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Home My WebLink About2560 OXFORD LN - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www,ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT ,lob Address: 2560 OXFORD LN Suite: Vicinity: MASTER BEDROOM Parcel Number: 14137332 Applicant: RENKER, SONA Address: 2560 OXFORD LN Zoning: Phone: 714360-0445 COSTA MESA, CA � Zip: 92626-6123 Owner: RENKER, JONATHAN AND SONA Address 2560 OXFORD LN COSTA MESA, CA Contractor. OW N ER-BU ILp ER Address: Phone: 714-360-0445 2ip: 92626-6123 Phorte: Sfatus: ISSUED Applied: 10/11/2004 � Issued: 10/15/2004 ISSUED BY: / Zip: License: 000000 Arch : TONY MASSARO Eng: Address: 3100 AIRWAY AV Address: C.M, CA Phone: 714-556-8299 � Phone: SUITE 714 � � Zip: 92626 License: C24376 License: SCOPE OF PERMIT CONSTRUCT A 22 SF ADDITION OF A WINDOW SEAT FOR A BAY WINDOW IN THE MASTER BEDROOM OF AN EXISTING ONE-STORY SFD. NOTE: SQ Ff OF BAY WINDOW IS ApPROXIMATELY THE SAME SIZE AS THE EXISTING FLOOR TO CEILING WINDOW. 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. MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existinq: a Rear 0-0 Rear 0-0 Reauired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation Righf 0. 0 / Right 0. 0 / Sz,soo.00 $2,500.00� NO710E: The work authorized by this permit shall comply with all applicabla handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 7, 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 foi a period ot 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inepeetlons and final epprovel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 � WORKERS' COMPENSATON DECLARATION: � I hereby eflirtn under penalry oi perjury one oi Ihe lollowing daclaratlans: ❑ 1 �Bve and will maintein e Ceritticate oi wnsent t0 5eN-InSure for workers' Compensallon, as provided for by section 3700 0l Ihe Lebor Code, lar the pertortnence of the work for whlch this permil is issued. ❑ I have and wlll maintein workers' compensation Insurence, as require0 hy sectlon 3700 ot the Labor Code, Por the partortnance of Ihe work for which thls permit is Issuetl. My workers' compensatlon Insurence carder entl policy numDer are: Carrier: Polity Number. (Thls sec(lon need not be comD�eted il the permit is velued et one huntlrea tlollers ($100) or less.) I certify thel in ihe peAormence of the work for which ihis pertnit is issued, I shall not employ eny Oerson In any menner so es to 6ecnme su6ject to the workere' mpensatlon laws of Celifomi and egree t If I shaultl Dawme subJect to Ihe workers' compensellon provisions of Secllon 3700 of Ihe Lebor CoAe, I bhell forthwilh comply with these provisio�j�� (b// 5�b �-I Applicent Signatura: � Date: WARNINO: FAILURE TO SECURE WOHIHI�R ' COMPENSATION COVEMGE IS UNLAwFUI M1D SHALL SUfiIEGT PN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED T}10USNND DOLLAHE (5100.000), IN ADDIiION TO THE WST OF COMPENSATION, DAIMGES AS PROVIDED fOR IN SEGTION �OB OF THE LABOli CODE, IMEREST, M1D ATTORNENS FEES. LICENSED CONTRACTORS OECLARATION: �I I hereby eHirm Ihat I am licensetl under Orovisions at Chapter 9(commencing with Sectian 7000) of DiNsion 3 of ihe Business antl Pmfessions Code, and my Iicense is in tull �� force end etted. Lic. M Class a I. Coniractor's Signeture: Dete: � CONSTRUC710N LENDING AGENCY: �❑ I hereby eflirm ihet Ihere Is a constmction lending egency tor the peAormance of ihe work br which this permlt is issuetl. (Sec. 3097, Civil Cotle). Lenders Neme: Lentler's Atltlress: '� Siqnature: Date: OWNER-BUILOER DECLARATIONS: I here6y eHirtn thei untler penalry of perjury that I am EXEMPT FROM hIE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Buslness end Protesslons Cotle: Any ciry or counry whic� requires a pertnit to construct, elter, improve, demolish, or repair any structure, pdor to its iuuance, also requires t�e epplicant lor such pefmit to file e slgnetl statement ihel he or she is licensad pursuent lo I�e pmvisions oi ihe Contractors lJcense Lew (ChaO�er 9(commencing with Section 7000) oi Division 3 01 the Business and Protessians Code) or that he or she is exempt therelrom end the basis for Ihe ellaged exemption. Any violation af Section 7031.5 by any epplicanc for a pertnit subjects the applicant to a civil penairy of not more Ihan live hundred dollars ($500).): ❑ I, es owner ol the properry, or my employees wlth weges es t�eir sole compensation, WILL DO 7ME WORK, end Ihe structure is not Intentle0 or oHered lor sale (Sec. 7044, 8usiness and Professions Code: The Conttactors License Law does not apply to en owner of property who builds or improves Ihereon, and who does such work himself or herself or ihrough his or her own employees, provided ihat such improvemen�s are not Intended or oHeratl lor sale. If, however, ihe building or improvement is sold within one year ol completion, the owner-bullder wlll have the burden oi proving ihat he or she did not build or improve tor Durpose of sale.). ' �� I, as awner of the propBM� am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS lo consWc� �ha project (SecJ044, Business and Professions Code: Tha comrecrors License Lew tloes nat epply to en awner ot propeny who builtls or improves ihereon, entl who contracis tor such project with a contrector(s) Iltense pursuent to the Contractors License Lews.). ❑ I em exer�ip Signeture: _ Ownar ID venlieA licen5e. �((] Yes ❑ No Business end Professions Code fo� (his reason: Date: l0 /5 /U DnvefsLicanseNo. � Expires: _Jr' -/�O-V� Verificetian af Owners�ip by (type of docurtTunt i.e. - properry tax blll or deed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby certity that no excavation five (5) or more feet In depih Inlo which e person is required to descend, wlll be made In connection with work authorized by Ihis pertnit, and that no building siructure, scattolding, lalsework, or demolilion or dismantling thereol, will 6e more than thirry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Titla 8, Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit trom the Division ol Indusirial Sefery, as notetl above, unleu such person hes e pertnit to do such work irom the division. Signeture: Data: Division ot Industrial Sefety Permit Number: CERTIflCATE OF COMPLIANCE AND A17THORVA710N OF ENTRV: I cenity under penelty oi perjury thal I have read ihis epplication entl state Iha� ihe infortnation given is correct. I to compty with ell state lews end clry ortlinances relating to bullding constmction, end euthodze representatives oi the CIy ot Costa Mesa to enter upon the ebove-des opg� tor i �ctAi n purpose�s. I agree not to occuOY or allow occupancy of eny buildinq authorized by this pertnit until finei inspection. /V�/t �/'(/� !.o �! S� � `i SignaWre Of Legel Owner(s) Date And/Or Authorized Applicant 400E �, INSPECTIONTYPE 1616 Fi:ed System Final Fire Prevention 1268 Pool Spa Finel 200 Finel Re-ROot 201 Flnal BIocWRetaining Wall 202 203 204 Final Factory Fire Place Final Sign Final Demolition Qdlf. IMRIALS CO�E I INSPECTION TYGE 206 Final Mechanical 20B Finel Plumbing 210 Finel Eledrlcel 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy � �� • 1 � � C''�i � L''.� ��va ��y D�� OWNER-BUtLDER VERIFICATION A city or county, which is reyuired to give notice pursuant to Section 19R30, shall attach to such noticc, and, as a condition precedent to issuing a building permit, reyuirc the completion and reyuire the rewm of, an owncr-builder vcrifica�ion. A�tention Property Owner. An 'owner-builder building permit has been applicd fur in yuur name and bcaring yuur signature. Please complete and return this informa�ion in thc envelupe pruvidcd at your earlies� opportunity iu .rvuid unnecessary deiay in processing and issuing your building permi�. No buildin� pennil will be issueJ until lhis vcnfication is rcceivcd. I. I personally plan to provide thc major labor and ma�erials for conswclion of lhe proposed property improvcment. ❑ Yes �No 2. I, ave ave not) signed an application for .i building permii li�r th oscd µ•ork. :t. I h:rve cantructed with thc fullowing penun (fimi) to pruvide the prnposeJ consWetiun: Namc L�� fJu-t �LLPi1/1- Address S�iLU�"u- �0� � City Phone ('I��) ��U' a'SiOS Contractur's Lic. No. 4. I plan lo pruvide portiuns o( the wark, but I havc hired �he fulluwing person to coordinaie, supervise and pruvidc thc majur µ�urk: Name Address City _ Phone ( ) Contracmr's Lic. Nu. 5. I will proyide some of the work but I iiave cuntracted (hired) the following persons to pru�-idc thc work indica�ed: Name Address Phonc 7'ypc of Wbrk IM9�a6 (FEV 99P� i i , JAN�21}2006 02:17 FRQM: ! I I � Y UNG & R BICAM I 8 ANDS �I I ; � I � � i o te: � A eniion: � _ � C mpany: � F x Number: i — I � � I I I I i � i i ! �I � I ( Fax Cover Sh� ��ob ' i i _ MA�R.�/ Jlk-t�J,E WE� i ! � T0:7t4 754 4856 P.1'3 ' • i i i i Young 8� Rubicam Braads �535 Irvine Cente� Dr i e Irvine, CA 92618 USA � � I I, � � ; i , �� : Number. � � `t 360� Pages: .3 _----- , � ,aQ _ � � 1iY_ �___F�.�c._—__.. � n _ _ 1 /1 �. �y�, �(',^/�[1 I'_ i � ......-_. '-'i .._.i.._.. � i i 1 _._._._.—._....-�............'-"_'__-.._.. � � i � d._...:....�........_...._...___._ __ �_..._..,... _: ._.__..-.�.._�..�_.= .-. I i�. _ � �.�....��.'_"__-__..._ .._.._�...�..�... I i � � � ..__ ..............w...-- --,-- ' ..... , i ' ' I i � � _...__......_...---.—._..._ __..._._..._...._._ ---_.._._�..—;----'-- i-• , � � � ' I � I ' � 1 � i i i ; � � i � ' I i I � 02:17 FROM: CITY OF 1 F.o. 6ox �zao • n FAIR OEVE�oPMENi SERVICES DE� � BUILDIP COURTESY NOTICE � i ITO•�t4 754 � I SZA ' � ' �� j� j �,� � January 13, 2006 ; � �� Jonathan & Sona Renker � �� ; lN �@,� 2560 Oxford Ln � ;� I i ��(�,V" Costa Mesa CA 92626-6123 i , ��} ��,U�� I ` I 1 V PERMIT NUMBERS: 804-0174Q I ' � I FOR: Addition ! � i i PROJECT ADDRESS: 2560 O�cfoid L�n., Costa Mesa � Our records indicate the above listed p'ermits were obtiineil for property impro alterations at the above address. Per the 1997 Uniform Esuilding Code, Sect Expiration, permits are valid for 180 days from the date'of such permit, or the c last inspection for the project and additional fees will�be requiFed to finalize expirec Actording to our records, the permits listed above have�not had an inspection 1 exceeding 180 days- If you have a signed inspection�card indicating an insF conducted within 180 days from the date of this letter, please contact this office corred our records. � � ' � If you need to request an inspection please ;call Iour Inspection Reque 714-754-5626. If you wish to request an, extension, r,equests must be madf addressed to Ed Petros, Chief of Inspection, at the'above acidress, detailing circ and listing an estimated date of completion. If you do not have an approved final your perrnits will expire on January 30, 2005. ' � � i If you have any questions, please contact the Building Division at 714-754-527 8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. The � records affecting your property is oUr g0al and we apprecfate your working with u� this matter. i � Sincerely, , � � �yl �� ; , Ma ane Weidenkelier , : O�ce Specialist II I � i � �� ;�. �� ,,�M� s��` �l� s(,�" ! ; � � 3 _ � � � ; � , , ' Butlding DidaM pia) 7sa-5z13 • CaOe En:woement (711� 751-fie23 � Plem�ing Division R1a) 750.52d5 Fwc�71a)7sa.esfi � roo'�7�.)7sasz�a . �.w,rw.u.mc�s-r�m,ca.u6 i � � i I ' � � ; ;men[s or i n 106.4.4 � ' �e of your ; �ermits. ! �', � a period � , �tion was � � we may � �' Line at � � in writing ; , mstances � ' ispection, ' � � . between ' ' :curacy of � to resoive � I I � ' ! -2006 02:17 FROM: � � TO•'14 754 A656 I ICt�Y OF COSTn MESA, 9WLpING SAFETV D�VISION I . OST IN CONSPICUOUS PLACE ON THE .lOB N0710E � � � � I � I ( �ecfl one worktley in edvanc0. To uhedule In6pecilon6, call (Md) Y5458t8. �oviGe Me fo�'llowing Inforntetlan; I nhei 2) JoD eEEresa, 3) �^6pecfion i[mn numher, 4) Day and tlale you:naetl �he InSp6C11p�. i � � � � � � � -D 7 ��•. � � I i i / ' S a6 �� Ph:etlepPomdt k60eopmli C_.£:)-7x.�u�� ?�' � a�w �eore / U / � (7 �> 1� �i c.G�'7't 11 NtER Rf uR CEYtlLII Y XL•L ��/'•' �C1!�� l-' � ERMIYS [XPIRE 180 DAYB (6 MON7X8� FROM ISSUE OR U18T INSPlC�ION • • •• � STRUGTURA� wr b �am � t POOL 6 SPA � or. uspper . 5i1e 1 94 Pod 5 EQulpnml laati�n � in Gar4 96 SL�d ReinMcemem I I 100 FknM1:alBonGin9 i �r� yy 102 RwgA Plumb 6 Rossve Tesl j In Roof 104 ApOrowl W Cover • Gunits � �nq 108 EbeCenduil-U�keryrantl � I f Cel np�5kuclu�M 109 Gat PipyUntlergran0 Tesl �, 3� p 170 BxNwuh L'mee, RTrep, � te E la5hinp 12 UMerpround � i�9 8 diig 112 Approval to WCF � i Igyp� 116 Ppd Plumbing Sy6lem � Finel � �su N inq ' 118 Pod Elerorei � Finel , � IBrB Coal 122 FMfM�ACOBSbIAlpfit19l1pplOV81 Grout � 12l ApprovellorPleatenng! i nlad t26 PooVSw Sn�ena • Final � - 52 So0 P� UMayroun� I % WatelPi -I1Nngip i 55 Unaerg Ges B2 Rpu� bing 6a Ragn �w 66 Rd:gh - F Fk¢pg : 6B Senef 5 M Gu MPo � Tes� I 90 G2s PiPe. esl • Final � 9Y WaterSe� ice�Final I I NOTE9, ' wuM Im.iqj � � � ; FINAL INSPEC710 S (Musl b I I omplcmA pdo� lo reQuc tinq a i iii i i C�� _ 210 � Flnal Electrcal j can pt�� anaaoo ro� m. rmio:nna: . YlY I Final F4o Fevention • I cm� ptq 75455rt �ro RI worana GYi qiar to fineL I � � Yi6 FNaIP�UcSva.DaptApp`pryl 7• Call(111)75V5]07FOiU»I011oring: ' 218 FinaICMSDI,pprpyal' �I�Cvl H e o lo , ��r�B � pll (711) 7545626 for the folbWnA: I 222 Finel5lte � � � . � FnmBulldinglpGwpanq ' i � . i I i 0 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.c��LDING PERMIT �� FAIR DRIVE, COS7A MESA, CA 92626 Job Address: 2560 OXFORD LN Suite: Vicinily: BqTHROOMS Parcel Number: 14137332 Applirant RENKER, JONATHAN Address: 2560 OXFORD LN COSTA MESA, CA Owner: RENKER, JONATHAN Address 2560 OXFORD LN COSTA MESA, CA Contractor: O W N E R-B U I LD E R Address: Zip: Zoning: Phone: 714-360-0445 Zip: 92626-6123 Phone: Zip: 92626-6123 Phone: License: 000000 Status: ISSUED Applied: 10/02/2003 Issued: 10/02/2003 Arch : TONY MASSARO En9: Address: 3100 AIRWAV AV Address: C.M, CA � Phone: 714-556-8299 Phone: SUITE 114 Zip: 92626 License: C24376 License: SCOPE OF PERMIT REMODEL EXISTING 2 BATHROOMS IN S.F.D. WORK TO INCLUDE: REPLACE EXISTING FIXTURES AND ADD A TUB TO EXISTING MASTER BATH. Plan Check: $254.31 Permit: $391.25 SMIP Res: $2.50 SMIP Com: 50.00 Other: 50.00 Inspection: $0.00 Total: $648.06 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Exi. stinq: o Rear 0-0 Rear 0- 0 Required: 0 FEESUMMARY PLANNING & ZONING Left 0. 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Righl 0- 0 52s,000.00 $25,000.