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Home My WebLink About2859 HICKORY PL - Building PermitsSeptember 30, 1999 Kokeb Belay 2859 Hickory Place #A Costa Mesa CA 92626 �.ITY OF COSTA ML�A CALIFORNIA 92628-1200 P.O. BOX 7200 DEVELOPMENTSERVICES DEPARTMENT RE: DEVELOPMENT REVIEW DR-99-16 2859 HICKORY PLACE, COSTA MESA Dear Ms. Belay: The Development Review for the above-referenced property has been completed. The various City departments have recommended approval of the project, based on the following description and findings, and subject to the conditions set forth below: PROJECT DESCRIPTION The applicant proposes to operate a large family day care home for up to 14 children, including the applicant's, in a three-bedroom apartment unit located within a four-unit apartment building. The property is zoned R3 (Multiple-Family Residential District) and has a General Plan designation of High Density Residential. FINDINGS A. Approval of the development review wiil allow a use, density, and intensity which is in accordance with the General Plan designation for the property. B. The project has been reviewed for compliance with the California Environmeniai Quality Act (CEQA1, the CEQA Guidelines, and the City environmental procedures, and has been found to be exempt from CEQA. C. The project is exempt from Chapter XII, Article 3, Transportation System Management, of Title 13 of the Costa Mesa Municipal Code. 77 FAIR DRIVE Building Divison (714) 754-5273 • COCe Entorcement (774) 754-5623 • Planning Division (714) 754-5245 Fn.0 (�ia� �sarass • Too �ia� �sa-szaa DR-99-16 September 30, 1999 Page 2 CONDITIONS OF APPROVAL Ping. 1 �� 3. � A copy of the conditions of approval must be kept on the premises and presented to any authorized City official upon request. The app�icant shall provide a copy of this letter, including the conditions, to the property manager/leasing agent. New licensees and/or property owners shall be notified of the conditions of approval upon the transfer of the day care license or ownership of the land. The approval herein is for a large family day care home for maximum ot 14 children only. If at any time the day care provider decides to provide day care services for more than 14 children, the applicant shall apply for, and obtain approval of, a conditional use permit prior to the increase in enroliment. Customer parking and child pickup/drop off shall be limited to the rear of the property (alley) only. No customer parking or child pickup/drop off shall occur at the front of the property (along Hickory Placel. If parking, or traffic becomes a problem with the use, this development review shall be reexamined by the Planning Services Division to address the concerns. Applicant is also advised that outdoor play activity shall be limited to the front of the property if noise complaints are received from neighbors. CODE REQUIREMENTS The following list of federal, state and local laws applicable to the project has been compiled by staff for the developer's reference. Any reference to "City" pertains to the City of Costa Mesa. Ping. 1. 2. 3. Bldg. 4. Fire 5 Approval of the development review is valid for one (11 year and will expire at the end of that period unless applicable licenses and other approvals are obtained and the use commences, or the applicant applies for and is granted an extension of time. The applicant shall compiy with all applicable State regulations for large family day care homes. Permits shall be obtained for ail signs according to the provisions of the Costa Mesa Sign Ordinance. If new construction is proposed, comply with the requirements of the Uniform Building Code as to design and construction and CCR Titie 24 pertaining to "Disabled Access Regulations". The large family day care facility shall comply with ali applicable provisions of the Ca�ifornia State Fire Marshall's Ordinance. Upon receipt of this Ietter, your project has been approved, subject to the above-listed conditions. A copy of the conceptuaily-approved plans are enclosed. The decision wiil DR-99-16 September 30, 1999 Page 3 become final on October 7, 1999, unless appea�ed by an affected party, or a member of the City Planning Commission or City Councii. If you have any questions regarding this letter, piease feel free to