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Home My WebLink About1103 MESA BLUFF DR - Building PermitsrrA ADDRESS OF BUILDING: 1103 MESA BLUFF DR UNIT: OWNERS NAME IF fO""' EGAN, THOMAS ROBERT AOORE55: 1103 MESA BLUFFS DR COSTA MESA,CA 92627 642-2841 APDL."ILING ADDRESS,- ARCHITECT DDRESS:ARCHITECT OR ENGINEER; UC. NO.: ARCN OR ENG.'S ADDRESS: UNIT: wNfnAcrays NAME: NOCK PLUMBING (714)895-1246 caNrnAcroRS MMIDfc 11.612 KNOTT ST ADDRESS: GARDEN GROVE CA LICND: 707775 92841 UNIT. 17 LICENSED CONTRACTORS DECLARATION: I hereby agxm under penally of perjury [het I am licenaed under pransions of Chapter 9 (commenomg with Section 7000) d Division 3 of the Business and professions Code, and my liens is in lull force and eHea. ""u""': 05 3 LIC -CLASS: C-36 LIC.NO.: � EXP: 02/98 Dere. C Co /vih\' "N ER BUILDER ECLARATION: hereby affirm under penalty of perjury that l am exempt from IM Comrades License Law f« the v^9 reason 15edion 7031.5 Business end Professions Code: Any City or county which recuires a permit to oonstmci. eller. improve. Nish, or repair any struclure, par to its issuance, also requires the applicant for such permit to file a signed steament that he or she .tensed pursuant to the provisions of the Contraol License law [Chapter 9 (commenam, with Section 7000) of Division 3 of the 3.enem end professions Cade[ or her he or she it exempt iherehom end the beans 1« the Alleged exemption. Any violation of Section 7031.5 by anry applicant f« a permit sobpde the applicant to a evil penalty of rhe more then Me hundred dollen IMN0[). ❑ 1, as owner of the propany« my employees wdh wages es their sole oompensegion, will do IM work. and the abucture is not intended or offered for sale (&scion 7044. Butner and Professions Cade: The Contractors License Lew does int apply to an ovmeral propedy wW build, or mproves thereon, and who does such work hmseR or herself or through his or Mr own employees, provided that such impnoyemer., are not intended or offered 1« Bale. If, haweser, the Wilding «inl,overneM is sold within ore year of completion. IM osmer4ailder will nave the burcem of preying M or she did nal Wild or impress f« the purpose of sale). ❑ 1, as owner of the propend. am exclusively contradling with licensed contrsolore to construct the project (Section 7044. Business and Protestant Code: The Corn s. Lcaress Lew does not apply to an ossein of «openy wW builds or imp�u thereon and who contact, for soot, "core with a contref«(s) licensed punuam to IM Conirec«s License Law). ❑ I am exempt under Section: B. A P.C., for this reason: Del.: Owser: 1 do hereby amity that Iam aware of erd nd mde elathe require pmts of Call.mie health and Safety Coda Sections 2553 25W5, 3, end 25534, and that I or my More Wilding occuPanl will / will red (dmls ore) need to comply with said sale odds, and the meuiremena for Dee: Applicant: WORKER'S COMPENSATION DECLARATION: I hereby affirm under tensity of perjury oro of the following declensions: ❑ I have and wD mailman a condi e d coneeat to sell-insom ldm w«k.n' canpanaetien, m lr W lor by Sectile, 3M d tha Labor Coda, for the performance of the sork for wNch this Permit is issued. jj I hat and will maintain wwken' mmpanwion ireunnaa ea rot uhad by Section 3700 d the Labor Code, ler the ped«mura of IM T� work 1« whits thio permit o issued. MY wvkare mmpenution imuraae urrbr and policy number ere: Canner: GOTMEN FArLF EXPIRES Polley Number: NWC 17114101 - 09/01/97 (Thin section need not les mmpleref d Ue Farm, o ler «a hundred ddlem (SIWI or Jose.) ❑ 1 candy Met In de perfomance of the work ler which this permit is issued, I shall not employ any, Person In try manner so as to become sublet tot worker' compenserkn lase d California, and almost that R I should become subject to the worlmn' compensation mania' era d S ion 3700 d the Labor Code, I Melt Irthwn ply w�(Ime pro seiose Dale: APpira,l: \ \ O Warning: Failure to s.. .