HomeMy WebLinkAbout227 PAULINE PL - Building PermitsaC•��p MFS9
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CITY OF COSTA MESA -
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
�»a) �sa-s2�a • Fax (714) 754-4856
Job Address: 227 PAULINE PL
Suite No
Vicinity: SECOND STORY ADDITION
Parcel Nunmber: 42614108
Applicant: DENNIS SIGGINS
Address: 1313 MILLER STREET
ANAHEIM, CA
owner: SLOMAN,AARON
Address 227 PAULINE PL
COSTA MESA, CA
Contractor: DENNIS SIGGINS
Address: 1373 MILLER STREET
ANAHEIM, CA -
Arch / Eng : ,
Address:
PLUMBING PERMIT
Phone: (714)961-1878
Zip: 92806
Phone: 714-961-1878
Zip: 92627
Phone:. p14)961-1878
Zip: 92806
License: 327341
Phone:
Zip:
+ License:
RMIT NUMBER
P00-00135
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 03/76/2000
Issued: 03/i6/2000
ISSUED BY: �� �/
SCOPE OF PERMIT
1 BATHTUB, 4 GAS OUTLETS, 1 SHOWER, 2 WASH BASINS AND 1 WATER CLOSET FOR 777 SF
SECOND STORY ADDITION. _
1:7�71:LbII�AiIK7
ISSUE FEE
BackFlow irrigation
BackFlow Preventer
Bathtub
Clarifier System
Connect pce,Soda,elc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
AMT
$23.50
$0.00
$0.00
$9.80
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
FEE SUMMARY
QTY AMT
Laundry Tub / Washer $0.00
0 Landscape Irrigation $0.00
0 P-Trap $0.00
1 Pressure Regulator $0.00
0 Process Piping (per 10 ft) $0.00
0 Receptors $0.00
0 Septic Tank $0.00
0 Sewer Cap for Demo $0.00
0 Sewer Connect $0.00
0 Sewer Private line $0.00
0 Shower $9.80
0 Sink, bar $0.00.
0 Sink, commercial $0.00
QTY
0
0
0
0
0
0
0
0
0
0
1
0
0
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr Bkflow(1-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$19.60
$0.00
$0.00
$9.80
$0.00
$0.00
$0.00
QTY
0
0
0
0
0
0
2
0
0
1
0
0
0
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremants under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 780 days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION:
I here6y attirm untler penalry of perjury one ot the following tleclarations:
❑ I �ave and will maintain a certificate of consent to self-Insure for workers' compensetion, as provided for by section 3700 of the Labor Cotle, for the peAormance of ihe
work tor which Ihis permit is issuetl. '
� 1 have and will maintain workers' compensation insurance, as reQuired by section 3700 of Ihe Lebor Code, for the pedortnance of tha work for which Ihis permit is issued.
My workers' compensation Irisurence carrier end policy number are:
Carrier Policy Number:
(Thls secfion neetl not be completed il the permit is valued at one hundretl tlollers ($100J or less.)
❑ I cetlify that in the p or ance of ihe work or which this permit is issued, I shell not employ eny person in any manner so as to becoma subjact to the workers'
compensation laws C fornia, and agree � t if I should become subject to the workers' compensation provisions of Section 3700 of Ihe Labor Code, I shall fonhwith
complywiththese ov' ons. • ` �
Applicam Signature: �G1.�"'� Date: �' ��" �
WARNING: FAILURE TO SECURE WORKERS' fAMPENSA I� C VEPAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FWES UP TO ONE HUNDRE�
T}K)USANDDOLLAflE(5100,0OO�,INAODITIONTOTHEW O MPENSATION,OAMAGESASPROVIDE�FORINSECTION3IO60FTHELABORCODE,IfdrEREST,PNDATTORNEY'SFEES.