contact me at 714- 754-5611; the best time to contact me is between 1 p.m. and 5 p.m. Sincerely, /'`��u-- MEL LEE, AICP Associate Planner cc: Engineering Fire Protection Analyst ater District hief Plans Examiner Margaret Lindsey 10081 Beverly Drive Huntington Beach, CA 92646 X � CITY OF COSTA MESA ; _ � suno►N� ��v�s►oN : DEVELOPMENT SERVICES DEPARTMENT 898-00700 � J•w PERMIT PERMIT NUMBER "e'ow� � (714) 754-5273 • Fax (714) 754-4856 gUILDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED �V� 1 ' Applied: 0 3/1 611 9 98 issued: 05/04I1998 JobAddress: 2859 HICKORY PL Suite: Vicinity: Parcel Nunmber: 13929618 Appliwnt: UNKNOWN Address: Owner: LINDSEY, MARGARET TR Address 10081 BEVERLY DR Contrector Address: Arch I Eng : Address: HUNTINGTON BEACH,CA Zoning: Phone: Zip: Phone: Zip: Phone: Zip: License: FY3Yiy Phone: ZiP License: SCOPE OF PERMIT ADp NEW 227 S� FT GARAGE TO EXISTING GARAGE, WORK DONE W/O PERMITS,PC#1002-98A Plan Check: $16.21 Permit: $99.75 Other: $0.00 Inspection: $0.00 Total: $115.96 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existina: o NOTES: Rear 0-0 Rear 0- 0 Reauired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Caic Valuation: So.00 Claimed Valuation: Sa,�si.00 Right 0-0 Right 0- 0 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, an all required inepeetlona end tinel approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this per G. FOR INSPECTIONS CALL: (714) 7545626 a � � WORKERS' COMPENSATION DECLARATION: I �ereDy aflirtn under penelry of perjury one of Ihe following decleretlons: ❑ 1 heve entl wlll meinteln a certificete of consent to seli-Insure tor workers' compensatian, as providetl for by sectlon 3700 at the Lebor Cade, for ihe peAarmence of the work for whlCh thi9 pertnit i9l5sued. ❑ I have end will meintein workers' compensatlon insurance, es requiretl by section 3700 of Ne Lebor Code, for �he perfortnence of Ihe work for which this permit Is issued. My workers' campensetion Insurence carrier anC pollcy number ere: Cartier: Policy Number. (Thls sectlon neetl not De oanpleted i7 the permit is va/ued et one huntlred tlal/ers (5100) or /ess.) ❑ I certiy t�et in t�e peAortnance ot ihe work tor which this pertnit Is issued, I shall not employ any person in eny menner so as to become subject to ihe workers' compensetlon laws af Celifomia, end agree Ihat II I should became suD�ect to the workers' campansation provlslons o1 Section 3700 ot the Lebor Cotle, I ahall forthwit� comply with these O��slons. Applicant Signeture: Date: WAHNING: FAILURE TO SEGURE WORKERS' COMPENSATION WVEMGE IS UNLAW FUL AND SHALL SU&IECT M! EMPLOVER TO CRIMINFL PENALTIES MID CML FlNES UP TO IXJE HUNDRED TIIOUSrWO OOl1ARE (E100,000). IN ADORION TO THE CQST OF COMPENSATION, DFMFGES AS PROVIDED FOR IN SECTION 37080F TXE IABOR CODE, INTERE5T, AND ATTORNEV'S FEES. �'�. LICENSED CONTRACTORS DECLARATION: !i I hereby ettlrm that I em Ilcensetl under provisions ot Chepter 9(commencing wlth Section 7000) oi Division 3 of tha Business and Professions Code, end my Ilcense is in tull i force end eNecL LJc. M Class p � Contractofs Signewre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirtn that there is a cans(ructian lending egency far the pertartnence oi the work for which this pertnit is Issued. (Sec. 3097, Clvil Code). Lentlefs Name: Lendafs Address: Signature: Date: OWNER-BUILDER DECLARA710NS: I hareby affirtn Ihat under penalry ot De�ury ihat I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the lallawing reeson (Sec. 7031.5, Business entl Prote55ions Code: Any ciry or counry which requires a pertnit m construd, alter, improve, Cemolish, or repair eny structure, pdor to Its issuence, also requires the applicent tor such permit to file n slgnetl stetemant [hat he or she is licensetl pursuent ro the provlsians oi the Contrectors License Law (C�apter 9(commencing with Seclion 7000) ot DlNslon 3 of ihe Business end Professions Code) or ihat he or she is exempt therefrom end the basis for the allegetl exemption. Any Wolatlon of Section 7037.5 by any applicanf tor e pertnit sub Ihe epplicent to e civil penalry ol not more ihan flva hundred dollers (5500).): 1, as owne� of ihe properry, or my employees with weges es Iheir sole wmpensation, WILL DO THE WORK, enO Ihe siructure is not Intended or offeretl tor