HomeMy WebLinkAbout1151 GLENEAGLES TERR - Building PermitsCITY OF COSTA MESA .--—.--;- - ;
A`�gTN Mp BUILDING DIVISION
i ,.,, 77 FAIR DRIVE, COSTA MESA, CA 92626 - (714) 754-5273 - Fax(714)754-4856 - www.ci.costa-mesa.ca.us ----'-
�. FOR INSPECTIONS CALL: (714) 754-5626
'`"°•��°�"' PERMIT NUMBER: BC10-00292
PERMIT TYPE: B_COMBO STATUS: ISSUED
Sub Type: RES—ALT DATE ISSUED: 11/24/2010
ISSUED BY: CAC
JOB ADDRESS: 1151 GLENEAGLES TR CM - ,...:,;.Suite/Unit:
APN: 42233203 ;Zoning:
Vicinity: REAR OF PROPERTY
" PrimaryOcc:
Const Type: V -B SQ. FT: 1745 Valuation:' $94,600.00
SCOPE OF WORK: ADD 158 SF TO A SFD WITH A NEW 1,085 SF DECK (484 SF TO BE COVERED). WORK TO INCLUDE THE
EXTENSION OF MASTER BEDROOM AND RELOCATION OF MASTER BATHROOM; NEW 1,085 SF DECK AT BLUFF WITH 484
SF TO BE COVERED. ALTER/REPAIR COOLING/HEAT, 1 FACTORY FIREPLACE, 1 VENT FAN, 6 LIGHT FIXTS,.1 O:OUTLETS, 6..
SWITCHES, GAS OUTLETS (1-4),2 WASH BASINS, 1 WATER CLOSET. REF# ZA-09-037.
OWNER: LOWE, WILLIAM W Address: 1151 GLENEAGLES TR Unit: - - -
Phone: 714319-7436 City/State/Zip: COSTA MESA, CA -
APPLICANT: SHERIFF, GARTH
Phone: 310-871-2833
CONTRACTOR: OWNER -BUILDER
Phone:
Cell:
ARCHITECT: GARTH SHERIFF AIA
ENGINEER:
COMBINATION PERMIT FEE SUMMARY
Building Plan Check:
Building Fees:
Electrical Fees:
Mechanical Fees:
Plumbing Fees:
SMIP Residential:
SMIP Commercial:
Bldg Std Admin Fund
TOTAL FEES:
Address:
City/State/zZip:
Address: Unit:
City/State:
License No.C7751
License No.
$623.19
$958.75
$47.70
$55.10
$59.05
$9.46
$0.00
$4.00
$1,757.25
License No. 000000
Unit' 1!:Y
ZipCode
PHONE:310-871-2833
PHONE`.
E
TI
'Refer to fee receipts for all fees paid for project -
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279
Monday thru Friday -7:00 am thou 7:00 pm. Saturdays -9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal holidays:
New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day
i L:i813
'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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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 inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit:
i -
CODER. INSPECTION TYPE DAIS INTITIALS CODER INSPECTION TYPE :DATE'r" I,INIITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: .
❑ 1 have and will maintain a certificate of consent to self -Insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain Workers' compensation insurance, as required by
section 3700 of the Labor Code, for the performance of the work for which this
pernit is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier:
(This section need not be wmpleled xthe permx is valued at one hundred dollars is 100) or less.)
Policy Number:
❑ I certify that in the performance of the work for which this permit is
issued. I shall not employ any person in any manner so as to become subject
to the workers' compensation laws of California, and agree that if I should
become subject to the Workers' compensation provisions of Section 3700 of
the Labor Code. I shall forthwith comply with these provisions.
Applicant's Signature Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES,
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect.
Lic. # Class #
Contractor's Signature Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the
performance of the work for Which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
five hundred dollars ($500).):
❑ I, as owner of the property, or my employees vwth wages as their sole
compensation, WILL DO THE WORK, and the structure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the owner -builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LIC SED CONTRACTORS to construct the project (Sec. 7044, Business and
Professions Code: The contractors License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for such project with
a contractor(s) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
`ir'iii 111 11
.
AW 11 �L0 • �
n
Owner ID v rlfi drifte. es ❑ No
Dr icense No. xpire:125 --1¢
enfication of Ownership by (type of document, i.e. - , y tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five (5) or more feet in depth into which a
person is required to descend, will be made in connection with work authorized
by this permit, and that no building structure, scaffolding, falsework, or demolition
or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp
2, Art 2, Sec. 341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would
require a permit from the Division of Industrial Safety, as noted above, unless
such person has a permit to do such work from the division.
Applicant's Signature Date
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature and pressure).
2. Does or will the applicant or present or future building occupant need to rite
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
temperature and pressure).
3. Does or will the applicant or present or future building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the
Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department,
4. If an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of this application a permit for such construction
or modification from the South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 65850.2 of the California Government Code requires that the requested
information be furnished on applications for non-residential building permits).
6. Will any part of the facility to be constructed under this permit be within
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If "yes", the facility must meet the requirement of Sections 25534 and 42303
of the California Health and Safety Code).
7. If a permit from the South Coast Air Quality Management District or other
air pollution control district or agency is required for the Work which is the
subject of this application, have all of the disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If 'yes", attach certificate of compliance from the appropriate air pollution
control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
Signature
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state that
the information given is correct. I agree to comply With all state laws and city
ordinances relating to building construction, and authorize representatives of
the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree n t to occupy or allow occupancy of any building
out rized is Fermi n net inspection.
Eld oV 4o10
S' azure of L g erO Date
And/or Authorized Applicant Date
-e-
;.
LI
Costa Mesa
City of Costa Mesa (Bui(ding (Owision
77 Fair Drive, Costa Mesa, CA 92626
714-754-5273 / Fax 714-754-4856
OWNER BUILDER VERIFICATION
Permit # `5CI u_()Z1Z
Disclosures & Forms for Owner- Builders Applying for Construction Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has be n submitted in your name listing yourself as the builder of the
property improvements specified at l [ l GZ, F/VE.4Ba 717— ('. M.
We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you
aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of
each provision, signed, and returned this form to us at our official address indicated. An agent of the
owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting
authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
(W11. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -
Builder" building permit that erroneously implies that the property owner is providing his or her own labor and
material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any
injuries sustained by an unlicensed person and his or her employees while working on my property. My
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder
and am aware of the limits of my insurance coverage for injuries to workers on my property.
WOK/2. 2. 1 understand building permits are not required to be signed by property owners unless they are
responsible for the construction and are not hiring a licensed Contractor to assume this responsibility.
U943. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that
I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his
or her name instead of my own.
U6)/ 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their
license numbers on permits and contracts.
vUf 5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors,
and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may
be considered an "employer" under state and federal law.
(d6. I understand if I am considered an "employer" under state and federal law, I must register with the state
and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and
contribute to unemployment compensation for each "employee." I also understand my failure to abide by these
laws may subject me to serious financial risk.
Wl,dZ. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family
residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed
by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of
the work is performed under contract with a licensed general building Contractor.
3148-30 CALBO Jan 1, 2009 OB Packet template 1 of 2
40
(➢) U)f.8. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I maybe held liable
for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent
construction defects in the workmanship or materials.
MOZ9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal
Revenue Service, the United States Small Business Administration, the California Department of Benefit
Payments, and the California Division of Industrial Accidents. I also understand I may contact the California
Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information
about licensed contractors.
(ikA X10. 1 am aware of and'consent to an Owner -Builder building permit applied for in my name, and understand
that I am the party legally and financially responsible for proposed construction activity at the following address:
Lx" 1. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will
abide by all applicable laws and requirements that govern Owner -Builders as well as employers.
t10(>J62. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the
information I have provided on this form. Licensed contractors are regulated by laws designed to protect the
public. If you contract with someone who does not have a license, the Contractors' State License Board may be
unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against
unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed
Contractor or employee of that individual or firm is injured while working on your property, you may be held
liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible
for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner
and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's
driver's license, form notarization, or other verification acceptable to the agency is required to be
presented when the permit is issued to verify the property owner's signature.
Signature of property owner � .Q..... %,._r_ Date: 94 r._-,ou ZO(o
Note: The following Authorization Form is required to be completed by the property owner only when
designating an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I
hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents
necessary to obtain an Owner -Builder Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled
out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form
notarization, or other verification acceptable to the agency is required to be presented when the permit is issued
to verify the property owner's signature.
Property Owner's Signature:
Date:
3148-30 CALBO Jan 1, 2009 OB Packet template 2 of 2
(949) 291-3912
I. Deputy Inspections, tc. Fax(949) 481-5866
www.deputyinspector.com Email: rpaquette4@cox.net
1903 Via Pimpollo
San Clemente, CA 92673
REGISTERED
INSPECTOR'S
REPORT OF:
I ❑ REINFORCED CONCRETE ❑ STRUCT STEEL WELDING
P1 REINFORCED STEEL ❑ EPDXY
E] POST TENSION CONCRETE ❑ FINAL REPORT
❑ REINFORCED MASONRY ❑ BOLTING ❑ OTHER
JOB NAME
Glenea les Residence
BLDG. PERMIT a
B10-00292
CITY OF PERMIT
Costa Mesa
JOBADDRESS
1151 Gleneagles
CONTRACTOR
Orange Co. Remodel
ARCHITECT
Sheriff
SUB CONTRACTOR
Peter Drilling
ENGINEER
Shucri Ye hi
LAB TESTING SAMPLES
Observed 4 caissons as per 5/S2 on approved plans.
All steel size and grade comply with approved plans.
Cacle were placed after inspection in holes. 3" CLR.
I HEREBY CERTIFY THAT I HAVE INSPECTED ALL OF THE ABOVE REPORTED WORK, UNLESS OTHERWISE NOTED, AND TO THE BEST OF MY
ABILITY, I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS & APPLICABLE BUILDING LAWS.
MATERIAL INFORMATION: CONCRETE❑ GROUT® MORTAR WELDER CERT.
SUPPLIER: MIX NO.: ADMIX: SAMPLES CAST.
SPEC. P.S.I.: TYPE: SLUMP: YDS. PLACED:
AIR -TEMP: CONC TEMP: MIXING TIME:
DATE START I STOP REG. HOURS O.T. HOURS
12/13/10 PM PM 4
All impmtiwa hoed w a minimum all hours mdawm d houm- B hour minimum, in addilma, unymawdma
M iidigpenaoun hmnwillhuon BhaurmNimum.Allh*i=mr will be d.*ffie hgrl pkgalmmwl
infirm, induding o9 mlleUian mm oldalfameY All mlurmd rhm/a willfinmhjmfma SM00ke
Approved By
SIG A OF REGISTERED INSPECTOR
12/13/10 1100030-49
DATE OF REPORT REGISTER NUMBER
December 24, 2009
CITY OF COSTA MESA
P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMENT SERVICES DEPARTMENT
Tim Johnson
5215 River Avenue
Newport Beach, CA 92663
RE: ZONING APPLICATION ZA-09-37
MINOR CONDITIONAL USE PERMIT FOR A RESIDENTIAL ADDITION
CLOSE TO AND EXTENDING OVER THE BLUFF CREST
1151-GLENEAGLES_TERRACE?COSTA MESA
Dear Mr. Johnson:
Review of the minor conditional use permit for the above -referenced project has been
completed. The application, as described in the attached project description, has been
approved, based on the findings and subject to the conditions of approval (attached).
The decision will become final at 5 p.m. on December 31, 2009, unless appealed by an
affected party (including filing of the necessary application and payment of the
appropriate fee) or by a member of the Planning Commission or City Council.
If you have any questions regarding this letter, please feel free to contact the project
planner, Rebecca Robbins, at (714) 754-5609 or rrobbins(@ci.costa-mesa.ca.us.
Sincerely,
WILLA BOUWENS-KILLEEN, AICP
Zoning Administrator
Attachments: Project description
Findings
Conditions of approval
Approved conceptual plans
cc: Engineering
Fire Protection Analyst
Building Division
Bill Lowe
1151 Gleneagles Terrace
Costa Mesa, CA 92627
SWding Division (714) 754-5273 • Code 6donoemeN (714) 754-5623 Planning Division (714) 754-5245
FAX (714) 754856 • TDD (714) 754-5244 w,,w� ci_coeta-mesa.ca.us
ZA-09-37
December 24, 2009
PROJECT DESCRIPTION:
• The property is zoned Single -Family Residential (R1) and is bounded by Gleneagles
Terrace to the east (front), Aviemore Terrace to the west (rear), and single-family
residences to the north and south (sides).
