The URL can be used to link to this page

Home My WebLink About3481 FUCHSIA ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��,s MBING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3 8 Fl1CMSIA:ST - Suite No Vicinity: Parcel Nunmber: 41217204 npp�icant: SPALDING, JASON Address: 17390 MT CLIFFORD CI Ownec Address _ ��, FOUNTAIN VALLEY, CA �� '".Phone:� 714-241-1414.. �. -� - _ - . Zip: 92708 � . .. i ' , , CHAPANOND,TUSSANEE 3481 F.USCHIA�ST - .- - ' ISSUED BY: Status: ISSUED Applied: 10103/2006 Issued: 10l03/2006 !� ; - " � Phone: p14) 682 2147 � _ � ��% , 1 � �� COSTA MESA, CA � Zip: 92626-1713 � ; �, .� , . i .�, .,, - Contractoc COAST ROOTER PLUMBING HTG AND AC ; Addre,ss: 17390 MT CLIFFWOOD ., �, � . .. Phone:' 714-241-1414 � FOUNTAIN VALLEY Zip: 92708 -R+�"' * ` � i, yl �Lr ar.i �` � sy. � £. � " License: 529127 � . � - ' . . , _ _ ' ._ `� . . . � � -� . , � ' ` ' - - � �� "^ � - SCOPE OF PERMIT � � .��.' ' , , �; �. � . � � � CHANGE OUT (E) WATER HEATER FOR SFD. - �- - � �- . . " � . . _ . � \. „ �, ` .. , . , AMT ISSUE FEE � $23.50 Backtlow irrigation $0.00 Backflow Preventer $0.00 'Bafhtub � � $0.00 ClarifierSyslem $0.00 Connecl Qce,Soda,etc) $0.00 Dental Units . - � $0.00 Dishwashe� , . � $0.00 Drain,�Floor , $0.00 Drain, Rainwater . � $0.00 Drain; Roof• - . � � $0.00 Drinking Fountain. , : $0.00 Expansion Tank $0.00 Gas Earthqualie Valve "$0.00 Gas (1-4 oullets) ' $0:00. Gas (Over 4 ouHels) � , $0.00 , Gas Repipe ' $0.00 � Gas Service , , $0.00 Interceptors (Grease; Oilj ;$0.00 , Interceptors (Sand Auto ) $0 00, \, :.' '.. " FEE SUMMARY � ' � grv � _ , nMT. "�_ �nMr carv � LaundryTub/Washer.- -$0.00 ,�0 ��-SumpPump � � $0.00 �0 0 � � . - � Landsiape Irrigation " � - - $0.00- - 0 : ' �' � Swimming Pool 30.00 0 0 P-Trap $0.00 , 0-. Trap Primer ' �$0.00 ' 0 0 Pressure Regulator $0.00 0� Urinal � -� $0.00 0 0 , � Process Piping (per 10,ft): __ $0.00� ;- 0 ,^, � _ . _ i Vacuum Brkr Bkflow(1-4) � _ , $0.00 0 0 _ Receptors _ � � - _ .. $0.00 ; � 0� ��= �� Vacuum Brkr Bkflow(5+) r ----$0.00 � 0 0 ' .. - SepticTank , � � �$0:00 �0. �- _ , Wash Basin `' � ' �- $0.00 �; 0 0 SewerCapforDemo $0.00�; 0 � WashBasinSet�. ,� �-.$0.00,;;,0 0 SewerConnect ,�$0.00 0 WasteandVentSystem�', $0.00� 0 0 � SewerPrivateLine - i-$0.00� .�0 �-WaterCloset(Toilet) � , $0.00�, 0 0 Shower ' $0.00 �'0 �WaterHeater/vent� � $12:30� 1 0 Sink, bar $0.00 0 Water Piping (I,nst or Rep.) .$0.00 � 0 0 Sink, commercial �" •� '� $0.00 0 WaterRe-pipe � � $0.00 0 0 Sink,.Floor:: -� -$0:00 0 Water Service � �$0.00 0 0 Sink,kitchen - $0.00'��v��0 WaterSoftener. � -'�,$0.00 0 0 i: . . ��Sink,service/mop � $0.00 ,�.0.,`'ti�,`,'?°��.�;- OTHER� � , $0.00 . �0 ' � Spa (private) ;. . � . $0.00 0" . �- VIOLATION � � �. �i $0.00 0_,;', Spa(public)�� - . = � $0.00 �� 0 �- rPLANCHECK !� � �� $0.00 0 „ _ ' . ' ' �� ,� -%.'REINSPECTION $0.00 0 �Q � . ./,, , : „- ;,.�, � : / .. ., _ - , _ � , , ~ �� ., � � �� TOTAL CALCULATED FEEB: $35.60 , , / COMMENTS I SPECIAL CONDITIONS -. .: .,. .,. , IOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related agulations. (Ord. No. 92-28, § 1, 12-21-92) XPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned v a period of 180 days. ISPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all qulred Inspectiona and tinal epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. )R INSPECTIONS CALL: (714) 7545828 iaas (sroo) WORKERS' COMPENSATION DECLARATION: � ' ' � . I hereby efflrm unCer penelty ot perjury one ot t�a following decleretlons: ❑ I heve end will melnteln e certiflcale ot consent to self-Insure for warkers' compensatlon, es proWtleE for by sectlon 3700 of the Lebor Code, lar Ihe perfortnence of the work for whlch this pertnit Is issued. " ❑ I heve�erltl will maintain workers' compensation insurence, as required by seccion 3700 of Ihe Lehor Cotle, for the peAortnance of Ihe work for which this pertnit is iswed. � �My Wo`rk s'1 ync { r�t� Insurance carrier and policy number ere: L � �Certier.� �..%�'�� + �PoOcy.Nu`mE� OQQ�� 7 %�� ,F7his sectlon need not be compl etl il the permif is ve/ued af one hundred dollers ($100) or IessJ ... ❑ I certity ihat in the performance of ihe work for which Ihis pertnil is issued, I shall not employ any person-in eny manner so es to become subject to Ihe workers' compensation laws of Califomie, end egree thet ii I shoula become subject to the workers' compensetion provisions of Sectlon 3700 of Ihe Lebor CoCe, I shell tonhwith campy with Uese provisions. Appliwnyt Signat� : � D'ete�,^�`�� .