HomeMy WebLinkAbout2308 HALF MOON LN - Building Permits(714) 754-5273 • Fan (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 2308 HALF MOON LN
Suite:
Vicinity: LOT 15
Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Construction: V-N
Parcel Number: TPN00518 Zoning:
Applicane WILLIAMS, GARY
Address: 1450 N. TUSTIN AVE
� _,
SANTA ANA, CA ,
Owner. SHEA HOMES LTD " '
Address 603 SOUTH VALENCIA AVE
BREA, CA
Contracror: ,OWNER-BUILDER
Address: � ' �
Phone: 714-245-9760.X24
Zip: 92705 � � .
Phone: 714-985-1300
Zip: 92823
Phone:
Status: ISSUED
' Applied: 01/31/2005
Issued: 04/18/2005
ISSUED BY: W 2C�`-�
��
Zip: � , � ;License: 000000 ' `
Arch : WILLIAM HEZMALHALCH _ _ , Eng: � .
�,, - Address: , WILLIAM HEZMALHALCH ARCHITECTS INC ~ Address: -
SANTA ANA,CA ' Phone: 949-250-0607 ' , Phone:
2850 REDHILL AV STE 200� � �
Zip: 92705-5543 License: C12920 ' License: �
SCOPE OF PERMIT
LOT 171 ' ' . � -- � , '
PLANS 2C � � - � -- � - - - '
CON57RUCT 2560 SF 2-STORY SFD WITH 449 SF ATTACHED GARAGE AND 72 SF PORCH. FIRST FLOOR WILL BE 7225 SF WITH 1335 SF
SECOND FLOOR. A FIREPLACE MODEL #4236 (ANSI U1127) WILL BE INSTALLED IN THE FAMILY ROOM; THERE WILL BE A 2ND FLOOR
IAUNDRY ROOM. , .
REF: G04-00010, PA-03-47, T-03-O6 '� � - _ ' '
SEE PA-03-47/T-16600 � � '
Plan Check: $30527
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 6- 0
Rear 10- 0
FEE SUMMARY
Calc Valuation: .
Claim Valuation:
PLANNING & ZONING
Left 5- 0 -. ,-� Right 5- 0
� $257,575.34
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Cali(ornia 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 780 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 applicable codes, and all
requlred Inspectiona and (inal epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
26C6d8Ifi/00)
WORKERS'COMPENSATON OECLARAnON: � �
I hereby eHirtn untler per�elty ol perjury one ot the following declaratlons:
❑ I heve end will mainiain e certificate ot consent to sell-Insure br workers' compensation, es providetl lor �y section 3700 01 the Labor Catle, for the performance of the
work for which Ihis Pertnit is issued.
❑ I have end vrill mai�tain workers' compensatlon insurence, es required by seMlon 3700 ot ihe Lebor Code. for ihe perfortnance of the work for which this permit is issued.
My workers' compa�setion Insurance cerrier end policy number ere:
Carner. - Policy Number:
(This section need no( be complefed il the permit is velued ef one hundred dollers ($100) or less.)
bceitity that in Ihe pertortnence of the work fo which Ihis permit Is Issued, I shell not employ any person in any manner so as to become suDject ro the workers'
`compensation law4 0l C Ilfomia, and egr � af f I should bec e ub�ect to the workers' compensation provisions of Section 3700 ot the Lebor Code, I shall forihwith
comply with these p�a� ns.
Ap�p „lica�""`n_tSlg_naue: f ' (Oate.�-_.�'����
WARNING: FAILURE O SECUR OR RS' COMPENSATIO I COV E IS UMAWFUT AND SHALL SUBJECT AN EMPLOYER'TO'CRIMI AL PENALTIES AND CIVIL FlNES UP TOIXJE HUNDPED
TFIOUSPND DOLURE , IN A ITION TO THE WST PENS/TION, DAMAGES FS PROVI�EO FOR IN SECTION 31p60F THE LA90R CODE, INiEREST, AND ATTORNEI^5 FEES.
LICENSED CON7AACTORS DECLARA710N:
I hereby affirm thai I am licensetl under provisions of Chapter 9(commancing with Section 7000) oi Olvision 3 oi the BuSiness and Professions Code, and my licen5e is in fUll
force end ettect. Lic. • Cless k
Contractor's Signature: Date:
CONSTRULTION LEN�ING AGENCY:
❑ I hereby aRirtn that there is a cronsiruction lending agency tor the peAormance of Ihe work for which this permit is issued. (Sec. 3097, Civil Code).
Lentler's Name: Lender's Addrass:
Signature: Dare:
OWNER-BUILDER DECLARA710NS:
I hereby attirtn that under penalry ot perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Protessions
Code: Any dry or county which requires a permit to constmcL alter, Improve, demolish, or repair eny slmcNre, prior to its issuanca, also requires the applicani for such pertnit
to tile a signa0 stetemeni Ihat he or she Is Ilcensed pursuenl b the provisions of t�e Conlrectors License Law (Chapter 9(wmmencing with Sectlon 7000) of DMsion 3 of the
Business antl Professions Cotle) or Ihet �e ot sha is enempl t�eretrom end Ihe basis lor ihe alleged eaempiion. Any violation of Seciion 7031.5 6y any applicant tor a permit
sublects the epplicani to e civil penelry of not more lhen live hundretl tlollers ($500).):
�.:..: 1,^asywner of the p�operty, or my employees with wages es iheir sole compensatlon, WILL DO iME WORK, and Ne structure is not intentletl or oReretl for sale (Sec.
