HomeMy WebLinkAbout2304 HALF MOON LN - Building Permits(714) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 2304 HALF MOON LN
Suite:
Vicinity: LOT 17
Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Construction: V-N
Parcel Number: TPN00516 Zoning:
npp�icant: WILLIAMS, GARY
Address: 1450 N. TUSTIN AVE
SANTA ANA, CA
owner. SHEA HOMES LTD '
Address 603 SOUTH.VALENCIA AVE
' BREA,CA � "
Contracror: OW N E R-B U I CD ER
,Address: ' "
Zlp: , ,
Arch : WILLIAM HEZMALHALCH
Address: WILLIAM HEZMALHALCH ARCHITECTS INC � �
SANTA ANA,CA , Phone: 949-250-0607
2850 REDHILL AV STE 200
StaWs: ISSUED
Applied: Ot/31/2005
Issued: 04/18/2005
- � - ISSUED BY: � Y'"
Phone: 714-245-9760 X24
Zip: 92705 � .
Phone: 714-985-1300 �
Zip: 92823 . � � � � - .
Phone:
' License: 000000
Eng:
Address:
e
Phone:
� Zip: 92705-5543 License: C12920 � License: �
SCOPE OF PERMIT
LOT 17 � . ' . . -. � .
PLANS 2A . . _ � . . � _ � �
CONSTRUCT 2560 SF 2-STORY SFD WITH 449 SF ATTACHED GARAGE AND 72 SF PORCH. FIRST FLOOR WILL BE 1225 SF WITH 1335 SF
SECOND FLOOR. A FIREPLACE MODEL #4236 (ANSI UL127) WILL BE INSTALLED IN THE FAMILY ROOM; THERE WILL BE A 2ND FLOOR
LAUNDRY ROOM. � ,
REF: G04-00010, PA-03-47, T-03-06 � " � � � ' � � ,_ - . �- �
SEE PA-03-47/T-18800 � � ' � � - �
Plan Check: $305.27
Permit: $1,878.55
SMIP Res: $25'.76
SMIP Com: $0.00
Other: $0.00 �
Inspection: , $0.00
Total: $2,209.58
SETBACKS
MAIN STRUCTURE Front 5- 0
FEE SUMMARY� � .
Calc Valuation:.- .'
- . Claim Valuation:
PLANNING & ZONING
Rear 17- 0 Left 5- 0 � Right � 5- 0
$257,575.34
so.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be consideretl legal, such work must comply with all applicable codes, and all
requlred Inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
�
WORKERS'COMPENSAnON DECLARAPON:
I hereby effirm under penalry of perjury one ot ihe following declarations:
❑ I heve end will maintein e cetliticeie ol consent to seH-Insure lor workers' compensaHon, es provltlatl for hy section 3700 ot the Labor Code, for ihe pertortnance of ihe
work tor which this permit i5 i55uetl.
❑ I heve antl will maintain workers' crompensetion Insurance, es required by section 3700 0l the Lehor Code, for tha pedormance of the work lor whlch [his pertnit is issuetl.
My workers' crompensation Insurence cerrler end policy number ere:
Cerdec Policy Num6ec
7iJs secf/on need not be crompfeted il the permit is velue0 et one hundred dollars ($100) or less. J
1 � �qrtify that in Ihe pertortnance of the work tor which this permit is issued, I shall not employ eny person in any manner so as to become subjeci to the worknrs'
rcompensation laws ot Caliiomie, end ee Ihet II I should hecome subjec� �o Ihe workers' compenseilon prwisions oi Section 3700 of the Lebor Cotle, I shall forihwlth
comply wi�h these pr 'sio�s. L'
� IicenlSig atu . Date.�� ��8/0�
WARNING: FAIWR O SE E N �RKERS' OOMP NS ON COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CFIMINAL PENALTIES AND pVIL FlNES UP TOONE HUNDRED
iHOUSAND DOLLARE ,000�, IN ADDIiION TO THE �ST OF COMPENSATION, DAMAGES AS PROVIOED FOR IN SECTION 3/p60FTHE LABOR CODE, INTEREST, AND ATTORNEI"5 FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aBirtn thai I am licensed under provisions ol Chapter 9(commencing wi�h Section 7000) of Dlvision 3 oi �he Business and Professions Cotle, and my licen5e is in full
force and effett. Lic. x �lass a
Contractor's Signature: Deta:
CONSTRUCTION LENDING AGENLV:
❑ I hareby aHirtn ihat Ihere i5 a cnnstruciion lending agency for Ihe perlormance of Ihe work br which t�is permit is issuetl. (Sec 3097, Civil Cotle).
Lender's Name: Lender's Address:
Signature'. Dste'.
OWNER-BUILDER DECLARAYIONS:
I hereby attirtn that untler penalry o� perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5. Business antl Professions
Cotle: Any ciry or counry which �eduires e pertnit to consiruct, alter, improve, damolish, or re0air any structure, O�ior to its issuance, also requires the applicant for such permit
to file e signetl stelemenl thal ha or she is licensed pursuent to ihe provisions ot ihe Contrectors License Lew (Chapier 9(commencing with Section 7000) of Dlvlsi0n 3 of the
Business end Prolessions Cod6) or ihat he or she is exempt therelrom and the basis for the ellegetl ecamptlon. Any violetion of Section 7031.5 by any applicant for a Dertnit
wblects'1hB epplicent to a civil penelry of not more ihen five hundred dollers ($500).):
��as owner of the properry, or my employees with wages as iheir sole compensatlon, WILL DO THE WORK, and Ihe stmcWre is not intendetl or oHered for sale (Sec.