�' �6 WARMN�i:.FAICURE TO S RE WORKERS' COIA EN ON WVEMGE IS UNIAWFUL ANO SHALL SUBJECT PN EMPLOVEFTO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED TiVW5iWD00lLARE�5100,000�.INA0DIT10NTOTHE TOFCOMPENSATION,DAMAGESASPROVIDEOWRINSECTION3IWOFTHELABORCOOE,IMEREST,ANOATfORNENSFEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn that I am Iicen�Q under provisions of Chapter 9(commencing with Section 7000) ot Division force and eXact .Lic. a :�.fn (a-1 _ _ Cotle, and my license Is in tull CONS7RUC710N LENDING AGENCY: ❑ I hereby attirm Ihal there is e construction lending agency for the peAormance of Ihe work for which this pertnit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lentlefs Address: Signatura: �ate: OWNER-BUILDER DECLARATIONS: � I hereby attirtn that under penelry ot perjury ihat I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Protessions Code: Any city or county which requires a permit to consiruct, atler, improve, demolish, or repair any strucNre, pnor to its issuance, also requires the applicant tor such pertnit ro file a signed stetement that he or she Is Iicensed Dursuant to the pmvisions ot ihe Contractors License Lew (Chaptar 9(commencing with Section 7000) ol Division 3 of the Business entl Pmtessions Gotle) or t�at he or she is e:empt Iherefrom and the basis tor the elleged eaemption. Any violation oi Section 7031.5 by eny applicent for e permit subjects tha applicant to a civll penalry c1 not more than tive huntlretl dollars ($500).): - ❑ I, as owner of �he property, or my employces with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or oHeretl tor sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves Ihereon, entl who doas such work himselt ar hersetl or ihrough his or her own employees, pmvided Ihat such impwvamenis are not intentled or oHered lor sale. If, howevar, Ihe building or improvement is sold within one year of completion, the owner-builder will have the burden ot proving that he or she ditl not Guild or improve tor purpose of sale.). ❑ I, as owner of tha properry, em EXCLUSIVE�Y CONTRACTING WITH LICENSED CONTRACTORS to construCl the O�olact (Sec. 7044, Business end Protes5ions Cotle: The conlractore License Law tloes not apply to an owner of property who builtls or improves thereon, antl who con�racts for such pro�ect with a contrector(s) license pursuant to the Comractors License Laws.). ' ❑ I am exempt under sec. Business and Professions Code for this reason: SignaWre: Date: Owner ID verifled 6y tlnveYs Ilcense. ❑ Ves 0 No Driver's License No. Expires: Venfication of Owners�ip by (type ol document, i.a. - property tan blll or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATON: ❑ I hereby ceNty Ihat no excavetion five (5) or more feet in depih into which a person is required to tlascen4 wlll be made in connection with work euthorized by ihis pertnit, and thai no building siructure, sceHoltling, falsework, or demolition or tlismantling ihereoi, will 6e more ihan ihirty-sin (36) feet �igh. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Califomla Administrative Code). � As owner-builder, 1 will not employ anyone to do work which would require a permit from the Division of Industriel Safety, es noted eDove, unless such person hes e pertnit to do such work from the division. Signeture: Division of InOustnal Safery Pertnit Number: Date: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATON: 1 Will the epplicant or present or future builtling occupant need to file end certity a Business Plan tor emergency response to release or ihraetened release of e hezerUous matenell ❑ Yes ❑ No � (Section 25505 of the Califomia Healih antl Safery Code requires, with some excep�ions, Ihat a Business Plan he filed with the Cwta Mesa Fira Departmen� by every busineu which has at any ona time tluring a reported year a quaniiry of harardous matenals equal to or greatar ihan a weight of 500 pountls, or e voluma of 55 gallons, or 200 cubic teet of compressed gas at standard temperature antl pressure). ......._..........__ ..........................................................................................................................................................._.__._..........................................................._......_..........._....................................._......... .................................................... 