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Home My WebLink About2810 FRANCIS LN - Building Permits' CITY OF COSTA MESA BUILD/NG DIVISION > , � 77 FAIR DRNE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 •_www.ci�.cosla-mesa.ca.us �. FOR INSPECTIONS CALL: (714) 754-5626 �4.a�md`1� f "^ "' PERMIT NUMBER: BC07-00313 PERMIT TYPE: B COMBO � STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 10/24/2007 'r ISSUED BY: SOK �oe aDORess: 2810 FRANCIS LN CM `�_ �Suite%Unif:' -., APN: 14133205 ^ � � ;ZOning:R1,, ;� . ; +' � Vicinity: ' ' ` �'� � . . .. .` Primary Occ: �_' - Const Type: V-N � �;,'�;? �,' � SQ.� FT. � �_ - ��0 , _Valuation: $5,500.00 ,... , _ � _ . .. ., - . � . . - - � ., SCOPE OF WORK: REPLACE^S�WINDOWS'AND 1 SLIDER TO MEET 1997 U.B.C. EGRESS REQUIREMENTS THROUGHOUT S.F.D. REPLACE WATER HEATER,�ADD 1:OUTLET IN GARAGE; REPLACE 3 EXTERIOR,LIGHT FIXTURES AND FLEXIBLE GAS LINE. . . _ _ � OWNER: SHEA, AMANDA � ^� � ' � . � � Add{ess - �2870 FR4NCIS LN � � � �� '--' �+� � Unit: Phone: 714-979-9771 : �- . �" ".City/Slate2ip:�-COSTAMESA,CA�.. . � ;,- _ ' APPLICANT: JAMES DEAN - � . � � Address: 3081 LOREN LN � " �- � Unit: : Phone: 714-549-3883 ,:, • . City/State/zZip: . COSTA MESA„CA .. . . � � .� ,' -.. - ' , CONTRAC70R: JAMES DEAN ` - � ' -� �� - � '�� Cicense�No. 82918Y-, •' �0 Phone: 714-549-3683 �Address: 3081 LOREN LNUniti � � � � Ceil: � � - � City/State; � COSTA�MESA, CA - �- - = _2ipCode 92626 ARCHITECT: � - ' LicenseNo. � f. � - �� PHONE.��t - � ' ENGINEER: - License No. - � .� � �. ° . r PHONE: ` � COMBINTATION PERMIT FEE SUMMARY �. ' Building Plan Check: - � � � � � $0.00 � � � � �- � � - � � � � - � BuildingFees: - $125.25. : , _, .._ � � ElectricalFees: ,`:°� �"" _ $27.90 -. � - , ._ . . �� . MechanicalFees: ��: :, ;r. ,�...-$0.00`-`� �:. �,<r ..1, ��- . . .. . -.: �,,,'� . Plumbing Fees: - - � � � $43:10 . � � �-� _ - SMIP Residential: , $0.55 ' ' , SMIP Commercial: ' $0.00 � �,� .- � � ' � .,,.�s - ' � , TOTAL FEES: $196.80 ` _ '•Refer to fee receipts for all fees paitl for projec[ � � NOTICE: The work authorized by this permit shall comply with all applirable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) . . � - . EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST IWSPECTION. � INSPECTIONS: In order for the work authorized under this permit to be wnsidered legal, such work must wmply with all applicable codes, and all required inspections and Tinal approval musl be obtained. Failure to obtain inspections and final approval will result in the expiration of Ihis permit. CODEN, INSPECTIONTYPE DRTE INTITIALS CODEN INSPECiIONTYPE DATE IN71ML5 1fi16 ' Fized System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final . 208 Final Plumbing 200 Finai Re-Roof 270 Final Electncal 201 Final Block/Retaining Wall p72 Final Fire Prevention 202 Final Factory Fire Piace 220 Final Planning Appmval 203 Final Sign 222 Final Site 204 Final Demoiition ' 250 Finai Building/Occupancy � / � 7 �%P� WORKERS' COMPENSATION DECLARATION: I hereDy affirm under penalty of peryury one of the lollowing tleclarations: ❑ I have and will mainlain a certifca[e o( consent [o sel(-Insure for vrorkers' compensation, as providetl for by section 3700 0( [he Labor Code, for the peRormance of the work for which this permit is issued. ❑ I have and will maintain v.orkers' compensation insu2nce, as required by sectbn 3700 of the Labor Cotle, (w the pertortnance of lhe wark fw vfiich this permil is issuetl. My wvrkers' compensation Insurance carrier antl poliiy numberare: ' Carrier. (Tlut serYan neetl rpl Ee cpndefe0 athepermrt a valuetl al me huiMrtd Oo1arslS1001 a"�eu) Policy Number: G�—I'certi(y ihal in the pedormance of the vrork for which this permit is rssuetl, I shall not employ any person in any manner so as to become subject to the v+orkers' compensation laws of Califomia, antl agree that if I shauld become subject to the workers' compensation provisions of Section 3700 of th a or Code. I shall f ITv71t omply with [hese provisions. . —_ i fs, i iaWr ' ' /=al-: - �, NING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF 7HE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLAR4TION: I hereby aKrm thal I am licensed untler provisions of Chapter 9(commencing with Section 7000) o( Division 3 of the Business and Professions Code, antl my license is in (ull force antl eflect. - 6Licr# Glas�� (_ _ � o ractc s Si —'�---� L, ie_/. �.--� CO TRUCTION LENDING AGENCV: ❑ I hereby aHirtn that there is a construcibn lentling agency for tha perfortnance of Ihe v.ork fa v.hich this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lentler's Adtlress: OWNER•BUILDER DECLARATIONS: I hereby affirm that untler penalty of perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE U1W for lhe following reason (Sec. 7031.5. Business antl Professions Cotle: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any sWcture, prior to its issuanCe, also requires the applicaN for such permit to file a signed statement that he or she is licensetl pursuaN to [he provisions of the Contractors License Law (Chapler 9(commencing with Section 7000) ot Division 3 of Ihe Business and Professions Code) or that he or she is exempt therefrom and the basis (or the alleged ezemption. Any violation of Section 7031.5 by any applicant for a pertnit subjects the apPlicant to a civil penalry of not more ihan five hundred tlollars ($500).): , ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intentletl or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an ovmer of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided Ihat such improvements are not intended or oKered for sale. If, however, the building or improvement is sold within one year of wmpletion, the owner-builder will have the burden of proving lhat he or she did no� build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVEIY CONTRACTING WITH LICENSED CONTRACTORS to consWct the projeG (Sec. 7044, Business antl Professions Code: The contractors License Law dces not apply to an owner o! property who builtls or improves thereon, and who contracts for such project with a cont2ctor(s) license pursuant b the Contractors License Laws.�. ❑ I am exempt under sec. Business and Professions Code for this reason: SlgnaWre . Date 305]-4fi(3/Ol) Owner ID verified by driver's . .e. ❑ Yes ❑ No Dnvers License No. Expires: Verification of Ownership by (rype of document, i.e. - property tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . ❑ I hereby certAy lha[ no excavation frve (5) or more feet in depth inlo wfiich a person is required to descend, will be made in connectbn vrith work�authonzed by this permit, antl that no building slrucWre, scaf(dding, falsework, or demolition or dismantling the2of, will be more Ihan Ihirty-six (36) feet high. (ChaD� 3.2, Grp 2. M 2. SeC. 341, Ttle 8, Cali(omia AOministrative Code). ❑ As ovmer-builder, I will nol employ anyone to do work which would require a permit from Ihe Division of Intlustrial Satety, as noted above, unless such person has a pertni[ to tlo such vrork lrom the tlivision. Appl¢dnfs SgnaWre Division of Industrial Safety Permil Number. _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will ihe applicant or present or fuNre builtling occupant need to file and certify a Business Plan tor emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safery Code requires, with some exceptions, that a Business Plan be filetl with the Costa Mesa Fire Depanment by every business which has at any one lime dunng a reportetl year a quantity of hazardous materials equal to or greate� than a weight o! 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperaWre and pressure). 2. Does or will the applicant or present or fulure building occupant need lo fle a registration form for awtely hazartlous materials? ❑ Yes ❑ No (Section 25533 0! [he Cali(omia Health and Safery Code, with some exceptions, requires registration with the Costa Mesa Fire Depanmem by each business which at any one time has on �and a quantily of acutely hazartlous materials equal lo or grealer than a weight of 500 pounds. or a volume of 55 gallons, or 200 cubic (eet of compressed gas at stantlard temperalure and pressure). 3. Does or will the applicaN oi present or fWure building occupant need to prepare an RMPP (Risk Management antl Prevention Program for acu[ely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health antl Safery Code pmvitles thal the Costa Mesa Fire Departmenl may require Ihe preparation, certifcation antl filing with the Fire Department of an RMPP by businesses which are required lo register aculely hazardous materials wilh I�e Fire Department. 4. I( an RMPP is presently required, has Section 25534 of the Califomia Health and Safety Code been fully complied wilh? ❑ Yes ❑ No 5. Does or will the applicant or present or fuWre building occupant require for Ihe work which is Ihe subject of lhis application a permil (o� suth con5tmcti0n or modification from Ihe South Coast Air Ouality Management DisMcl or from any other air pollution control districl or agency? � Ves ❑ No (Sectbn 658502 of the Califomia Govemmen[ Code requires that the requested infortnatbn be fumished on applications fa rron-resitlential buildinq pertnits). 