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Home My WebLink About514 HAMILTON ST - Building Permits(714) 754-5273 • Fax (774) 754-4B56 Job Address: Suite No Vicinity: CITY OF COSTA MESA BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 514 HAMILTON ST PARKING LOT AREA Parcel Nunmber: 42202117 npplicant: LIPPERT, JACQUELINE Address: Owner: 514 HAMILTON LLC AddreBs � �� 525 VICTORIA ST � ; COSTA MESA,CA Contractor: FRENCH, WILLIAM Address: 14630 MEGEE WHITfIER, 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 1000g Motors to 7 hp Motors to 10hp Motors fo SOhp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pale Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Status: ISSUED Applied: 06/17/1999 Issued: 06/1711999 ISSUED BY: � Phone: (949)646-9966 Zip: Phone: 714-646-9966 Zip: 92627 Phone: 562-947-8276 E� �� Zip: 90604 � c,, a� � I License: 68'1266 ^ _` Lvl'O . r�' V SCOPE OF PERMIT INSTALL TWO NEW 25' MAZ HEIGHT PARKING LOT LIGHT POLES & FIXTURES INCLUDING NEW � FOOTINGS. REF:B99-00914 4uantity $22.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $67.00 $0.00 $0.00 50.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 FEESUMMARY Temp Dist System / Lighting Busway /100 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 Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit - Misc. Conductor Circus ( gen or ride) Cirws (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee 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 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES E89.00 COMMENTS / SPECIAL CONDITIONS ,,` NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIHA710N: Thig permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned }or a period of 180 tlays. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, ana all requlred inapeetlons end final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: — � I hereby aNlrm under penalry ot perjury one of the following declarations: ❑ I heve entl will malntain a certilicate ot consent to setl-Insure for workers' compensation, as provitled for by section 3700 of Ihe Labor Cotle, for the peAortnance of Ihe wark for which this permit Is issuetl. , ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the perfortnanca ot the work for which this pertnit Is issuetl. My workers' wmpensation Insurence carner and poliry number are: Carnec . Policy Number: (This section neetl not be comp/eted i! Ihe permit !s velued et one huntlred dollers ($100) ar Iess.J ❑ I cenity that in the pedortnence of the work for which this permit is issueq I shell not employ any person in any mannar so as m become subject to ihe workers' wmpensation laws of Califomia, and agree that if I should become su6ject to Ihe workers' compensation provisions oi Sectlon 3700 of the Lebor Cotle, I shell fonhwith camply with sio s. . ' � �/ � Applicant Signature: 2�.c� i� iE.-/ Date: / 7�99 WqRNING: FAILURE TO $ E WORI ' fAlAPENSATION COVERAG�UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINE$ UP TOONE HUNDflED THOUSANODOLLARE�St ,000),INADDITIONTOTHEWSTOFCOMPENSATION,DAlMGESPSPROVI�EDFORINSECTION31060FTHElABORODDE,IMEREST,ANDATiORNEV'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby aNirm thai I am IicenseC under rovisions of Chapter 9(commencing with Section 7000) of Division 3 of Ihe Busines�5,�and Professions Cotle, and my license is in full lorce and efled. Lic. �ii Class # .l"S Contractors Signatu � � 6L� oate: -/ 7 q 9 CONS7RUCTION LENDING AGENCV: ❑ I hereby aHirm that there is a conswction lentling agency for Ihe pertormance ot the work for which this pertnit is Issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I herehy attirm t�et under penalry of perjury that I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sac. 7031.5, Business and Professions CoCe: Any city or county which requires a pertnit to cons�ruct, alter, improve, demolish, or repair any structure, pdor to its issuance, elso requires tha applicant for such permit to file a signed statement Ihat he or sha is licensed pursuant to ihe provisions ot the Contrectors License Law (Chepter 9(commencing with Sec�ion 7000) of Division 3 of the Business an0 Pmfessions CoOe) or ihat he or she is exempt iherefrom end the basis for the elleged exemption. Any violation oi Section 7031.5 by any applicant tor e permit su6�ect5 the epplicant to e civll penalry of not more than Tive hundretl dollars ($500).): ❑ I, as owner oi the property, or my employees with wages es their sole compensation, WILL DO T}fE WORK, antl the structure is not Intended or otteretl for sale (Sec. 7044, Business and