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Home My WebLink About3292 GEORGIA PL - Building Permits(714) 754-5273 • F8x (714) 754-4856 • www.cl.cosla-mesa.c�� nlNf� PFR�MkTrmTlATC4�r�I�RIVE, COSTA MESA, CA 92626 JobAddress: 3292 GEORGIAPL Suite: Vicinity: REAR OF HOSUE Primary Oce: R3 Parcel Number: 13904104 Applicant: JULIE TULLY Address: 3292 GEORGIA PL COSTA MESA, CA Owner: TULLY TRUST Address 3292 GEORGIA PL COSTA MESA, CA Contractor: OW NER-BU ILDER Address: Zip: Arch : Address: Zip: ALLO,'�E� Type of Construction: V�ER��--� Z��E�(PIRES Phone: 714-501-8853 Zip: 92626-2001 Phone: 714-501� Zip: 92626-2 Phone: License: 000000 Status: ISSUED Applied: 12/79/2005 Issued: 12/19/2005 ISSUED BY: G' � ' � Eng: JERRY TUCKER AND ASSOCIATES Adtlress: 350 E 17TH ST Phone: SUI7E 270 Phone: 949-645-2422 COSTA MESA, CA license: 92627 License: 2187 SCOPE OF PERMIT CONSTRUCT A44SF OPEN PATIO OUTSIDE OF REAR YARD AREA FOR SFD. FEE SUMMARY Plan Check: $99.61 Permit: $153.25 SMIP Res: 50.72 SMIP Com: 50.00 Other: 30.00 Inspection: $0.00 Calc Valuation: S7,i5�zs Claim Valuation: so.00 Totai: $253.58 PLANNING 8 ZONING SETBACKS MAINSTRUCTURE Front 0-0 Rear 0-0 Left 0-0 Ri9ht 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0•0 Right 0-0 PARKING Existin : 0 Reauired: 0 Pr000sed: 0 NOTICE: The work authorized by this permit shall compty with all epplicable handicap access requiremenis under Califomia statutes and retated regulations. (Ord. No. 92-28, § 7, 7241-92) EXPIRATION: Thls pertnit shall automaticaly expire erW become void if xrork is not commenced withln 780 days, or it work is suspended or abandoned for a pariod of 180 days. '� INSPECTIONS: In order for the work authodzetl under ihis pertnit to be considered legal, sueh work must eomply with all applicabte codes, end all ', requlrod Inspeetlona end final approval must be obtalned. Fallure to obtain Inspectlons and final approval vnll result in the ezpiration of this pertnit. FOR INSPECTIONS CALL: (714) 750-5828 zaase �aroo) WORKERS' COMPENSA710N DECLARATION: I hereby ettirm under penalry of periUry ona ot the tollowing declereUons: � � � - � � •. � I heve end will meintain a cenificate oi cronsem to salf-Insure tor workers' co�emetic;, es gfovitled for by section 3700 0l Ihe Lebor Cotle, for the peAormence ot the woM tor which this permit is issued. ❑ I have entl will maintaln worker9' �Peosetlan �nsurance, es requiretl by sectlon 3700 of the Lebor Code, lor t�e padortnance of Ihe work tor which Nis pertnit L5155ued. My workers' compensatlon Insu�ance cartler antl polcy number ere: . Cartier. Policy Number: (lhis secflon need nof be completeC �l the pemutls valued a! one hundred dollars (5100) o� less.) . . Ihe peAormance ol the work for wnkh this pertnit is Issueq I shall not employ flny person In eny menner so es to become sub�ed lo Ihe workera' lews ol Celifomla, entl egree thet ii I shwltl become sub�ect to t�e workers' wmpensatlon proWslons ol Sectlon 3700 ot the Labor Cotle, I shell foMwl(h Dat'8��.�'' �2—�-f—�� AWFUL rWD SHALL SUBJECr AN EMPLpYER TO CRIMINAL PENALTIES ANO CML FlNES UP TO ONE HUNDRED DAA+AGES tiS PHOVIDED FOR IN SECTION 3]OB OF THE LABOR WDE, INTEREST, AND NTTORNEY u PEES. LICENSED CONTRACTORS DEGLAAATION: I hereby aNirm Ihat I em licensetl under proWsions of Chapter 9(commenGnp wlih Sectlon 7000) ot Dlvision 3 0l Ihe Business antl Professlons Cotle, entl my Ilcense is In full torce entl ettect. Lic. M Cless q Gontrectors Slgneture: Date: CONSTRUCTION LENDING AGENC�: ❑ I hereby aNirtn t�el lhere is a c0�siruction lending egency lor the peAortnence ot the work tor whic� ihis pertnit is IssueC. (Sec. 3097, Civil Code). LenOefe Name: Lentlefs Address: Sipnature: Date: OWNER-BUIIDER 9ECLARATlONS: I hareby aAlrm ��at under penalty o1 perjury Ihat I am EXEMPT FROM THE CONTRACTOHS LICENSE LAW far the tollowing reaso� (Sec. 7031.5, 8uslness antl Protessions Cotle: Any dry or�wunty which raquires a pertnil to consWcl, alter, imprwe, tlemdish, or repair any siructure, pnor to its issuance, elso requires the applicant for such permi� b tile a signetl statemem that he or S�e is Iicensed pursuent to the provisions oi the Comractors LJcense Lew (Chepter 8(cammenc�ng with Secllon 7000) oi Division 3 of t�e Business entl Prafesslons Code) or tha� he or she is exempt iherelrwn entl the Dasis tor Ihe alleged exemptian. Any Nolation af Section 7031.5 by any epplicant tor e pertnit suDJects the epplicant ta e chril penalry af not more than tive �undred dallars (5500).): ❑ I, es owner of t�e property, or my employees with wages as thair sole compensa�ion, WILL DO TME WORK, entl t�e siructure Is not InterWed or ofleretl tor sale (Sec. 7044, Busineu end Professions Code: The Contrectoro License Lew does not apply to en owner ol properry who builtls or improves thereon, and who tloes such work himsetl or herself or ihrough his or her awn employees, provided thet such Improvements are not Intended or oMered tor sale. tl. havever, the building or Impmvement Is � ol�d ithin one year of completion, the owneabuiltler will have the burtlen of proving that he or she tlid not builtl or improve lor purpose of sale.). ' �;_ �JNBs owner o� �he property, am E%C WSIVELV CONTRACTING WITH UCENSED CONTRACTOPS to consiruct Ihe proJect (Sec. 7044, Business and Professions ✓�"'Cotle: The contrectors License Lew tloes not epply ro an owner ol property who builds or Improves thereon, and who conVacts �or such proJect with e contractor(s) license pursuent to Iha Contraclars License Laws.). ❑ I em exempt u de sec. 91�1131ure�� e� io �e� �ed c amars r�� Verification ot rship by (rype _ Business antl Professions Cotle for ihis reeson: `—oe�a: t�2—�a-vS ❑ No DAve s� censa No. pv� i.e. - property ta: blll or deetl): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATON: ❑ I hereby certlly that no excavatlon Trve (5) or more teet in Cept� Into whlch a person is requiretl to descend, will be matle In connection with work euthorized by this pertnit, end thet no building siN�Nre, swfldding, talsawork, or tlemdi�ion or dismamling thereoi, will be mora Ihan thirry-slx (38) teet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Title 8, Cellfomia Administlative Cotle). ❑ As ownar•builder, I will not emp�oy enyrone to do work which would require e perml� trom ihe Dlvlsion at Intlusiriel Selery, as notetl ebove, unless such pereon hes e pertnit ta tlo such work trom the division. Signature: Daie: Division ol Intlustrial Salery Pertnit NUmber: CERTIFlCATE OF COMPLIANCE AND A�OR¢A710N OF ENTAY: I cenity untler penalry of perjury t�at I heve read ihis applicetion antl state Nat the Informetion given is correct. I egree to compy wIU ell s�a�e laws enC ciry orainances relating to builtling construction, end eu�horize re0resentatives of the City oi Costa Mesa to enter upon Ihe ebove-descnbetl pro0erty for ir� pectiPn pu�g�; es. I egree nol to occupy or ellow occupenry of eny building euthonzetl by ihis permit until final inspection. / r 10i@--'11�R,�l.Y--X' . I �--f�--E�� 'Sf - ure�C3. gel� rner(sJ �Date1� Antl/Or Autharized Appllcant Date C�UE I. INSPECf1�NTYPE 161fi Fisod System Finel Fire PrBVenllon 1268 Pool Spa Final . 