�-7044, Business and Professions Code: The Contractors Licanse Law does not appry to an owner of property who builds or improves thereon, and who tloes such work
himsetl or herself o� Ihrough his or her own employees, providetl that such improvemenis ere not Intentled or oftered tor sale. If, howaver, the building or improvement is
5old within one yeer Ot completion, ihe owner-builder will have Ihe burden of proving ihat he or sha tlid not build or improve for purpose of sale.).
� I, as owner of the p�eperry, em EXCLUSIVELV CONTRACTNG WITM LICENSED CONTRACTORS to construct ihe project (SecJ0a4, Businass antl Professions
Cotle: TTe contractors Licanse Lew Ooes not eppty to en owner ol pwperty who builtls or impmves thereon, antl who coniracts for such project with a contractor(s)
license pursuent to �he ConirectOrs Liyense Lews.).
❑ lam
Venficalion
SeC.
�.r6 license.
by (rype ot
Business and Professions Code for this reason:
is ❑ No D�V L'icense'No.
i.e. - property tez bill or tleedJ:
DIVISION OF INDUSTRI� SAFETY PERMR CERTIFICA710N:
❑ I heraby cenify Ihat no exwvation five (5) or more feat in depth inm which a person is required to descend, will be made in connection with work authonzed by this
pertnit, and that no building siructure, sceflolding, talsework, or tlemolition or tlismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Tile B, Califomia Adminis�rB�ive Code).
❑ As owner-buildar, I will not employ enyone to do work which woultl require a permit trom the Division of Industnal Safery, as noted above, unless such person has a
permit to do such Work from the tlivision.
Signaiure: Date:
Division ot Indusinal Saf��y Permi� Number:
CERTIflCATE OF COMVL1NdCE AND A ORIZA710N OF ENTTiY: I cenity under penal�y of perjury thel I have reatl this epplicalion and state that the information given is
correct. I agree wmply with all ly s end ciry ordinances relating to 6uilding constmction, and authorize representatives of Ihe City of Casta Mesa to enter upon the
above�descd d roperty i ins f urposes. I reeno4to occupy or allow occupancy of eny building eulhorized Ihis p rmil until final inspacfion.
4�i8�o.� �
Signewre� �ge wner(s)a.: ". {,Date�?-
COOE t. INSPECTIONTYPE
7616 FixeO System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Rool
201 Final BIocWRetaining Wall
202
203
Final Factory File Place
Final Sign
204 Final Demolition
PlIE 1tl7II19ts
COOE 1 INSPECTION TYPE
206 Finel Mechenicel
208 Final Plumbing
210 Final Electrical
212 Finel Fire PreveNion
220 Final Planning Approval
222 Final Site
250 FinalBuilding/Occupency
Q�TE 1NIIIISLi
(714) 754-5273 �•'Fax�(774) 754-4856 • www.ci.wsta•mesa,c'ay�TRICAL PERMIT n�FAIRIDRIVE, COS7A�MESA, CA 92626
tLt
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
2308 HALF MOON LN
LOT 15
TPN00518
A licanr. WILLIAMS, GARY " '' >'"-� ..,
PP - `=%:=.�-���--' ��__ 'ISSUED'BY:
" . -e:. �� ��
Address: 1450 N. TUSTIN AVE -% �-�G r � �_ , - - - - � �� ` -`-'�,-��,�, ;�,.
Status: ISSUED
Applied: 04/27/2005
Issued: 04/27/2005
,/ ., . . , I ' �:: _
�r � , .-� ; Phone: ; /£ � �
rr k�r - 1. 1 ) � ti
SANTA ANA;;CA C�'� \ � Zip 92705 ' ! � ; / I ��.. � � .�'�a
/y ��r . � �.� t • ' ' n � ��� "e �V`� �: ��''v
�a...,, ��� :� 1 - _ �i �1 / � � �VA` `� �'
�t �
:: � � ,, , l C".!� .� _ . - — ` .. ,—.- •��•� � � � � \
� �.� �� -.
SHEA HOME$ LTD�c�',J J `c V `.�!r , � j�--, -\
� w- ; � �.�
603 SOUTH VACENCI AVE� "��'' �'�; �'� i i\���
\ � ' �\�.
-•.�`�.. �✓ \
'�a `�l�'/��i'` .\�\ j � �
,: j r;: .ti-:, �',�. r .� ,/�- " Phone. 714-985-9300 `y�,.\\ V ,^ � �' �l
,� ;. %�-i ' � ��'�'X`�' \ .