Professlons COEe: Ttie Contrectors License Law does not epply to an owner of property who builds or improves thereon, end who does such work himself or herealf or through his or her own employees, provitletl ihat such improvements are not intended or oHered for sale. H, however, ihe building or improvement is sold within one year of completion, ihe owner-builder will have ihe burden of proving that he or she did not build or improve tor purpose ot sale.). ❑ I, as owner of the property, am EXCLUSIVELV CONTRAC7ING WI7H LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business antl Protesslons Gode: The coniractors License Law tloes not apD�Y �o an owner of properry who builtls or improves thereon, end who comrects tor such project with a coniracmr(s) license pursuant to Ihe Contiectors'Cicense Lews.J. _ i�� 7 ❑ I am ezempt under sac. V�� S I Business and Professions Code for this reason: Signawre: Date: Owner ID verified by driver's license. - r��Ves ❑ No Dnver's License No. Expires: Venfication of Ownership by (type of document, i.e. - property ta�c bill or Geetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity �hat no e:wvation five (5) or more feet in tlepih in�o which a person is requiretl to descenG, will be made in connection wiih work authonzed by this permit, entl that no builtling sWCNre, scaXolding, felsework, or demolition or dismantling theraoi, will be more than thirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which woultl require a permit from ihe Division of Industrial Safery, as noted above, unless suc� person has a permii to tlo SUCh work ffom Ihe divi5ion. Signature: Date: Division ol Indusirial Sefety Permil Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I certify under penalry of perjury ihat I have read ihis application and state that the information given is correct. I agree to comply with all state laws and ciry ortlinances relating to building consiruction, and authorize representatives of the Ciry ot Costa Mesa to eniar upon the flbove-descrlbed propeny tor inspection purposes. I agree not to occuDY or allow occupancy oi any building authorizetl by ihis permit until tinal inspection. COdE �. INSPECTIONTVPE 1616 FixeC System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Reteining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition 2aa&48 �/i��99 ' Date Qa¢, f��j fQQ� INSPECTIONTYiE 206 Final Mechanical 20B Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency �g � ,:u:r - y�� ; •r:_::_ � �, ' CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT ��ia� �sa-sz�s • Fau (714) 754-4856 ,lobAddress: 514 HAMILTON ST Suite: Vicinity: PARKING LOT AREA Parcel Nunmber: 42202117 Applicant: LIPPERT, JACQUELINE Address: owner: 514 HAMILTON LLC Address - 525 VICTORIq ST �� COSTA MESq,CA Contractor. FRENCH, WILLIAM Address: 14630�MEGEE WHITfIER, CA Zip: 90604 Arch : � Address: BUILDING PERMIT Zoning: Phone: (949)646-9966 Zip: Phone: 714-646-9966 Zip: 92627 Phone: 562-941-8276 License� 687266 Eng: Address: Phone: r !1 NUMBER 77 FAIR DRIVE, COS�1 MESA, CA 92626 Status: ISSUED Applied: 06/17/1999 Issued: O6/17/1999 ISSUED BV: Phone: Zip License: Zip: License: � � SCOPE OF PERMIT • • INSTALL N10 NEW 25' MAZ HEIGHT PARKING LOT LIGHT POLES & FIXTURES INCLUDING NEW FOOTINGS. � c�aP�- c��a c� BqP,—c-� i 33� FEE SUMMARY , Plan Check: $13.65 Calc Valuation: $soo.00 Permit: $21.00 Claim Valuation: geoo.00 � SMIP Res: $0.00 SMIP Com: $0.50 � Other: � $0.00 � Inspection: $0.00 � Total: $35.15 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 E� Right 0- 0 Right 0- 0 I t��'i3yL . ^ ��,. � n , /,7vtv _�c'/ � - NOTICE: The work 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 permR 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 al1 requlred Inepections and finel epproval must be obtained. Failure to obtain inspeclions and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 754�5626 , `WORKERS'COMPENSATON DECLARATON: � ' ' hereby afrirm untler penalry oi perjury one of the following declaretions: � ❑ I have entl will maintain a certificate of consent to selFlnsure tor workars' compensation, as provided for by sectlon 3700 of ihe Lebor Code, for the pertortnance of the work for which this pertnit is issued. ❑ I have antl will maintain workers' wmpensatlon insurance, as required by section 3700 ot the Labor Code, tor the peAormance ot tha work tor whiU this permit Is issuetl. My workers' compensatlon Insurence carner and policy number ere: Carner: Policy Num6er: (This sec(ion need nof be comp/eted i! fhe permif is velued at one hundred dollers ($100) or less.) ❑ I certily