200 Final RB-Rool 201 Flnnl BIocWRetaining Wflll 202 203 204 Final Faciory Fire Plece Final SiBn Finel Demolition PAff II�L$ COOE� INSYELTIONTYPE 206 Finel Moc�anicel 20B Flnel Plumbing 210 Flnel Elocidcal 212 Flnel Fire Preventlon • 220 Final Planning Approvel 222 Final Slte � � 250 Final Bulltling/Occupancy �g � .uu. ; �� n� �� D�� OWNER-BUILDER VERIFICATION 'd� Pcrmit #: A city or county, which is required to give notice pursuant ro Section 19830, shall attach to such notice, and, as � wndition precedent to issuing a building permit, require the complelion and require the retum aC, an owner- builder verification. Attention Property Owner: An 'owner-builder' building permit has been applied for in your name and bearing your signawre. Please complete and retum [his inforniation in the emelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No buildine aermit will be issued until this verification is received. ��personally plan to provide the major labor and materials for construction of the proposed property improvement. ❑ Yes � No 2�1:,( a��e ave not) il(�V� signed the proposed work. an application for a building permit for 3� Lhave contracted with the following person (firm) to provide the proposed conswction: Name Q��- � tii1�, Address Phone ( City _ Contracror's Lic. No. 4. 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name Name 1042<6 lRev.11Na� Address Phone ( City — Contractor's Lic. No. 1 will provide some oT the work but 1 have contracted (hired) the following persons to provide the work indicated: Address Phone 'fype of Nork June 19, 2006 CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 DEVELOPMENTSERVICES DEPARTMENT Julie Tully 3292 Georgia PI Costa Mesa CA 92626-2001 PERMIT NUMBERS FOR: PROJECT ADDRESS: BUILDING DIVISION EXTENSION NOTIFICATION 605-02326 Patio 3292 Georgia PI, Costa Mesa This is to advise you that the request for an extension on the above permit has been approved by Ed Petros, Chief of Inspections. The extension is valid for 180 days. The new expiration date of the permit is December 18, 2006. You may call 714-754-5626 for inspection at any time prior to this date. The job must be completed, inspected and receive final approval before this date or your permits will expire. Additional fees will be required to finalize expired permits. If you have any questions, please contact the Building Division at 714-754-5273, between 8:00 a.m. and 4:30 p.m., and a staff member will assist you. We appreciate your working with us to resolve this matter. Sincerely, ,�%t�v�r��'�� Mary Jane Weidenkeller Office Specialist II Builtling Division (714) 754-5273 • Code Enforcemen� (714) 754-5623 • Planning Division p14) 754-5245 FAX (�14) 754-a856 • TDD (714) 75a-5244 •�w,w.ci costa-mesa.ca.us o��- �d �efr05 J �/��/oc� We would 1►ke �-o reQ ueS�- an ex }� �,nSloY� �� backyard pa+; o bu� Id�r� � �err'''rf -, a G{-,Y�}� hum I��' �05-p2321�. Dur address is 3zqz � �- Ca.�fu Me.s� , CA 4 z�2 (� . u o-� -�nd� h� � coh�rac+ar �r�� f ace, We are '�h .I-he p►-o�ess av�d ho�e, �o � �� , �5 soon as po5sibl�; �,o►,�uP,�; � ��+� � ��Irac,+or availabil� �� 7'han k yb� �i— }r�� be e�r-!� -F� I1 � � ��'f) 3lad - D3�� (714) 754-5273 • Fa�c (714) 75d-4856 • www.c�.costa-mesa.r�.�LDING PERMIT � FAIF ORIVE, COSTA MESA, CA 92626 Job nddress: 3292 GEORGIA PL Suite: Vicinity: Primary Occ: R3 Dwellings/ Cong Res <10 Type of Construction: V-N Parcel Number: 13904104 Zoning: Applicant: MARK TULLY Address: 8 DRIFTWOOD IRVINE, CA Owner: TULLY TRUST Address 3292 GEORGIA PL COSTq MESA, CA,' ConVactor: Address: Phone: 94&653-8934 Zip: 92604 Phone: 714-SOt-8853 Zip: 9262G2001 Phone: Status: ISSUED Applied: 04/15/2005 Issued: 0525I2005 ISSUED BY: � Zip: � License: Arch : SAMUEL qRTHUR MARTINEZ Eng: JERRY TUCKER AND ASSOCIATES Address: 2517 S TOWNSEND ST Address: 350 E 17TH ST Phone: 714-5458646 SUITE 210 Phone: 94&6462422 � SANTA ANA, CA COSTA MESA, CA - Zip: 92704 License: C5012 92627 License: 2187 SCOPE OF PERMIT ADD 846 SF TO EXISTING SFR. WORK TO INCLUDE: CREATE NEW GREAT ROOM, GAME ROOM (1 NEW FIREPLACE UL# M87603), STORAGE ROOMS, DEN AND NEW MASTER BATH. DEMO MASONRY FIREPLACE AND ADD PREFAB FIREPIACE IN GREAT ROOM. CONVERT EXISTING 3 BpDROOM, 2 BATH S.F.D. TO A 3 BEDROOM, 3 BATH S.F.D. Plan Check: Permil: SMIP Res: SMIP Com: Other: Inspection: Total: $595.89 $916.75 $8.82 $0.00 $0.00 $0.00 $1,521.46 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORV "L'L'�:1L`Lr Front 0- 0 Existina: 0 Rear 0- 0 Rear 0- 0 Repuired: 0 FEE SUMMARY PLANNING & ZONING Lefl . 0- 0 LeR 0- 0 Prouosed:' 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0-0 588,17o.ao So.00 NOTICE: The work authoAzetl by this permit shall compty wlth all appllcable hantlicap access requirements under Califomia etatutes and related regulations. (Ord. No. 9248, § 1, 72-21-92) EXPIRATION: This parmit shall automatically e�cplre and become void if vrork Is not commenced wlihin 180 days, or if work is suspended or ab oned for e period of 180 days. I�� INSPECTIONS: In order for the work authorized under this permit to be considered �egal, such work must compty with ali appllcable es, and all I requlred InapeeUona end final ¢pprovel must be obtained. failure to obtain Inspections and finel approval will resutl in the expiration is permN. FOR INSPECTIONS CALL: (71q) 7545628 zue-as �amo� WORKERS' COMPENSATION DECLARA710N: ' � • ' � � I hereby attirm under penalry ot perjury one of t�e lollowing tladaretions� '�.. , ❑ I heve entl will maintain e ceNficata ol wnsent to selFlnsure for workere' compensation, az�providetl tor by section 3700 ot the Lebor Code, tor tha paAortnence of the work lor which this pertnit is issuetl. � - ❑ I have entl will mainWin workers compensatlon insurerxs, as requiratl by section 3700 of tha Lebor Gode, for the perfortnance ot ihe work lor whiU Nis pertnit is issued. My workers' compensation Insurance carder antl policy number are: Cerner: Policy Number: (This setUon need nof be camplefe0/1 fAe permi( is valued et one huntlred tlollers (5100) or /essJ ❑ I cenity that In the pertormance ot tfie work lor'which this permit is 15sued, I shell not employ eny porson in any manner so es to �ocome su�ject to ihe workers' c: `compensetion laws ol Califomia, tl egre �at It 13[wWOi uEJect to t�e workers' compensatlon provislons of Seqqq lon 3700 o t�e Labor Catle, I s�all forthwit� compty wtlh Ihese pr Ys 5. C �/�� Arp.p_Fce.rtt'SIaneWre: �Dale�—�.