.. � i � ' ) ��� ,
BREA;.CA"-�=`�'� Zip: 92823 � A���. � % ;
. _ : : ' /� ; ,��/ .�� V'.�., ; ,
ti �A���
.�. % �,' /�i;�`V ,� . : �?VV� . � . _
j �� �
"ia' ' `'i � j%r:f :�.i �1�'� . " _
�'. , : i..;:, `�\; ,
Contrector�� OWNER BUILDER I
T� % . — .� , c �
� , Address �� � i .�.,."' , �.� �,.. ,,,�- �� � � ��� � i � , . �
;. + t `
or � v � ��" r �"� �0 1�'r - .Fhone v. . . . � �, � � ' ` '
,,� ; r �i y � � �.�^'�* _ . , (r - _ _ .— . - ' _.� ,'" • -
� - 1���� ./ j :� � � .�y;'L _�Zip: -- . .. _ .`� ,:� �, . .
s- r r �' .. .,� °�p ' � _ ��1� \,n , ti .,t ,
, � % ��� � License:000000 - " '; ' '
: 4 r � .` Iv { ` � e, � : i
i ` �� � f �" ��._ �� � ; . �l e � { 1 �.
�,.._ 1 ) y
�.. 1 i�h� ' _' . ��� . � � a t'��`{�i:{ � �"� l� ��_
!
`v�! � j%; � ' .<."z`'f �'Y �7 j*-�7� SCOPE OF PERMIT � . ^- \�
. i , , ; LOT 15/PLAN 2C it..-'� � ...0 :'�6' � ' :t' � L!' l�.r = t �.�'� �\
�
<' � . � , ' ='. ' .r� _`_ _.,"'._... =„.'–^�_�_=�.r.,-'— _ _ .. .r.: .-.'
�e._.-- i�,; ELECTRICAL PERMIT FOR NEW 2560 SF SINGLE FAMILY RESIDENCE FOR "SHEA HC
s' - ; 1'��' % 2 GGHT.FIXTURES, 3 RECEPTACLE OUTLETS, & 1 SWITCH IN GARAGE, & 1 RES A/C
: _ "' � i : � � . , i-' � '�. '� . � -� � 4 'l �}% i' i . . -
�'.} REP: BOS-00171 �. - - - ��--� � � ' �"'�- =''��
. . . . - . . . ' � . - _ • +..� . ..i ...�s f;l�� � �'
�' `' '�' ,' FEE SUMMARY�,�%
, � l
t�\� �G.�y_'�
t' `;. ,� ' :, Quantity -.. . .
ISSUE FEE; ,! ��,'�� � 523.50 . Temp Dist System / Ughting
Temp service.test � V �„• $0.00 ' . � �,��B�sway /100 R
Res>a/c'package \ �$5450 , -� �
WORKERS' COMPENSATION DECLARATION: � �
I hereby aRirm untlar penalry oi peryury one oi the tollowing declarations: '', ' , � ' - �
❑ 1 have entl will maintain e certificate of consent to self-Insure for workers' compensation, as provided for hy sectlon 3700 ot ihe Lebor Co�e, for ihe pertormance of Ihe
work tor whiCh thi5 pertnil is issued. "' - '
❑ 1 have and will mainWin workers' compensation insurance, as requiretl Dy section 3700 ot the Lebor Code, for the perfortnance of the work tor which Nis�permit is issuetl.
My workers' compensation Insurance carrier and poliq number ere: . • ..
Carner. POlity Number. ' -
(Thls section need not be comp/e(ed il the permil is valued at one hundred dollars ($100) or less.) �
�I certity ihet in the pertormence oi the.work for which this�pertnit is issued, I shell not employ any peison in any manner so as to become subject to the woikeis' '
compensatlon laws oi Californie, end sgree Ihat ii I ho 1 ecoma sub' to the workere' compensation provisions ot Sec'on 3700 ot tha Lebor Cotle, I shall forthwith
comply with these provisio �/
Applicant Sipneture: � Date: / 7 �O �
WFRNINO: FAILURE TO URE W CERS' DMPENSATION CAVE GE IS WFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED
TqU$AND OOl1ARE (5100,000 , N ADDITIIXJ TO THE COST OF COM ON, DAMAGES AS PROVIDED FOR IN SEGTIqJ 31O60F iHE LABOR CODE, IMEREST, AND ATTOHNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby ettlrm that I em licensed under provislons of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Cotle, and my license Is in full
lorce end eHecL Lia N Class k
Cantrectofs Slgnature: Date:
CONSTFUCTION LENOING AGENCV: '
❑ I hereby aflirm thai Ihere is e construction lending agency for the pertormance of the work for which this permit is issued. (Sec. 3097, Civil Cotle).
Lentlera Nama: Lenders Address:
Signawre: Date:
OWNER-BUILOER DECLARATIONS:
I hereby affirtn that untler penalry oi perjury that I em E7(EMPT FROM THE CONTRACTORS LICENSE LAW tor the toliowing reason (Sec. 7031.5, Business entl Professlons
Code: Any ciry or counry which requires e pertnit to consiruct, alter, impmve, tlemolish, or repair any stmcture, pnor to its issuance, elso requires ihe epplicani tol such pertnit
to fle a signe0 statemem that he or she Is Ilcensed pursuant to the provisions ot ihe Conirectors License Lew (Chapter 9(commendng with Seaion 7000) of Division 3 of the
Business antl Profassions Code) or ihat he or she is eMempt theretrom and the 6asis for the alleged evemption. Any violation of Section 7031.5 by any epplicant tor e permit
sublects the epplicant to a civil penalry ot not mora than five hundred dollars ($500).):
❑ 1, as owner ol the property, or my employees with weges as Ihelr sole compensation, WILL DO THE WORK, antl the strucWre is not Intentle0 or ottered for sale (Sec.