70d4, Business and Professions Code: The Contrettor5 License Law does not appty to en owner of property who builtls or improves there0n, an0 who does such work
himsetf or herself or through his or her own employees, provided �het such improvements are not intentlatl or offered lor sale. If, however, the builtling or improvement is
soltl wit�in one year of cor�pletion, the owner-buildar will have the burden of proving that he or she did not build or improve tor purpose of sale.).
❑ I, es ownar of Ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRALTORS lo constmct the project (Sec. 70a4, Business and Professions
Cotle: The coniractors Licanse Law tloes not epply Io en owner ol property who builds or improves thereon, and wM10 contracts for such prolect with a coniractor(s)
license oursuen� to the Co��{p53pr5 LiCense LawS.).
OWnar I�
Venficetion
Business and Professions Coda br ihis reason:
�� Ve5 � No
daumem, i.e. - properry tax bill or dead):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certiy that no exW�ation Five (5) or more feet in depth into which a person is required to tlescentl, will be made in wnnection with work aut�onzed by this
pertnit, anC that no builtling siruclure, scalloltling, talsework, or demolition or dismantling thereol, will be more than i�irry-six (36) feet high. (C�ap. 32, Grp 2, An 2, Sec.
347, Title 8. Calitomia Atlm�nistretive Cotle).
❑ A5 ownerDuiltler, I will no� employ anyone to Co work which would require a pertnit trom the �ivision of Intlustnal Safety, as noted above, uniess such person has a
pertnit to do such work fmm the division.
Signature: Date:
Division ol Industrial Safery Permit Number:
CERTIFlCATE OF COMPIJANCE AND UTHORVATON OF EHTRV: I cenity under penal�y of perjury t�al I have read �his epplication and stata that t�e information given is
correcL I egree o comply with 511 s vs entl cily ortlinances relaiing lo building conslmc�ion, antl au�honze represen�atives of the City of Casia Mesa to enie� upon t�e
ebove-descd Oroperty or in { urposes. I ree not to occupy or allow cecupancy oi eny builtling au�horized by I��mi1 until fio-1 inspection.
//
. %S/
ignaWre 1 Leg � nar(s) T Da[e
And�Or Authonzad Applicant Date
COQE �. INSVECTIONTYFE
1616 FIxeO System Final Firo Prevemion
1266 Pool Spe Final
200 Final Re�Rool
201 Final BIocWRetaining Wall
202 Final Factory Fire Plac�
203 Final Sign
204 Final Damolition
QajE �yj[J� �F� INSPECTIONTVPE
206 Finel Mechenical
208 Finel Plumbing
210 Finel Elecirical
212 Finel Flre Prevention
220 Finel Plenning Approval
222 Finel Sile
250 Final Building/Occupancy
L�AiE INTITIALg
(714) 754•5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.C�a,tiSTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
tLt(:
Job Address:
Suite No
Vicinity:
Parcel Nunmber.
2304 HALF MOON LN
LOT 17
TPN00516
Status: ISSUED
Applied: 04/27I2005
Issued: 04/27/2005
Applicanc WILLIAMS, GARY _ l�.- ,.��_ t.y.,-�' ,, ` ISSUEDBY:
.'/.J/, __ '. -... ..- -.,;,,Vt, .
Address: 1450 N. TUSTIN AVE ��; ,� ----•--� •-,µ 4 �.,,
�- a.'i- - . -_ .
/ . v i �} t � (� Phone ` � `� [\ � �
` t r! .% ) ' � I �. 1",
SANTA_ANA,.CA' ` � Zip 92705 , j j i i �'�., �',. 't.
_ 'j�'. ��`'� .�=-� 'r � . , '�� ...i` � ;�
'�: .l, � .� ` \
'�'.,i } .- _ �1 ._� .,�`.,
,.; .'',`. .,� . ;� �/�: _ r-- - ' � �. i r•� � F. �
owner � SHEA HOMES LTD �, .� _ - �' ` � '� �� �'V�1 ,� -�`
, � . \ � r �,
�Address� .603 SOUTH„VACENCIA AVE'" "^ �� ,+ � �-� \ �`f �\
� � � �� \
� � � 1.,,-.iF; :��� Phone: 774-985-1300 ���;.�.\/h�. ` �\, �`
�"'}' BREA.CA��'=:'�� Zip: 92823 ��;. �\ �/�� � �`
:�j.' �.,� � At .
. t`�;. � �� ` � . .. '
`='Contractor:��=�OW�NER-BUILDER ! ' � -�-`:'� � �
� ,
, nd'dregs ; Cf� � ;P` ;_ � ��', s -, ,�: .
, �. ��-i� , .
1 � . ���, ' � i l� '.�� � �r�P,hone , ,.. � . . - ,.
.'','/' . ,�• i °.' '. .' "_ , - ..� _`. �_ �
:,i � � �..9 � , '`Zip. ` . �-, ` ,
� � � ' License:000000 '-` " , '
• � �'V � ;' �'' ,,,,.... _ - - � .