- /—�� WARNINO: FAILURE TO SE RE WORKERS' COMPENSATION OOVEMOE IS U FUL AND SNALL SUBIECT AN EM%OYE O CRI NALAA PEtJ14TE$ M'D CML FlNES UP TO ONE HlAlDRED THOUSAND OOl1ARE (5100.0OO�.IN ADdTION TO THE WST OF C�OMGENSATIIXJ, DANAGES AS PROVIDED FOR IN SECiION 3'lO60F THE LABOR CODE, IMEREST, AND ATTORNEI^5 FEES. LICENSED CONTRACTORS DECLARATION: I �ereDy oHirm Ihet I em licensed under provlsions of Chapter 9(commencing with Secilon 7000) of DiNsion 3 0l Ihe Business and Professlans Cotle. and my license is in lull lorce and eHoc�. Lic. a Class M Conlrnctor's SlgneWre: Da�e: CONS7RUC710N LENDING AGENCY:� ❑ I hereby aHirm t�at t�ore Is e wnslruction lentlinp epenty for ihe peAormence ot the work lor which this permit Is issued. (Sec. 3087. Civil Gode). Lentlets Neme: Lentlels Atltlreu: Signatura: Date: OWNER-BUILDER DECLARATIONS: I hereDy ettirm that under penalry at perjury t�at I em E%EMPT FROM THE CON7RACTORS LICENSE LAW for Ihe following reeson (Sec. 7031.5, Business antl Protessions Cotle: Any ciry or counry which reQuires e pertnit to consWct, elter, improve, demolish, or repair eny siructure, pnor to its issuence, elso reQuires tha epplicant br such permit to lile e signetl statement Ihat he or she is licensad pursuant to the proNsions of tha Contrectors License Law (Chapler 9(commencing wiih Sectlon 7000) pi Divfsion 3 0l the Business end Profeuions Cotle) or Ihat he ar she Is ezempt t�eretrom and Ihe besis tor the alleged exemption. Any violation oi Section 7031.5 by eny epplicant for e pertnit subjects the epplicant to a clvil penalry ot not more then five hundred dollars (5500).): ❑ I, as owner of ihe propeny, or my employees with wages as thelr sole compensatlon, WILL DO THE WORK, and the structure Is not Intentle0 or ottered tor sale (Sec. 7044, Business and Professions Code: The Contwdors license Lew does not appy to an owner ot propeny who builds or Improves lhereon, end who does such work himself or herself o� ihrough his or her own employees, providad that such improvemenis ere not intentled or oHeretl lor sale. If, however, the building or improvemenl is �Id within one year ol completion, the ownerbuilder will �ave Ihe burden ol proving t�at he or she did not build or improve tor purposa ot sele.�. as owner ol ihe properry, am E%CLUSIVELV CONTRACTING WIiH LICENSED CONTRACTORS to construct the prolect (Sac. 7044, Business and Professions '�`=''Cotle: The cantractars Licensa Law does not appty to en owner ot pmpeny who builds or Impmves thereoq entl who con�rects lor such pm�ect with e coniractor(s) license pursuant to �he Conirectors License Laws.). ❑ I am exem �t jye/r �s Business and Prolessions Code for this reason: Sigrtehite•"-�-�Ix+�� r �.� �C � OViner ID verilied by tlriver's license. ❑ Yes No DriJers Llc'ense Vertlication ol Ownership by (rype of daument, I.e. � praperty tex bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certify �hat no excavatlon five (5) or more leet In tlepth into which e person Is requlreA to descend, will be made In connectlon with work euthorized by thls permi6 end Ihet no building stmcture, scafloltling, lalsework, or demoli�ion or dismentlinp ihereot, will be more ihan thirty-six (38) leet high. (Chap. 3.2, Gry 2, Art 2, Sec. 341, Ttle B, Catifomia AdminisVative Code). ❑ As owner�bullder, I will not emplay enyone to tlo work wNch would require e permit Irom tho Dlvislon al Industrial Selery, es notetl above, unless such pereon hes e permit ta tlo such wark trom Ihe divi5ion. Signetura: Date: Division ot Industnal Sefe�y Permil NumDar. CERTIFlCATE OF COMPLIANCE AND AllTHORIZ4710N OF ENTAY: I cenity untler penalry ol Derjury that I have read ihis appliwtion and state Ihat the infortnation given is correct. I egree to compty wlih all sWte laws end ciry ardinances r a�ng to builtling cons�ruction, anC euthorize representatives oi ihe Clry of Costa Mesa to enter upon Ihe aDove-descn � for pec�tion,�(� or ellow occupanry of eny building euthonzed by this permit un I linel inspeIXi n. /%� /�Y, � ,(.� . �—�7�� Of.LegatOwnw(s ---%i �oate' ^ % And/Or Auihorizotl Applicanl Date CODE L INSPECTIONTVPE'^ � • ' " "PAIE 1616 Fixotl System Finel Fire Preventlon . '' 1266 Pool Spe Final 200 Final Re-Roof 201 Finel BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Finel Demolilion lt�915 • � cooe� iNsveerroxnve .� 208 Finel Mechenical � 20B Finel Plumbing 210 Flnal Elecirlcal 2/2 Final Fire Preventlon 220 222 250 Final Planning Approval Final Site Final Building/Occupancy , L,it.�y v� �L,oa,ta ��a �`�r,�duu� Dia� OWNER-BUILDER VERIFICATION A ci�y or cuun�y, which is reyuired �o give notice pursuant to Sec[ion 19830, shall attach to such noiice, and, as a condition preccdent to issuing a building permit, require the completion and require the return of, an owncr-huildcr vcrilication. � Attentiun Propcny Owncc � An 'owner-builder' building permit has been applicd tiu in yuur name and be•sring your signaturc. Piease complete and return this information in ihe em�elupe provided at yuur earliest opportunity w avuid unnecessary delay in procestiing and issuing yuur building pennii. Nu buildint! nennil will be issueJ until Ihis verification is rcccived. I. I personally plan to providc major labor and matcrials f�or cunsWction uf the proposcd propertyimprovemenL Ycs ❑ No 2. I av ave not) /IGuie� signed an applicalion for a building pertnit fi�r the proposed work. 3. h.rve conlracted with the fol � ig person (firn�) tu provide the proposed construction: ame ��_ G �(XN l Address Phonc ( ) City Contractur's Lic. No. 4. 1 plan lo pruvide portiuns of the work, bul I havc hired the followin� person In coordina�e, suprnisc and providc thc majnr wurk: Natnc Addrevs Phonc ( Ciry _ Contractor's Lic No. 5. 1 will provide some of �he work but I iiave conVac�cd (hircd) Ihc following persons to pru��idc thc work indicated: Namc IIu2�a5 (PEV 9/9P� Address Phonc 7'ypc of Work (714) 754-5273 • Fax (714) 754-4856 • www.Ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Number: Appliwnt Address: Owner: 3292 GEORGIA PL BED AND BATH ADDITION 13904104 TULLY 7RUST 3292 GEORGIA PL COSTA MESA. CA � TULLY TRUST Address: 3292 GEORGIA PL COSTA MESA, CA Contraaor: O W N E R-B U I LD E R Address: MECHANICAL PERMIT Status: ISSUED Applied: O6123/2005 Issued: O6/23I2005 ISSUEDBY: Vl/'� J Phone: 714•501-8853 Zip: 926262001 Phone: 714-501-8853 Zip: , 92626-2001 Phone: Zip: License: 000000 SCOPE OF PERMIT MECHANICAL PERMIT FOR AN AOOITION OF 846 SF TO EXISTING SFR. WORK TO INCLUDE: CREATE NEW GREAT ROOM, GAME ROOM (t NEW FIREPLACE UL# M67603), STORAGE ROOMS, DEN AND NEW MASTER BATH. DEMO MASONRY FIREPLACE AND ADD PREFAB FIREPLACE IN GREAT ROOM. - CONVERT EXISTING 3 BEDROOM, 2 BATH S.F.D. TO A 3 BEDROOM, 3 BATH S.F.D. REF #BOS00615 WORK TO INCLUDE: 1 FACTORY FIREPLACE AND 1 HOOD W/MECH EXHAUST. ISSUE FEE Ins[ FAU <100 k BTU Inst FAU >100 k BTU Repair / Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refng Sys <100 k BTU' Refng Sys >100 k BTU . � � Gas Piping , Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers � $23.50 � ".$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 510.65 $10.65 $0.00 50.00 50.00 50.00 $0.00 Quantity 0 0 0 0 0 0 0 � 1 0 0 0 0 0 FEE SUMMARY Repair / Alt Absorbtion Unil , Repair/AltRefrigerationUnit - Ventillalion System , Evaporetive Cooler Commercial I nci nerator Domestic Incinerator � Compressors / Absorption S4stems' Upto3hp/100kBTU- 3To15hp/SOOkBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU' Over 50 hp / Over 1,750 BTU Boilers Upto3hp 3To15hp NOTICE: The work authorized by this permfl shall compty with all appllcable handlcap access requfrements under Calitomia regulations. (Ord. No. 92-28, § 7, 7241-92) EXPIRATION: This perml� shall automatically expire and become void il work Is not commenced within 1B0 days, or if work is susF for a period of 180 days. / Quantiry 50.00 0 50.00 0 30.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 related orabandoned INSPEC710NS: In order for tha work authorized under this permit to be considered legal, such work must comply with all ppliceble codes, and all required Inapeetlona and Iinel epprovel must be oblained. Failure to obtain inspections and linal approval will result in the piration of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 246&48 (fl�W) WORKERS' COMPENSATION DECLARATION: I hereby attirtn under penalry oi pefjury one o� �he tdlowirg dedaraLons: ❑ I heve end wlll meintaln e ceNficete of coosent to salt-Insure for warkere' compensation, es provldad Por by section 3700 at the Lebor Code, far Ne peAortnence of Ihe work tor w�ich thls pertnit Is issued. ❑ I heve and will maintaln vrorkers' compensetion irtsure�ue, as raquiretl by SecUon 3700 0l ihe Lehor Cotle, for the pertortnance oi Ihe work far whkh this permit L5 issueE. My workers compensalion Insurance carner and policy number ere: Cerner. Policy Numbec (This s on need nof be comp/eteC!! the pe�i� Is ve/ued et one hundred tlollers ($f 00) or /ess.) (� -1 ertity that in the pedortnance of the Wo br which Ihis rml is 1 ell not omploy eny peraon In eny manner so es lo becoma sub�ect tp ihe workers' �mpensetlon laws oi Callta I, end e that i e t Ihe workers' compensetlon provisions oi Section 37000ppp,of the Lebo/Cotle. � shell tort�with comptywit�t�ese ' /��/�� AA�p1IwR1�S�r eNre: � Delet�_ � WARM : FAILUHE TO SEIX1R WORI(ERS' �IA�ENS MJ COVEMGE IS U! SNAL� SUBIECr Ml EMPLOYEP TO CRIMINAL P TIES AN L FlNES UP TO ONE HUNDRED T/IOUSFNDDOLLARE(5100.000).WADDITIONiOT��^TOFC�APENSAT�OH. r1SPROVIDEDFORINSECT10N3]OBOFTHEIABOqCODE.INTEREST.IWDATfORNEY'SFEES. LICENSED CON7RAC70RS DECLARATION: � I hereby eHirm t�al I em Ilcensed untler proNS�w�s ot Cheptar 9(cammendng wit� Sectlon 7000) ol DMslon 3 ot Ihe Business and Prafessions Coda, entl my license is In tull brce end ettect. tic. a Class a CancrectoYs SigneWre: Dete: CONS7RUCTON LENDING AGENCY: ❑ 1 hereby eNirm t�at there is e cansiruction lentling egency for the pedormance of the work for whlch this permit is issued. (Sec. 3097, CMI CoCe). Londofs Neme: Lendefs AAtlress: Signeture: Date: OWNER•BUILDER DECLARATIONS: I �ereDy ettirtn Ihat under penalry o1 perjury tl�a� I em EXEMPT FROM THE CONTAACTORS LICENSE LAW lor Ihe tollowing reeson (Sec. 7031.5, Buslne55 end Professions Cotle: Any city or counry w�ich requires e pe�it to consWct, elter, Impmve, demolis�, or repair any strucNre, pnor to its issuance, elso requlres t�e applicant for such permil to file e signetl stetemem t�et he or she Ls Iicensed parsuant to Ne provisians at t�e Contrectors Llcense Lew (Chepter 9(commendng wlth Section 7000) oi Divlsion 3 of Ne Business end Professions Code) or Ihet he tl� she Is exempt Nerefrom and the besls for t�e elleged exemptlon. Any violatlon of Sectlon 7031.5 by eny applicant far e pertnit subjecis the epplicant to e civil penalry oi not more than tNe hundretl tlWlers ($500).): ❑ 1, es owner ot t�e property, or my ampl0yees whh wages es lhelr sole wmpensation, WILL DO THE W ORK, entl Me siructure Is not intentled or ofleretl tor sele (Sec. 704a, Business end Professions CoOe: The Conirectors Licensa Law tloes not apply lo an owner of property who 6uilds or improves Ihereon, end who does such work himsell or hersell or through his or �ar Ow� employees, pranded that such improvements ere not intended or ottered for sale. If, however, the building or improvement is �within one year of completion, the Pwner-builtler will heve the burden of proving that he or she tlid not build or improve for Ourpose ol sale.). ' w. as owner ol the properry, am EXCWSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business end Professlons Code: Ttie conirectors License Law doBs not epply to en owner ol property who bullas or Improvas thereon, entl who contracts tor such project wlih e contractor(s) license pursuant to the CoryryactorsJy�s7��/yJ . 0 � p Yes Veri/icatlon of Ownership by (rype ol dacumen4 �.e. DIVISION OF INDUSTRIAL SAFETY PERMR CER7IFICATION: and Pmfessians Cotle for thi9 reeson: or deed): ❑ I hereby certly thet no excevation ilve (5) or more feet In tlepth Into which e person is requiretl to descend, will be matle In connecUon wlih work euthodzetl by Ihis permit, end thet no building sirucWre, s�eNolOing, felsowork, or tlemolition or dismamling thereof, wlll be more than thirry-sl: (38) feet high. (Chep. 32, Gry 2, An 2, Sec. 341, Tltlo B, Celifomla Adminisirelive GOde). ❑ As owner-builder, I will not employ enywie to tlo work which would requlre e pertnit Irom the Divlslon at Indusirial Sefery, es noted ebove, unless such person has e permit to tlo suc� work fmm tho diWslon. Signeture: Date: Olvision oi Industnel Satery Permit Number. CERTIFlCATE OF COMPLUWCE AND UTH�A�710 EMAY: I certify under penalty ot perjury �het I heve reatl �his epplication entl state t�et Ne information given is cortect. I egree to co � Ith ell st laws e � e� es re mg ding mnstructlon, end authodze represeniaWes ot ihe Ciry of Cost Mesa to enter upon Ne above-descnb�� s e � pury es ree not o cu y I occupency of eny building euthonzed by this/P§ rmit ntil finel ins /i-a�n. —� !