The URL can be used to link to this page

Home My WebLink About923 HYDE CT - Building Permits(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 lob Address: 923 HYDE CT Suite No Vicinity: , .. Parcel Nunmber: 41808224 � PLUMBING PERMIT Status: ISSUED Applied: O6/15/2005 Issued: O6/1 00 ISSUED BY: �� Applicant: NOCK, CANDY-'. , i , Address: 1'1612 KN0T7 ST � �- - � � , •� - � SUITE_217 �., -. " �� -""P.hone�-p74}895-1246 : ., - %GARDEN GROVE CA �� `-.Zip. =92841 ._ � -�: � � � . � /�� '%" __ c:'" 7 � � � " ` � � �-" - - � _ . � �� . � " _� Owner: WASHING70N�,'PERCY LESHLIE � � , Address 923'HYDEC7;' , % �, j� Phone: , � ��. �:. . , _, .' .,;�:� , , �COSTA�,MESq,CA Zip:',92626 , •�; ., Jrt� : - ' �- _ �- . iV � �%,; - - �".° . ' � . , . � �-' �' . , . `, . Contractoc � NOCK PLUMBING� ;, � , , ' Address: ' 11612 KNOTf ST4:. � . � � -� � ' - . �. ' . � � - �SUITE 21T`�,. � , - � Phone: (714) 895-1246 '�` � ' - , �� - , ' GARDEN GROVE�,'CA Zip: 92841 � � ` „ . � � - -- Cicense:� 707775 � � � �' ; .--. - ;-j , . - � v - - • .:-: ,t �� . .. � . . , -' /'� i `-'� :� ' �: , ':.-�.__. ._ _ ", i_�_.�� lt�/_! . SCOPE OF PERMIT � . • � CHANGE OUT WATER HEATER; , , � - � _ . . . r�; . � . . , . _. ' � � FEE SUMMARY - � � ._ AMT QTY AMT QTY i` � �- AMT ISSUE FEE � $23.50 ` Laundry Tub / Washer . �$0.00 - - 0 Sump Pump , �� i � � $0.00 Backflow irrigation�., �•, $0.00 0 ! Landscape Irrigation � -`$0.00 � -0 � Swimming Pool %�': � � $0.00 Backfloda Preventer �� , .;$0.00 0 P-Trap :., ,� _ $0.00 0 Trap Primer� �' � �-' �- , $0.00 Bathtub � , A � >_$0:00 0 � Pressure Regulatoi ' - -- $OAO 0 Urinal �: �;' � � - $0.00 Clarifer System �' � $0.00�, 0� Process.Piping (per 10 ft) ��$0.00 � 0 Vacuum�Brkr�BkFlow(1-4p $0�.00 Connect Qce;Soda,etc)'�� $0 00��,� 0 Receptors�,� � - , � $0 00 -y,0 Vacuum'B�ki Bkflow(5+) _' $0.00 DentalUnits � � = $000��; .0 y + n-SepticTank , � ' �$000 �.'.0 z,�;5�„ Wash�Basin >, " �%�: $0.00 Dishwasher � � � \ $0.00 � � 0 � � - '"'-Se�ver Cap�for Demo . t. �� =$D.00 0 . � ,Wash Basin Set :; $0.00 Drain, Floor �� $0.00 � 0`��_ ,., ,SeweoConnect ��- $0.00 =0, "=Wa§te arid�Vent System; ,� $0.00 Drain,Rainwatei��`�� '$0.00�% 0 ` ��SeweiPrivate�Line` ` � $0.00� '0 " ��-WaterCloset(Toilet)�' $0.00 Drain, Roof � - $0.00 ,' -0 � ��Shower ' � � $0.00 0 Water Heater7 vent'� ; $12.30 g �� ,$0.00` �. 0 � �Smk;�ba� "'� _ - .$0.00 � 0 ', �� Watei�Piping Qnsl�or Rep.) $0.00 Drinkin Fountain Expansion Tank ��; � $0.00 � � ; 0 - � � , j Sink, commercial - - � - $0:00 - 0 � ` �, Water Re-pipe %. $0.00 Gas Earthquake Valve �`$0 OOi„ 0 / ��,-Sink Floor $0 00 -�. 0�� , '� Wate� Service' $0.00 Gas(1-4outlets) $0�00��0 1 • ' Sink-kitcheo,`� ��A(�_ �-$OOOG �0 �� Wate�-Softener $0.00 Gas (Over 4 outlels) $0 00 �. 0 ' ��'S�nk service/mop � i � . $0 00 '- b � � �OTHER' � $0.00 Gas Repipe $0.00 �'0 '' � _Spa (privale) � � :� `..�, � ,. t$0.00-" 0 , - '-`VIOLATION $0.00 GasService $0.00 0 � � Spa�(public) $0.00 ��0�_ �- '. "PLANCHECK $0.00 InterCeptors (Gfease, Oil) $0.00 0 �� . -, ,. . i�. ' �� _ � REINSPECTION $0.00 Interceptors (Sand Auto ) $0.00 0 � - � � - - - - � TOTAL CALCULATED FEES: §35.80 �N 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 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 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 ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, end all requlred Inspeetiona and final approVal must be obtained. Failure to obtain inspections and final approval will result in the axpiration of this permit. FOR INSPECTIONS CALL: (714) 75M5626 zaasae (aoo� WORKERS' COMPENSATION DECLAIiAT10N: ' I hereby efllrm un0er penalty ot perjury one ot the follOwing declaretions: ❑ I heve end will maintain e cenificete of consent b selFlnsure for workers' comDensatlon, es provided tor by section 3700 of the Lebar Code, for ihe peAortnence of Ihe wOrk tor whlch t�i9 pertnit is issuad. � I ve erW witl maintain workers' co nsation Insurance, es requiretl by secUon 3700 of ihe Lebor Code, tor the parFormance of the work for which Ihls permit is issuetl. s nsatlon In u `a car e e/ndj�°Ilcy number are: �j% Certier � �� ✓, � I� �/ � 1 PoliryNumber: ��he�_� (This sect�i n nee no let ' fh rmlt is alued et are huntlretl dollars ($100) or IessJ ❑ I certily that in Ihe peAortnance of the work