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Home My WebLink About3294 GEORGIA PL - Building Permits(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us ,- 77 FAIR DRNE, COSTA MESA, CA 92626 BUI,I:vINCi PERMIT Job Address: 3294 GEORGIA PL Suite: Vicinity: Parcel Number: 13904103 Applicant: SELL, RON Address: Owner: HOLLOWAY, TIMOTHY Address 3294 GEORGIA PL � COSTA MESA, CA Contrector. SELL ROOFING COMPANY Address: 18032 CEMON' YORBA LINDA , CA Zip: , 92686 Arch : Address: Phone: Zoning: Phone: 714-528-7758 Zip: Phone: Zip: 92626 Phone: (714)528-1758 License: 323842 Eng: Address: Status: ISSUED Applied: 09/26/2001 Issued: 09/26/2001 ISSUED BY: � Phone: Zip: � License: License: SCOPE OF PERMIT TEAR OFF COMP ROOFING AND COVER WITH NEW SHEATHING AND APPLY 30 YEAR COMP ROFOING FEE SUMMARY Plan Check: $0.00 Calc Valuation: Permit: $9725 ` ' Claim Valuation: SMIP Res: $0.50 SMIP Com: $0.00 Othec $0.00 Inspection: $0.00 Total: $97.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARK�NG Existinq: o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Right 0-0 Right 0- 0 $3,900.00 $3,900.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandonetl for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. �i FOR INSPECTIONS CALL: (714) 7545626 ?44fi3fi (NW) . WORKERS' COMPENSATION DECLARATION: . I herehy aHirm under penalty of perjury one ot the following declarations: ❑ I have and will maintain a certificata of consent to sel4lnsure for workers' compensation, as provitled for by section 3700 ot ihe Labor Code, for tha peAormance of Ihe work tor which ihis permit is issued. ❑ I have and will maintain workers' com nsation surance, as requiretl by section 3700 of the Labor Cotle, for Ihe peAormance of the work for which this pertnit is Issued. M workers' co�{ se' Insu ce carner d oli number ere: � ( Carrier:Y i)� �(�^—'� P cl' PolicyNumber, l6� �P �� i (This secfion need not e complefed il tM1e perm/f Is valued et one hundred dallers ($100) or /ess.) ❑ I certiTy that in the pertormance of the work for which t�is pertnit is issueQ I shall not employ any person in eny menner so es to become subject to ihe workers' compensation laws of Calitornia,§aQ agrea thet it IyJ�ould becJ� me subject to Ihe"workers' compensetion pmvislons of Section 3700 oi the Lebor Code, I shell forihwith Comply with IheSe provision5. /�/ Q_ // Q -' �� ^ O / Applicant Signature: �f��Ulti ,�%�� Dete: WAFNING FAIIURE TO SECURE WORKERS' COMPENSATION CqVERAGE IS UNLAWFUL AND SHALL SUflIECT AN EMPLOVER TO CFIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNORED THOUSAND OOLLAFE (5100,000), IN ADDITION TO THE COST OF fAMPENSATION, DAMNGES AS PRWIDED FOR IN SECTION 3]OB OF THE LABOR CODE, IMEFEST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm that 1 am licensed under provisi� force and efled. Lia a� ConirectoYs Signature: with Section 7000) oi Division 3 ot Ihe Business and Prafyssl=ns Cpdg,and my license Is In full Class M � � a� Date: f 6 — 2ir/'—O .�— CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn iha� there is a construction lending agency tor the peAormance of ihe work for which this permit is issued. (Sec. 3097, Civil Code). Lendefs Name: Lender's Address: Siqnature: Date: OWNER-BUILDEH DECLARATIONS: I hereby aHirm that under penalry ot perjury that I am EXEMPT FBOM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Buslness end Protesslons Cotle: Any ciry or counry which requires e parmit to constmct, alter, improve, demolish, or repair any strucWra, pnor to its issuance, also requires the epplicant for such permit to file a signed statement that he or she Is licensed pureuent to the provisions of the Contrectore License Lew (Chapter 9(commencing with Section 7000) oi Divislon 3 of iha Business and Professions Cotle) or that he or she is eaempt thereirom and ihe basis tor ihe alleged exemption. Any violetion of Sectlon 7031.5 by eny applicent for e pem+t subjecis Ihe applicant to e civil penalry oi not more than five huntlre0 tlollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and lhe stmcture Is not Intendetl or oltered for sale (Sec. 7044, Business and Protessions Cotle: The Contractors License Law tloes not apply �o an owner of property who builds or improves thereon, and who tloes such work himself or herselt or through his or her own employees, provided that such improvements ere not Intendetl or ottered lor sele. If, however, the building or improvement Is sold within one year ot wmpletion, ihe owner-builtler will have the burden ot proving that he or she tlid no� builtl or improve for purpose of sale.). ❑ I, as owner ot the properly, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct the Droject (Sec. 7044, Business antl Professions Code: Tha comractors License Law does not apply to an owner ol property who builds or improvas Iheraon, antl w�o comracts for such pmlect with a contrecmqs) license pursuant to the Contrectors License LawsJ. ❑ I am exempt under sec. Signature: Owner ID verified by dnvers liCenSe. ❑ Ves ❑ No Business and Professions Cotla tor this reason: Veritication of Ownership by (rype ot daument, i.e. - property tex bill or deed): DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTIFICATION: Orivefs LiCenSe No. Da�e: E:pires: ❑ I hereby certify �hat no excavation five (5) or more leet in tlept� into which a person is required to descend, will be matle in wnnection with work euthorized by �his pertnit, and tha� no building structure, scattolding, talsework, or demolition or dismantling thereot, will 6e more then thiity-six (36) feet high (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ttle B, Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a pertnit irom the Division of Intlustnel Setety, as noted abova, unless such person hes e pertnit ro do such work irom the divisian. Signature: Date: Division of Indusinal Safary Pertnil Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF EMAY: I cenify under penalry of perjury that I �ave read this application end state t�at ihe iniormation given is correct. I agree to com h ell state lews end ciry ordinances relating to buildinq construction, end authorize representatives of iha Ciry oi Costa Mesa ro enter upon the above-described prqpYrty�inspectio ry� I agree not to occupy or allow xcupancy ot any building euthonzed by �his pe�it until fina� spection� � � C(/ � r D �ig��wrpBt�legal �vner(s) Da e Kl � ( � And/Or Authodzed pplicant Date COpE 1, INSGECiIONTYPE 1616 Fixed System Finel Fire Prevention 1266 Pool SOa Finel 200 Final Re-Root 201 Flnal BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition o"re IMIiULS COOE♦ INSFECTIONTYPE 206 Final