sale (Sec. 7044, Business entl Protessions Code: The Contrectors Llcense Law does not apply to en owner of property who Dulltls or improves t�ereon, and who tloes such work himseN or herself or ihrough hls or her own employees, provieed the� such Improvements ere not intenAetl or ottered for sele. If, however, the builtling or Improvament Is 5old wlihin one yeer oi completion, the owner-bullder will have the burtlen of proving that he or she did not bulltl or Improve fo� purpose oi sele.). ❑ I, es owner oi Ihe property, flm EXCLUSNELV CONTRACTINC WI7H LICENSED CON7RACTORS to consiruct the project (Sec. 7044, 8usiness entl Professions Code: The conlrectors License Lew does no� epply to en owner of proDerty who builds or Impraves ihereon, antl who contrects tor such project with e conirector(s) Ilcense pursuant ro the Contrectors License Lews.). ❑ I em ex� Slgneture:� Owner lo veri Vedficafion oi unGersec. Business end Profeuions Code tor Ihis reason: ifslicense. Fj^/es ([�Mo by (rype of document, i.e. - property tex bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: Drivers Licensa No. Dete: Expires: ❑ I �ereby certity Ihet no excavation tNe (5) or more teet in tlepih Inta wNch e person Is reqNred to descentl, wlll be mede in connectlon with work aut�odzed by thLa permit, end thet no building structure, scattoltling, felsework, or demolition or tlismantling thereof, will be more lhen Ihirry-six (36) feel high. (Chap. 32, Gry 2, Art 2, Sec. 341, Tltle 8, Cellfomia Administre�ive Cotle). ❑ As owner•builder, I wlll not employ anyone to do work which woultl require e pertnit from the Division oi Intlusirlel Safery, es noted ebove, unless such person has e pertnit to tlo such work from the divisian. SigneNre: Date: Divisian oi Industnal Sefery Permlt Number: CER77FlCATE OF COMPLIANCE AND AIJfliORIZATON OF ENTRV: I cartily under penalry ot perjury Ihet I have read Ihis epplication and state ihat the infortnation given is correct I egree to comply with all state laws and ciry ordinances relaiing to building consiruction, and euthonze representetives ot the Ciry oi Costa Mesa to enter upon Ihe ebovadescnbed pmperty for'nspec/tlo�n purposes. I agree not ro acupy or allow occupancy of any building authonzed by Nis pertnit until final i,n.,s%p clion. �/a,4 n nh. ��'" o�. �S 'I / 92S �i "'—'�ign'a�ire � ega O ner(s) �� Dete V �And/Or Authodzed Applicent Date CO�E 1. INSPECTONTYPE 1616 Fixed System Finel Fire Prevention 1266 Pool Spe Finel 200 Final Re-Roof 201 Finel BIocWReteining wall 202 Finel Fectary Fire Place 203 Final Sign 204 Final Demolition 2a&a8 Qe¢ ��$ [�1 INSFECTION TYPE 206 Finel Mechenlcal 208 Final Plumbing 270 Final ElecidCel 212 Final Fire Prevention 220 Flnal Plannin0 Approvel 222 FInalSite 250 Final Bullding/Occupency � 1�� CITY OF COSTA MESA � BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT E98-00324 � PERMIT NUMBER (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: Address CoMrector. Address: Arch / Eng : Address: ISSUE FEE Temp service test Res. a/c package New Res (i-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 t000a Motors to 1hp Motors to tOhp Motors to SOhp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole 2859 HICKORY PL 13929618 LINDSEY, MARGARET TR 10081 BEVERLY DR HUNTINGTON BEACH,CA LINDSEY, MARGARETTR 10081 BEVERLY DR HUNTINGTON BEACH,CA. $22.00 $0.00 $0.00 $0.00 $0.00 $0.00 $3.00 $6.00 $2.00 $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 Quantity ELECTRICAL PERMIT status: ISSUED �vg Applied: 05/04/1998 � Issued: 05/04l1998 Phone: Zip 92646 Phone: " Zip:92646 ' ' � � � _ Phone:' Zip: �; � � � License� • �� ' Phone: Zip License: SCOPE OF PERMIT MISC ELEC. FOR FOR NEW GARAGE: FEE SUMMARY � Temp Dist System / Lighting Busway./100ft �_ Standing Section Misc Electrical Equipment Trensfo,rmers up to 1 kva/kw .............