The URL can be used to link to this page

Home My WebLink About2810 HAZEL PL - Building Permits� � PETRA COSTA MESA • SAN DIEGO • TEMECULA • LOS ANGELES July 28, 1998 J.N. 492-97 WILLIAM LYON HOMES, INC. 4490 Von Karman Avenue Newport Beach, CA 92660-3600 Attention: Mr. Gary Haddy Subject: Footing Observations, Lot 30, Tract No. 15570, City of Costa Mesa, Orange County, California. �� lU /�r„ 2� � PL References: See Attached References. Dear Mr. Haddy: Footing excavations for the proposed residence within the subject lot have been carried into firm, competent bearing soils and are considered geotechnically suitable for concrete placement. If you require any additional information, please feel free to call. Respectfully submitted, PE�' EOTECHNICAL, INC. �/ •��/ Ray Muhlenkamp Supervising Soils T chnic� RM/mel cc: 1998\400\492-9�.70 PEfRA GEOTECHNICAL WC. 3185-A AirwoyAvenue Cosfa Mew, CA 9262fi Tel: (714) 549-8921 Faz: p14) 549-1438 petwcm@ibm.net � REFERENCES I) Geotechnical Investigation, Proposed Residential Development, Tentative Tract No. 15570, Northwest Comer of Fairview Road and Adams Avenue, City of Costa Mesa, Orange County, Califomia; a report by Petra Geotechnical, Inc., dated December 29, 1997. 2) Geotechnical RepoR of Rough Gradings, Lots 1 through 34 and Lot "E", Tract No. 15570, Ciry of Costa Mesa, Orange County, California; report by Petra Geotechnical, Inc., dated Apri16, 1998. 3) Geotechnical Recommendations for design of Post-Tensioned Foundations in Accordance with Design Specifications of the PoshTensioning [nsRtute, Trac[ No. 15570, City of Costa Mesa, Orange County, Califomia; letter by Petra Geotechnical, Inc., dated April 14, 1998. PETRA GEOTECHNICAL, INC. J. N. 492-97 � . t`PARDUE, CORNWELL & ASSOCIATES, INC. Planning • Engineering • Surveying June 23, 1998 City of Costa Mesa 77 Fair Dr. Costa Mesa, CA 92628 Re.: Tract 15570. Lot 30 Dear Sirs: The engineer of record inspected the building forms for Lot 30 for the above referenced tract on June 23, 1998. Upon inspection, the finish floor elevation on Lot 30 of Tract 15570 located in [he City of Costa Mesa, CA. is within ± 0.1' of the elevation specified on the approved Precise Grading plan. If you have any questions or comments, please do not hesitate to call. Sineerely, PARDUE, CORNWELL & ASSOCIATES, INC. Principal 151 Kalmus Dr., Suite C-230. • Costa Mesa, CA 92626 • Phone (714) 2413400 . Fax (714) 241- 3432 � Insulation Certiticate �� D�l�z� P��-c� �`� �-1-� YY� eSci f�'o�.v��..��.��v�.� T�-� 15570 ``" �*3 D Co S�hdivision (,ai Yya+b�t Description of Installation ROOF _ Matcrial T�icknou finche:) Btand Name ihe�mal Resimance (R.Y�lue} CEILING 2 ` 5^,� � Bau or BlanketType \ J�T Bcand Name� `��nS 1 1� \t�� h,V� �� TTickness (inches) \" 'Ihemul Resisunce (R-Valuy �.— 3 C� l,00te Fill7yye Bnnd Nune Conuucor's minimum insuUrA weigh�ft` Ib Minimum thickneu incTa Manufac�urer's ins�ailed weighc per squue fooc [o acheive Thertnal Resisnnce (R•Value) EXTERIOR WALL h� Matetial � � ,_ Hrand Name �(��h b 1 � \Gl..h J� � �'2 7hickness (inches) S ' � Thertnal Resizmnce (R�Valuej RAISED FLOOR M�terial Thickneu (incAe:) Hrand Name Thermal Raiswice (R•Value) SLAB fLOOR • IvT�itria! Brmd Nune 7Tidcness (inches) 'Riernul Rcsiswice (R•Value� W idih (inchcs) FOUNDATION WALL Maicrial 'iT�ickness (inche5) Declaration Bnnd Name 7Termal Resisnnce (R•Yalu�) 1 hereby certif� that the aDovc insulation Wu innallcd in the building a[ the abovelocuion in confomance wich the current Hwlding Energy Efficiency Sundards for new residen:ial buildings containcd in Ti�a ?4 oi �he Catifomia Adminisuative Codc. Gcrsn! Concuwr (Suilder) Liee:uaNu:n6cr v�e�;��` ��.5 �u.l � l�.