� J � A � � �
o.� , �
� ; ` .', �'�;- f' ;r SCOPE OF<PERMIT� ^ '�
` lOT 17/PLAN 2A \� ; ` .. .: r y � !r t:.� 1 � . _�� � , ,
i - i � f . . .. �,. _ _ �_'> ._: --.t - . __�l-,_= c -:.__ � -.__-.� . . � �r �
_— ',;;, ELECTRICAL PERMIT FOR NEW 2560 SF SINGLE FAMILY RESIDENCE FOR "SHEA HOMES'•: INSTALL
�.� .��': 2 LIGHT FIXTURES, 3 RECEP.TACLE OUTLETS, 8 1 SWITCH�IN GARAGE, AND 1 RES A/C ." `�'
4 �✓
.. , PACKAGE. , . � .. .. ',` - � r x . , �'?4.
i :
- � ' REF: BOS-00168 ' � _• . . - '���i' - ' _ ' � ,
. , w . � � .% ! � .i.,�; .
ISSUE FEE �
Temp service test
Res. a/c package,,�`•�
New Res (h2units) ,
New Res (3+units)
Pool/Spa -�,_ti
Lighting Fixts
Recept Outlets .
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over t000a
Motors to 1 hp
Mo[ors [o tOhp
Motors to SOhp
FEE SUMMARY -:' , ' '
, A � Quantity . _ � � � QuantitY'�' �..,) .. ' /'l i
�..,. '•� ��---- ' � ��-i �' �'�:-
.. $23.50 � • .;_,� �, Temp Dist System / Lighting $0.00 -�,Or 1- , /, �, `
. ' 50.00 .. ,-F,`�- ` Busway-/]OOft $0.00 -,;;%',0 . ,'
, - .-.- .
� �' $54.50 � i Standmg-Section,. $0.00��/�� 0 f j,'. �
` $143:36 �, '� _2560;.,' � � Misc Electrical Eguipment <R:wsr$0.00� 0 ; /""i
w
' - $0 00 '. � 0 ; - � Transformers up to 1-kva/kw �'� �$O[00 . � 0 � � � �
;,
$220 2`� ' ` � � ....�.:... .:u�p to 50 k4 /kva � � � `�$0 00 �i 0. �. ,� �t �
�;' $0 00 � ` �0 *` up td10 kva,
� � � � - a/kw��'" �� $0.00, `f rp � /..� ;,;
, _
� $3:30 , `3�=?� �_. .:........ ....,up�tot00kva/KJi�r'$0.00�Ai0 /l i
� $1.,10 ,.`��, 1�'' � � ��........-:�over.,t00.kva/kw +�$0.00�/ O�;i)�,,,
, �; � �$0.00 ,� � � �, 0��, � � , -Low Voltage Eqwpmenl �: ti� - $0.00 � �0, �
-�$0.00 �,. � 0 � �-, Low Volt Wiring.System / Ckt� � � 30�00 � i 0� -
�`�;$0.00� �_`0 - � ,+'-': � . � tMisa Contluit (' \` 1 � $0:06 ;.F'0
71U�
$0:00 <, �,� 0�` ' � r' � - ' Misc.IConductor�}1/ � $0:00-' 0
$0.06'- � � : �0�-,_ `�-` ; �, �Circus.( gen orride) ��� jv?�' $0:00 0
$0.00 ����„0- ',� ry�- Grcus (mech ride oolighis);�-"�$0.00 0
$0.00 0"' `_ ' - ' :: �'Christmas Tree Stand � � $0.00 0
$0.00 0 - �- � -��FireworksStanil 50.00 0
NOTICE: The work authorized by this permit shall comply with all applicable hantlicap access requiremenis under California statutes and related
regulations. (OrU. No. 92-28, § t, 12-21-92)
EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 780 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must compty with all applicable codes, and all
required Inspeetions and flnal epproval must be obtained. Failure to obtain Inspectlons and final approval will result in lhe expiralion of this permit.
FOR INSPECTIONS CALL: (714) 7545826
zawa6 (arool
WORKERS' COMPENSATION DECLARA710N: — � - - ' ' "'� ' '
I hereby aflirm under penalry of perjury one of the following tladarations:'l ��' �" . '- � '� �' .
❑ I have end will maintain a certificate ot wnsent to self-Insure for workers' compensation, es pmvitled tor by saction 3700 ot the Labor Code, for the peAortnance of ihe
work for whiih this pertnit is issuetl. � � � � � - -' ' '
❑ I have antl will maintain workers' compensalion insurance, as requiretl by section 3700 of the Labor Cotle, for ihe pedortnance of Ihe work for which this permit is issued.
My workers' compensatlon Insurance carder antl policy number ere: �
Cerrier: Policy Number: - �
(This section need nof be completed i/ the permit is valuetl e! one huntlretl tlollars ($100) or less.) �
�I certity tFat in the Oedormance of t�e work'ibr which this pertuit is issued, I shall nol employ any parsoo iri eny manner so as7o 6ecome subject lo the�workers' .�
compensatlon laws of Cali i mia, enG agree that if I � e d become subject to ihe workers' compensation provisions of Section 3 00 ot ihe Lebor Code, I shall tonhwith'
comply with these provis'
ApplicentSigneture: Date: �/�7 � �
WARNING FAILURE TO SECURE �R! RS' COMPENSATION CAVfj GEI UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND qVIL FINES UP TOONE HUNDRED
THOUSANDDOLURE(E ,WO AD ITIONTOTHECOSTOFCOdpEFSATION,DAMAGESASPROVIDEDFORINSECTIqJ3lO60FiHELABORCODE,IMEPEST,ANDATTORNEI"SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm ihat I am licensed untler provisions of Chapter 9(commencing with Section 7000) ot Division 3 of the Business antl Protessions Code, end my license Is In full
force end ettect. Lic. q Gless n
Contrector's Signeture: Date:
CONS7RUC710N LENDING AGENCV: .