7044, Business antl Professions Coaa: The Contractors License Law does noi apply �o an owner of property who builds or improves thereon, entl who dces such work
himseN or hersetl or ihwugh his or her own employees, providetl ihai such improvemeNs are not intendetl or ottered tor sele. tl, however, ihe buiiding or improvement Is
soltl within one year ot completion, the owner-builder will have the burden of proving ihat he or she did not build or improve for puryose oi sale.). �
�I, as owner of the pmperty, em EXCLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Busineu and Professions
Code: The contrectors License Lew does not appty to an owner of propeny who builds or Improves Ihareon, and who contracts for such proiect with a contractor(s)
license pursuam to ihe Contrectors License Lyvs.).
❑ I em exempt u r sec.
Signature:
Owner I veritiea by tl ers�
(type of docGment, I.e.
DIVISION OF INDUSTRIAL SAFETY FERMIT CERTIFICATION:
and Professions Code for this reason:
bill ar tleetl):
Drivers LicenSe No.
�� ���. : . ,�. � ,
❑ I hereby canify thet no excavation flve (5) or more feet in depth into which a person is required to descend, will �e matle in connec�ion with work euthonzed by t�is
pertnit, and that no builtling siructure, scaflolding, talsework, or demoli�ion or tlismantling ihereof, will he more than Ihirty-si: (36) feet high. (Chap. 32, Grp 2, Atl 2, Sec.
341, 7tle 8, Celifomla Atlminisirative Code).
❑ As owner-builder, I will not employ anyone to do work which would require e permit from the Division of Intlustrial Safety, es notetl e6ove, unless such person has e
permit to do such work irom Ihe division.
SignaNre: Date:
Division oi Industnal Sefery Permit Numbec
CERTiFlCA7E OF COMPUANCE AND AI7THOR TIAN OF ENTRV: I ceM1ify untler penalry of perjury ihat I have read ihis application and siate ihat ihe information given is
correct I agree to compy with all siate laws ap� ��ordinances relating to building construction, and auihonze representatives oi the Ciry oi Costa Mesa to enter upon the
above-described perty tor inspeption p 6 6 gree not to cupy or allow acupancy of any building authorized by thIi perm until=inel inspection.
,.�.� ,/q _ . �!/z��os
/ SionaWre Ot Leaal Ow r(s) � Date
COOE I, IHSYELTIONTYPE' � • .. • . �.• • Q�'. .
1616 Fized System Final Fire Prevention �
1266 Pool Spe Final
200 Final Re-Root
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 FinalSign
204 Final Demolition
�� �QQ�� INSPECTIONTYPE"`- ` -
' � - 206 � Final Mechanical
208 Finel Plum6ing
' 210 Finel Electncal '
212 Final Fire Prevention
� 220 ` Final Planning ADPmval �
222 Final Sita
250 Final Building/Occupancy
Q,�f. ' �$'
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
MECHANICAL PERMIT
.lob Address: 2308 HALF MOON LN
Suite No
Vicinity: LOT 15
Status: ISSUED
Applied: 04l27/2005
Issued: 04/27/2005
_ --- - "�-;..-.W-'
Parcel Number. TPN00518 _- �� '-.- - - � ��-�"-�;== �':";^-� . ISSUED BY:
. . _ - } _-� , . .\
, ��;ii � : _ . - 1
Applicant WILLIAMS,.GARY-%--�i�-. �' , 3 � i"-� y�-�� '\
t', r'/✓ ` � � �.
Address: 1450 N TUSTIN AVE"+' \ � ' �� l �� 1 � ~' � � � �"
�!/c%'!`-. c� 1 �� , � ) � t ' x�� / �o !' `• �.r �";�C� '
,rt. -i �� 1\.�'\ r � �'Phone: - -'� r .� �\���
. SANTAANA CAA � l''/.�---Zip.. - 92705 "�� _ �� I �• � .'��� � �
� S?/ /v \ y �''� /..� � ._ . �A �..�'` �� \i � �
s .. � c �� - \. . \
� `�r;.e% .:e. �' iJ�-���•- � .: ���`��� i / � ``A�\
Owner SHEA HOMES LTD%�` ��� ., . �'%. ����
�,,r a_ . . � �i/i�� �,� � �,� �';�-�
Address: 603 SOUTH VALENCIA AVE �\�\� 7" �� -�
� %� . f�'!!� \.� � �� � ��
: �' f7 �-�P '�^�/` Phone: 714-985-1300 \v� ����/
f���'fI/ \4\�\ �.
,.;; j �;��BREA�CA:f' Zip: c92823 ������ � i� -.
-.J \♦ /
� r \ /! / :/ } �\ •\ ' •
.: a �� . l i���� 1�� • .. _ .. ._ \ \ � � .� .