�...up to 10 kva/kw .....:...........up to 50 kva/kw .................up to 700 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misc. Conduit � Misa 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 so.00 0 $0.00 0 $0.00 0 $0.00 0 30.00 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 533.00 COMMENTS / SPECIAL CONDITIONS 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. INSPEC710NS: In order for the work authorized under this permit to be consitlered legal, such work must comply with all applicable codes, and all required Inspectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in �he expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 N WORKERS' COMPENSATION DECLARATION: I hereby emrtn under penalry of parjury one ot the tollowing tleclaretions: ❑ I heve entl wlll melntein e ceRiticate ot consent to self-Insure for workers' compensetlon, es proNtled for Cy sectlon 3700 ot the labor Code, for the peMortnence ot the wark tor which ihis pertnit is issuetl. ❑ I heve end will maintain workers' compensation Insurence, as required by section 3700 oi ihe LeOor Code, for the perlortnance of Ne work for w�ich Nis pertnit is issuetl. My workers' compensation Insurance certler end policy number ere: ' Cartier: Policy Number. (lh/s sectlon neetl nof be comp/eted i/ Me pe�mit /s velued et one huntlred dallers ($100) or less.) ❑ I cenity t�el in the pertortnance oi t�e work for which this permit is issued, I shall not employ eny person In any menner so as to become sublect to the workers' compensetlon lews ot Celitomia, end egree Ihet tl I shoultl become sub�ect to iha workers' compensetlon provislons of SecHon 3700 of Ihe Lebor Cotle, I shell tonhwith comply with lhesa provislons. Applicant SlgnaNre: Dare: WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVEMGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER i0 CRIMINAL PENALTIES M1D GVIL FlNES UP TOONE MUNDRED TTIOUSAND DOLLARE (f100,000), IN ADDITIIXJ TO THE ODST OF WMPENSPTION, DAMAGES AS PHOVIDED FOq IN SECf70N 3]080f THE IABOR CODE, INTEREST, AND ATTORNEI^S FEES. LICENSED COMRACTORS DECLARATION: I �ereby ettirtn thet I em licensed under provislons of Chflpter 9(cammencing wlth Section 7000) of Divlsion 3 at Ihe Businass entl Professions Code, entl my Ilcense is In full torce and elted. Uc. a' Class a Contrnctols Signeture: � Dete: CONSTRUCTION LENOING AGENCY: ❑ I hereby eKrm Ihet Ihere is e construction lending agency tor the pedormance of ihe work for which Ihis permit is issuetl. (Sec. 3097, Clvil Code). Lenders Neme: Lende/s Address: Signature: Date: OWNER-BUILDER OECLARATIONS: I here6y effirm ihet under penalry ot perjury that I am El(EMPT FROM THE CONTAACTOHS LICENSE LAW far t�e following reason (Sec. 7031.5, Business end Protesslons Cotle: Any ciry or counry which requires a permit to consiruct, elter, Improve, EemWish, or reDair any sWcture, prior ro its issuance, alw reqWres Ihe applicant for such pertnit ro file e sipned slatement that he or she Is Ilcensetl pureuent ta the provisions oi tha Contrectors License Lew (Ghapter 9(commencing with Sectlon 7000) of DlNslon 3 oi the Business antl Professions Coda) or that he or she is exempt Iheretrom and Ihe basis for the alleged exemption. Any violatlon ot Section 7037.5 6y any epplicaM for a pertnit s�ects Ihe applicant to e Gvll penalry of not more fhen Tive hundred dollars ($500).): I, es owner of the property, or my employees with wages as their wle compenution, WILL DO THE WORK, end the structure is not intended or ottered far sale (Sec. 7044, Busineu flntl Professions Cotle: The Contractors License Law does not appry to an owner of property w�o builtls or improves thereon, flnd who does such work hlmself or �erselt or through his or her own employees, provldetl thet such improvemenis ere not Intended ar oHaretl for sale. If, however, ihe bulltling or Improvement Is soltl within one year of completion, ihe ov.•ner-bullder wlll heve iha burtlan oi proving that he or s�e tlitl not Dulld or improve far purpose of sale.). ❑ I, es owner o1 the properry, am E%CLUSIVE�Y CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Buslness end Professions Cotle: The contredors License Law tloes not apply to an owner oi property who Duiltls or Improves thereon, end who contracis for such pro�ect wlth e contrector(s) licensa pursuent to Ihe Contractors License Laws.). ❑ I em exempt under sec. Signeture: Owner ID ventied by � ers license. ❑ Yes Venflcnlion of Ov+ners Ip by (rype ot document, I.e. Business and Protessions Code for thls reason: tax blll or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CEPTIFICATION: Dnvefs License No. Expires: ❑ I �ereby catlity Ihat no excevatlon five (5) or mare feet In depih into whic� e person is raquired lo descenA, wlll