2 Does or will the applicant or present or future builtling occupant need to file a registration fortn tor eately hazerdous metenals? ❑ Ves ❑ No (Section 25533 01 the Calilomia Health and Safety Code, with some exceptions, requlres regi5tretion with the Coste Mesa Fira Department by eech business which et eny ona tlme has on hand e quantiry ot ecutey �azerCous materlels equel to or greater ihen e weight oi 500 pounds, or e volume of 55 gellons, or 200 cubic feet of compresseU gas at standard temperaNre and pressura). .....................................................................................................__............................................................... __................................................_....................................................................................................................... 3 Does or will Iha applicant or present or future building wcupant nead to prepare an RMPP (Risk Management and Prevenlion Program for ecutely hazardous matenals)7 ❑ Yes ❑ No (Section 25534 0l Ihe California Health antl Setety Cotle providas that the Costa Mesa Fire Depenment may require Ihe preparetion, certification and tiling wlth the Fire Department of an RMPP 6y businesses which ere requirad lo register ecutely hezardous materials with ihe Fire Department. ........................................ _ ..............__...........................................................................................................................................................................__................................................................................................. 4 N en RMPP is presently requireq has Seciion 25534 of ��e Califomia Health end Safery Cade been fully complied wi �- ..................................................................................................—._........................................................................................_..__......................................._............_... 5 Does or will �he epplican� or present or Wture Gulltling occupant require tor ihe work which is Ihe sublect of ihis a F tmm the South Coast Air �ualiry Management District or irom any other air pollution conirol tlisMct or agencyt � (Section 658502 of the Celifomia Govemment Gode requires ihel the requested iniortnation be fumis�ed on applica ................................_....................................................................._._........................................................................................................................................._......_.... 8 Will any part of Ihe facility to be consWdetl untler ihis permit be within 1oo01eet irom the outer boundanes of e sch� Qf yes", the taciliry must meet t�e requirement of Sections 25534 and 42303 of the Califomia Healih and Safety Ca .... _ .................................................................................................................................................................................""_. _ _.......................................... _........... 7 tl a pertnit trom Iha South Coast Air OualitY Menagement District or olher air pollution wntrol district or egency epplicallon, have ell oi tha tlisclwures prescnbetl by Calitomia Health entl Setery CoCe Sectlon 42303 been matla? ves ❑ No ....................................................................... a Permi� for such construction or {JND non-resitlential building pertnits). ...................................................................... � Yes ❑ No "'. _ ............... _............................................ �atl Por the work which is ��e s� ❑ No ..__________._..__. .. 8 (Ii yes', anach cetlificate ot compliance from tha appropeate air pollution control otticeq. CERTIFIGATE OF COMPLIANGE: I certify t�at untler penalry oi perjury the infortnation given above is correct. I agree to comply with ell state lews and ciry ordinances reparding Hazartlous Matenals and Emissions. Signature: �ate: CERTIFlCATE OF COMPLIANCE AND AllTFIORIZATON OF ENTRY: I cenify under penalry of perjury that I have reatl this application end state t�at ihe infortnetion given i: correcl I agree to comply with all state laws and ciry orainances relating ro building construction, and authonze representatives of the Clry of Costa Mesa to anter upon thi ebove-described properry tor inspection purposes. I agree not to occupy or allow occupancy ot any building au�horized by Ihis permit until finel inspection. �ega� �wneqs� �d:ed av_n pc,...,_.�.