LICENSED CONTRACTORS DECL TION: '
I hereby aftirtn that I am licensed nde provjsions of Chap r(commencing with Section 7000) of Division 3 of the Business an�ofessions Code, antl my licanse is in full
torce antl eflect. Lic. # 7 Y� ' qass k
ContractoYs Signature: Date: ��/ �. �
CONSTRUCTION LENDING AGENCY:
❑ I hereby attirm ihat ihere is a consimction landing agency for the pertormance of ihe work for which ihis permit is issued. (Sec. 3097, Civil Code).
Lentler's Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I �ereby aHirm ihat under penalry of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for �he following reason (Sec. 7037.5, Business antl Protessions
Cotle: Any ciry or counry which requires a permit b consimct, alter, impmve, demolish, or repair any strucWre, pnor to its issuance, also requires the applicant for such permit
to file e signed statement ihat he or she is licensed pursuam to ihe provisions of Ihe Contradors License Law (Chapter 9(commencing with SeIXion 7000) of Division 3 of the
Business and Professions Codo) or that he or she is exempt thereirom and the basis for the alleged ezemption. Any violation of Section 7031.5 by any epplicant for e permit
subjecfs Ihe applicant to a civil penalry of not more than five hundred dollars ($500).):
❑ I, as owner ot the property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the structure is not intentled or otteretl tor sale (Sec.
7044, Business and Professions Cotle: Tne Contractors License Law does not apply to an owner of property who builds or improves thereon, antl who does such work
himself or herself or ihrough his or her own employees, provided ihat such improvements are not intended or ottered for sale. If, however, the building or improvement is
soltl within one year ot completion, the owner-builtler will have the burden ot proving that he or she did not builtl or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sea 7044, Business antl Pmfassions
Cotle: The mniractors License Law tloes not apply ro an owner oF property who builtls or improves fhereon, and who coniracts for such project with a contracror(s)
license pursuant to ihe Coniraciors License Laws.).
� I am exempt under sec. Business and Professions Code for ihis reason:
Signature: Date:
Owner ID verifietl by tlriver's license. � Yes ❑ No Drivers License No. Expires:
Verification ot Ownership by (type of tlocument, i.e. - propetly tax bill or deed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CER7IFICA710N:
❑ I hereby certity Ihat no eacavation five (5) or more feet in depih into which a person is requiretl to descend, will be made in conneciion with work authorizetl by this
permit, antl iha� no building SimcWre, scaffolding, falsework, or tlemolition or dismantling lhereot, will 6e more than t�irty-siz (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, California Adminisirative Cotla).
❑ As owner-builtler, I will not employ anyone to do work which woultl require a permit from the Division of Industrial Safery, as noted above, unless such person has a
permit ta do such work irom tha tlivision.
Signature: Date:
Division of Industrial Safely Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will ihe applicant or present or future building wcupant neetl to file and cetlity a Business Plan for emergency response to release or Ihreatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 ot Ihe California Healih antl Safoty Code requires, wilh some exceptions, ihat a Business Plan ba filed with the Costa Mesa Fira Depariment by every
business which has at any one time during a reported year a quantity of hazardous materials equal m or greater ihan a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperaNre antl pressure).
2 Does or w"ill t�e applicam or preseN or future building occupant need b file a registration brm br acutely hazartlous materials? ❑ Ves ❑ No
(Section 25533 of �he California HeaRh and Safery Code, with some exceptions, requires registration with the Costa Masa Fire Department by each business which at any
one time has on hand e Quantity of acutely hazartlous materials aqual to or greater than e weighl of 500 pounds, or a volume of 55 gallons, or 200 cu6ic teet of
compressed ges at standard tempereture end pressure).
3 Does or will the applicant or present or future builtling occupant need to prepare an RMPP (Risk Management end Prevention Pmgram for acutely hazardous matenals)7
❑ Yes ❑ No
(Section 25534 of the California Heal�h and Safery Code provides tha[ the Costa Mesa Fire Department may raquire the preparation, cenitication antl tiling with the Fire
Depatlment ot an RMPP by businesses which are required to regis�er acmery hazardous materials with ihe Fire Department.