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremeMs under Calitomia statutes and related regulations. (Ord. No. 92-29, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1B0 days, or it work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor the work authorized under this permil to be considered legal, such work must comply with all applicable codes, and all required inspeetions end final approval must be obtained. Failure to obtain inspections and tinal approval will resutl in the ezpiration of this permit. FOR INSPECTIONS CALL; (714) 7545626 264fi-66 (NW) WORKERS' COMPENSATION DECI.ARATION: _ I hereby aflirm under penaly of perjury one of the following tleclarations: ❑ I have end will maintaip e certilicnte ot wnsent to self-Insure lor workers' compensation, es provided for 6y section 3700 oi the Labor Code, for the pndortnance of the work lOr whiCh thi5 pe�mii i5 issue0. ❑ I have antl will mainWin workers' compensation insurance, as requiretl by section 3700 0l Ne La6or Code, for Ne peAortnence of ihe work for which Ihis permit i5 issuetl. My workers' compensatlon Insurenca carrier antl policy number ere: Carrier: Policy Num6er: (Th/s secfion need no( be comp/eted i! fhe permif is valued et one hundred dollers ($100) or less.) � I certity that in the perfortnenca ol t�e work for which Ihis pertnit is issuad, I shell not employ eny pereon in any manner so es to becoma subject to the workers' compensation laws oF Celitomia, and egree that if I should become subject to the workers' compansation provisions ol Section 3700 0l the Lebor Code, I shall forthwith comply wi�h �h sions. �� /� ApplicantSignature:�7 ��Sti9.� Dete: �0��03 WMNING: FAILURE TO�CIyIE WORKERS' COMPENSATION COVERAGE IS UNLAW FUL AND SHP1L SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED T1KK15AND OOLLARE (510U;Efb�. IN ADDITION TO THE COST OF COMPENSnTION, DAMAGES AS PHWIOED W R IN SECTION 3108OF THE LABOR ODDE, INiEREST, AND ATTORNENS FEES. LICENSED CONTRACTORS DECLARA710N: I hereby eHirm that I am licensetl untler provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Professions Code, antl my Ilcense is in full force end eXecL Lic. # Class M Contractofs Signatura: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirm that there is a construction lending agency lor the performance ol lhe work for which Mis permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Atltlrass: Signeture: ' Date: OWNER-BUILDER DECLARATIONS: I hereby affirtn thet unAer penalty ot perjury that I am E%EMPT FROM THE CONTRAC70RS LICENSE LAW lor the tollowing reeson (Sec. 7031.5, Business and Professlons Code: Any ciry or counry which reduires a parmit to construct, elter, improve, demolish, or repair eny siructure, Dnor lo its issuance, also requires the epPlicant for such pertnil to file e signed statement �hat he or she is Ilcensetl pursuent to t�e pmWsions of the Contractore lJcense Law (Chapter 9(cammendng with Secuon 7000) of Division 3 of the Business en0 Pmfessions Cotle) or that he or she is e:empt therefrom entl the basis for the alleged exemption. Any violetion oi Section 7031.5 by eny applicent for a pertnit subjecis ihe epplicant to a civil penalry ot not more than live hundred dollars ($500)J: ❑ I, as owner of Iha property, or my employees with wages es their sole compensation, WILL DO 7ME WORK, and the siructure is not intenCeG or otteretl for sale (Sec. 7044, Business and Professions CoOe: The Conirectors License Law does not apply to en owner of property who builds or improves t�eraon, and who tloes such work himsell or herseit or through his or her own employees, provided thet such improvements ere not Intended or oflered tor sale. If, however, t�e bullding ar improvement is sold within one year oi completion, the owner-builtler will heve�the burden of proving that he or she did not build or improve tor purpose of sale.). � �I, as owner of the property, em EXCLUSIVELY CONTRACTINC WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business antl Professions Code: The conlractor5 License Lew does noI apply Io an owner of property who Dullds or Imprwe5 lhareon, and who conlrects lor such project wlih a contreti0r(s) license pursuam to the Contractors License Laws.). ❑ I em e untler ec. Business and Protessions Code lor Ihis reason: Siqneture: _ _ ' E:pires: S IL�O% Verilication of ership by (type ol document, i.e. - property tax bill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certify ihat no excevation five (5) or more teet in tlep�h into which a person Is required to descend, will be made in connection with work euihonzed by this � permit, and Ihat no building sWctura, scaHolding, talsework, or tlemolltion or dismantling ihereof, wlll be more than thirty-sia (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Titla B, Califomia Administretive Code). ❑ As owner-builder, I will not employ anyone to do work which would require e permit trom the Division of Indusinal Sefety, es noted above, unless such person hes a permit lo do such work Irom ihe tlivision. SiqnaWre: Date: Division of Intlusirial Salety Permit Number: CER71flCATE OF COMPLUWCE /WD AUTHORIZATION OF ENTRY: I certify untler penalty ol perjury that I have reatl �his applica�ion anC state �hal �he information given is correct. I to comply with ell state s and ciry ortlinances releting to building consiruction, and authorize representatives of Ihe Ciry of Costa Mesa to en[er upon t�e ebov � escnb o or insp 'on ryoses. I egree not to occupy or allow occupancy of eny building authorized by this permit un tl final inspection. _ � I�-� ,a L �03 �-�ature OI Leaal Ownerfsl Da�e COpE �. INSPELTIONTYPE Qdjf, IM1fIAL5 16/6 Fixed System Final Fire Prevention 7266 Pool Spa Final 200 final Re-Rool 201 Final BIocWRetaining Wall 202 Final Factory Fire Plece 203 Final Sign 204 Final Demolition CODE� INSPECTIONTYPE 206 Final Mechanical 200 Finel Plumbing 210 Final Electrical 212 Flnal Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtlinq/Occupency Date Q�jE IMIi11L5 �.., L�;t�y o� L.aa.ta ��leQa �ici�du y DiviQio�z OWNER-BUILDER VERIFICATtON A city or county, which is rcyuired to givc notice pursuant to Section 19830, shall attach to such nolicc, anJ, as a condition precedent to issuing a building permit, reyuire the comptetion and reyuire the remm of, an owncrvbuildcr verifica�ion. Attcntion Property Owncr: An 'owner-builder' building permit has becn applicd for in yuur name and bcaring your signaturc. Plcase complete and rE[urn this informa�ion in the envelupe pruvided at your earlies[ opportunity tu xvoid unnecessary dclay in processing and issuing your huilding permiL No buildingpermil will hc issued un�il �his verification is received, I. I person;Uly plan to provide the major labor and materials for construction of the proppsed property improvemen�. � Yes ❑ No 2. 1(have/have not) � signed an application for a building permii I�,r thc proposed work. '1. I have cahtracied with �hc fullowing persnn (lirni) to provide the proposed cnnslruction: Name �o �aP Wov� Address Phone ( City Contrxtur's Lic. No. 4. I pinn to provide portiuns of the work, bul I have hired lhe following person la cuurdinate, supervisc and providc �hc mtyor w�xk: Nutnc Address � Phone ( ) Ciry - ConVactor's Lic. No. 5. I will provide some of the work but 1 iiave cuntracted (hired) Ihe following persons to prnride the work indica�ed: Namc I(u9.afi �REV 990� Addmss Phonc 7'ypcofWork .lob Address: 2560 OXFORD LN Suite No Vicinity: Parcel Number: 14137332 Applicant: RENKER, SONA Address: 2560 OXFORD LN COSTA MESA, CA MECHANICAL PERMIT Phone: 714-360-0445 Zip: 92626-6123 Owner: RENKER, JONATHAN AND SONA Address: 2560 OXFORD LN Contracloc Address: COSTA MESA, CA Phone: 714-360-0445 Zip: 92626-6123 Phone: 2ip: License: SCOPE OF PERMIT NEW A/C UNIT LOCATED AT REAR OF PROPERTY MECHANICAL TQ INCLUDE: REFRIG SYS < 100K BTU ISSUE FEE Inst FAU <700 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Boz Vent Fan / Single Ducl Appliance Fire Dampers - Smoke Dampers � Inst or Relocate Appl Vent Air Handlers < t0000cfm Air Handlers > 10000cfm Floor Fumace Floor or Suspend Healer $23.50 $0.00 $0.00 $0.00 $0.00 $14.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 so.00 $0.00 $0.00 $0.00 $0.00 FEE SUMMARY Quantity 0 0 0 0 1 .r n Status: ISSUED Applied: 07/30/2004 Issued: 07/30f2004 ISSUED BY: Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillation System Evaporetive Cooler Commercial I nci nerator -. �Domesticlncinerator � Compressors / Absorption SYstems Upta3hp/100kBTU 3To15hp/500k8TU� � 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU "�� Boilers � , " , Upto3hp 3To15hp 15to30hp - . . � 30 to 50 hp � Over 50 hp ' Ofher Mechanical Fee . - Investigation Fee � Plan Check Fee � � � Reinspection Fee i Quantity $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 30.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements undar California statutes and ralated regulations. (Ord. No. 92-28, § i, 12-21-92j EXPIRA710N: This permN shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicabla codes, and all required inspeetlona end }Inal epproval must be oblainad. Failure to obtain inspections and final approval will resutt in tha expirafion o( Ihis permil. FOR INSPECTIONS CALL: (714) 7545626 2448<8 (fl/W) WORKERS' COMPENSATION DECLARATION: ' ' I hereby eXirtn under penelty of perjury one oi t�e foilowing tlecleratlons: ❑ I have and will maintaln e certificata ol consent to setl-Insure lor workers' compensetlon, es providetl tor by sectlon 3700 of tha LaDor Coda, tor the pertortnance of ihe work lor which t�is permit Is issuaU. ❑ 1 have antl will maintain workers' compensetlon Insurence, es reQuired by sectlon 3700 of t�e Lebor Code, tor tha pedortnanca of ihe work for which this pertnit is Issuetl. My workers' compensetion Insurence cerrler entl policy number ere: Carrier: Policy Number: (This sectlon need nof be completed il the permit is velued af one hundred tlollers ($100) or less.) I certity that in Ihe peAormance of the work br which Ihis pertnit is Issued, I shall not employ eny person in eny manner so as to bacome subjeci to ihe workere' �- 'compensetion lews ot Cellfomie entl egree �ha� Il l shoultl become sub�ect to Ihe workers' compensetion provislons ot Sec�lon 3700 of Ihe Lebor Code, I shall f0�hwllh comply with these provislon (� ' / qpplicen� Signeture: �], l/1/i/ �Dele:-�. �� 3V � U�I �i�fs- -' VIARNINO: FAIW RE TO SECURE WORKERS' ODMPENSATION C1�VERAOE IS UNLAW FUL AND SHALL SUBJECT AN EMPL V�CFIMINAL PENPLTIES AND CNIL FlNES UP TO ONE HUNDFED THOUSAND DOLURE (E10D,000). IN ADOITION TO TME COST OF COMPENSNTIIXJ, OAMAGE$ AS PROVIOE� WR IN $ECTIIXJ 37060F iHE LABOF CODE, IMEREST, AND ATiORNEI^S FEES. LICENSEO CONTRACTORS DECLARATION: I hereby aNirtn that I am licensed under pmvisions of Chepter 9(commencing with Sectlon 7000) of �ivision 3 of the Business and Pmfessions Code, antl my license Is in full force and eflecl. Lic. a CIa55 x Coniracrors Signewre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn Ihat the�e is a construc0on lentling egency lor Ihe pedortnance ot tha work lor which �his permit is issuetl. (Sec. 3097, Civil Code). Lentlers Name: Lenders Atldress: SigneNre: Date: OWNER-BUILDER OECLARATONS: I hereby ettirm Ihat under penalry of per�ury ihat I em EXEMPT FROM TME CONTRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or counry whic� reQuires a permit to construct, elter, improve, demolish, or repeir eny strucWre, pnor to iis issuance, also requires the applicant for such pertnit to fila a signed statement Ihet he or she Is Iicensed pursuant to ihe provisions oi ihe Contrectors LJcense Law (Chepter 9(commencing with SecUon 7000) of Divislon 3 of the Business and Pmfeulons Cade) or that he or she Is exempt therefrom enA the Dasis for the ellegetl esemption. Any violatlon ot Sectian 7031.5 by any applicant for e pertnit sub�ecls the eppliwnt to a civil penelry ot not more ihan five hundred dollers (5500).): ❑ I, es owner oi tha property, or my employees with wages es thelr sole compensatlon, WILL DO THE WORK, antl the structure Is not intended or oXeretl lor sale (Sec. 7044, Business and Professions Cotle: The Conirectors LicenSe Lew does not apply to en owner ot proper�y who builds or improves therean, and who tloes such work himself or herseN or through his or her own employees, pmvidetl thet such improvemems are not imendetl or oHeretl tor sale. Ii, however, the building or improvement is sold wit�in one year ol completion, the owner-builder will heve ihe burden ol proving that he or she did not build or improve for purpose of sale.). ' �1^as owner oF the properry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business and Protesslons Cotle: The contrectors License Lew tloes not epply to an ownar oi pmDetly who bullds or improves thereon, and who comrects lor such projed with a wNractor(s) licanse pursuent to lhe Contrectors License Lews.). 1 am exemplyntl¢[ sec. Business antl Professions Code for this reason: O`wne'r ID veritied by�lri�vers licensa. ❑ Ves ❑ No ry,T�Ddver's License No. Verificatlon of Ownership by (ype of tlocumenL i.e. - property tex blll or tleed)�-��y� DIVISION OF INDUSTRIAL SAFETV PEHMIT CERTIFICATION: ❑ I here6y cartity ihat no excavation five (5) or more teet in tlep�� into which e person is required to descend, will be made in connec�ion with work authorized by this permit, and ihat no building structure, scaHolding, falsework, or demolition or dismentling thereoi, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, 71tle e, Celllomia Adminis�retive Coda). ❑ As ownerbuiltleq I will not empioY anyone to do work which would requlre a permit from t�e Division of Industrial Safery, as noted ebove, unless such parson has a permi� to do such work from ihe division. Signature: Date: Division of Indusinal Sefery Permit Number. CERTIFlCATE OF COMPLIANCE AND AIITHORIZA110N OF ENTAY: I certify under penalty of perjury iha� I have read this application and state that the iniortnation given is correct. I egree to comply with ell stete laws entl ciry orainances relating to 6uilding consiruction, antl authonze representatives of the Ciry of Costa Mesa to enter upon the above-descr perty lor i pection Ourposes. I agree not to acupy or allow occupency of any building authorized by this pertnit until final inspection. �� loy(oy � na� pal.Owner(s)__ �� -�Date `�� AnNOr Authodzed Applicant Date CO�E I, INSPECTIONTYVE Pd7F RRID�LS 1616 Fixed System Final Fire Prevention 1266 Pool SDa Finel 200 Finel Re-Rool 201 Finel BIocWReteining Wall 202 Final Fectory Fire Place 203 Final Sign 204 Final Demolition COOE� INSPEGTIONTYPE 206 Final Mechanical 208 Final Plumbing 270 Final Electricel 212 Final Fire Preven�ion 220 Final Planning Approval 222 Final Sita 250 Final Builtling/Occupency $ 3 �/ A' ' � �•�.d G�,t 5;�;�-y �E51�ti�Ce. A;�'�-'ROVED (qIt11Y •.OF COSTA MESA �Fdd�,d0.