- -- SOOE 1, INSPECTIONTYPE 1616 Fined System Final Fire Prevention 1286 Pool Spe Final - 200 Final Re-Roof 201 Finel BIocWRetaining Well 202 Final Factory Fire Place 203 FInaI5lgn 204 Final Dem0lition IMRIpLS CODE� INSPECTONTVVE 206 Final Mechanical � - 20B Final Plumbirg 210 Final Elecirical _ .. _ 212 Finel Fire PraventlOn 220 Final Planning Approval 222 Final Site � � 250' � Final Building/Occupenry QaIE � It�l4@ • i �� — • � / � � (714)754-5273 • Fex(714)754-4856 JobAddress: 3481 FUCHSIA ST Suite: Vicinity: REAR OF HOUSE Parcel Number: 41217204 CITY OF COSTA MESA BUILDING DIVIS/ON DEVELOPMENT SERVICES DEPARTMENT PERMIT Applicant: CHAPANOND, TUSSANEE Address: 3481 FUCHSIA ST COSTA MESA, CA owner CHAPANOND, CHAN Address 3481�FUSCHIAST COSTA MESA, CA Contractor: OWN ER-BU I LD E R Address: Zip: Arch : r Address: ' Phone: BUILDING PERMIT Zoning: Rl R1 Phone: (714)269-9819 Zip: 92626 Phone: p14) 269-9819. Zip: 92626 Phone: License: 0 . Eng: Address: NUMBER I �/ B00-00080 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 01/20/2000 Issued: 04/26/2000 Phone: Zip: - License: License: , SCOPE OF PERMIT � CONSTRUCT 323 SF SINGLE STORY MASTER BEDROOM ADDITION AT REAR OF EXISTING HOUSE. � Plan Check: $68.58 Permit: $422.05 SMIP Res: $2.76 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $493.39 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING Existin : 2 NOTES: Rear 20-0 Rear 0-0 Required: 2 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation Right 5- 0 Right 0- 0 $27,676.50 so.00 4 NOTICE: The work authorized by ihis 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 1B0 days, or if work is suspended or abandoned or a period of 1 BO days. � NSPECTIONS: In order for �he work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all equlred Inapeetlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. °OR INSPECTIONS CALL: (714) 7545626 . �� WORKERS' COMPENSATION DECLARATION: I hereby aftirm under penalry ot perjury one of Ihe following dedarations: � ❑ I have and will maintaln a certificate of consent to selt-Insure for workers' compensation, as providetl tor by section 3700 of the Labor Cotle, for Ihe pertormance of ihe work far which this permit is issued. ❑ I have entl will maintain workers' compensation insurance, as required by sec�ion 3700 of the Labor Code, for ihe padortnance of the work for which ihis partnit is issuetl. My workers' compensetion Insurance carrier and policy number are: . Carner: Policy Number. (This section need nat be completetl i! fhe permif Is velued et ane huntlretl dollars ($100) or /ess.) ❑ I certify that in Ihe peAormance oi the work tor which this permit is issuad, I s�all not employ any person in any menner so as to becoma subjed lo Ihe workers' compensation laws of Calitomia, and agree that if I should become subjeci to the workers' compensation provisions of Section 3700 of ihe Lebor Code, I shall forthwith comply with these provislons. Applicam SignaNre: Date: � WARNING: FAILUflE TO SECURE WORKERS' COMPENSATION COVERAGE I$ UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIE$ AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLL4RE (5100,000). IN A�DITION TO THE COST OF CO�.APENSATION, �AM4GE5 AS PROVIOED FOq IN SEGTION 31O60F THE LNBOR CODE, IMEPEST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm �hat I am licensed under provisions ol Chapter 9(commencing wi[h Section 7000) of Division 3 of the Business and Professions Code, entl my license is in full force and ettect. Lic. # Class x Contractor's Signawre: Date: CONS7RUCT10N LENDING AGENCY: ❑ I hereby effirm that �here is a construction lending agency for the pedormance ot the work for which this permit Is issued. (Sec. 3097, Civil Cotle). Lenders Name: Lendefs Address: Signature: Da�e: OWNER-BUILDEfi DECLARATIONS: I hereby aXirtn that unCer penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions Cotle: Any city or counry which requires a permit to construct, alter, improve, demolish, or repair any structure, pnor ro its issuance, fllso requires Ihe epplicant for such permit to file a signetl statement Ihat he or she is licensed pursuant to Ihe provisions of ihe Contractors License Law (Chapter 9(commencing with Saction 7000) of Division 3 of Ihe Business antl Professions Code) or that he or she is e:empt Ihereirom and the basis tor the allegetl ezemption. Any violetion of Section 7031.5 by any applicant for e permit sub�ects ihe applicant to a civil penalty ot not more ihan five hundred dollars (5500).): ❑ I, es owner ot t�e property, or my employees with wages as their sole