thet in the pertormence oi the work for which this permit is issuetl, I shall not employ any person in eny manner so es to become subject to the workers' compensatio alifornia, end egree that if I shoultl becoma subject to ihe workers' compensation provisions of Section 3700 of ihe Lebor Code, I shall torihwith comply wii hese prov ions. • ' Applicant SlgnaN . � �o O ='� — o Date: � /�'/ %�� WARNING: FAILURE TO SE E WO S' COMPENSATIIXJ CAVERAG 1 UNLAWPUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED iHOUSAND DOLL4RE (51 00), IN ADDITIIXJ TO THE CQST OF COMPENSATIIXJ, DAhNGES PS PROVIOED FOF IN SECfiON 3lW OF THE L4BOR CO�E, INiEREST, AND ATTORNEI"5 FEES. LICENSED CON7PACTORS DECLARATION: I hereby attirm t�at I am licensetl under provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Pmfessions Cotle, and my license is In full forCB and BfleCt. '. M ' CIasS k Contractors Sig Nre: Date: �z � r CONSTRUCTION LENDING AGENCY: ❑ I hereby attirtn that there is a construc�ion lending egency tor ihe peAortnanca of the work tor which this permit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lentlers Address: Signeture: Date: OWNER•BUILDER DECLARATIONS: I hereby attirm that under penalry of perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business antl Profeulons Code: Any ciry or counry which requires a pertnit to construct, elter, improve, demolish, or repair any structure, pnor to its issuance, also requires Ihe applicant tor such pertnil to file a signed stetement that he or she is licensed pursuant to the pmvisions of Ihe CoNrecbrs License Law (Chapter 9(commencing with Section 7000) oi Didsion 3 of the Business and Professions Code) or that he or she is ezempt therefrom and tha basis for the allegatl evemption. Any violation of Section 7031.5 by any applicant for e pertnit sub�ects the applicem to a civil penalty of not more than five hundred dollars ($500).): ❑ I, es owner of the property, or my empbyees with wages as their sole compensation, WILL DO THE WOpK, antl the structure is not intentled or offeretl for sale (Sec. 7044, Business entl Protessions Code: The Contractors License Law tloes not apply to an owner of property who builds or improves thereon, and who does such work himself or harself or Ihrough his or har own employees, providad that such improvements are not intentletl or oReretl for sale. If, however, the builtling or improvement is sold within one year of completion, ihe owner-builder will have ihe burtlen of pmving Ihat he or she did not build or improve for purpose of sale.). ❑ I, as owner of Ihe properry, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business antl Professions Code: The contracrors License Lew does not apply to en owner of properry who builOs or improves ihereon, and who contracts for such project with a comractor(s) license pursuant to the Contracbrs License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: SignaWre: Date: Owner ID verifietl by dnver's license. ❑ Yes ❑ No Drivefs License No. Expires: Venfication of Ownership by (rype of tlocument, I.e. - property tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATON: ❑ I hereby certiy ihat no excavation five (5) or more feet in tlepth into which a person is required to tlescend, will be made in connection wlth work euthorized by this permit, end ihat no builtling sirucWre, scaftoltling, falsework, or tlemolition or dismantling thereot, will be more ihan thirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Califomia Adminisirative Cade). ❑ As owner-builder, I will not employ enyone to do work which would require a permit from Ihe Division of Intlustnal Safery, as noted above, unless such person has e permit �o Go such work trom Ihe division. SignaWre: Date: Division ai Industnal Sefery Permit Number: 5 8 7 W ill ihe epplicant or present or tuWre building occupant neetl Io file and certify a Business Plan for emergency response to release or threatenetl release of a hazardous material? ❑ Yes ❑ No (Sedion 25505 oi Ihe Calitomia Health antl Safery Coda requires, wit� some exceptions, that a Business Plan be filed with iha Costa Mesa Fire Depahment by every business which hes at eny one time during a reported year a quantiry oi hazardous matenals equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, Uoes or wm me appucant or present or tmure omiaing occupam neea [o me a regisirauon tortn tor acmery nazaroous matena�s'f LJ Yes LJ No (Section 25533 ot Ihe Califomia Health antl Sefety Cotle, with some exceptions, requires registration wiN the Casta Mesa Fire Department by each business which at