be metle in connection with work euthodzetl by tNs pertnl6 end �het no building struMure, scaXoltling, telsewark, ar demolitlon or dismantling Ihereot, will be more t�an ihirry-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 361, Title 8, Celitomia AtlministraWe Gode). ❑ As owner-builtler, I will not employ anyone to tlo work which would raquire e pertnit irom Ihe Division of Intlustnal Satery, es noted ebove, unless such person has e pertnit to do such work from ihe division. Signeture: Date: DiWsion ot Indusirlal Sefery Permil Number: CERTIFlCATE OF COMPLIANCE AND AUTHORVATION OF ENTTiV: I certily under penelry o� perjury Ihe� I heve reed ihis epplication entl state thei ihe intormetion given is correct. I egree to comply with all state laws end ciry ordlnances relating to 6uilding consiruction, and euthorize representatives of the Ciry of Costa Mese to enter upon ihe ebove-descnbetl property for i pection urposes. I egree not ro occupy or ellow acupan�y ot any bulltling auNodzed by Nis pertnit until linal inspection. � /H / 9 R� ignature O Legal Owngr( } -� Dete � And/Or Authorized App�cent Date cooe .. INSPECTION TYPE 1676 7266 200 201 202 203 Fzed Sysiem Finel Fire Prevention Pool Spa Final Flnel Ra-Root Final BIocWRetaining Wall Final Fectory Fire Place Final Sign 204 Flnal Demolition 2446d8 �ff I�� QpFJ( INSPECTONTYPE 206 Finel Mechenical 208 Finel Plumbing 210 Final Eladdcal 212 Finel Fire PrevenUon 220 Flnel Planning Apprwel 222 Finel SIIe 250 Flnel Building/Occupancy OA7E It�915 � - y, -�� c :.:.::: ; : � (774)754-5273 • Fau(714)754•4856 CIN OF COSTA MESA BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT dobAddress: 2859 HICKORYPL Suite No Vicinity: Parcel Nunmber: 13929618 Appliwnt: Address: Owner. Address Contractor: Address: Arch ! Eng : Address: 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 1000a Motors to 1hp Motors to 10hp Motors to 50hp Morors to 100hp Motors over 100hp Communiwtion drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intertned Pole LINDSEY, MARGARET TR 10081 BEVERLY DR HUNTINGTON BEACH,CA LINDSEY, MARGARET TR 10081 BEVERLY DR HUNTINGTON BEACH,CA $22.00 $0.00 $0.00 $0.00 $0.00 $O.Op $1.00 $1.00 $7.00 $0.00 so.00 $O.Op $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $O.Op $0.00 $0.00 $0.00 50.00 ELECTRICAL PERMIT Phone: Zip 92646 Phone: Zip:92646 Phone: Zip: License: Phone: Zip License: SCOPE OF PERMIT MISC ELEC. FOR GARAGE CONVERSION. Quantity FEESUMMARY Temp Dist System / Lighting Busway 1100 ft Standing Section Misc Electrical Equipment Trensformers up to 1 kvalkw ................up to 10 kva/kw .................up to 50 kva/kw .................up t0 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit Misa 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 E98-00323 v PERMIT NUMBER T7 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 05/04/1998 Issued: OS/04/1998 Quantity 50.00 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 50.00 $0.00 TOTAL CALCULATED FEES E25.00 COMMENTS I SPECIAL CONDITIONS � / ✓ I 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. INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable code_�s nd all required inapeetiona end flnal approvel must be oblained. Failure to obtain inspections and final approval will result in the ezpiration ot thi;•pertnl. FOR INSPECTIONS CALL: (714) 75M5826 / � WORKERS' COMPENSATION DECLARATION: I hereby eMirm under penelry of perjury one at the following dedaretions: ❑ I heve entl will melntein e certificete at consent to self-Insure tor workers' compensatlon, es provlded for �y section 3700 of the LeDor Cotle, for iha peAortnance of Ihe work lOr which Ihis pertnit is iuuetl. ❑ I heve end will meintein workers' compensation Insurence, es requiretl by seclion 3700 of Ihe Lebor Cada, for�Ne peAortnance ot Iha wark for which this pertnit is issuetl. My workers' campensetion Insurance caMer end policy number ere: Carrier: Policy Number: (Th/s secHon neetl nat be comp/eted /I the permit ls veluetl el one hundred dollers ($100) orless.) ❑ I ceNiy Net in Ihe pertortnance of the wark lor w�lch this pertnil is issuetl, I shall not employ eny person in eny manner so es to became subl� �a �he workers' compensetion lews oi Calitomie, entl egree t�et if I shauld become subject to Ihe workers' compensetion