6. Will any pan of the faciliry to De consWctetl under this pertnit De wit�in 1000 feet from the outer boundanes o( a school? ❑ Ves ❑ No (If yes", the facility musl meet the requirement of Seclions 25534 and 42303 of Ihe Calitomia Health antl Sa(ety Code). 7. I( a permi[ from [he Sou[h Coast Air Quality Management Dis[rict or other air pollution control tlistnct or agency is required for the woAc which is the subject of this application, have all of the disclosures prescribetl by California Healt� antl Safery Code Section 42303 been made? ❑ Yes � No 8. Qf 'yes", attach certificate of compliance lrom Ihe appropnate air pollution control oKcer). CERTIFICATE OF COMPIIANCE: 1 certify that under penalty of perjury Ihe information given above is correcL I agree to comply with all slate laws and city ordinances regarding Hazardous Matenals and Emissions. Signature Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify untler penalry of perjury that I have read lhis application and state that the informa[ion given is correct I agree to comply with all state laws and ciry ortlinances relating to building conslruction, and authorize representatives of the City ot Costa Mesa to enter upon the above-descnbed property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this pertnit until final inspection. $ignaWre o( Legal q� pa�e � l- AnC/orAulhonzeEAppli�anl � �V�• �� _�.�...-�' pta) �54-52�3 • Fax (»4) 754-a856 • www.ci.costa•mesa.ca.us 77 YAIH UHIVt� GVJIA MCJA, GH `JLOLO ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applicant Address: Owner: Address Contrector. 2810 FRANCIS LN 14133205 LUIS MOTA 602 N. ALAMEDA AV AZUZA, CA PAUL, JANET ELAINE 2810 FRANCIS LN COSTA MESA, CA ISMAEL MOTA Address: 602 N. ALAMEDA AV 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 7000a Service over 7000a Motors to 1 hp Motors to 10hp 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 AZUZA, CA Phone: 626-806-6876 Zip: 91702 Phone: Zip: Phone: 626-806-6876 Zip: 91702 License: 523628 Status: ISSUED Applied: 10/10/2000 Issued: 10/10/2000 � _o_ ISSUED BY: � SCOPE OF PERMIT 4 LIGHTS, 7 OUTLETS, 4 SWITCHES AND RELOCATE SERVICE METER. REF B00-01628. $23.50 $0.00 so.00 $0.00 50.00 $0.00 Sa.aO $7.70 $4.40 $0.00 $0.00 530.50 $0.00 50.00 $0.00 $0.00 $0.00 50.00 50.00 30.00 50.00 50.00 $0.00 $0.00 $0.00 Quantity FEESUMMARY Temp Dist Syslem I Lighting Busway /100 fl Sfanding Section Misc Electrical Equipment Trensformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kvalkw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misc. Conduit Misa Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electriwl Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Quantity 50.00 0 $0.00 0 50.00 0 $0.00 0 S0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 $0.00 $0.00 50.00 E70.50 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, 12-27-92) 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 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 inspaetlona and final epproval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of Ihis permit. FOR INSPECTIONS CALL: (714) 7545826 � 2d46�46 (fil00) WORKERS'COMPENSAnON DECLARATION: I hereby eHirm untler panalry of perjury ona af the following tleclara�ions: ❑ I have end will mAintain e cetli}icate oi consent ro self-Insure br workers' compansation, as provitletl for by section 3700 0l the Labor Cotle, for the peAormance of Ihe �work for whlch this permit is issued. � ��1 have and wlll mainWin workers' compensation insurence, es requiretl by section 3700 of the Labor Cotle, for Ihe padortnance of tha work for which this permit is Issuetl. My workers' compensation Insurance carner and policy number era: Cartier. Polity Numbar. (This section need nof be crompleted il the permit is velue0 ef ono hundred dollers ($700) or less.) ❑ I certity thet in the Pertortnance oi the work tor which this ermit is issuetl, I shall not employ any person in any manner so as to become subject to Iha workers' compensetion IaWs of Califor ' an0 agree Ihat if I shou become sub�ect to the workere' compensation pmvislons ot Sectlon 3700 ot t e Labor Cotle, I shall lorthwi[h comply with th85e V�a�sian � � /7 Applicant Signatur� �-. `�iCi( � Dete: l iV /. U/�� WARNING: FAILURE'TO'SECURE WORKERS' COMPENSAiIIXJ ClJVERAGE IS UNLAWFl1L AND SHAl15UB1EGT.AN.EMFLOVERSO CRIMINAL ENALTIES AND CML FlNES UP TOONE HUN�RED THOUSAND DOl1ARE (5100.000�, IN ADDITION TO THE CQST OF CAMPENSATION, �AMAGES A$ PPOVIDED FOR IN SECTIdJ 3108 OF THE LABOR CODE, INrEREST, ANO ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirmlhafl am licensed untle�r rovisions of Chapter 9(wmmencing with Section 7000) ot Division 3 0l ihe Business and Professions Code, and my license is in tull brceentl�eNect.Lic�a �-ZOS �i� d Clessa � - C • Comractor' j IgoaWre: � �� Dat`� } f� � 8/ Q J --��' CONSTRUC710N LENDING AGENCY: ❑ I hereby aHirm tha� there is a construction lending egency for ihe pertormance of Ihe work for which Ihis permit is issued. (Sec. 3097, Civil Code). Lendefs Name: . __. __ LenOefs Atldress: SigneWre: OWNER•BUILDER DECLARATONS: Date: I hereby affirm Ihel unde� penalry of perjury Ihat I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for t�e lollowing reason (Sec. 7031.5, Busineu end Professions Code: Any ciry or county which requires a pertnit to construct, alter, improva, demolish, or repair any siructure, prior to its issuance, also requires the applicant for such pertnit to lile e signetl statemeR that he or she is licensed pursuant to the proNsions of the Contrectors License Law (Chapter 9(commencing with Section 7000) oi Division 3 of ihe Businass and Prolessions Cotla) or that he or she is eaempt therefrom entl the hesis for ihe alleged e:empiion. Any violalion oi Section 7031.5 �y any apP�icant for e pertnit sublecls the applicaN to a civil penalty of not more than live huntlretl dollars ($500)J: ❑ I, as owner of Ihe propeny, or my employees with weges es Iheir sole compensation, WILL DO THE WORK, ena the simcture is not intendetl or oflered tor sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does suc� work himself a hersell or through his or her own employees, pwvided lhet such improvements are not Intendetl or oMered lor sale. If, however, the building or Improvement is sold within one year of completion, ihe owner-builder will have ihe burden of proving Ihat he or she did not build or improve for purpose of sele.�. ❑ I, as owner oi the property, am EXCLUSIVELV CONTRALTING WITH L�CENSED CONTRACTORS to consWct the Oroject (Sec. 7044, Business antl Professions Code: The contraC�ors License Law does not epply to en owner ol property who builds or improves thereon, entl who coniracts for such pmject wit� a contrector(s) license pursuant t0 �he Coniractors License Lews.). ❑ I em exempt unde� sec. eusinoss end Professions Code tor Ihis reason: Signature: _ Dete: Owner ID verified by dnvefs license. ❑ Ves ❑ No Driver's License No. Expires: Veriifcalion ot 6wne�ship by Oype oi documem, i.e. - property tax bill or deetl): DIVISION OF INDUSTiiIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby certify Iha� no excava�ion tive (5) or more faet in tlepih into which a person is required to tlescenq will be mede in connection with work authorized by t�is permit, and that no building structure, scattolding, falsework, or tlemolilion or dismantling thereoi, will be more t�en thirry-siz (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle B, Califomia Adminisirativa Cotle). ❑ As owner-builder, I will not employ anyone to do wo�k which would require e permil from the Division oi Intlustnal Safery. es noteA above, unless suc� person has a permit to do such work imm ihe divisian. SigneWre: Da�e: Division of Indusirial Safety Permit Number: CERTIFlCATE OF COMPIJANCE AND AUTHORIZATON OF ENTHV: I certity under penalry of perjury that I �ave read ihis appli[ation antl state that �he intortnation given is correct. I agree to comp�y wilh all stace laws end city ordinences relating to builtling construction, and euihonze representatives ot �he Ciry ot Cwta Mesa to enter upon the above-tlescribed property �or inspection purposes. I agree not to occupy or allow occuDancy ot any building au�honzed by this pertni� until final inspection. ature Of Legal Own s) Antl/Or A horized Applicant COOE �. INSVECTION TYPE 16i6 Flxed System F�nal Fire Prevention 1266 Pool Spe Final 200 Final Re-Rool 207 FInaI8locWRetaining Wall 202 Final factory Fi�e Place 203 Final Sign 20a Final Demolition Pdli ItlIIDALi COUE 1 INSPECTION TYPE 206 Finel Mechanical 208 Final Plumbing 270 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building�Occupency 3 0'•- ViIQ1ALS I (714J 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR OHNE, GOSIA MtSA, GA 926'L6 Job Address: 2810 FRANCIS LN Suite No Vicinity: Parcel Nunmber: 14133205 Applicant: PAUL, JANET ELAINE Address: 2870 FRANCIS LN COSTA MESA, CA � Owner: PAUL, JANET ELAINE Address 2810 FRANCIS LN Contractor: Address: Arch / Eng : Address: COSTA MESA, CA PLUMBING PERMIT Phone: 714-435-9462 Zip: Phone: Zip: Phone: Zip: License: Phone: Zip: License: SCOPE OF PERMIT REF: 600-01628. RELOCATE SHOWER PLUMBING AND ADD BATHTUB. ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Connect Qce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Ezpansion Tank Gas Earthquake Valve Gas (t-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT 523.50 $0.00 $0 00 $9.80 $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 SO_00 QTY� p1 � 1; ' 0 � 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY AMT Laundry Tub I Washer $0.00 Landscape Irrigation y0_00 P-Trap $0.00 Pressure Regulator y0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Seplic Tank $0.00 SewerCapforDemo $0.00 Sewer Connect $0.00 Sewer Private Line 50.00 Shower $9.80 Sink, bar 50.00 Sink, commercial 50.00 Sink, Floor $0.00 Sink, kitchen 50.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: 07/30/2001 Issued: 07/30/2001 ISSUED BY: � Sump Pump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Hea[er / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Sokener OTHER VIOLATION PLAN CHECK REINSPECTION AMT 50.00 50.00 50.00 50.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 50.00 50.00 $0.00 50.00 50.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: E43.10 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. . INSPECTIONS: In order for tne work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectlone and final approvel must be obtained. Failure to obtain inspections antl final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2416-a8 (&V0) WORKERS'COMPENSAnON DECLARAnON: I hereby eflirm under penelry ol perjury one ol the following tleclarations: ❑ I have 9ntl will malntein e certilicete ot consent to self-Insure for workars' compenseHon, as provided tor by section 3700 of Ihe Lebor Coda, for Ihe pertormence of the work tor which this permit is Issuad. ❑ I have antl will maintain workers' compensaUon insurance, as requiretl by section 3700 of lhe Lebor Cotle, for ihe peAortnance ot the work tor which [his pertnit is issued. My workero' compensatlon Insurence cartler entl policy number ere: Cerrier. � Pplicy Num�er. {�This sectlon need nof be crompletetl i! t�e permil /s ve/ued et one hundred dollers (S700J or less.) � rmance ol the w or which this pertnit is issued, I shall not employ any person in eny manner so as to bacame sublect lo the workars' elito la grea at I I should become sub�aci to the workers' compensatlon proWsions of Sectlo 3700 of t e Lebor Coda, I shell lorlhwlih ;�0 5 � 3�%a 1 � Date: WORKER$' COIAPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL P LTIES D CIVIL FlNES UP TOONE MUNDRED IN nDD1TION TO THE C0.ST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SEGTION 3%OB OF THE LABOF CODE, IMERESi, AND ATiORNE1^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm thet I em Ilcensetl under prrnislons of Chapter 9(commencing with Section 7000) ot Division 3 0l the Business and Professions Code, end my license Is In full force antl eNecc Lic. M Class x Cantrectofs Signeture: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby aNirm Ihat there is e construction lentling agency for the peAormance of Ihe work for which ihis permit is issued. (Sec. 3097, Civil Code). Lendefs Name: Lentlers AUtlress: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby efflrtn thet under penelry ot per�ury thet I am E%EMP7 FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Buslness end Prolessions Code: Any ciry or counry which requires a permit to consWct, alter, improve, demolish, or repair eny strucWre, pdor to its issuance, also requires the epplicant for such permit to lile e signed stetement ihat he or she is Ilcensetl pureuant to the provislons ot t�e Contrectors License Lew (Chepter 9(wmmencing with Sectlon 7000) ot Divislon 3 of the Business antl Protessians Code) or that he or she is eaempt thereirom and Ihe basis for the allegetl exemption. Any dolation of Saction 7031.5 by any applicant tor e pem+; s.u.,D/jects the epplicant to a civil penalry of not more ihan five hundred dollars ($500).): �p I, as owner of Iha properry, or my employees with wages as their sole compensetion, WILL DO 7ME WORK, end ihe structure is not intended or oHereC far sale (Sec. 7044, Business and Professions Code: Tha Contractors License Lew does not epply lo an owner of property who builds or improves ihereon, and who does such work himself or herseN or through his or her own employees, provided Ihat such improvements ere no� Intentletl or ottered for sale. If, however, iha building or Improvemant is sold wiihin one year of wmpletion, the owner-builder will have Iha burden ol proving thet he or she tlid not bulltl or improve for purpose oi sale.). ❑ I, as owner ot the properry, am EJ(CLUSIVELV CONTRACTING WIT1 LICENSED CONTAACTOPS to consiruct Ihe project (Sec. 7044, Business entl Professions Cotla: The comractors Licensa Lew does not apPty to an owner oi pmperty who �ulltls or improves ihereon, entl who wntracts tor such project wlth a contractor(s) license pul,suent lo the Cgatrac(ors �se Laws.). ❑ lam � Business anA Professions Code lor ihis reeson: Date: ❑ Yes ❑ No Drivefs License No. � Expires: by (rype of document, I.e. - properry �a+c hill or tleea): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby ce�lly thet no azcevation five (5) ar mare feet in depih into which e person is required to descend, will be metle in connaction with work euthodzed by this pertnit, end thet no builtling structure, scaflolding, talsework, or demolltlon or tlismantling Ihereof, will Ge more Ihan thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Tltle B, Californla Administretiva Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permil irom the Division of Industriel Safety, as noted ebove, unless such person has e pertnit to tlo such work Irom the division. Signeture: Date: Division oi In�ustrial Selaty Permit NumUer: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF ENTRV: I certify untler penalry ol perjury Ihat I have read this application and s�ate that �he iniormation given Is correct. I egree to c ly with ell�a entl ' rdinances releting to building construction, and authorize representatives of the Ciry of Costa Mesa to enter upon the aDove-descnbetl m lo �� ction pu ose I a ree not to occupy or allow occupenty ol eny building euthonzed by this pertnit until final inspection. �� Signa ure Ot Legal ner(s) � �O/ � I Date e.�n�n.�e�n��m.nnniican� T— Date [�TIiS�CF97�9 T•P�N7q 1616 Fixed System Final Fire Prevention 1266 Pool Spa Finel 200 Finel Re-Rool 201 FIneI BIocWRetalning Well 202 Flnel Fectory Fire Plece 203 Flnel Sign 204 Final Demolition o�re ItiL➢ELS CO�E� INSPECTIONTYPE 206 Final Mechanlcal 208 Final Plumbing 210 Final Electricel 212 Final Flre Preventlon 220 FinelPlanning Approval 222 Final Site 250 Finel Building/Occupancy PAg I[�Lfl 8-�a-OI �� (71a) 754-5273 • Fau (714) 754-4856 • wv+w.ci.costa-mesa.ca.us n rnin unrvc, �w �r n��.., �.. �� ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: ApplicanC Address: Owner: Address Contractor. 2810 FRANCIS LN 14133205 LUIS MOTA 602 N. ALAMEDA AV AZUZA, CA PAUL, JANET ELAINE 2810 FRANCIS LN COSTA MESA, CA ISMAEL MOTA Address: 602 N. ALAMEDA AV ISSUE FEE Temp service test Res. a/c package New Res (t-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 7000a Motors to ihp Motors to 10hp Motors to SOhp Motors to 100hp Motors over 700hp Communication drops Sub panel to 200a Pole Light Pkg Si9n Circuits Temp Pwr Pole Intermed Pole I_r/�1/etyel Phone: 626-806-6876 Zip: 91702 Phone: Zip: Phone: 626-806-6876 Zip: 91702 License: 523628 SCOPE OF PERMIT ISSUED BY: Status: ISSUED Applied: 10/10/2000 Issued: t0110/2000 2 LIGHTS 4 OUTLETS AND 2 SWITCHES REF B00-01628, LEGALIZE WORK DONE WITHOUT A PERMIT. $23.50 50.00 50.00 50.00 50.00 $0.00 52.20 $4.40 sz.zo $0.00 $0.00 50.00 $0.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 50.00 50.00 50.00 50.00 $0.00 Quantity 0 0 0 2 4 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway /100 ft Standing Section Misc Electrical Equipment Trensformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw ...............:.up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment - - - Low Volt W ring System / Ckt Misc. Conduit Misc Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Olher Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantiry $0.00 0 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 50.00 0 $0:00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 $32.30 50.00 $0.00 TOTAL CALCULATED FEES E64.60 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements 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 tor a period of i 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 required inspeetlons 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 2b66-46(fi/00) WORKERS' COMPENSATON DECLAHA710N: - I hereby aXirm untler penelty of perjury one of fhe following tleclarations: ❑ I have end will �aintain e certificate ol consent to selt-Insura tor workere' compensation, es OroNdetl for Dy sectian 3700 ot the Labor Cotle, for the p0rtortnence of the �wo�k tor which thle permit is issued. ❑�I heve antl will mein in workers' compensation insurance, as required by sectlon 3700 of Ihe Labor Cotle, for Ne pertortnance oi the work for which this pertnit I5 issuetl. My wOrkers' cor�persation Insurance carrier and policy number are: Cerrier: Policy Number. (This sectlan need no� be wmp/etetl i! the permit is valued at one hundred do/(ars ($700) ar less.) ❑ I cenity t�et in ine pedormance ot the work for which this permit is issued, I shall not employ any person in eny manner so as to become subject to Ihe workers' compensetion 18w5 of Califomla, a agrea that if I should yecome subject to t�e workers' compensation provislons ot Section 3700 of the tabor Cade, I shall fotlhwith c�y wlih �h`Se provi5ions. 