��{(Iy�i.DAu [SlON Sl��S1��—d .� _ v\ i SN o►ita�� NO;��. ��IONS, DELETI S, OR COR��fr'j'�I(:711t1�{�s'�� APPR�2,VED BY,TH�6�Pt^A`N�V�9�1G DIV. (/ I \ .� E / ' ,l.l�l � , / 13 TE: R /� (714) 754-5273 • Fax (714) 754•4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suile No Vicinity: Parcel Nunmber: ELECTRICAL PERMIT 2560 OXFORD LN 14137332 npplicant: JOE VILLALPANDO Address: 74133 SKYVIEW RD Status: ISSUED Applied: 1 V02/2004 Issued: 11/02/2004 '�� : �LI'� Phone: 559-822-7402 MADERA,CA Owner: RENKER, JONATHAN AND SONA Address 2560 OXFORD LN COSTA MESA, CA Contractor. LEVEL BUILDERS INC Address: 14133 SKYVIEW RD MADERA,CA ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) � Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors t0 1hp Motors l0 10hp Motors to 50hp Motors l0 100hp Motors over t00hp Communication drops Zip: 93638 Phone: 714-360-0445 Zip: 926266123 Phone: 559-822-7402 Zip: 93638 License: 710077 SCOPE OF PERMIT REMODEL EXISTING 2 BATHROOMS IN S.F.D. WORK TO INCLUDE: REPLACE EXISTING FIXTURES AN� ADD A TUB TO EXISTING MASTER BATH. REF.: 803-01695 ELECTRICAL TO INCLUDE: 6 LIGHT FIXTURES, 4 OUTLETS, & 6 SWITCHES. 823.50 $0.00 $0.00 $0.00 $0.00 $0.00 $6.60 $4.40 $6:60 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 6 4 6 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighling Busway /100 ft . Standing Section � , Misc Electncal Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw ....: ...........up to 50 kva/kw � .................up to 100 kva/kw .....:............over 100 kva/kw Low Voltage Equipment � Low Volt Wiring System / Ckt Misa Conduit Misa Conductor Circus ( gen or ride) .Cirws (mech ride or lights) Christmas Tree Stand . , Fireworks Stand Other Electrical Fee � Investigation Fee �uantity $0.00 0 $0.00 0 50.00 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 NOTICE: The work authonzed by ihis permit shall comply with all applicable handicap access requirements under California statutes and relatetl regulations. (Ord. No. 9248, § t, 12-21-92) j. EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or ebandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applic �c�, and all requlred Inspections and finel approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2G4&48 (B�W) WORKERS'COMPENSATON DECLARAnON: • , I hereby eHirm untler penelry ot perjury one oi the following declarations: ❑ I heve end wlll maintein a certifiwte ol consent to selt-Insure tor workers' compensatlon, es provided lar by seccion 3700 of ihe Lebor Code, lor Ihe pertortnence of the work tor which �his permit Is Issued. 'Q1J heve end vnll maintain workere' compensation insurance, as requiretl by sectlon 3700 ol the Lebor Code, for the pedormance ot Ihe work for which ihis pertnit Is issued. C�ywork/e/y,i� m er satlonln rancecarrier d olic numberare: �% �� 'iC i' �i ��, � P Y Poliq N�umR6er. > . �(ihls sectlon nebd not be canp ered i�ermit is velued ef one huntlretl dollers (5/00) or less.) �"' . . . ❑ I certiry that in the pertormance of the work tor w�ich ihis permit Is issuetl, I shall not employ eny person in eny manner so es to become subject �o the workers' compensetion laws oi Celifomia, and a ree that if I should become subject to t�e workers' crompensetion pravisions oi Seciion 3700 of Ihe Lebar Coda, I shall torthwlth comply with Ihese prov' on9. � �_—'__ . / %%� - / Applicant Signeture: �> aP % .f �— �/G��/ fpete:�/( — Z Z O O y I�v:.a . ��-- . ,y,�_ . , WARtSWG: FAIL�RE TO SECU WORKERS' COMPENSATION COVERAGE IS UNL4WFUL AND SHALL SUBIECT AN EMP�OYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO IXJE HUNDRED THOUSANDDOLLARE�$100,� �,INADDITIONTOTHECOSTOFCAMPENSNTION,�AMAGESASPROVIDEDFORINSECTION3]O60FTHEL4BORCADE,IMEREST,ANDATTORNEV'SFEES. LICENSED CONTRACTORS DECLARA710N: I hereby eMirm ihat I em licensetl under provisions of Chapter 9(commencing wlth Section 7000) ot Divislon 3 of ihe Business antl Professlons Cotle, and my license Is in full Jw�eHect�:Lla_:A ,"e—?�•- . — Z S9 O ,, Class tl_.. � Contractor'S Signature:�"�"�" � �, Date �/ _� 2 0� .ii�-"—_ _ .. ' I i 7 CONSTRUCTION LENDING AGENCY: ❑ I hereby eNirm t�at ihere is e conslruction lending agency for the peAormance ol the work lor whic� ihis permit is issued. (Sec. 3097, Civil Cotle). Lendels Neme: Lender's Address: SignaWre: OWNER•BUILDER DECLARA710NS: Date: I hereby eHirtn thet under penalry of peryury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7037.5, Business antl Professions Code: Any ciry or counry which raquires e permit to consimct, alter, improve, tlemolis�, or repair eny stmcture, prior to its issuance, also requires the applicant tor such permil to tlle a signed stetement thet he or she Is Iicensed Dursuam to the provisions ot Ihe Contractors License Law (Chapter 9(commencing with Section 7000) ol Dlvislon 3 ot ihe eusiness end Prolessions Code) or thet he ar she is enempt therelrom and Ihe basis br t�e ellegetl ezemption. Any violetian of Section 7031.5 by eny epplicant for e pertnit subjects the applicent to e civll penelty of not more than five hundretl dollars ($500).): ❑ I, as owner of the property, or my employees with wages as Ihelr sole compensation, WILL DO THE WORK, and ihe structure Is not intendad or offeretl tor sale (Sec. 7044, Business and Professions Cotle: The Contrectors License Lew does noi apply to an owner ol property who builds or improves thereon, and who tloes such work himselt or herself or through his or her own employees, provitletl ihat such improvements era not intended or otteretl for sale. If, however, the building or improvemeni is sold within one yeer o� complo�ion, ihe owner-builder will have t�e burden ol proving that he or she did not build or improve for purpose o� sele.). ' ❑ I, es ownar of lhe proDerty, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTflACTORS to constmct the praject (SecJ044, Business antl Prolesslons Cotle: The contrectors License Lew does not apply to an owner of propeny who bullds or Improves thereon, entl who contrects for such pro�ect with e comractor(s) license pursuent to tha Con�rectors License Laws.). ❑ I am exempt under sec. Signature: Owner ID verified 6y drivar's license. ❑ Ves ❑ No Business ana Professions Code for this reason: Verification ot Ownership by (type ot dwument, i.e. - property ten bill or deed): OIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Driver'S LiCenSe No. Date: Ezpires: ❑ I hereby cenity that no excavetion tive (5) or more feet in depih into which a person is requiretl to tlescen0, will be made in connection with work authodzed by Ihis permi�, end the� no building structura, scattoltling, falsework, or demoli�ion or dismantling Ihereof, will be more ihan thirty-six (36) leet high. (Chep. 32, Grp 2, Art 2, Sec. 341, TiUe 8, Gelifomla Adminisirative Code). ❑ As ownar-builder, I will not employ enyone to do work which would require e permit irom the Division ot IntlusMal Safery, es notetl above, unless such person hes e permit to tlo such work irom Iha division. SignaNra: Date: Division ol Industnal Sefety Permii Number: CERTIFICATE OF COMPLIANCE AND AUiHORIZA710N OF EMRV: I cenify under penalry ol perjury ihat I have reatl this applicetion end state that �he informe�ion given is correc�. I egree to comply with ell state laws and city ordinances releting to building consimclion, entl authorize representatives of ihe Clry of Cosle Mese to enter upon �he ebove-descri6ed property for inspaction purposes. I egree not to occupy or allow acupancy of any building authorized by this permit until final inspection. Legal COOE �. INSPECTIONTYPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Finel Ra-Roof 201 Final BIocWReteining Well 202 Finel Fectory Fire Place 203 Finel Sign 204 Final Demolltion OATE z vv CODE� INSPECTIONTIPE 206 Final Mechanical 208 Final Plumbing 270 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling�Occupancy WEIDENKELLER, MARY JANE From: KENNERSON, SILVIA Sent: Thursday, October 02, 2003 921 AM To: W EIDENKELLER, MARY JANE Subject: 2560 OXFORD LN ADVISED PROPERTY OWNER HE HAS AN EXPIRED PERMIT AND YOU SENT HIM A 10 DAY LATER EARLIER THIS YEAR. HERE'S THE PERMIT #602-01141. THANKS! Silvia O. Kennerson City oFCosta Mesa Bldg. Dept. (714) 754-56b2 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA. CA 92626 Job Address: 2560 OXFORD LN Suite No Vicinity: Parcel Nunmber: 14137332 Applicant: JOE VILLALPANDO Address: 74133 SKYVIEW RD MADERA,CA PLUMBING PERMIT Status: ISSUED Applied: 11/OZ2004 Issued: 17/OZ/2004 ISSUED BY: Phone: 559-822-7402 Zip: 93638 Owner: RENKER, JONATHAN AND SONA Address 2560 OXFORD LN COSTA MESA, CA Contracior: LEVEL BUILDERS INC Address: 14133 SKYVIEW RD MADERA,CA Arch / Eng : - Address: - � - ISSUE FEE BackFlow irrigation BackFlow Preventer . Balhtub Clarifier System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Phone: 714360-0445 Zip:, 92626-6123 Phone: 559-822-7402 Zip: 93638 License: 710077 Phone: Zip: License: SCOPE OF PERMIT REMODEL EXISTING 2 BATHROOMS IN S.F.D. WORK TO INCLUDE: REPLACE EXISTING FIXTURES AND ADD A TUB TO EXISTING MASTER BATH. REF.: B03-01695 F�u��th PLUMBING TO INCLUDE: 2 BATHTUBS, 1� GAS (1-4 OUTLETS), 1 SHOWER, 2 WASH BASINS, 2 WATER CLOSETS, AND 1 WATER HEATER. .'� . , AMT $23.50 50.00 50.00 579.60 50.00 30.00 $0.00 30.00 $0.00 30.00 FEE SUMMARY QTY AMT Laundry Tub / Washer $0.00 0 -Landscape Irrigation � 30.00 0 � P-Trap " 50.00 2 Pressure Regulator $0.00 0 Process Piping (per 10 ft) $0.00 0 �Receptors $0.00 0 Septic Tank � � $0.00 0-- Sewer Cap for Demo 50.00 0 � Sewer Connect $0.00 0 Sewer Pnvate Line $0.00 QTY 0 0 0 0 0 0 0 0 0 0 Sump Pump Swimming Pool Trap Pnmer Urinal Vacuum Brkr Bktlow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closel (Toilet) AMT so.—oo 50.00 $0.00 $0.00 $0.00 50.00 $79.60 50.00 50.00 $19.60 �TY 0 0 0 0 0 0 2 0 0 2 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, § i, 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 suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes�,*anC,all requlred Inspections and Ilnal approval must be obtained. Failure to obtain inspections and final approval will resuA in the expirati�perrriit. FOR INSPECTIONS CALL: (714) 7545626 2d48d8(8N0) WORKERS'COMPENSA�ON DECLARAnON: � , ' I hereby aHirtn under penalry of perjury one of Ihe lollowing declarations: - ' ❑ I have entl will maintain e certiticate ol consent to sel4lnsure for workers' wmpensetion, es provitletl for by section 3700 of the Labor Code, for Ihe pertortnance of t�e work tor which this permit is issuetl. ❑ I have ena will ma'ntain workero' compensation insu nce, as requiretl Dy section 3700 of Ihe Lebor Code, for Ihe pedortnance ol the work for which �his pertnit is Issued. M workers' ens n Ins cerrler end ic number are: � / / / c� � Carner.Y , � � �� Y Policy Number: l� (� ��!O J (This secNon need nof be compleretl i/ the permif i elued at one hundred dollers ($100) ar IessJ . _ _ ❑ I cetlify ihat In Ihe pedormance ol the work lor which this pertnit is IssueQ I shall not employ any person in eny menner so as to become subject to the workers' compensetlon laws ot Calitomia, arW egree that it I should hecoma su6�ect to the workers compensation provisions ol Section 37W ot the Labor Cotle, t shall torthwtih comply with these prohsions. Apvlicani Signewre: �,(� �/� Date: ��—Z Z O V � WARNING: FAILURE TO SECUPE W ERS' COMPENSATION G ERAGE IS UNL4WFUL AND SHALL SUBJECT PN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUN�RED THOUSANDDOLLARE�5t00,000),IN� DITIONTOTMECOSTOFCOMPENSATION,DAAKGESASPROVIDEDFORINSECTION3]OBOFiHEIABORCODE,IMEREST,ANDATTORNEYSFEES. LICENSED CONTRACTOfiS DECLARATON: I hereby aHirm Ihat I am licensed roroe ena enec�. uc. a Contractor's Si9neture:� CONSTNUCTION LENDING AGENLY: Chapter 9(cammencing wilh Section 7000) of Division 3 of Ihe Business end Professions Code, end my license Is in lull qass a .�i �2 _. _. Date: // � � 2 i� 0 �/ ❑ I hereby ettirm Ihat there is a construction lending agency for the pedormance of the work for which this pertnit is Issued. (Sec. 3097, Civil Code). Lendafs Neme: LentleYs Address: Slgneture: Date: OWNER•BUILDER DECLAF7A710NS: I hereby eNlrm ihat under ponalry oi perjury ihat I em EXEMPT FROM 7ME CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Buslness entl Professlons Cotle: Any city or county which requires e permit to constmct, alter, improve, tlemolish, or repair any strucWre, prior fo its issuance, elso requires �he epplicant tor such permit to tile e signed stetement ihat he or she is Ilcensed pursuent to the provlsions oi the Contrectors License Law (Chapter 9(commendng with Section 7000) of Division 3 oi the Business and Professions Code) or Ihet he or she Is exempt theretrom end ihe besis for the alleged exemption. Any violatlon ot Section 7031.5 by any epplicant for e permit subJects Ihe applicant to a civil penalry ot not more then fiva huntlred dollars (5500).): ❑ I, as owner ot Ihe properry, or my employaes wi�h wages as their sole compensation, WILL DO THE WORK, end the s�ructure Is not intentled or oHered for sele (Sec. 7044, Business and Professions Code: The Contracbrs License Law tloes not apply to an owner oi property who builds or improves theraon, antl who does such work himself or herself or �hrough his or her own employees, providetl t�at such improvemen�s are not intended or oNered lor sale. If, however, Ihe builtling or improvement is sold within one year of complation, the ownerbuilder will heve ihe Durtlen ot proving that he or she dtd not builA or improve for purpose of sale.). ' 0 1, as owner ot the properry, am E%CLUSIVELY CONTRACTNG WI7H LICENSED CON7RACTORS to construct the prolect (Sec. 7044, Business and Professlons Code: The contractors ��cense Lsw tloes not epply to en owner ot propeny who builtls or improves Mereon, and who contracis br such project wllh a coniraaor(s) license pursuant to th9 Coniracbrs License LewsJ. ❑ I am exempt under sec. Business and Professions Code tor Ihis reason: Signatwe: Dete: Owner ID verified by dnvels license. ❑ Yes ❑ No Driver's License No. Vedficetion of Ownership by pype ol document, I.a. - property tax bill or deetl): Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I here6y certily that no excavation tive (5) o� more feet in tlepth into which e person is required to dascend, will 6e made in connection with work euthodzed by this permit, antl that no building siructure, scattoltling, lalsework, or tlemolition or dismamling thereoi, will be more ihan thiny-siz (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Celifomia AOminisire�ive Code). ❑ As owner-builder, I wil� �ot employ anyone to tlo work which would require a permit Iwm the Division ot Intlustnal Salery, es notetl aDove, unless such person hes a permit ro tlo such worK ham Ihe division. SignaNre: Date: Division ol Intlustrial Sefery Pertnit Number. CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF EMAV: I cenity under penalry at perjury ihat I heve read this epplicatian and stete thal the infortnatlon given is correcL I agree Io Comply wRh ell siate laws enC ciry ordinances relating to building consiruction, and authorize representetives of the City of Costa Mesa to emer upon the ebove-described property foY inspection purpases. I agree not to occupy or allow occupancy of any building authorized by this pertnit until final inspection. GO�E �. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spe Final 200 Finel Re-Roaf 201 Final8lwk/Retaining Wall 202 Flnal Factory Fire Place 203 Finel Sign 204 Finel Demolition PeIE ItL�1dLi �a�e �l _ j� 2�86 � Date COUE� INSVECTIONTYYE 206 Final Mechenicel 20B Final Plumbing 210 Final Eleciricel 212 Final Fire Prevention 220 Final Planninq Approval 222 Final Siie 250 Final Building/Occupanty pAIF 1[�EL9 • • ► (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: 2560 OXFORD LN 14137332 JOEL WIRTH 180 NEWpORT CENTER DR #180 NEWPOR78EACH,CA ELECTRICAL PERMIT Phone: (949)644-8801 Zip: 92660 Owner: RENKER, JONATHAN AND SONA Address 2560 OXFORD LN COSTA MESA, CA Convacror. ACME ELECTRIC Address: 180 NEWpORT CENTER DR #180 ISSUE FEE Temp service lesl Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a � Service to 1000a Service over 1000a Motors to 1hp Molors to 10hp Motars to SOhp Motors to 100hp MotOrS Over 100hp Communication drops Sub panel to 200a NEWPORTBEACH,CA NEW A/C UNIT Phone: 714-360-0445 Zip: 926266123 Phone: (949)644-8801 Zip: 92660 License: 527459 SCOPE OF PERMIT ELECTRICAL TO INCLUDE: 1 RES. APPL. AND 1 MISC. CONDUIT 523.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $4.75 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway N00 ft Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw . .................up to 50 kva/kw = .................up to 100 kva/kw ..................over 100 kva/kw � Low Vollage Equipment . Low Volt Wiring System /�Ckt Misc. Conduit - � ' Misa Conductor . Circus ( gen or nde) � Circus (mech ride or lights) Christmas Tree Sfand Fireworks Stand Other ElecVical Fee - " _ Investigation Fee Plan Check Fee Status: ISSUED Applied: 07/30/2004 Issued: 07/30/2004 Quantity 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 , 0 30.00 0 $0.00 ' 0 $1820" 1 $0.00 0 $0.00 ' '0" $0.00 �' 0 $0.00 0 $0.00 0 $0.00 $0.00 50.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. Nb. 92-28, § 1, 12-21-g2) 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. INSPEC710NS: In order for tha work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspections and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 is ::!ar•,.rn WORKERS' COMPENSAnON DECLAFiATON: I hereby ettirtn untler penalry of perjury one of tha following declarations: ❑ I heve end wlll maintein a certificate oi consent to self�lnsure for workers' compensation, es provided lor Dy sectlon 3700 0l the LaDor Code, for the peAormance of the ��WOrk lor w�lth thi5 permil i5 issuetl. F � Lfieve entl wlll malntain workere' compensation Insurance, es requiretl by section 3700 of the Lebor Cotle, Por the pedortnence ol Ihe work for which this permit Is Issued. `��My workers' com ensation Insu)r nce ca�rner entl policy number ere: /' Ce e� S�?v 7�i.✓� .,,F`o�Il,cyNu`mber.�;.��—�, 3 S^b � (fh� tlar neetl not be cromp/etea7! the perm/t !s velued af one hundred dollars ($100J or less.) ❑ I certlly ihat in ihe peAormence of Ihe work tor which this pertnit is issuetl, I shall not employ any person in eny manner so as lo become sub�ect to the warkers' compensailon laws of Celitomia, end egree that ii I should become sub�ect to the workers' campensation Drovislons ot Sectlon 3700 oi the Lebor Code, 1 shall torthwith wmply vrith Ihese provisio . / �ienl Signeture:""'�� /�y� Dete''': +�-�, � U /ZcJ `J 4 WAfilllNO:'fPILURE TO SE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SWll1 SUBIECT AN FIAPCOYER TO CRIMI PE TIES AND GVIL FlNES UP TOONE HUNDRED TIqUSAND DOLURE ($100,000), IN AD�ITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE LA90R CODE, IfJrEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS DECLARATION: ihat I em licensed u der pwvisions of Chapter 9(commencing with Section 7000) ol Division 4ihe�Busi�ress and Professlons Code, and my license is in full t: Llc'a^`_��7 �/S 9y Clase�p� � �a CONSTAUCTON LENDING AGENCY: ❑ I hereDy aNirtn that there is a conslruction lending agency lor the performence ot Ihe work tor which this pertnit is issued. (Sec. 3097, Civil Code). Lenders Name: Lender's Address: SlgnaNre: OWNER•BUILDER OECLARATIONS: Date: I hereby etfirm Ihe� under penalty of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. Business end Protessions Cotle: Any ciry or counry which reQuires e pertnit to consiruct, elter, Improve, demolish, or repair eny strucWre, pnor to Its issuance, also requires the applicant for such permit to file a signed stetement t�at he or s�e Is Ilcensed pursuent to Ihe pmNsions oi ihe Contractors Llcanse Lew (Chapter 9(commencing with Sectlon 7000) oi Division 3 af Ihe Business end Professions Code) or thet he or she is exempi therafrom entl the Dasis for the alleged exemption. Any violation of Soction 7031.5 Ey eny epplicent for e partnit suhjects the applicant to e civil penelry ol not more than tive hundred dollers (5500).): ❑ I, es owner of the properry, or my employeas with weges es ihelr sole compensation, WILL DO 7HE WORK, and �he structure is not intentled or ofleretl lor sale (Sec. 7044, Business and Professions Code: The Contractors License Lew does not apply to an owner ol properry who builds or improves Ihereon, and who does such work himself or herself or through his or her own employees, provlded ihat such improvements ara no� Inientletl or oflered for sale. If, however, ihe building or improvement is soltl wit�in one year ot completion, the owner-builder will have the burden ot proving ihat he or she ditl not build or improve for purpose ot sale.). � ❑ I, es owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to cons�ruct ihe prqect (Sec. 7044, Business and Proteulons Code: The coniractors Llcense Lew does not apply to en owner of property who builds or Improvas Iheraon, antl who contracts for such prol�t with a contrector(s) license pur5uant to i�e Contrectors License Lews.). ❑ I am exempt undet sec. BusinBsS end Professions Code br �his reason: SlgneNre: Date: Owner ID venTietl by Cnvefs licansa. ❑ Yes ❑ No Driver's License No. Venlication ot Ownership by (type of tlocument, I.e. - property ta: bill or deed): Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hareby certify that no excavation five (5) or more feet in depth Into which a person is required to descend, will be made in connection with work euthonzed by this permit, and that no building sWcture, swflolding, talsework, or tlemolition or Cismantling thereof, will be more than thirty-siz (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title B, Calitarnie Adminisiretive Cotle). ❑ As ownervbuiltler, I will not employ enyone to tlo work whic� would require e permit fmm the Division of Industrial Sefery, es noted ebove, unless such person has e permlt to do such work from ihe division. Signeture: Date: Divisian of Indusirial Safery Permit Number CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRY: I certity under penalry of perjury ihat I �ave read this applicelion antl state t�at the infortnation given is correct. I egree to comply with ell stete lews entl ciry ortlinances rela�ing to buildinq construction, end authodze represemetives of Ihe City ol Costa Mesa to enter upon ihe ebove-described properry tor inspection purposes. I agree not to occupy or allow occupancy o( any building authonzed by this Oermi� until linal inspection. COOE �. INSPECTIONttVE p�[ ' �, 7618 Fixetl System Flnal Fire Prevemlon 1266 200 201 202 203 204 Pool Spa Finel Flnel R8-Root Final Block/Reteining Wall Final Factory Fire Place Flnal Sign Final Damolition Date r%�a �f/ o Y ��_Date CODE 1 INSPECTION TYPE 20fi Final Mechanical 20B Final Plumbing 210 Flnal Electncal 212 Finel Fire Prevention 220 Flnal Planning Approval 222 FInalSite 250 Final Bullding/OccuDency F:�� '�� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.c��LDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 Job /+ddress: 2560 OXFORp LN Suite: Vicinity: Parcel Number: 14137332 Applicant: RENKER, SONA Address: 2560 OXFORD LN COSTA MESA, CA Zoning: Phone: 714-360-0445 Zip: 92626-6123 Owner: RENKER, JONATHAN AND SONA Address 2560 OXFORD LN COSTA MESA, Cq Contractor: Address: Zip: Arcn : TONY MASSA Address: 3100 AIRWAY AV C.M, CA SUITE 114 Phone: 714360-0445 Zip: 92626-6123 Phone: License: Eng: Address: Phone: 714-556-8299 Status: ISSUED Applied: 10/30/2003 Issued: 11/OS/2003 � . : 6�J Phone: Zip: 92626 License: C24376 License: SCOPE OF PERMIT REPLACEMENT OF 3 WINDOWS (ONE IN THE OFFICE AND 2 IN BEDROOM #2). HARDIE SIDING (ICBO #NER 405) WILL BE ADDED TO THE FRONT OF THE RESIDENCE. A GABLED ROOF WILL BE CONSTRUCTED ON THE EXISTING GARAGE WHICH CURRENTLY HAS A FLAT ROOF. NO SQAURE FOOTAGE IS BEING ADDED TO THE RESDIENCE. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $99.61 $153.25 $0.80 $0.00 $0.00 $0.00 $253.66 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Fmnt 0-0 PARKING Existinq: 0 FEE SUMMARY Calc Valuation: Sa,000.00 Claim Valuation: Sa,000.00 PLANNING & ZONING Rear 0-0 Left 0-0 Right Rear 0-0 Left 0-0 Right Required: 0 Proposed: 0 � r NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes antl 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 1 BO days. INSPEC710NS: tn order for fhe work authonzed under this 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 Ihe expiratlon ot this permit. FOR INSPECTIONS CALL: (714) 7545626 zaasss (s�oo� WORKERS' COMPENSATION DECLARATION! I hereby aHirm under penalry of perjury one of ihe following declarations: ❑ I have and will maintein a cartificate ot consent to self-Insure for workers' compensation, es provitletl for by section 3700 of the Wbor CoOe, for the peAormance of the work for which this permit is issuetl. /\ ' A i\ � have anp will maintain Workere' c�npensation Mr,��asscquired by section 3700 of the Wbor Cotle, Por the perfortnance of the woAc for which this permit is Issuetl. workeTs;c�pensation�lnsurence carner antl policy numbar ere: Ca ner. Policy Number: (lhis section need not be complefed il fhe permit is valued at one hundred dollers ($100) or less.) ��I certiy that in the peRortnance of Ihe work for which this permit is issued, I shall not employ eny person in any manner so as to become subject to the workers' compensation laws of Celifomia, and egree that if I should �ecome subJed to tha workers' compensation pmvisions of Section 3700 of the Labor Coda, I sheli forthwith comply with these pr s. Applicant Signature: �� /� 4. Data: I I�� IO ?i WARNING FAILUPE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVEF TO CFIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUN�RED THOUSAND DOLLAFE ($100,000), IN AODITION TO iHE COST OF CAMPENSATION, OAMAGES AS PROVIDED FOR IN SECTIQY 3]Ofi OF THE LABOF CODE, IMEFEST, AND ATTORNE`f5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am Ilcensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, end my license is in full force end ettect Lia # Class N Contractor's Signawre: Da[e: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm that there is a construction lending agency Por the pertormance of the work for which ihis permit is issuetl. (Sec. 3097, Civil Code). Lender'S Name: Lender'S Adtlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eHirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business and Professlons Code: Any ciry or counry which requires e permit b constmct, alter, improve, demolish, or repair any siructure, pnor to its issuance, also raquires the aDD�icant for such permit to flle a siqnad statement thal he or she is licensetl pursuant to the provisions of the Contrectors License Law (Chapter 9(commencing with Section 7000) oi Division 3 of ihe Business end Professions Cotle) or Ihet he or she is exempt Iherefrom end tha basis for the allegetl e:emption. Any violation of Section 7031.5 by any apPlicem for a permit subjecis ihe epplicant to a civil penairy ot not more than five hundred dollars ($500).): ❑ I, as owner of ihe properry, or my employees with weges es �heir sole compensation, WILL DO THE WORK, and ihe structure is not intentletl or oHered for sele (Sac. 7044, Business and Professions Cotle: The Contractors License Law does not apply to an owner of propeny who builds or improves thereon, and who does such work himself or herself or through his or her own employees, pmvided �hat such impwvemenis are not intentletl or oHered br sale. If, however, the building or improvement is sold within one year of completion, the owner-builtler will heve Ihe burden ot proving ihat he or she ditl not Duild or improve for purpose of sale.). ' �, I,.as owner of Ihe pmperty, am EXCLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS m constmct the project (SecJ044, Business and Profeuions � Code: The contredors License Lew does not epply to en owner oi property who builds or impmves thereon, antl who coniracts for such pmjact with a conhactor(s) license pursuent to the Comractors License Lews.). ❑ I am ea 0 der sec. Business antl Protessions Cotle tor this reason: Signature: � i � Date: � � Owner ID verifie y dnver's license. Yes ❑ No Dnver's License No. _ Expires: 05� � b� U.F Verification of Ownership by (type of docum�nt; i.e. - proparty tax bill or deedj: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenity that no excava�ion five (5) or more feet in depth into which a person is required to tlascentl, will be made in connection with work euthorizetl by this permit, and tha[ no builtling structure, sceHolding, falsework, or demoli�ion or dismantling Ihereof, will be more fhen ihirty-six (36) fee� high. (Chap. 3.2, Gry 2, Art 2, Sec. 341, Title 8, Califomia Adminisirative Code). ❑ As ownerbuilder, I will nat empioy anyone to do wark which would require e permit fmm the Division ol Industriel Sefety, as noted ebove, unless such person hes e pertnit to do such work from ihe division. Signature: Date: Division ot Industrial Safery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF EMRV: 1 certity under penalty of periury that I have read this application and state that ihe information given is conect. o comply with all state laws end ciry ordinances relating to builtling consimction, and au�honze represen�atives of Ihe City of Costa Mesa to enter upon Ihe ebove-de 'b roperty nspection purposes. I agree not to occupy or allow occupancy of any building authorizad by this permit umil final inspection. Il15/U3 Signature Of Legal Owner(s) Date And�Or Authorized Applicant Date COUE I, INSPECTIONTYPE 1616 FixeG System Finel Fire Prevention 1266 Pool Spe Final 200 Finel Re-Roof 201 Finel BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition PdIE 1I�19L9 COUEX INSPECTIONTYPE 206 Finel Mechanical 208 210 212 220 222 Final Plumbing Final Electrical Final Fire Prevention Finai Planning Approval Final Site 250 FinalBuilding/Occupancy PEIE I[�LS .a �� o� �?oQta i� �'uit'du y Du�i�ia�s OWNER-BUILDER VERIF[CATION A city or county, Which is reyuired to give notice pursuant to Sec[ion 19830, shall attach to such notice, and, as a condition pre�edent to issuing a building permit, require the completion and require the retum of, an owner-builder venfica[ion. Attention Property Owner: An `owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and retum this information in the envelope provided at your earliest opportunity ro avoid unnecessary delay in processing and issuing your building permit. No buildinc cemtit wili be issued until this verification is received. L I personally plan to provide the major labor and materials for conswction of the proposed property improvement.'