for which this Dermit is Issued, I shall not employ eny person in any manner so es to become suDject to the workars' compensatlon laws ot Calttomia, antl egree thet it I shoultl bewme sub�ect ro tha workers' compenselion provisions oi ectlon 3700 of Ihe Lebor Cotle, I 5he0 forthw0h �,��e�p .. g �I—� � Applicant Slpnetur � - . Dete: \ WARNIN(3: FNL TO SECURE ORKERS' Q7MPENSIITION COVEMGE IS UNLAW FUL AND SHALL SUBJEGT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED THOUSrW D DOLLARE (5100,000), IN FDDfTION TO THE COST OF COIAPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3%O60F THE LABOR CODE, IMEREST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affrtn Ihat I em Iicery5 y r Wslo torce and eMect. Llc. # Contrectors Sicnatur �� . of Chapter 9(commencing with Sectian 7000) ot Divislon 3 of Ihe Businessp{��jofessions Cada, end my Ilcense is In full Class # < <� ,.� oa,a: r � "�g a-� CONSTRUCTION LENDING AGENCY: ❑ I hareby aHirm Ihat there is e conslruIXion lenaing agen�y tor Ihe peAortnance of the work for which Ihis permit is iuued. (Sec. 3097, Civil Code). Lendera Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eflirtn that under penalry of perjury ihat I em E%EMP7 FROM THE CON7RAC70RS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business entl Professlons Code: Any dry or counry w�icli requires a pertnit to construd, alter, Improve, demolish, or repeir eny sUucture, D�or to its issuance, also requires the epplicant tor such pertnit to tile e signetl stetement thet he or she is licensed pursuent to the provisions of the Contractars License Lew (Chapter 9(commencing wilh Sectlon 7000j of DlNsion 3 of Ne Businesa and Professions Code) or Ihat he or she Is ezempt Uerefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by eny applicant for a pertnit sublecte the epplicant lo e civil penalry ot not more than five hundred dollars ($500) J: ❑ I, es owner o1 the D�oPenY� or my employees with weges as Iheir sole compensation, WILL DO 7HE WORK, and ihe structure is not intentletl or oHered tor sale (Sec. 7044, Busineu flnd Professions Code: The Contraclors License Law does not apply to an owner of property who builtls or Improves thereon, entl who tloes such work himself or herself or ihrough his or her own employees, provided that such imprwements are not intentled or oHered for sale. If, however, the building or improvement Is sol0 within one year o1 completion, the owner-builder will have the burden of proving thet he or she did not build or improve for purpase of sele.). � ❑ I, as owner oi the praperty, am EJCCWSIVELV CON7RACTNG WRH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Professions Cotle: The conlreciors License Law Ooes not apply to an owner ol Droperty who builds or Improves Ihereon, end who contracts for such pro�ect with a contractor(s) license pursuent to Ihe Contractors LJcense Laws.). ❑ I em exempt under sec. SlpnaWre: Owner ID verified �y drivefs licensa. ❑ Ves � No BuSineu end Prol85sions Code tor Ihis reason: Verificetion ot Ownership by (rype of tlocument, I.e. - property tu blll or tleed): OIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATION: Oriver5 LJcense No. Date: Expires: ❑ I hereby certify ihat no exwvaiion five (5) or more feet in depth into which e person is requiretl to descen4 will be matle in connection with work euthonzed by this permit, an0 that no builtling siructura, scaflolding, felsework, or tlemolition or dismantling thereot, will he more than thirry-six (36)leet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title e, Celilomia Administrative Cotle). ❑ As owner-builder, I will not employ enyone to do work which would requira e pertnit trom the Division of Indusinal Setery, es noted ebove. unless such person hes e pertnit to do such work irom the tlivision. Signature: Date: Division af Industnal Sefery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUTXOR¢ATION OF ENTAY: I certity under penalry of perjury that I have read this eppliwtlon end stete that the intortnation given Is coned. 