Mechenical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy PAIE I[�ALS (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3294 GEORGIA PL Suite: Vicinity: NEW DOOR IN MASTER BEDROOM Parcel Number: 13904103 Applicant: MORTON, YVONNE Address: 7314 E CHAPMAN AVE ORANGE,CA Owner: HOLLOWAY, TIMOTHY Address 3294 GEORGIA PL COSTA MESA, CA Contractor: ALL PRO REMODELING Address: 1314 E CHAPMAN AVE OR4NGE, CA Zip: 92866 Arch : Address: Zoning: Phone: (714)288-1374 Zip: 92866 Phone: Zip: 92626 Phone: (774)288-1314 License: 574698 Eng: Address: ISSUED BY: Status: ISSUED Applied: OS/77/2001 Issued: 0 511 7/2 001 Phone: . Phone: Zip: License: License: SCOPE OF PERMIT INSTALL NEW DOOR BETWEEN MASTER BEDROOM & ATTACHED PATIO ENCLOSURE. REF: 801-00568 Plan Check: $15.28 Permit: $23.50 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Totai: $39.28 FEE SUMMARY Calc Valuation: Ssoo.00 Claim Valuation: $soo.00 � _ PLANNING & ZONING -�� - � � � SETBACKS MAIN STRUCTURE Front 0- 0 Rear 0- 0 ACCESSORY Front 0-0 - Rear 0-0 PARKING Existin : 0 Reauired: 0 NOTES: LeR 0- 0 Right 0- 0 Left 0- 0 Right 0- 0 Pro osed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 244fi-06 (fi/00) WORKERS' COMPENSAnON DECLAFiArON: � I hereby aflirtn under penalry oi perjury one of the following dederetions: ❑ I have entl wlll maintein e cert��a�e of consent to selFlnsure tor workers' compensation, es pmvided for �y section 3700 oi ihe Lebor Code, for tha pertormance of the work lor which this permit is issuetl. �� I have entl wlil malntain woBefs' compensa � n insurence, es required by sectlon 3700 of the Labor Code, tor the pertortnance ot Ihe work for which ihis pertnit is issuetl. M workers�' �en,s tion I urance wr and oll number ere: f -Certier.Y�(!�. p� P� PolicyNumDer:' � 6�W�O I—qqn 7n ;� � _(This section neetl nol be comp/efed �� e Oermi lued et one hundred Oollers ($ f 00) or /ess.J �" ""- �— ❑ I certify thet In Me performen f the work for whic this parmit is Issued, I shell not employ any person in any menner so es to become subject to ihe warkers' compensetlon laws of Celifo ie end eqree ihat if I hould become sub�e o the workers' compensatlon provislons of Sectlon 3700 of the Labor Cotle, I sheli forthwith comply wlth these provision . ' �_ I^/�� ApplicentSigneWre: � �Date: � � ��WARNING: FAIIURE TO SECURE WORKERS' CQMPENSATION COVERAGE 5 U WFUL AND SHALL SUBIEGT AN EMPLOYER TO CR�MINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED TSqUSAND DOl1ARE (5100,000). IN ADtl�TION TO THE taS� OF COMPENSATI , qMAGES 0.S PROVIDED FOR IN SECiION 31060F iME LABOR CODE, INiEFEST, AND ATiORNEY'S FEES. LICENSED CONTRACTORS DECI.ARATION: I hereby aflirtn Ihat I en force end eflact: Lic. a, Contrectofs SlgneWre: with Saction 7000) of Division 3 of the Business and Prpfgssions Cade, antl my licanse is in full Class q� � Dale: CONSTRUCTON LENDING AGENCV: � ❑ I hereby aflirtn ihat there is a GonsWction lending egency lor ihe peAormence of Ihe work for which this permit is issued. (Sec. 3097, Civil Code). Lentlers Name: Lendefs Atltlress: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby aHlrm ihet under penelty of perjury that I am E%EMPT FROM THE CON7RACTORS LICENSE LAW for iha following reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or county which reqwres a permit to construct, elter, improve, demolish, or repair any simcture, prior to its issuence, elso requires the epplicant for such permil to lile e signetl stetement thet he or she Is licensed pursuent to the provlsions of ihe Conirectors License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 of ihe Business antl Protesslons Cotle) or ihet he or she is exempt therefrom antl ihe besis for tha elleged exemption. Any violetion oi Section 7037.5 by any applicant for a Oermit subjects the epplicent ta e civil penelry of not more than tive hundred dollers ($500).): ❑ I, as owner ol t�e praperty, or my employees wiih wages es their sole wmpensa�ion, WILL DO 7ME WORK, entl the siructure Is noI Intentlad or otferetl for sale (Sec. 704a, Business end Protessions CoOe: The Coniractors License Lew does not apD�Y �o an owner of property who builds or improves ihereon, and who does such work himself or herself or ihrough his or her own employoes, provided thet such improvements ere not intended or oMeretl br sale. If, �owevar, ihe building or improvament is sold within one year of compla�ion, the owner-builtlor will heve tha burden al proving ihet he or she did not build ar impmve for purpose of sale.). ❑ I, as owner of Ihe property, am EXCLUSIVELY CONTRACTING WITN LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business and Professions Code: The coniracbrs Licens9 Lew does not apply to en owner ot pmPerty who builds or impmves Ihereon, and who contraci5 �ar suc� project with a con[ractor(s) license pursueni Io the Conirectors License Laws.). � I em exempt under sec. Business end Prolessions Cotle tor this reason: Signatura: Date: Owner ID venlietl by dnvefs license. ❑ Ves ❑ No Drivels License No. Verilication of Ownership by (type ol documant, i.e. - propehy tax blil or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Expires: ❑ I hereby certify �hat no excevallon tive (5) or more feel in depth into w�ich e person is requiretl to tlescend, will be me0e in connection with work euthorized by this permit, end thet no builtling siruoiure, scaflolding, falsework, or demolition or dismantling thereof, will 6e more then thirty-siz (36) leet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title B, Calilornia Administretive Catle). ❑ As ownar-builtler, I will not einploy anyone to do work which would require e permit fwm the Division of Indusinal Safery, es notetl ebove, unless such pereon has a pertnit ta do such wark fram the division. Signature: Date: Division oi InAusirial Sefery Permit Number: CERTIFICATE OF COMPLIANCE AND AU7HORIZATION OF ENTRV: I certity under penalry of perjury that I have read this epplication end state that ihe information given is correct I agree to compry with all stete laws and ciry ordinences relating lo building construction, and authonze representatives of ihe Ciry of Costa Mesa to emer upon t�e ebove-descnhe�property for inspection purposes. I agree not ro acupy or ellow acupancy of any building authorized by this permit until tinal inspection. {{I9�4:bYi3af[9AW39 1616 Fixetl System Final Fire Pre�ention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIxWRetaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition pATE � CO�E! INSPECTI�NiYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electricel 212 Flnal Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final Builtling/Oaupency 'S' /"Y�I ��I:lttiLl41 � � . �_ . �-n., -�...