❑ I �ere6y ettirtn thet there is a consiruction lending a9ency for the peAormance ot the work for whic� this pertnit is issuetl. (Sec. 3097, Civil Code). �,
Lentlels Name: Lender's Address: ',
Siqneture: Data: �
OWNER-BUILDER DECLARATIONS:
I hereby aHirtn ihat under penelry of perjury that I em EXEMPT FROM THE CONTAACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Protessions
Cotle: Any ciry or counry which requires e�pertnit to consirucL alter, impmve, demolish, or repair any sirucWre, prior to its issuance, also requires Ne applicant for such pertnit
to tile a signetl statament that he or she is licensed pursuent to t�e provisions of tha Contractors License Law (Chaptar 9(wmmencing with Section 7000) ai Division 3 of the
Business end Profeulons Code) or ihat ha or sha is exemD� �herefrom and ihe basis for ihe elleged e:emption. Any violation oi Section 7031.5 by any applicent for e pertnit
subjects lhe eDPlicant to e civil penalty of not more than tive huntlretl tlollars ($500).):
❑ I, es owner of the property, or my employaes with weges as iheir sole compensation, WILL UO THE WORK, and iha structure Is not intendetl or oHeretl tor sale (Sec.
7044, Business antl Professions Coda: The Contractors License Law does not apply to en owner of property who builds or improves thereon, and who tloes such work
himselt or hersetl or through his or her own employees, providetl �hat such improvemenis ere not Inlended or ottered for sale. If, however, ihe builtlinq or Improvement is
sold within one year of completion, the ov+neo-builder will have Ihe 6urden ot pmving that he or she tlitl not build or improve for purpose ot sale.). -
[� I, as owner ot ihe proparty, em E%CLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
�` Code: The contractors License Law tloes not epply to an owner of pmperty who builds or Improves thereon, end who contracts tor such project with a comractor(s)
license pursuant to the Conirectors License Laws.).
❑ I am exemp der sec.
SigneWre:
Owner ID 'fietl tl efs license.
Verilicetion af wnership by (type at
Business and P�ofessions Cade lor this reason:
'� No Dnvefs License No.
property �az blll or tleed):
DIVISION OF INUUS7RIAL SAFETV PERMIT CERTIFICATION:
Expires: fi �
❑ I hereby certity that no excavation tive (5) or more tae� in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, an0 that no building strucWre, scaflolding, falsework, or tlemolition or dismantling thereof, will be more than ihirty-six (38) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner�Duilder, I will nat employ anyone to do work which would require a permit irom the Division of Industnal Sefery, es noted ebove, unless such person �as a
pertnit to do suc� work from the divisian.
SignaWre: Da�e:
Division of Indusirial Safery Permit Number:
CERTIFlCATE OF COMPIJANCE AND AUTMORIZATON OF ENTRY: I cenify under penalry of perjury that I have read ihis application and state that ihe information given is
wrrecl. I agree to comply with ell state le ary ortlinancas relating to Duiltling constmction, antl authonze representatives of t�e Giry of Costa Mesa to enter upon Ihe
ebove-descnb properry lor insyectiop s. I eqree not occupy or allow occupancy oi eny building authonzedyry ihi per�until final inspection.
P+..1 %UA 1 y/�o.1
Sianature Of Le Owner �r Date
COUE �. INSPECTIONTYFE' � � � � �
1616 Pixed System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Root '
201 Final BIocWRetaining Wall
202 ` Final Factory Fire Place�'
203 Final Sign
204 Final Demolition
�, .•,. .Q�.. • � INrRIRLS. . •• • � COOE1 - INSPECTONTYPE , �
-' �' � � 206 Final Mechanical. ,
208 Finel Plumbing
" " ' �210 � Final EleCtrical
212 Final Fire Prevention
� � - � � 220 Final Planning Appmval
� � � 222 Final Site
250 Finel Buildinq/Occuparicy
(714) 754-5273� •� Fan (714) 754-4856 •� www.ci.costa-mesa.ca.us- 77FAIR DRIVE; COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
2304 HALF MOON LN
LOT 17
Parcel Number: TPN00516
Applicant: WIL
Address: 1450
MECHANICAL PERMIT
Status: ISSUED
Applied: 04/27/2005
Issued: 04/27/2005
_ __'__._, .z---,.� � .
f�.,; , , . _,-� --� 4z _ ISSUED BY:
. ��1�,..--�: _. . " �^. �. �"�`..,
ir "� - '
RY ��t ;� ; t �"'-, ,=,.:� � _'�_..
= -i _ ' � . f , �h'�-z_�\,
dE- � �. � , l;� l ��-;,�.'�
-' »! � �: :�, �� '' '� �. , � � . . I I„ � `. ,} .. . . .
pi'/r � ?�� ,y'1 1 , Phonei � r 1 , � . �.'�. ,.. ,. �•,�
/ SAN� ANA CA�` \ ��/�_ -Zip. � 92705 ". � - � `� �v � \�� . ,�.
i lF'r� \pt./ �/�i � � ' ,A
r :� . '"� � ��� t�
�' (�%'%,:r' > r �,,''.-,`i ��. -� 1 '
Owner � .SHEA HOMES LTD� �� °�`�`; .�_%� /"j�� � \
i;,li �.'� �, i.j.%%v7 ���,:�;: �� �/ , A�
Address: 603 SOUTHyAI:ENCIA AVE .����✓'> � �._'.