�/��i / / � + i natu �t:�" 't,Ownerls i {; ai� % AnNOr Aulhodzetl Applicent Dete GODE 1. INSPECTIONTYPE 7878 Fixatl System Final Flre Preventlon 1288 Pool Spa Finel 200 Finel Re-Rool 201 Flnal8lock/Retalning Well 202 Finel Fedary Fira Place 203 FIneI5lpn 20a Finel Demolitlon PAiE U�Lfl COOE 1 INSPECTION TYPE 208 Finel Mechenical 208 Finel Plumbing 210 Final Electrical 212 Final Flre Preventlon 220 Finel Plenning Approval 222 Finel Site 250 Flnel Bulltlinp/Occupency � ' O�1-:I�/ 113 �� (714) 754-5273 • Fax (714) 754-0856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3292 GEORGIA PL Suite No Vicinity: Parcel Nunmber: 13904�04 Applicant: TULLY TRUST Address: 3292 GEORGIA PL COSTA MESA, CA Owner: TUILY TRUST . Address 3292 GEORGIA PL COSTA�MESA, CA Contractor: OWNER-BU ILDER Address: � � ISSUE FEE BackOow irtigation BackFlow Preventer Bathtub Clanfier System Connect pce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof PLUMBING PERMIT ISSUED BY: Phone: 714-501-8853 Zip: 92626-2001 Phone: 714-501-8853 Zip: 92626-2001 Phone: Zip: License: 000000 Status: ISSUED Applied: O6/23/2005 Issued: O6123/2005 �v SCOPE OF PERMIT PLUMBING PERMIT FOR AN ADDITION OF 846 SF TO EXISTING SFR. WORK TO INCLUDE: CREATE NEW GREAT ROOM, GAME ROOM (1 NEW FIREPLACE UL# MB7603), STORAGE ROOMS, DEN ANO NEW MASTER BATH. DEMO MASONRY FIREPLACE AND ADD PREFAB FIREPLACE IN GREAT ROOM. CONVERT EXISTING 3 BEDROOM, 2 BATH S.F.D. TO A 3 BEDROOM, 3 BATH S.F.D. REF #BOS-00615 WORK TO INCLUDE: 2 BACKFLOW PREVENTER, 1 BATHTUB, 1 DISHWASHER, 3 GAS (7-4 OUTLETS), 1 TAUNDRY TUBNJASHER, 1 SHOWER, 1 KITCHEN SINK, 1 WASH BASIN SET AND 1 WATER CLOSET (TOILETI.�. \ ' AMT $23.50 $0.00 ��$79.60 `$9.80 50.00 50.00 $0.00 59.80 $0.00 50.00 50.00 Qrr 2; 0 1 0 0 0 1 0 0 0 FEE SUMMARY AMT Laundry Tub / Washer $9.80 Landscape Irtigation $0.00 "' P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) 50.00 Receptors $0.00 SepGc Tank $0.00 Sewer Cap (or Demo $0.00 SewerConnect - .$0.00 Sewer Private Line $0.00 Shower $9.80 QTY 1 0 0 0 0 0 0 0 0 0 t SumpPump Swimming Pool Trap Pnmer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) � Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent AMT $0.00 $0.00 $0.00 50.00 30.00 50.00 $0.00 $9.80 So.00 $9.80 50.00 QTY 0 0 0 0 0 0 0 1 0 1 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes related regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced wlthin 180 days, or if work Is suspen d or abandoned for a penod of 180 days. � INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all epp�'cable cales, end eil requlred Inapeetlona end final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpirdfion of this permit. FOR INSPECTIONS CALL: (714) 7545626 2dd&d8 (8�00) WORKERS'COMPENSAnON DECLARAnON: I hereby atlirtn untler penalry of perjury one of iha fdlowinp tledarations: ❑ t have antl wlll malnteln e ceNiicate ot consent lo selt-Insura tor wwkers' compensetlon, es pmvided lor by sectlon 3700 0l the Lebor Code, for the pertortnance of (he work lor w�ich t�is permit Is Issuea. ❑ I heve and will mainleln workera' compensetlon insurance, a5 reQuiretl by section 3700 of Iha Labor Code, for Ihe peRortnence af the work lor which Nis pertnil is Issued. My workers' compensatlon Insurence carrier entl pollcy number ara: Cerder. (Thls s� ve/�Bd Bt one oi less.) Policy Number: rtily t�a� In t�e pertortnance ot t�e � orfi fw which thls pe �� =, shell not employ flny person In eny manner so es to Decome sub�ect 6 ihe workers' �'� pensetion laws of C� le, erW �rea Ihat hE6�e mni� �ta Ne workers' compensation provLvlons ot Sectlon 37 ot t�e Labor tle, I shall torthwith co p�y_witp.4 e e pro i A eoL�$ignB ure: Date7�_; _ � WNRNINO: FAILURE TO SECURE WORKE0.S' NMPF1 ATION COVERRGE IS UNUW ANO SMALL SUBJECT AN EMPLOYER TO CFIMIN � lALTIES ANO IVIL FlNES UP TO ONE HUNDRED TFIOUSAND DOLLARE (5100,OOD), IN ADDI710N TO THE 00ST OF Cq.IPENS�TION, UMAAGES 0.5 PROVIDED FOR IN SECfION 3]OB OF THE LABOR OODE, INTEREST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHlrtn t�at I em Iicensed under provislons at Chapter 9(commencing with Sectlon 7000) of Divislon 3 of 1he Buslness and Protesslons Code, end my Iicense is In tull brce en0 ettect. Lic. a Class a Contrectofs Slgnamre: Date: CONS7RUC710N LENOING AGENCY: ❑ I hereby eHirm ihat ihere Is e conslruction lentlinq egency lor Ihe DeAortnence oi Ihe work tor which thls pormit Is Issuetl. (Sec. 3097, Civil Code). Lontlo/s Neme: Lentlers AOdross: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby eHlrtn Ihat under penalty ol perjury that I em El(EMPT FROM THE CONTRACTORS LICENSE LAW lar the tollowing reason (Sec. 7031.5, Business en0 Protesslons CoGe: Any ciry or counry which requires a permit to construct, alter, improve, tlemolish, or repair eny structure, prlor lo its issuance, elso requires the epD�icent for such pertnit ro ille a signed slatement Ihat he or she is Iicensetl pursuant to Ihe prmdsions at t�e Contreccors License Lew (Chepter 8(cammendng with Sectlon 7000) of DlNslon 3 of Ne � Business entl Professions Cotle) or Uet he or she is exempt theretrom and Ihe besls for the alleged exempHon. Any violation of Sectlon 7031.5 by eny applicant for e partnit sublecis Ihe applicant to e cidl penelry of not more Ihen five hundretl dollars ($500)J: �❑ I, es awner at the pmperry, or my employees wlih weges es Iheir sole compensetion, WILL DO THE WORK, end t�e siructure Is not Imended or offered lor sale (Sec. 7044, Business and Professions CoOe: TTe Contractors IJcense Law tloes not apDN �o en owner of propeM1y who builds or improves Ihereon, and who does such work himself or herselt or Ihrough his or her own employees, provided ihat such ImprovemenLs ere not Intended ar oNeretl for sale. tl, however, the huilding or Improvement is �within ona year ot wmpletion, ihe owneo-builder will have the burtlen ol proving ihat he or she did no� build or impmve for purpose of sale.