• The applicant proposes a single story addition setback, five feet from the bluff crest,
and decks projecting 10 feet past the bluff crest. A deck wing wall will extend along
the right side property line. The wall is to be solid to the bluff crest, with a safety
railing extending over the bluff crest constructed of glass or plexiglass and open at
the top to the roof. Decking along the left side property line is open, aside from the
safety railing, starting five feet from the bluff crest, and extending 10 feet past the
bluff crest. Since the addition and decks encroach within the required bluff crest
setback and includes decks that extend over the bluff crest, a minor conditional use
permit is required.
• Staff supports the addition and covered decks because there are several other
properties in the general vicinity with homes built at the bluff crest and decks
projecting 10 feet beyond the bluff crest. The abutting properties on either side have
received approvals for similar additions and decks in January 2008.
• Conditions have been included to ensure that the structure is properly built to
maintain the stability of the slope and that dense landscaping will be provided at the
property's rear to screen the decks.
• The covered decks and residential addition are consistent with General Plan Land
Use Objective LU -2A.13 in that a geotechnical report will be required to ensure that
the integrity of the existing slope is protected. The natural topography and views will
also be protected because the residential addition will be setback five feet from the
bluff crest, the solid wall of the deck along the right side property line will not extend
past the bluff crest, and only decks will cantilever, with their transparent railings, over
the bluff.
FINDINGS
A. The information presented complies with Costa Mesa Municipal Code Sections 13-34 and
13-29(g)(2) in that allowing the residential addition and covered decks to encroach into the
bluff crest setback is compatible with developments in the same general area. Granting
the minor conditional use permit will not be detrimental to the health, safety, and general
welfare of the public or other properties or improvements within the immediate vicinity.
Specifically, the.proposed development is compatible with other encroachments in the
immediate vicinity and, as conditioned, would not detract from the visual identity and
integrity of the bluff. The decks should not interfere with access for fire protection and a
geotechnical report is required to confirm the improvements will not endanger the stability
of the slope. Granting the minor conditional use permit will not allow a use, density, or
intensity that is not in accordance with the general plan designation for the property.
B. The proposed project complies with Costa Mesa Municipal Code Section 13-29(e)
because:
1. The proposed development and use is compatible and harmonious with uses
both on-site as well as those on surrounding properties.
2. Safety and compatibility of the design of the buildings, parking areas,
landscaping, and other site features including functional aspects of the site
development such as automobile and pedestrian circulation have been
ZA-09-37
December 24, 2009
considered.
3. The project is consistent with the General Plan designation for the property.
4. The zoning application is for a project -specific case and does not establish a
precedent for future development. '
C. The project has.been reviewed for compliance with the California Environmental Quality
Act (CEQA), the CEQA Guidelines, and the City environmental procedures; and has
been found to be exempt from Class 1 of CEQA.
D. The project is exempt from Chapter XII, Article 3, Transportation System Management,
of Title 13 of the Costa Mesa Municipal Code.
CONDITIONS OF APPROVAL
Ping. 1.
All structures shall maintain a minimum five-foot setback from each side
property line.
2.
Any future residential addition shall not project beyond the bluff crest without
proper City approval.
3.
The deck wing wall along the right side property line extending over the bluff
crest shall contain glass panels on the bottom, not exceed 36 inches in
height from the decks' floors, and shall remain open on the top, extending up
to the deck roof.
4.
The proposed support posts for the decks shall be located as close to the bluff
edge as feasible to minimize visual impacts to the bluff.
5.
No modification(s) of the approved building elevations including, but not
limited to, changes that increase the building height, removal of building
articulation, or a change of the finish material(s), shall be made during
construction without prior Planning Division written approval. Failure to
obtain prior Planning Division approval of the modification could result in the
requirement of the applicant to (re)process the modification through a
discretionary review process such as a minor design review or a variance, or
in the requirement to modify the construction to reflect the approved plans.
6.
Landscaping shall be provided, to the satisfaction of the Planning Division, to
screen the decks and support structures. Landscaping material shall consist of
dense, evergreen plants and trees.
7.
Two (2) sets of detailed landscape and irrigation plans shall be required as part
of the project plan check review and approval process. Plans shall be
forwarded to the Planning Division for final approval prior to issuance of
building permits.
8.
Two (2) sets of landscape and irrigation plans, approved by the Planning
Division, shall be attached to two of the final building plan sets.
9.
Landscaping and irrigation shall be installed in accordance with the approved
plans prior to final inspection or occupancy clearance.
10.
All construction -related activity shall be limited to between the hours of 7 a.m.
and 8 p.m., Monday through Friday, and 8 a.m. to 6 p.m. Saturday.
Construction is prohibited on Sundays and federal holidays. Exceptions may
be made for activities that will not generate noise audible from off-site, such
as painting and other quiet interior work.
11.
The conditions of approval and Code requirements of Zoning
ZA-09-37
December 24, 2009
Application ZA-09-37 shall be blueprinted on the face of the site plan as part of
the plan check submittal package.
12. The applicant shall contact the Planning Division to arrange for Planning
inspection of thesite prior to Building final inspection. This inspection is to
confirm that the, conditions of approval and Code requirements have been
satisfied.
CODE REQUIREMENTS
The following
list of federal, state, and local laws applicable to the project has been
compiled by staff for the applicant's reference. Any reference to "City" pertains to the
City of Costa Mesa.
Ping. 1.
Approval of the planning application is valid for one (1) year from the effective
date of this approval and will expire at the end of that period unless applicant
establishes the use by obtaining building permits for the authorized
construction and initiates construction. If the applicant is unable to obtain
building permits within the one-year time period, the applicant may request an
extension of time. The Planning Division must receive a written request for the
time extension prior to the expiration of the planning application.
Bus. 2.
All contractors and subcontractors must have valid business licenses to do
Lic.
business in the City of Costa Mesa. Final inspections, final occupancy and
utility releases will not be granted until all such licenses have been obtained.
Bldg. 3.
Comply with the requirements of the 2007 California Building Code.
4.
Submit a soils/geotechnical report Submit a soils report as part of the building
plan check package. One boring shall be at least 10 feet deep. Soils report
recommendations shall be blueprinted on the plans.
5.
Submit grading and drainage plan.
6.
Provide erosion control measures and plans.
Eng. 7.
A Construction Access Permit and deposit of $730.00 will be required by City
of Costa Mesa, Engineering Division prior to start of any on-site work,
necessary during construction for street sweeping and to guarantee
replacement costs in case of damage to existing public improvements.
Fire 8.
Provide approved smoke detectors to be installed in accordance with the 2001
Edition of the Uniform Fire Code.
9.
Comply with all Fire Code requirements.
SPECIAL DISTRICT REQUIREMENTS
The requirements of the following special districts are hereby forwarded to the applicant:
Sani. 1. It is recommended that the applicant contact the Costa Mesa Sanitary
District at (949) 645-8400 for current district requirements.
AQMD 2. Applicant shall contact the Air Quality Management District
(800) 288-7664 for potential additional conditions of development or for
additional permits required by the district.
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 1151 GLENEAGLES TR
Suite:
Vicinity: AROUND PERIMETER
Parcel Number:
42233203
Zoning:
$83.25
Applicant:
LOWE, WILLIAM W TR
$0.00
Address:
1151 GLENEAGLES TER
Other:
$0.00
'
Phone:
714.896.1060
COSTA MESA, CA,
Zip:
92627-4030
Owner:
LOWE; WILLIAM W TR
Address
1151 GLENEAGLES TER
'
Phone:
-
COSTA MESA, CA '.
Zip:
92627-4030
Contractor:
OWNER -BUILDER
Address:
Phone:
Zip:
License:
0
Arch :
Eng:
Address:
Address:
Status: ISSUED
Applied: 07/15/2002
Issued: 07/15/2002
ISSUED BY:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
COSNTRUCT 117 LF, 6 -FOOT HIGH BLOCK WALL ALONG THE FRONT OF THE SITE (SEE VARIANCE PA -01-07) WITH 6
LF, 3 -FOOT BLOCK WALL IN THE MIDDLE OF THE SITE PER CITY STANDARDS.
Plan Check:
$54.11
Permit:
$83.25
SMIP Res:
$0.00
SMIP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total: $137.36
SETBACKS
MAIN STRUCTURE Front 0-0
ACCESSORY Front 1-8
PARKING Existing: 0
NOTES:
FEE SUMMARY
Calc Valuation: $2,460.00
Claim Valuation: $0.00
PLANNING & ZONING
Rear 0-0 Left 0-0 Right 0-0
Rear 0-0 Left 0-0 Right 0-0
Required: 0 Proposed: 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 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 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) 754-5626 _
!""6 (s )
DECLARATIONS
WORKERS' COMPENSATION DECLARATION: - -
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is Issued.
❑ 1 have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued.
My workers' compensation Insurance carrier and policy number are:
Carder: Policy Number:
(This section need not be completed it the permit is valued at one hundred dollars ($100) or less.)
9_1 certify that in the performance of the rk for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensallon laws of California, an ree that if II should become subject to the Wq ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
complywith
�heseyr/pv igna/ 11I� Xl �C� (K G J �i L ?—CO-7—
WARNING:
C�C� 7_
Applicen` tSl�nature:_ ItL 1'ezf Date:
WARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 31060E THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES,
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full
force and effect. Lic. # Class #
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 01 the
Business and Professions Code) or that he or she Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. It, however, the building or improvement Is
sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
I�11 ,w owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractors)
license pursuant to the Contractors License Laws.).
❑ I am axe pt un er ac Busi s and Pr ssions Code for this reason: r
Signature: -
Expires:
Verification of Ownership by (type of doc L i.e. - property tax bill or tlaetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume 0155 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
..
............................ .................... ................................................_...................................................................................................................................... _................................ _.................................................. -............................................ .............
2 Does or will the applicant or present or future building occupant need to file a registration forth for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
......................._.................... _....... ..._......... __.............. ........... _._............................................. ............... —__.._..__...__........................ ................................ ....._............... -.._........ _........................... _............................
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
................................._........._..........._................._................._................................................................................................................................................................................... ......................I...............
4 It an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
......................................................................................................................................................................................................................................................................................................................................................- .................................
5 Does or will the applicant or present or future building occupant require for the work which is the subject of thisa f plication a ermit for such construction or mociificallon
from the South Coast Air Quality Management District or from any other air pollution control district or agency./ H Yes No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on .applications for non-residential building permits).
.....
.......................................................................................................................................................................................................................................................................................................................
8 WIII any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(It yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
........................................................._.........-._.........................._...__..........................................................................................................................................................................................................................................................-....................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
...6 .....(If yes"....................................................................—_............... __............ _............................................ _..............._
. ahach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and ci idinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-desgribr♦d p rty for inspection urposes. ree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature Of Legal Owner(s)
And/or Authorized Applicant Date
LODE r. INSPECTIONTYPE DATE INTMAL6 COAD 0 INSPECTION TYPE PATE INTIMAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Root p 1 210 Final Electrical
201 Final Block/Retaining Wall O // _y� 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
`t.VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and,
as a condition precedent to issuing a building permit, require the completion and require the return of, an
owner -builder verification.
Attention Property Owner:
An 'owner -builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit will be issued until this .
verification is received.
I. I personally plan to provide the major labor and materials for construction of the proposed
property improvement. ❑ Yes K No
2. 1 (have/have not) Whvjug signed an application for a building permit for
the proposed work.
3. 1 have contracted with the following person (firm) to provide the proposed construction:
Name TO pt;m F�RDV l tj �j�
Address City
Phone ( ) Contractor's Lic. No.
4. 1 plan to provide portions of the work, but 1 have hired the following person to coordinate,
supervise and provide the major work:
Name
Address City
Phone ( ) Contractor's Lic. No.
5. 1 will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated:
Name Address Phone Type of Work
1 M2-46 (REV. 9198)
I I i
44
7,4l71fT10 4 '_i i4TLS'
I o—L6A7ir %Grr
2..CCU 770,AJ .7a fes
-Dr ,, ,`OF'Ll INC
i
- A P P Ry Y.p. -- -
n;akexrnyur..y ?ec:nGlio,�SlUStbek
------ ------ rrd33'v-Uitwo, SFr: r.enr�>1r,,ezfhn�l tor,: l'-vbalaAInes...– ;I
. Y � f3 -v35a Gn �t ,SIS
^nlg5gnffl- M3X1n
------ — ------ -- t.. L'Itao' H
p� •.„ H �,a 6u nJ
-- '-----�` --__._.. ---- Tb• 056' --:fa^ te`cD[.7L%(jnT4i1 p`f --.Rldo ?nlll(O _...'-
_ ' itis"; h0 i. t
71DDTTIONS, DELETI b a �119rni' "a;l ,!!i';a3'aCfdhl "n Fne al
ONd n :n.p ��..., ea %,rb:•!r.,t anima d_O.Sl
"o 'j)
arC:n;,a:_ .- .l.rnartbo�rer r 01
t�--tHEPLNNI1J �..eperu ;u; vo�il T
a � � ' '•�" is f � ,.; a<,a 1
--Q(VIS[O�f. _ .,,,,,,,j,r'ilm'so nay 98L
-
S� 3
�i
po2c f` PA -11
_.. _ J-50 Z — D { �2wkcN
VE D
CHrGLI
SUBJECTDIV—
;TO BLDG• DEPT. REG.