�s � g ( �-"� � �'TfSubCoa ctor(Luut nlrsc r (,�uKcH�yT ��'vd,��c,m �an4�ev wove�a�- �� '�99� SitnAure uid 7�uc Dam Gopi�nce Faro� ]muary 1. 3995 � .. CITY OF COSTA MESA � eva��N6 oms►oN � �� ; DEVELOPMENT SERVICES DEPARTMENT �w � _._..............�.. . PERMIT "��am� � ,. •:� . • . FQR_n�FiR3 �/ PERMIT NUMBER (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 281 O HAZEL PL Suite No Viciniry: Parcel Nunmber: TPN98045 Status: ISSUED Applied: O6/29/1998 Issued: O6/30/1998 npplicant: FLYNN, DAN Address: Phone: �-' � ir ."rZip''._ ___ -_ '� �' . / :�� ,.;�'-�- �' i' , l�`.''_�,'� �'� � t., � � � I � ; ��,- '� ndd ess W. L � N%%.OMES-',_\ '` ,. � :_� 1�� i i ��l �J \`.\. /�/i (��'� \ / i Phone . -�� . \ � i � � 'J � \ \ \\ ii� � � �// _. � �� \ � J�� I, /� � �� / %.- i =ZiP � aA��.,..; � (\ � � i � �,��j� � ;��/;-% �\\��\`� i� \\��\ i/� _ trec�tlr� WILLIAM id"ress: � 4490 VON:M : �� ✓� ��(i �� C.M CA'� �r ii� / / �- � i� ��; � �l��, �f I i; .� f;%-�', ',�, � ' � I :, � �i� � ��\`�� \� i �\\,, N HOLMES �� AN / ,, � �� Phone:-�714-076-7361 �_,�� ' � � ��A Zip:�'92660 _ _ '�',�` � ;, •License:.��i661�58•�• • ' � �'� ' �� ` � _a � r �� { � ' ....�1 i(�� -+-�7 ,' ..�� ,��.,. � � ' . A � �r,i, i � 1 �.: , f'o, � � ' ._ —�_, ,6`�' -� �.�� ` . SCOPE OF PERMIT �,� % �. - -' � �ti�/ �.;;.. . ' �� ' NEW SFR L0T�30; PLAN 26. INST 1 EACH SWICTH, RECEPTACLE, OUTLAT AND`PANEL `-� - �.1 � i<.= �� ,�� \ �L..-' '� / � ' . ' _. �_ �A' t'� % �,;'� i4 i � I� ISSUEFEE '�� ' Temp service test �� Res: a/c package �,}�.`,' "" New Res (1-2 units) , � • New Res (3+units) 1 � � �`� � Pool I Spa - ' �, '�., LightingFi#s'-� , �� ' Recept Outlets ,.� �- ':�� 1' � Switches, ��,,: ` ,, A,� � Non Res Appl� '� - �; � Res Appl \ ��, - �- Service to 200a� � Service to 1000a`' � '. �• Service over 1000a_� Motors to 1 hp ' ' Motors to 10hp �� - Motors to SOhp � Motors to 100hp Motors over t00hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole � Intertned Pole $22.00 $0.00 $0.00 $99.85 50.00 $0.00 $0.00 $2.00 ;�Pr''�(,) i FEESUMMARY��,� /`�),� ��A � �" .� � �_t = � � � �„ ' � �.Quarit(tyv==-=--__ �.,1._�.,'�. .... Quantity \ Temp Dist System /�Lighting �� $0.00 0 , '. � Busway /100 R P' so.00 0 �i-,_��✓��J;}�� Standing-Section'�-��,`)-. $0.00 0 1997� �_—_ — ,=Misc E�ectrical Equipment�"_ ; $0.00 0 , 0 -' ' Transformers up to 1 kva/kw $0.00 0;, ' 0 ......... ...:up to�10 kvalkw $0.00 0 � � 0 ........ l�- .up to 50 kvalkw �� $0.00 ,0.�; � 2 � u to 100 kva/Icw $0 00 0 . , � �.� �� , �l . �� P / ' � 1 . ................over700kva/kw $0.00 'i�.0� ' ��'� � � � � � ' 0 f��-Low�Voltage Equipment '�$0.00 ��j�0 � �! %� �� . 0 �t G��,.riLow`VOIIWiringSystem/Ckt $0.00��% 0 �� „i,�, 0 -,� 1' . MisaCondWt�, $000� 0,�' :��: y 0, t � �� f� ` Migc: Conductor $0�00 0' .,� ,�� \�� 0 y �,n, � � Grcus ( gen oi iide) ,,' �$0 00 � �� 0 � ��; ! " $0.00\\ ��\ 0 \ ` `>��; �j -� Chr stm seT eedStand9hts/ i $0 00 \ ��O�y' � $0.00� > 0 � � \��, �. '�" � Fiieworks Stand: - _ $0 00 0 � �� $0.00 j , ;�0 �� - � -��=r�� .Other Electrical Fee " � � � $0.00� %�'� ;$0.00?i,��p'��, -'.- .�- _-_ _- � �� i $0:00 ^ ��0�� .�'�� , Investlgation�Fee i ,', = "$0.00;=�� 52725:� �1 ' � , . � � -Pla'n Check Fee_':' �� , ,, $0.00= � . $0.00�.._�- � 0 � � i � . Reinspedion Fee � - $0.00 $0.00 � '0: - _� .. A\�,- .. . ' -.�/'. $0.00 0 _, . ••�-TOTAL•CALCULATEDFEES 5152.10 50.00 0 _. _� ;.