�. � � I, owner ol lhe property, am EXCLUSIVELY CONTRACTNG WfTH LICENSED CONTAACTORS to construtt the project (Sec. 7044, Business antl Profes5ion9 e: The contrectors Llcense Lew does not apply to en awner ot pmperry who builtls or improves ihereon, and who contracis for such pro�ect with a contractor(s) license pursuant to the Contragors Lim�== �=w= � M 0 Owner ID vedfletl by tlrivers Ilfensa, Vedllcation at Ownership by (type ot end Pmfessions Code for this reason: i.e. - properry tar bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CEHTFICATION: � ❑ I hereby ceNfy Ihat no azcavatlon tive (5) or more Iee1 In depth into which a person Is required lo descentl, wlll be made in connectlon wl�h work euthorized by this pertnil, and Ihat no builtling strudure, scaflolding, lelsework, or demolition or dlsmantling Ihereof, will be more than thirry-six (36) leet hiph. (G�ep. 32, Grp 2, Art 2, Sec. 341, Title B, Calilomia Atlmini5tretNe Cotle). � As owner-huiltler, I wlll not amploy enyone to do work which would require e permit trom Ihe Dlvision of Intlustrlal Satety, as notod abwe, unless such peraon hes e permll lo tlo such work Irom tha division. Signeture: Date: Division oi Intlustriel Safery Permil Number. CEHTIFlCATE OF CAMPLUWC D AUIHOROJITION OF ENTRV: I cenify unEer penalry ol per�ury Uet I have read ihis flpplicalion antl state Ihet Ihe intoimatlon gNen Is correc�. I egree lo comply wlih I atete la n inene t o bulltling construction, entl euthorize representatives of Ihe Clry ol Coste Mese lo enler upon Ne ebove- � r e f r i ction es. I egree ot o ; r ellow occupancy ol eny building euthonzed by this pe il un finel ins n. �73 F»�- '�LSlg�lilL6,OLl:egel:0'wner LQ� '� AnNOr Authorized Appllcant Date CODE 1. INSPECTONTYPE f 618 Fixed System Final Flre Preventlon 1268 200 201 202 203 204 Pool Spa Final Finel RaRool Finel BIacWRelalnlnp Well Finel FeMory Fira Place Finel Sipn Flnel Demolitlon pA� It�LS CODEI ixsvernaxrrre 206 Final Mechanical 20B Finel Plumbing 210 Flnel Eloc�riCal 212 Final Fire Preventlon 220 Flnel Plenninp Approvel 222 Flnel Slte 250 Flnel BUIIdInplOccupenq � It� � • . \ (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 3292 GEORGIA PL MASTER BED AND BATH ADDITIONS 13904104 npplicant: TULLY TRUST Address: 3292 GEORGIA PL COSTA MESA, CA Owner:�- TULLY TRUST - . Address 3292 GEORGIA PL' �'� COSTA MESq, CA Contractor: OWNER-BUILDER Address: � Phone: 714-501-8853 Zip 92626-2001 Phone: 714-501-8853 Zip: 926262001 Phone: Zip: License: 000000 Status: ISSUED Applied: 06/23/2005 Issued: 06/23/2005 ISSUED BY: W✓� SCOPE OF PERMIT. ELECTRICAL pERMIT FOR ADDITION OF 846 SF TO EXISTING SFR. WORK TO INCLUDE: CREATE NEW GREAT ROOM, GAME ROOM (1 NEW FIREPLACE UL# MB7603), STORAGE ROOMS, DEN AND NEW MASTER BATH. DEMO MASONRY FIREPLACE AND ADD PREFAB FIREPLACE IN GREAT ROOM. CONVERT EXISTING 3 BEDROOM; 2 BATH S.F.D. TO A 3 BEDROOM, 3.BATH S.F.D. REF #805-00815 WORK TO INCLUDE: 27 LIGHTING FIXTS, 20 RECEPT OUTLETS AND 19 SWITCHES. � . � . � � FEE SUMMARY � . Quantity � �.. . Quantity � ISSUEFEE �'$23.50 . � � T D'tS t"7L' hf $000� 0� Temp service test $0.00 � � " Res. a/c package . $0.00 � � New Res (1-2 units)„ ' $0,00� _� New Res (3+units) . � ��. " $0.00 Pool / Spa � , , $0.00 � Lighfing Fixts $27:11 ReceptOutlets �'� �$22.00�' Switches ' $20.90 � Non Res Appl � �$O.OD Res Appl $0:00 -. Service to 200a $0.00 Service to 1000a $0.0p Service over 1000a $0.00 Motors to 1hp $O.OD Motors to tOhp $O.OD �0 p. 0 27 20 19 '0 0 0 0 0 0 0 emp is ys em ig ing . Busway/100ft - � -� ' Standing Section � _ Misc Electncal Equipment ' . Transformers up to 1 kvalkw �.. „ ' .......:........up to 10 kva/kw � .................up to 50 kva/kw , .................up to 100 kva/kw � . ..................over 700 kva/kw - � , Low Voltage Equipment. , , Low Volt Wiring System / Ckt � � Misa Conduit " Misa Conductor Circus ( 9en or nde) Cirws (mech ride or IighLs) ChrisVnas Tree Stand $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 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Calitomia statutes and re ad regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or andoned 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 applicabl�codes, and all required inspectlons and final approVal must be obtained. Failure to obtain inspections and final approval will result in the expiretion 6{ this permit. FOR INSPECTIONS CALL: (714) 75M5626 zaaaae �u�oo) WORKERS' COMPENSATION DECLARATION: I hereby eKrtn untler penalry of perjury one of ihe following declarations: ❑ 1 heve and will maintain e certificete ol wnsent to selt-Insure for workers' compensation, es provided tor by seciion 3700 of the Lebor Cotle, for the peAortnanca ot the work far which this permit is issued. ❑ I have and will maintain workers' compensation Insurence, as required by section 3700 of the LEbor Code, tor Iha performance of ihe work for which this pertnit is issued. My workers' wmpensation Insurence wrtier end policy number are: Carrier: (This sS IiceAHy Ihet in Ihe perfofinence ot the compensetion laws of Califorgia, end !s veWetl af one for which this oe WARNING: FAILUiiE TO SECURE WORKERS' P�MPENSATION COVEHAGE IS ITNI TFqUSAND DOLLr1RE ($100,OOOf, IN ADDITION TO THE COST OF CqMPENSATION, Policy Number: dollars ($f00) orless.) I shall not amploy any person in eny manner so es to become subject to ihe workere' �. to the workers' compensation pmvisions of Saction 37 of Ihe La r Cotle, I shall fotlhwith � ,�-a�. � %%a� . AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PE TIES GVIL FlNES UP TO IXJE HUNDRED IES AS PROVI�ED FOR IN SECTION 3�O60F THE L4BOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eMirtn that I am licensed under provisions ot Chapter 9(commencing with Section 7000) ot Division 3 of the Business end Prolessions Code, and my license is in tull torce and eHecL Llc. N Cless # Cantracbfs Signature: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that there is a construction lending agency for t�e peRormance of the work tor which this permit is issued. (Sec. 30W, Civil Code). Lenders Name: Lender's Adtlress: Signature: Date: OWNER-BUILDER DECLARA710NS: I hereby aflirm t�a� untler penelry of perjury that I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, 8usineu end Professions Cotle: Any ciry or counry which requires a pertnit to conslrucL alter, improve, tlemolish, or repair any structure, prior to its issuance, also requires the epplicant for such pertnit to file e signetl statement that he or she is Ilcensetl pursuant b the provislons of Ihe Coniractors Llcense Lew (Chapter 9(commencing with Sedion 7000) of Divislon 3 ot ihe Business end Profeuions Code) or that he or she is exempt theretrom and ihe besis tor the alle9ed e:emption. Any violation of Seqlon 7031.5 by any