Contracror � OWNER-BUILDER � �� 5� • ' �� � �
sf� . �. «. v' 1'`. . . , \.\ �. '
i ' ddfe33i : �jtf � , r � f� �L- � � � . ; . . ' l� . � .
f � �
r�
r
i / L � l 4 � � Y !f 'l r� I • '
�'JI i �Nr '"''' ^Phone _' � "� - -
� �n
' ,��J� ! -1 1 I "-0 (���il _ '...-;- „ ' � /�i .
i t a�� , _ �Zil
t�� � _ ..- P� _ � � ;.
r � / 1 � � � fi 3��,�'�� �P �j+ < i-� . •
- � '✓ � /�. �., License.000000 . �` _'; ; ,
k� �.��- 7�r. .�1 .`�w'r.i �1 ;�'.�-.
_ . •
� t� -',:� �_� _SCOPE��OP`PERMIT—= =�_ � '; I'�!' � �'
,
�'�! � '; LOT 15/PLAN 2C �0 �''v � +�t} i ) %�+� 7(1 �t' � - .—r �\ t i , �
t. ,'i; ' � ' 1 � '
r J� li i� iv ..: �j 3t^1� !�, 1 f� ,�i �\ ,. �''t: I . vl
� 1.'„MECHANICAL PERMIT FOR�NEW�2560 SF�SING[E-FAMIEY'RESIDENCE FOR�"SHEA HOMES r . _. `
,-" �:�y'iINSTALL 2 FAU'S,�1 DUCTWORK, 2iFACTORY FIREPLACES, 6 VENT FANS, 2 FIRE DAMPERS,�„ /���•" � �! i' '
.. � S � �� ;&-2 A/C CONDENSORS.-E,r"� � ':a � n.� �k� . u .. ,::� ; .
°, c ' - .t. �t ��'' �,s''-�j"r" , '�„ � j,i -� :
� * ' �'- `� REF: 805=00171 . f _"� -7- - �`- - -.,.�^y r . _ � � - ,
, . . _ � - _ ._ _, .�. s g _.._-- _ , ; .. , � , �
,,,
„r y ,, � r
� FEE SUMMARY ,'r, . ; C � ' � �' l
.� a, � `�� - Quantity , -. ==-- ' �� ��/ �� � Quantity�
ISSUE.FEE ��A.j � � $23.50 ,�, ,,�aRepair/AltAbsorbtionUnit � �'�l %$000 - O�,a���
Inst FAU <100 k BTU� � �> �- $29.60 2 ;,� ��,� ",'Repair / Alt Refngeration Unit '. �%fj; `�80 00� 0 ; /
Inst FAU'>100 k BTU � �� . $0 00 0 `�� VenGllation System ` � �1% $0 00 �0' -
Repair / AIt, Cooling/Heat � � �' $,13 70 7 , . , , �Evaporahye�Cooler . �� � � /{ $0 00��0 ��
Inst/ Rep. Recess walCRh .' $0 00 -,0 .xiey Commercial;lncinerator.�7� "!���"'� ,' $0 00. � ,0
Refrig Sys <100�k BTU ' � �`$0 00 � 0 -',� % � "�Domestic Inc nerator � � � �� � $0.00'� / 0
Refrig Sys >100 k BTU �� , 50 00 � 0 %� � Oompressoi`s / Absorotion:Svstems �1� �,�r�
p g _ � �,$0 00'�, 0��.A 3 Up to 3�hp C100 k 87UI j /`, , �� �$0 00
GasPl in �A�`'� � i/' �' � i l�!`�� �'
Factory Fireplace ��- �' � � !!$21 30 2���`� � `? �' .3 To-15 fip.I,500.k:BTU �.^\� � �v /,�(�$0.00
Hood w/Mech Exhaust :�� ; ..$0.00 �; 0 � `" � - _ =.�15 Ta30,hp"!'I,000 k BTU >.�, {/ !-� ;'$0.00
VAV Box '�� ��� �`$0 00 �� 0�� �- - -� _30 To30 hp / 1,750 k BTU�"�j . j� '`✓� �' $0.00
Vent Fan /$ingle Duct � $43 50 / 6-. �.i!< � y s` ` rOver SO,hp /10ver 1,750 BTU' /!� j� $0.00
Appliance � � �-$0 00 � 0 �� _, �.�E � � � � � Boilers � ���, � 1 �/'��
Fire Dampers $14.50`�_2 '-� �.- i, � ,, -' • '-Up',to 3 hP��a --^� �!. �-= / $29.40
SmokeDampers $0.00'�0:���� --' � � ,: �3To�15h'p - %��° � $0.00
Inst or Relocate Appl Vent $o.00 � o_ '- . --, 15 to.30:hp.;; j, %';--''� $0.00
Air Handlers < 70000cfm $0.00 0 � - _: .�''�'-";- �30'to 50 lip:��' ` $0.00
Air Handlers > 10000cfm $0.00 0 '"'--' --- �Over 50 hp 50.00
0
0
0
0
0
2
0
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
. FJCPIRATION: This pertnit 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 lagal, such work must comply with all applicable codes, and all
required Inspectlona and final apprrnel must be obtained. Failure to obtain inspeclions and final approval will result in the expiration of this permit.