provislons of Sactlon 3700 oi lhe Lebor Cotle, I shell lonhwith comply wlih these provisions. Applicant SlpneWre: Date: WARNIN�: FAILURE TO SEIXIRE WORKER$' COMPENSATION COVERAGE IS UNLAWFUL AN� SNALL SU81ECf AN EMPLOYER TO CRIMINAL PENALTIES M1D GVIL FlNES UP TO ONE MUNDRED hKK15AND DOLIARE (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES A$ PROVIDED FOR IN SECf1IXJ 3]O60F TME LABOR ODDE, INiEREST, qND ATTORNEVS FEES. UCENSED CONTRACTORS UECLARATION: 1 hereby effirm ihet I am licensed under provisions oi Chepter 9(commencing with Sectlon 7000) ol Division 3 of Ihe Business antl Professions Code, antl my license is in full force and etlect. Lic. p Class x CoMrecto/s SlgnaNre: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby effirtn thet there is a canstructian lentling egenq for the OeAortnanca ol the work for which this pertnit Is issued. (Sec. 3097, Civil Cotle). Lenders Neme: Lentlels Address: Signature: Date: OWNER-BUILDER DECLARATONS: I hereq• eMirtn Ihet under penalry o1 per�ury thet I am EXEMPT FROM 7HE CON7RACTORS LICENSE LAW for Ihe tollowing reeson (Sec. 7031.5, Business and Pratessions Cotle: Any ciry or counry which requires a permit to construct, alter, impmve, demolis�, or repair any structure, pdor �o its issuence, elso requires the appliwnt lor suc� pertnit to file e slgne0 stetement ihet ha ar she Is Iicensed pursuent �o t�e provislons of Ihe Contreclors Llcense Lew (Chepter 9(commencing with Sectlon 7000) of Olvislon 3 oi t�e Business and Professions Code) or thet he or she is exempt Ihereirom end ihe basis lor the allegetl exemption. Any violation oi Section 7037.5 by any applicant for e pertnit '� su �ecG the applicant ro e civil penalry oi no� more then fve huntlretl dollars (3500).): I, es ownar oi the proparty, or my amployaes with weges as their sole compensation, WILL DO TME WORK, antl the structure Is not intentled or otterea for sale (Sec. 7044, Business end Professions Code: The Contrectors License Lew tlaes nol epply to en owner af properry who builds ar improves Iherean, end who does such work himsell or herseH or Ihrough his or har own employees, provitled ihat such Improvements ere not Intantled or oMered tor sele. Ii, however, Ihe building or improvement Is saltl withln one year oi completion, the owner-bulltler wlll have ihe burden ot proving thet he or she did not build or improve for purpose oF sele.). ❑ I, es owner ot ihe property, am EJ(CLUSIVELY CONTRACTING WIT}i LICENSED CON7RACTORS to construct ihe pro�ect (Sec. 7044, Business antl Protessions Coda: The cnntrectors License Law Coes not appty to an owner of praperry who bulltls or Improves ihereon, antl who coniracts for such project with a wntractor(s) Ilcense pursuant to ihe Contractors License Lews�. ❑ I nm exE SignaNre: � Owner ID verl Verificetlon of untlersec. license. ❑ Yes . (type of document, I.e. � Business antl Professlons Coda,(or tMs reason: DIVISION OF INDUS7RIAL SAFETV PERMR CERTIFICA710N: bill or tleetl): Drivefs Licensa No. Expires: ❑ I hereby certity Ihat no e:cavatlon ilve (5) or more leet in depth imo whic� e person Is required to descend, wlll be mede in connectlon with work authodzetl by this pertnit, end that no buildinq siructure, scattoltling, lalsework, or demolition or tlismentling theraof, will be more then thirty-six (38) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Gelifomla Atlministretive COCe). ❑ As owner-bulltler, I wlll nat employ enyane to do work which would require a permit irom ihe Dlvision of Indusiriel Safery, es noted ebove, unless such person hes a permit to do such work tmm the division. Signature: Date: Division at Industnal Safary Pertnit Number. CERTiFlCATE OF COMPLIMlCE AND AUiHORPA710N OF EMRY: I certity under penelry of perjury that I have reetl ihis appllcetlon end stete thet the intortnetion given is cortect. I egree to comply with all state lews and ciry ordinences relating lo building construction, end authorize representatives ot the Ciry of Cosia Mesa lo enter upon the ebove-tlescn0ed properry f r insDe n,Purposes. I agree not to occupy or allow occupanry ot eny building authorized by this permit until final Inspection. �/N /9R Signature Of egfll er(s) � Dete And/Or Authorize pplicant Date COUE f INSVECTIONTYPE 1676 Fixed System Finel Fire Prevention 