��-� sn.-,� ��. � .�A,� !T9.Z� K.�MoD.e��K�e I3��i Ls.' . C1�airaAn A.xd'. C/i.aKbr,. C� �'2�6�. "1 CK ' Z..S b �.3 ! �t . , � c. ., Uv,w K�'. • - i'iM � �irv�M`:s }�o�leu;wy 3Z��( (�.c't�eL�a �lac6 Cos�,;Meso,,.C�a. �jZb2� `1�K ,�lz� oS�� ' . ,��i�r:Or��81PMEt;�r�TY . � , �'1 and�°�caila'$n,,. �a�,�,�•� . � I o�abeanavr�. , 'SMsc � �9��taAe�(qwnoneatr� �� , j(��toP°"" aad�u� $�°'�' : maR p1 CA�1a�a�e�F°dt1a��oreC 101 �taMe�' � p en6v�Nt�eo ��. and'�a� c1tNnC , pnselU}Y �come��a�day� �- —, �M1�16t1o� , me�eaexp' � m a�,u9C6� . , � . ; .�pisneet� o�a�p; -- �L"�S � Z3� —;_- �°Mi�re'•- ; ' �clsitir. c.� , � �� ,�--I1% yvY�` , , . . . _ .. / ��CL:ttt� `, � ' . . . _ ppg ... � . j„� ' �^"0 S' , .. _. . . 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',�� •�, � � ��olP'�a"P,'�� o,�a�a � ��oN � � � a V �d °��, 'CMS� dcn�� t(A� ��G Q � 7' Q � . ;u,p �yG olttiS�eo�s�oos0�a ��mh�'� �CE3�� \J 1— e� � �mp's9 o�aoYp uOxN�e�a�"e _ � � � i a tiewo�iw"�pqe�`� � �a �3n5 .pe� . "�.. no! �, 'r' (714) 754-5273 • Fex (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suile No Vicinity: Parcel Nunmber: 3294 GEORGIA PL 13904103 ELECTRICAL PERMIT Applicant: HOL�OWAY, TIMOTHY S TR Address: 3294 GEORGIA PL COSTq MESA, CA Owner: HOLLOWAY, TIMOTHY S TR Address 3294 GEORGIA PL ConVactor: Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Oullels � Switches Non Res Appl Res Appl Service to 200a � . Service to 1000a Service over t000a Motors to 1 hp Molors to 70hp Molors to SOhp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Lighl Pkg Sign Circuits COSTq�MESA, CA OWNER-BUILDER Phone: 714-429-0578 Zip: 92626-2007 Phone: Zip: 92626-2001 Phone: Zip: License: 000000 SCOPE OF PERMIT NEW qC UNIT AND REPLACE CURRENT FAU. , . $23.50 50.00 $0.00 $0.00 50.00 50.00 50.00 � $0.00 $0.00 $0.00 $0.00 50.00 ` $0.00 so.00 $0.00 ' $12.30 $0.00 50.00 $0.00 $0.00 � $0.00 $0.00 $0.00 Quantity ' � 0 0 0 0 0 0 0 . 0 0 0 0 b 1 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System hLighting Busway�l100 R Slanding Section Misc Electrical Equipment Transformers up to. t kva/kw ................up to 10 kva/kw • � .::...:..........up l0 50 kva/kw ' ..........:.:..:.up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment , Low Volt Winng System / Ckt � Misc. Conduit ' ' Misc. Conductor , Circus ( gen or ride) Circus (mech nde or lighls) Christmas Tree Stand Fireworks Stand ,Other Electncal Fee Investigatlon Fee �Plan Check Fee Reinspection Fee Status: ISSUED Applied: 11/15/2004 Issued: 11/15/2004 ISSUED BY: Quantity $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00, 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0:00 0 50.00 0 50.00 S0.00 $0.00 $0.00 NOTICE: The work author(zeq by this parmlt shall comply with all appiicable handicap access requiremanis under Calitornia statutes and related regulations. (Ord. No. 92•28, § 1, 12-21-g2) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period ol 180 days. INSPECTIONS: In order lor the work authorized under this permit to be considered legal, such work must comply with all appliceble codes, and all requlred inapectlona and flnal approval must be obtained. Failure to obtain inspections and final approval will result in �he expiratlon of �his permit. POR INSPECTIONS CALL: (714) 7545626 24a&48 (8�00) WORKERS'COMPENSAnON DECLAFiAnON: . I hareby �rtn untler Denalry ol perjury one of Ihe following declaratlons � �� ❑ eve end will maintain e certificate ot consent ta self-Insure lar workers' compensation, es proNded lor by saction 3700 oi ihe Labor Code, for the performance of Ihe � ork tor whith ihi5 pertnit is issued. a intaln workers' canpensatlon Insurance, es requiretl Dy section 3700 0l the Lebor Cotle, tor t�e pedortnance ot the work lor whic� this permit Is Issued. My warkars' compe surance cerrler end policy number ere: Carner: Policy Numbec (fhis sec(ion neetl nof be comp/efed i! Ihe permif is velued al one hundred dollers ($ f00) or less.) ,. ❑ I cenify thel in the peAormence ol the work for which Ihis permit is issued, I shall not employ eny person in eny manner so as to becoma subject to tha workers' Compensetlon laws of Celltornia, end egrea t�et If I should become suD�BtI Io the workers' compensation provisions of Seclion 3700 of the Labor Cotle, I shell forthwlih comply with these provisions. Applicant Signeture: Date: WARNING: FAILURE TO SECUFE WORKERS' CAMPENSATIdJ CQVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TFIOUSAND DOLL4FE (E700,000), IN AODITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]Ofi OF THE LABOF CODE, INiEREST, AND ATTOiiNEV'S FEES. �, LICENSED CONTRACTORS DECLARATION: II hereby ettirm thet I am licensed under provisions of Chapter 9(commencinq with Section 7000) of Division 3 of the Business and Pmtessions Code, end my license Is in tull ' fo�ce end etlect. Lic. q Class e Conirector's SigneWre: Date: CONSTRUCTION LENDING AGENCV: ❑ I hareby aHirtn that there is e constmction lentling agency for the pertormance of ihe work Por which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Adtlress: SigneW re: Date: OWNER-BUILDER DECLARATIONS: I hereby eflirm thet under penalty of perjury Ihet I am EXEMPT FROM THE CON7RAC70R5 LICENSE LAW for Ihe tollowing reason (SecJ031.5, Business an0 Pmtessions Code: Any ciry or county whic� requires a permit to cnnsWct, alter, impmve, demolish, or repair any strucWre, pnor to its issuance, also requires the applicant for such pertnit to file a signad sletement Ihet he or she Is Ilcensetl pursuent to t�e provisions ol the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Prolessions Code) or thet he or she is eaompt therefrom and the basis for t�e elleged ecemption. Any violation of Section 7031.5 by eny applicant for a permit suDjects the applicent to e civil penelly oi not more Ihan five huntlretl tlollers ($500).): ❑ I, as owner of Ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the structure is not in�endetl or ottered for sale (Sec. 7044, Business and Professions Cotla: The Contractors license Law does noi apply lo an owner of propeny who builds or improves ihereon, and who does such work himselt or hersalt or through his or her own employees, providetl Ihat such improvemenis ere noi intentletl or offered for sale. If, however, ihe building or improvement Is sold within one year of completion, the owner�builder wiil heve the burden ol proving thet he or she did no� build or improve for purpose of sale.). ' I, as owner of the property, em E%CLUSIVELY CONTRACTINC WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business and Profeuions � The contrecrors License Lew does