4 If an RMPP is presentiy required, has Section 25534 of the California Healih and Safery Code been fully complied with? ❑ Yes ❑ No
5 Does or will Ihe applicant or present or futura builtling occupan� require for the work which is the sublect of Ihis a plicaiion a germii for such consimction or modifica�ion
irom the South Coast Air Ouality Manegement Disirict or from eny othE3r air pollution control tlisirict or agency9 � Yes u No
(Section 658502 of the California Government Code requires ihat the requested information be furnishetl on applications for nomresidential builtling permits).
6 W ill any part of �he faciliry to be consimcied untler Nis permit be within 1000 feet from �he outer boundaries of a school? ❑ Ves � No
(If yas", the facillry must meet the requirement of Sections 25534 and 42303 oF the California Health and Safety Code).
........... ........... _ ___.. .......__ .......... .......... . ..._.__.... ...._._............._
7 N a permit irom the South Coast Av Quality Managemen� Disirict or other au pollution control tlisirict or agency is repuued for the work which is the subject ot Ihls
application, have all of the tlisclosures prescribed by Califomia Healih and Safety Cotla Section 42303 been made� ❑ Ves ❑ No
Qt yes", attach certificate of compliance from thi
CERTIFICATE OF COMPLIANCE: 1 certity ihat
regartling Hazardous Materials and Emissions.
Signature:
penalty of perjury ihe information given above is wrrecL I agree to comply with all state laws antl ciry ortlinances
Date:
CER7IFICAtE OF COMPLIANCE AND AU7HORIZATION OF EN7RV: I certify under penalty of perlury that I have read this appiication and state ihat the information given is
correct. I agree t ompiy with all state laws and city ordinances relating to building consimction, and authorize representatives of ihe Ciry of Costa Mesa to enter upon the
above-tlescn pr perry for inspection puryoses. I agree not to occupy or allow occupancy of any builtling authorized by this permit until final inspection.
C N INSPECTIONTVPE
1616 Fixed System Final Fire Prevention
1266 Pool Spa Finai
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Finai 5ign
204 Final Demoiition
2aas as
�
0
INTI� ��EN INSPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212
220
222
250
Final Fire Prevention
Final Planning Approval
Final Site
Final Building/Occupancy
3-/(_ O'O
Date
P9IE
' . J:
(714)754-5273 • Fax(714)754-4856
Job Address: 227 PAULINE PL
Suite:
Vicinity: SECOND STORY
Parcel Number: 42614108
Applicant: UNKNOWN
Address:
Owner: SLOMAN,AARON
Address 227 PAULINE PL
COSTA MESA,CA
Contractor. DENNIS SIGGINS
Address: 1313 MILLER STREET
ANAHEIM, CA
Zip: 92806
Arch :
Address:
CITY OF. �OSTA MESA '
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
Zoning:
Phone:
Zip:
Phone: 714-961-1878
2ip: 92627
Phone: (714)961-1878
License: 327341
B00-007%3
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 02/10/2000
Issued: 03/16/2000
ISSUED BY: CJ 1 ► /
Eng: PIN CHING LI
Address:
Phone: Phane: 905-595-7755-
Zip: License: License: 38408
SCOPE OF PERMIT
777 SF 2ND STORY ADDITION AND 60 SF FRONT PORCH. 2 BEDROOM AND BATH. REPLACE EXIST. FRONT WINDOW .
Plan Check: $495.79
Permit: $762.75
SMIP Res: $6.69
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Totai: $1,265.23
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Existin : o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
$66,920.50
so.00
NOTICE: The work authorized by ihis permit shall comply wi�h all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § i, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspendad 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 Inepectlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WOfiKERS' COMPENSATION �ECLAqqTION: , " '
I h¢eby aHirm under penalry of perjury one of the following tleclaretions: �
❑ I heve and will maintain a certificate of conseni to selt-Insure for workers' compensetion, as provitletl tor by section 3700 of the Labor Cotle, for tha pedormance ot the
wo�k for which Ihis permit is issued. -
�� 1 have and will maintain workers' cqmpensation insurenca, as requlred by section 3700 of lhe Lebor Code, for the pertormance of the wofic for whic� Ihis pertnit is issued.