1266 Pool Spe Final 200 Finel Re-Root 201 Final BIocWReteining Wall 202 Finel Fedory Fire Plece 203 Final Sign 204 Final Demolition 2a46d8 CAiE II�AIS CO�E� INSVECTIONTYGE 206 Finel Mechenical 208 Final Plumbing 210 Final ElectAcel 272 Final Fre Preventlon 220 Final Planning Apprrnal 222 Final Sita 250 Final Building/Occupancy �� r L'i �: ,uu: :. � , , CITY OF COSTA MESA - � BIIILDING p1VIS10N + � � DEVELOPMENT SERVICES DEPARTMENT 698-00698 �� PERMIT PERMIT NUMBER �� (714) 754-5273 • Fax (714) 754•4056 gUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 2859 HICKORY PL Status: ISSUED �� Suite: Applied: 03Ii611998 Vicinity: Issued: OSI04/1998 Parcel Nunmber: 13929618 Applicant UNKNOWN Address: Owner: LINDSEY, MARGARETTR Address 10081 BEVERLY DR Contractor. Address: Arch / Eng : Address: Plan Check: Permit: Other: Inspection: Total HUNTINGTON BEACH,CA Zoning: Phone: Zip: • Phone: Zip: 92646 Phone: Zip: License: Phone: Zip: License: SCOPE OF PERMIT 205 SQ FT GARAGE CONVERSRION TO BDRM, DONE WIO PERMITS, PC#1001-98A $20.27 $124.75 $0.00 $0.00 $145.67 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Fmnt 0-0 PARKING existinq: o NOTES: Rear 0•0 Rear 0. 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: So.00 Claimed Valuation: Ss,soo.00 Right 0- 0 � Right 0. 0 EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to ba considered legal, such work must comply with all applicable codes, and all requlred Inapectlone end final epp�ovel must be obtained. Feilure to obtain inspections and final approval will result in ihe expiration of ihis pe� �t''; FOR INSPECTIONS CALL: (714) 7545826 �� f" WORKERS'COMPENSATONDECLARAnON: I hereby eHirtn untler penalty of perJury one of ihe following tleclaretions: ❑ I heve end will meintain e certlficate W consent to selt-Insure tor workers' compensetian, es pmvidetl for by sectlon 3700 of the Lebor Code, tor the pertortnence ot the wOrk for whiCh Ni5 pertnil is issued. ❑ I heva eiW will maintein workers' compensatlon insurence, as requiretl by section 3700 0l tha Lahor Cotle, for the perfortnence ot the wwk ta which this permit is issuetl. My workers' compensatlon Insurence cartier entl pollcy number ere: Cartier. Policy Numhec (Thls sectton need not be completed ll me permit is velued er one hundred dollars ($100) o� less.) ❑ I certity that in the peAormance ol the work lor which this pertnit is issued, I shell not employ eny person in any menner so as to become sub�ect to the workera' compensetion laws ot Celltomie, end egrea thet It I shoultl become subject to the workers' campensation provlslans ot Sectlon 3700 of the labor Code, I shell forthwith comply with these D�ovislons. Applicant Signeture: Date: WARNIN6: FAILURE TO SEWRE WOPo(ERS COMPENSATION CUVERAGE IS UNUWFUL PND SHALL SU&IEGT AN EMPLOVER TO CRIMINFL PENALTIES Ml� CML FlNES UP TO ONE HUNDRED hKKISAND OOLLARE (5100.000�. IN ADDfTION TO THE COST OF COMPENSATION, DAMAGES A$ PROVIDED FOR IN SEGTON 3)OB OF TXE LA80R COOE, INiEFE5T, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: 1 here6y eHirm thet I am Ilcensetl under provisions of Chapter 9(commencing with Sectlon 7000) af Division 3 of Ihe Business and Protessions Cotla, end my license is in full force end eflect Lic. N Class p Conirectors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 here6y affirtn that Ihera is e constructlon lending egenq for t�e peAortnance of iha work for which this pertnit Is issued. (Sec. 3097, Civil Cotle). Lendels Name: Lenders AAdreu: Signature: Date: OWNER-BUILDEFi DECLARATIONS: I hereby eXirm that under penalry of perJury that I am EXEMPT FROM TME CONTRAC70R5 LICENSE LAW for ihe following reason (Sec. 7031.5, Business entl Protessions Coda: Any ciry or county which repuires e Oertnit to consiruct, elter, Improve, demolish, or repelr eny structure, ptlor to its issuance, elso requires the epplicant far such permit b Nle n si8netl statemem that he or she Is Ilcensed pursuant ta Ihe proWsions ot the CONractors License Law (Chepter 9(commencing with Sectlon 7000) of Divislon 3 oi the Business end Pmfessions Code) or that he or she is exempt therefrom end the basis tor the alleged exemption. Any videtion o1 Sectlon 7031.5 by eny applicant for e pertnit �suD' Is the epplicent to a dvll penelry of not more then five hundred dollars ($500).): , es