'p /n � J AppllcenCSignature: �—p i-�k � liLf � �'�V � ,�Date: � �7��'�� Il �/ a U WARNING: FAILURE TO SECURE WORK�"Fi5' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPI EOV R TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN�RED T1qU5AND DOLIARE (5100.000), IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOP CA�E, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm.thahlrem licensetl under provisions of Chapter 9(commencing with Section 7000) ol Division 3 of the'Business and Pwlessions Cotle, end my licensa is in full force antl� fi cL Lic. K � Z- �+ %%= -� qass q� tZ f-�- J L CONSTRUCTION LENDING AGENCY: . ❑ I hereby eMirtn tnat there is e construction lending agency for �he peAormance of ihe work lor which this permit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lender's Adtlress: SignaWre: OWNER•BUILDER DECLARATIONS: Date: I hereby eflirm ihat under penelry ot perjury that I em E%EMPT FROM 7ME CONTRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, Business anA Protessions Code: Any ciy or counry which requires a permit to construct, alter, improve, demolish, or repair eny structure, prior to its issuance, also requires the applicant for such partnit to file e signetl stetement Ihet ha or she is Ilcensetl pursuant m the provisions of Ihe Comrectors Licensa Law (Chepter 9(commencing with Section 7000) of Division 3 01 the Business antl Professlons Code) or Ihat he or she is ezempt therefrom and the basis br Ihe alleged exemption. Any violatian of Section 7031.5 by any epplicant br a permit subjecls Ihe epplicent to a civil penalty of not more than five huntlred tlollars ($500).): ❑ I, as owner of �ha property, or my employees with wages as �heir sola compensation, WILL DO THE WORK, and ihe strucWre is not imentled or ofleretl for sele (Sec. 7044, Business dnd Pwlessions Code: The Contractore License Law does not aOPly to an owner of property who builds or improves thereon, antl who does such work himselt or hersel� or Ihrough his or her own employees, provided ihat such impmvements are not Imentletl or ottered br sale. If, however, Ihe building or improvemeN is sold within one year ol completion, the ownerbuilder will have lhe burden of proving ihat �e or she did not 6uild or improve for purpose of sale.). ❑ I, as owner ot �hB property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct Ihe project (Sec. 7044, Business and Professions Code: The contrac�ors License Law tloes no� apply ro an owner of property who bullds or improves thereon, entl who contraGs for such pmjem with a contremor(s) license pursuant lo the Coniractors License Lews.). ❑ I am eaempt under sac. Business and Protessions Code lor Ihis reason: SignaWre: _ Date: Owner ID venfied by tl��efs license. ❑ Ves ❑ No Dnvers License Na. Verificetion ot OwnersPip by (type of tlocument, i.e. � properry tax bill or tleed): DIVISION OF INDUSYRIAL SAFETY PERMIT CERTIFICATION: Expires: ❑ I hereby cetlity Ihat no axcavation five (5) or more feet in tlep�h into which e person is required to descend, will be made in connection with work euthodzed by Ihis permit, and Ihat no building strucNre, scaflolding, falsework, or tlemolition or dismantlinq I�ereol, will ba more than thirry-six (36) feet high. (Chap. 32, Grp 2, Ari 2, Sec. 341, lltle B, Calilomie Administretive Cotle). ❑ As owner-buildef, � will not employ anyone to do work whic� woultl require e permit from the Division ol Indusirial Sefery, as notetl e6ove, unless such person �es e permit to do sucn wark fmm the division. Signature: Date: Division ol Industrial Sa�ery Pertnit Number. CERTFICATE OF COMPLIANCE AND AUTHORIZATON OF ENTHY: I cenify under penalty of parjury that I have read this applica�ion and stete thet the informa�ion given is correct. I agree to comply with all stete laws end ciry ordinances relating to builtling construction, antl authonze representatives of t�e City of Coste Mesa to enter upon the above-tlescribed property tor inspection puryoses. l agree not to occupy or atlow occupancy ot eny 6uilAing authorized by this pemiit until tinal inspection. SODE �. INSVECTONTYPE ' LAIE II�ISl9 1616 1266 Fixed System Final Fire Prevention Pool Spa Fin81 200 Final Re-Rool 207 FInaI BIocWRB�aining Wall 202 Final Feciory Fire Place 203 Final Sign 204 Finel Demolilion /n�(n%n� �=--a Date �-- COOE I INSPECl10N TYPE 208 Final Mechanical 208 Final Plumbing 270 Final Elec�rical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy �g � 3 ��fJ2 (714) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 2810 FRANCIS LN Suite: Vicinity: SIDEYARD Parcel Number: 14133205 Applicant: GRIEGO, MAUNEL Address: 1261 NORTHWOOD AV BREA,CA Owner: PAUL, JANET ELAINE Address 2870 FRANCIS LN COSTA MESA, CA Contractor M G CONCRETE Address: 3134 S RITA WAY SANTA ANA, CA Zip: 92704 Arch : Address: Zoning: R1 R1 Phone: 714-525-3844 Zip: 92821 Phone: Zip: Phone: 714-525-3844 License: 384563 Eng: Address: Phone: ISSUED BY: Status: ISSUED Applied: 09/09/2002 Issued: 09/09/2002 Phone: Zip: License: License: SCOPE OF PERMIT � CONSTRUCT 58 LIN. FT. OF BLOCK WAIL 6 FT IN HEIGHT ALONG INTERIOR SIDE P.L. Plan Check: $0.00 Permit: $44.85 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $45.35 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING Ezistinq: 0 NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 �eft 0- 0 Proposed: 0 Calc Valuation: Claim Valuation Right 0-0 Right 0-0 s�,�so.00 so.00 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 becoma void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under Ihis permit to be considered legal, such work must comply with all applicable cotles, antl all requlred inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of �his permit. FOR INSPECTIONS CALL: (714) 754-5626 . taas-as �s�ao) WORKERS'COMPENSAnON DECLARAnON: �� '' I hereby aflirm under penalry of perjury one oi the following declarations: � ❑ I have and will maintain e certifiwte of Consent lo self-Insure br workere' compensation, es provided for by section 3700 of the Lebor Code, for the pertortnance of Ihe work far which this permit is issuetl. I h ve antl w'll mainlain workers' compe�sa6on insurance, as requiretl by section 3700 of ihe Labor Code, for ihe perfortnance oi the wrnk for which thispe rmit is' uetl. y wo e�com ensa�q�nsura�n/ce" �cartier end policy number are: ��[ / � ��[/� CBRIBf: � \� ! �n [ ,1 Policy Numher: � � / � � � / � � (This section need nof m/ete i/ th it is velued et one hundred Oollars ($700) or less.) ' ❑ I certiFy thet in the pertormance oi w k for which this permit is issuetl, I shall not employ any person in any manner so as to become subject to the workers' compensation laws ia a ae thet if I should become subject to the workers' compensation provisions o�ction 37�0 of the Labor Coda, 1 shell forthwith complywiththese ovi ns. ��a Q Applicant Signeture: Data: � � � WARNING FAILURE TO SECURE WORKERS' P SA QV COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPIOYER TO CRIMINAL PENALTIES NND qVIL FlNES UP TOIXJE HUNDRED THOUSAND OOLLARE ($100,000), IN ADDITION TO T � F COMPENSATION, DPM4GES AS PROVIDED FOR IN SECTION 3]O6 0F THE LABOF CODE, INTEREST, AND ATTOFNEYS FEES. LICENSED CONTRACTORS I hereby eNirm Ihat I am licen: force entl eHecL Lia a Coniracrols Signature:� CONSTRUCTION LENDING AGENCV: ❑ I hereby eHirm thel there is a cons Lendefs Name: Signeture: OWNER-BUILDER DECLARATIONS: of C�apter 9(commencing with Section 7000) of Division 3 oi �he B�� Cless ri Date: _ Code, and my license is in full agency for tha peAormance ot the work for which this permit is issued. (Sec. 3097, Civil Code). Lendefs Address: ...