FORINSPECTIONS�CALL: (774)7545626
zaaers(doo)
WORKERS'COMPENSAnON DECLARATON: ! � � � ' '
I hereby alfirm untler penalry of perjury one of the lollowing declarations: ' ' , � ,
❑ I heve entl will inaintain e certiticate of consent to self�lnsure for workers' compensation, es provitle0 br by section 3700 of �he Labor Cotla, for the pertormance of t6e
woM tor which this permit is iuuetl. � � - � -
❑ I have antl will maintain workers' compensation insurance, as requiretl by section 3700 of the Labor Code, for t�e peAortnance ot the work for which this pertnit is issuetl.
My workers' compensatlon Insurence carner entl policy number ere:
Cerrier: Policy Number. '
(This sectlon need not be camp/eted i! the permit is velued et one huntlretl dollers ($100) or less.) � �
�I certity that in the peAortnance�ofihe woAc for which Ihis pertnit is issued, I shall not employ any person in any manner 3o es to become'sutiject to the workers'
compenutlon laws ot Celitomia, end 'agree that it I I become sublecl lo lhe workere' compensation provisions of Se tion 3700 of the Labor Code, I shall forthwlth
wmply with Ihese DrovlSi L�
ApplicentSigneture: Date: • Z%,�s
WARNING: FAILURE TO ECUR ORKE COMPENSAiION COVERAGE IS UNLAWFUL AND $W1LL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDPED
THOUSAND DOLLAHE (5 . . IN ADDITION TO THE CQST OF COMPENSATION, OAM1WGES AS PROVIDED FOfi IN SECTION 3]O60F THE LABOR CODE, INfEREST, PNO ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aMirm �hat I am licensad under provisions of Chapter 9(commencing with Section 7000) ot Division 3 of the Business antl Protessions Cotle, and my license is in full
forca entl eflecL Llc. M Class M
ContractoYs SignaWre: Date:
CONSTRUCTION LENDING AGENCV: �
❑ I hereDy aHirtn Ihat there is a consWction lending agency for iha peAormance oi the work for w�ich ihis permit is issueC. (Sec. 3097, Civil Code). �
LenOefs Name: LendeYs Atldress: �
Signeture: Date: i
OWNER-BUILDER DECLARATIONS:
I hereby ettirtn Ihat under Oenalty ot perjury thet I am EXEMPT FROM TME CONTRACTORS LICENSE LAW tor iha toltowing reason (Sec. 7031.5, Buslness and Protessions
Code: Any ciry or county which raquires a permit to construct alter, improve, demolish, or repair any sWCNre, pnor to its issuance, elso requires the applicant tor such pertnit
to file a signatl stetemem that he or she is Ilcensetl pursuant to the provisions of the Coniractors Ucense Law (Chepter 9(commencing with Sectlon 7000) of DiNsion 3 of ihe
Business end Professions Code) or Ihet �e or she is exempt therefrom and ihe �esis for t�e ellegea axemption. Any violation oi Saction 7031.5 by any applicant for e partnit
subjects Ihe epplicant to e civil penalry of not more then five hundred dollars ($500).):
❑ I, as owner of Ihe property, or my employees with wages as their sole compensatlon, WILL DO THE WORK, and the structure is not Intended or oHeretl for sale (Sec.
7044, Business entl Protessions Code: The Coniractors License Law tloes not apply to an owner of p�operry who builds or improves thereon, entl who does such work
himseN or herself or Ihrough his or her own employees, Orovitletl ihat such improvemenis ere not intended or oRered tor sele. If, hawever, the builtling or improvement is
sold within one year ot wmplation, tha owner-builder will have the burden ol proving that he or she did not build or improve for purpase of seleJ. �
�I, as owner of Ihe property, am EXCLUSIVELY CON7RAC71NG WITH LICENSED CONTRACTORS to consimct the project (Sec. 7044, Business antl Professions
Code: The contraaors License Lew does not eppry m an ownar ol property who builtls or Improves thereon, antl who contrects tor such pmject wit� e contrector(s)
license pursuant to the Contractors License Laws�. .
❑ I am exempt u er sec. Business end Professions Cotle tor �his reeson:
SignaWre��o---i ! -
Ezpires: QI
�..." _, % ' 7i" /W
Venfication ofUWR�ship b� (Iype oi tlocument, is- property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
� I hereby certity thet no excavation tive (5) or more feet in tlep�h into which a person is requiretl to descend, will be made in connection with work euthonzed by this
permi�, entl Mal no building siruMure, swltolding, talsework, or demolition or dismantling thereof, will be more Ihan ihirty-sia (36) feet high. (Chap. 32, Gry 2, Atl 2, Sec.
341, Title B, Celitornia Adminisirative Code).
❑ As owner-builtler, I witl not employ anyone to do work which would require e permit from the Division ot Intlustrial Safery, as notetl ebove, unless such person hes e
permit to do such work irom ihe tlivisian.
Signature: Data:
Division of Industrial Sefery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHOR TON OF ENTRY: I cenify under penalry oi perjury that I have read this application and state that the intortnation given is
correct. I agree to wmply with all state law city ordinances relating to builaing construction, and euthonze representatives of ihe Ciry of Costa Mesa to enter upon the
above-descn property for ins ectio s. I egree not t� upy or allow occupancy ot eny building authonzed by is Der t until tinal inspection.