DATE
`--" I...�....�..��..e,.....v.._.............-._...._. _.._..._J �_ I— - � Wood
51X FST BLOCK Wk -L /JZON li/LLL 4.• I . .
i
s� C71 C" u14
_ ALK GcYrcGZr/'iM�2oK Z�C;
-- — :_— - —
Cement Coping Optional
Channel Block With 1-3/8J6
Horizontal Top of all
Fences
For Fences 5'or Less
Vert. Bars 3/8" 0 at 4' -0" O.C.
For Fences Higher Than 5'
Vert. Ban 3/8-0 at 32" O.C.
Fill Cells Solid With Grout
Where Steel Occurs
Rclnfnrcing Steel Shall
Conform to Sec.A 15 39
A.S. T.M.
All Steel to be Lapped
24" or to Code
NATURAL GRADE
TWO 3/8"6 BARS
CONTINUOUS TOP
6 BOTTOM
HOQIi STEEL MUST BE TIED IN
PLACE AT TIME OF TRENCH
INSPECTION
TYPICAL 6" CONCRETE BLOCK FENCE
1 n nit�l
n n -aIL- Ili
F►-WIOTF
t SEE CHI
BELOW
P
FOOTING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR: One Part Plastic Cement, and
Three Parts Sand
GROUT: One'Port Cement Three and
One Half Ports Sr and
COPING: One Part Cement, Three
Parts Sand
CONCRETE: Well Mixed 1:2-1/2:3-1/2
Max of 7-1/2 Gollons of
Water Per Sack of Cement
GROUT MAYBE POURED FROM THE TOP
OF THE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLS AND AREASOF HORIZONTAL REIN
FORCEMENT SHALL BE CLEAR, CLEAN IL
FREE OF ALL MORTAR DEBRIS. ETC.
H LF EARTHTCOTH
V7 THE HEIGTH OF FENCE
MrLOW BOTTOM OF FOOTING
SCALE: 1/2"= I'
WIDTH
14"
14
12",
12"
THICKNESS
10
10"
B"
8 "
DEPTH OF EARTHTOOTH
24
20"
16
12"
SPACING OF EARTHTOOTH
12'
14'
16'
16'
BUILDING DIVISION
c
• THIS SKETCH IS FOR INFORMATIONAL PURPOSES
ONLY. APPLICANT 15 RESPONSIBLE FOR PROVIDING
AN ACCURATE REPRESENTATION OF THEIR PROPERTY
IN CASE THE SHAPE AND SITE DO NOT CORRESPOND
WITH THE INFORMATION PROVIDED ON THIS SHEET.
• SOLID WALLS/FENCES BETWEEN 2'-6'& 6- IN HEIGHT SHALL
BE SETBACK AT LEAST 10' FROM FRONT PROPERTY LINE.
• SOLD WAILS/FENCES SHALL NOT EX Y WIN HEIGHT
WITHIN 101 OF THE FRONT PROPERTY LINE (40T CURB LINE).
• VERIFY DISTANCE FROM CURB TO PROPERTY LINE
AND SHOW ON FLAN. VERIFICATION FROM THE CITY'S
ENGINEERING DWOON S REQUIRED. CALL (714) 7545311
FOR INFORMATION.
I I
X
K
RESIDENCE RCS<7EML
I
EFm 1
wa I
1
1
I
I I
a I
L
I�
RESIDENCE RESIDENCE
REstiaDE
I
I I
1
1 ..................... j: jta.P40QiVAi SET IC ................
STREET
RESIDENCE
i
BLOCK WALL LAYOUT FOR' BUILDING PERMIT
PLANNING DIVISION
jk,.
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
.lob Address: 1151 GLENEAGLES TR
Suite No
Vicinity:
Parcel Nunmber: 42233203
Applicant:
LOWE, WILLIAM W
Address:
1151 GLENEAGLES TR_
Issued:
F l/
Res. a/c package
$0.00
New Res (1-2 units)
COSTA MESA, CA'
New Res (3+units) .
$0.00
Owner:' :
LOWE, WILLIAM W
Address
1151 GLENEAGLES TR-- "
Recept Outlets
--'� '$22.73
'
COSTAMESA.CA
Contractor:
OWNER -BUILDER
Address:
-
Service to 200a
$30.50
ELECTRICAL PERMIT
ISSUED B1
Phone: 949-631-8630
Zip: 92627-4030
Status:
ISSUED
Applied:
08/18/2004
Issued:
08/18/2004
Phone: 949-631-8630
Zip: 92627-4030
Phone:
Zip
�,;✓ `.
License: 000000
SCOPE OF. PERMIT
INTERIOR WORK TO ELEVATE THE KITCHEN CEILING AND THE CHANGE OUT OF A 6FT SLIDING
TEMPERED GLASS DOOR TO A 5 F TEMP. GLASS DOOR AND THE REPLACEMENT OF A KITCHEN '
WINDOW WITHIA BAY WINDOW. REF B04-01461.
20 LIGHTS, 21 OUTLETS (9 DETICATED), 14 SWITCHES AND UPGRADE EXISTING SERVICE TO '
200 AMP. AND 1 SUBPANEL
i
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements un
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
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comp)
required inspections and final approval must be obtained. Failure to obtain inspections and final approval willre`suI
FOR INSPECTIONS CALL: (714) 754.5626
2a4 6l61ool
statutes and related
is suspended or abandoned
with all applicable codes, and all
in the expiration of this permit.
FEE SUMMARY
ISSUE FEE '��
$23.50
Temp�service test
t,`$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
Lighting Flxts ��
`� - $22.00'
Recept Outlets
--'� '$22.73
Switches
$15.40
Non Res Appl
��^ ^^ $0.00
Res Appl
` " $0.00
Service to 200a
$30.50
Service to 1000a
$0.00
Service over 1000a
$0.00
Motors to 1 hp
$0.00
Motors to 10hp
$0.00
Motors to 50hp
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements un
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
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comp)
required inspections and final approval must be obtained. Failure to obtain inspections and final approval willre`suI
FOR INSPECTIONS CALL: (714) 754.5626
2a4 6l61ool
statutes and related
is suspended or abandoned
with all applicable codes, and all
in the expiration of this permit.
FEE SUMMARY
Quantity
'' ` .
Quantity
Temp Dist System / Lighting
$0.00" '0
Busway /100 ft `:f :
$0.00 ��% 0
/
- Standing Sectioh,- _= - �'�.:fi=
- -_$0.00,. 01'
0'
- Misc Electrical Equipment
$0.00 - 0
0
- - Transformers up to 1 kva/kw
- $0'001"', 0 -
-� 0-,
..... ...up to 10 kva/kw -.= �.
$0.00 /'0�
. ......:.........up to 50 kva/k;4>
, $0 00 , <"0
. 21
- - ..-".up to 100.kva/kw .
-. _.:
' '.$f),00�/ 0,
14 ..
_ _ -� ..............0:..over 100 kva/kw ,
$0.00 0�
/ 0_1 '�
Low Voltage Equiprrierit
," $0.00 0
0
' Low Volt Wiring System/ Ckt
$0.00 0
_
1 -'
Misc. Conduit --- -
-'-$0.00' 0
0
.. Misc.Conductor - - ;-',$0.00
0
0-
- - Circus ( gen or ride)
$0.00 0
0
Circus (meth ride or lights)
$0.00 0
0
'- - - -- �Christmas-Tree Stand
$0.00 0
0
Fireworks Stand
$0.00 0 / /(
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements un
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
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comp)
required inspections and final approval must be obtained. Failure to obtain inspections and final approval willre`suI
FOR INSPECTIONS CALL: (714) 754.5626
2a4 6l61ool
statutes and related
is suspended or abandoned
with all applicable codes, and all
in the expiration of this permit.
DECLARATIONS n
WORKERS' COMPENSATION DECLARATION: -
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit Is issued.
❑ I have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My workers' compensation Insurance carrier and policy number ere:
Cartier: Policy Number:
(This section need not be completed i/ the permit is valued of one hundred dollars ($100) or less.)
❑ I certity that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with mese provisions.
Applicant Signature: Date:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TOTHE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
force and effect. Lic. q Class k
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a cMl penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is
,sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
�1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ 1 Al axe u sec. Business and Professions Code for this reason:
Signature: �122.
Deter
Owner ID verified by drivers license. X Yes ❑ No Drivers,License NNp. -�� -Expires: -
Verificallon of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title B, California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed With the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
r n r future building Occupant need to file a registration forth for acutely hazardous materials? Yes N
..................................................PP............ p .. .. .....
2 Does or will the applicant or present o g p g y ❑ ❑ o
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
..............._.........._.........._.........._..............__.................._........................_..._..........__................................_...................................................................................................._.._........................................._........................._..............................
3 Does or will the appplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materiels)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
......_.........._............._..........._._.....tly required,
ha.....................................................alif..................................................................................................................._............ .............._........................................._...........................
.......
4 Ii an RMPP is presently required, has Section 25534 of the California Health antl Safety Cade been fully complietl with? ❑Yes ❑ No
.................................................................................................................... ildi.......................................................................................................................................pipl................a.........................................................................ccli..................
5 Does or will she oast Air u present or future building occupant require for the work which is she subject of this a plication a ermis for such construction or motllficetlon
from the South Coast Air Quality Management District or from any other air pollution control district or agency? � Yes � No
(Section 65650.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(if "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
................................... _.................... __.._................................... _.................................... _........... ..........................................................................._......:.................................................._..............................................................................................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by Celifomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
......._.........._..........._..
........._............_........._......................_................... _.___........... _................................. ... ...................................... ................ _.................................. __.................. _................................................. _.........................
B (If yes', attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws a Ity ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-de d try for ins p do pI agree not to occupy or allow occupancy of any building authorized by this pernit until final inspection.
,.ice
Signature Of 116gal Ovmer(s) Date
And/Or Authorized Applicant Date
CODE F. INSPECTION TYPE 2AN IRMAL$ CODEC INSPECMONTYPE GATE INTnlALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 200 Final Plumbing
200 Final Re-Raaf 210 Final Electrical
201 Final Block/Retaining Well 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 1151 GLENEAGLES TR
Suite:
Vicinity: KITCHEN
Status:
ISSUED
Applied:
08/18/2004
Issued:
08/18/2004
Parcel Number: 42233203
Zoning:
INTERIOR 300 SF KITCHEN REMODEL OF AN. EXISTING SINGLE -STORY SFD.•N/0RK TO
INCLUDE REMOVAL OF A NON BEARING STUB
WALL AND THE REMOVAL OF EXISTING CEILING JOITS IN THE KITCHEN AREA TO ELEVATE
Applicant: LOWE, WILLIAM W
REPLACEMENT OF A KITCHEN WINDOW
ISSUED BY:
Address: 1151 GLENEAGLES TR-
' PLUMBING FIXTURES; ELECTRICAL AND MECHANICAL WORK TO BE DONE..
- -.
FEE SUMMARY
_. Phone:
949-631-8630 _ -
-
' Permit:- ."$167.25
COSTA MESA -,CA . -
- Zip:
92627-4030
§MIP Com:-.
Owner: LOWE, WILLIAM W`
Inspection: $0.00
Address 1151 GLENEAGLES TR_
- _ -
- - - _ _
•�
��,.,�
Phone:�-
' COSTA MESA, CA -
Zip:
92627-4030
Contractor: OWNER -BUILDER
" Address:
"•
Phone:
Zip:
License:
000000..
-
-
,Arch -
,. Eng:
Address: - -
- Address:
-�
. - Phone:
Phone:
Zip: - License:
��
�
License: ,
- SCOPE OF PERMIT-,.