1 agree to comply with ell slate lews and ciry ordinences ralating ta building consWdion, and authonze represeNatives ot the Ciry of Costa Mesa to enter upon the above-tlescribed properry for inspection purposes. I egree not to occupy or ellow occupancy ot any building authonzed Dy this pertnit unlil finel inspection. COUE �. INSPECTIONTYPE PAff. IIIDOL{e4 1676 Fixed System Final Fire Preventlon 12fi8 Pool Spa Final 200 Final Re-Rooi 201 Final BIocWRetalning Well 202 203 Flnel Feclory Fire Place Final Slpn 204 Flnel DemoliUon Lf' /�� \ ) Date COOE I INSPECTION TYiE 206 Final Mechanical 20B Final Plumbing 210 Final Electricel 212 Final Fire Prevention 220 Final Planning Approvel 222 Flnel Site 250 FIneI BulldlnyOccupaney PAIE It�fl r • �Ti ��L�� : . (714) 754-5273 • Fyx (714) 754-4856 • www.ci.costa-mesa.c��ILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Jab AddreSs: 923 HYDE CT Suite: Vicinity: 2ND STORY BEDROOM Parcel Number: 41808224 Zoning: npp�icant: WASHINGTON, PERCY LESHLIE Address: 923 HYDE CT . � , � ��'� -� . Phone: 714-545-9756 COSTAMESA,�CA- Zip: 92626 Own�r: WASHINGTON, PERCY LESHLIE Address 923 HYDE CT � � - � � Phone: COSTA MESA; CA �- -` Zip: 92626 Contractor. OWNER;BUILDER Address: ' , � Phone: Zlp: Arch : Address: Phone: License: 000000 � Eng: � Address: ISSUED BY: � StaWs: ISSUED Applied: 10/Ot/2003 Issued: 10/01/2003 Phone: Zip: License: License: SCOPE OF PERMIT EXPANSION OF 117 SF TO AN EXISTING BEDROOM BY ENCLOSING THE BALCONY IN A SFD. FEE SUMMARY Plan Check: $126.91 . � Calc Valuation: S�o,s�o.eo Permit: $195.25 - - - Claim Valuation: go.00 SMIP Res: $1.08 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $323.24 SETBACK$ MAINSTRUC7URE Fronl 0-0 ftear 0-0 ACCESSORY Front 0-0 Rear 0-0 PARKING Existin : 0 Re uired: 0 NOTES: PLANNING & ZONING Left 0- 0 Right 0- 0 Left 0- 0 � Right " 0- 0 Pro osed: 0 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 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 qays, INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl an requlred inspectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 ?d66-46�6�00) WORKERS' COMP,ENSATON DECLARAnON: — ' �� I hereby t}'rfirm unde� penalry of perjury one oi t�e tollowing declarations: - , ' ❑ I �ave entl will meintain a certificate of consent to selFlnsure tor workers' compensation, as provitled tor by section 3700 of the Lebor Cotle, for Ihe peAortnance of t�e work tor which this permit is issued. � [•� I have antl will maintain workers' wmpensatlon insurance, as requiretl by section 3700 of ihe Labor Code, for ihe peAortnance of Ihe work for which this pertnit is issuetl. My workers' compensation Insurance carder antl policy numbar are: Cartier. ,� . �, Pdicy Number: (This secnon need not be cromp/eted ii fhe pe�mit /s valuetl e( one hundred dollars ($100) or less.) ❑ I certity that in Ihe pedormanrr.^t t�e work for whic his pertnit is issue4 I shell not employ ang person in any manner so as to become s �bject to the workers' compensation laws comDlY with Nesa F WARMNG?.F7iILURE TIiOGSPND DOLLAi and agree that i should become sublect to Ihe workers' compensation provisions ot Section 37 0 01 t �Labor Cotle, I shall lorthwlih . , Dale:= � � NSATION CAVERAGE IS UNLAWFUL PND SHALL SUBIECT AN EMPLOYER TO CflIMI E ES AND GVIL FlNES UP TOONE HUNDRED N! OTHECOSTOFCOMPENSAilON,OAMAGESASPROVIDEDFOHINSECilON3l060FTHE FCOOE,IMEREST,ANOATTORNEYSFEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm�that 1 em licensetl under provisions of Chepter 9(commencing with Section 7000) oi Division 3 of ihe Business and ProFessions Code, and my license is in full force antl aflect Lic. a qass k Contractors Signeture: Date: CONSTRUC710N LENDING AGENCV: ❑ I hereby aRirm that there is a conswction lending agency for Ihe pertormance of Ihe work For which ihis permii is issued. (Sec. 3097, Civil Code). Lendefs Name: Lentlefs Atltlress: SignaNre: Date: OWNER-BUILDER DECLARATIONS: I hereby effirtn ihat untler penalry of perjury Ihet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business entl Professions Code: Any ciry or counry which requires e pertnit fo consirucL alter, impmve, demolish, or repair any strucWre, pnor to its iuuance, also requires ihe applicant tor such permit to tlle a signetl statemem that he or she is licensed pursuant to t�e provisions of the Contractors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of the Business end Professlons Cotle) or that he or sha is eaempt Iherefrom end the besis for ihe alleqed ezemption. Any violatlon