eny one time has on hantl a quantiry of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume ol 55 gallons, or 200 cu6ic feet of compressed ges at s�andard temperelure and pr855ure). Does or will the applicant or present or future building occupam need to prepare en RMPP (Risk Management antl Prevention Progrem tor ecutely hazardous matenals)? ❑ Ves ❑ No ` (Section 25534 oi the California Health and Safery Code provitles that the Costa Mesa Fira Department may require t�e preparation, certilication and tiling with the Fire Depanmem ot an RMPP by businesses which are required to register acutely hazardous metenals with the Fire Depanment. It an RMPP is presently required, has Section 25534 of [he Calilomia Health and Safery Code been fully complied wi�h7 ❑ Yes ❑ No Does or will the aDPlicenl or pre5ent or fuWre builtling occupant require tot ihe work whic� is the subject of Ihis e plication a gertnit for such wnstruction or motlification imm the South Coast Air Oualiry Management Distncf or tmm any other air polWtion control tlistnd or agencyt � Ves u No (Section BSB502 ot the Califomia Govemment Code requires ihat the requestetl information be furnished on epplications tor nomresideniial building pertnits). Will eny part of tha faciliry to be constructetl untler Ihis permit be within 1000 teet irom the outer 6ountlades oi a school? ❑ Ves ❑ No pl yes", Ihe feciliry must meel lhe requirement of Sections 25534 and 42303 of ihe Celifornie Healih and Safety Cotle). It a permit trom the South Coast Air Oualiry Management Disinct or other air polWtion control tlistnct or agency is requiretl tor the work which is the subject of Ihis epplication, have all of Ihe disclosures prescnbetl by California Healih and Safery Code Section 42303 been matle? ❑ Yes ❑ No QI'j�es', ettach cenificate of compliance tmm t�e appropriate air pollution control oHicer). CER7IFICA7E OF COMPLIANCE: I certity that under penalry oi perjury the infortnation given above is correc�. I agree to compty with all state laws antl ciry ordinances regartling Hazerdous Matedals antl Emi�s�sioj�n�s.�' SignaWre: �"�1�� )� � Dete: CERTIFICA7E OF COMPLIANCE AND AI7THORIZATON OF EMAY: I certity under penalry ot perjury that 1 have read this application and state that the infortnation given is correct. I agree to comply with all state laws and city ordinances relzting to huiltling constmction, antl authonze representatives ot the Ciry of Casta Mesa to anter upon the abwe-descnbetl property tor inspection purposes. I agree not to occupy or allow occupancy of eny building authonzetl by thls permit until final inspection. COUC'�. INSPECTION TYPE �e�6 Fixatl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Reteining Wall 202 Final Factory Fire Plece 203 Final Slgn 204 Finel Demolition 2468de �g � /� �/99 Date f[j� t�fp� INSPELTIONTYPE �� 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 220 222 250 Final Fire Prevention Final Planning Approval Pinal Site Final Building/Oaupancy 1 .. � A:.-"' il:_., u.Pl � r �� .. ._ H . ; 1 � � ' ( i i n� 1 �. I i ld t.4r. �'dN.i 1-, �1t L�i.t�y a� C,ac.�a �i�eaa � ' ' D 'cu�a�o�s D�CIARATION O� AuTHORtZ.�TION �OR AGEIVTS OF CONTRACT�R TO APPLY FOR PERMITS i,�ili, iam.1'renC�_, ^, declaru that [ hcrcl�y ntilhurizc thc fulluw�ing p��rtii�n(s) t�� u6i;iin penni�ti on m�� lxl�alf: ' . � SIGtin�rukE � .7atqueline L�Ppe�_,,. E0438602 D L PRI`!'I' NAME UAIVF.R'S LIf.'I:NRI•, OR SOC'Ht, �I�CI IRITY 1 � � •.... �IUhATUR[ ... -' •_.•• i'ulhT ,`7�M11Ii --_.. � •..SlfT,\l4'kf,.. ...�— �— ... 1'kI�TN4p11�. •.. ,- �• URIVER'S Ur;IIn�P:OR SU:IAI tilil:UNIT1' N.. ..~ 1)MI1'ER'$ LI('D.NtiI! UR RIXNL 51�('I;NIn' N ..� � ?. f u�ill ;dsu file a Wurker's Cumpensatiun Inturance C'enificute, is.eued hy my �ii�urance agrni, crn�ering all pc��sons Ghploycd by myscl(, tny cornpany or cn�porntiun prior tci Iht: issu�nce ul i�ny permiis in sccord;mcc K•ith Sc�liqn 3$(Nl nP Iht Siplc. u(C�lifurtiia L,��bur Codc. 3. I und��niund thui ,ny sign;dum Ixlow acts as a continuuus authoriuitiun until a wrilicn docunirni cancelling such authorizniirin of tm�� nr all �,f �hc {xrson.v listed abv�e is irccivCd by thc Lluilding qirision. Any additions o� m��diticiilinns will rcyuire a ncw form. 4. 1 ngn:c to inden�nify and huld lhe City of Cnst� A4c+e� und its umpioyees ot i�fticers hiinnlcss Rom nnp claim resultin� in dantage ur personal injury tu myself ur any other pilrtic5 ns �i rez�dt of H�urk au�hc�rir,cd h}' the, permita frum the City u� Costn Mcs1. S. I havc read and undcrstand che nbo.e statcments ns thcy prrtnin lu tlie issuancc nf penni(s hy qic City ni Cnsw Me.s,� nnd the C'uli(orni:� Sluu C'oMr�ictnr's Liccnsc [3�ard. 6. f de.alnre. under Ihe pennliy of pa/rjury thut the fnregoing is truc imd cc�rrect. Excculed (his G� day c�l' --,�"'ti"�' � b- , 19 �, u� Oran�;c County� C:iQifurnia ///` �� j. _ �! /._�l...