compensation, WILL DO THE WORK, end the structure is not intentled or ottered tor sale (Sec. 7044, Business and Professions Code: The Contrectors License Law does not apply to an owner of property who buiitls or improves ihereon, and who tloes such work himseN or herself or ihrough his or her own employees, provitled that such improvements are not intended or oflered for sale. If, however, ihe Duiltling or improvemem is sold within one year ot completion, ihe owner-builtler will have �he burtlen of proving Ihat he or she did not build or improve for purpose ot sale.). ❑ I, as owner oi �he properry, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct tha project (Sec. 7044, Business and Protessions Code: The contractors Licanse Lew does not apply to an owner ot propeny who builtls or impmves thereon, and who contrects for such project with a contrector(s) license pursuant to the Comractors License Laws.). ❑ I am ex9rypLy�der sec. Business�nd Professions Code for ihis reason: Signature: � Owner ID venfied by dnvers license. ❑ s ❑ No Venfication oi Ownership by (type of document, i.e. - property tax bill or deed): Dete: /v O Driver's License No. �� Expires: !il- OQ— � DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify thai no excavation five (5) or more taet in depth into which a person is required to descend, will be made in connection with work authorizetl by this permiC and that no building stmcNre, scattoltling, falsework, or tlemolition or tlismantling thereot, will be more than thirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 347, Title 8, Calitomia Administretive Code). ❑ As owner-builder, I will not employ anyone to tlo work which woultl require a permit from the Division oi Industrial Safety, es noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number. CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENTHY: I certity under penalty of perjury that I heve reatl t�is application and state Ihet the information given is correct. I agree to comply with all s�ate laws and city ordinances relating to builtling wnstruction, and amhorize represematives ot the Ciry of Cosla Mesa to�enter upon the abQ/�� _e;cribed properry for inspect�ion �pu7rpases. I agre�a not to /o�c upy or allow occupancy ot any builtling euthorizetl by this pertnit until ilnal inspection. %�.C�2/J l/m00 �yyl�ml. h-ti'/�' !� �� i �o� �Cl 7� S�gnaWre tegel Own r s) Date AnNOr Authonzed Applicant CO�E t. INSiEGTIONTYVE 1616 Fi:ed System Finel Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition 2GCBdfi x• P9IE INiR1AL5 CODE� INSPECTIONttPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 272 Finel Fire Pravention 220 Final Planning Approvel 222 Final Site 250 Final Building/Occupancy �IE . INTITIALS i • . ; ��„`�i' Q� ��,�w �� ACl�� L/ClfCdG4�2 OV1/NER-BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section I983Q shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require [he re[urn of, an owner-builder verifica[ion. Attention PropeRy Owner: An bwner-builder' building permit has been applied for in your name and bearing your signature. Please complete and retum this information in the emelope provided at your earliest opportunity ro avoid unnecessary delay in processing and issuing your building perntit. No building pemu[ will be issued until this verification is received. I. I personally plan to prov�de e major labor and materials for conswction of the proposed property improvement Q Yes ❑ No 2. 1(have/have not) Ll�ih/� signed an application for a building permit for the proposed work��- 3. I have convacted with [he following person (firm) to provide the proposed construc[ion: Name Address Phone( ) City _ Contractor's Lic. No. 4. I plan to provide portions of the work, but I have hired the following person [o coordinate,- supervise and provide the major work: Name Address � Phone ( ) City _ Contractor's Lia No. 5. I will provide some of [he work but 1 liave contracted (hired) the following persons to provide the work indica[ed: Name 1042-46 (REV.9/98) Address Phone Type of Work (714) 754-5273 • Fax (714) 754-4856 Job Address: Suite No Viciniry: Parcel Nunmber: CITY OF COSTA MESA BI/ILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT. PERMIT 3481 FUCHSIA ST NEW MASTERBEDROOM 41217204 Applicant: CHAPANOND, TUSSANEE Address: 3481 FUCHSIA ST COSTA MESA, CA Owner: .CHAPANOND, CHAN Address. � 3481 FUCHSIAST COSTA MESA, CA Contractor: O W N ER-BU I LD ER Address: ELECTRICAL PERMIT Phone: (714)662-2147 Zip: 92626 Phone: (774)662-2147 Zip: 92626 Phone: , Zip: License: 0 NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 04126/2000 Issued: 04126/2000 _r SCOPE OF PERMIT ' - " ELECTRICAL PERMIT FOR NEW MASTER BEDROOM ADDITION. INSTALL 5 LIGHT FIXTURES, 7 tECEPTACLE OUTLETS,'& 3 SWITCHES. � - :EF: B00-00080 ISSUE FEE Temp service test Res. alc package New Res (1-2 units) New Res (3+uniis) , Pool / Spa Lighling Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors l0 1 hp Motors to 10hp Motors to SOhp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a � Pole Light Pk9 Sign Circuits Temp Pwr Pole Intermed Pole $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $5.50 $7.70 $3.