___ .. _—_ _- ... ___— __—__ _-__ Date: . _. _. I hereby aftirtn ihat under penalry of perjury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, 8usiness end Professions Cotle: Any ciry or counry which requires a permit to construct, alter, improve, tlemolish, or repair any structure, prior to its issuance, also requires �he applicant for such permit to fila a slgnetl statament ihat he or she is licensed pursuent to the pmvislons of the Contrectors License Law (Chapter 9(commencing with Section 7000) of Division 3 oi the Business and Professions Code) or that he qr she Is exempt theretrom and Ihe basis tor the alleged eaemption. Any violation of Section 7031.5 by eny applicant for a permit su6jecis ihe epplicant to a civil penairy of not more than fve hundred dollars ($500).): ❑ I, as owner oi ihe propeny, or my employees with weges as their sole compensation, WILL DO THE WORK, and ihe structure is not intended o� ottered for sale (Sec. 7044, Business antl Professions Code: The Contractors License Law tloes not apply to an owner of property who builds or improves thereon, and who dces such work himself or herseN or through his or har Own employees, provided ihat such improvemenis ere not intended or offered for sale. If, however, iha 6uilding or improvement is sold within one year oF completion, the bwner-builder will have the burtlen of proving that he or she did not build or improve tor purpose of sale.). ❑ I, as owner ot the propeM, am EXCLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS to constmct the Drojea (Sec. 7044, Business an0 Protessions Cotle: Tha contractors Licanse Lew dobs not epply to an owner of property who builds or improves ihereon, and who conirecis for such projecl with e coniracbr(s) license pursuan� �o the Contractors License Laws.). ❑ I am eaempt under sec. Signatura: Owner ID verified by driver's license. ❑ Yes ❑ No eusiness end Pwfessions Code for this reason: Veritication of Ownership by (typa of Oocument, i.e. - property tax blll or tleed): DIVISION OF INDUS7RIAL SAFETV PERMI7 CER7IFICATION: Drivers License No. Date: Expires: ❑ I hereby certity �hat no excavation fiva (5) or more faet in depth into which a person is requiretl to descentl, will be made in connection with work euthonzed by this permit, and iha� no building sWCNre, scaffolding, falsework, or tlemolition or dismantling thereof, will be more ihan ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title e, California Adminisiretive Code). ❑ As owner-builder, I will not empioy anyone to do work which would require e permit irom the Division of Industnal Safery, as noted above, unless such person has e permit Io do such work from �he division. Signature: Da�e: Division oi Intlustrial Safery Permit Number: CER7IFlCATE OF COMPLIANCE AND A IZqTON OF ENTTiY: I certity under penalty of perjury Ihat I have read ihis application and state Ihat the iMormation given is correcc I agree to comply with ell state ws an ciry ordinances relating to builCing conswction, and authorize representatives of the Ciry of Costa Mesa to enter upon the above-described property for inspecti urposes. egree not to occupy or allow occupancy of any building authorized by Ihis permit until final inspection. CO�E 1, INSPECTONTYPE \ 1616 Fixed System Final Fire Prevention 1266 200 Pool Spa Finel Finel Re-Rool 201 Final BIocWRetaining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition \ �jE �NTITIRlS J 3 2 %a'F�. � � � i-Qat� CJ Date COpE 1 INSPECTION TYPE 206 Final Mechanical 208 210 212 Final Plumbing Final Electrical Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 � Final Builaing/Occupancy BflIE Ixim�l5 � ..., . • TFflS SKE[Q-I LS FOR IIJFORMATIONAL PURP066 • SOL(D WALLS/FEN�S BEIWEQd 2'�• k 6' iN FffIGtiT SHALL ONLY. APPIJGATI' LS RFSPONSIBLE FOR PROVIDIIJG BE SETHAIX AT IFASf 10' FROM FROM PROPER7Y LINE. AN ACNRATE RiPRFSFNTA770N OF'[}IEDt PROPERTY QJ USE TF� SHAPE AND S7ZE DO NOT CORRFSPOND • SOI.m WALIS/FFNQ�S SFiALL NOT S%�D 2' 6• W Fff]CHf N7fH THE INFORMA770N PROVmID ON h� 9�Ef. WCI}�i IV OF'fF1E FRON7 PROPFRTY IINE (NOT CUR91.Wi�. • VERffY D6TAN� £ROM NRB i0 PROPEKI'Y I.VJE AND 9tOW ON PLAN. VFFRII�7GIlON FROM 7HE QIYS FNCWffitING DN6fON 6 REQUIR�. GLL (714) 7545343 POR INFORMATION. ��Z��l ��Z �� CITY F COST MESA '�"� P NNING IV. SUBJECT 0 BLDG. EPT. RE . BY /v �'� DNTE 7 � I ��1 , � � Y RC90EMQ t _.: ;: U�'��sj��'��,�s�a ` 1 L:�;; c�Y��Y�.V�y n , � �e. �il �r l.l ��' __. _,.,.ao^;'•��s �.�1. �I'g��.�.... I�' ' •_ I�,::` STREET - � ------ - ------------ , -- -- � BLOCK WALL LAYOUT FOR BUILDING PERMIT PLANNING DIVISION �U� TYPICAL 6�� CONCRETE BLOCK FENCE Cemenl Coping Opt�onal — Channel Bbck With 1�3/B� Hori=onUl Top ol all Fences For Fences 5' or Less Vert. Bars 3/8" yS a� 4' �0" O.0 For Fences Higher Than 5' Ven. Ban 3/8"Q at 32" O.C. � FJI Cells $olid With Gmut W here Steel Occurs Rrinl�rcing S1vel $hall Cunbrm Io SecA�15�39 A.S.T.M. All Stee� to be Lapped 24" or to Code NATURAIGRADE TWO ]/8"O BAPS Li CONTINUOUS TOP � 6 BOTTOM HOQ�ZSTEEL MUST BE TIED IN PIACE AT TIME OF TRENCH INSPECTION. a 0 n x V r u � W O >z > ' a f � W O ii r �e n o N D^ �KIDTh � SEE Cw � BELOW o I - WIDTH 7HICKNESS DEPiH OF EARTHTOOTM SPACING OF EARTHTOOTH 14" I 0'� 2 4" �2' FOOTING REQUIRENIENTS CHART 14" . 12� 10" 8 ° 20" � 16" 14' 16' BUILDING DIVISION GENERAL- NOTES MORTAR; p�e part Plostic Cement, and Three Parts Sand GROUT; One Part Cemenf TNee antl One Half Ports S�and COPING: ,pne Part Cement, Three Ports Sand CONCRETE: Well M�aed f.2-I/2:3-I/2 Mav of 7-I/2 Gal;cns ot Wa�ar Per Sock of Ceme�t GROVT MAV BE POURED FROM TME TOP OF THE FENCE IN CELLS WHERE STEEL OCCURS. CELLS ANU AREAS OF HORIZONTAL REIN FORCEMENT SHAIL BE CLEAR, CLEAN 6 FREE OF ALL MORTAR DEBRIS, ETC. H CF C4RTMT(;OTM i/? hlE HE�GTH O� �ENCE B�IOW BOTTOM OF �OGTiNG SCALE: I/2�� = I� 12„ 8'� 12" 16� pia) �sa-s273 • Fax pta) �sa-aess • www.ci.costa-mesa.c��LDING PERMIT �� hAIH UHIVt, GVJIA MtJA, GH tlGbLb JobAddress: 2810 FRANCIS LN Suite: Vicinity: Parcel Number: 14133205 Applicant: LUIS MOTTA Address: 602 N. ALAMEDA AV AZUZA,CA Owner: PAUL, JANET ELAINE Address 2810 FRANCIS LN COSTA MESA,CA Contractor ISMAEL MOTA Address: 602 N. ALAMEDA AV AZUZA, CA Zip: 91702 Arth : Address: Phone: Zoning: R1 R1 Phone: 626-806-6876 Zip: 91702 Phone: Zip: pd616 Phone: 626-806-6876 License: 523628 Eng: Address: Status: APPLIED Applied: 10/10/2000 Issued: ISSUEDBY: �/Y`- Phone: 2ip: License: License: SCOPE OF PERMIT LEGALIZE 1695F CONSTRUCTED WITHOUT A PERMIT . Plan Check: $163.31 Permit: $251.25 SMIP Res: $1.45 SMIP Com: $0.00 Other: $251.25 Inspection: $0.00 Total: $667.26 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0- 0 Re uired: 0 FEESUMMARY PLANNING 8 ZONING Left 0- 0 Left 0- 0 P�oposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0- 0 $14,449.50 so.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-20, § 1, 72-21-92) EXPIRA710N: 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 ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all required Inspections 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 241648 (fJ00) � WORKERS' COMPENSA710N DECLARATON: I hereby affirtn undar penalty of perjury one of the following tleclaretions: ❑ I have antl will maintain a cenificate of consent to setl-Insure tor workers' compensetion, es pmvided br by section 3700 of the Lebor Code, for t�e pedormenca of t�e work for which this permit is issued. ❑^I have and will maintain wo�kers' compensation insurence, es requiretl by secfion 3700 of Ihe Labor Code, lor ihe peAortnance of ihe work tor whiU this pertnit is issued. � My workers' compensatlon Insurance wrrier and policy number ere: Cerrier. Policy Number: (This section need nat be completed il the permit is valued ef one huntlred dollars ($100J or less.) ❑ I certity ihet in the peRormance oi �he work for wh' this pertnil is issued, I shall not employ any person in any manner so as to become subject to ihe workers' compensation laws of mia, and egree that shoultl become subject to the workers' compensation provisions of Section 3700 0l ihe Lebor Cotle, I shell lorthwith compty with these pro s. / ApplioenYSl9�`N : �� • �Date:�� l� � A/ d � WAONINGi FAILURE TO SECURE WORKERS' COMPENSATIIXJ CAVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL ES NND CIVIL FlNES UP TOONE NUNDRED TMOUSAND DOl1ARE �510p.000�, IN ADDITION TO THE COST OF CAMPENSATION, pAMAGES AS PqOVIDED FOR IN SECTION 31080F THE LABOR CODE, IMEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DkCLARATION: I hereby aRirm that 1 em licensed under provisions of Chapter 9(commencing with Section �000) ot Division 3 of the Business and Protessions Code, entl my license is In full torce end eNecVCic..M class N—�� L�{' L-iT C Comractofs Sigqal�� =�y�_ Date: �9 / i ,y�� .