�L�.�. _ �. �.. ....� � � nn r�, r� � s�c;� v ,�r��-� �'�,�.-s� , _�!`.��' ... ,_ (:t tMPANY n nnn�, NAMG (h�K i��rrn pR rr �•�:u� .•. CY�MPANI'TlTl.i; ... ..� ��.�� 1�1�L � . K-' . __ �� .. 6 6_ �/�E fJ\1V,\Nl' AGCIKI _1ti %'I'A?E 0� 1: AI,ININNIA C01"I'KAI'I 11R' i P'GA111171 r, �'i �... �� • �� , �...._.c�.r1. . �`cnMrnvr r�ionr ni�Mer:a — clns.0 irn„un - AN ,I(.'KN(1WLGD(:N:MIiNT 1{Y A NU7'��R1' Pl1Hl.11' OF ('ONTRACTOR•� SICNn'I'UR61) NF.QUIRF:u. A'CTA('H CUPY OF tiT'ATr l;11NTRAC'1'OR'S I`ICLNS�. 1' � Y (714)754-5273 • Fax(714)754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT JobAddress: 514 HAMILTON ST Suite: Vicinity: Parcel Nunmber: 42202117 Applicant: FRENCH, WILIAM Address: Owner: 514 HAMILTON LLC Address 525 VICTORIA ST COSTA MESA,CA Contrector: FRENCH, WILLIAM Address: 14630 MEGEE GRADING PERMIT Zoning: Phone: Zip: Phone: 714-646-9966 Zip' 92627 Phone: 562-941-8276 . WHITTIER, CA � Zip: 90604 License: 687266 Eng : CHARLES KUN HUANG CHEN Address: 7721 W GARVEY AV # C Phone: 626-576-2646 ALHAMBR4, CA 91803 Zip: 91803 License: 7300 SCOPE OF PERMIT CUBIC YARDS : GRADING FOR FUTURE PARKING LOT . 75 Plan Check: $22.00 $o.00 Permit: $33.00 Other: $0.00 $0.00 Inspection: $0.00 $0.00 Total: $55.00 NOTES: FEE SUMMARY PLANNING & ZONING T7 FAIR DRIVE, COSTA MESA, CA 92626 Calc Valuation: EXP Status: ISSUED Applied: 0724/1998 Issued: 03/01 /1999 $o.00 � �e�r� �e� EXPIRATION: This permit shell automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepectiona and tinel approvel must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545828 WORKERS' COMPENSATON DECLARATION: I,hereby affirm untler penelty oi perjury one of lhe following declarations: : • � 7 1 heve entl will meintein e certificate oi wnsent to self-Insure for workers' compensetion, es provided tor by section 3700 of the Labor Cotle, For the peAormance of Ihe work far which ihis pertnit is issued. ❑ I have en0 will maintain workers' compensation insurance, as requiretl by sedion 3700 ot the Labor Code, tor fhe peAortnance ot Ne work fp which this permit is issuetl. My workars' compensation Insurance carrier and policy number are: Carrier: Policy Number: (71r15 secNon need not be completed i1 the permit Is va/uetl at one hundred Collars ($f 00) or /ess.) ❑ I certiy that in ihe peAortnance of Ihe work tor which this permit is issuetl, I shall not employ eny person in any mannar so as to becwne subject to t�e workere' wmpensatlon laws ot Celifomla, fln a ree ihat R I should become su6ject to the workers' compensation piovisions of Section 3700 of the Lebor Cotle, I shell fotlhwith comply with ihese D�ovisions. � `�� /y Appllcant Signature: Date: �� 7 WARNING: FAILURE TO SECURE WOR 5' COMPENSATION ODVEMGE IS UNLAWFUL PND SHALL SUBIECT AN EMPLOYER TO CRIMINAL P(NALTIES AND Cl�l FINES UP TOIXJE HUNDRED THWSAND Dp1FRE (E100.OW), IN ADDRION TOTHE COST OF COAIPENSATION, DAM4GES PS PROVIDED FOR IN SECTION 31060F THE LABOR CODE, IMEREST, M1D ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirtn Ihet I am licensed untler provisions of ChaO�er 9(commencing with Section 7000) of Division 3 of tha Business antl Professions Code, and my licanse is in full force end eflect. LJc. M .1 Class p _ _. Contrector's Signature: Date: CONS7RUC710N LENDING AGENCV: ❑ I hereby affirm that there is a construction lending agency tor the peAormance of �he work for which Ihis permit is iuued. (Sac. 3097, Civil Cotle). Lentlefs Name: Lenders Address: Sipnature: OWNER-BUILDER DECLARATIONS: Date: I hereby aHirtn Ihat under penalry of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for t�e tollowing reeson (Sec. 7031.5, Business entl Professions Code: Any ciry or counry which requires a permi� to construct, alter, Improve, tlemolish, or repair any sirucNre, prior to its issuance, elso reqWres the epplicant tor such parmit to file a slpneE slatement tha� he or s�e Is licensetl pursuant to the pmvisions of t�e Contradors Licensa Lew (Chapter 9(commencing with Section 7000) of Divislon 3 of the Business antl Profeuions Cotle) or that he or she is exempt theretrom and t�e hesis tor the alleged exemption. Any violation oi Section 7031.5 by eny epplicant for a permit subjecls lhe epplicant to e civil penalry of not more than five hundred dollars ($500).): ❑ I, es owner ot Ihe properry, or my employees with wages as Iheir sole