P4� ':t„�/ if,.�--y, � .
� ,�� r, . , � ,�,., -; � ..
,.. � t / Phone: 714-985-1300
'�Pk� ' �. //�� � �'�il\*.` �.
, � (f %BREA/CA'�f Zip: �92823 V '
-.'i',' . � �/��'�✓� � �\�� �� -
��.: �ili�/ � �rw v - , . � \� �' >
Contractor OWNER BUILDER �• ��
. � , : � . _ �.. 4 < �„y ; `�.. .
�
Address� /�I:�� >C��,'1 x "�' _ ; �.� (
ie 1 �1��' r- -°' �.� � ��! . � >>, �
r
tr? l.: / i ` ' ,.� ,,, �""�'h � - e�'�Phone..�::... ,- , ' . � V
r.�r,' �; ' ,��+'-'-c�yJrare �-`�-- � _ -_ - .,.ti� /r;� t _
: �Jt j � ° � � '.' Zlp: ' ' `'R .� �- � �� `
� , _
„�, �• % _
` �. � �� . � Llcense:000000 �� � -
�
1. �t" 1�{� ��`"' .f�'� .a�"'� _ , l ,���'.,�i
... �.- f t�ll�' �r ...=v ;-�.__..__.� �♦ . ..y:.'.4 1,';�f"1 _ .,
� � • -- =SGOPE°OF=PERMIT --`= _ � � � r . " �
� � ,' LOT 17/PLAN 2A `� ��° /�� �! ° 4 � � i �' r/�*�-/�}/ %�� � r , , �, L;� � �� i ' _
i (�'� . ":'-"' I �5,. L. �:� t� :! 11 k�J L ii �. �� 1 1._iJ � - s''. �
� ���' MECHANICAL P�RMIT'FOR-NEW2560'SF`SING[E`FAMIL`Y�RESIDENCE FOR "SHEA HOMES . � �f"; , . -__:'
- - , ' � '�INSTALL 2 FAU'S, �7 DUCTWORK, 3.F,ACTORY FIREP�P.CES, 6 VENTj,FANS, 2 FIRE DAMPERS, � � � _ �
' s � � , 8 2�A/C CONDENSORS. _ ��, __ -.�i.�, / > ` � -
s�`.i „., - � J'../ z i�?,y"? r�am � Fr+1.'. ��r�. �i��t .
� � � '-S ',�REF: BOS-00168 � e '. � .._ _ �' 3.; s' "� ''.«`-'� '__._. . ;i�-� .
. ,i - - �.._ _ .„ r7 �(�� r
� 6
�_,.-- , c� - � �
,
.., '�'z;.�, ,
`. :-' n-.. . � Quantity
ISSUE�FEE �, A.,,. ' �� �V ' $23.50
Inst FAU <100 k,BTU � �� � - $29.60
Inst FAU >100 k BTU � � � $0.00
Repalr / Alt Cooling/Heat � �� ���9
Inst / Rep. Rece`ss Wall HV �. �
�
Refrig Sys <100 k.BTU �� '
i;;
Refdg Sys>100�k'BTU ��; � � ,�
Gas Piping � � �� '" � �;
Factory Fireplace .�� �/!
Hood w/Mech Exhaust : f' � �, �.
VAV Box 'ti �� "'
Vent Fan / Single Duct ��.•-� 9
Appliance �� :
Fire Dampers �� 9
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < t0000cfm
Air Handlers > t0000cfm
2
0
1
:r:0
��0
~0
�
2
�0
A
_�'_�'�'�,:�-
I �M.`: �:..i r '.
�`.
;j..,..`�i� .
/ Alt Absorbtion Unif ,
/ Alt Refrigeration Unit 1
;�q� ;-. ,v i
;i�
� t ��i
���� ,r``-�Quanfity�
� J$0.00 / 0/�t.'�
�$p0.00/ O,i'.
W�.O� �'
t�$0.00 �,�0��
L. r$O.00�G' 0
� . - , i o �uomesuc mcnierawra- - �u.w� i u
�, -�"`✓/� � A
� � � �� . �" � Comoresso�s�/ AbsorpGon Svstems �,� `-. �'!%� f
C. ` � �� �' `U to 3��h L100`k:BTU�� ' � `✓� `$0.00 0
�'� �"�\.� , ' 3 To 151ip /r500�,k',BiU�-���,� �� i,�i$0.00 0
�'�- �:� --75 To 30,hp /�1�000 k BTU�G' � r/ � �i "$0.00 0
;� '- ���w30�To�50hp/1,750kBTU��,(�,�i_ �ll��$0.00 0..