�' ) IrT•• I CONSTRUCTION LENDING A6ENCY: ❑ 1 hereby aftirm that ihere is a cons�ruction lentling agency for tha pertormance oi �he work for which this permit is issued. (Sec. 3097, Civil Cotle). Lendeis Name: Lender's Address: Signawre: OWNER-BUILDER DECIARATIONS: Date: I hereby attirm ihat under penelty of perjury thet I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Proiessions Cotle: Any city or county which requires e permit to wnstruct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires the epplicent for such permit to tile e siqned statement Ihat he or she I5 licensed pursuant to the provisions of the Coniractors Llcense Lew (Chepter 9(commencing with Section 7000) ot Olvision 3 of the Business and Professions Coda) or that he or she is eaempt therefmm and the basis for the alleged exemption. Any violation oi Section 7031.5 by eny applicant tor e pertnit subjects t�e applicant m a civil penalty ol not more than five hundred tlollars ($500).): ❑ I, as owner ot t�e properry, or my employees with wages as Iheir sola compensation, WILL DO THE WORK, entl Ihe structure is not intended or ottereG for sale (Sec. 7044, Busineu antl Pmfessions Code: The Contractors License Law dces not apply to en owner of pmperty who builds or improvas thereon, antl who tloes such work himsetl or herself or through his or her own employees, provided ihat such improvaments are not intended or oHered for sale. If, howaver, tha building or improvement is sold within one year of completion, the ownervbuilder will have t�e burden ot proving that he or she did not huild or improve lor puryose of sale.). ❑ I, as owner ol ihe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Pro}essions Cotle: Tha contractOrS License Law does not epply ro en owner ol property who builds or Improves thereon, antl wh0 contracts tor such pmject wlth a contrector(5) license pursuani �o Ihe Contrectors License Laws.). ❑ I am exempt under sec. Business and Prolessions CoOe for this reason: Signatura: Data: Owner ID verifietl by tlnvers lice�se. ❑ Yes ❑ No Drivefs license No. Vedfication ot Ownership by (typd of daumen6 i.e. - property tax bill or tleed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ExO�res: ❑ I hereby certify t�a� no exca�ation five (5) or more fee� in tlepth into which a person is required to descend, will be mede in conneciion with work euthonzed by Ihis pertnit, and t�at no DuilCing s�rucNre, scaflolding, falsework, or tlemoli�ion or dismantling ihereof, will be more than Ihirty-six (36) teet high. (Chap. 32, Gry 2, Ad 2, Sec. 341, Title B, Calitomia Atlministrative Coda). ❑ As owner-Duilder, I will not employ enyone to tlo work which would require a permit from ihe Division of Industrial Safery, es notetl ahove, unless such person hes e pertnit to do such work frorn ihe division. Signature: Date: Division of Indusinal Safery Permit Number: CER7IFlCATE OF COMPLIANCE NdD AIfTFiORIZATON OF EN7AY: I cenity under penalty ol perjury t�at I have read this application and state tha� the inbrmation given is correci. I agree to comply wlth all state laws end ciry ordinances releting to building consiruclion, end authodze representatives of ihe Gry of Costa Mese to enier uDon the eDwe-dascribatl Droperly tor inspection puryoses. I eg�ee nol lo occupy or albw occupa�y ol any buiWing auttwrized by ihis pennil untit tinal inspection. GODE �. INSPECTONTYPE �ff 1[fIIDE4@ t676 Fixetl System Final Fire Prevention 1266 200 201 202 203 Pool Spa Final Final Ra-Rool Final BIocWRe�elning Wall Final Factory Fire Place Final Sign COOE I INSPELTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elactncal 212 Finel Fire Prevention 220 Final Planning Approval 222 final Site 204 Final Demolition 250 Final Buili r�n��i5wnty (7ia) 75a-52�3 • Fax (7ta) �sa-aess • vnvw.ci.costa-mesa.�. +�LDING PERMIT �� FAIF UHNt, GU51 A MtJA, GA ylb[b JobAddress: 2810 FRANCISLN Suite: Vicinity: Parcel Number: 14133205 Applicant: LUIS MOTTA Address: 602 N. ALAMEDA AV AZUZA, CA Owner: PAUL, JANET ELAINE Address 2810 FRANCIS LN COSTA MESA, CA Contrector: ISMAEL MOTA Address: 602 N. ALAMEDA AV AZUZA, CA Zip: 91702 Arch : Address: Phone: Zoning: R1 Rl � Phone: 626-806-6876 Zip: 91702 Phone: Zip: Phone: 626-806-6876 License: 523628 Eng: Address: Status: ISSUED Applied: 10/10I2000 Issued: 10/10/2000 � C � ISSUED BV: C/� Phone: Zip: License: License: � SCOPE OF PERMIT ADD 112SF TO THE REAR OF RESIDENCE FOR EXTENDING THE BEDROOM AND A NEW WALKING CLOSET. Plan Check: $117.81 Permit: 518125 SMIP Res: $0.96 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $300.02 SETBACKS MAW STRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING existinq: o NOTES: Rear 0-0 Rear 0-0 Required: 0 FEE SUMMARY PLANNING & ZONING LeR 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation Right 0- 0 Right 0- 0 $9,576.00 so.00 NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § i, 12-21-92) EXPIRATION: This permil shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period ot 180 days. � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspeetlons 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 /� zanbas(aao) / / V WORKERS' COMPENSATION DECLARA710N: I hereby affirtn untler penelry of perjury one ol ihe tollowing tleclarations: ❑ I have end will r�aint0in e certificate ot consent to selbin5ure far wOrkers' compensation, es provided for by seclion 3700 0l the Lebot Code, lor the peAortnance of Ihe �wark for which Ihis pertnit is issuetl. � I have antl will maintain workers' compensation insurence, as requiretl Dy section 3700 ot the Labor Cotle, lor Ihe pertonnance of the work tor which ihis pertnit is issuetl. My workers' compensation Insurance carrier entl policy number are: Cerrier. Polity Number: (This section need not be comp/etetl i/ the pertnit is valued et one huntlred do/lers ($100) or less.) ❑ I certiy Ihat in tpe pertortnance ot the work for which ihis pertnit is issuad, I shell no� employ any person in any manner so es to bewma subject to the workers' compen5ation 19w5 0l Calit mia, and agree that i I should becoma subject to the workers' compensation provisions oi Section 3700 of the Lebor Code, I shall forihwlth comply_wi�h.�hese provi ' S. ApPI(ca tn Signature:–=� �<�. , Dare:_ / Ci//0/V � WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL NND SHALL SUBJECT AN EMPLOVER�TOGRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE MUNDRED THOUSANO OOLL4RE ($100.000), IN ADOITION TO THE COST OF CAMPENSATION, DAMAGES AS PFOVIDED FOR M SECTION 3]Ofi OF THE LABOR CADE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRAC70R5 DECLARA710N: I here6y aflirm that I am licensed und r pmvisions ot Chapter 9(commencing with Section 7000) of Division 3 of t�e Business entl P,rqlassions Code, and my license is in full Iorce�en'_d e�Lic, d � /C�ass a�i 1� 7-1 1 L Coniraaor'sSlgnamr9: ,c._, ' �G_i ( � �Oate�~ �.l� c��% A C� CONSTflUCTION LENDING AGENCV: ❑ I hereby aHirtn tpat there is a conswction lending agency for the pertortnance of ihe work br which this pertni� is issuetl. (Sec. 3097, Civil Code). Lenders Neme: Lender's Atltlress: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby aflirm thet untler penalry of Oerjury Ihat I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for Ihe following raason (Sec. 7031.5, Business antl Professions Cotle: Any city or county which requires e permit to construct, alter, improve, tlemolish, or repair any siructure, prior to its issuance, also requires ihe applicant tor such permit to file a signed stetement ihat he or she Is Ilcensed pursuant to the provisions of the Conirectors License Law (Chapter 9(commencing with Sectlon 7000) ot Divislon 3 of Ihe Business and Pmfessions Code) or that he or she is exempt iharelrom and Ihe basis tor ihe aliegetl e:emption. Any violation of Section 7031.5 by any applicant for e permit sublec�s �he applicent lo e civil penalry of not more ihan five huntlretl dollers ($500).): ❑ I, as owner of Ihe propetly, or my employees with wages as Ihelr sole compensa�lon, WILL DO 7HE WORK, and ihe simctura is not imentletl or ottered for sale (Sec. 7044, Business and Professions Code: The Coniractors License Lew does not apD�Y �o en owner of propeny who builds or improves thereon, and who does such work himsell or hersed or Ihrough his or her own employees, provi0etl �hat such improvements are not intendad or oNeretl for sale. If, howaver, Ne building or impmvemem is �soltl wit�in one year of completion, the owner-builder will heve Ihe burden ot proving tha� he or she tlitl not build or improve for purpose of saia.). � I, as ownar of the pmperty, am EXCLUSIVELY CONTRACTINC WITH LICENSED CONTRACTORS to construct the Oroject (Sec. 7044, Business ana Professions Coae: The contracrors Licensa Law does not apply to en owner of propeny who bullds or Improves ihareon, antl who contrac�s for such projec� with a coniractor(s) license pursuant to the Con�ractors License Laws.). ❑ I am exempt under sac. Signature: Owner ID veritied by d��ers license. ❑ Ves � No Business an0 Professions Code for this reason: Venfication ot Ownersh�p by (rype of tlocument, i.e. - propeny tax bill or tleed): DIVISION OF INDUSYF7�AL SAFETY PERMIT CERTIFICA710N: Drivefs License No. Date: Eapires: ❑ I hereby cenity tpat no e:wvetion five (5) or more faet in tlepth imo which e person is requiretl to descend, will be matle in connection with work autho�zed by Ihis permit, and that no building s�ructure, scattolding, falsework, or tlemolition or tlisman0ing thereof, wiil be more ihan inirry-six (36) feet �igh. (Chap. 32, Grp 2, Atl 2, Sac. 341, Title 8, Califomia Administrative Code). ❑ As owner-builder. I will not employ anyone to do work which would require a permit from the Division of Industriel Sefe�y, as notetl above, unless such person