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Home My WebLink About253 HANOVER DR - Building Permitsti �� MF � CITY OF COSTA MESA M ° ' BUILDING DIVISION � � � DEVELOPMENT SERVICES DEPARTMENT J° �� . � PERMIT � (714) 75a-5273 • Fax (714) 754-4856 Job Address: 253 HANOVER DR Suite No Vicinity: Parcel Nunmber: 14�39106 Applicant: RON Address: W/ NOCK PLUMBING Owner. GRUBER, JON Address ,253 HANOVER DR � � - COSTA MESA,CA Contractor. ` `NOCK PLUMBING Address: 11612 KNOTT ST ArchlEng: Address: GARDEN GROVE , CA DISHVJASHER CHANGE-OUT ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Connect(Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Qiq Interceptors (Sand Auto ) AMT $22.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $8.75 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 •� PLUMBING PERMIT Phone: 714-895-1246 Zip: Phone: Zip: 92626 Phone: 714 895-1246 " Zip: 92841 License: 707775 Phone: Zip: License: SCOPE OF PERMIT FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap � $0.00 Pressure Regulator � $0.00 Process Piping (per 10 k) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo . $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS PERMI'z� R P98-00844 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED APplied: 11 /10/7 998 Issued: 11/10/1998 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin � Wash Basin Set� � � Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or RepJ Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $30.75 x ��,D � io 0 0� DR'� aTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 .7� EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. . INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspectiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 75Y5626 WORKERS' COMPENSA710N DECLARATION: ' ' ' I hereby affirtn under penalry of Derjury one ot the tollowing declarations: ❑ I heve antl will maintain a certiticete of consen� �o self-Insure lor workers' compensa�ion, es provided tor by seClion 3700 oi �he Labot Cotle, tor the perfortnence ot Ihe rk for which Ihis pertnit is issued. I have and will maintain workers compensation insurance, as requiretl by section 3700 of the Lebor Code, tor tha performance of the work for which Ihis pertni� is issuetl. My workers' compensation Insu�ren�9\ certie�-r -a�nd ppolicy number are: Cartier. �`/>L/%GOV f� / I�� aorcy Number. IU f•i��'T � 3`f �i"O � (This section need not be comp/eletl it (he Oermit I5 valued at one hundretl tlollars ($ f 00) or less.) � I certity thet In the pertormance oi the work for w�ich ihis parmit is issuetl, I shall not employ any person in any manner so as to become su6ject to Ihe workers' compensetion law5 ot Calitomia, end agree Ihet it I should hecome subject to the workers' compensalion provisions of Seclion 3700 ot Ihe Labor Code, I shell lorthwith comply with Ihese provisions.�� c ApplicanlSigne�ure: \/ �\� ___ DB�B: �/� � L-- /� WARNING: FAILURE TO SECURE WORK FS' COMPENSATION COVERAGE IS UNLAWFUL ANO SHALL SUfl1ECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED T/IIXISAND DOLLARE (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEGTION 3]O6 OF THE LABOR CADE, INTEREST, AND ATTORNEV'S FEES. LJCENSED CON7RACTORS DECLARA710N: I hereby eHirm Ihat I am licensetl under provisions otf� aptar 9(commencing with Section 7000) ot Division 3 of the Business and Professiors Code, end my license is in tull force antl eHect. Lic. a �%D %�% 1 Class M �� ContractorsSigneture: �� 7--��1 _ Dale: /%'/'2— g� CONSTRUCTION LENDING AGENCY: ❑ I hereby a%irtn Ihat there is a wnsiruction lending egency tor tha peAortnance of ihe work for which this pertnit is i5sue0. (Sec. 3097, Civil Code). Lendefs Name: Lentlels Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I herehy ettirtn thet under penalry of perjury thet I em EXEMPT FROM THE CON7RAC70BS LICENSE LAW for the following reason (Sea 7031.5, Business end Professions Code: Any Ciry or county whiCh requires a permii to con5lruct, elter, improve, demolish, or repair any siruclure, pnor to its i55uanCe, 815o requiras the epplicant for such permit to tile e signetl statement lhat he or she is licensed Oursuant to the provisions of �he Contractors License Law (Chapter 9(commenung with Section 7000) of Division 3 of Ihe Business and