oi Sectlon 7031.5 by eny applicant tor e permit sublects Ihe epplicant lo e civil penalry ot not more than five hundrad tlollars ($500).): ❑ I, as owner of Ihe property, or my employees with wages es their sole compensation, WILL DO THE WORK, antl t�e structure is not intentleG or oflered for sale (Sec. 7044, Business flntl Professions Cotle: The Contractors License Law does not apply to an owner of propeM who builds or improves thereon, end who does such work himsetl or herself or t�rough his or her own employees, provided ihat such imprwements ere not intendetl or oNered tor sale. If, �owever, ihe building or Improvement is sold within one year of completion, the owner-builder will have lhe burden ot proving that ha or s�e ditl not builtl or improve for purpose oi sale.}. � �a owner oi the property, am EXCLUSIVELV CONTRACTING WITH LICENSEO CONTRACTORS to consiruct ihe pwjecl (Sec. 7044, Business antl Professions Cotle: The comrectors License Law tloes not appty to en owner ol propeny who 6uilds or impmves thereon, antl who comracts for suc� pro�ect wii� e coniraaor(s) license pursuanyy the Comracto�License Laws.). � ❑ lam Business and Professions Code tor �his reason: �`aYa. Owner ID�n1kd by drf'vCP�Rl4nse. Vedfiwtion af Ownership by (type at ❑ No � properry Wx bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certity thet no excavation fiva (5) or more feet in tlepih into which a person is required to descend, will be made in connaction with work authonzea by �his permit, and �hat no bulltling sirucWre, scaNWtling, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle B, Celitomia Administretive Cotle). ❑ As owner-builder, I will not employ anyone lo do work which woula require e permil irom the Division of Indusirial Sefery, as noted ebave, unless suc� person hes e pertnit to do such work trom tha tlivisian. SignaWre: Date: Division ot Intlustnal Sefety Permit Number: CERTIFlCATE OF C P�CE AND AUiHOHIZA710N OF ENTRY: I certify under penalty ot perjury Ihat I have reatl this application end stata that the infortnation given is wrrect I agree m wtth ell state law d dry ordinances relating to building consiruc�ion, antl aNhonze representatives of the Ciry of Cwta Mesa to emer upon the above-descd tl pro rty for inspection p oses. I egree not to occupy or allow wcupency ot any building authonzed by this pertnit� until �ti +ms tion. �_ �,��zn/ i�/ _03 re�Oblegal.0 ner(s) ' -�-_ `ate t / -_ _ And�Or Authorizetl Applicam Date COUE �. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWReiaining Wall 202 Finel Factory Fire Place 203 Finel Sign 204 Final Demolition • • Q�g . .INTI71p15 +• � �QQ�j INSPECTIOHTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy � Itf�L5 �� a� �?odta. 7?2eQa �'uit'd�y DiuiQi�+� OWNER-BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach t� such notice, and, as a condition prccedent [o issuing a building permit, requirc the compleNon and require the retum of, an owner-builder venfication. Attention Property Owner: An 'owner-builder' building permit has been applied for in your name and bearing your signa[ure. Please complete and retum this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permi[. No buildine oermit will be issued until this verifica[ion is received. l. I personally plan to provide the m or labor and materials for conswction o( the proposed property improvemenL Yes �Io 2. 1(have/have noq signed an application for a building permi[ for the proposed work. 3. 1 have contracted with the following person (tirm) to provide the proposed conswction: Name J CJ t1- !V 1� 1't'L. L Address � % % 3 �%v��/�� L City � i Phone (�- ��iY � Contractor's Lic. No. 4. 1 plan to provide portions of the work, but 1 have hired the following person to coordinate, supervise and provide the major work: Name Address � %.7 � City � Phone �� S 5�� r- Irid Convac[or's Lic. No. 5. I will provide some of the work but 1 i�uve contracted (hired) the Collowing persons [o provide the work indicated: Name Address Phone Type of Work �i� n� � .1��'a.r,,� asa !�$p-�,.sz 100206 (FEV.9/99) I hereby affirm that I have received a copy of the information set forth in Section 19830 of the S[a[e of Califomia Health and Safety Code and have comple[ed [he above informa[ion to the bes[ of my personal knowledge, in compliance with this State law. C.D.L. # OR S.S. # Date: (1 / 4 For more information call City ot Costa Mesa Building Division at (714) 754-5273. 