�,,, - - COMMENTS / SPECIAL CONDITIONS EXPIRATION: This permit shall aulomatically expire and become void if work is nol commenced within 180 days, or if work is suspended or ebandoned for a period of 780 days. INSPECTIONS: In order for the vrork aulhorized under this permit to be considered legal, such work must comply with all applicable codes, end ell required inepeetlone end final approval must be obtained. Failure to obtain inspeclions end final epproval will resutt in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545828 WORKERS'COMPENSATONDECLARATION: I hereby ettirtn under penalry of per�ury one oi iha fallowing dederetions: .. �., . � ❑ I heve end wlll maintein e certificete of consent to self-Insure tor workers' compensatlon, es provided for by sectlon 3700 of the LeGor Code, (or the pertortnenca of the work tor which thls pertnit is Issued. � ❑ I have end will melntein workers' oompensation insu2nce, as requlretl by section 3700 oi the La6or Code, for Ihe peAormence of ihe work for which Uis pertnit is issued. My workers' compensetion Insurance cerrier entl policy number are: Carrler. Policy NumDer. (Ihls sect/on need not be completed it the pertnif is valued af one hunCred Collars ($100) or less.) ❑ I cerlity that in the peAortnance of Iha wark for which Ihis permit is Issued, I shall not employ eny parsan in any menner so es �o become sub�ect to Ihe workers' compensetlon lews of Calitomia, and egree thet If I should become sub�ed to Ihe workers' compensetlon proNslons o1 Section 3700 at the Lahor Code, I shell fort�with comply wit� Ihesa p��Q° s. / t� Applicant Signature: In / ��l' Dete: `�i l/ / i� WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVEMOE IS UNLAWFUL AND SHrLLL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED TFKKISAND DOLLAFE (5100.000), IN FDDIiION TO THE COST OF COMFENSATION, DMMOES AS PROVIDED FOR IN SELTON 3]OB OF TME UBOR CODE, IMEREST, AND /TTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby atllrtn ihet I am licensed under provisions of Chepter 9(commencing with Section 7000) oi Dlvislon 3 ot the Business antl Professians Cotle, flnd my license is In tull torce entl eNect. Lic. x Class x � Contrectofs Signature: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby effirtn Nat t�ere is e consirucUon lentling agency to� Ihe paAartnance of the work tor which this pertnit Is luued. (Sec. 3097, CINI Code). Lendefs Name: __�� Lenders Atldress: Signatu�e�� Date: / OWNER•BUILDER DECLARATIONS: I heraDy eHirtn ihel under penalry of perjury that I em EXEMPT FROM TME CONTRAC70RS LICENSE LAW for Ihe tollowing reeson (Sec. 7031.5, Business and Profeulons Code: Any ciry or counry which requires e permit to consirud, elter, Improve, demolish, or repalr eny siructure, pdor to its luuance, elso requires ihe applicent for such permlt lo lile e signetl stetement thet he or she is IlcenseA pursuant to the D�eNslons ot the Coniradors License Lew (Chepter 9(commenGng with Section 7000) oi DiWsion 3 ot Ihe Business entl Professlons Code) or Ihat he or she is exampt theretrom entl Ne Gasis for the elleged exemption. Any violation of Section 7031.5 by any epplicent for e permit sub�ecls Ihe epplicant to e civil penelry of not mare ihen fve hundretl dollers ($500).): ❑ I, es owner oi t�e property, or my employees with wages es t�elr sole wmpensation, WILL DO TME WORK, end the atructure Is not inlentled or oHeretl tor sele (Sec. 7044, Business and Professions Code: The Contrectors License Lew tloes nol eppty to an owner of properry who builds or improves