*.a' c enNtlon Coymega /s uniawN( and shall a n employer to cd rW pens pend cal haw rpt is era hundred thauartl dd/an (S109000X M addtitan is Me cost of nmpsrrsaWry damages N P'ovidsd Jaffe Swdw 3105 at fits labor Cods, Infant and sta msy's fears. CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there o a construction lending agency far the performance of the work for which this permit Is eaumd (Seann 3097. CN. C). LENDER'S NAME: LENDER'S ADDRESS: I candy the I have read this apphomon and des that the above information is carted. I agree to comply with erg city and county ordinances and state laws relaI g to Wild" construction end hereby auth r, relv.senatbea of this dly to enter upon Me above-n,renr,ad Prop" for inspedinn purposes. ON NOCK -t Date' Signature of Owner/AgentIAMlicenl/Contredor (5151da.WP) Whea-Buildkp A Sdery: Green -Rte: Canary-Appkcem: Pink -Revenue: Goldenrod-Asse,e« CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 063010 PERMIT NO: P 083010 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLO PURPOSE: OTH JOB DESCRIPTION DISHWASHER CHANGE OUT SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 / COMMENTS: NO OTHER WORK ASSOCIATED WITH THIS PERMIT BERtiE***BE FE SE BE�tBEStBE�E*SE*B(��rSr SE*Sr*SE*SES*BE�E�iEBr BE BE*Bt BE*BrBE+�SEx�EBE**+tiE�E�EBESE�*�Ex*BtBEBt*Bt*SE SEBE�StBE�Sr*BE )r Z O N I N G S E T B A C K S R E Q U I R E M E N T 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 PARKING RE PROV: PARCEL; 93592003 ZNE; REF NO: PLANNING N TES> > dE ♦E dE dE 16 * BF BF dE 16 dE d6 iE 1F iE * iE k k 1E dE 1E dE 1E BE dE iF 1f 1F 1F d6 irk ♦E iE 1E iE 16 iE 1F iE dE dE dE dE BE RE dE d6 Bt i6 RE Rb RF iF 1F irk dF iF iE 1F iE BF 1F iE * iE dE 1E BE d6 iE BE BE * it d6 dE * 1E 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 T S ZONING APPROVED BY BUILDING APPROVED BY : DATE: DATE: APPLICATION ISSUED BY: DATE: 861E 1E 1E 1E 16 dE BF BF 16 dE 1F 161E 1F 1E iE♦E 1F iF iE kill;f�iFiF')'F7FiF�iF�F7f'3F�iFiF�iFiF iE 11 il1E 1E 1E'N'dE iE iE 3E 4E LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 8.75 258 SMIP/NON—RES PLAN ISSUE FEE 22,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 8.75 22.00 0,00 30,75 30.75 .00 REVENUE DIVISION TOTALS--> COLLECTED: 30.75 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 30,75 * if 1E 1E 1E 1E iE 1E 1E k iE 1E * 1E 1f 1E if 1E R61F 1E 161E 16 BE 1E * iE 1f * 1E iE 1E * 1E iE 1E 1E 1E 1E RE 1E 1E dE 1E 1f 1E 16 k 1F BE BF dE 1E dF 1E 1E 1E 1E BE 1f ♦f 1E 1F B61E iE iF 1E 1E 1E 1E 1E 1E 1E 161E 1E 16 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T 1 0 N UNIT COST PLO - i DISHWASHER 8.75 END OF FEES ?'EXPIRED !V Sig 1� TOTAL COST 8.75 06-29-1997/10:02 A,1/538.75 PERMITF:T083018 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTAMESAtC/ONLSTRIJCTIO PERMIT P # Project Address /�D`-,' NY �i./�,(��ur-%n Dr. Applicant's Mailing Address. s(fine_ Owner's Name T�M� � • E&4yv Phone Address Sgsrre Arch/Eng, e# L r 1907 erl~-e License No. CO /(v 3Z% Address mx l4Z CorronA Oel /tori C,4 92G z3 Contractor's Name Phone Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) -of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No. Date Signature WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self -Insure or a certificate 'Norkers' Compensation Insurance, or a certified copy thereof (Section 0, Lab. C.) - Iicy No. Company - 1 B Certified copy is hereby