� Yes ❑ No 2. l hav /have not) signed an applica[ion for a building permit for th oposed work. 3. 1 have contrac[ed with the following persun (�irm) ro provide the proposed construction: Name Address Phona ( City — Contractor's Lic. No. 4. 1 plan to provide portions of the work, but 1 have hired the folluwing person [o coordinate, superv�se und provide the major work: Name Address Phone ( City — Contrac[or's Lic. No. 5. I will provide some of the work but I iiave conVacted (hired) the following persons to provide [he work indicated: Name Address Phone Type of Work 100246 (REV.958� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT Job Address: 2560 OXFORD LN Suite No Vicinity: FAU IN CLOSET Parcel Number: 14737332 Appliwnt: CLARK, DAVID Address: 6892 CARNELIAN ALTA LOMA, CA Owner: MORGAN, ROBERT L Address: 2560 OXFORD LN COSTA MESA, CA Contractor: SOCO AIR CONDITIONING Address: 6892 CARNELIAN ALTA LOMA, CA ISSUED BY: Phone: (909)944-1340 Zip: 91701 Phone: Zip: 92626 Phone: (909)944-1340 Zip: 91701 License:333239 SCOPE OF PERMIT REMOVE & REPLACE EXISTING FAU. . ISSUE FEE Insl FAU <700 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Retrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers � . Smoke Dampers Inst or Relocate Appl Vent Air Handlers � t0000cfrn� AirHandlers> 10000cfm Floor Furnace Floor or Suspend Heater Quantity $23.50 $14.80 1 - $0.00 ' 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 . 0 $0.00 " 0 � $0.00 0 � so:oo=,�o,. ` � /,� $0.00 -_0 �- � . � $0:00� 0- - � ,' $0.00 0 . �$0.00 �,0 $0.00 0 . $0.00 �0 � . FEE SUMMARY Status: ISSUED Applied: 07/16I2007 Issued: 07/162001 �Repair I Alt Absorblion Unit Repair! Alt Refrigeration Unit Ventillation System Evaporative Cooler Commercial I nci neretor Domeslic Incinerator Compressors / Absorption SVstems . Upto3hp/700kBTU � 3To15hp/500kBTU , 15 TO 30-hp /_7,000 k BTU 30 To 50 hp /�1,750�k BTU Over 50 hp! Over 1,750'BTU .. , Boilers Up to'3 hp - , - i � - 3To15hp -� - � , " 15to30hp � - - , � 30 to 50 hp �, , � Over 50 hp � � OtherMechanical�Fee ' Investigation Fee ; � � Plan Check Fee Reinspection Fee; - TOTALCALCULATEDFEES COMMENTS / SPECIAL CONDITIONS Quantity $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 E38.3o NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-92) 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 for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspectiona and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 204fi-461N00) WORKERS'COMPENSPnON DECLARAnON: � � I hereby aNirm untler penalry of perjury one oi the tollowing declarations: ❑ I have and will main�ein a certificate ot consent to salf-Insure for workers' compensetlon, es provided lor Dy sedion 3700 ot Ihe Labor Code, for the pertormanca of Ihe work lor which Ihis partnit is issued. `�� I have end wlll meintain warkers' cpnpensation insurence, as requiretl by sectlon 3700 ol Ne Labor Code, for Ihe peAortnance of the work for which Ihis pertnit is issued. My workers' wmpe sation Insurence carner and policy number are: . /' 6 �Cartier: i ��72 Fu h � . � PolicyNumber - .� %� % 6�0 -�J / (This secHwrneed no! be �omp/eted il the Oermit Is valued et one hundred dollars ($100) or /essJ — ❑ I cenity thst In t�e pOAortnance oi Ne wock for which this pefmil is issued, I shafl not employ eny person In arcy manner so as to becrnne suD�act to the workers' compensetion laws a� Califomle, antl agr thet ii I should become su��ect to the workers' compensation provislons of Section 3700 0l the Lebor Coda, I shall forthwith compty with these ns. /� Applicent Signeture:`�� —✓��7 � �Dete� � /G / % � � ln ^ � / , WARNING:'FAILURE TO SECURE WORKERS' COMPENSATION COVEMGE IS UNIAWFUL M!D SHALL SU&IECT rW EMPLOVER TO CRIMIWIL PENALTIES AN� CNIL FlNE$ UP TO ONE NUNOHED THOUSAND DOLURE (5100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PHOVIDED FOR IN SECTION 3]Ofi OF THE LABOR CODE, IMEREST, AND AiTORNE`fS FEES. LICENSED CONTRAC70AS DECLARATION: I hareby aNirm thel I.em force and eHect. Lic. N Contractors Si4netura:� 9(commencing with Section 7000) of Divislon 3 of the Business antl Professions Code, entl my license Is in full ' Class q � i� � � i7' /� %Daie: � 7 —1 G �U / CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn Ihat ihere is e consiruc�ion lending agency for Ihe peAortnanca ol the work for which �his Oermit is issuetl. (Sec. 3097. Civil Code). Lenders Name: Lentlafs Adtlress: Signature: Date: OWNER-BUILDER DECL�ATIONS: I hereby eMirtn that untler penelry ot perjury thet I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business end ProFessions Cotle: My ciry or wunty Which requires a permit to construct, alter, improve, tlemolish, or repair eny siructure, prior to its issuance, elso requires the eppliwnt for such partnit to tile e signed statemant thet he or she is Ilcensed pursuant to the proNsians of [he Conirectors License Lew (Chapter 9(commendng with Secibn 7000) ot DlWslon 3 0l the Business end Professions Code) a thet he or she is exampt therefrom and the besis tor Ihe elleged e:emption. Any violation of Section 7037.5 by any epplicent far e pertnit subjects t�e epplicent to e civil penalry of not mora Ihan five hundred dollers ($500)J: ❑ I, es ownar M the property, or my employees with weges as lfieir sWe compensation, W{LL DO TME WORK, and the structura is nof Intentletl or orieretl for sale (Sec. 7044, Business antl P�ofessions Code: The Comractors License Law tloes not apply to an owner ol property who builds or improves ihereon, and who tloes such work himselt or hersetl or �hrough his or her own employees, providetl tha� such Improvements ere not Intended or oHered lor sale. If, however, �he building or Improvement is soltl wi�hin one yeer of completion, the owner-builder will heve t�e burtlen of pmving thai he or she did not build or improve tor Durpose ot sale.). ❑ I, as owner of the prd7erty, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business entl Prolessians Cotle: Tha contracto�s LicenSe Lew does not apply lo en owner ol property who hulld5 Or Improves thereon, entl who contracls for such prolect wlth e coniractor(s) liten5e pursuent to tne Contrectors License Laws.). ❑ I am eaempt under sec. Business and Professions Cotle br �his reason: SlgneWre: — - Date: Owner ID venfietl Dy tlrivei's license. ❑ Ves ❑ No DnveYs License No. Expires: Vedficetian oi Ownership By (type of document, i.e. - properry tex bill or tleetl): DIYISION OF INDUSTRIA� SAFETY PERMIT CERTIFLCATION: ❑ I hereby certity that no excevation five (5) or more tae� in depih into which e person Is required to descentl, will be made in connection with work euthonzed by this pertnit, end thet no building structure, scalloltling, falsework, or demolition or dismantling t�ereol, will be more ihan ihirry-six (36) teei high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, 71t1e 8, Califomle Adminisiretive Cade). ❑ Ps ownar-Dullder, I wi�l not employ anyone to tlo work wnich woultl require a permit from the Division of Industrial Safery, es notea above, unless such person has a permit to do such wa�k tmm the tlivision. SignaWre: Date: Division of Industrial Salery Permit Numbec CER71FlCA7E OF COMPLUINCE AND AUTHORQATON OF ENTflV: I certity under penalry oi perjury ihat I have read ihis epplication antl state ihat ihe informauon given is correct. I egree to comply w��h ell sta�e laws entl ciry ortlinances relating �o bulltling consiruction, and authoriza represen�atives of ihe Ciry of Coste Mesa to enter upon 1he ebovo-described property far inspection puryoses. I egree not to occupy or ellow ocapency of eny building authorized by ihis permit un�il final inspection. FOUE �. INSPECTIONTYPE PAtF INTRIALS 1616 Fized System Fin81 Fire Preven�ion 7266 200 201 202 203 Pool Spa Final Final Re-Rool Final BIocWReteining Wall Final Feciory Fire Placa Finel Sign 204 Final Damalitian COOEA INSPECTIONTYPE 206 Final Mechanical 208 Finel Plumbing 210 Final Electrical 212 Finel Fire Prevention 220 Final Planning Approval 222 250 Final Site Final BuiltlincyOccupancy -/ �V �G/ (714) 754-5273 • Fex (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: Applicant: Address: 2560 OXFORD LN KITCHEN AND FAMILY ROOM 14137332 HENRY,STEVE 2744 ROBERTA DRIVE ORANGE,CA Owner: RENKER, JONATHAN Address 2560 OXFORD LN COSTA MESA, CA Contractor: STEVE HENRY ELECTRIC INC Adtlress: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over t000a Motors to 1hp Motors to 10hp Motors to SOhp Motors to 100hp Molars over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole 2744 ROBERTA DRIVE ORANGE,CA Phone: 714.771.7047 Zip: 92869 Phone: Zip: 92626-6123 Phone: 714.771.7047 Zip: 92669 License: 650501 ISSUED BY: Status: ISSUED Applied: 09/05/2002 Issued: 09/05/2002 SCOPE OP PERMIT 1513 SF INTERIOR REMODEL OF THE KITCHEN AND FAMILY ROOM OF AN EXISTING ONE-STORY SFD. 15 LIGHT FIXTURES, 20 OUTLETS, 12 SWITCHES, 1 SERVICE T0200A (CHANGE-OUT). REF:B02-01141 523.50 $0.00 $0.00 $0.00 $0.00 $0.00 $16.50 $22.00 $1320 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 15 20 12 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist Syslem / Lighting Busway /100 ft Standing Section Misc Electrical Equipment Trensformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Vol[ Wiring System / Ckt Misc. Conduit Misc. Conducfor Circus ( gen or ride) Circus (mech nde or lights) Christmas Tree Stand Fireworks Stand ONer Electriwl Fee Investigation Fee Plan Check Fee Reinspection Fee Quanlity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 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 $105.70 COMMENTS I SPECIAL CONDITIONS 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, t2-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if vrork is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inepections end tinal approval must be obtained. Failure to obtain inspections and final approval will resutt in the expiration of thls pertnit. FOR INSPECTIONS CALL: (714) 754-5626 zanans�eroo� WORKERS' COMPENSATION DECLARATION: � I hereby eMirtn under penalry ot perjury one of the following tleclaratlons: ❑ I heve and wlll malntain a ceNiiwte of wnsent to sel4lnsure lor workers' compensetion, es pmvided br by section 3700 of the LeDor Code, for t�e pertormence of Ihe ,–,/ work for whith this pertnii is issuad. y� I have and will maintain workers' compensation Insurance, as require0 Cy section 3700 0l the Lebor Coda, for Ne pertortnance ot the work br wMU this pertnll is issued. My workars' compensatlon Insurence wrder entl policy number are: Carrier. S�T�wT,F �'µai,o PolicyNum�er. �d94/ZS� %� (fhls section neetl not be comp/eted i/ the permiNs valued af one hundr�tl dollars ($100) or less.) ❑ I cenify that in the pertormance of the wo tor w�ich thi�p em compensetlon laws of CaliFornla�e d a ee ihet If I sh Eltl 6e1 compty with these provision3/ � Applicent Signeture: i� '� WFRNINO: FAILURE TO SECURE WORI(ERS' OOMPENSATIqJ WVERAGE T1i0USAND OOl1ARE (5100,W0), IN AOUfTION TO THE COST OF COMPEN& LICENSED CONTRACTORS DECLARATON: I hereby aHirm that I am Ilcensed under p�ovisions oi Chap�er force end eHect. Lic. A / Sa f"'y'f%L_ / Contractofs SignaWre: issue0, I shell not employ any person in any manner so as to become sublact to the workers' sub�ecl to the workers' compensatlon provislons of Sectlon 3700 of Ihe LeDor Code, I shall forthwlth � oe�a: �,� l� � MWR1L AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AN� GVIL FlNES UP TOONE HUNDRED , DPA41GE5 AS PROVIOED FOR IN SECTION 3106OF THE LABOR OODE, IMEREST, AND ATTORNEVS FEES. with Section 7000) ot Division 3 0l the Business antl Prolessions Cotle, antl my Ilcense is in tull Clessx C�—/o oece: 9%s /p � CONSTRUCTON LENDING AGENCV: ❑ I hereDy ettirm Iha� there is e consWction lending agenq tor Ihe peAormance ot [he work tor which t�is pertnit is issued. (Sec. 3097, Civil Code). Lenders Name: Lendefs Atltlreu: Signature: Date: OWNER-BUILOER DECLARATIONS: I hereby ettirm that untler penelty ol peryury thet I em EXEMPT FROM THE CONTRAC70RS LICENSE LAW lor the following reason (Sec. 7031.5, Business entl Prolesslons CoOe: Any ciry or county which requires e permit to construct, elter, improve, demolis�, or repair any structure, prior to its issuance, elso requires Ihe epplicant for such pertnit to flle e signed stetement ihet he or she Is Iicensetl pursuam to the proWslons ot the Contractors Licensa Lew (Chepler 9(commencing wlth Secllon 7000) ot Division 3 01 t�e Business and Prolessions Code) or thet he or she is exempt theretrom antl the 6asis for Ihe ellegad exemption. Any violetion oi Sectlon 7031.5 by eny applicant for e permlt subjects Ihe applicant to a civil penelry of not more than Tive hundred dollers ($500).): ❑ I, es owner of the property, or my employees with wages es iheir sole compensation, WILL DO THE WORK, and the structure is not Intendetl or otteretl for sale (Sec. 7044, Business antl Protesslons Code: The Contractors License Lew Aoes not epply to an owner ol proparry who builds or