My workers' compensation Insurance carrier antl policy number ere:
Cerrier. S� �C% �� Policy Number.
(lhis section need not 6e completetl il the pertnit is va/ued et one hundred dollaro ($100) or less.)
❑ I certify that in the peA nce o} ihe work for w ich this pertnit is issued, I shell noi employ any person in any manner so as to become subject to the workers'
crompensation laws ol ali rnia, and egree t�et i hould become 5ublect to the workere' cnmpensation provisions of Section 3700 of t�e Labor Cotle, I shell forthwith
comply wit� Ihese r visi s. • /
Appliwnt Signawre: �� Date: � �C�"� �
WAANING: FARURE TD SECURE WORKEPS' �pMPEN5AT10N GE IS UNLAWFUL AND 5/44LL SUAIELT AN EMPLOYER TD CRIAUNAL PENAlT1E5 AND pVIL FINES UP TO ONE HUNDRED
THOUSAND DOILFRE (5100.000), IN ADDfiION TO THE COST O NSATION, DAN4GE5 AS PROVIDED FOR IN SECTION 31060F THE LABOR ODDE, IMEREST, AND AiTORNEYS FEES.
LICENSED CONTRACTORS
I hereby ettirm t�at I am lice
force antl eHecL Lic. # �
Contractor's SignaNre:
of pter 9(commencing with Section 7000) ot Division 3 oi the Busine��nd Professions Code, and my license is in full
Class a CJl _
Data: i—��—�
CONSTRUCTION LENDING AGENCV: V V
❑ I hereby ettirm that there is a construction lending egency br Ihe pedormance of iha work for which ihis permit is issued. (Sec. 3097, Civil Cotle).
Lentler's Neme:
Signature: _
OWNER-BUILDER DECLARATIONS:
Lentler's Atldress:
Dale:
I hereby affirm that untler penalty of perj4ry �hat I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for ihe following reason (Sec. 7031.5, Business antl Profassions
Code: Any city or wunry which reQuires a pertnit to construct alter, improve, demolish, or repair any stmcfure, pnor fo its fssuance, also requires the applicant for such permit
to file a signetl statement that he or she Is licensed pursuem to Ihe provlslons oi Ihe Contrectors License Law (Chapter 9(commencing with SecNon 7000) of Division 3 of Ihe
Business antl Professions Code) or that ha or she is exempt therefrom and the basis lor the allaged exemption. Any violation of Section 7031.5 by eny apD�icant for a permit
sub�ects the epplicant to a civil penalty of not more than live hundred dollars ($500).):
❑ I, as owner oF ihe property, or my Bmployees with wages as their sole compenselion, WILL DO THE WORK, antl ihe structure is not intended or oHered for sale (Sec.
7044, Business antl Professions Cpde: The Contractors License Law tloes not epply to an owner of property who builds or improves ihereon, and who tloes such work
himself or herself or ihrough his or her own employaes, Orovided thet such improvements are not intended or offered tor sale. If, however, the building or improvement is
soltl within one year ot completion, ihe owner-builtler will have tha burden ol provinq that he or she ditl not build or improve for purpa5e of saleJ.
❑ I, es owner of the property, am EXCLUSIVELV CONTRACTINC WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions
Cotle: The contraaors License LaW tices not appty to an owner of pmpeny who builds or imDroves thereon, and who comracis for such project with a coniractor(s)
license pursuant to the Contractors License Laws.).