- :--:
INTERIOR 300 SF KITCHEN REMODEL OF AN. EXISTING SINGLE -STORY SFD.•N/0RK TO
INCLUDE REMOVAL OF A NON BEARING STUB
WALL AND THE REMOVAL OF EXISTING CEILING JOITS IN THE KITCHEN AREA TO ELEVATE
THE CEILING. ALSO INCLUDED WILL BE .
REPLACEMENT OF A KITCHEN WINDOW
;.WITH A BAY WINDOW AND A 6 SLIDER WILL BE REPLACED WITH A 5• SLIDER TO GAIN
COUNTER SPACE. CHANGE -OUT OF EXISTING
' PLUMBING FIXTURES; ELECTRICAL AND MECHANICAL WORK TO BE DONE..
FEE SUMMARY
°''
"Plan Check: $108.71
Calc Valuation: -r%,� $9,000.00
' Permit:- ."$167.25
Claim Valuation:,",' "' -: $9;000.00
�8MIP Res: x$0.90
'$().'00
§MIP Com:-.
Other: $0.00 'r
Inspection: $0.00
Total '$276,86
-PLANNING & ZONING
SETBACKS
MAINSTRUCTURE Front 0-0 `Rear 0-0 Left - 0-0 ` Right 0-0-
ACCESSORYFront 0- 0 Rear _ 0-0 0- 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced w
for a period of 180 days. //
INSPECTIONS: In order for the work authorized under this permit to be considered legal,such
required Inspections and final approval must be obtained. Failure to obtain inspections and final
FOR INSPECTIONS CALL: (714) 754-5626
26x646 (6/00)
under California statutes and related
80 days, or if work is suspended or abandoned
work must comply with all applicable codes, and all
approval will result in the expiration of this permit.
DEItLAWATIONS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations: 16
❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit Is Issued.
❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued.
My workers' compensation Insurance carver and policy number are:
Carrier: Policy Number:
(This section need not be completed it the permit is valued of one hundred dollars ($100) or less.)
❑ 1 certity that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Celifomia, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code. I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100.000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
force and effect. Uc. N Class p
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 o1 the
Business and Professions Code) or that he or she Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is
!sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
;7_i! as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exam t u r sec. Business and Professions Code for this reason:
Sigv n, eture;? � (ay L L (sQ !
% Expo iras 3- �i-%f1�
Verification of Ownership by (type of tlocument, i.e. -property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Califomla Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standar temperature and pressure).
....._......._......._................ ........ _............... .... ............... ..._.......................................................... _.._.........-.-......................... ............................... ..................................................................... ..._........................................................................
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Ves ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materiels equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
................... _............... ........ .................................................................................................................................................. .................................................... .......... _.................................... _.......... _.........
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
.........................................................-........................._.........__............................................................_........................................................................_......................................... ............................................................................................
4 Ii en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
.................._....................._........__.............._...................... .................. .... .... ._..._._..._............................................. _.................................. ......................... ............................................................................ _...........
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes a No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
..................................................._............._.............._................................................................................................................................................................................................... ..........................................................................................
6 will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Ves ❑ No
(If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
.................................................................................................._...................................................................................................................................._....__......................................................................................................-.......................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
............................................. _............ _........... _........... __........................................................ ................... ..... ... .._.............. .---- _ .... ...................................................... ..........................................................................................................
e (If yes', attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I ag{{{{ree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above party party for ins�pecqon Du s. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
((((((fie _GIN , . Olt,-e�_ lB A*(4 _nth
r Signature O Legal Owner(s) /late
And/Or Authorized Applicant ••�"� Date
CODE t. INSPECTION TYPE 29I€ INTRIALS CODE 1 INSPECTION TYPE 2&U INTITA
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pod Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
t'
OWNER -BUILDER
VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and,
as a condition precedent to issuing a building permit, require the completion and require the return of, an
owner -builder verification.
Attention Property Owner:
An 'owner -builder' building permit has been applied for in your name and hearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit will be issued until this
verification is received.
i. I personally plan to provide the major Tabor and materials for construction of the proposed
property improvement. Ryes M No
2. 1 (have/haw;-u ) signed an application for a building permit for
the proposed work.
3. 1 have contracted with the following person (firm) to provide the proposed construction:
Name Tb tz C l�� f NtS1�
Address City
Phone ( ) Contractor's Lie. 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 T ;i) -M i% -s bQ70RtYt(Nfs(N
Address City
Phone ( ) Contractor's Lie. No.
5. 1 will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated:
Name Address Phone Type of Work
J
1W 46 (REV 9M)
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
.lob Address: 1151 GLENEAGLES TR
Suite No
Vicinity:
Parcel Nunmber: 42233203
Applicant:
LOWE, WILLIAM'W
Address:
1151 GLENEAGLES TR"
AMT
$0 0000
COSTA MESA, CA
OTY
0
ISSUE FEE
owner:'
' LOWE, WILLIAM W
Address
1151 GLENEAGLES TR
x,,
'
COSTA MESA, CA
Contractor:
.OWNER -BUILDER
Address:
. Landscape Irrigation-
Arch / Eng
Address:
PLUMBING PERMIT
Phone:
Zip:
License: 000000
Phone: -
i--
- -- - -_ -_ Zip(, ._ -. ...
License: - - -
SCOPE OF PERMIT '
INTERIOR WORK TO ELEVATE THE KITCHEN CEILING AND THE CHANGE OUT OF A 5FT
TEMPERED GLASS DOOR TO A 5 FT TEMP. GLASS DOOR AND THE REPLACEMENT OF,
_ WINDOW WITH A BAY WINDOW. REFW'4=014,d'
1 GAS(14 OUTLETS), 1 KITCHEN'SINK.
FEE'SUMMARY
- iAMT
$2 3.50
Status: ISSUED
Laundry,Tub /Washer
AMT
$0 0000
Applied: 08/18/2004
OTY
0
ISSUE FEE
Issued: 08/18/2004
�.
�
x,,
ISSUED BY:
Backflow irrigation��^
, x $0.00
0
. Landscape Irrigation-
,
0
i
Phone:
949-631-8630
0
- Zip:
92627-4030
0
P -Trap----` - -
$0.00-
0'.
Trap;Primer��
$0.00
0
Bathtub
N, $0.00
0 . !•
Pressure Regulator -
$0.00
,0-�
` \ Urinal /// /
$0.00
0
Clarifier System
$0.00
0
Phone:
949-631-8630
^'
Zip:
92627-4030
0
Phone:
Zip:
License: 000000
Phone: -
i--
- -- - -_ -_ Zip(, ._ -. ...
License: - - -
SCOPE OF PERMIT '
INTERIOR WORK TO ELEVATE THE KITCHEN CEILING AND THE CHANGE OUT OF A 5FT
TEMPERED GLASS DOOR TO A 5 FT TEMP. GLASS DOOR AND THE REPLACEMENT OF,
_ WINDOW WITH A BAY WINDOW. REFW'4=014,d'
1 GAS(14 OUTLETS), 1 KITCHEN'SINK.
FEE'SUMMARY
DING; _I
TCHEN. i ��'./%
�-
- iAMT
$2 3.50
QTY
Laundry,Tub /Washer
AMT
$0 0000
QTY �j .�� �� AMT
0 Sunip Pump / j �/ $0.00
OTY
0
ISSUE FEE
�.
�
x,,
1
Backflow irrigation��^
, x $0.00
0
. Landscape Irrigation-
,
0
i
m
Swvnmg Pool
$0.00
DING; _I
TCHEN. i ��'./%
�-
- iAMT
$2 3.50
QTY
Laundry,Tub /Washer
AMT
$0 0000
QTY �j .�� �� AMT
0 Sunip Pump / j �/ $0.00
OTY
0
ISSUE FEE
�.
_�
x,,
Backflow irrigation��^
, x $0.00
0
. Landscape Irrigation-
$0.00
0
i
m
Swvnmg Pool
$0.00
0
Backflow Preventer
,-$0.00
0
P -Trap----` - -
$0.00-
0'.
Trap;Primer��
$0.00
0
Bathtub
N, $0.00
0 . !•
Pressure Regulator -
$0.00
,0-�
` \ Urinal /// /
$0.00
0
Clarifier System
$0.00
0
.Process Piping (per 10 ft)
_., $0,00 .
0,
Vacuum Brkr Bkflow(1-4)
$0.00
0
Connect (Ice,Soda,etc)
$0.00
-, 0
_Receptors
$0;00
^'0 ,
,Vzcuuin Brkr Bkflow(5+)
$0.00
0
Dental Units
$0.00
_0 -
Septic Tank
$0.00
-'b -
>Wash'basin
$0.00
0
Dishwasher
$0.00
0-
,
Sewer Cap for Demo -
1$0.000,
-r �?
"j Wash Basin Set
$0.00
0
Drain, Floor
$0.00
0
Sewer Connect
-'
- $0.00-z-
:..0'
Waste and Vent System
$0.00
0
Drain, Rainwater
$0.00
0
SewerrPrivate Line''
$0.00--
0-
Water Closet (Toilet)
$0;006
0
Drain, Roof
$0.00
0
Shower - _
$0.00
0
Water Heater / vent
$0.00
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under.Celifornia 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 180 days.
I
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 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) 754-5626
2446-46(6/00)
i
DECLARATIONS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit Is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued.
My workers' compensation Insurance carrier and policy number are:
Carder: Po icy Number:
(This section need not be completed it the permit is valued at one hundred dollars ($100) Orissa.)
❑ I certity that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
1 hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
force and effect. Lic. N Class»
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Cade).
Lenders Name: Lender's Address:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby affirn that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031,5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any appllcant for a permit
subjects the applicant to a civil penalty of not more than two hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
7R� s owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ 1 am ax/ep/�pt unrile/r sec. Business and Professions Code for this reason:
Signatu(¢: �b - t�y}7(ti Date:— u -b
Owner ID verified by drivers license. a LJ No Drivefs:i9cense No. _ Expires:03_1n _ZW
Verification of Ownership by (type of document, Le. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify that no excavation five (5) or more feet In depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) teat high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title B, California Administrative Code).
❑ As owner-bullder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Cade requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
._.........._............._.............._._................................-...................................................................................__.____..._.._.............._..............__...._......................................_...... ._.............................................. _.............................
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will theappplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
......._......__.........._.......................................................................................................................__.___.__..._................................................_._............................... _...........................................................................................
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
....__ ................ ............ _.........................._............. ........................_.................._....................................... _....__..__._.._..................._...._....._._....___._.................................._.._................................ _................ _...........................................
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aPPermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes [No
(Section 65850.2 01 the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed untler this permit be,witt 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
................................................ ..............................._......... ........................................................................................................................................................................ ___...................................................................................................................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by Celitomla Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
....................... ............ _..........._............__....................._.__._.......................................................................................... ................................. ........................................... ..................................................................
B (If yes", attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions. .
Signature: Date:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above -de, nbpd try for inspection pp s. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
I//tel i /_P. I: I/Nn I rc L/8//fL_C,(�l
Signature fie ,Owner(s) Date
And/Or Authorized Applicant Date
CODE 0. INSPECTION TYPE PAIS INTITIALS CODES INSPECTION TYPE 2M INTMALE
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1268 Pool Spa Final 208 Final Plumbing 1 -7
200 Final Re -Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
MECHANICAL PERMIT
Job Address: 1151 GLENEAGLES TR
Status: ISSUED
Suite No
Applied: 08/18/2004
Issued: 08/18/2004
Vicinity:
rll?m
Parcel Number: 42233203
-_ - - ISSUED BY:
Applicant: LOWE, WILLIAM W' "
Address: 1151 GLENEAGLES TR
-
= f "-
Phone: 949-631-8630
COSTA MESA, CA' -
-_ Zip: - -926274030 -
-,
Owner: LOWE, WILLIAM W'
Address: 1151 GLENEAGLES TR.
1
Phone: 949-631-8630
,
COSTA MESA, CA
Zip: 92627-4030 -
Contractor: OWNER -BUILDER
Address:
,.
' -Phone:
-`
'
- Zip:-
• - -
License: 000000
SCOPE OF PERMIT
INTERIOR WORK TO ELEVATE
THE KITCHEN CEILING AND THE CHANGE OUT OF A 6FT
SLIDING TEMPERED GLAss°DOOR TO k15 FT TEMP. GLASS_ DOOR AND THE REPLACEMENT 05A ,
KITCHEN WINDOW WITH A BAY WINDOW. REF B04-01461.'