improves Iheraon, and who tloes suc� work himselt or herselt or Ihrough Ms or her own employees, provided that such impmvements ere not Intended ar afleretl tor sale. If, howaver, the building or Imprrnement is soltl within one year ot completion, �he owner-builder will have tha burtlen of proving thai he or sha ditl not build or improve tor purpose ot sale.). ❑ I, es owner at the pmperty, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to conslruct the prol�t (Sec. 7044, Busineu end Prolessions Coae: 7Te contractore Llcense Lew does not epply to en owner of propeny who hullds or Improves Ihereon, and who wntrects lor such project with e contractoqs) license pursuant to the Contrectora License LawsJ. ❑ I em exampt under sec. Business and Professions Cotle for this reeson: SlgnaWre: Date: Owner ID verifled by dnvers IlCense. Ves ❑ No Driver's Liten50 No. VenTication ol Ownership by (Iype af document, i.e. - property lex bill ar Aeetl): Expires: DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATON: ❑ I hereby certify Ihat na excavetlon fiva (5) or more feet in dept� into which e person Is required to descend, will �e made in connectlon with wark euthorized by this permit, and ihat no building siructura, scattolding, falsework, or demolitlon or tlismantling �hereot, will be more ihan thirty-sis (36) teel high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Adminisirative Code). ❑ As owner-builtler, 1 will nof employ anyone to do work which woultl require a pertnit irom ihe Divislon ol Industrial Safery, es notad above, unless suc� person �as e permit to do such work from ihe division. Signa�ure: Date: Division of Indusinel Satery Partnit Number: CERTFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I certiy under penalry of perjury that I have read ihis epplication antl state that the information given is correcL I agree to comply with ell state laws end city ordinances releting to building consiruction, entl eNhodze representa�ives of ihe Gty of Costa Mesa �o enter upon Ihe ebove-descn6etl property for inspection purposes. I egree not to occupy or allow occupancy ot any building euthonzed by ihis permit until final inspection. GOOE �. INSFECTONTYPE 1616 Fixed System Final Fire Preventlon 1266 200 201 202 203 Pool Spa Finel Finelfie-Root Finel BIocWRetaining Well Final Faclory Fira Place Finel Sign 204 Finel Demolition � � SLs/p � Date CODE 1 INSPEGTION TYPE 206 Finel MeChanical 20B Finel Plumbing 210 Finel Elecirical 212 Finel Fire Prevention 220 Finel Planning Approval 222 Finel Site 250 Finel Builtling�Occupanry � /l 81 6Y— It� I (714) 754•5273 • Fan (714) 754-4856 • www.ci.costa-mesa.ca.us T! FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 2580 OXFORD LN Suite: Vicinity: KITCHEN AND FAMILY ROOM Parcel Number: 14137332 Zoning: Applicant: RENKER, JONATHAN AND SONA Adtlress: 2560 OXFORD LN COSTA MESA, CA Owner: RENKER,JONATHAN Address 25600XFORXDLN COSTA MESA Contracror: VALENTE, RICHARD Address: 2300 FAIRVEW RD COSTA MESA, CA Zip: 92626 Arch : Address: Phone: Zip: 92626 Phone: Zip: 92626 Phone: 714-215-4883 License: 724232 Status: ISSUED Applied: 07/24/2002 Issued: 08/29/2002 ISSUED 8Y: �/L!'\ • ' • � j' / � ♦' Eng: NELSON CONSULTING ENGINEERS Address: WILLIAM M NELSON Phone: IRVINE, CA Phone: 949-752-2070 17815 SKY PARK CI STE G Zip: License: 92614 License: SE3417 SCOPE OF PERMIT 1513 SF INTERIOR REMODEL OF THE KITCHEN AND FAMILY ROOM OF AN EXISTING ONE-STORY SFD. WORK TO ALSO INCLUDE MODIFICATIONS TO THE ROOF AND CEILING. NO ADDED SQUARE FOOTAGE AND 67 SF COVERED FRONT PATIO. Plan Check: Permit: SMIP Res: SMIP Cam: Other: Inspection: Total: $320.29 $492.75 $3.50 $0.00 $0.00 $0.00 $816.54 SETBACKS MAIN STRUCTURE Front 20- 0 ACCESSORY Front 0- 0 PARKING Existin : 4 NOTES: Rear 28- 0 Rear 0- 0 Reauired: 4 FEESUMMARY Calc Valuation: S35,000.00 Claim Valuation: 5se,000.00 PLANNING & ZONING Lefl S 0 Right Left 0- 0 Right Pr000sed: 0 5- 0 0- 0 NOTICE: The work authorized by this permit shall comply with all applicabla handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandonad tor a period of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspectlona and final epprovel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 zsae-es�aroo� WORKERS'COMPENSATON DECLARATON: _ � . I hereby affirm under penelty of perjury ona of the following tlaclaratlons: ❑ I Oave end wlll meiNein a certiticate of consent to setl-Insure tor workers' compensation, as provided lor Dy section 3700 ot the Lebor Code, for the pertortnance of Ihe work for which ihi5 permil Is issuetl. �I have entl wlll maintain workers' compensatlon Insurence, as requiretl by sedion 3700 of the Lebor Catle, for t�e peAortnance of Ihe work for which this pertnit is issued. My workers' compensatlon Insurenca wrder end pollcy number are: Carnar: Policy Number: (Th/s secflon need not be completed il (he permlt !s velued et ane huntlretl tlollers ($100) or less.) ❑ I certifyd In the peAormence of Ihe work for which chis pertnit is Issued, I shall not employ any person in eny manner so as to become subject to the workers' compensetion s of Califomia, end egrea thel H I shoultl become uh�ect to ihe workers' compensetlon roNsions of Section 3700 ot the Lebor Cotle, I shell lorthwith com � rovislons. / � picamSignatur/e: �� V, Date: ��~�2�� WARNINO: PIETO SECl1PE WORNEPS' COMPENSATION COVERA E IS UNUWFUL AND SMPLL SUBIECT AN E VER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOIXJE MUNDRED D OOLLARE (5100,000). IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SEGTON 3/0fi OF TME UBOR CODE, INfEREST, PND ATTORNEV'S FEES. LICENSED CONTAAC70RS DECLARATION: I he m Ilcens d nder provisions Cha ter 9(commencing with Section 7000) of Division the Business end,.Qrolqs io�Cotle, entl my Ilcense is in tull fo antl eH '. q �. %7 ��L..�%r�f/ Class q 1J l'f o ctors natura: i ��T— e: �/r-2q—?lJDZ– c CONSTRUC710N LENDING AGENCY: ❑ I hereDy eNirtn Ihat there is e construction lentling egency br ihe pertormence of the work for which this pertnit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: SignaWre: Date: OWNER-BUILDER DECLARATIONS: I hereby eflirtn that under penelry of perjury thet I em EXEMPT FROM TNE CON7FiAC70R5 LICENSE LAW tor t�e following reason (Sec. 7031.5, Business entl Professions Code: Any ciry or counry,which requires e parmit to constmct, elter, improve, demolish, or repair any sWcture, prior to its issuance, elso requires ihe epplicant for such permil to file a signed stetement thaLhe or she is Ilcensed pursuent to the provisions of the Comractors License Lew (Chepter 9(commencing with Sectlan 7000) 01 Divlsion 3 of the Busine55 Bntl Pmtesslons Gode) Or ihet he Or She i9 exempt therelrom end the basis tor Ihe alleged e:emption. Any violation at Section 7031.5 Ey any Bpplicent for e pertnil subjects ihe epplicant to a clJi(penaly af nat mare than five huntlretl tlollers ($500).): ❑ I, es owner ol the property, or my empl0yaes with weges es Iheir sole compensation, WILL DO THE WORK, and the Slructure is not intended or offeretl for sale (Sec. 7044, Business entl Professlons Code: The CONractors License Lew does not apply to an owner ot propeny who builds or improves ihereon, and who does such work hlmseli or herselt or ihrough hls or her own employees, provided Ihat such impwvemems are not imended or oflered for sale. tl, however, ihe building or impmvament is soltl wit�in one year of completion, �he owner-builder will have �he 6urdan of provin91hat he or she did not build or improve for purpose ol sale.). ❑ I, as owner of ihe property, am E%CIUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construcl the project (Sec. 7044, BuSiness end Professions Cotle: The contracmrs Llcense Lew does not epply to en owner ot propeny w�o builds or impmves Nereon, end who contraas br such pmject with e contractor(s) license pursuent to the Contrectors License Lews.). ❑ I em exempt under sec. Business entl Protessions Code lor ihis reeson: Signeture: Date: Owner ID venfied by dnver5liCenSe. ❑ V05 ❑ No Drivers Licen90 No. Expire5: Verificetion at Ov.nership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTFIAL SAFETY PERMIT CERTFICATION: ❑ I hareby certiy Ihet no ezcavetion five (5) or more teet in depth into which a person is required to descend, will be made in cannection with work authorizetl by thls permit, end thet no building siructure, scaflolding, talsework, or demolition or dismantling thereof, will be more than Ihirry-six (38) teet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, Califomla AOmIni5lrative Cotle). ❑ As awner-bullder, I will not employ anyone to do work which would require a permit from the Divislon at IndustAal Sefety, es noted ebove, unless such pereon hes e permil to tlo such work irom Ihe tlivision. Signature: Date: Division oi Industriel Selery Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the eDP�� or present or fuWre bulltling occupant neetl to file antl cerlify a Business Plan for emergency response to release or threatened release oi a hazardous matedel7 ❑ Ves ❑ No (Section 25505 0l the Calilomie Heelih end Sefery Cotle requires, with some exceptions, thet e Business Plan be filed with the Costa Mesa Fira Depertment 6y every busineu which has et eny one time tluring a reported year a quantity ol hazardous meterials equal to or greater than e weight of 500 pounds, or e volume of 55 qallons, or 200 cuhic faet o1 compressed ges et slendard �emperature antl pressure). .....................__.......................__............................__......_......................._._.__........................._........................_._..._.......................__......................................................—""'.............................._...................._........._ 2 Does or will t�e epplicent or presem or tuture building occupant need to file a registration form lor acutely �arartlous matedals9 ❑ Ves ❑ No (Section 25533 0l Ihe California Heelth end Setety Code, with soma a:cepIlons, requires registretion wlt� the Casta Mesa Fire Depanmen[ by each buslness which at eny one time has on hand a quentiry oi ecutely �erardous meterials equal to or greatar Ihan e welght ol 500 pountls, or e volume ot 55 gellons, or 200 cubic faet oi 3s or will the epplicant or present or future bullding occupant neetl to prepare an V89 ❑ No (Section 25534 of t�e California Heelth end Sefety Code provides that the Cos�a Mesa Fire Depanment may requlre ihe preperation, certlflcation and filing with the Fire bepanment ol en RMPP by businesses which are reqWreO to register acutely hazardous matedals wlth the Fire Depertmen�. 4 If en �RMPP is presently required,�hes Saction 25534 of �he �Celifomie Heelth antl Sefety Code been fully compliad with7 ❑ Yes � ❑ No ........................................................................................................................................................................................................................................................................................................................................................................................ 5 Does or will the eppllcent or present or tuture bulltling accupant require tor the work which Is the sublect of this a plicetion a germit for such consiruciion or motlificatlon from tha Sauth Coesl Alr Qualiiy Manegemem Disirict or imm eny other alr polWtion comrol dlsidc� or agency7 � Ves LI No (Section 65850.2 of the Cellfornle Government Cotle requires ihat ihe requested informetion 6e furnished an apPlicetlons for non-residentiel bullding permits). ....................................................................................................................................................................................................................................................................................... ....................... ................................................................. 6 Will any pan of the feclliry to be conslructetl undar this pertnit ba within 1000 feet from t�e outer boundedes of e school7 ❑ Yes ❑ No Qf'yes", the feclliry must meel the reqWrement of Sections 25534 entl 62303 ot the Celibmia Health end Safery Cotle). .........................._.._....................................................................................................................__............................................................................................................................................................................................................................... 7 tl e yermil from the Soulh Coest Air �uality Menagement DlStntl or other air pollutlon control dislrici or egency is requlretl for the wark w�ich is Ihe suDject of lhis eoolicetlon. heve ell ol the disclasures orescrl�etl bv Californle Health and SafeN Cotle Section 42303 been mede7 ❑ Ves ❑ No Qt yes', atlech cenificate oi compllence irom the appropnate e CERTIFICATE OF COMPLIANCE: I cenify that untler penalry regarding Hazertlous Materials end Emissions. Signature: perjury the information given above is correct I egree to comply with all state lews and ciry ordinances Date: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF EMRV: I certify untler penalty of perjury thet I heve reatl this epplication and stete Ihat the informa�ion given is wrrect. I agree to compty wlih all state laws end ciry ordinances relating to building construction, and euthorize representatives of the Clty of Casta Mesa to enter upon Ihe ebove-descnbed property lor inspection purposes. I agree not to occupy or allow occupancy of eny building authorized by t�is Dermi� until final inspection. COUE 1. INSPECTIONTYiE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Flnel 200 Final Ra-Root 201 Final BIocWRetelning Well 202 Finel Fectory Fire Place 203 Final Sign 200 Finel Demolitian Q�¢, INTRIRLS �QQE� INSPECTIONTYPE 206 Final Mechenical 208 Final Plumbing 210 Final Electrical 212 Final Fire Preventlon 220 Final Planning Approvel 222 Finel Site 250 Final Building/Occupency VI.tl�I:nnL1R1 (714) 754-5273 • Fax (714) 754-4856 •�wiw.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT .lob /+ddress: 2560 OXFORD LN Suite: Vicinity: ROOF Parcel Number: 14137332 Applicant: RENKER, JONATHAN Address: 2560 OXFORb LN COSTA MESA, CA Owner: RENKER, JONATHAN Address 2560 OXFORD LN COSTA MESA, CA Contractor. O W N E R-B U I LD E R Address: Zip: Arch : Address: Phone: 2oning: Phone: 714-360.0445 Zip: 92626-6123 Phone: Zip: 92626-6123 Phone: License: 0 Eng: Address: SWtus: ISSUED Applied: 09/12/2002 Issued: 09/12/2002 Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 1/2" PLYWOOD, 15# FELT, METAL EDGING AND FLASHINGS, 30 YR COMPOSITION SHINGLES. 