compensatlon, WILL DO THE WORK, antl ihe structure is not intentletl or offered for sale (Sec. 7044, Business end Protessions Code: The Contractors License Law does not apply to an owner of proparry who Duiltls or Improves fhereon, and who does such work himself or herself or ihrough his or �er own employees, providetl that such Improvements are not intended or oflered for sale. If, however, the bullCing or Improvement is sold within one year o1 completion, the owner-builder will have the burden ot proving that he or she ditl not builtl or improve for purpose of sale.). ❑ I, es owner of the property, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to wnstruct ihe proleci (Sec. 7044, Business entl Professions Cade: The con�redors License Lew does not appty ta en owner af praperty who 6uiltls or Impraves thereon, entl who contracts tor such project with e contractor(s) license pursuaM �o the Contractore License Laws.). ❑ I am exempt under sec. Busineu antl Professions Code tor this reason: SignaNre: Data: Owner ID vedfied by Orivefs license. ❑ Yes ❑ No Dnvers License No. E:pires: Vedticatlon of Ownership by (rype ot document, i.e. - pmperty tex bill ar deed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I hereby certlty that no excavation fiva (5) or more feet In tlepth Into which a person Is required to descend, will be made in connectlon with work euthorizetl by this pertnit, end thet no building swcNre, sceflolding, felsework, or demolition or dismantling Ihereof, will be more than ihirty-six (38) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Celllomia AdministratNe Cotle). ❑ As owner-builder, I will not employ anyone to tlo work w�ich would require a pertnit from the Division of Industrial Safery, es notetl ebove, unless such person has e pertnit to do such work from the division. Signeture: Date: DiNsion oi Intlus�rial Satery Pertnii Number: CERTIFlCATE OF COMPLIANCE AND AUfHORQATION OF ENTRY: I certify under penalry of perjury ihat I have read ihis application and state thet ihe intortnetion given is correct. I agree to wmply with all stete laws end ciry ordinances relating to building construciion, and authonze representatives of the Ciry of Casta Mese to enter upon the ebove-described properry tor inspection purposes. I egree not Io occupy or allow occupancy ot any builtlinq authorized Dy Nis pertnit until final inspeclion. e Of Legel Owner(s) �A r Authodzetl Applicant COOE � INSPELTONTYVE 1818 FIxeC System Final Fire Preven�lon 1268 Pool Spe Final 200 Flnel Re-Roo1 201 Finel BIocWReiaining Wall 202 Finel Fectory Fire Plece 203 Finel Sign 204 Final Demolitlon zaawe �.11fI�C�iiln�+ �/� /��ate f Date COOE� INSPEC710NTYPE 206 Finel Mechenlcel 208 Finel Plumbing 210 Finel Electrical 212 Finel Fire Prevention 220 Finel Planning Approvel 222 Final Site 250 Finel Building/Occupency GAff It{IIDAlS I '� CITY OF COSTA MESA ,` _ � BI/ILD/N6 DIVISION � DEVELOPMENT SERVICES DEPARTMENT u�� PERMIT RMITNUM ER 698-01330 (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 5'I4 HAMILTON ST Suite: Vicinity: Parcel Nunmber: 42202117 npp�icant: FRENCH, WILLIAM Address: Owner: 514 HAMILTON LLC Address 525 VICTORIA ST COSTA MESA,CA Contractor: FRENCH, WILLIAM Address: 14630 MEGEE BUILDING PERMIT Zoning: Phone: Zip: Phone: 714-646-9966 Zip: Phone: 562-941-8276 Status: ISSUED Applied: 07/24/1998 Issued: 03/Ot/1999 � WHITfIER, CA - � Zip: 90604 License: 681266 � Arch : PEN JIUN KAO, PJ DESIGN Eng: Address: 2327 FALLEN DR . Address: , ROWLAND HTS Zip: 91748 Phone: 626-839-9385 License: Phone: License: SCOPE OF PERMIT • -REPAVE, RESTRIPE, LANDSCAPE AND INSTALL LIGHTING FOR A PARKING LOT ADJACENT TO A MULTI-FAMILY APARTMENT COMPLEX, IN ACCORDANCE WITH PLANNING ACTION 97-52. LIGHT poles WERE INCLUDED WITH THIS . PLAN CHECK, REQUIRES ENGINEERING, CHARLES. � FEE SUMMARY , Plan Check: 5495.46 � Calc Valuation: Sao,000.00 Permit: $76225 Claim Valuation: Sao,000.00 SMIP Res: $8.00 - , SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $7,265.71 SETBACKS MAINSTRUCTURE Front 20-0 ACCESSORY Front 0-0 PARKING NOTES: Existinq: 0 Rear 0-0 Rear 0-0 Required: 0 PLANNING & ZONING LeR 0- 0 Right Left 0- 0 Right Proposed: 0 0- 0 0- 0 � � , � . i � � ii 1 � � . 