1 KITCHEN AND.1 VENT FAN.
-
-
-FEE SUMMARY
• 4
-
Quantity
- _ _ , _ _
- Quantity
ISSUE FEE $23.50
Repair/ Alt Absorbtion Unit
`. $0.00 0,
Inst FAU <100 k BTU$0.00 0
Repair/ Alt Refrigeration Unity
$0.00- 0
Inst.FAU >100 k BTU $0.00 0
Ventilation System
i'r $0.00_ . 0
Repair/Alt Cooling/Heat-. $0.00 0
•
Evaporative Cooler
_x$0.00 -, 0,:
Inst/ Rep. Recess Wall Htr, $0.00 0
.....Commercial Incinerator -�',�
$0'00r 0.' �
Refri S s'<100 k BTU $0.00 0
-
--'� - Domestic Incinerator
$0.00 /0 /
Refrig Sys>100 k BTU, $0.00 0-
Compressors / Absorption Systems
g1$0.00
Gas Piping',,, ` �' 1 $0.00 0 ''_-
e- ` - Up to 3 hp /:100 k BTU . -- /'�
$0.00 , 11 0
.00
Factory Fireplace $0-- o:_ �.
_
,- 3 To 15 hp / 500 k BTU" - �!'%
$0.00 /,0
Hood w/Mech Exhaust $10.65 1-
-
- 15 To 30 hp / 1,000 k BTU" ;`�' "-
$0.00" 0
-
VAV Box �.� - �' $0.00, .0
30 To 50 hp'/ 1,750 k BTU -: '✓j -'
$0.00 0
Vent Fan / Single Duct , . $725 - 1
'0�-
Over 50 hp / Over -1,750 -BTU ,'
'Boilers
' ; x$0.'00 0
Appliance - $0.00 -
,
Fire Dampers �� $000--0.
-- -'r ' "Upto3hp�� ;�� --i" i,��'
-
$0.00 0
Smoke Dampers \ $0.00., 011
- - 3 To 15 hp % ' j'
/ $0.00 0
Inst or Relocate Appl Vent ' _ $0.00 0,
_ _ -_ 15 to 30
/
$0.00 0
Air Handlers < 10000cfm $0.00 ' 0 -
r,
30 to 50 hp ?
$0.00 0
Air Handlers > 10000cfm - $0.00 - 0
Over 50� hp : • - 'ii' ��
-
$0.00 0
Floor Furnace $0.00 0
Other Mechanical, &a
Floor or Suspend Heater $0.00 -0 ` "< -
� . -- - Invesfigafion Fee' ,
$0.00
-
-' - -Plan-Check Fee--
$0.00
-- Reinspection Fee
$0.00
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 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 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) 754-5626
244646 (6/00)
DECLARATIONS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit Is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued.
My workers' compensation Insurance carder and policy number are:
Cartier: Policy Number:
(This section need not be completed If the permit is valued at one hundred dollars ($100) Orissa.)
❑ 1 cortity that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDmON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES,
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
force and effect. Uc. a Class x
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this pennit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any dry or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors Ucense Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
� as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I1a exeplp) I see. Business and Professions Code for this reason:
Signature:l Ji iw ,� faire Date:
.Owner ID verified by drivers license. as ❑ No Drivers License No. Expires: —
Verification of Ownership by (type of document Le. - property tax bill or deed): �«
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Cade requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
..._.........._._..........................__..I., .......................................................................................................................................................................... ..............................................._..........................
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑ No
(Section 25533 of the California Health and Safety Code. with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
............._............__............_.............. _............... _._.............. ___..... _...................................................................................... _____...... _........................... _.._...................... _.................................... _................ _........................... _.
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required. has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑ No
......_.......................................... _............... ....................................................... ........... ..................I..................................................................._..................................._...............................................___............_........................
5 Does Or will the applicant or present or future building occupant require for the work which Is the subject of this a plication aRPennit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? IJ Yes L) No
(Section ...
65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
.....
........................................................................................................................................................................................... _.......................................... _................................ _...................... .......... .......................................... _.............................
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
_..........__........._..........._......._........._..............._._.._......... _............................................................................................................................................................................................... ...............................................................................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
..... ..........................._........................ _.............._...............___.........................................................................................................................................................
......................................................................
8 (If "yes', attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with ell state laws end tryortlinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-des abed pr Ty for mspecyon urpo I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Slg�t� ,Of Legal owner(s)Date--�
And/Or Authorized Applicant Date
CODE I, INSPECTION TYPE pA1F INITIAL CODES INSPECTION TYPE RM
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Root 210 Final Electrical
201 Final Block/Retaining Well 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 1151 GLENEAGLESTR Status: ISSUED
Suite: Applied: 03/18/2002
Vicinity: Issued: 04/19/2002
Parcel Number: 42233203 Zoning:
Applicant: LOWE, SHIRLEY ISSUED BY:
Address:
1151 GLENEAGLES TER, -
_
Notal:
$230.46
Phone:
949-631-8630
MAIN STRUCTURE
Front ` 0-0 Rear 0-0
ACCESSORY
COSTA MESA, CA . -"
Zip:
92627-4030
Owner:
LOWE,�WILLIAM W TR
Address
1151'GLENEAGLES TER
• I_.
- Phone:
-
COSTA MESA, CA '
Zip:
92627-4030
Contractor:
- -
•�`
��-
Address:
'
Phone:
Zip: -
License:'
Arch : JAMES GILBERTSON
Eng:
_
Address:
-
-
Address:
-• Phone:
(714) 839-6329
Phone:.
'Zip:
License:
License:
SCOPE.OF PERMIT,—
INSTALL
ERMIT,INSTALL SLIDING GLASS DOORS AT REAR OF DWELLING. REMOVE WINDOWS TO_INSTALL SLIDING DOORS, DEMO AN
EXISTING MASONRY FIRE PLACE AND INSTALL AN ICBO FIREPLACE IN AN ALTERNATE LOCATION; REMOVE AND
INSTALL NEW WINDOWS IN DEN.
FEE SUMMARY' ,
Plan Check: $90.51 Calc Valuation: $7,000.00
Permit: $139.25 Claim Valuation:, $7,000.00
SMIP Res: $0.70
SMIP Com: $0.00
Other:.. $0.00
Inspection:
$0:001
Notal:
$230.46
SETBACKS-
MAIN STRUCTURE
Front ` 0-0 Rear 0-0
ACCESSORY
Front 0-0 '-Rear 0-0
PARKING
Existin : 0 .-Required: 0
NOTES
r
PLANNING & ZONING
Left 0-0 Right 0-0
Left 0-0 Right. , 0- 0
Proposed: 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 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 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
DECLARATIONS C)
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ 1 have and will maintain workers' compensabon insurance, as required by section 3700 of the Labor Code, for the performance of the won for which this permit is issued.
M workers' cam ��1Yns�a�°%I Insurance�J roar and olio number are: j
Carder:y pV / `�Y ✓ p y Policy Number: 1
his section need nofba completed it in I
permit is valued at one hundred dollars ($100) or less.)
certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Califo and agree that if I should become subject to the workers' compensation provisions of Section 3 of the �bor Code, I shall forthwith
comply with these provision 'n
U
Applicant Signature: / Date: T
WARNING: FAILURE TO SECURE WORKERS' C APENSAT N COVERXGetS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES,
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full
force and effect. Lia If Class R
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the fallowing reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her Own employees, provided that such improvements are not intended or offered for sale. It, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s)
license pursue 91)0 the Contractors License Laws.).
❑ 1 am exempt er s i Business and Professions Code for this reason:
Pr
Signature: — • - Date:
Owner ID verified by drivers ense. ❑ Yes ❑ No Drivers License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required t0 descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would require a pernil from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
....................................................................................-......................................................................................................................................._..._.........................................................._......................._...........................................................
2 Does or will the applicant or present or future building occupant need to file a registration forth for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
....._......_........._........__...........__.............__....
.........
_......._.__................
..............................................................._..................................................................................................................................................................................................
3 Does or will the appplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ NO
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
.................................................................. .........................................................................................................................._................. ___....................... ......................................................................... ...... ...................... .......... ....... ................
.
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
......._.........._............_............_.........__.__.............__......_..—_.............................................................________.__._............................................................................. ................... .................................I..............................
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this plication apernil for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LI Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
....._........................._.......—....................... _.................__._.........___....................................................................._.._._......_.______._............................-..........................................................................................................................
8 Will any par of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
............................................................................................................................................................................................._.............................................................................................._............................_...................................-..........._...........
7 If a Permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
........._...................._................................................................................................................................................................................................................ ............................................................. .... .............. ................................ ............................
B (If yes', atech certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-described pro for inspection u as. I agree t to occupy or allow occupancy of any building authorized by this %p rmil uetil nal inspection.
SOr� r7 BSU—C� � l I �'!
above-described
fLegal OWne $) Date
AncVOr Authorized Applicant Date
CODE t. INSPECTION TYPE OATS INTITALS CODE# INSPECTION TYPE Big II{1ITIAL9
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 210 Final Electrical
201 Final BlocWRetaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
..a�.SJ �j 1 it J'I
��i$i$ i1 �'yt/
S •
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and,
as a condition precedent to issuing a building permit, require the completion and require the return of, an
owner -builder verification.
Attention Property Owner:
An `owner -builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit will be issued until this
verification is received.
1. I personally plan to provide the major labor and materials for construction of the proposed
property improvement. ❑ Yes ❑ No
2. 1 (have/have not) signed an application for a building permit for
the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name
Address City
Phone ( ) Contractor'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
Address City
Phone ( ) Contractor's Lic. No.
5. 1 will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated:
Name Address Phone Type of Work
1002-06 (REV. 998)
HOOK,GARY
From:
GUEVARA, MICHAEL
Sent:
Wednesday, June 12, 2002 2:15 PM
To:
HOOK, GARY; CHALMERS, SYLVIA
Subject:
1151 GLENEAGLES TER
All Engineering Conditions of Development related to PA -01-07 at 1151 Gleneagles Ter have been completed.
HOOK,GARY
From: PETROS, EDWARD
Sent: Monday, June 17, 2002 7:10 AM
To: BUCK, RANDALL, COCHRAN, ROBERT; ELLINGSON, BEN; HOOK, GARY, NUNES, BILL;
TENACE, PETER
Subject: FW: Final for 1151 Gleneagles Terrace (B01-01013)
-----Original Message -----
From: LEE, MEL
Sent: Thursday, lune 13, 2002 3:33 PM
To: PETROS, EDWARD; CHALMERS, SYLVIA
Subject: Final for 1151 Gleneagles Terrace (1301-01013)
I signed off on the Planning final for the garage addition at the above address today. Let me know if you have any
questions.
Mel
(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:
Applicant:
Address:
Owner:
Address
Contractor:
Address:
1151 GLENEAGLES TR
GARAGE
42233203
LOWE, WILLIAM W TR
1151GLENEAGLES TER
-
COSTA MESA; CA-
LOWE, WILLIAM W TR
i
1151 GLENEAGLES TER
COSTA MESA, CA
Status: ISSUED
Applied: 03/07/2002
Issued: 03/07/2002
ISSUED BY: fAn�
cr
Phone: 949-631-8630
Zip: 92627-4030
Phone:
Zip: 92627-4030
..��Fhone:
Zip:
License:
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 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 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) 754-5626
244646 (r>=)
SCOPE OF PERMIT
ELECTRICAL TO INCLUDE: 4 LIGHTING FIXTURES, 12 RECEPT OUTLETS', 9"SWITCHES AND 1 -SUB - y
PANEL TO 200 A IN THE GARAGE.
REF: B01-01013 -
--FEE SUMMARY
�.
Quantity
, j
Quantity
ISSUE FEE
$23.50
Temp Dist System / Lighting
$0.00 0' ;
Temp service test
$0.00
Busway 1100 ft , '
$0.00 0 �!
Res. a/c package
$0.00
Standing Section
. $0.00 '-01 i1,1
-
New Res (1-2.units)
$0.00
0
. Mlsc Electrical Equipment
$0.00 -0,'
/
New Res (3+units)
- $0.00
0
- -- Transformers up to 1 kva/kw
$0.00 L/o
Pool / Spa'
�'' $0.00
0
............:.... Up to,,10 kva/kw
$0.00 / % 0 i 1
Lighting Fixts,,
x$4.40
4
.....up to 50;kva/kw'I,
0.
Recept Outlets '
, $1320\, :
� "'''12r'
_ -./$0.00/%
.': , .....° ......up to 100 kva/kw' ',
-$0.00 0' ;
Switches
�� $9.90\V 9"
--.......... ;....... over 100 kva/kw -
$0:00/ 0
Non Res Appl �_
$0.00'
�� C10 `
_ Low Voltage Equipment -,�
i$0.00-0
Res Appl
$0.00-,
- �0�
- Low Volt Wiring System /,Ckt%
$0.00 /
Service to 200a
$0.00-,
0_
Miso. Conduit - -- -";,$0,00:.
