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Home My WebLink About292 PALMER ST - Building Permits(71a) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT lob nddress: 292 PALMER ST Suite No A002 Vicinity: � . Parcel Nunmber: 93806001 Applicant: MOSS, TANIA' ., Address: 2737 S CRODDY� �- � , � STE.D„ � �� _ � SANTA ANA, CA � " / � i; ' � � Owner: 'JONES,-ERIC,STEPHEN A�ddress 292 PALMER ST UNIT A2 Contractor: Address:: COSTA"MESA, CA Phone:- (714)241-1414 Zip: 92704 Phone: Zip: 92627-3749 Status: ISSUED Applied: 02/25/2002 � t Issued: OZ25/2002 ISSUED BY: G� /�---� COAST ROOTER PLUMBING HEATING & AIR CONDITIONING � ... � 2737 S CRODDY , � - � �STE�D . - � Phone: p14) 241-1414 � � � � SANTA ANA;-CA Zip: 92704 � - � License: 529727 Arch/Eng:� �. � i,-;- �' / �,,,-' Address: Phone: Zip: �� License: REPLACEMENT OF WATER ISSUE FEE �" � � Backflow irrigation Backflow Preventer� Bathtub Clarifier 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 (Santl Auto ) AMT QTY $23.50�V� , i $0.00 0 ' $0.00 ��0 �� ; $0.00 ; 0 -� $0.00 0 $0.00 , 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 _ _ ;_ ^,.,ry ' - . <. �� , � : `-� '' � -� l�, �. i _ t � � , � � _ _- �,��, � ' � . �. „ "FEE�SUMMARY., � � , ' � AMT '� QTY , - �'�.AMT - .. ��` Laundry Tub / Washer $0.00-- , � 0. � � "+,: ^.r Sump'Bump , �� $0.00 - Landscapelrrigation, $0.00 0 SwimmingPool ' � �"i$0.00 P-Trap � '" - $0.00 0 ; Trap Pnmer , '�� $0.00 . .- Pressure Regulator� " $0.00 0 . - Udnal.-- � "' �� $0.00 Process,Piping (per 10 ft) $0.00 0 Vacuuin Brkr BkFlow(1-4) $0.00 Receptors � $0.00 0 ' Vacuurti Brkr Bkflow(5+) $0.00 Septic Tank $0.00 0 .� Wash Basin '�� 50.00 . Sewer Cap for Demo $0,00 0 �� Wash Basin�Set 50.00 �Sewer Connect $0.00 0 Waste and Vent System 50.00 Sewer Private Line $0.00 � 0 -' Water Closet (Toilet) 50.00 Shower � - - . $0.00 0 . � � Water Heater / vent $12.30 �� Sink, bar $0.00 0 � Water Piping (Inst or Rep.) $0.00 Sink, commercial , $0.00 0� Water Re-pipe $0.00 Sink, Floor $0.00 0 Water Service $0.00 Sink, kitchen $0.00 0 Water Softener $0.00 Sink, service/mop $0.00 0 OTHER $0.00 Spa (private) $0.00 0 VIOLATION $0.00 Spa (public) $0.00 0 PLAN CHECK $0.00 REINSPECTION $0.00 COMMENTS / SPECIAL CONDITIONS TOTAL CALCULATED FEES: E35.80 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 U] NOTICE: The woik authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period ot 180 days. �NsveCnoNs: in order tor the work authorizetl under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetiona and flnal approvel must be obtained. Failure lo obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 r<•.,�.•a�.u:m WORKERS'COMPENSAnON DECLARAnON: � . , �' � ' I hereby affirtn untler penalry of perjury one oi Ne following declarations: � � ❑ 1 have and will malntain e certificate of consent to sel4lnsure tor workers' compensation, as provitled for by section 3700 of the LaDor Code, for ihe pertortnence of the work tor whiCh this pertnit is iS5u80. � � I have and will maintain workere' compensation insurenca, as required by section 3700 of Ihe Labor Cotle, for the peAormance of the work tor whiU this permit is issued. My workers' compensa�ion Insurance rner an,d/�p number are: I I- /� ' Cerrier: ,� �T� ��i .1 Policy Number: I�O I Y/ Z�V - O� (Iiris section need nof be comp efed iI the permit is valuetl af one hundred dollars ($100) or /ess.) ❑ 1 certify that in Iha perfor ance ot ihe Ac or which ihis permit is issued, I shall not employ any person in any manner so as to become suDject to the workers' compensatlon laws o ifomia, e agrae hat if I should become subject to the workers' compensetion provisions of Sectlopp 3700 of tha Lebor Cotle, I s�all forthwith compy wiih these pro� � ions. �/J Z�Z' �/� 2 l�pplfcan(Sfgneture:'-'^ Date: WARNING FAILURE TO SECUR ERS' COMPENSATION COVERAGE IS UNLAWFLL AND SHALI SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINE$ UP TOONE HUNDRED TiqUSAND OOLLARE (5100,000), IN ADDITION TO THE C0.5T OF COMPENSATION, DAMFGES AS PROVI�EO FOR IN SEGTION 3/O60F THE LABOR CODE, INTEREST, M1D