1 / EXPIRATION: This permR shall automatically expire and become vold if work is not commenced within 180 days, or it 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 Inapactione and final approval must be obtained. Failure to obtain inspections and final approval will rasult in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5826 � �RKERS' COMPENSATION DECLARATION: — ' ' reby attirm unaer penaliy ot perjury one ot Ihe following declaretions: I heve en0 will malntaln a ceritlicate ot consent to setl-Insure tor workars' compensetion, as provitletl for Dy sectlon 3700 of the Lebor Code, tor the pertormence of the work tor which Ihis partnit is issuetl. ❑ I heve and will meiniain workers' compensatlon insurance, as required by section 3700 ot Ihe Labor Cotle, tor the perfortnance of the work for which this pertnit is issued. My workers' compensation Insurence cartie� antl policy number ere: Carrier: Policy Number: (Th/s section neetl not be comp/eted I/ the permitls valued at one hundred tlollars ($100J oi /ess.) ❑ I certify ihat in the pertortnance oi �he work tor which this permi� is issued, I shall not employ any person in eny manner so as to become sublect to the workers' compensation laws of Celif le, en ree Ihat ii I should bewme subleci to the workers' compensetion pmvisions oi Sectlon 3700 of the Lebor Coda, I s�ell forthwith compty with tnese provislo � /j / �J� � y Applicant Signeture: Dale: � WARNINCa: FAILUPE TO SECURE WORKE MPENSATION COVERAGE IS UNLAW R/L AND SHALL SUBJECT AN EMPLOYER TO CNIMI PENALTIES AND VIL FlNES UP TO ONE HUNDRED TlKKI$PNO DOLLARE ($100,000), IN ADDITION TOTHE CQSi OF COMPENSATION, DAMAGES AS PROVIDED f-0R IN SECfIIXJ 31060F THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CON7RALTORS DECLARATION: I hereby ettirtn thet I am licensed under prohsions of Chapter 9(commancing with �ection 7000) of Divisian 3 of the Business end Professions Code, end my license is in full force end eMecL Lic. N Class e Contrectors Signeture: „ e, � Date: �, CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn that thera Is a construction lending egenty for the perto(mance of the work for which this pertnit is issued. (Sec. 3097, Civil Code). Lentler's Neme: Lentlers Addfess: Signature: � Date: OWNER-BUILDER DECLARATIONS: I hereby elfirm ihet unaer penalry of perjury that I em EXEMPT FROM THE CONTFiACTORS LICENSE LAW tor the following reeson (Sec. 7031.5, Business antl Professions Cotle: Any ciry or counry which requires a pertnit to construd, elter, improve, demolish, or repair eny structure, prior to its issuance, elso requires t�e applicant for such permit to file e signetl statement thet he or s�e is Iicensetl pursuent to the provisions of �he Contredors License Lew (Chepter 9(commencing with Sectlan 7000) of Divislon 3 of the Business and Protessions Cotle) or I�ei he or she is exempt therefrom and Ihe basis for Ihe allegetl exemption. Any violation oi Sectlon 7031.5 by any epplicant for e permit subJects the epplicant to e civil penalty ot not more than five hundreC dollars ($500).): ❑ I, as owner o1 the properry, or my employees with weges as their sole compensation, WILL DO TNE WORK, and the structure is not intentletl or oflered for sale (Sec. 7044, Business and Professions Code: The Contractore License Lew does not apply to en owner of properry who builds or improves t�ereon, and who does such work himself or herself or through his or her own employees, provitled that such improvements ere not Intended or oRered for sele. tl, however, the builtling or Improvement Is sold wlthin one year of compleUon, the owner-builtler will have Ihe burden of proving Ihat he or she tlitl not builtl or improve for purpose of sale.J. ❑ I, as owner of Ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct ihe projact (Sec. 7044, Business and Protessions Code: The contractors License Law tloes not appty to en owner of property who Duiltls or improves thereon, and who contracts for such project with a wnireqor(s) Iicense pureuant to the Contractors License LewsJ. . ❑ I em eaempt untler sec. Business and Professions Code for this reason:,- Signature: vx;~ Date: Owner ID vedfletl by tlnvefs license. ❑ Yes ❑ No Dnvefs License No. - ' ExDires: Venficetlon o1 Ownership by (rype of document, i.e. - property ta< bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIPICA710N: - i�'`i �"' "`+'` s`; .� ❑ I hereby ceNiy that no e:cavatlon Me (5) or more feet in tleD� into which e person is requlretl'_to tlescend,�will be matle in cnnnectlon with work aut�odzetl Dy thls pertnit end ihet no building stmcNre, sceXolding, felsework, or demolitlon or dismantling ihereof, will be�more than thirty-sla (38) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Tltle e, Celifamia AdministretNa Coda). ' „ ; ❑ As owner-builder, I wlll not employ enyone to do work which would require a pertnit trom the Division of IndusMel Sefery, es noted ebove, unless such person hes e pertnit to do such work from the Givision. . Signature: � Date: ?