1 1062J6 (RkV. &88) (714) 754-5273 • Fax (714) 754-4056 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: 923 HYDE CT 2ND FLOOR BEDROOM Parcel Nunmber: 41808224 Applicant: Atldress: WASHINGTON, PERCY LESHLIE 923 HYDE CT COSTA MESA,�CA , Phone: 714-545-9756 Zip: 92626 Owner: WASHINGTON, PERCY LESHLIE .- , _ - Address � 923 HYDE CT � � - - � COSTA MESA, CA Contractor: O W N ER-B U I LD ER Atldress: 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 Nan 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 100hp Communication drops Phone: Zip: 92626 �Phone: Zip; . . License: 000000 ISSUED BY: Status: ISSUED Applied: 10/Ot/2003 Issued: 10/Ot/2003 � SCOPE OF PERMIT ELECTRICAL PERMIT IN�CONJUNCTION WITH 117 SF EXPANSION TO�AN EXISTING BEDROOM BY ENCLOSING THE BALCONY IN A SFD. � � - � - - 4 RECEPT OUTLETS . . REF: 603-01664 $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $4.40 30.00 $0.00 $o.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY Temp Dist System / Lighting Busway /100 k �' - Standing Section �� ' `• Misc Electrical Equipment � � Transformers up to t kva/kw ..........._...up l0'10. kva/kw .................up to 50 kva/kw . .................up to 100 kva/kw .. .........:�........oven100 kva/kw � Low Vollage Equipment , Low Volt Wiring System / Ckt Misc. Conduit � Misa Conductor Circus ( gen or nde) Circus (mech ride or lights) , Christmas Tree Stand Fireworks Sland Other ElecMcal Fee Inves6gation 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 So.00 NOTICE: Tha 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 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 7 BO days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inspectlona end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2aa6-as lerool WORKERS' COMPENSATION DECLARATION: � � �' . I hereby aflirm untler panalry ot perjury one of the following declarations: � . ❑;� I�heve end will meintain e cenificare of wnsent to sel4lnsure for workers' compensation, as provided tor by section 3700 ot ihe Labor Cotle, for the performence ot the � work fo(w�ith lhis pertnit is issued. � � " ❑ I have and will mantain workers' compensatlon insurance, es required by seciion 3700 0l the Labor Code, for the peAortnance oi the work for which this pertnit is issued. My workers' compensation Insurance carder and policy num6er are: Carrier. Policy Number: (This section neetl no( be comp/efed i/ the permit !s valued et ane huntlretl dollars ($100J or less.) �, cerUty Ihet in ihe peAormance oi the work for which this pertnit is issued, I shall not employ any person in'any manner so as to bec ie subject to the workers' wmpensation laws oi California, and egree ihat it I shoultl hecome suD�ect to Ihe workere' compensation provisions ot Sectio 370 oi Ihe Labor Code, I shell forthwith wmply with these pr hs,io�ns. 'l, D AppIIcant Slgnalure'\ �C/G�-!�/ �� !�%�l�� `Date:'ti W�INOTFAILURE TO SECURE WORKER COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT PN EMPLOYERTO CRINJ AL � ALTIES AND QVIL FINES UP TOONE HUNDRED TVqUSAND DOLLARE (5100.OW). IN ADDITION TO THE COST OF COMPENSATION, DAhUGESIS PROVIDED F-0R IN SECfION 3/060F TNE IABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED COMRACTORS DECLARATION: I heraby aHirm that I am licensetl untler provisions of Chapter 9(commencing wilh Section 7000) of Division 3 of the Business and Professions Code, flnd my license is in full (orce anC ettect. tic. a CI255 k Comractors Signature: Dete: CONSTRUCTION LENDING AGENCV: ❑ I hereby eMirtn thal there is a consWction lending egency for the pedormance of ihe work tor which this permit is issued. (Sec. 3097, Civil CotleJ. Lende(5 Name: Lendefs Atldress: Signacure: Date: OWNER•BUILDER DECLARATIONS: I hereby aHirm Ihat under penalry oi Derjury thai I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business entl Profeulons Code: Any ciry or counry which requires a permit to construct, alter, improve, tlemolish, or repair any sirucNre, prior to its issuance, also requires the epplicant tor such permit to tile e 5iqneC stetement that he or she is licensed pursuant to the provisions ot the