has a permit to do sucq work from the division. Signature: Date: Division ot Induslrial5afery Pertnit Number. CER7IFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTHY: I certity untler penalty of perjury that I have read this application antl state that the information given is wrrect. I egrae m comply with all stete laws and city ortlinances rela�ing to Ouilding consWction, and authonze represanta�ives of the Ciry oi Costa Mesa to enter upon Ihe ebove-described property lor inspection purposes. l agree not m occupy or allow occupancy ot any 6uiltling auNorized by lhis pertnit unUl tinfll inspection. COOE �• 1616 1266 ignature Of Legal O Dat 10%/ ll d v Antl/Or , ulhodxe �Applicent � 'D te � Fixetl System Final Fire Preveniion Paal Spe Fin91 200 Finel Re-Root 201 Final BIocWRetaining Wall 202 203 204 Final Factory Fire Place Final Sign Finel Demolition P,IE lt{�45 ' —.T�� GODE� INSVECfIONTYVE 206 Finel Mechanical 208 Final Plumbing 270 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy P� I[IIID�L$ � C�TY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-5273 • Fax (714) 754-4856 • ��ci.costa-mesa.ca.us ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: Applicant: Address: Owner Address Contractor: Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Li9hting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to t 000a Service over 1000a Motors to 1 hp Motors to 70hp Motars to 50hp Molors to 700hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole 2810 FRANCIS LN 14133205 PAUL, JANET ELAINE 2810 FRANCIS LN COSTA MESA, CA PAUL, JANET ELAINE 2870 FRANCIS LN COSTA MESA, CA ABOVE GROUND SPA. NOTICE: The work authorized regulations. (Ord. No. 92-28, § t, $23.50 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 51.10 50.00 50.00 $0.00 50.00 $0.00 $0.00 $0.00 $12.30 $0.00 $0.00 $0.00 $0.00 $0.00 $O.OD $0.00 50.00 $0.00 EXPIRATION: This permit shall for a period of 180 days. 1 Phone: 714-435-9462 Zip: . , PERMIT NUMBER E00-00728 77 FAI DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 07/26I2000 Issued: 07/26I2000 ISSUED BY: '/� Pho�e: J-� Zip: R , � n V' � V;� � Phone: \' � � ��I Zip: , w ) "h �v �., License: Quantity Temp Dist System / Lighting Busway /100 ft Standing Section 0 Misc Electrical Equipment 0 Transformers up to 1 kva/kw 0 ................up to 70 kva/kw 0 .................up to 50 kva/kw 1 .................up to 100 kvalkw 0 ..................over 700 kva/kw 0 Low Voltage Equipment 0 Low Volt Wiring System / Ckt 0 Misc. Conduit 0 Misa Conductor 0 Circus ( gen or ride) 0 Circus (mech ride or lights) 7 Christmas Tree Stand 0 Fireworks Stand Ofher Electrical Fee � � � � \� _Y,/ \ � L✓ � Quantity $0.00 0 $0.00 0 y0.00 0 50.00 0 $0.00 0 50.00 0 30.00 0 50.00 0 S0.00 0 $0.00 0 $0.00 0 57820 1 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee 50.00 TOTAL CALCULATED FEES E55.10 COMMENTS / SPECIAL CONDITIONS permit shall comply with all applicable handicap access requirements untler California statutes and related expire and become void if work is not commenced within 1B0 days, or if work is suspended or abandoned INSPEC710NS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, antl all requlred Inspeetlons and tlnal epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration ol this permit. FOR INSPECTIONS CALL: (774) 754-5626 2446dfi (NW) WORKERS'COMPENSAnON DECLARAnON: � I hereby attirm under penalry ot perjury me of the tollowing declarations: ❑ I have antl will maintein e certificate ot conseN to self-Insure for workers' compensetion, as pmvitletl for Oy section 3700 of the Labor Code, for Iha pedortnence of Ihe work for w�ich Ihis partnit is iuued. �j. I have entl will maintein workers' compensation insurance, as required by sectlon 3700 of Ihe Lshor CoOe, for ihe peAortnance ot the work tor which this pertnit Is issuetl. My workers' compensation Insurance carner antl policy number are: , Cartier: Poliry Number: (This section neetl nof be cromp/efed i/ the permit is valued ef one hundretl tlollaro ($100) or less.) ❑ I certity thet in the peAortnance of the work for which Ihis pertnit is issued, I shall not employ any person in an manner so as to become subject to the workers' compensatlon laws of Celifornie, entl agree t�ai Ii I should become suDject to ihe workars' compensatton provisions @@@ction 3700 ot t�e Labor Cotle, I shall forihwith A� co' ply with these rovision5. \ ican ure: Date: / WARNING: FA�ILUF URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SW1LL SUBJE N EMPLOYER TO CRIMI PENALTIES AND CIVIL FINES UP TOONE HUNDRED TTIOtlSAIVUOOl1AFE(�Ete00,OW),INAODRIONTOiHEWSTOFCOMPENSATION,OAMAGESASPROVIDEDFORIN LABOHCOOE,IMERES7,ANDATTORNEI"SFEES. b�aH�im that I am end eHecL Lic. N _ Contractor's Signeture: provisons of Chapter 9(commencing with Section 7000) ot D� sion 3 of ihe Busir�ss and Professions Cotla, and my licensa Is in full Class a \ Date: CONST LENDING AGENCY: �� ❑ I hereby aHirtn Ihat there is a construction lentlinq agency br ihe peAormance of the work tor whic� ihis permit is issued. (Sec. 3097, Civil Code). Lendefs Name: Lentler's Atldress: Signature: OWNER-BUILDEFi DECLARATIONS: Date: I �ereby aNirtn ihat untler penelty ot perjury thet I am E%EMPT FROM THE CONTRACTORS UCENSE LAW lor the tollowing reason (SecJ031.5, Business entl Professlons Cotle: Any ciry or wunry which requires a permit to construcL alter, improve, tlemolis�, or repair eny structure, pnor to its iwuance, also requires the epplicant tor suc� permit to file e signetl stetement that he or she Is licensed Dursuant to Ihe provisions of Ihe Contractors License Law (Chapter 9(commencing with Section 7000) oi Division 3 of the Business antl Professions Cotle) or that �e or she is e:empt therelrom and Ihe basis lor the ellegatl exemption. Any violation of Section 7031.5 by any epplicant for e permit subjecis ihe applicant to a civil penalty of not more than fiva hundretl tlollars ($500J.): ❑ I, es owner ot Ihe properry, or my employees with wages as their sole compensaiion, WILL DO TNE WORK, and the structure is not intendetl or otteretl tor sale (Sec. 7044, Business and Professions Code: The Contrectors License Law tloes not apO�Y �o an owner ol properry who builds or improves thereon, and who does such work himselt or herselt or Ihrough his or her own employees, provided that such improvements are no� intended or oflered tor sale. tl, however, the building or improvement is ��sold within one year of completion, the owner-builder will have ihe burtlen ot pmvinq �het he or she did not build or improve for purpose of seleJ. I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS lo construct ihe project (SecJ044, Business and Professions Code: The coniractors Lic� l�u(does not apply to an ownar of property who bullds or Improves ihereon, antl who contracis for such project with e contredor(5) licensg�pur¢uant to�Jp6pontrgcj6rs License Laws.). ❑ lam Owner F�e ec. J� Business antl Professions Code for this reason: �� 4" � / . Ca�� i O� 3nti by anvers icense. --ves ❑ No � orivef.s:ucanse No. / � �Expires_ 0 00 of Ownership by (Iype ol dorcu� i.e. - pwpetly Iax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CER7IFICATION: ❑ I hereby cenify Ihat no exwvetion tive (5) or more feet in deD�h into which e person is required Io descend, will be made in connection with work euthonzed by this permit, antl ihat no builtling structure, scaffolding, falsework, or demolition or tlismantling Ihereof, will be more than thirry-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Celilomia Atlminisirative Coda). ❑ As owner�builtler, I will not employ anyone to tlo work which would require a permil irom the Division ot Industrial Safery, as noted ebove, unless suc� pereon �es e permit to tla such work tmm the division. Signature: Dare: Division of Indusirial Salely Permit NumDer: CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF EMRV: I cenity under Oenalry of perjury that I have read this apD�iwtion and state that the information given is correct. I agree to comply with all state'I�.vs @iry ortlinances releting to builtling consimction, end authonze representatives oi ihe Ciry oi Costa Mesa to enter upon the ebove-d sc/nqed�� y�)-� spection u s/es�l agree not to occupy or eliow occupancy ol eny building authonzed by this pertnit umlil tinal inspection. �/ aJci{ �� % /rJ��O/�d . Stgneture:01 Legai Owner(s) Da e AnNOr Authorized Ap0licant Date CQOE �. INSPEGTIONTYPE i816 Fl:atl System Flnal Fire Prevention 1266 Pool Spa Finel 200 Final Ra-Root 201 FInaI BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final �emolition �� CODE I INSGECTION TYPE 206 Finel Mechanical 20B Finel Plumbing 210 Finel Electncal 212 Final Fire Pravention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupanq � I�� : � / / /� II� �oonessaem�w�a: 2g10 FRANCI5 LN wm�Karw�EiF�'w: LUJAN, LENORA ' �ooness: 2g10 FRANCIS LN COSTA MESA,CA 92626 557-2176 APPL. WIlMOI�OPE55: �M CITY OF COSTA MESA — BUII�DING PERMIT PERMIT NO: H 076330 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR i�PERM NO: B 07633U GOVT: N SUPP: N PURPOSE: OTH �qCNRECTORENfiNFEP: �C.NO.: JOB DESCRIPTION . T/OFF RESHEATH AND COVER W/ COMP SHINGLE SQ FT: S, 000 MCN.OP ENG.'41DDPE55: . UNT: CLAIM VALUE: 5,000.00 CALC—VALUE: 5,000.00 GROUP OCC: R-3 /U-1 CONLRACTqI'S N�YE: . cam�ctoas�uwa *�******i�**iMt�**x�D*****�*******�****Dx-***+�-****�t*B*******x�*it**ic��t******�-****�-**�x-** �nm�ss: uc xo.: urir: Z O N I N G R E Q U I R E M E N T S LICENSED CONTfl�CTOR4 DEGIAH�TION: I Feroby art'rm ��« oere�Y d peijury ihm I em Icxuetl uMar porhbm d Chepa e S E T B A C K S (oomme�q wu� Seclian 1000) d D'rv'nion a d ine B�snea uW Pmimeiona Coda. vtl mY Goeroe u in hA luce ud atlae. cmuc.No.: uc.cuss: uc.No.: EXP: ------------ MAIN BUILDING ---------- FRNT: FT IN REAR: FT IN o�a: c�,�,oa�: LEFT: FT IN RGHT: FT IN OWNEN BUILUEH OEC4flATI0N: I Mmby elfiim urdx pene�Y d psrjury �hel I am exmmq Imm iM Comreppa Limnae Lew la Ihe --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN iwb�,��s,a�,�oaua,..b..