not eppty to an owner ol proparty who builtls or improves ihareon, and who comracts for such projaq wlih e contractor(s) li ensa;pursuant)e�e Contradors Licanse Lews.). �� Venficetion pf �wnersMp by Business antl Pcof0551Enc,Gode for ihis reason: �e. es ❑ No of tlocume i.e. - property tex bill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CEFiTIFICA710N: ❑ I hereDy certity ihat no excavetion five (5) or more fee� in deplh imo which a person is required to descend, will he made in wnnection with work euthonzed by Ihis permi�, antl t�at no building strucWre, scattoltling, falsework, or demolition or tlismantling ihereoi, will be more than thirty-sia (36) teet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title B, Califomia Atlminisiralive Code). ❑ As owner-Duilder, I will not employ enyone to tlo work which would require a permil irom the Division of Indusinal Sefery, as notetl ebove, unless such person hag e permit to do such woB irom �he tlivision. Signature: Date: Division at Industrial Safety Permit Num�er. COOE �, INSPEC710NTYFE �¢� 7�AL�a . Se4.Ff! INSPECTIONTYPE Q�]E �fl 1616 Fizetl System Final Fire Pravention 206 Final Mechanical � 1266 200 207 202 203 Pool SDe Finel Finel R8-Root Final BIocWRetaininp Well Final Factory Fire Place Final Slgn 204 Final Demolition 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Appmval - 222 Final Site 250' �Final BuildinyOccupancy . ` r � MECHANICAL PERMIT ,lobnddress: 3294 GEORGIA PL Suite No Vicinity: Parcel Number: 13904703 Applicant: HOLLOWAY, TIMOTHY S TR Address: 3294 GEORGIA PL COSTA MESA, CA Owner:' HOLLOWAY, TIMOTHY S TR Address: 3294 GEORGIA PL COSTA MESA, CA Contractor: O W N E R-B U I L D E R Address: ISSUED BY: Phone: 714-429-0578 Zip: 92626-2001 Phone: Zip: 92626-2001 Phone: Zip: License: 000000 SCOPE OF PERMIT NEW AC UNIT AND REPLACE CURRENT FAU. ISSUE FEE Inst FAU <100 k 8TU- �. Inst FAU >100 k BTU Repair / Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig.Sys >100 k BTU Gas Piping , , Factory Fireplace ' � Hood 'w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance � � . Fire Dampers -� Smoke Dampers ' Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > t0000cfrn Floor Fumace � Floor or Suspend Heater $23.50 $14.80 $0.00 50.00 $0.00 $14.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 30.00 $0.00 ' � $0.00 ' $0.00 $0:00 $0.00 So.oO $0.00 0 Quantity .. Repair / Alt Absorbtion Unit 1- � . Repair / Alt Refrigeration Unit �0 � _ � � VentillatiodSystem 0 Evaporative Cooler 0 - Commerciallncinerator 1 Domestic Incinerator 0 Compressors�/ Absorpiion Systems 0 Upta3hp/100kBTU 0 -.� _3 To 15 hp / 500 k BTU 0 , ,��-15 To 30 hp / 1,000 k BTU 0 .- � � 30 To 50 hp,/ 1,750 k BTU 0 - . Over 50 hp /�Over 1,750 BTU '� -0 � Bailers - - � 0 Upto3hp � � � " 0 � 3To15hp ' _ � 0� � 15to30hp , � 0' �� __ , �30to50hp. � , ' 0 -, Over50�hp � � 0 Oiher Mechanical Fee 0 � � Invesiigation Fee � � � Plan Check Fee . - . .Reinspection Fee , TOTAL CALCULATED FEES Slatus: ISSUED Applied: 11/15/2004 Issued: 11/15/2004 Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 ' $0.00 0 � 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $53.10 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) � EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period ot 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspectlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOH INSPECTIONS CALL: (774) 7545626 saaass lcvoo� WORKERS'COMPENSAnON DECLAFAnON: ' _ �� ' ' � , I hereby aftirm under penalry of perjury one of the following tleclarations: ' ` �, � � ❑ I have and will maintain a certlficete ot consent to setl-Insure for workers' compensation, es provlded for by section 3700 of ihe Lebor Code, tor thu pedormance ot the work for which ihis permit is issuetl. � . ❑ I have and will maintain workers' compensation insurence, as requiretl by section 3700 of the Labor Code, tor the pertortnanca oi Ihe work for which this permit Is Issued. My workers' compensation Insurance carrier antl policy number are: - Carrier. Poliry Number. (This section need nof be completed i! the permit is valued et one hundred tlallars ($100J or less.) ., ❑ I cartity that in the pedormance of the work tor which this permit is issued, I shall not employ any person in any manner so as to become subject to ihe workers' compansation laws of Calitornia, end agree ihat if I should become suhject to ihe workars' compensation provlslons of Section 3700 of the Labor Code, I shall tonhwith comply with ihese provisions. Applicant SigneWra: Date: WAfiNING: FAILURE i0 SECURE WORKERS' COMPENSATIIXJ CAVERAGE IS UNIAWFUL AND SNALL SUBIECT AN EMPIOYER TO CiiIMINAL PENPLTIES ANO CNIL FINES UP TOONE HUNDqED TqUSANO �OLLARE �St00.000�, IN ADDITION TO THE CAST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 310fi OF THE LABOR WOE, INTEREST, AN� ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I here6y aHirm that I am licensed under provisions of Chaptar 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, antl my license is in full force and eHect Lic. a Class N Contractor'S Siqnature: Date: CONSTRUCTION LENDING AGENCY: ❑ I �ereby attirm that there is a constmction lending agency for ihe peAormance of the work tor which ihis permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: SiqnaWre: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirm ihat under penalty of perjury ihat I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions Code: Any city or counry which requires e permit to constmct, alter, improve, demolish, or repair eny stmdure, prior to its issuance, also requires ihe applicant tor such permit to file a signetl statement that he or she Is Ilcensed pursuant m tha provisions of the Coniractors License Law (Chapter 9(commencing wlth Section 7000) of Dlvision 3 ot the Business and Professions Code) or Ihet he or she is exempt thereirom and the Oasis for the alleged ezemption. Any violetion of Section 7037.5 by any applicant for a permit su6jects the applicam to a civil penalry oi not more then five hundred dollars (5500).): ❑ I, as owner of the property, or my employaes with wa9es as their sole compensation, WILL DO THE WORK, and ihe structure is no� intentletl or offered for sale (Sec. 7044, Business and Professions Code: The Coniractors License Law does not apply to an owner of propeny who builds or improves thereon, and who does such work himself or herseN or ihrough his or her own employeos, provided ihat such improvements ere no� in�entled or ottered for sale. It, however, the 6uilding or improvement is �sold within one year of completioq the owner-builder will have the burtlen oi proving ihat he or