0="�
Service to 1000a
_ $0.00
0
-- Misc. Conductor- - ;,
`/$0.00 0
Service over 1000a
$0.00
0
Circus ( gen or ride)- . -
-$0.00, , ; 0 '
Motors to 1hp
$0.00
,0
Circus (mech'ride or lights) . --"$0.00:"
,'0
Motors to 10hp
-$0.00
0
Christmas Tree Stand' ..-$0.00
0
Motors to 50hp
$0.00_
0
Fireworks Stand -
$0:00 0
Motors to 1 00h
$0.00 "-�
'0
Other Electrical Fee , ;'' ., -'
$0.00
Motors over 1 00h
$0.00
- 0
- - �, ,- -
Communication drops
$0.00
0
Investigation Fee
$0.00
Sub panel to 200a
$30.50
1
Plan Check Fee
$0.00
Pole Light Pkg
$0.00
0
Reinspection Fee
$0.00
Sign Circuits
$0.00
0
Temp Pwr Pole
$0.00
0
TOTAL CALCULATED FEES
$81.50
Intermed Pole
$0.00
0
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
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) 754-5626
244646 (r>=)
DECLARATIONS n
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations: -
❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My workers' compensation Insurance carder and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued atone hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that if I she d become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these rrov/15I ss L
1p�pp�I—can-
AW fiMNG: FAILURE TO SECURE WORKERS' WMPENSATION WVERAGE IS UNLAWFUL AND $HALL SU61ECi AN EMPL ER TO CflIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,ODO). IN ADDITION TO THE CAST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full
force and effect. Lic. N Class N
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lender's Address:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars (5500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
W11, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am ex pt un sec. Business and Professions Code for this reason:
Signature:n-
_
Verification of Ownership by (type of d nmen , i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Perrin Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Cade requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
.................................................................................................................... ........................................................................................................................................... .................................... .................. -....................................................................
.
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet o1
compressed gas at standard temperature and pressure).
....._........_................_........_..........._..........__................_..-....................._.........................
_............._.._._...
_._....
_...................._......._._...
.........................................................................................................................................-............
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
.................................................................................................................................................................................................................................................................................................................No,.................................................................
4 If an RMPP .. presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑ No
5 Does or will the applicant or present or future building occupant require for the work which is the subject ofthis a plication a ppermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control distract or agency? Yes ❑ No
(Section 65850.2 of the California Government Cade requires that the requested information be furnished on applications for non-residential building permits).
..... ....................................................................................................... _........... _._..................................................-................................................. ....................... _............-...........................
e Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Ves ❑ No
(It 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
............ ............. _.......... _........... _.......... _.......... _......................... .................__..-_....................................................................................................................................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
............................................................................................................ ........................ .... ............................................................................................................ ................................. ......................... .................... .......................... ............. - .............
....
e (If yes', attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I cenlfy that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws a Ity ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-ddscri ed any for inspeto ion _purp9pitfs. I agree not to occupy or allow occupancy of any building authorized by this peat until fin al inspection.
i ns
griaNie'_-_ afOJiner(s)) . Date"F';�1
And/Or Authorized Applicant Dale
CODE.. INSPECTION TYPE PAIS INTITALS CODE. INSPEUONTYPE PATE Iti1ITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 210 Final Electrical
201 Final Block/Relaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 . Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 1151 GLENEAGLESTR
Suite No
Vicinity:
Parcel Nunmber: 42233203
Applicant:
LOWE, WILLIAM W TR
Address:
1151 GLENEAGLES TER-
,!
COSTA MESA; CA,
FEE SUMMARY-
Owner:,'.
LONE, WILLIAM W TR"
Address".
1151 GLENEAGLES TER
_ Quantity
COSTA MESA, CA
ELECTRICAL PERMIT
Status: ISSUED
Applied: 04/29/2002
Issued: 04/29/2002
ISSUED BY:
Phone: 949-631-8630
Zip: 92627-4030
Phone: '
Zip: 92627-4030 - -
Contractor: "OWNER -BUILDER
Address:
Phone:
Zip:
License: 0
SCOPE OF PERMIT ,
' ELECTRICAL TO INCLUDE: 2 RECEPT OUTLETS AND 1'SWIT,CH.
REF: B02-00375 - -
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
fora period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
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
244s-46 (6/00)
FEE SUMMARY-
_ Quantity
- ---,� _--�
/
Quandt -�,
y
ISSUE FEE
$23.50
Temp Dist System / Lighting
$0.00
0
Temp service test
$0.00
Busway /,100 ft
.. $0.00
0 .
Res. a/c package
$0.00
Standing Section,
$0.00
0'
New Res (1-2 units)
$0.00
0
Misc Electrical Equipment
$0.00
0;
New Res,(3+units)
$0.00
0
Transformers up to 1 kva/kw
$0.00
,
Pool / Spa'=.
$0.00
0
...............:up to 10 kva/kw
$0.00 `
0
Lighting Fixts,
'- $0.00
0
--- ....... _.,..::iup to 50 kva/kw
$D.O,O:j
0 '
-
Recept Outlets-
.$1.10 ..
1 .'-
.................up to 100 kva/kw, c.,
0
Switches
$2.20 ; I'
�- � 2, -:
..................over 900 kva/kw � �
_ ,50.00`;
'$0.00'
0
Non Res Appl ,;'
$0.00 �_�?
0
Low Voltage Equipment
x$0.00 ,
- 0
,
Res Appl
$0.00 -
- �o
Low Volt Wiring System / Ckt -
= $0.00-
0
Service to 200a ',
$0.00
0 1,, -
Misc. Conduit -
$0.00 .,
0
Service to 1000a
$0.00
0
Misc. Conductor -
$0.00
0 -
Service over 1000a
$0.00
0. -
Circus ( gen or ride)
$0.00''
10
Motors to 1hp
$0.00 , _
0
Circus (mech ride.or lights)
$0.00,,-
'10
0Motors
Motors to 10hp
. ' $0.00 -
- 0
Christmas Tree Stand
- $0.00 :%
,'0
Motors to 50hp
$0.00
0
Fireworks Stand
$0.00 - "-
0
Motors to 100hp
$0.00 -
- 0 -
Other Electrical Fee
$0.00
Motors over 100hp
$0.00-
0
-
Communication drops
$0.00
- 0
Investigation Fee='
$0.00
Sub panel to 200a
$0.00
0
Plan Check.Fee
$0.00
Pole Light Pkg
$0.00
0
Reinspection Fee
$0.00
Sign Circuits
$0.00
0
Temp Pwr Pole
$0.00
0
TOTAL CALCULATED FEES
$26.80
Intermed Pole
$0.00
0
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
fora period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
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
244s-46 (6/00)
DECLARATIONS r)
WORKERS' COMPEN5ATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My workers' compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Calito ia, and agree that if I should be me subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these rov' io \\
A SIgnalure: �� ri a, lAJ (JY CDaIW.N 29 /jPR 7��
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CObfAd IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLAAE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION XM6 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full
force and effect. Lic. N Class 11
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lender's Address:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
;��I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License La .).
❑ 1 am axe pt un c. Business and Professions Code for this reason:
_Signature: C
CEzpires:_
Verification of Ownership by (type of doc e , i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify that no excavation five (5) or mote feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ NO
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
...........................................................................................................................................................................................................................................................................................................................................................................................
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Ves ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
.............................................................._.......... ............................................ ............................................................................................................................................................................... ......................................................................... _............
3 Does or will the applicant or present or future building Occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the Calitomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
........._........._............_............_........__...............__..............._................................_._............................aali...................................d"a,.....e-e-........_............pli'.......................... .............._.............................................................................
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety, Code been fully, complied with? ❑Yes ❑ No
..................................................................................................................... ildi........................................................................................................................................_..................................................................................................difi...............
5 Does or will the applicant u present or future building occupant require for the work which is the subject c this a plication agermil for such construction or modification
from the South Coast Air Quality Management Distract or from any other air pollution control district or agency? � Yes 8 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
......__...........__.........._............._............_................_......................................................................................................................................................................................-.......... .........................................................................................
6 Will any pan of the laciliry to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑ No
(if 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
.
_............... .......... _........... ...._....... ._.......... _.......... .......-_.......... ...................................................................... ..............................................................................................................................................................................................................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
....................... .......................................................I................................ ................................................................. ...................... ................................................ -................................ ....................
.......
e (If yes', attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I cenity that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to c mply with all state laws and cipeordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above -de d d pr for mspecti pu gree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
e7, . �RVJ cpf-n 29 APR zop z
cWature Of Legal Owrwrr(s) Date_�
And/Or Authorized Applicant Date
CODE 11, INSPECTONTYPE grill: INTITIALS CODE INSPECnONWPE 2&U INTITA�
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing _.
200 Final Re -Root 210 Final Electrical A�2
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
2D4 Final Demolition 250 Final Building/Occupancy,
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
Job Address: 1151 GLENEAGLES TR Status: ISSUED
Suite No Applied: 03/07/2002
Issued: 03/07/2002
Vicinity: GARAGE
Parcel Nunmber: 42233203 ISSUED BY:
Applicant:
LOWE, WILLIAM,W:TR
Address:
1151 GLENEAGLES TER
/
Phone:
949-631-8630.
COSTA MESA, CA
Zip:
92627-4030
-
- •- ;
Owner:
LOWE, WILLIAM:W-TR
Address
1151 GLENEAGLES TER
,•�%
Phone:
�
'
COSTA MESA, CA
Zip:
92627-4030
Contractor:
" Address:
-
....
-
Phone:
..
"
License:
Arch Eng
Address:
Phone:
I
,.
Zip:
..
License:
SCOPE OF PERMITS
PLUMBING TO
INCLUDE:
2 LAUNDRY TUB/WASHER IN THE GARAGE.
'
REF: B01-01013
FEE SUMMARY
AMT_:
QTY.-:: r•.
-
AMT-
;QTY -;+y
-^-r-'. i
••AMT
QTY
ISSUE FEE -
$23.50
Laundry Tub / Washer $19.60
2Sump"Pump
�;
1$0.00
0
Backflow irrigation -
$0.00
.0--;" ,
Landscape Irrigation
$0.00
0
.
Swimming Pool �, .,
$0.00
0
Backflow Preventer,
$0.00 .'
0 ',� ��••:�
P -Trap
` $0.00
0 -
'; 'Trap "Primer,/ /�. ;/
$0.00
0
Bathtub -
x$0.00;
�-Pressure
Regulator
$0.00
.0'�
, Urinal;- `-� ,- ; /
$0.00
0
Clarifier System
,-0
$0.00
0
Process Piping (per 10
ft) $0.00
0
', Vacuum Brkr Bkflow(1-4)
$0.00
0
Connect (Ice,Soda,etc)
$0.00 -"
0
Receptors
$0.00
0
Vacuum Brkr Bkfl6w(5+)
$0.00
0
Dental Units
- $0.00, -.
0 , ",' ' , -
• Septic Tank
$0.00
.' 0
`- Wash. Basin i
$0.00
0
Dishwasher
$0.00
-0
Sewer Cap for Demo
$0.00
0
Wash Basin Set
$0.00
0
Drain, Floor
$0.00 "
0 -
Sewer Connect
$0.00
10;
Waste and Vent System
$0.00
0
Drain, Rainwater
$0.00
0 -
Sewer Private Line
$0.00
0
` Water Closet (Toilet)
$0.00
0
Drain, Roof
$0.00
0 .'
'Shower
$0.00-
.0 ''
- Water Heater / vent
$0.00
0
Drinking Fountain
$0.00
0
- Sink, bar
$0.00 `
0 -'
Water Piping (Inst or Rep.)
$0.00
0
Expansion Tank
$0.00
0
Sink, commercial
$0.00
0
Water Re -pipe
$0.00
0
Gas Earthquake Valve
$0.00
0
Sink, Floor
$0.00
0
Water Service
$0.00
0
Gas (1-4 outlets)
$0.00
0
Sink, kitchen
$0.00
0
Water Softener
$0.00
0
Gas (Over 4 outlets)
$0.00
0
Sink, service/mop
$0.00
0
OTHER
$0.00
Gas Repipe
$0.00
0
Spa (private)
$0.00
0
VIOLATION
$0.00
Gas Service
$0.00
0
Spa (public)
$0.00
0
PLAN CHECK
$0.00
Interceptors (Grease, Oil) $0.00
0
REINSPECTION
$0.00
0
Interceptors (Sand Auto ) $0.00
0
TOTAL CALCULATED FEES: $43.10
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 comm ked within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
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
2448-46 (6'00)
DECLARATIONS C)
WORKERS' COMPENSATION DECLARATION: _
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Cade, for the performance of the
work for which this permit is issued.