1,000 S.F. FOR RESIDENCE ONLY. Plan Check: $0.00 Permit: $54.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $54.50 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existina: o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Lefl 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Righl 0- 0 $1,478.00 $1,478.00 NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Califomia slatutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permlt 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 for the work authorized under this permit to be considered Iegal, such vrork must compty with all applicable codes, antl all requlred Inspectlons and final epproVel must be obtained. Failure to obtain inspections antl final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754�5628 taaae �aroo) WORKERS'COMPENSAnON DECLARATON: �' � I hereby aMirm untler penalty ol perjury one of the tollowing declarations: ❑ I have and wlll mainteln e certiilcate ol consent to selFlnsure tor workers' compansetion, es provitletl for by sectlon 3700 oi the Lebor Code, for ihe pertortnance of the work far which this permit Is issuetl. ❑ I have end wlll mainteln workare' compensation insurance, as requiretl by section 3700 of the Lehor Cotle, br the peAortnflnce ol Ihe work for which ihis pertnit is issued My workers' compensatlon Insurance ca�rle� entl policy number are: Carrier: Policy Number: (This section need nat be completed i! fhe permit is velued et one hundred dollers ($100) ar less.) '�� I certity that in Ihe peAormence of the work for which this pertnit is luued I shall not employ any person in any manner so as to become subject to Ihe workars' compensatlon lews of Califomia, entl egrea thet tl I should become subject to Ihe warkers' compensatlon provisions ot Sectlon 3700 of the Labor Catle, I shell forthwith comply with the rovisions. � n�, � �PP�� I'Slgnaturb�y� 1L�}�-�/�. Deros '� L2�O�j� WARNINO: FAILURE TO UPE WORKERS' COMPENSATIIXJ COVERAGE IS UNLAWFI/L AND SHALL SUflIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED TlqUSrW D DOLLARE (5100,ODO�.IN FDDITION TO THE COST OF COMPENSATION, DAA4IGES AS PROVIDE� FOR IN SECTION 3/W OF THE IABOR COOE, INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm that I em Iicensed under provisions ol Chapter 9(commencing with Sectlon 7000) ol DlWslon 3 of the Business antl Professions Code, and my Iicense Is In tull force end eXect. Lic. N Cleu a Cantractofs Signeture: Date: CONS7AUCTION LENDING AGENCY: ❑ I heieby effirm �hat there is a construction lending agency for the pertormanca ol the work lor which this permit is issued. (Sec. 3097, Civil Code). lenders Name: Lentlels AtlCress: Signatura: Date: OWNER-BUILDER DECLARATIONS: I hereby ettlrtn that under penelry at perjury thet I am EXEMP7 FROM 7ME CONTRACTORS IICENSE LAW for the tollawing reason (Sec. 7031.5, Buslness and Pratessions Code: Any ciry or counry which reduires a parmit Io consimct alter, improve, demolis�, or repair eny stmcWre, prior to Its issuence, elso requires ihe epplicant tor such permit m file e signetl stetement that he or sha Is Ilcensed Dursuant to ihe provisions ol the Coniractors License Lew (Chepter 9(commencing wlth Sectlon 7000) of Division 3 of Ihe Business end Pmtessions Code) or thet ha or sha is exempt therefrom antl the basis for the elleged exemption. Any vloletion of Sectian 7031.5 by any applicent for a pertnit subjects the eppllcent to e civll penalty ot not more than tive hundred dollers ($500).): ❑ I, es owner ol the property, or my emplayees with weges as Iheir sole compensetion, WILL DO TME WORK, and Ihe structure Is nat Intended or otfered tor sele (Sec. 7044, Business end Professions Code: The Contraciors Licensa Law does not apply to en owner of property who builds or improves ihereon, antl who does such work himself or herself or through his or her own employees, providetl that such Improvements are not Inlentled or oNered for sale. If, however, the building or Improvement is sold within one yeer of completion, the awner�builder will have ihe burden at praving Ihat he ar she tlitl not �uiltl or improve for purpose of sele.). ❑ I, as owner of the properry, em E%CLUSIVELY CONTPACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business and Professlons Code: The contrectors Llcense Lew tloes not apply to en owner of property who Duiltls or Imprwes t�ereon, end who contraas for such pmject with a cnmracbr(s) � licensa pursuant to the Contrectors License Lews.). sec. Business and Protessians Cade for Ihis raason: cDOIB:� Z O% 3Yslicensa. Yes ❑No �DriveCs.LicenseNo. � �pire_�;y L Dy (type oi tlo me Le. - properry ta: bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ 1 hereby cenily Ihet no excevation five (5) or more feet in depih into whiCh e per5on i9 required to descend, will be made in conneciion with work authorized by Ihis pertnit, end that no buildinp swcture, scaMolding, falsework, or demolition or dismantling Ihereol, will be more then Ihirty-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Celifomle AOminisiretive Cotle). ❑ As owner-Duiltler, I will not employ anyone Io tlo work which would raqulre a pertnit trom the Division ol Industrial Sefery, es notetl above, unless such persan has a permit to do such work irom the divisian. Signature: Date: �ivi5ion ot Industrial Setary Permit Number: CERTFICATE OF COMPLIANCE AND AUTHORIZAl10N OF ENTTiY: I certify untler penalry of perjury ihat I have read Ihis epplication and state Ihat ihe information given is wrrect. I egree m compty with ell stete laws end ciry ordlnances releting to bullding construction, and authonze representatives ot the City ot Costa Mesa to anter upon the ebove-describ rop tor inspection purp se . a ree not to occupy or allow occupency of eny building authorized by Ihis permit unl finel inspection. �� i �21o'Z _sie��,�a or.iea� ad�is�- �oec�� AnNOr Authorized Applicanl Date 40DE �. INSPECTIONTYVE 1616 FIxeU System Finel Fire Preveniion 12fi6 Pool Spe Finel 200 201 202 203 204 Finel Re-Rool Finel Block/Retelning Well Final Pectory Flre Place Finel Sign Finel Demolition PdIE 1l�915 • �:� COOE 1 INSPECTION TYPE 206 Final Mechanical 208 Flnel Plumbing 270 Final Elettncel 212 Flnal Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Finel Builtling/Oaupency � �^ I[{�L8 L�i � C''.�. �;� �� D�� OWNER-BUILDER VERIFICATION � A city or county, which is reyuired to give notice pursuant ro Secti�n 19830, shall attach to such notice, and, as a condition precedent to issuing v building permit, require the completion and require [he remrn of, an owner-builder verifica[ion. Attention Property Owner. An 'owner-builder' building permit has been applicd for in your name and bearing your signature. Please complete and remm this information in the envelope provided at your earlies[ opportunity to avoid unnecessary delay in processing and issuing your building permit. No buildine aermit will be issued until this verification is received. I� 1 personally plan to provide the major labor and materials for conswction of the proposed property improvemen[. � Yes ❑ No a1(have/have not) ��'� '_ signed an application for a building permit for the proposcd work. 3. 1 have contracted with the following person Qirm) to provide Ihe proposed conswction: Name Address Phone ( ) City — Convactor's Lic. No. 4, 1 plan to provide portiuns of the work, but 1 have hired the following person ro coordinate, supervise and provide the major work: IYame Address Phone ( City _ Contractor's Lic. No. 5. 1 will provide some of the work but 1 have contracted (hired) Ihe following persons to provide Ihe work indicated: Name t002�a6 (REV.9RJ8) Address Phone Type of Work (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 2560 OXFORD LN Suite No Vicinity: Parcel Nunmber: 14137332 Applicant: VALENTE, RICHARD Address: 2300 FAIRVEW RD COSTA MESA, CA Owner: RENKER, JONATHAN Address 25600XFORDLN COSTA MESA, CA Contractor: VALENTE, RICHARD Address: 2300 FAIRVEW RD Arch / Eng : Address: COSTA MESA, CA PLUMBING PERMIT Phone: 714-215-4883 Zip: 92626 Phone: Zip: 92626-6123 Phone: 714-215-4883 Zip: 92626 License: 724232 Phone: Zip: License: SCOPE OF PERMIT RELOCATE KITCHEN SINK AND 1 GAS OUTLET FOR STOVE.. REF 602-01141 ISSUE FEE BackFlow irrigation BackFlow Preventer Bathtub Clarifer System Connect Qce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outleLs) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $23.50 $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 $6.15 $0.00 $0.00 $0.00 $0.00 $0.00 �TY FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $g.gp Sink, service/mop $0.00 Spa (pnvate) $0.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: 09/O6/2002 Issued: 09/O6/2002 ISSUED BY: SumpPump Swimming Pool Trap Pnmer Urinal Vawum Brkr BkFlow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $D.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: §39.45 �TY 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 California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatirally expire and become void it work is not commenced within 180 days, or it work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must comply with all applicable codes, antl all requlred Inspeetlona and flnal epprovel must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 241646(N00) WORKERS' COMPENSATION DECLARATION: . � I hereby ettirm under Denalry of perjury one oi the following deGaretions: ❑ I have antl wlll maintain a certificate of conseni lo self-Insure for workers' compensation, es provided tor by sectlon 3700 ot the Lebor Cotle, for the peAortnance ot the work tor whk� thi5 permii is issued. I have flnd will maintain workers' compensation Insu2nce, as required by section 3700 oi the Lebor Cotle, for the pertomiance ot Ihe work fw which this pertnit is issuetl. y workere' wmpensatlon Insurence wrner and poliry number are: Carrier: Pdicy Numbec (This section need not be complefed i! the permit is valued ef one hunOreC dWlars ($100) or less.) ❑ I certity that in the pertormance oi �he work tor which ihis partnit is issued, I shall not employ any parson in any manner so as to becoma subjed to ihe workars' compensation laws oi Calitomi end agre thet if I hould co subject to the workere' compensatl rovisions oi Section 3700 0l the Lebor Cotle, I shall torthwilh ese provision licant Signat : � Det � 6 �� WARNI AILURE TO $ECURE WORKER$' COMPENSATION COVERAGE IS UMAWFUL AND SHNLL SUBJECT AN EMPLOYER TO CPIMINAL PENALTIES AND GVIL FlNES UP T ONE HUNDRED TFKKISAND DOLLARE (5100,000), IN ADOfT10N TO THE ODST OF GUMPENSATION, UAMAGES AS PROVIDED WR IN SECTION 37060F THE tABOR COOE, INTEREST, AND ATTORNEI^S FEES. =D CONTRACTORS DECLARATION: attirtn t licensed underprqvisynsyt Chapter 9(commencing wit� Section 7000) of Division �lehthe�ness ary)Proteuiyns Code, entl my license is in lull CONS7RUC710N LENDING AGENCV: ❑ I hereby aHirm Ihat Ihere is a consiruction lending agency for Ihe peAormance ot Ihe work for which Ihis permit is issued. (Sec. 3097, Civil Code). Lentlefs Name: Lentler'S Atldreu: Signalura: Date: OWNER-BUILDER DECLARATIONS: I hereby aKrm that untler penalry of perjury thet I am EXEMPT FROM TME CONTHACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business end Professions Cotle: My ciry or counry which requires e pertnit to construct, alter, improve, demolish, or repeir any strucWre, prior to its issuence, elso raquires ihe epplicant tor such permit to file a signed statement that he or she is licensed pursuant to Ihe provisions oi the Comraaors License Lew (Chapter 9(commendng with Sectlon 7000) of Division 3 of Ihe Busineu and Proteuions Code) or that �e or she is exemp� therefrom antl the Dasis tor ihe allege0 exemption. Any violatian at Sedion 7031.5 by any epplicant for e pertnit sublecis the epplicent lo a civil penalry of not more than Nve �undretl dollars ($500).): ❑ I, as owner of the property, or my employees wit� wages as t�eir sole compensation, WILL DO THE WORK, and the strucwre is not intentletl or oHeretl tor sale (Sec. 7044, Business and Profeuions Code: 7Te Contractore License Law does not apply to en owner of proPerty who builtls or improves ihereon, end who does such work himself or herself or through his or her own employees, provided that such improvemenis are not intended or ottered for sale. Ii, however, Ihe building or Improvement Is sold within ona year oi completion, the awneabuiltler will have the burtlen of proving t�at he or she tlitl not builtl or improve for purpose oF seleJ. ❑ 1, as owner ot the pmperry, am EXCWSIVELV CONTRACTNG WITH LICENSEO CONTRACTORS to construct the pralect (Sec. 7044, eusiness end Proteuions Coda: The wntractors License Lew does not eppty to en owner ot properry who builds or improves Ihereon, antl w�o wntracis for such project with a contrector(s) license pursuent to the Coniractors License Lews.). ❑ I am exempt under sec. Business antl Professions Cotle for this reason: SignaWre: Date: Owner ID veritietl by drivers license. ❑ Yes ❑ No Driver5 License No. Venfication of Ownarship by (rype oi documenL I.e. - proparty lax blll or deed): 6cpires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . ❑ 1 hereby ceriify tha� no excavetion five (5) or more tee� in depih into which e person is requiretl to descend, will be made In connection with wwk euthorized by Ihis pertni6 end ihat no building strudure, scattolding, talsework, or tlemolition or tlismaniling Ihereof, will be more than thirry-sLc (36) tee� high. (Ghap. 32, Grp 2, Ar12, Sec. 341, Ttle 8, Celitomla Adminisirativa Cotle). ❑ As owner-buildar, I will not employ anyone to Ao work which would require a pertnit Irom the Division ot Industnel Safery, es noted ebove, unless such person hes e pertnit to do such wark tmm ihe division. SignaWre: Date: Divislon of Intlustrial Safery Permit Number. CER71FlCA7E OF COMPIJANCE AND AUTHORIZA710N OF ENTRV: I certity under penalry of perjury that I have reatl this epplicalion and state Ihat the information given is cortect. I agree to comply with ell slate laws and ciry ordinances relating to building construction, end euthodze representetives of Ihe Clty ot Casta Mesa lo enier upon Ihe above-described property for inspection puryoses. I agree no� to acupy or allow xcupancy oi eny builtling authorized by this permi� until final inspection. COUE 1, INSPECfIONTYPE 1616 Fixed Sysiem Final Fire Prevention 1266 Pool Spa Final 200 Finel Re-Root 201 Finel Block/Relaining Well 202 Final FaCtory Fire Place 203 Final Sign 204 Final Demolition (I� ��5 �QQf�a INSPECTIONTYPE 206 Final Mechanical 208 Finel Plumhing 210 Finel Elecincal 212 Final Fire Preventlon 220 Finel Planning Approval 222 Final Site 250 Finel Building/Occupancy Da��_'� G/ ��1.