thereon, and who does such work hlmself or hereelf or through his or her own employees, provided Ihet such improvements ere not Intended or otteretl for sele. It, however, the building or Improvement Is sold wlthln one year oi completion, the owner-bulltler will heve ��e burtlen ol proving thet he or she dld not bulld or Improve for purpose of sale.). � I, as owner of the property, am E%CLUSIVELY CONTAACTING WITH LICENSED CON7HACTORS to wnstruc� the projecl (Sec. 7044, Business and Professions Code: The contrectors License Lew Coes not eppy ro an owner oi properry who bullds or improves thereon, and who contrects tor such proJect with e comractor(s) Iicense pursuant to the Contrectors License Laws.). ❑ I am exempt under sec. Busineu end Professlons Code for ihis reeson: Signeture: Dete: Owner ID venlled by dnvefs license. ❑ Ves ❑ No Dnvefs License No. Expires: VedNcetion of Ownarship by (type of document, i.e. - property tex bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ 1 �ere�y cetlity ihal no excevalion fWe (5) or more teet in Aept� into which e person Is requiretl to tlescend, wlll be metle in connectlon wiN work euthodzed by t�ls permlt, entl thel no huilding struclure, scattolding, falsework, or tlemolition or dismantling thereoi, ivill be more ihfln thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle 8, Cellfomie Atlministrative Code). ❑ As owner-Duiltler, I wlll not employ anyone to do work which would require e pertnit trom the Divislon of Industrial Sefery, es noted above, unless such person has a pertnit ta do such work irom Ihe division. SlgneNre: Date: Divlsion ot Industrial Selery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORPATION OF ENTAY: I certify under penalry ol perjury that I heve reed Ihis application and state thet the infortnetion given is corred. I egree to compty with ell state laws end aty ordinences relating to builCing construction, end authorize representatives of Iha City ot Costa Mesa to enter upon �he above-descrlDed properry for inspection purposes. I egree not to occupy or ellow occupancy of any bullding authorized Dy this permit until final inspedion. t00E �. INSPECTIONTVPE 1618 Fized System Finel Fire Preventlon 1268 Paol Spe Flnel ' 200 Flnel Re-RooY 201 FInaI BIocWReteining Well 202 Finel Fectory Fire Place 203 Final Sign 204 Final Demolition zaae-se QAiE U1iIDlt5 � ^ �[7ate � YrS Date �pp� ixsvecnaxTrve 206 Finel Mechenical 20B Final Plumbing 210 Finel ElecMcal 212 Final Fre Preventlon 220 Flnel Plenning Approvel 222 Flnal Site 250 Final Bullding/Occupancy �: 1 JIII. �/ �'/ . � ► • �J: . qa'�., � �: � •.: _:: � � (714J754-5273 • Fax(714)754-4856 Job Address: 281 O HAZEL PL Suite No Vicinity: Pareel Nunmber: TPN98045 Applieant: FLYNN, DAN Address: CITY OF COSTA MESA BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT �,'" /,/�" ; " i,,'%.- . G: �/ Owner. W.'L'YONS HOMES" ��i - Address: � �� , � � / � �, /� �� '� � � �- �� /.> , � � /;5/ , Cont�aotor:_ WILLIAM�LYON HOLMES -.� Address:; , 4490 VON KARMAN �i �/ ,�� ,%�. .,. ' C.M: CA � ,. ArchlEng: - ",� � Address: . " ' % . � , . �� + , MECHANICAL PERMIT Phone: Zip: Phone: Zip: Phone:; 714-476-7361 . Zi{i: �. 