� s Division of Industrial Safery Permit Number: ARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WIII Iha appllcent or present or future building ocaDam need ro file and cenify a Business Plan for emargency response to release or IhrealeneC release ot a hazerdous matenel9 ❑ Yes ❑ No (Section 25505 of the Califomia Health end Sefery Cotle requires, with some excaptions, that e Business Plan be fletl with the Coste Mesa Fire Depariment by every buslness which has at eny one time dunng a reported year e quantiry of hazardous meterials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, ___ .. . . . . . . . .. . . . z uoas or vnn me eppucam or D�esem or nmre ounang ocwpen[ neea �o uie a registreuon iorm ror ecmeiy nazemous me�eneisr u res LJ �o (Sectlon 25533 of the Celifomle Heelih end Safery Gode, wlth some exceD�lons, reQulres reglsiretion with ihe Casta Mesa Fire Deperiment by each 6usineu which et eny one tlme hes on hentl a quantiry oi ecutely hazerdous metenals equel to or greater than e weight ot 500 pounds, or e volume of 55 gellons, or 200 cubic feet oi compressetl gas et stentlartl tempereture end pressure). ..............................................................................................................................................:................................................................................................................................. . 3 Does or will the aDDlicant or present or future building occupant need to prepare an RMPP (Risk Menagement and Prevention Program tor acutely hezarUous metenals)7 ❑ Ves ❑ No (Sectlon 25534 ot the California Healih and Sefety Cotle provides that ihe Cwta Mesa Fire Department may require ihe preparetion, certiticetion entl filing with �he Fire Depertment of en RMPP by busineues which are required to register acutety hazardous metenals with the Fire Depertment. . ................................................................................................................................................................................................................................................................................. 4 If an RMPP is D�esently reQuire4 has Seclion 25534 of the Calitomia Health and Satery Code been fully comDlied wiih? ❑ Yes ❑ No . 7 uoes or wm me appucam or presem or mmre ounamg occupam reqmre ror me wonc wmcn is me suoJec� or mis e pncanon e ertnn tor sucn consvuaion or from �he South Coesi Air Ouelity Menagement Disirict or from any ot�er air pollu�ion con�rol tllstrict or egency? Ves No (SecYion 858502 ot the Califomia Govemment CaAe requires that t�e reQuested infomiatlon 6e fumishe7 on epplications for non-residential bullding permits). ...................................................................................................................................................................................................................................................... Will eny pert af the feciliry to be consiructetl untler this pertnit be within 1000 taet irom ihe auter boundaries of a school7 ❑ Yes ❑ No (N yes', the faGliry must meet iha requirement of Sectlons 25534 and 42303 of t�e Gelitomia Healt� antl Safery Cotle). CERTIFICATE OF C� regerding HaraMous Slgnature: ' r otner atr poiwuon controi mstnct or egency and SateN Code Section 42303 been made7 ot compllence from ihe eppropriete eir polNtian contml otticer). 'LIANCE: I certify that untler penalry of perjury Ihe inlormation given above is correct. I agree to comply with ell state laws entl ciry ortlinences Dete: CERTIFlCATE OF COMPLIANCE AND AIJfHOR¢AT10N OF ENTRY: I certify under penalry of perjury t�et I have reed this application end slete that ihe Intormation given is correc�. I agree lo comply with ell state laws and ciry ordinances relaiing to huilding construction, end euthorize representatives of �he Ciry of Coste Mese to enter upon ihe above-descnbed properry for ins�pe7ction purposes. I egree not to occupy or allow occupancy of any building authonzed by this pertnit until final InspeIXion. r'l 11°�7.' 'n �r.�:7rf Signature Of Legel Oxn�er� Lg.� Date � And/Or AuNorized Applicant Date �Q�y INSPECTIONTYPE 1616 Fixetl System Finel Fire Prevention 1286 Pool Spe Final 200 Final Re-Roof 201 Final BIocWReteining Well 202 Final Fectory Fire Plece 203 204 Ye49�<6 Final Sipn Finel Demoli�ion �AIE II1�Al5 CODEt VlSPELTONME 206 Finel Mechanical 208 Finel Plumbing 210 Final Electncel 212 Final Fire Preventlon 220 Finel Planning Approvfll 222 Final Site 250 Final Builtling/Occupancy � I��