' r� Over 50 hp�/ Overy1,750 BTU f j� j 50.00 0
'V ` - j � � ` r-6oilers�� C-�A �j � /%'.i
14:50'�.,2 ' � - . ! : . „ �.UPito 3 hp�-^�._--1 l-��`� $29.40 2
�, ... �' _',; � '� �<� r ,-.i-;,�!',%�,.�
50.00�� 0 � � � � . �.i`3�To 15 hp ` - ' C� � $0.00 0
$0.00 �0- � - - 15Io30.hp�j��`�.'�-%� $0.00 0
$0.00 0 � ,- ' �'r. �i!130.to.50�h'p _ --' $0.00 0
$0.00 0 -`�' � ' -- --Over"50 hp $0.00 0
�;
�NOTICE:_ The work authorized by�ihis permit.shall comply with all applicable handicap.accessarequirements,under Califomia_statutes and ralated
;regulationsr(Ord. No. 92-28; §'1, 12=21-92)
� EXPIRATION:: This�permi4 shall automatiqally expire.and�become void if work�isnot commenced within� 180 days; or if work is suspended�or abandoned
' for a penod of 780 days.
,INSPECTIONS: In�order focthe.work�authorized under this:permit to be considered.legal�, such work,must�comply with all epplicable codes, and all
;requlred Inspeetions:and.final approval must be.obtained. Failure�.to obtain�inspectlonsand.final approval wilLresult�in the�.expiration of this permit.
� FOR INSPECTIONSICALC: (714) 7545628�:
zaasre laoo� .
WORKERS' COMPENSATION DECLARAnON: — ' �� ' ' �
I hereby aMirtn under penalry oi perjury one of the following tleclarations,' ' ,,' -
� I have entl will maimain e certificate ot conseN to self�lnsure br workers'.compensation, as provided for by saction 3700 of the Lebor Code, for Ihe pertortnence of t�e
work lor which ihis pertnit is issuetl. ' .�
❑ I have antl will maintain workers' compensation insurence, as required by section 3700 ot Ihe Labor Code, for the pedortnance of the work tor which this permit is issued.
My workers' compensatlon Insurence carner and policy num6er are: ..
Cerrier: Policy Number.
(This sectiar need not be comp/eted il the permit is valued at one hundred tlollars ($700) or less.)
�( I certity tha� in the peAormance of ihe work for which this ertnit is issued, I shall not'employ eny person in eny manner so as to become subject to the�workers'
compensetlon laws of Califo ia, entl egree that if I s o come sub ect m the workers' compensation provisions of Saction 3700 of Ihe Labor Code, I shall tonhwith
wmply with these Drovisio
AppliCen� S18nature: Date: Y 2-% f C!�
WARNING: FAILURE TO CURE WO ER ' DMPENSATION COVERACj IS 111 WFOL ANO SHALL SU&IECT AN EMPLOYEP TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
T}IOUSAND DOILARE (51 .OW), IN A 7TI N TO TME WST OF CAMPEN M16N, DAMAGES AS PRWIDED FOR IN SECTION 3lW OF iHE UBOR CODE, IMEREST, M1D ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Businass and Professions Code, and my license Is In full
force and ettect. Llc. N Class N
Contractors Signamre: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby aXirtn Ihat there is a construction lentling agency for the pertortnance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lentlefs Name: Lendefs Address: '
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eflirm ihat under penalry ot per�ury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business end Professlons
Coda: Any Gry or counry which requires e pertnit to consWct, alter, improve, tlemolish, or re0air any structure, pnor to its iuuance, also requires Ihe applicant for such pefmit
to tile e signeC statement ihat he or she Is licensed pursuant to the pmvisions ot the Comrecrore License Law (Chapter 9(commencing wit� Sectlon 7000) of Division 3 oi t�e
Business antl Protessions Code) or thet he or she is e:empt lheretrom anC t�e basis tor the allegetl eaemption. Any violation ot Sectian 7031.5 by eny applicent for a pertnit
su6jects the apP�icant to e civil penalty of not more Ihan five hundred dollers ($500).):
❑ I, es owner oi the praperty, or my employees with wages es their sole compensalion, WILL DO THE WORK, and ihe slructure I5 not intended or oHeretl for sale (Sec.
7044, Business and Protessions Catle: The Contractors License Law tices not apply lo an owner of property who builds or improves thereon, and who does such work
�imself or herself or through his or her own amployees, pmvidad thet such impmvements are not intentled or oNeretl for sale. tl, however, the building or impmvement is
sold within one year ot completioq the owner-builder will heve ihe burtlen of proving �hat he or she ditl not builtl or improve for purpose of sale.). �
�I, es owner of the propeM. am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business and Professions
Coda: The coniracbrs Licensa Law does not apply to an owner oi propeny who builds or improves thereon, and who contracts lor such project with a contwctor(s)
license pursuant to Ihe Conirac�ors Licen e Lews.).
❑ I am eaempt er sec. Business end Professions Code for this reason:
Signature� Date:
Owner I ventied b nv s licensa. Yes ❑ o Drivers License No. � Etpires: 4
Verilication nership by (type of daumeni, i.e. operty ta: bill or deed):
DIVISION OF INDUS7RIAL SAFETY PERMI7 CERTIFICATON:
❑ I hereby certify �hat no excevation flve (5) or more feet in depth into which a person is required to descend, will be made in connection with work euthorizetl Dy Ihis
permit, entl that no 6uilding siructure, scalloltling, falsework, or demolition or dismantling thereof, will be more than ihirry-six (36) teet high. (Chap. 32, Grp 2, Ar12, Sec.
341, Ttle 8, California Adminisirative Code).