92660 - � � . �,Lice sn e: 661158 � '_ �_, Pho�e: Zip: License: PERMIT�/ M98-00321 ✓ 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applled: 07124/1998 Issued: 08I04/1998 ; ' � � � � � -� SCOPE OF� PERMIT � � • NEW SFR PLAN 28 LOT30, REF 898-00651 INST 1 FAU UNDER 100K BTU, t FIREPLACE AND 4 � � . VENTFANS` � .. . _ FEE SUMMARY , �' , � � Quantity � . Quantity ISSUE FEE � � 522.00 Repair I Alt Absorbtion Unit $0.00 0 Inst FAU <100 k BTU � $13.25 Repair I AIt.Refrigeretion Unit $0.00 0 Inst FAU'?100 k BTU �� , � $0.00 Ventillation System ' $0.00 0 Repair I Alt Cooling/Heat �: $0.00 0 Evaporative Cooler $0.00 0 Inst / Rep. Recess Wall Hh '�� $0.00 0 Commercial Incinerator $0.00 0 Refig Sys <100 k BTU . $0.00 0 , . Domestic Incinerator $0.00 0 Refig Sys >100 k BTU . `$0.00 0 , ' Compressors I Absorption Svstems . Gas Piping � � ''$0.00� 0' �- "" �� Up to 3 hp I 100 k BTU � $0.00 0 Factory Fireplace , � 89:50��. 1- '_ � " ". 3 To 15 hp / 500 k BTU $0.00 0 Hood w/Mech Exhaust � "$0.00 0 �15 To 30 hp / 1,000 k BTU $0.00 0 VAV Box $0.00 0 �_ 30 To 50 hp / 1,750 k BTU $0.00 0 Vent Fan I Single Ducl _ � $26.00 4 '� .. Over 50 hp / Over 1,750 BTU 50.00 0 Appliance $0.00 0 Boilers � Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers -$0,00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 , 15 to 30 hp 30.00 0 Air Handlers < t0000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers > 10000cfm $0.00 0 Over 50 hp ' $0.00 0 Floor Fumace $0.00 0 Other Mechanical Fee ' Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES 570.75 COMMENTS / SPECIAL CONDITIONS EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a perlod of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeetlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � WORKERS' COMPENSA710N DECLARATION: 1 hereby ettirm untler penelry oi per�ury orre of the followinq declarations: ❑ I heve antl will melntain e certificate af consent to selt-Insure for workers' compensetion, es O�ovided for by sectlon 3700 of ihe Lebor Code, for the peAortnance oi the work for which this pBrtnli is issuetl. ❑ I heve and will meintein workars' campensation insurer�ce, as required by seclion 3700 of Ne Lebor Cade, for the peAortnance ot the work for which Nis pertnit is issued. My workers' campenseiian Insurence cartier antl policy number ere: Cartier: Policy Number: (This sectlon neetl not be comp/eted I! the pe�mit is velued et one hunAretl dollars ($ f 00) or less.) ❑ I ceNiy that in the pertortnance of the work lor which this pertnit is issued, 1 shall not employ any person in any manner so es to become subject to �he workers' wmpensetion lews ol Califomie, entl egree t�at If I s�oultl become subject to Ihe warkere' compensation provisions of Sectlon 3700 of Ihe Lebor Cotle, I shall fonhwith Comply wi�h Ihese prOvji� ns. q s Applicant SlgneWre: /// Date: �"' — � — / (J WpRNING FAILUFE TO SECURE WORKERS' COMPENSATIIXJ COVERAGE IS UNUWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALilES AND GVIL FlNES UP TOONE HUNDRED TFi0U5AND DOLLAPE (5700,000), IN ADDRION TO THE COST OF COMPENSATION, DAM4GES AS PROVIOED FOR IN SECiION 3'!OB OF THE LABOR CODE. INiEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm Ihet I em Ilcensed untler provlslons of Chapter 9(commencing with Seclion 7000) oi Dlvision 3 of the Buslness end Protessions Code, and my license is in tull foma and eflecL Lic. p Cless k Contrectofs Signeture: � Date: _ ^ CONSTRUC170N LENDING AGENCY: ❑ I hereby etfirtn thet there Is e construction lentling egency for t�e pertormance of the work for which this pertnit Is issued. (Sec. 3097, Civil Code). Lendefs Neme: Lenders Address: Signature: Dete: OWNER-BUILDER DECLARA710NS: I hereby eflirm that under penalry oi per�ury thet I em E%EMPT FROM THE CON7AACTORS LICENSE LAW tor the tollowing reeson (Sec. 7031.5, eusiness end Professions Code: Any ciry or counry which