she did not build or improve for purpose of sale.). I, as o e t Ihe property, am E%CWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consimct fhe project (Sec. 7044, Businass antl Professions Code� he c tractors License Law does not apply to an owner of pwpeny who builtls or Improves thereon, and who contracis for such prolect with a contractor(s) lice e pursu nt to the Contractors License Laws.). Business and Pmfessions Code tor Ihis reason: OwnacJB'�i d D tlriveY lic�e. �s ❑ No � Verification Ow ership y(type of document, i.e. - propeny tex bill or tleetl): OIVISION OF INDUSTRIAL SAFETY PEHMIT CERTIFICATION: ❑ I hereby canify thai no excavation five (5) or more fee� in depth into which e person is required to descend, will be made in connection with work au�honzetl by �his pertnit, and lhat no buildinq sWcture, scaHolding, falsework, or tlemolition or tlismantling ihereof, wiil be more ihan thirty-six (36) feat high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Calilornia Administreliva Cotle). ❑ As owner-builtler, I will not employ enyone to tlo work which woultl require a permit from the Division of Indusinal Safety, as notetl above, unless such person has a permi� �o do 5uch work from �he divi5ion. Siqnature: Date: Division of Indus�rial Sefety Permit Number: Will the applicant or present or fuWre builtling occupant neetl to file antl cenity a Business Plan lor emergency response to release or threatened release ot a hazardous material? ❑ Ves ❑ No (Section 25505 of the Califomia Health antl Safery Cotle requires, wit� some ezceptions, ihat a Business Plan be filed with ihe Costa Mesa Fire Depenment by every business which has at any one time during a reported year a quantity of hazardous materials eQual to or greater ihan a weight of 500 pounds, or a volume of 55 gallons, uoes or win tne eppucant or presem or mmre omiaing occupam neea to me e regisiretwn rorm �or ecmeiy nazaroous ma�eriais! LI res V no (Section 25533 of ihe Calitornia Heallh and Safery Cotle, with some exceptions, requires regisiretlon with the Costa Mesa Fire Department by each business which at any one time hes on hand a quantiry oi ecutely hazardous meterials equel to or greater ihan e weight of 500 pounds, or a volume of 55 gallons, or 200 cuhic teet of compressed gas at standartl temperature and pressure). . .............._._..............................._....._............................................................................................................................................... ............................................................_.........._._.............................................. Does or will the applicant or presem or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazartlous materials)9 (Section 25534 of Ihe Califomia HeaIN and Safery Code provides ihat the Costa Mesa Fire Department may require ihe preparation, certification and filing wi�h Ihe Fire Depariment oi an RMPP by businesses which are required to register acmely hazardous materials with ihe Fire Depariment. ....................................................................................................................................................................................................................................................................................................................................................................................... 4 If en RMPP is oreseniW reouired. hes Section 25534 of iha Calitornia Healih end Safetv Code been fullv comolied with7 ❑ Yes ❑ No 5 Does or will ihe epplicant or Dresent or tuWre bulltling occupant reqWre tor ine work wnlcn Is tne sublect ot tnis e pucaoon a ermn tor sucn constmcnon or moaincanon irom ihe South Coast Air Oualiry Manegement Distric� or trom eny o��er eir pollu�ion coniml tlistrin or agenc� � Ves � No (Section 658502 of ihe Califomia Govemment Code requires ihat ihe requested inbrmalion be furnished on appiications for non-residential building pertnits). ..................................................................................................................................................................................................................................................................................... .................... . ................................ 6 W ill any paR ot �he �aciliry to be constmcted under Ihis permit be within 1000 fee� fmm the outer boundanes of a school7 ❑ Yes ❑ No Qf "yes", ihe facility must meet Ihe requiremen� of Sections 25534 antl 42303 of ihe Calitomia Health antl Safe�y Cotle). ........................................................................................................................................................................................................................................................................................................................................................................................ 7 tl e permit from the South Const Air Quali�y Manegement District or other eir pollution con�rol tlis�ric� or egency is required for Ihe work which is the subjec� ot Ihis application, have all of the disclosures prescribetl 6y Celifornia Health and Sefery Code Section 42303 been made9 ❑ Ves ❑ No ....................................................................................................................................................................... ...................................................................................................................................................................., 8 Qt'yes", attach cenificate of compliance fmm the appropriate air polimion control oHicer). CERTIFICATE OF COMPLIANCE: I certity Ihat untler penalty of perjury ihe information given aDove is correct. I egree to comply with all state laws antl ciry ordinances regartling Hazardous Materials and Emissions. /Sonature� Da�e: _ . __ __ _ _ '�E AND AUTHORIZATON OF ENTRY: I cetlity under penalty ot perjury thai I have read this application and stete ihat ihe intormation given is all state laws and ciry ordinances rela�ing �o building constmction, and authorize representatives of Ihe Clry o4Costa Mesa to enter upon Ihe ;pe � . I agree not to acupy or altow occupancy of any building au�honzed by this pe it u iHinal ins ction. i re_O__tLegalOwner ) te COpE �. INSPECTIONTYVE 1616 Fixed System Final Fire Prevention 1266 Pool Spe Finel 200 Final Re-Raof 201 202 203 204 Final Block/Retaining Well Pinal Faaory Fire Place � Final Sign Final Demolition �7�� IMRIALS 4QpE.[ INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Elecirical 212 Final Fira Prevention 220 Final Planning Approval 222 Final Site 250 ' Final BuildincyOccupancy' � � � : r � C� � C� ��'leda �uiE'di� Di�i�io�s OWNER-BUILDER VERIF[CATION A city or county, wNich is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent ro issuing a building permi[, require the compietion and require,the retum of, an owner-builder verification. AI[en[ion Property Ownec An 'owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelupe provided at your eadiest opportunity �u avoid unnecessary delay in processing and issuing your building permiL No buildin� oermit will be issued until this venfication is received. l. 1 personally plan to provide the major Iabor and materials for construction of the proposcd property improvemenL ❑ Yes ❑ No 2. (hav ave not) signed an application for a building permit (or the proposcd work. 3. I have convacted with the following person (fimi) to provide the proposed conswction: Namc �� fl H1r /� Address 710 .� r� i� L City �LU7(iI,M Phone ) �3' ��p�n Contractur's Lic. No. ��-i .52� 4. I plan to provide portiuns of the work but I have hired the following person to coordinate, supervise and provide the major wurk: Namc Addrecs City _ Phone ( ) Contractor's Lic. No. 5. 1 will provide some of the work but I have conVacted (hired) the following persons to provide the work indica[ed: Namc Address Phonc Typc of Work iM206 (REV. 958) � c" � � � � � i� � � ,�� CITY OF PLANNI SUBJECT 1'O NOTE: ADDIT OR CORREC 1 4V G� STA MESA DIVISION )G. DEPT. REG. fS, DELETIONS, �NS SHALL BE 's PLANNING DIV. DATE: �� /� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 3294 GEORGIA PL Suite: Vicinity: Parcel Number: 13904103 Applicant: MORTON, EVONNE Address: Owner: HOLLOWAY, TIMOTHY Address 3294 GEORGIA PL COSTA MESA, CA contractor: ALL PRO REMODELING Address: 1314 E. CHAPMAN AV. ORANGE,CA Zip: 92866 Arch : Address: Zoning: Phone: 714-288-1314 Zip: Phone: Zip: 92626 Phone: (714)288-1374 License: 574698 Eng: Address: Phone: Status: ISSUED Applied: 04/25/2001 Issued: 04/25/2001 ISSUED BY: � Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT 170 SQ. FT. PATIO COVER. ICBO # P3190. Plan Check: $54.11 Permit: $83.25 SMIP Res: $0.50 SMIP Com: ' $0.00 Other $0.00 Inspection: $0.00 Total: $137.86 SETBACKS_ � �� MAIN STRUCTURE Front � 19-6 ACCESSORY Front 0- 0 PARKING Existinq: 2 NOTES: FEE SUMMARY PLANNING 8 ZONING Rear 23- 0 Left 5- 0 Rear� 0- 0 Left 0- 0 Re uired: 2 Proposed: 0 Calc Valuation: Claim Valuation: %, � i Right 5- 0 ' Righ[ 0- 0 Sz,�ao.ao so.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to ba consitleretl legal, such work must comply with all applicable codes, and all required Inapeetiona and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration.ot this permit. FOR INSPECTIONS CALL: (714) 7545626 za�as �r�ao� WORKERS'COMPENSATION DECLARATION: ` � � � ,� I hereby aHirm untler penalry ot perjury one oi the following declarailons: - � ❑ I heve end will n�aintain a certificate of consent to selt-Insure for workers' compensation, as provided for by section 3700 oi the Lebor Code, for the peAormance oF the work tor whiCh tPiapertnit i5 issued. �I heve and will maintain workers' cwnpensatlon Insurenca, as requiretl by section 3700 of the Labor Cotle, lo� ihe peMortoanca of the woM for which t�ls permit is Issuetl. My workers' compensat on Insurance cerner end policy number ere: Cerrier: Policy Num�ec (This secGon naetl nof be completea i! fhe pertnit is valuetl at one huntlretl tlollars ($ f 00) o� /ess.J , . ❑ I certity thet in the pertortn of ihe work for whic� compensatlon IeN's of Cali ia, antl agre ihat If I s a rovisio p' nt SlgnaWre� �I NIN � T05ECURE WO{iKEFS' CQNPENSATION R TFKKISAND OOLLARE (5100.000). IN ADDfTIIXJ TO THE COST OF C by3flirm ihat I em entl eflect. Lic. a _ I shall noi employ any person in eny manner so as to become subject to the workers' I to the workers' compenselion pmvislons ol Section 3700 of the Labor Code, I shall lorthwith - �-�s-�� IS UNIAWFUL AND SW1LL $UBJECT �TION, OAMAGES AS PROVIDED f-0R 9(commencing with Section 7000) of Date: JAL PENPLTIES AND CIVIL FINES UP TOONE HUNDREO LA00R CODE, IMEREST, AND ATTOFNEYS FEES. and Projgssions Coae, and my license is in tull CONSTRUC710N LENOING AGENCY: ❑ I hereby aflirm ibat there is a construction lending egency for ihe pedormance of ihe work for which this permil is issuatl. (Sec. 3097, Civil Cotle). Lender's Name: Signeture: _ OWNER-BUILDER DECLARATIONS: Lender's Address: Date: I hereby aHirtn Ihet under penalry oi perjury that I em EXEMPT FROM TME CONTFiAC70R5 LICENSE LAW for Ihe following reason (Sec. 7031.5, Busine55 end Professlons Cotle: Any city or counly which requires a permif to construct, alter, improva, demolish, or repair any structure, prior to its issuance, also requires Ne epplicant tor such permit to lile a signed stetem6nt thet he or she is licensed pursuent to Ihe provislons ot ihe Contractors License Lew (Chapter 9(commencing with Sectlon 7000) ol Dlvision 3 0l the Business end Professions Code) or t�et he or sha is exempt therefrom and ihe basis for ihe alleged exemption. Any violetion of Section 7031.5 by any epplicant lor a pertnit suDjects the eppllwN to a civil penalry of not more than Ilve hundred dollare ($500).): ❑ I, es owner of th6 property, or my employees wilh wages as their sole compensation, WILL DO TT1E WORK, antl the structure is not intended or oHeretl tor sale (Sec. 7044, Business and Professions Code: The Coniractors Licensa Law dces not apply to en owner ol 0�openy who builds or improves thereon, end who tloes such work himselt or herseN or through his or her own employees, pwvitled Ihat such impmvemams are not intendetl or oMered lor sale. If, however, ihe building or Improvement is soltl within ona year of completion, the owner-builder will have Ihe burden ol proving ihat he or she did not build or improve for purpase of saleJ. ❑ I, as owner ot lhP pm0erty, em E%CLUSNELV CONTRACTNG WITM LICENSED CONTRACTORS to construtt the project (Sec. 7044, Business and Profession5 Catle: The ConirO��OrS LiCenSe Law does not apply to en owner ol property who builds or improves Nereon, antl who conirecis for such project with e Conirettor(s) license pursuant to the Contrecbrs License Lews.). ❑ I am exempt under sec. Businass antl Protessions Code br this reason: Signelure: Date: Owner ID veritietl 6y dn�er's license. ❑ Yes ❑ No Driver's Licenso No. Veritication ot Ownership by (type of tlocument, i.e. - pmpeny tex bill or tleea): DIVISION OF INDUS7R�AL SAFETY PERMIT CERTIFICATION: Expires: ❑ I hereby certify tnat no excavation fiva (5) or more feet in dept� into which a person is required to descend, will be mede