Contrectors License Law (Chapter 9(commencing with Section 7000) of Division 3 ot t�e Business and Prolessions Code) or thet he or she is ezampt theretram and the basis for the alleged exempiion. Any violetion ot Section 7031.5 by any epplicant for e pertnit subjects the eppliwnt to e civil penalry of not more than five hundred dollars ($500).): ❑ I, es owner ot Ihe property, or my employees with wages as iheir sole compenution, WILL DO THE WORK, and ihe structure is not intanded or otteretl for sele (Sec. 7044, Business and Professions Cotle: Ttie Contractors License Lew does not apply to an owner of property who builds or improves thereon, and w�o does such work himsetl or herself or Ihrough his or her own employees, provided that such improvemenis are not in[ended or oHered lor sale. If, however, the builtling or Improvement is soltl within one year ol completion, the owner-builder will heve t�e burden of proving ihat he or she did not build or improve for purpose ot sale.). � �owner of the property, am E%CLUSIVELY COMRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business antl Professions �� Code: The contrectors License Law tloes not aDPN �o an owner of property who �uiltls or improves ihereon, antl who contrects tor such project wtlh a contrecror(s) license pursuant fo the Conirectors Licensa Laws.). t� Owner ID verM�Cby tlrjy�rp'IiL`ense Vedficetlon of Ownars�ip by (type of and Pwfessions Code br this reason: s ��No DtNefstiCense'No�, i.e. - properry lan blll or deetl): DIVISION OF INUUS7RIAL SAFETV PERMITCERTIFICATION: ❑ I hereby cerlity that no excavation five (5) or more feet in depih into which e person is requiretl to descen4 wiil be made in connection wlih work authorizetl by ihis permit, and that no building structure, scaffolding, falsework, or demolition or tlismantling ihereof, will be more than ihirty-six (36) fcet high. (Ghap. 32, Grp 2, Art 2, Sec. 341, Tltle B, Califomia Adminisirative Code). � As ownerbuilder, I will not employ anyone to do work which would require a pertnit from the Division ol Intlustrial Sefery, as notetl above, unleu such person has e permit to tlo such work from ihe division. Signawre: Date: Division of Industnel Safery Pertnit Numbec CERTIFlCATE OF MPLJANCE AND AUTHORVATION OF ENTFiY: I certify under penalry of Derjury ihat I have read ihis application antl state that the information given is correct. I eg� o mply with all state s end ciry ordinances relacing to building construction, end authorize representatives of t�e Ciry oi Coste Me to enter upon Ihe ebove-de Cibe roperty tor inspecti purposes. I gree not to occ py or allow occupancy of eny building authorized by this permit until finel ins �tion /� d3 naWreOt�L f wne s)—�' Di te^ � 4_�� And/OrAuthorized Applicant Date COOE 1. INSYECiIONTYPE 1618 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 203 Finel Fectory Fire Place Finel Sign 204 Final Demolilion PdIE I�IALS CODEI INSPECTIONTYPE � 20fi Final Mechanicel , 20B Final Plumbing ' 210 Finel Eledrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuiltlinryOccupancy �. �. .�m � � �% PNOJECT AUOflE55: q z j HYD E Ci� � UNIT: owxEasxame: IdASHINGTON, PERCY LESHLIE aoonEss: WASEIINGTON, WANDA M 923 HYL�E CT COSTA MESA,CA 92626 ANCHIENGINEEB: �iG7 /�/EGC_�Oo�` pEG.NO.: aooness: ,3.3�° %�E�a ('^`J . C%� -�3�'— 12gg PERMITTEE: ar �•+n„ R(1flFTNG COMPANY ( 714 ) 8Sv-o 0 aooeess � � � � � � �.. HIINTTNf:Tnnt_pFACA CA 92644 LICENSEO CONTNACTOB OECUINFTION: I �ereby aHirm ��a� I am licensetl untler provisions ot Chapter 9(cammencing wilh Sec�ion 7000� ol Divlsion 3 ol Ihe Business antl Pro�essions Cotle. antl my license is in full �arce ana e��eci. CITY LIC.. n r . J. . c -. �,- � _ n.