. Famiiles I Rooms � cLinefrom RearYard Z �t street 54 stde vard D nmcnu.rwrrnrr nF wnuu � Demolish 8ize� y 1'J79 Rooms Stories � `^rior W011 I Roof :ring Covering �PPRQ�7�S' l.�e of New Building Residence & Detached Foundation Location Inspector Date Forms, Materials, • Gara B Under-Pinning � • Frame: Fire Stops, Bracing, Bolts " I hereby acKnowledge that I have read this Application ;; and state that the above is correct and agree to comply Lath. Int. v with all City Ordinances and State Laws regulating : � building construCtion. Lath. Ext. '�� ,�� StgnatureotH8PbOT Construction Co. -• Permittee Plaster, Int. � Authorized Agt. Plaster, Ext. 'R Valwation PermitFee $ �� ^ Masonry Reinforced $ 11 200 . P�an Check $ /'� — eond eeam ` � Total v Fee $ � FINAL FORM 204 5-BP 3M 6-55 � PLOTPLAN 6how IoCation and distances Trom property Iina and beSween bulldinga • -f v , �� Y • OWNER LESTER DATE JOB ADDRESS 2557 Oxford Lane BQILDING PERMIT NO. (�j�9� GENERAL CONTRACTOR Owner-Builder VALL[E $ 60.00 1 f. LOT TRACT FIRE ZONE DESCRIPTION OF WORK B10Ck F0riC2 GROUP TYPE ZONE PLAN NO. INSPECTIONS I DATE I SUBCONTRACTOR � __ PERMITSISSUED _ Test 6t�90 , 0 H w W � f N LL O. COSTA MESA BUiLDIfVG DEPARTMENT P. O. BOX 317 COSTA MESA CALIFORNIA C.l. OF STREET " _�iPROP. TINE _ r 10 FT. FOR 60 FT. STREET � � � � � IW �a �� a LEY QR PR � � PROP LINE --�-=--�---- C.L. OF STREE 61 J �.,. �...�. IF I w � w �I z w f" z N m � J � � O ___a U LINE 1 a� �j r �� -� i� FT S T. MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES------ MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES I ��C� ��B�E� I fi49n I 3�7/s8 Y«- FOR APPLICAIVT�'P�O �� IN/� BUILDING ADDRESS�� s�,'�'u , ' � T `p7&�A/-�-� )''L! Owner E b d i� E � t S T E 2 Mail Address z � �� ! �� 4""-'�� City G o-.vZ`�a- �-`-^`t- Ph. No. �. S-3 °� I Contracto� I � (1J @. 1't - - - - -Ph. No- - - - - - - - City Lic. No. State Lic. No. Size of Lot iG� .� / C.S � AP No. %� �� 5?�� Setbacks: C/L Street �� Rear G" ,� Side Yard - Righ�b Left —'" Type of Fence � t` ��' �� E' C�' �1�' 3e F�'r (`a rv G- S� r=r (�r2r 1��c3�„/ �� •, � c,�- I hereby acknowledge that I have read this application and state that the above is correct and aqree to comply with all City Ord- inances and State Laws regulating building construction. Signature �� / � �-7�� ..v ne...,;��ee L�LC_.f _ dL:C/2J FOR OFFICE USE ONLY ��90 3 - %—� � I 3- 7—Sd' VALUATION Permit Fee / OL'o �O �- Plan Check TOTAL FEE $ � � USE REVERSE SIDE FOR DETAILS