❑ As owner-builder, I will not employ anyone to do work which would reQuire a permit irom ihe Division of Intlusinal Safery, as notetl above, unless such person �es e
pertnit to do such work irom ihe division.
SignaNre: Date:
Division of InCustrial Safery Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUfHORQATON OF ENTAY: I certify under penalry of perjury that I have read this application end stata that Ihe information given is
correct. I agrea to mply with all state laws an§§§d��� ciry ces relating to building construc�ion, and authorize representatives of Ihe Ciry of Casla Mesa to enter upon Ihe
ebove�described perty tor inspecti� purpos . I not to ocw r ellow occupancy of any building authorized � ihis,permit yntil fi_ ne� ction.
6�+�/ //� � /�7 /LL.7
�i��ure Ot Leaal n sl � � Date
COOE 6 INSPECTIONTVPE' ' � ' ' � ' P�LF ' ° INTff1AL4
1616 Fixed System Final Fire Preventlon '� �"
7266
200
Pool Spe Final _
Finel Fe-Roof - � _
201 Final BIocWRetaining Wall
202 Final Factory Fire Placa
203 FinalSign
204 Final Damolition
�
CODEI INSVECTIONTYPE '- •
206 Final Mechanical
20B Final PlumDing
210' FinalElectrical�
212 Final Fire Prevention
220 ' Final Planning Approval
222 Final Site �
250 Final Builtling/Occupency
�Z �
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 2304 HALF MOON LN
Suite No
Vicinity: LOT 77
Parcel Nunmber: TPN00516
Applicant: WILLIAMS, GARY.:' . '
Address: 1450 N.TUSTIN.AVE � - �
Owner:
Address
Contrector:
.� ,Address:
SANTA ANA, CA
� �� ,
SHEA HOMES CTD .
,603 SOUTH VACENCIA AVE
BREA;CA
OWNER-BUILDER
PLUMBING PERMIT
Phone:
, , ZIp: 92705 ' � ,
Phone: 714-985-1300
Zip:, 92823
� Phone: �
Zip:
License: 000000
Status: ISSUED
Applied: 04/22/2005
Issued: 04/22/2005
ISSUED BY:
�
.
- ' SCOPE OF PERMITr " -
LOT 17
PLAN 2A
PLUMBING PERMIT FOR NEW SINGLE.FAMILY RESIDENCE FOR "SHEA HOMES". INSTALL 3 �, �
BATHTUBS, 1 DISHWASHER, 7 GAS OUTLETS, 1 PRESSUREREGULATOR, 1 SEWER CONNECTION, 3
SHOWERS, 1 KITCHEN SINK, 1 SERVICE SINK, UP TO 4 VACUUM BREAKERS, 3 WASH BASINS, 1 ""
WASH BASIN SET, 1 WASTE & VENT SYSTEM, 4 WATER CLOSETS, 1 WATER HEATER, 1 WATER _
PIPING, & 1 WATER SERVICE. . - - � �
REF: BOS-00168 � - ,,
AMT �� QTYr:� �
ISSUE FEE $23.50 � �
BackFlow irrigation $0.00 0 � _
BackFlow Preventer 30.00� " 0 ,
Baihtub � � $29.40 - 3
ClarifierSystem �:$0.00� � 0' �
Connect Qce,Soda,etc) ��� $0.00 �� 0 � �,
Dental Units 50.00 � 0 � �
Dishwasher $9.80 � 1
Drain, Floor $0.00 0 .
Drain, Rainwater $0.00 0 � � "
Drain, Roof $0.00 0 �
Drinking Fountain $0.00 0
�� FEE SUMMARY � ` ' � �
� , , AMT = :-QTX � ., -,;,-. _.: . �, � . . �� AMT
�.� Laundry Tub / Washer � $9.80 1 � Sump Pump� , ; . �$0.00
Landscape I«igatiom "" 50.00 '� 0 ., Swimming Pool , $0.00
� P-Trap � $0.00 0 - - , Trap Primer . $0.00
��' Pressure Regulator � $9.80 1 �� Urinal . � - 50.00
Process Piping (per 10 ft) $0.00 . 0 ��� Vacuum Brkr Bkflow(1-4) $12.30
� Receptors � - $0.00 0 . � ' Vacuum Brkr Bkflow(S+) $0.00
. Septic Tank $0.00 ' 0 ' Wash Basin . � $29.40
, Sewer Cap for Demo $0.00 0. Wash Basin Set $9.80
Sewer Connect � $24.65 1 Waste and Vent System $9.80
Sewer Priva[e Line � $0.00 0- '- Water Closet (Toilet) $3920
� � Shower $29.40 - . 3 � _ Water Heater / vent $12.30
-Sink, bar � � = $0.00 . 0 " Water Piping (Inst or Rep.) $9.80
QTY
0
0
0
0
1
0
3
1
1
4
1
1
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned
for a period of 180 days. '�
INSPECTIONS: In o�der for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
Irequired Inspections end final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration ot this permit.
FOR INSPECTIONS CALL: (714) 7545626
�3�G'5�.�.L�Y("L:91
WORKERS'COMPENSAnON DECLARAnON:
I hereby ettirm untler penelry of perjury one of ihe following declarations:
❑ I heve end will meintein e certificete W consent to self-Insure for workers' compensation, as provitled for by section 3700 of the Labor Cotle, lor the peAortnance ot ihe
work for which ihis pertnit is issued.