-..., . n S 9 5 ' oate 7�� G� Signawre _ _ WOflNEflS' COMP NSATION OECL�1flFTI0N: I herehy aifirm �hat certihcale oI consen� Io 5e14in5ure o� a ceM1ilica�e o� WOBerS' Compensaiion Insurance, or a ceni�ietl copY thereoi (Semion 3800. Lab. C). POUCY NO.: 1 2 U U.i J S E%P. OpTE: �7 %� O S I 9 S comraxr: STATE FCTND � CetlifieA coOY is hereby Wmished. QQ Ceriitie� coDY is filetl wit qet7 ilding Oivision. Date: ApplicanC % O E%EMPTIONfPOMWO (Efl5'COMPENSIITIONOECIABRTION: (Th neetlno�becomplete0ifthepertniiisforonehuntlretl(S1W)orlew�. I ceriity �ha� in ��e pedormance of �he work tor whic� this permit is i55ue0, I s�all nol employ any person in any manner so as to become sublecl to Ihe Workers' Compensation Laws ol Califomia. Dale: SignaWre: NOTICE: If, atler making Ihis Jeclara�ion, you shaultl become sublec� to the Workers' Compensation provisions o� �he La6o! CoOe. you must lotlhwith compty wilh such provisions or �his permit shall be Oeemed revoked. CONSTflI1CTI0N LENOING BGENCY: I herehy a�firm Ihal Ihere is a tonstrutfi0n lentling agenty tor �he pedormance o� lhe work �or which ihis Oermii is issuetl (Seciian 3097. Civ. C). LENOEP: FODRESS: OWNEfl BOILUEfl DECLNBRTION: I �ere�y aflirm thai I am erem0� �rom �he Coniracmrs' Slaie License Law fo� Ihe fallowing reason (Seclion 703L5 Busin¢ss and Pm�¢ssional COde: Nny tily o� tounty which require5 a pefmit �o tonstmct, alt¢r, impmve, demolish, Or repair any simcture, prior lo its issuance. also requires the applicant for sucn permit to tile a siBned statemenl tnat he/she is licensed pursuanuo Ihe provlsions o� �he Comracmrs' Sia�e License Law (Chap�er 9(commencing wi�h Sec�ion 7000) o� Oivision 3 0� Ihe Business ane Pwfessians Cotle) or ihat he/she is e�empt therelrom antl ihe basis for Ihe allegetl exemption. Any violation of Section 7031.5 6y any applicani tor a permi� SuDle�tS �he applicant to a civil penalry of no� more �han five hunEretl tlollars (5500). I, as owner ol �he pmDetly ar my employee5 wi�h wages as thelr sole compensa�ion, will Oo Ihe woM1, antl [he ❑ s�mmure is no� inten0etl or o�feretl for sale (Section 704a. Business antl Pmlessional Cotle: The Comrac�ors' S�ate License Law Ooes noi apply �o an awner oi a pmperty w�o builds or impmves t�ereon, antl w�o tloes such work himself/Aerseli or �hrouBh his or her own employees. pmvitletl that such impmvements are no� in�ended or ofleretl �or sale. II, however ��e GuilCing or impmvemen� is so10 wiihin one year o� complelion. I�e owner wili have Ihe burden of pmving Ae/she tlitl no� builtl or imD�ove lor the purpose of sale�. I, as owner o� the pmperty. am exclusively contrac�ing wit� licensed contractors lo cons�mct Ihe pmlecl (Sec�ion 7044, Business ❑ and Pmfessions Cotle: ihe Cantracmrs' S�ale License Law tloes no� appty to an owner of Ompeny w�o hwltls or impmves thereon and who conirads for such pmjecls wi�h a con[ractoqs) license pur5uani Io �he Conlraclo�s' S�ate License Law). I am aware Ihai O�ool ol I�eir Worker's Compensa�ian insurance shoultl �e O�ovitletl �o me. � I am e�empi under Section: 8. 8 P. C. lor Ihis reason: Dale. Ownec I tlo hefeby c¢tli�y Illal I dm dwafe o� dn0 untl¢fSidnd IhP f¢quir¢m¢pt5 0� Cdli�Ofnia Nealth and $d�¢Iy COQ¢ $¢C�i0n5 25505, 25533, dnd 25534 antl Ihat I or any future �uilding occupant willlwill no� (circle one) neetl �o comply with saitl sta�e codes and Ihe requirements lar a permA for cons�mclion or mo�ilicalion imm �he Air �uali�y Management �isirict. FeSidential constmc�ion applications are exempi hom Ihese pmvisions. �ale: Applicanf I hereby cer0ly Ihat I have reaA Ihis apPlicalion and state Ihatihe ahoveintorma�ion is correcL I agree to comply wit� allciry and coun�y ordinances and s�aie laws rela�ing to �uil0ing conslmclion and hereby aulhor¢e represen��yves oi �his ci�y �o enter uDon ��e a�ove-meniioned p�opetly fori pection urposes. �/ p Oate: � Signalure: eL��/"��.�:��" 4� �river'S License or Sacial Seamy M: �^—�� . �6Gt�46 W�ule—Bmlaing; Green—Cotle Enlorcement; Canary—ApplicanC Pink—Revenue; Goltlenrotl—Assessor C2TY OF COSTA MES'A - HUILDING PERMIT PERM NO: B 068041 PERMIT NO: B 068091 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION : REROOF/T-O RESHEATH E REROOF W/COMP. SQ FT: 1,100 CLAIM VALUE: 1,100.00 CALC-VALUE; 1,100.00 GROUP OCC: R-3 /M-1 COMMENTS: ** �r*��c*��r.-**�r��c*�c*�r#*************�c-*�x��cx�***�**�**�c**,r***�r*��#**+r****��rf�r�t*�r**�r��c**�+c Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARICING REQ: PROV; PARCEL: 41808224 ZNE: REF NO: PLANNING NGTE5> ._.. +�it#it*+�at�e�*x�*x�;Lt��:+��r*+tit��r�r�r*+t��r�ritx�**�**�*iriFft�t*x�r�*��t+�**+�*ic**��+r�r+f*�rjE�it�**+rer�;it D E V E,L O P M E N T S E R V I C E S R E Q U I R E M E N�"I' S ZONING APPROVED BY DATE: � HUILDING APPROVED BY : DATE; APPLICATION ISSiJED BY; / � DATE: � ' � ^ 3FiEiEihiFii�iF�K��h3FiEiFKM�1E#*ifiFiEiEiEi:iFit�lt�FitlFlt�ltiE1F��.