❑ 1 have and will rrbintain workers' compensation insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued.
My workers' .1 compensation Insurance carder and polity number are:
Carrier. Policy Number:
(This section need not be completed if the pemrit is valued at one hundred dollars ($100) or less.)
&-E1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that if I should bec a subject to the workers' compensation provisions of Section 37GO of the labor Code, I shall forthwith
comply with these r s�'pQns.o /�l
plican Signatuid""Ip��/i6�Q���
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES,
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade, and my license is in full
force and effect. Lic. # Class #
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division Sol the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License s.).
❑ 1 am ex t u sec. Business and Professions Code for this reason:
Signature: FDate�i: � — 'L
,Oww�mer ID.'vedfleC tiy,dnvers Ilcensed es ❑ No (IQjpiets:Lirerise,Nd' Fc,�.: testi U
edficatV ion of Ownership by (type ofd ment, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
...................._........_............_.............-.............. __..................... _......................................................................___.................................................... __._............................... _....................................... ..... ...... _... ........................._............
_.......
...
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 50O Pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
............................................................................................................................................................................................................................................................................................................................................................................................
3 Does or will the applicant or present or future building Occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
............................................................... ...................................... _......................................... ....................... ........... _..... ...................................... ..._.............................. ............................................. .............................................................................
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
.................................................................................................................................................................................................................................................................................................................................................................-........................
5 Doea or will the applicant or present or future building occupant require for the work which is the subject of this a plication agennit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency, Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
..................................................................................................... _............................................................................................................................................................................................................................................................................ _ .......
e Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
..........................................._........................_........._..............._.........................................................................._............. _................. _.................................... _........
7 It a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
.............._............_........._.........._............_................................................................................I.................................................................................................................................
8 (If yes", attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city rdmances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-desld�ropg for inspection purposes. ea not to occupy or allow occupancy of any building authorized by this permit until final inspection.
�I
.SrFr igriature'Of Waiitwnier(ss Ci-Date:!"
And/Or Authorized Applicant Date
CODE.. INSPECTION TYPE JIME INTRIALS CODE I INSPECTION TYPE 2&11 INITIM S
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final BlockfRetaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
MECHANICAL PERMIT
Job Address:
1151 GLENEAGLES TR
Status: ISSUED
Suite No
Applied: 04/29/2002
-�
Issued: 04/29/2002
Vicinity:
Parcel Number:
42233203
ISSUED BY:
Applicant:
LOWE, WILLIAM WyTR
Address:
1151 GLENEAGLES TER"
f -
Phone: 949-631-8630 i,
COSTA MESA, CA -
Zip: 92627-4030
Owner: '
LOWE, WILLIAM -W TR
Address:,
1151 GLENEAGLES TER
Phone:
-
COSTA MESA, CA
Zip: 926274030
Contractor: "
OWNER -BUILDER
Address:
Phone:
Zip.
i
' -
License:0
SCOPE OF PERMIT
'
MECHANICAL TO INCLUDE: 1 GAS PIPING AND 1 FACTORY FIREPLACE
REF: B02-00375. i---
- - f --, - -
FEESUMMARY
Quantity
Quantity',
ISSUE FEE
$23.50____
- Repair/ Alt Absorbfion Unit
x .$0.00
-0-
Inst FAU.<100 k BTU
$0.00' -0 -
- Repair / Alt Refrigeration Unit
I ','$0.00
0
Inst FAU >100 k BTU
$0.00 0
Ventillation System
11 ,1$0.00_
0
Repair / Alt Cooling/Heat $0.00 0
Evaporative Cooler
$0.00
0
Inst/ Rep. Recess Wall
Htr $0.00 0
Commercial Incinerator '-
$0.00
0
Refrig Sys <100 k BTU
$0.00 0
Domestic Incinerator
,-
0
Refrig Sys >100 k BTU
$0.00 0_
Compressors / Absorption Systems
1$0.00
Gas Piping i
$6.15 1
-Up to 3 hp / 100 k BTU
��
o , r _ $0.00
�0.
Factory Fireplace
$10.65 1
_
.. 3 To 15 hp / 500 k BTU
.'' $0.00
; ,10
Hood w/Mech Exhaust
-
$0.00 0
15 To 30 by /.1,000 k BTU
$0.00
'0
VAV Box
,
\ `� $0.00_ : 0 -<.
" 30 To 50 hp, 1,750 k.BTU-.:,
,y .
som
',0
Vent Fan / Single_ Duct
1$0.00 0
- Over 50 hp / Over. 1,750 BTU ,.
$0.00
i 0
Appliance
$0.00 , 0
Boilers
Fire Dampers �� -
- - $0.00 ;0 ; ,
Up to 3 hp
- $0.00
0
Smoke Dampers
$0.00 10 "-".,
3 To 15 hp -
/ $0.00
0
Inst or Relocate Appl Vent - $0.00 "- 0
- 15 to 30 hp
, '$0.00
0
Air Handlers < 10000cfm ' ' - $0.00,- 0
30 to 50 hp
' $0.00
0
Air Handlers > 10000cfm �. - _ $0.00 , 0--
Over 50 hp r;
. �- $0.00
0
Floor Furnace
x`$0.00 .0
"'
Other Mechanical Fee
Floor or Suspend Heater - ' $0.00. 0 `��
Investigation Fee ' ; i��i
50.00
Plan Check Fee
$0.00
..
Rein spection,Fee
$0.00
TOTAL CALCULATED FEES $40.30
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
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
2"a (sroo)
DECLARATIONS C)
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued.
My workers' compensation Insurance carder and policy number are:
Carder: l Policy Number:
(This section need not ti mplefed it the permit is valued at one hundred dollars ($100) or less.)
,06> I certify that in the performance of the work for which thispermit i Issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Califom and agree that it I should be a subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply With these p si is /
Applicam Signiiture: � % p�C,,k 1, )b Gtr Lte: Z9 AP2 Zoo?
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full
force and effect. Uc. N Class a
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lenders Address:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the fallowing reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
y� I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ 1 am ex u sec. Business and Professions Code for this reason:
Signal4 'Da- Lem %9 A AP 2CO7
Owner ID verified by drivers license. ves ❑ No DnvetsAlcense;Mo.. Expir—w:?
Vedflcetion of Ownership by (type of docu en ,.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Cade requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
...........................................................................................................................................................................................................................................................................................................................................................................................
2 Does or will the applicant or present or future building occupant need to file a registration forth for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, Or 200 cubic feet of
compressed gasat standard temperature and pressure).
............................................................................................................................................................................................................................................................................................................................................................................................
3 Dces or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
........................................................-............................................................................................................................................................................................................................ .............................................................................................
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑ No
5 Does or will the applicant or present or future building occupant require for the work which is the subject this a plication appertnit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
._ ...................... _............ .......... _........ _.-.............. -................. -........................ ......................... ............................................................................ ........ ....................... I ................ ........................ ................................................I.........................
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑ No
(if 'yes", the facility must meet the requirement Of Sections 25534 and 42303 of the California Health and Safety Code).
.......................................................................................................................................................................................................................................................................................................................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all Of the disclosures prescribed by California Health and Safety Cade Section 42303 been made? ❑ Yes ❑ No
..........._.........._........- ......... _.......... __........ _........... __-........... --.................................................................................................................................. ............................................... _.................. _.-...... ........... _.................... _....... ...._..........
e (If yes', attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the Information given is
Correct. I agree comply with all state laws a city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above- s b perry for ins cti n p s. I agree not to Occupy or allow occupancy of any building authorized by this permit until final inspection.
r. � ogr 29 AP2 zOICIE-
Signature of Legal Owner(s)1 Data
And/Or Authorized Applicant Date
CODE I. INSPECTIONTYPE INTmALS CODES INSPECTION TYPE PATE IdTITIAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical G - �- �a 4
1266 Pool Spa Final 208 Final Plumbing _.
200 Final Re -Roof 210 Final Electrical
201 Final Block/Retaining Well 212 Final Fire Prevention
202 Final Factory Fire Place 220 . Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
4
llllll� i l
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 1151 GLENEAGLES TR
Suite:
Vicinity: GARAGE
Status:
ISSUED
Applied:
06/29/2001
Issued:
09/25/2001
Parcel Number: 42233203 Zoning:
Applicant: LOWE, SHIRLEY L ISSUED BY:
Address: 1151 GLENEAGLES TR
- Phone: 949-631-8630
COSTA MESA; CA' Zip: 92627-4030
r -
Owner: LOWE TRUST
Address 1151 GLENEAGLES TER
Phone:
,COSTA MESA, CA- Zip: 92627-4030
Contractor: OWNER -BUILDER
Address:
Phone::,` -
Zip: - - License:' 0 '
Arch - Eng:
AddressAddress:'
Phone:- - Phone: - -�
Zip: - License: 'License:
SCOPE OF PERMIT. _
CONSTRUCT A 292 SQ. FT. 1 CAR GARAGE ADDITION TO AN EX_IS_TIN_G'2-CAR GARAGE; ADD 75 SF DORMER OVER
FRONT ENTRY; ADD 213SF TRELLIS AT FRONT.
(VARIANCE FROM FRONT SETBACK REQUIREMENTS, REF: PA -01-07
FEE SUMMARY
Plan Check: $108.71 Calc Valuation: '$8,359:60
Permit: $167.25 Claim Valuation: $0.00
SMIP Res: $0.84
SMIP Com: $0.00
Other:' $0.00
Inspection: $0.00
Total: $276.80
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 22-0 Rear 38-8 Left 5-5 Right, 6-,1
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 2 Required: 2 Proposed:.- 3
NOTES:
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 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 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) 754.5626
244646 (6/00)
J
L
DECLARATiONS
WORKERS' COMPENSATION DECLAFiAT10N:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued.
My workers' compensatlon Insurance carrier and policy number are:
Carrier: Polity Number:
(This section need not be completed it the permit is valued atone hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHAH SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION Woo OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES,
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
force and effect. Lic. K Class q
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lender's Address:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commenting with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a penny
su facts the applicant to a civil penalty of not more than five hundred dollars ($500).):
I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt undo /I Business and Professions Cade for this reason:
Signature: Date: nef
Owner ID verified by drivers lice ❑ Yes NO Driver's License No. Expires:
Verification o1 Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more then thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has e
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 WIII the applicant or present or future building occupant need to file and comity, a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be fled with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
...__............._.........._._................_..................__..................._......._..............._._._....................................................................................................................................................................................................................................................
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Masa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
............................................................................................................................................................................................................................................................................................................................................................................................
3 Does or will the appplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
..................................................................................................................... ildi............................................................................................................................................................................................................................................difi...............
5 Does or will h applicant u present or future building occupant require for the work which is the subject c this a plication aPPermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control tlistdct or agency? � Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits).
......._........_.........__........._..... ....... _............ _....................... _............................................................................ _.... __....... _.__.......................... .._.__................................................................................._.................._..........._............_.
8 WIII any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? []Yes ❑ No
(it 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
............................................................................................................................................................................................................................................................................................................................................................................................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
_............_...................._........._.........._........._.................._.._................._.................__............................................................................................................................._......................_....................-........._......................._.....................
8 (It "yes". attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-descdbedo�e��inspection pI}ryoses. I agre not to occupy or allow occupancy of any building authorized by this permit until final inspection.
/7l/G-Il% A�/K� Deas O�
Sign r f Legal r(s) Date
And/Or Authorized Applicant Date
CODE r. INSPECTION TYPE gAI€ ItiTMALfl CODEC INSPECTONTYPE OATS INEMIlLH
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy Q- —BZ y�-�
0
#I F
VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and,
as a condition precedent to issuing a building permit, require the completion and require the return of, an
owner -builder verification.
Attention Property Owner:
An `owner -builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit will be issued until this
verification is received.
tel. I personally plan to provtd the major labor and materials for construction of the proposed
property improvement. [Yes ❑ No
2. I (havelhave not) hili 2_ signed an application for a building permit for
the proposed work.
,-3. I have contracted with the following person (firm) to provide the proposed construction:
Name To eji .V6 r,42141AJkD
Address City
Phone ( ) Contractor's Lic. No.
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address City
Phone ( ) Contractor's Lic. No.