❑ I have end will maintein wo�kers' cnmpensation Insurence, as required by section 3700 of the LeDor Code, for the performance of the work for which this pertnit is issuetl.
My workers' compansetion Insurence carrier end pollcy number ere:
Carrier. Policy Number:
(This secf/on need not be cromplete0 il the permit is velued et ane hundred dollars ($100) or less.)
❑ I cetlify Ihat in the pertortnance ol ihe work for which this permit is issued, I shell not employ eny person in any manner so as to becnme subject ro the workers'
compensation laws oi Califomie, end egree that if I shoultl become sub�ect to Ihe workers' compensation provisions ot Section 3700 of Ihe Labor Coda, I shall forthwilh
comply with these provisions.
Applican� Signature: Dete:
WARNING: FAILURE TO SECURE W�KERS' COMPENSr1T10N COVERRGE IS UNIAWFUL FND SHALL SUBJECT AN EMPLOVER TO CFIMINAI PENALTIES ANO CIVIL FlNES UP TOIXJE HUNDRED
TFIOUSAND DOLIARE (St00.000�.IN ADD�T�ON TO TME COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SEC�IIXJ 3JO60F iHE LABOR CODE, IMEREST, AND FTTORNE`f5 FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aNirm that I am IicenseA under provisions ol Chapter 9(commencing wllh SecOon 7000) ol Division 3 of the Business antl Profassions Code, and my license is in full
torce and eNea. Lic. r Cless u
Coniracbr'S SignaWre: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby aRirtn that there i8 a consiruction lending agency for the pedormance ol iha work for which ihis permit is issued. (Sec. 3097, Civil Code�.
Lenders Name: Lender's Atltlress:
Signaturet Date:
OWNER-BUILDER DECLARAT�ONS:
I hereby ettirtn that under penalry ol perjury Ihat I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business an0 Professions
Cotle: Any ciry or county which reQuires a pertnit to construct, alter, improve, demolish, or repair eny stmcture, prior to its issuance, also requires the applicant for such pertnit
to file a signetl statemenl thet ha or she is licensed pursuent to Ihe provisions ol tha Contraclors Llcense Lew (Chapter 9(commencing with Section 7000) of Division 3 01 Ihe
Busine5s anC Professions Cotle) or thet he or she i9 eaempt therelrom end the besls for Ihe elleged exemption. Any violation o� Section 7037.5 by any applicant for a pertnit
subjects the epplicant to e civil penalty ol not more t�en fiva huntlred tlollers ($500).�:
� I, as owner ie properry. or my employees with weges es their sole compensation, WILL DO THE WORK, and the sirucwre is not inientletl or offeretl for sale (Sec.
70a4, Bu � ess e ProfeSsions Cotle: Th rs Licensa Law does noi apply to an owner ot property who builds or improves ihereon, and who tices such work
himsell r he or ihr or er own employees, provided Ihat such impmvements ere not intended or ottered lor sale. If, however, the builtling or improvement is
�sold w hi e ye o comPletion, the owner-builder will heve the burtlen of proving that he or she did not build or improve for puryose ot sale.).
I, es owner ot the Droperry. am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 704a, Business antl Protessions
Coae: The contrectors License Lew does noI epply to an owner of pmperty who builtls or ImOmves thereon, ana who wntrects for suc� project with a conlractor(s)
license pursuant to the Conlrattors Litense Lews.).
❑ lam
license.
(rype o(
� Business and Pmfessions Cotle lor Ihis reason:
Date:
❑ No Drivers License No. � Expires: o
i.e. - property taa bill or deetl):
DIVISION OF INDUSTRIAL SAfETV PERMIT CERTIFICATION:
❑ I hereby certity ihat no e:W�ation five (5) or more feet in depih into which e person is required to descend, will be mada in connection wit� work authorizad by Nis
pertni6 and that no building siructure, scaftolding, lalsework, or demolition or dismantling thereot, will be more than ihirry-siz (36) feei high. (Chap. 3.2. Grp 2, Art 2. Sac.
3a1, Ttle B, Calilomia Administrative Code).
❑ As owner-builtler, I will no� employ enyone to tlo work which would require e permit irom ihe Division of Industnal Satery, as notetl above, unless such person has a
pertnit ta do such work fmm the division.
Signature: Date:
Division of Indusinal Safery Permit Number:
CEHTIFlCATE OF CAMPL1ANCk AND AUTHORVATION OF EMRY: I cenity under penalty of perjury that I have reatl Ihis application and stale ihat ihe intormalion given is
correct. I a ree to comply with s e laws and city ordinances relating to building construction, end eWhonze represematives ot Ihe Ciry of Cos�a Mesa to enter upo� the
above-d ibed prop rty f r i ion purposes. I aqree not to occupy or allow occupency oi any building authorized by ihis permi� until final inspection.
2 /y
S" a re e wner�s) � ' Date
y�zz/�
OrAutho ed ica —� �ate
COOE 1
1616
1266
FizeO Syslem Final Fire Prevention
Pool Spe Final
200 Finel Re-Roof
201 FIne181ocWRetaining Wall
202 Final Factory Fire Place
203 Finel Sign
204 Finel Demolition
PdIE INTITIALS
GODE� INSPECTIONTYVE
206 Final Mechanical
208 Final Plumbing
210 Finel Electrical
212 Finel Fire Prevention
220 Final Planning Approval
222
250
Final Sila
Final Building/Occupency
Q.�
��