in connection with work authorized by Ihis permit, and ihet no building strucWre, scaHoltling, talsework, or demolition or tlismantling thereof, will be more then Ihirly-sia (36) feet high. (Chap. 3.2, Gry 2, Art 2, Sec. 345, Ttle 8, Calitomia Adminisirative Code). ❑ As owner-builtler. I will not employ anyone to tlo work which would require a permit irom the Division ol Industnal Safery, as noted above, unless such person has a pertnit to do sucb work from the division. Signature: Dete: Division ol Industrial Sd�ety Permit Number: CER7IFlCATE OF COMPLIANCE AND AUTHORRATON.OF ENTRY: I certily under penalty of perjury ihat I have reatl ihi5 appliwtion antl state l�a� ihe inbrmation given is correcL I egree to wmply with all state laws end city ordinences relating to builCing consWction, and euthorize represen�atives of Ihe Ciry ol Costa Mesa lo enter upon the above-describetlD�opertY �o� inspectio� puryoses. I agree not to occupy or ellow occupency of eny builtling authorized by this pertnit until final inspeclion. cooe �, iNsvecnoNrrra ' 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Fina� 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demoliti0� UAIF' irmm��s =� �( t�� 6] aT CODEA INSPECTIONTYPE 206 Flnal Methanical 208 Finel Plumbing 210 Finel Eleclrical 212 Final fire Prevention 220 Final Planning Approval PdIE IMITIALS 222 Final Site 250 Final Building/Occupancy ��'�� 04/2�/Z001 07:55 F.� T23 2&9 "'7 ALL PRO RE910DELIYG VO�NE ttORTOti f�0�i . �.,on4-t'-R/��.c'. � ' bt,,,l��'2,'. ` �:�1 ,QQ-0 {��MODe1'�u(a T'�t-1. w �innri�c' 1-4ollewwy l�.!`"�, �. CI�nAH i�ei'. 32�i�{ G.caeL.a Piace' �(i.�rab� .CAA r1286[p C45� F''��S'd, .�e�. �1Z626 �1 �'4 �$ 6 13 (�f `7 ��( �l2`t � S7 � �. . � , � 126Qo.S�p : � . � � � .� zo�- � � i�.... �*�lM� � �,�.� �aa�, ' (�� 1° x Z2� x �2'Y I�IIH� r'Ks� ki�r��.�N.OF DUILDII�'G SAFETY ! 7� 1; �� l: � ITY CiF COSTi4 MESA , U , A-PPROVED . . � � �'- ci.~ri� �Y-- � - � � �+ `� .fF��R<(-� :.�b 1�hTiii::eFclpa�,�ard. �'�--._Dato Z.SI� r�wka;.�y `Gr.cifrcafi:ns MiiSi ee kepi �n Ihs jop ��g time� end'd . . ��"... Sw�}�t'I�', , mNi�ta�y.C�'qy��jUhtaMssa.��°�@m:lttn � P�masbn Gam the DA�i ,7I� the 5a'oClW of IAis:pMi ardspoa&a6ac S1W�,� n,�T � held 6� c; c;c vreta;'ro.� o! arty omr:�yas ot �� . y�ay. PeRnAwtobe wns ;n!� wrm' �,�ry ' ii Costa Mose OMmance and/o . . . � � � � i;rorY. i: iri c� .� e.�e aj fim't.� ios ;irn Ir,,tme nu1:� � k.�_, , c..+`:-6,,,, va�dif�ha - . -:^.,.._...>a� .. . � . ... , , •� �`v3 (d; ixflyj, � ,�, � � G��S L3� , ��r��: � , '�'i �?` • '� °y" 2.8 . . �Gss/� • . . � .. . /� ��f I, � � . �a �. �o� ' . ' � �-,� ��M � � �� ._.. -� , . . � , � Q 7 ; ; /'� r� s� �--� . ; r �mn � L s sc5's� «�4 � , �, � �, Z o `' , ' . . ' ; _ � k ... . Y � �'n�M. s�oE- Pf ' � -r� e��l�.c�¢s �� j �� 4a it / ! Z� i �r Q G�7a i 1 I ; ; ,. _ _; � ' � - I ' �. .... � � I � .�GP.-�d' . � ' � q ;../ �"=2.�� P'`'� . �a�... � � ( s-b g..... . F��' . , , ... 3 Z,�c 4 t��aa��. Pls�� i��i.�� , CITY.OF.COS�A MESA, • PLANNING DIV. , _. _ i SUBJ ECT' TO, BLDG.; DEPT. :REG. ; . .. ; , , 8Y; /"V"'� .DATE� �I " , . ' (714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: ApplicanC Address: Owner: ELECTRICAL PERMIT 3294 GEORGIA PL NEW ENCLOSED PATIO ADDITION 13904103 MORTON,YVONNE 1314 E. CHAPMAN AV. � ORANGE,CA HOLLOWAY. TIMOTHY Address 3294 GEORGIA Pl COSTA MESA, CA Contrector: ALL PRO REMODELING Address: 1374 E. CHAPMAN AV. ORANGE,CA Phone: (714)288-1314 Zip: 92866 Phone: Zip: 92626 Phone: (714)288-1314 Zip: 92866 License: 574698 Status: I SSU E D Applied: 04/25/2001 Issued: 04/25/2001 ISSUED BY: �/Y�'� SCOPE OF PERMIT ELECTRICAL PERMIT FOR NEW ENCLOSED PATIO ADDITION TO EXISTING SINGLE FAMILY RESIDENCE. INSTALL 1 LIGHT, 5 OUTLETS, 8 1 SWITCH. REF: BOt-00568 ISSUE FEE Temp service test Res. a/c package- New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts ' Recept Outlets Switches Non Res Appl � � � Res Appl Service to 200a Service to t000a Service over 1000a Motors to ihp Motors to 10hp Motors to 50hp Motors to t00hp Motors over 100hp Communication dmps Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole $23.50 $0.00 50.00 $0.00 $0.00 $0.00 51.10 $5.50 51.10 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 50.00 $0.00 Quantity FEE SUMMARY Temp Disl Syslem / Lighting Busway 1100 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 VOIt Wiring System / Ckt � Misc. Conduit Misa Conduclor ' Circus ( gen or ride) Circus (mech ride�or lights) _ Christmas Tree Stand � Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee �uantity $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� i -' � ,�$0.00� .`�0 i. ./ $0.00 0 $0.00 0 '� $0.00 �"�0� $0.00 . 0 $0.00 0 $0.00 0 $0.00 0 $0.00 50.00 $0.00 $0.00 TOTAL CALCULATED FEES S3'1.20 COMMENTS / SPECIAL CONDITIONS / NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 7241-92) EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or If work Is suspended or abandoned for a period of 1 BO days. INSPEC710NS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all requlred Inapectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in tha ezpiration.of this permit. FOR INSPECTIONS CALL: (714) 7545626 2aawe �dool WORKERS'COMPENSAnON OECLARATON: I hereby aXirtn unCer penalry of perjury one ot Ihe �ollowing tleclaretions: ❑ I have antl will mainiain e certificate ol consent to self-Insure for workers' compensatlon, es provitletl for 6y section 3700 0l the Lebor Code, lor the performance of the work for whlLh t�is pertnit is issuetl. �I have arM wi�l maintain workers' compensatlon insurexe, as requiretl by sectian 3700 ol Ne Labor Catle, for ihe pertortnance ol t�e work for which ih¢ pertni� is issu¢d, My workers' Gompensation Insurance carti0� and policy number are: Cerrier. Poticy Number. (Th/s secf/on need not be comp/eted i! tlie Oermif Is value0 e( one hundred dW/ers (S I00) or /ess.) _ ❑ I certiy that in t�e pertormance ol ihe work �or whic� this pertnit is issueQ I shall not employ eny person in eny menner so es to become suhject to the workers' com s of Calilarnie, n egree Net II I s ultl become sub�ect to tho workers' compensetion provislons ol SecUon 3700 of Ihe Lehor Code, I she0 forthwith ywi 50 foVi5ion5. � ( � 9� APPlicent Signet � Date: � � :FAILURETOSECUREWORKERS'COMPENSATIONOOVERAGEI WFULANDSMALlSUBJEGTAN LOYERT IMINALPENALTIESANDdVILFlNE$UPTOONEMUNDRED TFKKISAND OOLURB R��.