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $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 ft Standing Section Misc Electrical Equipment Transformers 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 Wiring System / Ckt Misc. Conduit Misa Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Invesligation Fee Plan Check Fee Reinspection Fee Quantity $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 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES 540.00 COMMENTS / SPECIAL CONDITIONS v NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related �egulations. (Ord. No. 92-28, § 1, 12-21-92) . ?XPIRATION: This permit shall automatically expire and become void if work is noUcommenced within 1 BO days, or if work is suspended or abandoned or a period of 1 BO days. . NSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all equlred Inapectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. 'OR INSPECTIONS CALL: (714) 7545626 . � j I' WORKERS' COMPENSATION DECLARATION: ' �' I �ereby attirtn under penelry of perjury one of ihe following declarations: ❑ I have and wlll maintain a cenificate of consem to selFlnsure For workere' compensatioq as pmvitled for by section 3700 ot the Labor Cotle, tor i�e peAormence ot Ihe wark lor which Ihis permit is issued. . ❑ I hava and will maintain woAcers' compensation insurance, as requiretl 6y sac�ion 3700 of the Lebor Code, for the peAortnence of iha work tor which this pertnit is issuea. My workers' compensation Insurance carner and policy number ere: . Carner. Policy Number: (This section need not be comp/eted I/ Ihe peimif is valued et one huntlretl dollers ($100) oNess.) ❑ I certify that in Ihe peAormance of the work tor which this pertnit is issueQ I shall not employ any person in any manner so as to become su6ject to lhe workers' compensation laws oi Califomia, and agree thet if I should become subject to the workers' compensation provisions of Section 3700 ot the Labor Coae, I shell forihwith comply with these provisions. - Applicant Signeture: Date: WARNING FAILURE TO SECURE WORKERS' WMPENSATION ODVERAGE IS UNUWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND pVIL FINES UP TOONE HUNDRED THOUSAND DOLIAAE (5100,000�. IN ADDITION TO THE WST OF COMPENSATION, DMA4GES PS PROVIDED FOR IN SECTION 3]O6 OF THE LABOR CADE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Coda, entl my license is in full torce and eNect. Lia A Class q Coniractor's Signature: Data: CONSTRUC710N LENDING AGENCY: ❑ I hereby aHirm ihat ihere is a construc�ion lentling agency for the peAormance ot the work tor which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lendefs Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I here6y affirm ihat under penalry ot perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or counry which requires a permit to construct, alter, improve, demolish, or repair any structure, pnor to ils luuence, also requires the applicant for such permi� to file a signe0 statement �hat he or sha is licensed pursuant to the provisions of the Contractors License Lew (Ghepter 9(commencing wiih Section 7000) of Division 3 of ihe Business and Protessions Cotle) or that he or she is exempt thereirom antl ihe basis for ihe alleged eaemption. Any violation of Section 7031.5 by eny epplicant for a permit subjects the applicanl to a civil penalry ot not more than five hundred tlollars ($500).): ❑ I, as owner ot the property, or my employees with wages as their sole compensation, WILL DO 7HE WORK, and Ihe stmcture is not intentletl or ottered for sele (Sec. 7044, Business and Protessions Code: The Contractors License Law does not apply to an owner of pmperty w�o builds or improves Ihereon, antl who tloes such work himself or herseli or through his or her own employaes, provided Ihat such improvemenis ere not intended or oHered for sale. If, however, ihe building or Improvement is sold within one year ot completion, tha owner-builtler will have the burden of proving that he or she did not build or improva tor purpose oi sele.). ❑ 1, as owner oi ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sac. 7044, Business antl Professions Cotla: The contracmrs License Law does not apply to en owner of properry who builtls or improves thereon, and who conirecis tor such project with e comractor(s) license pursuani to the Coniractors License Lews.). ❑ I am exem, �t un er sec. Business an%tl �ofessions Code for this reason: Signature: T i/��)j��,_ .nQ�E Sy_�.