ATTOfiNEV'S FEES. LICENSED CONTFiACTORS DECLARATON: I hereby attirm that 1 am licensetl u�tle�r� 9(commencing with Section 7000) of and my license Is in full CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirtn that ihere is a constmction lending agency for the Oerformanca of the work for which this permit is issuetl. (Sec. 3097, Civil Cotle). Lentler's Name: Lender's Atltlress: Signature: � Date: OWNER•BUILDER DECLARATIONS: I hereby aHirtn that untler penalry ot perjury that I am EXEMPT FROM THE CONTRACTORS IICENSE LAW tor the tollowing reason (Sec. 7031.5, eusiness and Protessions Cotle: Any ciry or counry which requires a permit to construcL alter, impmve, demolish, or repair any structure, pdor to its issuance, also requires Ihe epplicant tor such pertnit ro file e signed statement that he or she Is licensed pursuant to the provisions oi ihe Contracrors License Lew (Chepter 9(commencing with Section 7000) oi Division 3 ot the Business end Profeuions Code) or ihet he or she is exempl Iherelrom and the besis for Ihe allegetl exemption. Any violetion of Section 7031.5 by eny applicent tor a pertnit subjecis the epplicent to e civil penalry of not more than five hundred tlollars ($500).): ❑ I, as owner oi the propeny, or my employees with wages as their sole compensatioq WILL DO THE WORK, antl ihe structure is not intendetl or oflered tor sale (Sec. 7044, Business and Protessions Code: The Contractors License Law dces not apply to an owner ot property who builds or improves thereon, antl who does such work himsetl or herself or Ihraugh his or her own employees, provided ihet such improvemenis ere not intendetl or offered for saie. I(, however, the builtling or improvement is soltl within one year of completion, the owner-builder will have ihe burden of proving ihat he or she ditl noi build or improve for purpose of sale.). ❑ I, as owner ot Ihe proDerty, am EXCWSIVELV CONTRACTING WITH LICENSED CONTRAGTORS to construct the project (Sec. 7044, Business and Professions Cotle: The contrectors License Law tloes not epply to an owner oi property who 6uilds or improves Ihereon, and who contrects tor such pmject with a coniracior(s) license pursuant lo lhe Contraciors License Laws.). ❑ I am exempt untler sec. 8usiness and Professions Code for this reason: Signature: Date: Owner ID vBnfiBd by tlriver's license. ❑ Ves ❑ No Drivers License No. Eapires: Vedtication oi Ownership by pype ot tlocumem, i.e. - propeny tex bill or tleatl): DIVISION OF INDUSTRIAI. SAFETV VERMIT CERTIFICATION: ❑ I hereby certity ihat no exwvation tive (5) or more fee� in tlepth into which a person is required to descentl, will De matle in connection wilh work euthonzed by this permii, and that no building structure, scattolding, falsework, or tlemolition or tlismantling Ihereof, will be more than ihirty-sis (36) feet high. (Chep. 32, Grp 2, An 2, Sec. 341, Title B, Califomia Administrative Coda). ❑ As owner-buildar, I will not employ anyone to do work which would require a permit from tha Division of Industrial Safety, as notetl aDove, unless such person hes e pertnit to tla such work from Ihe division. ' Signature: Date: Division of Industnal Salery Permit Number: CERTIFlCATE OF COMPLJANCE AND AUTHORIZATION OF ENTAV: I cenity under penaly of perjury iha� I have read Ihis appliwtion and state that the informalion given is wrrect I agrea to comply with all s:ata laws and ciry ordinances relating to building construction, and euthorize representatives ot ihe Ciry ot Goste Mese to enter upon �ha ebove-descnbetl property tor inspection purposes. I egree not to occupy or allow occupancy of any building authonzed by this pertnit until final inspection. Owner(s) Z D �2^ AOOlicant �- u: .� D te CODE�, INSPECTIONTYVE j�IE 7616 Fixed System Final Fire Prevention 1266 200 201 202 203 Pool Spa Final Final Re-Rooi Final BIocWReWining Wall Final Factory Fire Place Finel Sign 204 Final Demolition ,wi. � CODE� INSPECTIONTYPE 206 Final MechaniCal 208 Final Plumbing 210 Final EleCirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site . 