�1. IN ADDIiION TO TME CQST OF COMPENSATI �AM4GE5 AS PROVIDED F-0R IN SECTI OF THE LABOR CODE, IMEREST, qN0 ATTORNEY'S FEES. LICENSED C0�9eCTORS DEGLARATION: I harypq irm ihat I a lice und yp 'sio s Chapter 9(commancing with Section 7000) ot sion 3 of the Business end Praf ions CaAe, antl my license Is in lull yerce ndeHect.lJG�» � " Co trectofs5igneW : — Date: "� CONSTRUCTION 4ENOING AGENCY: ❑ I hereby aflirm ihat there is e construction lending egency for iha pedarmance of l�e work tor which this permit is Issuetl. (Sec. 3097, Civil CoCe). Lender's Neme: Lentlefs Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby effirm ihat untler penalry of pe�ury thet I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for ihe following reason (Sec. 1031.5, Business flntl Profeulons Cotla: Any ciry or cPunry which requires e permit to conswcL alter, improve, demdish, or repair eny strucWre, prior to its issuance, alsa requires the epplicani br such pertnit to file e signetl statameN that he ar she is Iicensed Dursuent to the pmvisions oi the Contredors License Lew (Chapter 9(commancing with Sectbn 7000) of D'Msion 3 of tha Busineu end Proteuions Cotle) or t�a� ha or she is exempt Iherelrom antl the Oasis lor the elleged exemption. Any violetion ol Section 7031.5 Ey any aOPlicant for a pe��t subjects the epplicent to a civil penalry ot not more then live hundred Aollars �5500).): ❑ I, as owner af the praperty, or my employaes with wages es iheir sole compensation, WILL DO TME WORK, and Ihe siructure Is not Imentle0 or ottered for sale (SeG. 7044, Business and Professions COUe: The Contractors Licensa Law tloes noI appy lo en owner of property who 6uilds or improves ihereon, and who dces such wo�k hlmsell or herselt or Ihrough his or her own employees, pmvided that such imprwements are noi Intended or ofleretl for sale. If, however, ihe building or impmvemeN is sold within one year of completion, the ownar�6uilder will have the burtlen of proving ihat ha or she did no� build or improve for purpose of sale.). � ❑ I, as ownar ol the pmperry, em E%CLUSNELV CONTRACTING WITH LICENSED CONTRACTOFS to constmct the project (Sec. 7044, Business and Professions Cotle: The contrectors License Lew does n0I epPN �o an owner of pmperty who Oullds or Improves thereon, antl who coniracts tor such projact with e contractor(s) license pursuaN to �he Contraaors License Lews.). ❑ I em exempt untler sec. Business and Professions Code br this reeson: Signature: Date: Owner ID verilied by drivefs license. ❑ Ves ❑ No Drivefs License No. Verificatlon ol Ownarship by (rype of Cocument, i.e. - propeM1y tax biil or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTFILATION: Expires: ❑ 1 hereby cerliiy Ihal no excavatlon Ilva (5) or mora feet in deplh info whlch e person is required to descend, will De made in conneciion with wwk euthorizad by this permit, end that no builtling siructure, sceHolding, falsawork, or demolition or tlismantling thereof, will be more than thirty-si: (38) laet hig�. (Chep. 32, Gry 2, An 2, Sec. 345, Ttle B, Calilomia AaminlstratNe Cade). � ❑ As owner-bullder, I will not employ enyone to do work which would requlre e pormit from I�e Division of Intlusirial Seloty, es noted above, unless such person hes o permit to do such work iram Ihe tlivision. Signeture: Oalo: Division of Industnel Safety Permit Numbor; CER71FlCA7E OF COMPLIANCE ANU AUTHORPJITION.OF ENTAV: I cenity under penalry of perjury ihat I ha�e read this appliwtion and s�ate that Ihe infortnation given 15 correcL I egree Io rAmpty with all state laws enC ciry orClnances relatlng to building constructlan, end authonze representatives of ihe Clry ol Costa Mesa to enter upon the ebove-descnbed pmperty for inspection purposes. I egree not ta accupy or ellow acupency ot eny building aulhonzed by this permit until tinal inspection. COOE �. INSPECTIONTYYE 7618 Fizetl System Final Fire Prevenlion 1288 Pool Spa Finel 200 FIneIRe-RW� 201 Final BIocWRetaining Wall 202 Flnal Fectory Fire Place 203 Finel Sign 204 Pinal Demolition QAIE' II4m9LS �i.QQF.,( INSPECTIONTYPE 206 Finel Mechanical 20B Flnel Plumbing 210 Final Eleciricel 212 Final Fire Preventlon 220 Final Planning Approval 222 FinalSite 250 FinalBuilding/Occupancy � � uw. � � , D .il�_/. OWNER DATE JOB ADDRESS 3�q�i (}Pn�via Place � BUILDING PERMIT NO. 150C�3 GENr7RAL CONTRACTOR M�rt.arlaGG Rlnek VALUE $ �90.00 AP. No. LOT TRACT FIRE ZONE DESCRIPTION OF WOAK IN$PEGTIONS I DATE GROi7P TYPE ZONE R_l SUBCONTRACTOR � PERMITSISSUED OCCUPANCY Form 210—SM-11-59 SB P . ZSOC�3 _ � 't. .. -- �p 3 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 3f7 C09TA MEHA. CALIFORNIA For Applicanf fo Fill In Complefely TYpE OR PRINT BUILOING ADORE55 L � COSTA MESA CALIFORNIA � _ � /1 �.r_ • I MAIL � a. !� . . /i . TEL. cirr S /� � STATE i n, r� �_ n Y � ( � I O�J / I NO. O�NBlDGB. NOW �T [ BLTBAGI( LINC PPOM DESCRIPTION OF WORK EXTERIOR WALL IROOF COVERING GOVERING USE OP BUILDING AND WORK TO BE PEftFORMED � � F �T,�, ' a � . 1 HEPHBY AGKNOWLEDGC THAT I HAVE R¢AD THI9 MPLIWTION ANO 8TAT2 THAT TN8 AB�e IB CORfl¢CT ANO AGREB TO COM- PLY WITH ALL GITY ORDINANCE6 AN� 9TATE LAWB Ii6OUlATINO BIIILpINO CONBTRU4TON. �/ // SIGNATUH80F�nnnMl2 'L/�/l/�i✓�'.. 'AUTNORIZED AGENT � FE�RECEIVED AUG 1 1961 FINANCE DEPT. CITY Of COSTA MESA APPLICATION FOR PERMIT BUILDING For Offiee Use Only rsece�rr rvo.. '�NMI l.Y eY (�-BIE��o I I� I e �d9� � � d_ COSTA MESA. CALI RNIA FIRE zoxe / I r+o. or I uee ov Hew a�t Fo o- '�'"` PlANB �� BUILDINOQ�T/}/(//VG�✓'%G �— L6OAL ) 0 � 3 C"R �/iJ 2 � ( / /� OH6LRIPTION L� '� UT </�� YARDS APPROVED (C6NT[R LINB � \/ � �/ � i N 0 TNE AMOUNT 9XOWN UNDEH VALUATION IB FOR TH6 PUlIP088 OP ¢HTAB{JBHINO A PERMIT FEE ONLY. VALUATION � ''' PERMIT FEE $ � � $�G�-� PLAN CHEGK $ � � �.17 ; 1. , . 9.��3 COSTA MESA BUILDING-SAFETSY DEPARTMENT P, p, BOX S17 COBTA MfiBA. CALIFORNIA For Applicanf fo Fill In Complefely TYPE OR PRINT BUILDING ...... . .. . _. _.. _ .�. _ _ _ COSTA MESA. CALIFORNIA rr York Avenue Pro�ert: � MAIL Costa � BIZE 0 l`:9 TEL. a, Cali.f. No:Li. 8-1159 I NO. OP BLDG FEE RECE►�Eu ,�so .� f1i��E ��' . ��T! OF. COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only RECEIPT NO, PLPMIT NO. COSTA MESA. CALIFORNIA PIRE ZONE TYPE GROUA� APPROVED BY DATE � ZONING 20NB NO.OP UB¢ OP N¢ R�1 I PL�N9 2 9UILD�N4j.T� $tt gAT'. L86AL � . _ _ ... �i ... BQTBALK LINB FROM [[ <CHNiew LINs ai.l cer+rew or srneer 00� REAR YARD 3�� FRONT 91DE YMD I LEFf S� I RIGNT S� w g�DE I-DESCRIPTION OF WORK NO. OF EXTE0.tOR COVHRING USE OF BI I X¢p6BY AFKNOWL¢Dae TH�T I XAV6 pBAD THI9 APPLIGTION }Hg AMOUNT BXOWN YNOBH VALUATION �B IOP TH8 ANO eTATH THAi T!� ABOV¢ �8 GOPRHCT ANO AORGH TO COM- PUIiP098 OP 89TABL19HING A PHRMIT PH6 ONLY. PLY WITH AL� CITY ORDINANCE9 ANO BTAT6 I.�WB pBGULATNO oUiLolNo cONeirtuGi�� VALUATION SIGNATURE OF � PERMIT FEE $ • PERMITE s 14,179• PLAN CNECK $ ].%• AUTHORIZED NGENT D].}CC & Colegrove� Ti1C• ioTAL FEe %rl• s LL