requlres e pertnit to construct, alter, improve, tlemolish, or repair eny structure, pdor to its issuance, also requires the epplicant for such pertnit to file e slgned statement Ihet he or she Is Ilcansetl pursuan� to ihe provisions oi the Contrectors License Law (Chepter 9(wmmencing with Sectian 7000) of Division 3 af the Business end Professlons Code) or that he or she Is e:empt therefrom and the basis for Ihe alleged exemption. Any violetion of Sedlon 7031.5 by any applicant for e pertnit sublects the flpplicant to e civil panalry of not more ihan flve hundred tlollars (5500) J: ❑ I, as owner of Ihe O�operty, or my employees with wages as their sole compensation, WILL DO 7ME WORK, end the structure is not intentled or otfered tor sale (Sec. .7044, Business and Professions Cade: The Contractors License Lew does nat appty to an owner af properry who builds or Improves thereon, end who does such work �imseN or herself or Ihrough his or her own employees, provitled Ihat such improvemenis ere not Intended or otfered lor sale. If, �owever, ihe building or improvement Is sold within one year of complation, ihe owner-builder will have Ihe burden of proving that ha ar s�e tlitl not bulltl or Improve lor purpase oi sela.). ❑ I, es owner of Ihe properry, am E7(CWSIVELY CONTRACTING WRH LICENSED CONTAACTORS to wnstruct the pm�ect (Sec. 7044, Business end Professions Code: The contrectors License Lew does not eppty to an owner ot properry who builds or Improves Ihereon, end who contracts tor such project with e contractor(s) license pursuani to the Contractors License Lews.). ❑ I em exempt under sec. Business antl Protessions Code tor t�is reason: Signeture: Date: Owner ID veritied by dnvefs license. ❑ Yes ❑ No Drive/s License Na. Venfcatlon oi Ownershlp by (rype of tlocument, i.e. - property taz bill or deed): Ezpires: DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certity Ihet no ezcavetlon five (5) or more teet in depth into which a person Is requlred to descend, wlll be mede In connection wlth work aut�orized by thls permit, antl thet no building swcture, sceflolding, telsework, or Gemolition or dismenUing thereof, will De more than thirry�six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, 71I1e 8, Celtlomla Atlminlsiretive Code). ❑ As owner-builtler, I wlll not employ anyone to do work which would require a permit from Ihe Divlslon of Industdel Sefery, es noted ebove, unless such parson hes a pertnit to do such work iram ihe division. � Signature: Date: Division ot Industnel Satery Pertnit Number: CEHTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTiiY: I certity under penalry of perjury thet I heve reed this epplication entl state thet ihe informetion given is corred. I egree lo comply wllh all state lews end ciry ortlinances relating to builtling conslruction, and authorize representatives of the Ciry ot Costa Mesa to enter upon the above-tlescdbed property for inspection purposes. I egree not to occupy or allow occupancy of eny building authorized by this parmit uMil final inspedion. n el O.vner(s) - � -SS - r�- � Antl/Or AuthoAzed Appliwnt . Date COUE I.� INSVECTIONiYPE PAIE II�lS 1616 Fixed System Flnal Fire Pravention 7286 Pool Spa Final 200 Finel Re-Roof 207 FIneI BIocWRetelning Wall 202 Finel Fedory Fire Place 203 Final Sign 204 Finel Demolltion 2446-4fi COOE I INSPEClION TYPE 206 Final Mechenlcal 208 Final Plumbing 210 Final ElecMcal 212 Final Fre Preventlon 220 Final Planning Approvel 222 Final Si�e 250 Finel Builtling/Occupancy �.1 �11. • • � ,