applicanl for e permit subjects the apPlican� �o e civil penalry ot no� more then five hundred dollars ($500).): ❑ I, es owner of Ihe properry, or my employees with wages as iheir sole compensetion, WILL DO 7HE WORK, and the structure Is not intendetl or oHered for sale (Sec. 7044, Business entl Professions Code: The Coniractors Licensa Law tices not apply Io an owner of propeny who builds or improves ihereon, and who does such work h�mself or herself or through his or her own employees, providetl thet such improvements ere not imendetl or oNered for sale. tl, however, the building or impmvement Is old within one yeer of completion, ihe owner-builtle� wiil have tha burtlen of proving ihat he or she did not build or improve for purpose of sale.). i� I, as owner of lhe property, am EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRACT08S to construct the prqect (SecJ044, Business antl Profeulons Cotle: The contrecmrs License Lew tlaes not epply �o an owner oi property who builds or Impmves iheraon, and who contrects tor such prolect with a conirecror(s) license Oursuant to the Contr�qlas Licays� Laws�nn lam Owner ID venfietl-by tlrivafs license. Verificetlon ot Ownership by (typa of Oocument, i.e. - propeny DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: and Professions Cade tor this reeson: ortleetl): � I hereby certiy thet no exwvation five (5) or more fee� in depih into which a person is requirea to descend, will be made in connection with work euthorizetl by this pertni�, antl that no builtling siructure, scaHolding, falsework, or demolition or dismantling thereof, will be more Ihan Ihirry-si: (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Calitornia Adminisirative Gode). ❑ As owner-builder, I will not empioy anyone to do work which would require e permit trom the Division ot Industrial Safery, as notetl a�ove. unless such person has e permit to do such wark from iha division. Signature: Date: Division oi Intlustrial Sefery Permit Number: CERTIFICA7E OF COMPLJANCE AND AUTHORIZA � • certify untler penalty of perjury Ihat I have reed this application end state thet the information given is cortect. I egree to comply with stete I orain es I m building construction, and authonze representatives of ih Giry ot CaSte Mesa to enter upon ihe ebov escn e h, r i ecti � �e e�ot , or ellow occupancy of any building authonzed by Ihis �t u il final ins�� r � 'S,9.^:it'ure'Of.'r9aVOvm`er(s)1"'- r;'� AnNOr Authonzed Applicam Date CODE �. INSPECTIONTYPE 1616 Fixed System Pinal Fire Preven�ion 1266 Paol Spa Finel 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Factary Fire Place 203 Final Sign 204 Finel Demoll0on p�g �C� COpE1 INSPECTIONTYPE 206 Final Mechenical 208 Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 222 250 Final Planning Approval Finel Site Finel BulidinglOccupency P� Iti�dL@ '�'%Q ��' ` CITY OF COSTA MESA � ° BUILD/NG DIVISION �J� � � � .�� DEVELOPMENT SERVICES DEPARTMENT J •,� � PERMIT PERMIT NUMBER "bb4� 898-01307 (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 3292 GEORGIAPL Suite: Vicinity: Parcel Nunmber: 13904104 Zoning: Applicant CRANK, JIM Address: , - � Phone: - i • Zip: %�; Owner. THOMASON;"ROBERT E TR �. Address P O BqX=3701 �, \ � - �. -- � .. . . � . . -- � � -_ _ �. , �'�. �i�"/ ! \ , ,- j' Phone:" -- -. , �/COSTq�MESA,CA � _ -- � Zip: 92828 � -�i ' r.,� / �� _ Contrattori � CRANK BROT.HERS ROOFING CO ; i • �. � i-. Adtlress: 00126 COMMERCIAL WY Y �'//��, Status: ISSUED Applied: 0712 1/1 9 9 8 Issued: 0 712 111 9 9 8 . � � �� - �< ' , .� . �� . �- � �� , �� \ . � . �, ��, � - ';�;`, �� Phone:�, ��, �� . . � /� � : / �, �,' �: �� COSTq�MESA CA Zip: � 92627 � � ' - . 4 i `-. "�.� 'i �. � . � . - - i%%�� License:, 408677 � [ � � ," APih / Eng : � .' � � _. . . j�"��' ' . . Address: � � ' '� - ; � , � ,. �� Phone:' .. ��. . � . � � ,' /� � - _ . ' �i '�N•�. Zip: . , � � i.. '. License: . � � ' � f � SCOPE OF PERMIT , � � , � / � , T/0 ROCK ROOF AND INST 25 YR SHINGLES.- �- -� . , � � � . � ,Plan Check: Permit: 'SMIP Res: � SMIP Com: '�, Other. ' Inspection: : � � , Total: � - $0.00 $99.75 �, $0.50 >, $0.00 ,, $0.00 �:$0.00 $100:25 �.��. � — /ri' . SETBACKS MAINSTRUCTURE Front � 0-0 ACCESSORY Front- � 0-0 PARKING NOTES: , FEE SUMMARY ; j _ _ - _ - ! j � i .� i <�� _ F �� \.,f ,` " . Rear ,Rear � � Exislina; 0 - , - , Required: -0 g �" JNING 8 ZONING • ��Left � �0-0 Left . 0= 0 Proposed: 0 Calc Valuation: Sa,sss.00 Claim Valuation: sa,sss.00 Righl 0. 0 Right� _ 0-0 EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a perlod of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply vnih all applicable codes, and all required inapectlona end final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 WORKERS' COMPENSATION DECU1RA710N: • I hereby effirtn under penalry af perJury one of the fdlowing declaretion5: ❑ I have end will melmein e certificete of consent to salt-Insure tor workers' compensatlon, as provided for by section 3700 at the LeDor Code, for the peAormpnce af the w lor whic� thls partnit is Issued. I heve end will melntaln workers' compensation insurence, es requiretl by section 3700 of Ihe Lebor Code, ior ihe peAom�ance ot Ihe work tor wNch Ihis pertnit is issuetl. My warkers' co ense�fninsurance carrier antl pollcy number are: � `'{.._ 2 8S- �h- pdcx�a� Cerrier: Policy Number: (7Irls sectlon need nof be complered il fhe permit is valuetl at one hundred dollers ($100) or less.) ❑ I cenify ihet In �he pertortn e of the work tor which t yq pe it is Issued, I shell not employ eny pereon in any manner so as to �ecome subject to the workers' compensatlon lews ot Celifo , and egree thet It I 8 bec � ub�ect to the workers' compensation provislons ol Sectlon 3700 ot the Labor Code, I shell forthwith comply wit� Ihese provisions. � _ ^ �^ �� ApplicaN Signature: Date: fT WARNINO: FAILURE TO SE RE WO CEfiS' CAMPENSATION COVEMOE IS UNUWFUL AND SH4LL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE MUNDRED T}qU5PND00LLARE(E1 ,000), ORIONTOTHECOSTOFCOMPENSATION,DAMNGESlSPRWIOEDFORINSECilON31080FTMELABORCODE,INTEREST,ANDATTORNEV'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby effirtn ihet I am li setl und pr91'�sions oi Chapier 9(commencing with Saction 7000) oi Division 3 0l the Business end Professlons Cotle, end my license is in full force and eflect. Lic. p �{� Ce Clau # Comracrols Signature: Date: % � CONSTRUCTI ING AGENCV: . ❑ I hereDy aHirm that there is e construction lenaing agency for ihe DeAormance of ihe work for which this permit is iuued. (Sec. 3097, Civll Code). Lenders