�1/ Date: � ' . Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: �; /�/7� Verification ol Ownarship by (type of tlocument, i.e. - properry ta�c bill or tleetl): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby certity that no excavation five (5) or more feet in tlepth into which a person is required to descenq will De matle in connection with work authonzetl by Ihis permit, and that no building sWCNre, scattolding, talsework, or demolition or dismantling thereof, will he more ihan Nirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Califomia Administrative Cotle). ❑ As owner-builaer, I will not employ anyone to do work which would require a pertnit from the Division of Industriel Safety, as noted above, unless such person has a permit to do such work irom ihe tlivision. Signatura: Division of Indusirial Safery Pertnit Number: Da�e: HAZARDOUS MA7ERIALS AND EMISSIONS CERTIFICATON: 1 Will Ihe applican� or present or future building wcupant need to file and cenify a Business Plan for emergency responsa to release or threatened release of e hezartlous matenall � Yes ❑ No (Seciion 25505 oi ihe Califomia Health and Satery Cotle requires, with some exceptions, that a Business Plan �e filetl with the Costa Mese Fire Depanmem 6y every business which has at any one time dunng a reported year a quantiry ot hazardous matenals equal to or greater Ihen a weight of 500 pountls, or e volume of 55 gellons, or 200 CubiC feel ot ComO�essed gas at Stantlartl temDerature antl pressure). 2 Uoes or win [ne appiicant or present or mture omiaing occupani neetl ro nie a regisireuon tortn ror acutely nazartlous matenels7 U Yes LJ No (Section 25533 of the Californla Healih and Safery Code, with some exceptions, requires registration with the Costa Mesa Fire Department 6y each husiness which at any one time hes on hand a quantiry oi acutety hazardous materlals equal to or greater ihan a weight ol 500 pounds, or e volume of 55 gellons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the appliwn� or present or future bulltling occupant need to prepare an RMPP (Risk Management and Prevention Progwm for awtely hazardous materials)? . of the California Healih an RMPP by businesses a I(an Fire Department may i ma�enals with the Fire Code Deen fully tomoli� ihe with7 ❑ Yes cenification antl filing with Ihe Fire �es or wni me appucant or present or ruture omloing occupant reqmre tor Ine worR wnicn is Ine suDJetl OI IfllS a pliCeiwn e perml� Ior suc lm [he Soulh Coast Air Qualiry Manegement Distdct or fmm any other air polWtion con�rol disirict or agency7 � Ve5 I�J No ection 650502 ot ihe Calitomia Govemmen� Code requires Ihat ihe requestetl infortnalion be fumi5hed on applica�ions for nomresitlentiel ill any pan of the faciliry to be constructed untler this pertnit he within 10001eet from iha outer bountlarles of a school7 ❑ Ves ❑ � yes', tha faciliry must meet ihe requirement oi Sectlons 25534 and 42303 ot the Califomia Health and Safery Code). a pertnit irom the South Coast Air Oualiry Management District or other eir polWtion contml disirict or egency is required for the wor �olication, have all of the disclosures orescribed bv Califomia Healih and SafeN Cotle Section 42303 been matle? ❑ Yes ❑ No or CERTIFICATE OF COMPLIANCE: I certity that under penelry of perjury the informatlon given above is correct. I agree to comply with all state lews and city ortlinances regartling Harardous Materials end Emissions. Signatura: Date: CERTIFlCATE OF COMPLJANCE AND AUTHORIZATION OF ENTRY: I certify under penalty ot perjury that I have reatl Ihis application and stata that the information given is correcL I agree to wmply with all state laws and city ordinances relating to building consiruction, antl authoriza representativas ol tha Ciry of Cwta Mesa �o enter upon Ihe aDove-dBScnbetl pmperty for inspeaion u�agree not to occupyD/ allow occuDancy of any building authonzed b� is p0�1' until final Inspection. ( T �/ l i 1 .CiA��'� �12'X�%i C:T'C� / ignaNre Of al Owner(s) '' Date And/Or Auihorized Applicant Data COUE �. INSVECTIONTYPE 7616 Fixed System Finel Fire Prevention 1266 Pool Spa Finel 200 Final Re-Roof 201 Final BIocWReteining Wall 202 Final Factory Fire Place 203 Final Sign 204 ., Final Demolition 2aa6 08 ' OqTE ��pl�l¢ GOOEt 206 20B 210 LMSPECPONTYPE Final Mechanical Final Plumbing Final Elacincal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 FinalBuilding/Occupancy �g IA T�e..' cdpy. t� I?