furnished. Certified copy is filed with the city Building Division. Da to Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection need not be completed if the permit is for one hundred ($100) or less). certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become sub' o the Workers' Compensation provisions of the Labor Code, you must rthwit comply with such provisions or this permit shall be deemed vok CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the per nc of the work for which this permit is issued (Section 3097 Lender's Name Lender's Address OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit t0 construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt ,refrom and the basis for the alleged exemption. Any violation of Section ;1.5 by any applicant for a permit subjects the applicant tc a civil ialty of not more than five hundred dollars ($500)., L� I, as owner of the property.or my employees with wages as their sole compensation, will do the work, and the structure is not intended or.offered for sale (Section 7044, Business and Professional Code: The Contractor's License law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. 1f, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of sale). ❑ 1, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contracts for such projects with a .on. tractor($) license pursuant to the Contractor's License Law). I am aware that proof o/ their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section B. & P. C. for this reason V. Date Owner' I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relaling.to building construction, and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for Inspection purposes. Signature Date Drivers' License or SS 9F TYPE OF CONSTRUCTION NEW ADD ❑ CONVERSION ❑ DEMOLISH ❑ OTHEF DESCRIPTION OF WORl</USE OF BLDG."iSZ TYPE OF PERMIT LJ GRADING ❑ TENANT ❑ ELECTRICAL ❑OTHER PROJECT DESCRIPTION SQ. FT.� REPAIR J FOUNDATION 'LJ STRUCTURAL PLUMBING ❑ MECHANICAL CONSTRUCTION TYPE- VALUATION $ LyrF SL1 -� ZONE GRADING CU. YDS. ACRES Remarks:gyp t—J 7 7S— Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinkin Fo AIMM anaLffains YA Fo a ervioe%,Outlets ' Interceptors Kitchen Sink L les p Roo Reinspection Fee $15 Boiler J!Etem ❑ Multiple ElFirepl/Fact. 1311.ICBO * Heating System & Ducting ❑0100,000 BTU ❑ 100,000 BTi Reinspection Fee I $15 0865-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor U CX I IX tT S Main Building: Accessory Building: T Front B Rear A C Right S . Left Ping. Ref. +PA — — Zo Parking Req./Provided Planning Notes: Zone O N I N G R E Q M T S. Issue Fee 1 $ 3 ELECTRICAL FEES IMBIN FEES Automatic Washer Construction Pole sub. Transformer ❑ 15-50 KW El 50+KW Showers Service Sink Cooking Unit Meter ❑up to 100 amps ' Sewer Cap Dishwasher Meter E) over 100 amps Dryers ❑Gas ❑Electric Sub Panel Sewer Connection Fan Motors❑0.1 HP❑1%-8 I rs F.A.U. Ind Solar 09-15 HP 016-15+ " Pi Fixtures Microwave Swimming Pool w/Spa - Device Boxes Pole Light Urinal Outlets Range Water Closet Switches Sign Garbage Disposal Standing Sections Water Heate Generator 005 KW 05-15 KW Trash Compactor Wat ice sundry Trays Reinspection Fee $15 Issue Fee $ 3 DEVELOPMENT SERVICES REQUIREMENTS: I e 3 Zoning Approved By Building Approved By Date Date 'FEES YJ Hoo o Type I El Issued By Date SUMMARY OF FEES nop Type II ❑ BUILDING PERMIT PLAN CHECK $ Z6S•a% SMTP $ $ PERMIT Refrigeration System ❑0100,000BTU 1:1100,0008TU PLUMBING PLAN CHECK 25% $ ISSUANCE $ $ ENERGY P.C. $ System Repair/Alteration ELECTRICAL $ GRADING $ Fire Dampers PLAN CHECK 50% MECHANICAL' $ MICROFILM $ $ .TOTAL FEE $ Registers PLAN CHECK 25% $ Issue Fee 1 $ 3