�%/ y z.� %s�
Signature OI Legal Ow Date
An[UOrAUlhonzed cant Date
CODE �. INSPECTIONTYPE'
1616 Fixed System Final Fire Prevention
1266 Pool Spe Final
200 Final Re-Roof
201 Flnal 61ocWRetaining Wall
202 Final Factory Fire Place
203 Finel Sign
204 Final
". ' gf�F,.` . INf1iIRLS
COpE1 INSPECTIONTYPE � ' ' �
206 Final Mechanical . �Z J
208 Finel Plumbing
210 Final Eleciriwl
212 Final Fire Prevention
220 � Final Planning Appmval'
222 Final Site
250 Final Building/Occupency
�
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 2308 HALF MOON LN
Suite No
Vicinity: LOT 15
Parcel Nunmber: 7PN00518
0
PLUMBING PERMIT
�'- ' .
Appiicant WILLIAMS, GARY � , _ -
Address: 1450 N. TUSTIN AVE �' �
Phone:
Zip: 92705 � �
SANTA�ANA; CA
Owner: "� SHEA HOMES CTD � � �
Address 603 SOUTH VALENCIA AVE
BREA, CA
Phone: 714-985-1300
Zip: . ,92823
Status: ISSUED
Applied: 04/22/2005
I ssued: 04/22/2005
ISSUED BY:
Contractor: �OWNER-BUILDER
�..Address: � � .. . �;, ' � - -
Phone:
Zip:
, , , License: 000000
' - ' . - � -:" - . , - . _ .
' SCOPE OF PERMIT �
LOT 15
PLAN 2C � ��. �
�PLUMBING PERMIT FOR NEW SINGLE�FAMILY RESIDEIVCE FOR "SHEA HOtv1ES". INSTALL 3 "
BATHTUBS, 1 DISHWASHER, 7 GAS OUTLETS, 1 WASHER, 1 PRESSURE REGULATOR, 1 SEWER
CONNECTION, 3 SHOWERS, 1 KITCHEN SINK, 1 SERVICE-SINK, UP T04 VACUUM BREAKERS,�3 `'
WASH BASINS, 1 WASH BASIN SET, 1 WASTE 8 VENT.SYSTEMS, 4 WATER CLOSETS, 1 WATER/ �
HEATER, 1 WATER PIPING, & WATER SERVICE. . �- � . ,
REF: B05-00171 - - � ' ' , - � "
� ' . "', - � ., . - - � .
� �� : , � � �FEE SUMMARY ��'�"'�. . �i , �
AMT � �QTY.-•'�� • � - , AMT �.QT�Y� -'�- ��� ' � AMT QTY
ISSUE FEE $23.50 -� Laundry Tub / Washer $9.80 1 �, Sump Pump� �,$0.00 0
BackFlow irrigation � , $0.00 . 0 � ' Landscape Irrigation, ' $0.00 0 :- �Swimming Pool � ; $0.00 0
Backflow Preventer - $0.00 � 0 _ '"�-P Trap - � $0.00 0 � � �Trap'Primer �. - - $0.00 0
Bathtub � . ,.$29.40 3 � Pressure Regulalor � � $9.80 1 ; � , Urinal . , 50.00 0
Clarifier System � �$0.00 0;" Process Piping (per 10 ft)_ $0.00 .0 Vacuum Brkr.BkFlow(1-4) $12.30 1
Connect (Ice,Soda,etc) 50.00 � 0 . Receptors $0.00 0 -, Vacuum Brkr,Bkflow(5+) $0.00 0
Denial Units -$0.00 � 0. Septic Tank $0.00 0�- `. Wash Basin.. ' $29.40 3
Dishwasher $9.80 t� ' , Sewer Cap for Demo � $0.00 0�. Wash.Basin Set $9.80 1
Drain, Floor $0.00 0 � Sewer Connect $24.65 1� , Waste and Vent System $9.80 1
Drain, Rainwater $0.00 0 . Sewer Private Line' ' �30.00 0 ,� � Water Closet (Toilet) $39.20 4
Drain, Roof $0.00 0 -� Shower $29.40 �, 3 ' - Water Heater / vent $12.30 1
Drinking Fountain $0.00 0 Sink. bar - �$0.00 0 Water Pipinq (Inst or Rep.) $9.80 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, 12-27-92)
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 considered legal, such work must comply with all applicable codes, and all
required Inapectlons and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
[6V0-itl �IYUV)
WORKERS'COMPENSAnON DECLARAnON: �
I hereby eHirtn untler penelry ot perjury one of the following decleretions:
❑ 1 heve and will meintein e certificete ot conSeM lo self-Insure br workers' compensetlon, as providad lor by section 3700 of the Labor Cotle, for ihe pertormance of ihe
wark tor which this pertnit is issued.
❑ I have end will rtiaintain workers' compensetion insurance, es required by sectlon 3700 of Ihe Lebor Code, for t�e pertormance of ihe work for which Mis pertnit is issuetl.
My workers' compensetion Insurence cardar and policy number ere:
Carrier: Policy Number:
(This sect(on need no� be completed il fhe pertnif is ve�uetl ef one huntlred dollars ($100) or /ess.)