�eP,w��saes:��y�ay«��v.,n�a,,,u�n,.,o,�,�,„�o�,��,,n,,,�mww.., PARKING REQ: PROV: PARCEL: 14133205 ZNE: REF NO: eemaen.«�av�d+rs��,a�ro.w�«ioma.��..�..c��•�n�md�ui«.�no��ora..,p�„asim�mmmne«.ne pLANNING NOTESJ ' . � IiconseE Dunueni m iho povhions d IM Conlrenom Licepae Lew �Chepm 9(cemmeridrq wilh Seqion 1000) d Divebn 9 d Ib nineea vd Hdeftotn Codel w iMt M a ahe is exemq th>aM1om aM IM Estit la IM elbpeE etemqion. My videlon d Sadqn � ' O�t.SMaM'WdicenilweV+�mnw4�sIMeVWicen�to0+�+lDe�YdMmoralhenfrveh�nCredddlenR`�ll. iE�EiE1EiFiEiFiFlElfiEiEififi(�iElfiEiEfE3EiElElE1EiE1EiF1flEifiFififIF1E3E3E�E3EjElEiE1f-iE1f�7Eif1EiE�E�EiEiFififiFiFiEiEiEiEiElfi(�1E�E1F lfiFif � I, es oxror d Ihe popony ar my empbyeee wIh weg» e� Ihe'v ede mmpannelion, will Eo Iha vroek, enE Ihe sl�uewre e nw iniendad «ollered lor eeb (Seclbn ]ou. ewirea eM vmlaeeion.Caee: TM Comreame Lioenae lew doea rot wdi to en owner a poperly wM W AEs or inpmvae �hereon, enE who Eoee nuc� vroM MmeeX or henep or ihrouph he a her ovm empbyeea. O�dad ihet euch impovemams era ra imeMed a Weretl Iw eeb. H, hawever, ihe buiNinp a'unprovemam ie eoM wilhin ma yeer d compinon, the �axner-0uiker uill heve IM buNen d pmviip he or elie db � b�iW w impon /w �Iw Wmose d eele). I. ro ownar d iM piopeity. am udmwly mntrmip Milh licansed convacbn to emsVutl iM pqea (��'�. Businsas vM rm�e..ia,. coee: The canlrean. lienm Ler me. na epWr �o en w,w a o�we�v wno wiu. « imp�w« �he�on .�a Wio convacie lor wM prqeae wnh e conlrador�e) IkenaeC {�unueM lo IM Contrmars Licerua lew). � � 1 em uemq uMm SxYon: B. 8 P.C.. Nu m: �"�.� Dats: Oxror. ��ti�/i A � �� i m nerenr �«iM w� i�...... a.m u�wm.�ana ine na�t�emero d c.ieomr w.nn .�d sete�v coee seean. u, zssa�, ena 255J1. ud Net I a�nY hAws buildW om�uu xiA / wa na (arcb aw) � b canW wh �eiC mta mdr ud ihs nVuiran�nb br eM�4faowuvuctiannmaddmunham�heAi�ly aMO��Diprie.Rridwu�ImM�udianWGfu1'vnenexemNtmmNme proviaona. Dma: Appfiw��: WORKEF'S COMVENS�TION DECUFATION: I heraby elfum �� paWly d psjuy ar W Ne Idbwuq Jedaratiom: � I hew eed wil meinlein e arlilieete d mneent io veHiro��a br v.orkeii eanpanwian, u prwidad iw by Setlian 3]OU d ths lebar eoe., i« m. p.rt��. a u» won�e« �:�n m�. �m�a 4 m�a, ❑ I lieva eM xitl mamein waMere compeneeton insueend. ee reVuired by Senion �)W d tM Labar Cade, br Ihe pe�lwmentt of tM waM lor wl�'xA Ihis permn is ioued. My worken' rompen�� ineurvice renbr and poliry number ere: cem . vatiyN�mb«: hia sMian nsed rat 6s tompbfeC /!he pamrl i+ br one hUnErW OWlan /j1001 w Isae.J '� I mtN � in IM pMameMe G ihe wak for vfich ihh pe�n b i�a�etl. I e1Wl iwl empby enY Oe� ��Y mannar n n lo became eubjw to �M xaken' romponeatian lexw d C anie. enE yrse Ihtl d I 4wk become alje lo; t�GvMeri companztlion pmrieiqq d SeCian 9)00 0l �M1e Lebor CoEe. I lo wnh oompfy wilh IMse P/ry+/� oi Dete: Appliceiu: -VC ' W�minp: F�Nun ro ucun worten'rompauetlon cev�rp� l� un4WuA �� l ubpct ur r�vloyw ro crlMiW u�m elv0llrws �q ro on� �vrJrstl flwuunE ba/kn (SfOQOdOA b' �Itlon b M� co�f ol eompxwtbn, tlenupu u br In S�ctlm 91G8 0l M�WorG6. iNwv4 �eMm�yi /Iu. CON9TfiUCTION LENDINO AQENCY: I Mmby elfirm uMa pe�eM d per'ryry tlw iMn u e oonstwion kM'vp por y br iM perlamerca d tM hoek la whidi Ihe pemit u cwed (SetliM� �]. CH. CI. LENOEH'S NIWE: LENDEN'4 ADDRESS: I ceniry ihet I hew neE Ihia epplceiwi eM 9me ihe� ihe abova ��«mmion ie mrred. I eprae to compN �h ell ary eM mumy oNinvKas uM ekle kvn Mmiq lo buikip ttwvueion end Mreby aW Wrze reyeumetivee d �h'v dryto amx upan the ebwe-mentioneE popeM lorimpanion purponea. LENORA LUJAN � Pnm Name � �^ � _ . '}��/� l � � �0 �SlSlye WP) WMe-BuiN'vq d Sefety: Green-Fla; Cenery-Ap cenl: Fnk-Revenue: GdEenroE-Asseaor IEaEiEiEfEiEiE�E 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 DATE: BUILDING APPROVED BY : DATE: -� APPLICATION ISSUED BY: DATE: 2` 7-9.F� 1E�E�IEiEiElE�E1E1EifiEiFiEiElEifiElfiElElEiE P iEifiEfEiE1ElElEikiE�7FiFiEiE LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y i HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 72.00 ' .5,0 , SMIP/NON—RES PLAN ISSUE FEE HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL ', PAID DUE TOTALS----> 72.50 0.00 0.00 72.50 , 72.50 .00 REVENUE DIVISION TOTALS--> COLLECTED; 72,50 OVER/SHORT: .00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 72.00 :50 1EfE1F1FiE1F1EiflfiEifiEfEfEfEfEiElkiEiEfEfEfE�EiEiEfEiEiEiEikiElklElEIE1EiElEiElFiEiFiEikiE1E1E1E�FiflEiEiE1EiE1EiFiElEiEiEiEiElElEikiElElEfElEfEffiElElFiFiE 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 I O N UNIT COST TOTAL COST SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE "1.00 END OF FEES � � �4<i:e.� iAT:.... (!, 5,000.00 �.'�l�l _ _ "_ �- - • . - __ / - \4 ' i � / � CONSTRUCTION AND PLANNING POOL ,'A APPROVALS Permit # Date inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement . 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding , 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electriwl UFER Grnd. 57. APPROVAL TO COVER�GUNlTE • 7. Footings 58. Elearical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe�Undrgrnd. - ' 60. Backwash Lines, P�Trap, � Undrgrnd. 70. StruMural Floor System � 61. APPROVAL TO DECK � 71. Property Sewer Line & House Connection 62. Backwash & Receptor-Finai , 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System � Final 74, Rough Plumbing � � 65. Electrical-Finai 15. Rough Electriral-Conduit - 66. Solar System-Final 16. Rough Electr'ic Wiring .�67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Cond�tioning FIRE DEPT. RE�UIREMEN7 . 20. Rough Pactory Fireplace - APPPOVALS� Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilatin� - � - 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test - 72. Underground Fiush 24. Roof Framing ' • 73. Undergmd. Storage Tank O Gas ❑ Oil 25. Roof Sheathi�g �/; �� - 74: pverhead HY��o t 'U 26. T�Bar Ceiling (Structuraq & Monowat . 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe � 28. Lathing & Siding ' � - � 77. FIXED SYSTEM,FINAL 29. Insulation 78, FIRE PREV. FINAL 30. Drywall Nailing . FiEAITH DEPT. REQUIREMENT 37. Plaster Brown Coat 79. FINAL INSPECTION 32. Electriwl Power Meter�Final 80�. FOOD CERTIFICATE ISSUED 33. Final Electric � Notes: 34. Final Heating & Air Conditioning �. . , ' ' 35. Final Gas Pipe-Test � 36. Hood or Canopy � � 37. Final.Factory Fireplace '" 38. Final Plumbing � '" � 39. Water Service-Final � 40. Gas Service�Final � ' 47. Solar pomestic-Final - � � 42. Backflow Preventer . Z�/�-ra'l ... c�� ,�, / -C�' % 43. Backflow �Irriqation cr C� I� �� 44. Landscape Irrigation System ' � � �Q �T��v , �g,n � . '-�' 45. Sound Attenuation � �.� 46. HandicapRegulations - . �0�� ,�.,�� -__��'Y`+ 4J. FINAL STRUCTURE & BUILDING /d.�/b� G%(y G � rv 48. FINAL PLANNING ' ' 49. Electric Reiease to Edison • 50. Gas Release to Southern California Gas Co , 51. CERTIFICATE OF OCCUPANCY No. Date � � _f_•lti-,ij\i COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 C08TA MEBA, CALIFORNIA For Applicanf fo Fill Iri Complefely YYPE OR PRINT COSTA MESA. CALIFORNIA CI7Y COIOIlB ARCHITEGT � STATE �� .' � + OEC� " Lo-r ss, PZ/��+! 3��,6�GZ 'r �;i�b�;, .�_.. APPLICATION FOR PERMIT BUILDING Fo� Office Use Only necetrr No. vytN�S no�. _ REC81 6D EY DA pEC61VE DATC 186UCD .z: /• —7` ° ^�*on�ac ADDRE55 2810 Fi8nCi8 Lane COSTA MESA. GALIFORNIA , Coast Highvav ioNe M8CC0 APPR� lil$ a21 M8 � BV del Mar `o"` TEL. � t¢GAL ' NO. oeeCn � t. I NO. Op plDGO. � BHTBAGK {JN6 FROM � �� cerrten on srr+eer O— REAR YARD I / I // SIOE YARD LEFT RIGHT - DESCRIPTION OF WORK BUILDING NO. OF SIZE ROOMS EXTERIOR WALL ROOF COVERING COVEF USE OF BUJLDING AND WORK TO E ZONING Ho. or I use or new rurvsn am�o�eo _. LIN! BTq �XENEBY�KNOWLEDGB TXAT I HAVE HGD TMIB MPLIGTION THQ AMOUNT 9HOWN IIND¢R VALUATION IB IOR TXe AND BTAT THAT THH ABO E IB COPRECT �NO AGR M GOM• pUPP08[ OP [BTA�LIBMIN6 A P6RM�i P68 ONLY. PlY WITH Pll CITY Ofl�� N ANO 6TAT6 lAWB QUURN6 9uRDINo CON8TqU4TON! VALUATION �( I 81GNATURE OF /� � _PERM17 REE $ 3�� Q� PERMITTE / IS I�� p( L) . �'O PLAN CFIECK $ I�%. :�'� AUTHORIZED AGENT TOTAL F8E