5. 1 will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated:
Name Address Phone Type of Work
1042-46 (FEV. 9/98)
t
CHALMERS, SYLVIA
From:
GUEVARA, MICHAEL
Sent:
Wednesday, June 12, 2002 2:15 PM
To:
HOOK, GARY; CHALMERS, SYLVIA
Subject:
1151 GLENEAGLES TER
All Engineering Conditions of Development related to PA -01-07 at 1151 Gleneagles Ter have been completed.
CHALMERS, SYLVIA
From:
LEE, MEL
Sent:
Thursday, June 13, 2002 3:33 PM
To:
PETROS, EDWARD; CHALMERS, SYLVIA
Subject:
Final for 1151 Gleneagles Terrace (601-01013)
I signed off on the Planning final for the garage addition at the above address today. Let me know if you have any
questions.
Pilal
CHALMERS, SYLVIA
From:
GUEVARA, MICHAEL
Sent:
Wednesday, June 12, 2002 2:15 PM
To:
HOOK, GARY; CHALMERS, SYLVIA
Subject:
1151 GLENEAGLES TER
All Engineering Conditions of Development related to PA -01-07 at 1151 Gleneagles Ter have been completed.
ADDREss gp 6wLDgc: 1151 GLENEAGLES TR UNIT:
ONNERS NAME 1p KNOMN: MAED ER, LORETT E J TR
!e ADDREss: 1151 GLENEAGLES TER
COSTA ME5A,CA 92627
ApPL."UM ADDRESS:
ARCNRECT OR ENGINEER: UC. Ni
MCN. OR ENG.'S ADDRESS: UNIT:
Co ACTOR'SNAME: PERFORMApICE ROOFING CO, (714)645-2382
CONTRACTORS MNUNG 2476 NEWPORT BL
ADDRESS: COSTA MESA CA LIC.NO.: 661267
92627 UNIT: 1/2
LICENSED CONTRACTORS DECLARATION: I Hereby aMsm under penaly of perjury that I am Ikanaed under provision of Chapter 9
(commen hN with Section ]DOD) of Dbieion 3 of the Butane. and Profession. Code, end no, license is in Iu11 force and affect.
V.NO.:!'5-923 uc.cuss: C-39 uc. 0: 66 26— EXP: 12/95
S 4 Connector: BU DER ECLARATICN: I hereby affirm under penally d penny that I am axe pr from t e Contractee liseme Lew la the
dlawng meson (Section TIX11.5 Bush4ee and processions Code: Arty cry a marry which parmil to sp semen ever. a or she
I, molsh, or repair any er e Variation
prior lo its eCuapse, rs coquinas the applicant for such peers to fib a cipnnd 00) of set lhol he or she
Icenaed pursuant to the prd.] ort d the Contractors Umnee Law [Chaplin the 9 (s for Mea ll cosh exemption
emi tion 0) i Division 3 of the
* 703,1 S b erhd Proleeskns Cadet «that he or she is exempt Ih«eh«n and the loam let Ne lexi hu dre dolly MY vioblion d Sedan
70375 by anY applicant la a permit .beds the applicant to a will penalty d rot more than (wa hundred olden Issaop.
1, as owner of the propend or my employees with wages. their sole compenmbn, will do the work, and the swcture s rax intended
a nd offefor ser (Section 7000, Business and professions Code: The Contrectoro License Lew does not apply to an owmr a property
who Wad. or mprpvee theri and who dose such wale himself or heRBC or through los. her own emplorwe, provided that such
jr,ann mans me not intended or offeror for aide. U, however, the Wieirg or knpraemem is saU within one Year of completion. the
owner�buikler will have the burden of proving he or she did not Wild «improve for the purpose of sale).
I.. owner d IM properly, are exdutbely onlrenkg with licensed contractors to construct the project (Section 704,1, Business and
professions Code: The Contractors License Law does ml apply rep an owrnr of property who Wilds or improvm thereon and who
convect f« sushi protons with a commune) Icensed Ime"I 10 Me Convae«s Lkeme Law).
1 am exempt under Section: B. 8 P C., for this reason:
Gets: Cwrher:
I do hereby cee fl, Mat l me aware of and und.mmd the rommarems d CaNaTAe //aelh and Satisfy Code Sectio. 25505, ]5533, err
25530, and that I or any Mum buieing oaupmt will / will not (once one) need to comply with veld ante axles and the requirements for
apermtformnevuction«modifiratknhomtho Air ne�tY anegement Dindd. Reekentiel oondrWion eppEralianaere exampfrom Me.
poviama.
Date: Applicant:
WORKER'S COMPENSATION DECLARATION: I hereby dfium under penalty of perjury ahs of the following decimations:
I haw end will maintan a certifaate d patent 10 aeainwro for wakes' ampenwion,. prandad I« by Stlkn 3700 d tM lab«
coda. for the xidom ori d the work for which this permit is sound.
and will maintain snorters' compensation insurance. As required by Semon 3700 of Ma Labor Code. W the pedemance of IM
weir 1« which this penes is issued. My workers' amparmtion insurance carrier and policy number me:
Carrier: STATE FUND EXPIRES
Policy Number: 1 .] i rel i 6 —'j 10 01/01/96
(This senior need ria be commmed if Me permAs W one hundred dollars I$IW) or b..)
I canal, that in the perormmae d the waN W which qhs perms ie sate shell ml empkry arty person
b enY manrw oro . to
///bbbaae subject !o he waken' caeparewit lows d en res that a ahs became abject to the workers'
mom ansatio Drmvi ane of Section 37W d the labor Code, Cations".1 shill to compty Iha romias.
/ ata: S 4 S Applicant:
ng: Fail. In securo woric"' mod en.0on covaroge Is unlawful, and shell subject an i/TtTNInMnel P.M. and
civil fin. W m ora hundred fhouaand do oro (5104000), he listen on b the roof al ro fen, mops es proyh sat ler In
Secdon 37M of fits Labor Code, Infaro i end momay s less.
CONSTRUCTION LENDING AGENCY: I hereby affirm under moatty of perjury that liters s e construction lending agency W the
performance of the work ler which his perms is sued (Sedbo 3097, Cb. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this eppikedion and mete that the abaw information is correct. I agroe to comp"It all city and county «dinences
and state lows riming to Wilding mnRrodkn and homy, authorize representatives of this city to enter upon the above-mentioned popery
for inspenim purpose" TERRY DELACRUZ
Pnnt N
n� Data:
4.�X ... .. ... __..
(515146 WP) Whoa-Saldvq & Salary; GrmrFRle: Canary -Alphas: Pink-Rewnw: Goldenrod -Assn.«
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: E 072236
PERMIT NO: B 072236 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: SIR PURPOSE: REF
JOB DESCRIPTION I/O ROOF, REROOF W COMP SHINGLES SQ FT: 5,900
CLAIM VALUE: 5,900,00 CALC—VALUE: 5,900.00 GROUP OCC; R-3 /M-1
COMMENTS: SMOKE DETECTORS REQ PER 91UBC
#.y.#######9E##*###aE*i4.N.##M:.V_**# IE##iE##Is#######-Y#.�-X
Z 0 N I N G R E Q U I R E M E N T S
S E T B A C Y. S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RC.HT; FT IN
PARI:ING REQ: PROV: PARCEL: 42233203 ZNE; REF NO;
PLANNING NOTES>
############ 1F{(-#Yaf ifaF+F4#iF)f i4#N-i�iE-1f Y#tc )f i4#3R jf #Y ir-�4{c#coif #1F 11#{t -#if +a aR i:-Yif###+c ::xlE at aE jf'N-iF ii -K i:##aF -IE is
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N'T S
ZONING APPROVED BY DATE;
BUILDING APPROVED BY ; DATE:
APPLICATION ISSUED BY: DATE: ^\J�
#########4###ia!-+Eau-#####iz3F iE 1F3Fir3FII jF'iF 3F YiF±Fir't.:/4 irN*�p;F$iF ilii i7+fii17iF iFY�iF#if il-iR at#iF+f tcr �# iF as'
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL S GME T:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 81,00 ,59
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS ---- > 81.59 0.00 0.00 81.59 81.59 .00
REVENUE DIVISION TOTALS--> COLLECTED; 81.59 OVER/SHORT; 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
81.00 .59
#########u####iF+fM-###iF iE iF'1r iE aE:MnE iF iF iF ie'1EYiE'lE#if iF##1E##Y-'IE iF#iF##fr 1F iF;(-iF 1F-nF iE#iEKif it #+E iF in Y-L-#iE#i: i.#<JFM
I N D I V I D U A L F E E B P. E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 5900 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 5,900.00
END OF FEES
01 00181540-00121541 TOT 81.55
DATE: 05/09/95 'HME. 1`:40
CONSTRUCTION AND PLANNING;
IlAPPROVALS Permit# DateTI
spector
POC SPA .
APPROVALS, Permit #
Date
Inspector
1. Temporary Electrical Service or:Pole•
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.
53. Steel Reinforcement -'
3. Electrical Conduit Utility-UndrgrAd.
54. Forms
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd.
57. APPROVAL TO COVER-GUNITE
1
7. Footings
58. Electrical Conduit-Undrgrnd.
8. Foundation
i
59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, 0, Undrgrnd.
10. Structural Floor System
61. APPROVAL TO DECK`, �1
11. Property Sewer Line & House. Connection
62. Backwash & Receptor -Final
12. Sewer Cap
63. Heater & Vent -Final - -
13. Roof Drains
64. Plumbing System - Final;
14. Rough Plumbing
65. Electrical-Finalj -
15. Rough Electrical -Conduit
66. Solar System -Final'
16. Rough Electric Wiring
67. Fencing & Access Approval
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
18. Rough Electrical -T Bar Ceiling
69, POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
-
71. Product Piping 0 Gas 00il
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank OGas 00ii
25. Roof Sheathing
74. Overhead Hydro
26. T -Bar Ceiling (Structural) & Monocoat
75. Dry Chemical
27. Frame and Flashing
76. Dry Standpipe
28. Lathing & Siding
77, FIXED SYSTEM FINAL
29, Insulation
78. FIRE PREY. FINAL
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79. FINAL INSPECTION
32. Electrical Power Meter -Final
80. FOOD CERTIFICATE ISSUED
33. Final Electric
Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe -Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service -Final
40. Gas Service -Final
41. Solar Domestic -Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
1474,17
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 317 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
BUILDING
ADDRESS 1151 r1PnP.FLg1P- Te
COSTA MESA. CALIFORNIA
FEE REq. NED
W JUN280
FINANCE DEPT.
CITY Of COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT NO. q '(fERMIT
OWNER C � �
''NEeO.
.ILi,�3
MAIL -
RECTI EO. BY O
TECEIVED DATE ISSUED
.?n
ADDRESS ..7844,E,.. -Rosecrans
� ✓'-(o 8 19SI
CITY Paramountj Calif. NQE 6-1261
ADD EISS
CE liffssPaeTEL.
NOWA 3-122
COSTA MESA.
CALIFORNIA
OR Associates
ADDRESS 90254 E. Florence Ave. Downey
FIRE
ZONE TYPE
V GROUP
CONTRACTOR
APPROVED
BY
DATE
ADDRESS 3800 E. Coast Highway
ZONING
ZO
NO. OF q /
U8E OP N
CITY
PLANE
y
BUILDING
ucTNo. 98808 -SB -1 No. OR 3-4220
LEGALLot 39 Tract No. 3470
DESCRIPTION
of
SIZE
NO. OF BLDGB.
OP LOTct 0NOw
ON LOT
A. P. NO.
-�--
USE OF
YARDS
EVES
EXI TING BLDG.
APPROVED
ALLO ED
SETBACK LINE FROM
(CENTER LINE ST.)
,j
CENTER OF STREET REAR YARD
FRONT
FT. IN.
SIDE YARD ILEFT
(RIGHT
R.SIDE 1A
FT. IN.
DESCRIPTION OF WORK
L. SIDE
F7. / IN.
NEW I X II ALTERATION I IIADDITION I
REAR
FT. IN.
REPAIR I I MOVING I DEMOLISH I
APPROVED // /
A/
/
DATE Yy �J
BUILDING - NO. OF
SIZE ROOMS 'STORIES
EXTERIOR WALL
ROOF
COVERING
COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
Res W Att. Gar.
Pa 27S
G - 552 S.F.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
PURPOSE OF ESTABLISHING
A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
VALUATION
BUILDING CONSTRUCTION.
SIGNATURE OF ��-L-L-QP..,
_PERMIT FEE $j 70A
PERMITTEEF
$ 17,959.00
PLAN CHECK $ 18.500
k&
AUTHORIZED AG
55.50
TOTAL FEE