❑ I am ezempt under sec. Business end Professions Cotle for this reason:
Siqnature: Date:
Ownar ID venfied by drivers license. ❑ Yes ❑ No DriverS License No. Ezpires:
Veritication of Ownership by (rype of daument, i.e. - property taz bill or Geed):
DIVISION OF INDUSTRIAL SAFETY P�pM1T CER7IFICA710N:
❑ 1 hereby certi(y that rro ezcavation (ive (5) or more feet in depth into which a person is reQuired to descerW, will be matle in connection with work authorizetl by this
pertnit, end that no building structure, scaflolding, felsework, or damolition or tlismantling t�ereof, will be more ihan thirty-six (36) teet high. (Chap. 3.2, Grp 2, An 2, Sec.
347, Ttle B, Califomia Administratiye Cotle).
❑ As owner-6uilder, I will not employ anyone to do work which would require a permit irom iha Division of Industrial Safery, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Sefety Permit Numpec
CER7IFICATE OF COMPLIANCE AND qUTHpRIZATION OF ENTRY: I certify untler penelty of perjury that I have read this application and stale that the intormation given is
correct. I agree m comply wi�h all state laws and city ortlinances relafing m building constmction, and euthorize representatives ol the City of Costa Mesa to enter upon the
ebove-describgd�plpperty for ins0ection purposes. I agreo not to occupy or ellow occupancy of eny builtling authorized by this permit umil final inspectioa ,
�OpE �, INSGECTIONTYPE V
1616 Flaed System Final Fire Prevention
1266 Pool Spe Final
200 Final Re-Root
201 Finel BIocWRetaining Wail
202 Final Factory Fire Place
203 Finel Sign
204 Finel Demolition
2aa&4fi
3-/�-e�
Date
QAjF INiffIALS �1 INSPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
270 Final Electnwl
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 FinalBuiltling/Occupancy
OpTE I�als
NEWPORT-MESA UNIFIED SCHOOL DISTRICT
CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES
PURSUANT TO AB 1600 AND AB 181
To: QC) City ofCosta Mesa
( ) City of Newport Beach
( ) County of Orange
Applicant: D�N nI � r7 il �C� l t.� �j
Address: 13L3 M I L L E�. Gi"[" PrAl4 4-J-�I N� ('�, � 2�0(0
Telephone Number:
0
3328 '��
District Receipt No. I Fp t51
Plan Check No. �` •ODll3
TractlParcel and Lot Number(s): 42(O' �4� •�
Location of Project: 22� Q� �—� �( �- �!�—• (�D� M�i5'�`� , Gi�
Number of Square Feet of:
Residential Space
Commercial and
Industrial Space
Commercial/Industrial Project is: (Check One)
�
Warehouse
R8D
Movie Theater
Mini-storage
Heavy Industrial
Regional Shops
Light Industrial
This project is exempt because
�1� x$1.84
x $ .30
Motel
Bank
_ Neighborhood Shops
_ RacqueUHeatth
_ Hotel
Medical Office
Office Park
Total
Total
Preschool
Auto Repair
Hospital
Large Office
Office Bldg.
Restaurant
Fast Food
This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code sections
53080 and 65995. The Building Perrtuls for this square footage in this proposed development may now be issued by your jurisdiction.
Checks are to be made payable to Newport-Mesa Unified School District.
ey: 12Yt�J M � l.a�
Authorized Representative
The above representation as to square footage is true. Applicant
true, then this certificate shall automatically terminate and the a�
Date: �r����
Applicant
that if it is later determined that such representations are not
ite City/Counly shall be notified.