❑ I certily that in �he pertortnance of the work for which this pertnit is issued, I shell not employ any person in any manner so as to become sub�ect b ihe workers'
compensation lews of Celifomie, end egree thel II I should become suh�ecllo ihe workers' cnmpensatlon provisions ot Section 3700 of the Labor Code, I shall fotlhwith
comply with th8se provisions.
Applicant Signature: Dete:
WARNING: FAIWRE TO SECURE WORNERS' COMPENSATION COVERAGE IS UNLAWFVL PN� SNNLL SUBJECT AN EMPLOVER TO CPIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
T}IOUSAND DOLIARE (5100.000). IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIpED FOR IN SECTION 3/O60F THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
IICENSED CONTRACTORS DECLARATION:
I herehy attirm that I am Iicense0 under pmvislans at Chapter 9(commencing with Section 7000) ot Division 3 0l ihe Business and Professions Cotle, and my license is in full
torce and ettecl. Lic. x Class x
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby attirtn that there is a consiruction lending agency for ihe pertormanca of the work for which Ihis permit is issued. (Sec. 3097, Civil Code).
LenOer's Name: Lender's ntldress
Signature: Date:
OWNEH-BUILDER DECLARATIONS:
1 here6y aflirtn thal untlar penalry o1 parjury that l am EXEMPT FROM TME CONTRACTORS LICENSE LAW for the lollowing reason (Sec. 7031.5, Business and Protessions
Code: Any ciry or co�nry which requires a permit to construct, alter, improve, tlemolish, or repair any stmcWre, prior to its issuance, also requires the applicant for such permit
�o tile a signad steter�ent thet he or she is licensed pursuent �o �he pmvisions of the Contrecbrs License Law (Chapier 9(commencing wiih Section 7000) of Division 3 of t�e
Business entl Professions Cotle) or thet he or sha I5 ezempt therefrom end Ihe besis for Ihe alleged evem0��o�� Any violetion of Section 7031.5 Dy any applicant for a pertnit
subjects ihe epplican� to e civil penelty of not more than Nve hundred dollars ($500).):
�1, es owner of Ine property, or my employees with weges es their sole compensallon, WILL DO TME WORK, antl the simcWre is not inientletl or oflered lor sale (Sec.
7044, Business end Protessions Cotle: The Contractors License Law does not apply b an owner ot proDerty who builtls or improves ihereon, antl wno dces such work
/himsell or here0lf or through his or har own employees, providad Ihat suc� impmvements ere not Intended or ofleretl for sale. N, however, the buil�inq or improvement is
soltl within one yeer ot completion, the owner-builtler will have iha burden of proving ihat he or she tlid not build or improve for purpose oi sale.).
I, es owner ot tpe properly, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to conslmct Ihe pmject (Sec. 7044, Business and Professions
Cotle: The contractors License Law tloes not eppiy to an owner of property w�o bullds or Impmves Iheraon, and wbo contracts lor such prolect with a contractor(s)
license OurSu� �o the Comrectors license Laws.).
❑ lam
Owner �D veniietl D tlny4rs license.
Venfice{�on ol er5tifp by (rype ot
� 8usines5 and Prolessions Cotle for this reason:
,' Date: 1.
❑ No Drive(s License Expiras: /�I
i.e. - pwperty faz Dill or tlae0):
DIVISION OF INDUS�7IAL SAFETY PERMIT CERTIFICATION:
❑ I hereby ceniy Ihat no excavation five (5) or more feet in depih into which a person is required to descend, will 6e made in connection with work autnonzed by this
pertnit, antl Ihat no building sWCWre, scaHoltling, falsework, or demolition or tlismantling thereof, will be more Ihan thirty-six (36) feet high. (Chap. 32. Gry 2, Art 2, Sec.
341, Ttle B, Califomia Atlministrative Cotle).
❑ As owner-builtle�, I will noI employ anyone to do work which would require e permit trom the Division of Intlustnal Safery, as noted a6ove, unless such person has a
pertnit to do suGh woAc Irom the division.
SignaWre: Dare:
Division ot Industrial 6afery Parmit Number.
CERTIFlCATE OF CtlMVLIANCE AND AllTHORIZA710N OF ENTRV: I cenify undar penalry of perlury ihat I have reaA Ihis ep0�icalion and state Ihat tha information given is
w¢ecL 1 agree comply with all stete I ws nd ciry ortlinances releling to building conslmction, and authonze represeNatives of the Ciry of Costa Mesa to ente� upoa the
ebove-descn mpeny for inspe io ses. I agre ot to occupy or allow occupancy ol eny building authorized hy Ihi perm until final inspection.
gnaWre gal / Date
�� Z
nN Authorized Applic Date
COUE I.
1616
1266
200
201
202
203
FizeO System Final Fire Prevemion
Pool Spe Finel
Final Re�RoO�
Final BIocWFeteining Well
Final Factory Fire Place
Finel Sign
204 Final DemolU�on
D�TE INTITI�LS
CODEY INSPECTIONTYPE
206 Final Mechanical
20B Final Plumhing
210 Flnel Elecirical
212 Finel Fire Prevention
220 Final Planning Approval
222 Final Sile
250 Finel Building/Occupancy
1=�--�H