Professions Code) or that he or she is exempt Ihereirom and the �asis tor the alleged exemption. Any violation ot Section 7031.5 by any apD�icant tor e pertnit subjecis Ue epplicant to e ciml penalry of not more ihan tive hundred dollers ($500).): ❑ I, es owner of the property, or my employees wit� wages as their sole compensation, WILL DO TME WORK, and t�e structure is not intended or offered tor sale (Sec. 7044, Business and Protessions Code: Tha Contrectors License Lew does not epply to an owner oi properry who builtls or improves thereon, end who does suc� work himseli or hereelt ar Ihrough his or her own employees, provitletl ihat such Improvemenis are not intended or ottered for ule. If, however, ihe builtling ar improvement Is sold within one year oi comptetion, Ihe owner-builtler will have ihe burden of proving that he or she tlid not Duild or improve for purpose oi sale.). ❑ I, fls owner of tha pmperty, am EXCWSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to conswct the project (Sec. 7044, Business and Professions Code: The coniractors License Law does not apply to en owner of property who builds or improves thereon, and who con�racts for such project with e coniracror(s) license pursuant to the Contractors License LewsJ. � ❑ I am ezempt under sec. Business and Professions Code tor this reason: Signature: Date: Owner ID venfied by drivers license. ❑ Ves ❑ No Orivers LicenSe No. Veritication of Ownership by (rype ot tlocument, I.e. - property tac bill or deed): Expires: DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATON: ❑ I hereby certtly that no excevatlon five (5) or more feet in depth into which a parson Is required to descand, will be made in connectlon with work authorizad by this permit, and thet no building strucWra, scattolding, talsework, or demolition ar dismamling thereof, will be more Ihan ihirry-six (36) feet high. (Chep. 32, Gry 2, An 2, Sec. 341, Tltle B, Celifornia Administrative Cade). ❑ As owner-builder, I will not employ enyone to tlo work which would require a permit from ihe Division of Intlustnal Safery, as noted above, unless such person hes a permil to do such work trom ihe tlivision. Slgneiure: Date: Division of Indusinal Safery Permit Number: CERi1FlCATE OF CAMPLJANCE AND AIfiHORIZATON OF ENTAV: I certity under penalty of perjury that I have read lhis application and stale thal the information given is correct. I agrea to comply with all state laws and ciry ordinancas relating to building consiruciion, and euthorize represeNetives ot the Ciry of Costa Mesa to enter upon the ebove-tlescnbed property for inspection purposes. I agree not to occupy or allow acupanty of any building authonzed by this permii until final inspaction. i nat� urepf Legal Owner(s) � C �� t � / Z And/Or Authonzetl Applicant C cooe.. iNsvecnaxrrve DAIE V�ALS 1676 Fiaed System Final Fire Prevention 1266 200 Pool Spe Final Final Re-Roof 207 Final BIocWRetaining Wall 202 Final Fectory Fire Plece 203 Final Sign 204 Final Demolition 24a&a6 GODE 1 INSGECiION TYFE 206 Final Mechanical 208 210 212 220 final Plumbing Final Elecincal Final Fire Prevention Flnal Planning Approval 222 Final Site 250 Final Builtling/Occupancy �AiE It1�65 PACIFZC FNSTALLE�g, I\C. 7541 Anthony Avenue Garden Grove, California 92641 P. 0. Box 728 Westminster, Calif. 92683 Director Dept. of 'ldin and Safe� ty Citp of �/%(,�,¢�� !' � o20�f� Dear Sir: Please be advised that as � �l(o Dste / � —�% r Permit No. ,3�/S O Tyoe of Permit__�� - Dated / � - �p aur work on above- named permit has been cancelled, and as of that date we would like the permit cancelled; so that our responsibility for any work accomplished at: � f�� [,/�— for customer: �.��C�i�� wi11 be ended. Very truly yours, or: Pacific Instsllers, Inc. 7541 Aathony Avenae ;arden Greve, Cali.`ornia staee Lic. ;� ��9� Citv Lic. �i P.I. 264 Rev. 2/7I -OWNER COLLrGL PAI?.i� i�io.l� ADDRESS 253 Hanover Drive GENERAL CONTRACTOR HBrbOt CORStnxCtlori VALUE $ 11,200•00 AP. No. LOT 6 TRACT jl�i% PIRE ZONE DESCRIPTION OP WORK Res, W�Btt, gaP. GROUP I& J TYPE V ZONE Rl � PLAN NO. . ri291 " 1� `ECTIONS DATE I SUBCONTRACTOR PERMITSISSUED DATE I NUMBER COSTA �`721 MESA BUILDING DEPARTMENT P. O. BO% 31] COSTA MESA. CALIFORNIA � ' d �.E �ECEi��D S P 1 3 1957 FINAP�CE DEPT. r�Tv nF r.oS7A PAESA