/�.,,,,,,,..� i.L�n,;Q- RECEfU�,� Ti2ACT N0. I S C+TY Or' CP �'. `C`�';a IAT �'0. � pL , p,.;,:... . � �� 1 ` �»�9 a�nxEss 3 �� f �i��oi .. .� � : . �M � � i � ei t l�ti� ��5�� H DATE . � � /� The developer of`•the above entitled tract desires to sell the above set forth Iot prior to the time that the tract has been conpleted and its streets accepted by the Cfty of Costa Mesa. The unde signed, by executing this agreemen:, acknowledges that (he-��-'�'---y)__�d�(was eT'E.�Z'e) �� advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the City at the Lime the final tract map was approved. The City assames no liability for the er.forcemer.t of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless fror.: any claim resulting in damage or personal injury to the undersigned by reasor. of the aforetzentioned uncompleted condition. BY � ��,' � Purchaser �� _�— , ( /. / � ` BY �-,:..1"<'`'- ;? i/�11,-,-:_�=!`�_ Developer and/or authorized representacive �%-� � l./� � 9Y _-� ,.e,�u,� , ��- k Lender i_ �-___.r-_w.....-._ _..--....... n .-.-+..-. .._._-..-.-._-.,....-.--...--.- .. -_.._._—.-...-_-. " ' OWNER DATE JOB ADDRESS 3!�$1 Fuchsia Street BUILDING ERMIT GENERAL CONTRACTOR cnma DESCRIPTION of WORK Rac _ t.r/ o F LOT TRACT I/. CrloNs Si naru SOIL � GAS W nTER ROUGH PLUM9ING PROP. SWR. LINE USE CON. SPFINKLING SVSTEM MISCELLANEOUS FOUGN HEATING ANO AIR CONOITI TEMPORARV SERVICE OR POLE UNDEPGFOUNO � POWER � ROUGH WIRING FRAME ANO f'LASHING LATHING - IN ( PL•� -'R, BRO N COAT 5' iRqL, FINAL SUBCONTRACTOR Z . aU Z Z � � N am J 7 J N ¢1 J m J Q UN Z a W � d W WZ J Q m z J � W w � ZH w� �¢ �o 353�� ar_rr, , , �PR i 1-73cr�-.. {�7 584" %::: � I 5�I.311 COSTA MESA 6UILDING-SAFETY DEPARTMENT ' �- )LA P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 � PP I ATION F BUILDING PERMIT ForApplicanttoFil/inCompletely qE E BV DA E ECEIVED DATEISSUED BVILDING � �- ppR 1 0 1973 ADDRESS PERMI'L P10J:('� OWNER Larwin Southern Calif. A.P. NO. �S(�. )f i? MAIL 16255 Ventura BIVd. AD'DRIEss,j y��G/�/Sy� �T ADDPESS cirv Encino, Calif.. No'986-8890 TRACT 7718 �oT �F BLOCK CONSTRUCTION Lanain Southern Calif. Ew oo n� a LENDER BRANCH 16255 Ventura Blvd. / /\/� ADDRE55 Encino, California ; owNER ` '�� '�" VALUE ��/� ORENGINEER Larwin So. Calif. NE`:' 278-4464 SE�/ S�.Lil:r%%� S �/"" I FIRE � ADDFESS 9100 Wilshire B�.Vd. � B2V. Hill's ZONE VPE GROUP Larwin Southern C2�lf. B�PROVED DAT � "'7 CONTRACTOR ADDRE55 16255 Ventura Blvd. TEL. Z�NE p�qryg "Zj BUILDING EWS� �FS UJ CITV Encino, Calif. No. 986-8890 � A STATE ' CITV VARDSAPPROVED VAPDSAPPROVED uc. No. 191311 LIQ NO. B�� MAIN BUILDING ACCESSORV BUILDING SIZE' NO.OFBIOGS. �'IFROMGLSTREET) OF LOT 6O X LOO � NOW ON LOT 0 FRONT FT. � FT. USE OF EXISTING BLDG. S FT. ' FT. NEW BLDG. 198� ROOMS STORIES 1 L. SIDE � FT. FT. EXTERIOR WALL SCllCCO ROOF WOOd shingle REAR Z� FT. FT. COVERING COVEGiING USE OF BUILDING qND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & - MAIN BLDGS. ACCESS. BLIX'aS. � VAR. # DATE ' Construction Single Family Residence C.U.P.# APPROVED . APPROVED / �_ _ .� �FIOLD FOR PECIA REQU S I hereby acknowledge that I have reatl this application and state D� that the above intormation is correct antl agree to comply with all laws regulating byiltling construttion, antl I shall not employ - any person in violation ot the workman's compensatian laws of 'the State ot Calitomie. � I hereby certify that I am properly licensetl as a conttactor untler SQ. FT. the State of California Business and Professions Cotle, Divisicn 3, THE MOUNT S WN,UNDER VALUATION IS FOR Cnap[er 9, and [�ax such licenses a�a in full force antl effect, or I THE PURPpSE OF ES7Ag��SHING A PERMIT FEE ONLV: am exempt irom the p�ovisions of the State of California Business VALVATION antl Professions e, Division 3, Chapt¢r 9. ZO1. SO PEFMIT FEE 5 Signature � � D. Downs � '- -SO.7rJ Permitte � $ 29�8�� PI.ANCHECK$ /V . Authorizetl Agent TOTAL FEE $ 152. 25