250 . Final Building/Occupancy � • _ :��:-, � : , � 8407 12/12/79 130.52 TL COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUC'I'URAI, PERMIT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 � C D ERMIT � �j � For Applicant to Fill in Compl, — Use Ink Only `� .BUIIOING A.P.NO. -� 2.- Qy �� . ADDRESS BUILDING "' OWNER OR ,, j '� V �� 1 ADDRE55 `� I�� S�. TENANT �y iJV,,/) n `- - MAILING � 33 S�u `J '�/ STC -L SPACE NO. � /]'"r�Z_ ADDRE55 , �} p1/�( TR.NO. LOT BLK. CITV�(7�(,,,�IM � IZOt� NO��'�SOI / �O� CONSTRUCTION '] � ��.�/y�� G NEW DD ALTER REVAIR MOVING DEMOLISH LENDER Yl�(i' � r �+{/�-�I'�• �i �� BRANCH q�� n .�1 �/ ,�( p . �.�'VPQI� �.j� � p OWNER �iiu IAI�VjiSy M�l.i�S OZ � ADDRESS n Er,�Pni2T ( �l�['� �G . .� 1 vu� uF �_ _ _ ADDRESS �� p/ i1 4 i¢WA F�V� �.M � ZONE /� � TVPE GROUP �� /��.� APPROVED CONTRACTOR IfSC (�,� 'LWCf". B�' DATE ADDRESS ��7� S• �dq � E 1 . 1^'"W�EI TE 4', CITV• NO. J',31-Q�Q ' � STATE /t CITV APPROVEDSETBACKS � LIC.N0.3"75�� LIC.NQI��Q�b 'l, {y� SIZE t5�s�� NOWONLO�� I (FROMC/LSTREETI6 G. OF LOT qOM d FT. - a EXISTING BLDG. D�M ' .Sb O �Ch !JC �v�Cti �Lyl0. .�. � FSeparate permits are required for L. SIDE q� FT. v q electric, plumbing and heating work-. aEAR S FL � (.�� USE OF BUILDING ANO WORK TO BE PEFFORMED P�qNNING ACTION � �II Z!E-7�1-1I � DATE � a, /.�aM �.►l STQ11G f o arPaoveo � 7 APPROVED (� � /�U ( p O , �. CC Q I heraby aeknowletlge that 1 have reatl Mis application antl rtata ,yULU FOR SPECIAL RF.QWRE�'1 L �� [(� that the above information is correct and agree to comply with �� . all laws re8ulating buildinB �onstruction, and I shall not amploy �,.> ,� any pe�son in violation of Me workman's compensation laws of ^� W the State of Californie. � � 3 I hereby certify that I am properly Iicensetl as a contractor under SQ. FT. ' L` N \. ihe State of Califo�nle Business antl Prafessions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o] � Chapter 9, antl that ch lieenses are in full torce antl affact, or I THE PURPOSE OF ESTABLISHING A PEFMIT FEE ONLV: �� am exempt from e rovisions f the Staie f Calttnrnia Business 1O VALUATION PERMIT FEE � and Pi6�lons , Oivislon a te� . $ m ��Z�� PLANCHECK $ �1,� � "� Signatura of Y "" � ♦ •� h ! � LL Permittee $ �- TAX $ � o� � � �/ V Auffiorizatl ABent Date TOTAL PAID $ f Qn� S 7 F�+ Ci a a � � s F� G W F � 6 i r a a v� o. O a o. z s 3 _� � 383� 3/21/80 195.00 TL ` COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCNRALPERMIT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 RECEIVE V PERMIT�/�,._�� For Applicant to Fill in Completely — Use Ink Only BUILDING � j � � A,P, NO. AODRESS �/y �� ( BUILDING T�ENANT�R D $ �I �/�I�� S ADDRE55 MAILING SPACE NO. ADDRE55 I7 �3 S, /�(.0 �!� TR.NO. ' TE �� pTV NO. CONSTFUCTION ��„ _. ,�' �_ , NEW AI �n . C.4� BFANCH ARCHITECT ' OR ENGINEE ADDRESS �� CONTRACTOR ADDFESS �7� CITV ` STATE ��. No. 3 4 SIZE OF LOT �'y� < :� YITU'r�/C. �J� � / LOT 1LTER REPAIR MOVING DE � OWNER j( � USE /n Q + ZONE ' .. APPqOVED i . I No. ys i- CITV �-y IIC. Nn �" � NO. OF BLOGS. NOW ON LOT Separate permits are required for electric, plumbing and heating work: UIIDING AND WORK TO BE PERFORMED APPROVEDSETBACKS (FROM C/L STREET) REAR FT. PLANNING ACTION APPROVED I hereby acknowletlge that I have reatl thts epplication antl siate that the above information is correct antl agree to comply with all laws reBulatinp builtling cons[ructlon, end I shall not employ any perwn In violation of the workman's compensation lews of the State of California. 1 hereby cartify that I am prope�ly licensetl as a contractor untler SQ. FT, the State of Califarnia Business and Frofessions Cotla, Division 3, THE AMOUNT S Chapter 9, antl that such licenses ara in full force antl aftect, or I THE PURPOSE OF am exempt from e provislons ot the Stata ot California Business VALUATION antl Pr i �� s� j�{' ,I�� ' `� � Per $ or �.. ' �' ia� VALUE b DATE ' S — DATE APPROVED m C � v' / � 7 VN UNDEfl VALUATION IS FOR m 'ABLISHING A PERMIT FEE ONLV: � PERMIT FEE $ a - N - m PLAN CHECK y �� o TAX S � LL F U TOTALPAID $ � (^