owner of Ihe properry, or my employees wlih wages as thelr sole compensatlon, WILL DO THE WORK, entl the structura is not intended or oflered for sale (Sec. 7044, Business and Professions Code: The Contrectors License Lew does not eppty to en owner of Oroperry who builtls or improves thereon, end who tloes such woAc himseli or herself or ihrough his or har own employees, provitletl that such improvements ere not inrentletl or oXeretl for sele. Ii, however, the bulltling or Improvement Is sold within one year o1 completlon, the owner-bull0er wlll have the Durden of proving that he or s�e did not tuild or improve tor purpase o1 sele.). ❑ I, es owner of the property, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business antl Protessions Code: The contrectors Llcense Lew tloes not apply to an owner ol property who bulltls or Improves thereon, antl who contrecis tor such project with e contrector(s) license pursuant to the Contractors License Lews.). ❑ I em exe�mnp� Signeture: �j Owner ID verifietl veAncntlon or Ow undersec. license. O Yes (rype of document, i.e. Business and Professions Cotle lor this reason: Date: - � Drivefs License No. _ Expires: � irop len bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I �ereby certify Ihat no excevetlon tive (5) or more teet In depih Into which e person Is raqulretl to descend, will be metle In connectlon with work euthodzed by ihis permit, end that no bullding strucWre, scaffolding, felsework, or demolition or dlsmentling thereol, will be more then thirty-si: (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Tule B, Califomla AtlministretNe Code). ❑ As owner-builder, I wlll no� employ enyone to tlo work which wou10 require e pertnit irom �he Division of IndusMal Setery, es noted above, unless such person �as a pertnit to tlo such work imm tha division. Signature: Date: Division of Industnal Sefery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AIJfHORRJITON OF ENTRV: I certiry under penelry of perjury thal I have read ihis eppliwtion an0 stete Ihat the infortnation given is correct. I egree ro comply with ell stete lews and ciry ordinences relating to building construction, entl authonze representetives ot the Ciry oi Costa Mesa to enter upon the above-descri6ed pmperty for inspe tion pury s. I agree not to occupy or allow occupancy oF eny building authotlzed by this permit until final inspection. `� f/1(��h. ��,.;,_ o,.-, '�l / S / 9 � T Signemre 61 Legal Owner(s) � � Date And/Or Authorizetl Applicant Date cooe �. MSPECTIONTYPE 1616 Fixed System Flnel Fire Preven6on 1266 Pool Spe Finel 200 Final RB-Roof 201 Finel Block/Reteining Wall 202 Finfll Fectory Fire Poece 203 Final Sign 204 Final Demdition 2M649 GAjE I�{$ GQpj1 INSPEC110NTYPE 206 Final Mechenical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtlinp/OccuDancy Cdg : � .uu. . COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31] COSTA MESA. GALIFORNIA fOR APPL/CANT TO f/L[ /N COMPLETELY TYPE OR PRINT � BUILDING �r} ±-G��/ �' y�-«" ADDRE55 �p � L� COSTA MESA, CALIFORNIA ADORESS ]_ E� 1 L3� �,T,. Costa Mesa, Calif. TNpuI ARCHITEGT Carlson PY LIC. OR ENGINEER h • NO. AODRESS Garden Grove Dike & Colegrove, Inc. STATE � LEGAL I LOT ry I I�� OESCRIPTION NO. ( BLOCK C A.P. NO. OF LOT /O� x 96� I NO.OF BLDGS. NOW ON LOT SETBqCN LINE FROM �1 CENTER OF $TflEET SO' REAR YARD �/� I LEFf ZO� I RIGHT ]_I DESCRIPTION OF WORK NEW I' II ALTERATION � II A�DITION REPAIR I II MOVING I II DEMOLISH BUILDING [ C NO.OF SIZE �SZO \ ROOMS STORIES USE OF BUILDING AND WORK TO BE PERFORMED i4ulti le far.t' attached garage. (Four living units) n 1 MEiEEBY qCKNOWLEDGE THAT 1 HAVE READ THIS APPLICqTION ANO STATE THAT THE ABOVE IS CORRECT AND RGFEE TO COM- PLY WITH pLL QTY OqOINpNCES RND STATE LAWS NEGULATING BVILOING CONSTRVCTIO�.� SIGNATURE OF� PERMITTEE AUTHORIZED AGENT Dilce & Co grove� InC. i��`� E'�R�Ct1��fl �uJ // - � �9 APP�J��j171�� RMIT �� uii FOR OfF/CE USE ON[Y I flECEIPT NO, f� /-�� R_�� 9V I OATE�ECE�� _L DM i St/ 11l BUILDING ADDRESS COSTA MESA, FIRE .i ZONING NO. OF USE OF NEW /, PLANS � BUILDING ICENTEF IINE STJ � R�NIA — f--! T Iln THE AMOUNT BHOWN 11NDER VALUATION 19 FOR TME PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. VALUATION PERMIT FEE $ SO.00 PLAN CHECK $ 2Jr.Cfl g 30, 97� blf7 TOTAL FEE $ �T5•CO