%hi.�ititi�iF1`ieitihiti(-itirieiF�tit�iFititit�lfikiElF'IF1EiEfEiFiE�F�.ciFM�• it�itil�aE iE 3E it iE iE i(� i4 �k-�)F 3: N• iE iP T� iE iM1 # iE 3F iF iF i4 iE iE # fi- )E 3E iE iE iF if� if If IE iF 9E # iE iE �k N- iE iE fF iE iF ih iE it iE iE iF i4 i! # iE aE iF aE if� iF iF �1(� if iF if� iF i! iF iF ib iE iE �7f if iE # it LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGAM1E�IT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE 3MIP/RES GRALIING PERMIT 27,00 50 PLAN ISSUE FEE BUILDING-DIV-> TOTALS----> PERMIT ISSUE PLAN-CHECK 27.50 0.00 0.00 REL�ENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 2�,�� SMIP/NON-RES TOTAL PAID D[JE 27.SQ 27,50 ,00 27.50 OVER/SHORT: .00 FIRE SMIP/TOT GRADING PLAN-CHECK .50 9E iE �1:� iE �E #� �E �F iF iF 1E iE iE 1E iklblF if * if �f �t ik if iF iF iE jE if if 9f 1f iE 1E iFlE i( iE ii� 3E ik iE dt 1E 9f iE ft fE iE i: -lE iE iE iE iE iF ik 1E i(- tE 9F iElE 3E iE 3F 1f #° i! if 1E iF i.' if sElf 9F 1E iE Z N D I V I D U A L F E E H R E A K D O W D1 TYPE QTY L� E S C R I P T I O N UNIT COST TOTAL COST SFR 1100 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 1,100.00 END C�F FEES 01 00263965-Q0163966 TD T Z],5� DATE: 07/13/94 TIME: I3:02 CONSTRUCTION AND PLANNING POOL cv SPA APPROVALS Permit # Date Inspector APpROVALS Permit # Date I�spector , i . 1. Temporary Electrical Service o+ Pole � 52. Pool & Equ�pmenc LocaUon . 2. Soil Pipe�Undrgmd. � �. �.. 53. Steel Retnforcement ' 3. Elecvical Conduit Uti�ity-Undrgrnd. ��:� 54. Porms 4. Electricai Conduit-Undrgrnd. � 55. Etectrical Bondir.g 5. Steel Reinforcemenc 56. Rough Plumbing & Pressure Tzst � 6. Electrital UFER Grnd. 57. APPROVAL TO COVER�GUNITE � 7. Footings �58. Electrical Conduii-Undrgrnd. , � 8. Foundation , 59. Gas Pipe, O U�drgmd., Tesc ��, i ,, 9. Wa:er Pipe•Undrgrnd, i ! 60. Backwash Lines, P-Trap, Cl Undrgmd. '•'��' / 7Q. Svuctural Floor SYstem � f ',)� 61. APPROVALTO DECK ��• i t. Property Sewer Line & HousE Connection ,'� 62. Backw.ash & Receptor�Final . - 12. Sewer CaP �-- "�� 63. Heater & Vent-Final 13. Roof Dra�ns 64. Plumbiny System � Final 14. Rough Plumbing 65. Electrical-Pinal -' I 75. Rough Electrica6Conduit 66. Solar SVstem-Final ' . i 76. Rough Electric Wiring 67.-Fenciny & Access Approvai � 17. Rough Wirinq Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical�T Bar Celling 69. POOUSPA SYSiEPAS FINAL 19. Rough Heating & Air Conditioning PIRE DEPT, REQUIREMENT 20. Rou9h Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, V¢ntilating 77. Product Piping �Gas OOiI 23. Gas Pipe•Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas CiOil 25. Roof Sheathing 7��U �'� J4. Overhead Hydro � C 26. T�Bar Ceiling jStructural) & Monocozt 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEh1 FINAL 29. Insulation 78. FIRE PREV. FINA� 30. Dry�vall Nailing HEALTH DEPT. REQUIREN7ENT 37. Plaster Brown Coat 79. FINAL INSPECTION � 32. Elzctrical Power Meter-Finai 80. FOOD CERTIFICATE ISSUED 33. Final Electric '. Notes: 34. Final Heating & Air Conditioning � � 35. Finai Gas P�Pe-Test � 36. Hood or Canopy �, 37. Finai Factory Fireplace 38. Final Plumbing 39. Water Service�Final 40. Gas Service-Final 47. Solar pomestic-Final . 42. Backflow P�eventer �� 43. Backflow Irrigation 44. Landscape IrriAation System 45. Sound Aitenuation 46. Handicap Regulations ' 47. PINAL STRUCTURE & BUILDING �,.qG� 4a�,[ a8. FINAL PLANNING 49. Electric Release to Edison . 50. Gas Re4ease to Southern Califomia Gas Cn 51. CERTIFICATE OF OCCUPANCY No. Dace �ncT :,e. 10445 �,�1•� August 6, 1980 t.a: �o. 24 ' nDDREss 923 Hyde Court, Costa Mesa, Califronia 92626 Development Services Depn:t::�en[ Planninz; Division City of Costa ?;esa J7 Fair Drive Costa ?1esa, CA 92626 nece�eioz,: xr. raut Dudley Dcar �;r. Dudlcy: Please be aware that the undersigned are aware that a certificate of occupancy on the above refcrenced lot and unit is bcing requested prior to the entire tract and its streets .�nd coranon areas Ueing completed and accepted by the City of Costa Plesa. B Y /� � � il��s ��J T . OF PURC}tA • . BY (CyGt�� URIi OF DEVELOPI�R A1ll OR R"UTHOR3'LED REPF�fiSEivTAT?VP.) sY_ f� � — CITY�� OS A M�A �T "SZG�?,TUF.E OF Lea�f:r.) ntl►ELOPM[NT SERVICES DEPARTME(� AUG u �J IJ�� AM i��L' S�nr�"'•iii ��1I;.i�li IL �