\i�I:inYqHJ )►-I3-o� l3N �ooeEssaem�ur�a: `560 O:tiFORD LN °w�'Eas"'WE�`�'°"": MORGAPI, R09ERT L i,00ncss: 2560 OYFORD LN COSTA MESA,CA �rn..�uuxo�noncss: I/JiCNREtTORfiMiNHX: �xcx on �•s aooirtss: � �I � i� � ��.: 92626 uc. xo.: uxr: ca+m�crarsw� NOCY. PLUAIBING ( 719 ) 895-1296 cam�crorcswuurw 11610 SEA$OARD CIA �°o"Eu: STANTON CA �'N0' �'�1971 IICENSED CONTHACTOFS DECLAHATION: I �ereby elfirm 9a� ��n�w Po��ry �n� i.m r.��a under qevieions oi Chepter 9 �oomme�a ..nn s«i� �000� a w.��, a d u» a,a� d,e vm��,s cme..m mv i�tio m�� wn r�, d,d are,a. C LIC. NO.: LIQ CLASS: LIC. NO.: 050386 C-36 51197� EHp 02/95 Deta� ..�c "�✓� �� ConVaaor. � �`i� PLvM/d�/��"'�---+ NEX BUILDEfl UECUPATION: I hareby elfiim �nder panely d per'ryry ihet 1 em eRemq fmm Ihe Contredas Licenee lew la �he �dbwin8 rmwn (Saeion'lasl.s Buemesa erN Proleseiom Code: AM c'ry v muny whidi reauiree e P�il �o mrrewd, eper, imwwe, bmolah, w repei eny alrudure, peior io in usue�wa, abo requires Ihe epplkaM for euch peimn to file e eg�E eutemant I�m M a aM n liceneed WBuent to IM provivme W �he Conlreams Licenee law �Chepter e(rommend�q wnh SeUun ]000) W Diveion 3 ot ihe eusniae. ane Praesaiona cod.l a�w ne « sM e e,amp �n>ehum ane �ne nsw �« un elbpaE memqion. ary vidmon a s«rbn ]031.5 by any epplirant for e parmX euEjene �ha epdk�� o e crvil panaliy al �w more ihen frva hundred tlollan j55W��. � I.esowrerdthaMWa�YamYmmGMe�wihrepe=avihaiedammP�aeiion.willdoUaxoh.aMiheeln�clureeMinie�Med or oflered br eele (Seclion ]OC�, Businem enE ProleasioneCOUe: The COMrenors L"wenae lew does nw eppty �o en ov.mer ol D�M who W iCs a inpmvea theraon. aW xtw doee auM work NmseM a Mnetl u thraqh he a her oxn empbyeea. prarideC thm wch impraremama era rot imeMeE a dleretl lor aele. II, however, lhe Witliiq a inporemam ia edd wnhin wro yev d wmpbtion, the awnarbuiWer will heve ihe burden d qovinp M or ehe did na build or impwe /or iM WrWee M eele�. ❑ I. sa ovmar N �ha v�%M. d^ �duaiveFy ooniradip xi�h limmetl contraclas ro conatruG IM qojecl (�� 1014. Businme eM Pmfeaiana Code: Tha Conlretlae Lcanse lew doea Iw epph� b an owror d prope�y w1w Wilda or impovee IMroon eM who COI1�l8C19 �IX Nlf�l W9Btlf `.YII�I fi CIX1�10f}p1�H) �CBf1fBd V�ISUBI1� �O I�1B CiOf11f9tlpH �I(HR9B �6W�. � I em uamq urder Semon: B. 8 P.G.. br tho raeeon: De�a: �� I do hereEy cerliy ihet I em awere d eM uMermtvM Ma requimnmb d Calfwnie Neellh vM Satery Code Sediona 25505, 252t3, erd Z5531, ard Ihe� I a etry Mure buiki�q ampenl will / wYl nol (ti�cb me) neaE lo mmply w1� aek Wa�e coEea enE iM repuiremenb Im e pg�mF lormruwction amodifralionhan �heA'r�epemem D"gwip. Reaidamielpynmewian eppire�ioman uamqhan theae � WOPKEP'S CONpEN3AtION DECL�N�T�ON: I M1ereby dfiem uMer penaMy d perjury aro d Me Idbvnip Csderatiwa: ❑ � n.n ene xio meimen. cenXir�e a omsem m.en:�wro b.rorken• comv��, e+a� r«W smian aroo a Ine lmn. Code, ta iM pa�loimvice d IM v.wk fa wFich thia pe�mu ia iasued. �n� �e �� m� �n�.• o�o��, ��re�. m rea��roe er smp, a�oo a o» �e« cm<. ro� me wN«m� a me wk lor which I�ia perme ia ieaued. My worke% mmpenaman inwrema cerrier eM pdiry number are: ��°' EXPIRES Pdicy Number: ' 0 3/ 0 Z/ 9 5 �rnr:.�c�o,��d�wee�W.reei�o�xoro.J o�JLea lsiwa�,.� � I eMfi/ Ihm in the perlomience M ihe work br whieh thin paemil in iae etl, I ehell nd empby a�ry pereon in eny menner eo ea �o becmie wbjetl to the xwknn' compenaatbn kvn a Calilania epree iMl tl I k become wbjecl to IM wwken' (/��q�comperne�etion prorvisbna �d Sqedion ]00 al �he lebor Code. I M lan ' h mm/p�y� with mriuone. � be�el pr. �/ J C� �OG�cen1: � \ i i i ... i �ii�I/rroaFW ro ms�undrsJ �use� skntl(Sfoo,oW� �etltlltlon�fc tlie cwf�o ro�mpsiue�fbn,�nme�pi �� pro� br� sxtlon 3]P6 0l Ms LaborCOW, Inhnat, nW �from�Y's I�u. CONSTFUCTON LENUINO PGENCY: I hereby �rm uMer penelry ol perlury the� �hara is e wnst�udan bMi�q epericy fa IM �dom,� d m, ..w ia.n�a� mo ro�� n e�,ae (sea� aos�. c. c�. LENOEH'S NAME: L61�EN'S ADDNE%: I ceMiy thai I I�eve read Ihis eppir.etion vM vele thet �M ebove iMammion ia cmad. I eprae io compy xilh ell Uy eM counly aEineMee endaietelawsrelaimgiobuiWinB��w^+��ebyeu�� empreaente�iveaolthedryloanterupontMebwa�mmtionedpmpaM iwinapedion purposa�) � �� r ome ,��/ S —°(-� (5151<e WP) Whne-Buildinp B Sefaly: Graeo-Rle; Cenery-ApPG��: Pink-Revenue; OolCenrod-Feae�or CITY OF COSTA MESA - BUILDING PERMIT FEP.M r70: P 071123 PERMIT NO: F 071123 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V-N PERMIT TYPE; PLU PURPOSE: OTH SOB DESCRIPTION ; C/O WATER HEATER SQ FT; CLAIPI VALUE: CALC-VALUE; GROUP OCC: R-3 / COMMENTS: NO OTiIER TdORK AUTHORIZED BY THIS PEP.MIT *r**.�u*�-�r*�r*�r�,r*r**,�,�*+�*�r*r*+�**r+c-«+�**�-r*�«******�**r**�*r�+�+�***x��x*+�*�-x**�r*x+� Z U C] I N G R E Q U I P. E M E N T S S E T B A C K S ------------ MAI�1 bUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FANT; FT IN REAR: FT IP7 LEFT; FT IN RGHT; FT IN LEFT; FT IN RGAT: FT IN FARKING REQ• PROV; PARCEL: 14137332 ZNE: REF NO; PLANNING NOTES> i jf if jF ff iFaE af if afiFiEif 1fi� ifif if if #F jF iE iE if jf af iE iE if if iE if if iE aflf ?f if if if if iF iF iE if if if iF'ifiE iFif KiF +f if if iRjt if iR af iE iE ik if aF aF iG aF iF if #� aF i4�?'r if ifiF D E V E L O P M E A1 T S E R Cr I C E S R E Q U I R E M E N T S ZONIPIG AF+PROVED HY DATE; bUILDING APPROC�ED BY : DATE: APPLICATION ISSUED bY; �� UATE: � I�i I� ?fif#iEifiF�Yj(-ififiEiFiEiEififilfF7tiEtEiE ifiEl�xuiflc�lfil�R .�7fiF af iF if aE Y it if if iF �f if iE iE i4 if if af 1E 1E 1f aF 1E 1E jf iE if if iE?E jf if 7F jf if M iR {f iF � 1f iE if iE jf iF jE 1f;E #� i4 if iF V if iF if Jf aF %* a� aR iR af is aF if ?f Y iF �f �f i4 �F if iFY # iF LEGALIZATIOrI;rl F E E S U A9 M A R Y STP,UCTURAL SEGAIENT;N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRALIP7G PERMIT 7,04 25: SMIP; NON-P.ES PLAN ISSUE FEE 2Q,Q0 BOILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL FAZD DUE TOTALS----> 7,00 20.Q0 0,00 27.00 27.00 ,00 REVENUE DICTISION TOTALS--> COLLECTED; 27,00 OL'ER/SHORT; 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIBE SMIP/TOT GRADIP]G PLAN-CY.ECK 27.00 if M iF i! iE if +F k')f'k if :M'lk 3!')f if �f M§E if �lf if')f ?f'If'k 4 4'lf jF iE M i4 iE'k if')f'IF iF iF'Ih iE i�)f iF if iE �1E if if iF±lY iF i(' if i: iE iF?f ?f if 1f'k 1F aF 1F M' if iF 1F iF if if if if 1E �if Y I N D I V I D U A L F E E B R E A K D O L•I N TYFE QTY D E S C R I P T I O N UNIT COST TUTAL CdST PLU 1 WATER HEATER AND/OR VENT 7,00 7,00 END OF FEES C�i Oe17b6p.-�]i}175f,82 T9:1T =i.OD OATE: p2!iSJ9°� 7IIiE: I1eG1 CONSTRUCTION AND PIANNiNG � PO. y SPA APPROVAIS Permit # � ' Date Inspector APPROVALS Permit # Date inspector 1, Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soii Pipe-Undrgrnd. 53. Steel Reinforcement . 3. Electricai Conduit Utility�Undrgmd. 54. Forms 4. Electrical Conduit�Undrgmd. 55. Electrical Bonding ' � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' � 6. Electricai UFER Grnd. 57. APPROVA� TO COVER�GUNITE ' • 7. Footings 5$. Electrical Conduit-Undrgmd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Tes2 ` 9. Water Pipe-Undrgmd. 60., Backwash �ines, P�Trap„C Undrgrad. 70. Structural Fioo� System 61. RPPROVAL TO DECIC-' 11. Property Sewer L.ine & House Connection 62. Backwash & ReceptorFinal 12. Sewer Cap 63� Heater & VenbFinal 13. Roo` Drains 64, Pyumbing System - Final' 14. Rough Piumbing 65. Electrical-Final 75. Rough Electrical�Conduit 68. Solar SVstem-Final 16. Rough Electric 4Viring 67. Fenciny & Access Approval i7. ftough Wiring Sign 68. APPROVED FOR PLASTERING 18. flough E7ectricai-T 8ar Ceiling 69. POdVSPA SYSTEhAS FINAL i9. Rough Heating & Air Conditionin9 �IRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS -Permit # � 21. Duc:s, in Structure � 70. Undergro�nd Hydro 22. Duc2s, Ventilating 71. Product Pipin9 O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Undergro�nd Plush 24. Roof Framing 73. Undergrnd.5torageTank �Gas GOiI 25. Roof Sheathing � 74. Overhead Hydro 26. T-Bar Cei{ing IStructuratl & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe � 28. Lathing & Siding � 77. FIXED SYSTEhA FINAL � 29. Insulation � �� 78. PIRE PREV. FINA� 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTIQN 32. Electrical Power MeterFinal 80. FOOD CERTIFICATE ISSUED 33. Finai Electric Notes: � 34. Final Heating & Air Conditioning _� / y�.� �1� � _` 5 ` '.� ;��, .� 35. Final Gas Pipe�Test S_�6,�'' �1��_ �' 36. Hood or Canopy 37. Finai Factory Fireplace . 38. Fina� Plumbing `�� +'� i 5iJ 1J 39. iNater Service�Final �40. Gas Service-Finai . 41. Solar pomestic-Final � 42. Backflow Preventer 43. Backflow Irrigation . 44. Landscape irrigation System � � 45. Sound Attenuation ' 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. FINALPLANNiNG 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIPICATE OF OCCUPANCY No. Date OWNER cOLI.Fr,E"PARK -- oATE 12-11-56 - JOBADDRES3 2560 Ox£ord Drive BUILDINGPERMITNO, #(1Q(�� GENERALCONTRACTOR Harbor COIIS't. CO• VALUE $ u,ZOO.00 LOT 18 BLOCK TRACT 272(� Rg9. w/det. �az'. _ GROUP I Sc J TVPE V ZONE R�i FIREDISTRICT �]S2 INSPECTIONS I DATE I SUBCONTRACTOR I PERMITSISSUED Trench 9s1 7d- � / - ion Forms and Grade to Gar oe Rough Framfng Plumbina. Rouoh to Slab am S'- S" 195 ), Final h�Yi,�j IG a7 ,r�l _--�—�� A-�u.Y�l House ,( SeweqSt. �Yi �5 Ll-�j-S % ��%�,,,,,.�, u. .�• `ll- Lathinq.ln Out Plumbing,Final,FixturesComplete/��,$ �7-S% � Plumbing, Fin.al Gas Test �c5� %N�,�j 6-%%3 i � _ Wiring,Final 7-J��7 ' _ OCcupancy � � _ ��_)�� FOflM 210 3M lO�iS , Costa Mesa Building Department APPLICATION FOR PERMIT'� �, : t� 111 EAST 20th STREET �� 2 g v f L p,` N G ' � • rtl1RTA MFSA GA1 IF(IRNIA ' FOR Ok'FICE USE ONLY FOR APPLICANT TO FI�L YN Receipt No. Permit No. Buflding /'b / 7 Address 2�6� QXFORD �R I VE 7 �o / �iOStA� �05&� ria�01111A� Received by Date Rec'd. Date Issued Nearest �� + I �_s / �_� �-�`-' CrossSt F{ARBOR �LVD. Building Address Owner �.O L L E G E P A R K N O. 2 Costa Mesa, California Mail Address Z � � 6 $O. MA I N $T. Nearest 7e�, Cross St. City q AN CA F No. K I Zone No.of Typa Group Arohitxtor Lic. I P1ans I f Engfneer � No. Approved b Date Address CORRECTIONS c�cY uo. 6 � - Contractor iiARBOR CONST.CONo. Address $ M De crption I Not I 8 I Block j Tract2726 (Attach Metes and Bounds) � � No, of Bldgs Size of Lot ',O Now on Lot � Useof No.of No.of A Existing Bldg. I Families Rooms � Setback Line fram Rear Vard Z Center ot Street � Side Vard y DESCRIPTION OF WORH . � New I 7( I Alteration I I Additfon I 0 Repair I I Moving I I Demolish I n Building No.of � Size I Roams Stories �Exterior Wall I Roof ApPR�VE�s Covering Covering j Use of New Building R E S I D EN C E R[ D E T A C H E D Foundation Location Inspector Date Forms, Materials, G AR A G E Under-Pinning sa Frame: Ffre Stops, N Bracing, Bolts p I hereby acknowledge that I have read this Application p and state that the above is correct and agree to comply Lath. Int. � �� with all City Ordinances and State Laws regulating building constrUction. Lath. Ext. Signatureaf Qermittee H ARROR CON TRU T I ON CO , p�aster, �nt. Authorized Agt. Plaster, Ext � Valuation Permit Fee $ ac8�'� Masonry Reinforced � � ��200, Plan Check $ I7 � Bond Beam $ Total (��f Q Fee $ 70�—r FINAL � FORM 2D4 S-BP 21vI 8-55 v C 'J c. 0 a` a Street PLOT PLAN &how locatlon and dislancea Trom �� properly Ilna and bMween buildinga d �' c N O O l� _ . O W m r� _ y owrr�x CAIIV, JACK DATE PERMIT INSPECTIONS Signature DATE I GROUP 1 TYPE Y ZONE RJ SoIl PEfLMITS ISSUGll `.,,,, SUI3CONTR�ICTOR nnmc i rrrin�riu�n w � ;: - ,.. 2 I 050 CTpSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 8l7 COBTA M88A, CALIFORNIA For Applicanf to Fill In Complefely TYPE OR PRINT - JRE'SS �.5 ,s� nX��,-/ ,�a COSTA MESA, CALIFORNIA L FEE RECEIVED MOV 2 2 1963 FINANCE DEPT. CITY OF COSTA MESA APPLIC TION FOR PERMR BUILDING For Offtce Use Only R[C[III'NO. I P[RMITNC �� TEL. .� APPROVSD BY NO. ��u6 c�rr �os $TATE /l LIC. NO. /\ SIZE OFLOT � . USE OF EXISTING BLD6. BETBACN LINE FROM � Si./!i�/-% (i0� � a . /�7t�sa 63s No �� io�L / � 4 — I .�,��.,�.�.� �ooa. � DESCRtPT(ON OF WORK EXTERIOR WALL{ /, �.QI COVERINO /.C/T N/�/ I GOVERING �JTC( USEOFBUILDIfiCANDWORKTOBEPbRFORMFD � S'J=u r%j -% �i G.�O S� I HEREBY �CKNOWLEOOE THAT I N�VH RH�O TXIB APPLICATION ANO BTATE TX.�T THH ABOV6 �8 COflRECT AND AORlB TO COM. PLY WITH pLL CITY OqDINANCiB ANG BTATB LAW6 R80ULATINO BUILOINO CONBTRlICT10N. f � _ / � AUTHORIZED AGENT teow� YARDBAPPROVED MAIN BUIL�INO o�srwNce MAIN BLD VAR..}F o�reiesueo /—zz�63 ZONING BHAL,L BE LESB THAPI (U.B.C.REQUIREMENT' YARD9APPROVED AGCESSORY BUILDIN6 DATE / r n � 5a.�. �-z s� o TH8 AMOUNT SHOWN YNOlH VALUATION IB FOR TXE F PIIRPOSE OF fi6TABLIOHINO A PERMIT F88 ONLY. Q VALUATION ..� O� m � PERMIT FEE $ � � � ��hyy-� GRO m $ /�v H C ¢ / ___-- __ _ � O✓ LL OWNER EPANS. W. F. �os annaEss 2560 ox£orfl Lane ' II BUILDING PERMIT NO. 560�1 GENERAL CONTRACI'OR HE2b BTOS, � � VALUE S 1SO.00 AP. No. LOT 18 TRAC72726 FIRE ZONE DESCRIPT[ON OF WORK Grape Stake Fence GROUP TYPE • ZONE PLAN NO. �iGil INSPECTION& \DATE PERMITSI$SUED _ SUBCONTRACTOR DATE NUMBER coat 5(�4 . 0 0 � W W rc � y � o. JI T. m a � COSTA MESA BUILDING DEPARTMENT ✓ P. 0. BOX 317 COSTA MESA CALIFORNIA C•l• OF STREE7 ' _��PROP. TINE _ r 10 FT. FOR 60 FT. ST�REET— � � � � � � IW �a �o �� a Y OR PROP LINE �` � �� i C.L. OF STREE P, L I �n a � � i~i � W Fd� � � j � V 1 m oZ° �� . �u � ~�' � � U j � � � 2I —J� al O rc a� ' � � —' ------� � 1- w m a f- N U. 0 J ci FOR APPLICANT TO FILI. IN BUILDING ADDRESS 2s//'D �%�l`Uf(U �,�/, ! Owner ��i l� , /� v�� 5 Mail Address x•� �� if%f�rD� .iiL�, City �� n5%�� /!,�/f' �S'!i' Ph. No. Contractor�� T��.5 Ph. No �/¢'s-� Z y9 City Lic. No. %J�� State Lic. No. �S �� Size of Lot AP No. 2,77_ � �+ �r /� Setbacks: C/L Street �7 G J�` Rear � Side Yard - Righr o� y��J Lef Type of Fence ��1�n �l.��i�P /s � �G �� / I hereby acknowledge that I have read this application and state that ihe above is correct and agree to comply with all City Ord- inances and State Laws regulating building construction. Signature of Permittee �/J i , iY-T_:�i ... �-. �-. i . �� . — FOR OFFICE USE ONLY FT ! I i 0 F ST. Received by Date LE �VED � �- , O,{ /9 �� VALUATION flt AN EPT. � Q , CITY OF CO A�IESA Q/� �,�� MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES------ MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES .� -/� AUG 2 0 1957 Permit Fee Plan Check TOTAL FEE USE REVERSE SIDE FOR DETAILS � _"