Name: Signature: _ OWNER-BUILDER DECLARATIONS: Lender's Adtlress: Date: I hereCy eMirm that untler penalry of perjury Ihet I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, eusineu entl Professions Code: Any ciry or counry which requires a pertnit to construct, alter, improve, demollsh, or repair any sWcture, pnor to its issuance, elso reQulres the applicant tor such pertnit to file e slpne0 stetement t�e� �e or she is Iicensetl pursuen� to �he Drovislons ot ihe Conirectors License Law (Chepter 9(commencing wlth Sectlon 7000) of Divislon 3 oi Ihe Business antl Professlons Cotle) or ihat he o� she is exempt iherefrom antl ihe besis for the alleged exemption. Any violation of Sectlon 7031.5 by eny applicanf tor a permlt sub�ects the epplicent to e civil penalry of not more than fve hundred dollars ($500)J: ❑ I, es owner of the pmperty, or my employaes with wages es their sole compensatlon, WILL DO THE WORK, and the slrucNre Is not Imantletl or oRered for sala (Sec. 7044, Business end Protessions Code: The Contractors Licensa Lew daes nat eppty to an owner of properry who builds or improves thereon, end who does such work �Imsetl or hereelf or through his ar her own emplayees, proNtletl that such Improvements are not inlended or aHaretl lor sele. If, however, the bullCing or improvement Is sold within one year ol completion, ihe owner-6ullder will have �he burden of proving Ihet he ar she Oltl not hulltl or improve lar purpose of sele.). ❑ I, es awner o1 the properry, am E%CLUSNELY CONTRACTING WITH LICENSED CONTRACTORS to consWct ihe pmject (Sec. 7044, Business and Professions Code: The contrectors Llcense Lew does not eppty to an owner of properry who builds or improves thereon, entl who contracts tor suU D�o�ect with a contractor(s) Ilcense pursuani to the Contradars License Lews.�. ❑ I em exempt under sec. Business antl Prolessions Cotle for this reason: Signeture: Date: Owner ID verifietl hy dnvefs license. ❑ Yes ❑ No Drivefs License No. Vedflcetlon of Ownershlp by (rype of tlocument, i.e. - properry tax blll or tlee0): DIVISION OF INDUSTRIAL SAFETY VERMR CERTIFICATION: Expires: ❑ I hereby cetlity ihet no e:cavetion five (5) ar more feet In tlapth Into w�ich e person Is required to descend, will be matle in connectlon with work authotlzetl by tMs permit, end that no bullding siructure, sceHoltling, felsework, or demolitlon or dismentling ihereo�, will be more ihen ihirty-siz (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Tltle B, CelHomla AtlmlNstrative Cotle). . ❑ As owner-builtler, I will no1 employ enyone to do work which would requlre e pertnit Iram the Division of Industriel Satery, es noted ebove, unless such person hes a pertnit ta do such wark trom ihe division. Signature: Date: Division of Industrial Satery Permil Number: CERi1FlCATE OF COMPLIANCE AND AIfTMORRATON OF EMRY: I certify under penalry of perjury ihat I have read �his epplication and ste�e that ihe infortnetion given is correct. I egree to comply with ell state laws and ciry ordinances relatinq to building construction, end authorize representetives ot ihe Ciry of Coste Mesa to eNer upon the aDove-describad properry tor inspecGon purposes. I agree not to occupy or ellow occupency ot any building authonzed by this Dermit until iinel inspeclion. LOOE I. INSPECTIONTYPE 1616 Fized System Finel Fire Pravention 1268 Paol Spe Flnel 200 Flnal Re-Roof 201 Final BIocWRetaining Well 202 Finel Fectory Fire Plece 203 Finel Sign 204 Final Demolitlon 246&IB �ff I�� Z�`-( oel`d Date COOEY INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Finel Electrlcal 272 Final Fire Preven9on 220 Fnal Planning Approvel 222 FinalSite 250 Finel Bullding/Occupency JOB AllllRF.SS AP No.].13—�2 INSPECTIONS Lambert L. LOT 3-15-62 rG PERMIT NO. VAL 1'RACP rIRL ZONE AI'sSCRIPTION OF WORK Signature DA7'E GROUP$1,Wfl11TYPE 7.ONE PER\9: - SUBCONTRACTOR n�.r.T Wall � i s��o FEE R�C�IIi�� . ,; 'J. COSTA MESA BUILDING-SAFETY DEPARTMENT � MAR 1 5 1962 P. O. BOX 917 C08TA MHBA. CALIPORNIA FINANG�E�@��fi: For Applicani fo Fill In Complefely APPLICATION��R �RK�II'I`fi� �� TYPE OR PRINT BUILDING i '' BUILDING ADDRESS � �^'f/� � 1 �• COSTA MESA. CALI ORNIA For O#ice Use Only neceirr No, e rt No. OWNER ADDRE6S a 2 � � �IV¢o BY I� x�et qn I�— y/u� � � TEL. BUILDI C� � GITY 0�- • NG. ADDRE58 � i ARCHITeC7 TEL. COSTA MESA. CALI RNIA OR ENGINEER NO. ADDRESS FIRE '� ZONE TYPE GROUP CONTRACTOR <.PPROVED / BY DATE AODRE66 D v �UC1 ZONING CITY �1^C. . O I PLAM9 '�/ I BUILDINO � BTATE TEL. �ga�� J LIC. NO. � NO. �/ � ') � DH9CRIPTION � BIZE — Y' 0 I D I NO. OP B1D08. _ � OF LOT NOW oN LOT q, p, NO. UBE OF YARO6 EVE6 EXISTING BLDG APPROVED ALLOWED BHTBACN LIN6 FROM ��MaA L1Ne �T'� /J L 3 CeNTER OP 9TPEET REAR YARD FRONT FT. IN. SIDE YARD ILEFT IRIGHT R.SIDE FT. IN. DESCRIPTION OF WORK � 2%TERIOR WALL IROOF � COVERIN6 COVHRING U6E OP BUILDING AN WO K TO BE P ORMED (� / � � �/ � / � // /� % � / o� I HBfiHBY ACKNOWL8D08 THAT I XAVH qHAD TX18 APPLIGTION THe AMOUM BXOWN UNOHp VALVATION IB ppq TH[ AND 9TATH THAT iNe ABOVH 19 CORRECT ANO AGNHH TO COM- pUliP088 OP CBTA9LIBXINO A PHRMIT F88 ONLY. PLY WITH ALL CITY ORDINANCBB AND BTATe LAW! RSOULATINO 9u1LnIHo CONs u oN. VALUATION � 81GNATURE OF /�.(� PERMIT FEE $ PERMI7TE �( � � � S �� PLAN CHEGK $ �� p AUTHORIZED AGENT . � O TOTAL FEE LL � �,. :' .^ g2�� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 C08TA M88A. CALIFORNIA For Applicani fio Fill In Complefely TYPE OR PRINT eui�o�No ADDRES9 3292 Geor iJ Place COSTA MESA. CALIFORNIA Costa P-lesa IRC. APPROVED BY ZONH BTATE 167293 No:� g-u59 LIC. NO. oF ioT 55 X 120 I r�+o:r°oe+ �� USHOP ___' eeTeACK LINB PRom � � REAR YARD 6O � C8NT6R OP 9TfiHHT SIDE YARD LEFT �� I RIGXT �� DESCRIPTION OF WORK .��... I i� II .. xe.r�..v I II ennir�nn� I �P 6 MS EXTERIOR WALL R� COVERING 9t.11CCO G � USE OF BUILDING AND WORK � Sin le famil residence with attached garage, Flan 40AR I HEREBY ACKNOWLHOGB TN�T 1 H��'6 RHAD TXIB A'PLIGTION AND BTATe TM�T TH8 ABOVH IB CORflBCT AND AOIiB¢ TO COM- PLY WITH ALL CITY OIiDINANCHB AND BTAlB lAW9 MEOULATINp BOILOINO CON9TROCTION. ' BIGNATURB OF Dike & Colearove. Inc. �AUTHORIZED AGENT LEGAL f EE RECEIVED � �:�� av i e �sso� . FlNANCE DEPT. CITY- Of COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only COSTA MESA. CALIFORNIA ZONING NO. OP I U8H OP NHW PLAN9 /1 BUILDINO , G Lot 36. Tract 31 YARDS EVES APPROVED ALLO �eer+ren uHs er.> �—_ THE �YOUM BNOWN UND6R VAIUATION IG POR THH PIIRp088 OP EBTI�BLIBHIN� A P6RMIT PH8 ONLY. VALUATION PERMIT PEE S � �� $ 1S��4J PLAN CHECK $ 17�5� T[]T�L FPP A l<1l0