, PINR 16 20�Q/11:32 A%/f 1423.68
. .�.n kCFi4:a1-�856050
Insulation Certificat
���'� o� ��7�
aa-� /�A��fivV�
Number and Sveet
�T-�9N�
co�,cy s�
Description of Instailation
ROOF �-/_
Matcrial /'! C�.�Gi/
Thickness (inches) _� '�
CEILING
baiv;:;on Lot tiumber
Brand Narne �p� K 7�� /'►�/UV �"V
7hertnal Resistance (R-Value) �— 3�
Batt or Blanket Type Brand Narne
Thicl=ness (inches) 7'hermal Resisrance (R-Value)
I,00sz Fill Type Brand Name
Conu'actor's minimum installed weighdit` Ib Minimum thickness inches
Manufac[urer's installed weight per squaze foo[ [o acheive Thermal Resistance (R-Value) _
EXTERIOR WALL j� �p
Material ��y� li� �
Thickness (inches) _ .� «
RAISED FLOOR
Matetial
'I'hickness (inches)
SLAB F400R
Material
'I'hickness (inches)
Widih (inches)
FOUNDATION WALL
Material
Thickness (inches)
Declaration
Srand Narne ����/fY!/`"Cr
T'hecmal Resiscance (R-Value) �j / 3
Brand Name
Thermal Resistance (R-Value)
Srand Narne
Thermal Resistance (R•Value)
Brand Narne
"Ilierma] Resistance (R-Value)
I hereby certify that the above insulation w3s installed in the building at the above location in confomance u, i��
the current Building Energy Efficiency Standa;ds for new residential buildings con[ained in Tide 24 of the
Califomia Adminisva[ive Code.
1�! 5 {�.s
Genet Coneactor (Buildzr) ,,�p
�'�.C1/�`�1L
igna rz dTide
Sub-Convacwc (Insulation Lutaller)
Signanue andTide
'�a� �� i
License Number
�l`1.�l—�
Date
License Number
Comp��wce Forms J�uary I, 1995
L�� M�s
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��ia� �sa-sz�3 • Fa: (�ia) �sa-aess
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
ADDITION.
CITY OF COSTA MESA
BUILDING DIYISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
227 PAULINE PL
SECOND STORY ADDITION
42614108
DENNIS SIGGINS
1313 MILLER STREET
ANAHEIM, CA
Owner: SLOMAN,AARON
Address 227 PAULINE PL
COSTA MESA,CA
Contrador: DENNIS SIGGINS
Address: 13f3 MILLER STREET
ANAHEIM,CA
ELECTRICAL PERMIT
Phone: (714)961-1878
Zip: 92806
Phone: 774-961-1878
Zip: 92627
Phone: (714)961-7878
Zip: 92806
License: 327341
NUMBER
E00-00224
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 03/16/2000
Issued: 03/16/2000
ISSUED BY: c�r / ' 1
SCOPE OF PERMIT
1 RES A/C PACKAGE, 12 LIGHTS, 20 OUTLETS, 12 SWITCHES FOR 777 SF SECOND STORY
��: E2ir�-CX��� �
FEE SUMMARY
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to t000a
Service over 1000a
Motors to 1 hp
Motors to t Ohp
Motors to SOhp
Motors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
$23.50
$0.00
$54.50
$0.00
$0.00
$0.00
$1320
$22.00
$13.20
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$o.00
$0.00
$0.00
$0.00
50.00
Quantity
0
0
0
12
20
12
0
0
0
0
0
0
0
0
0
0
0
0
0
Temp Dist System I Lighting
Buswayl100ft
Standing Section
Misc Electrical Equipment
Transformers up to 1 kvalkw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System I Ckt
Misc. Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tiee Stand
Fireworks Stand
Other Eledrical Fee
i
�nvestigatiori Fee
Plan Check Fee
Reinspection ,Fee
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
So.00 0
$0.00
so.00
$0.00
so.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for ihe work authonzed under this permi� to be considered legal, such work must comply with all applicable codes, and all
requlred Inspeetlona antl final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754•5626
WORKERS'COMPENSATION DECLARAnON:
I herehy ettirm under penalty of perjury one of the following declarations:
❑ I have end will meintain a certificate ot consent to self-Insure for workers' compensetion, as D�ovidetl tor by sectlon 3700 0l the Labor Cotle, lor ihe pertormance of the
work for which this permit is issuetl.
� I hava and witl maintain workers' compensation insurance, as required by section 3700 of the Lehor Code, for the peAortnance ot the work for which this permit is issuetl.
My workers' compensation Insurance carrier antl policy number ere:
Carrier. Policy Number:
(This section need not be completed I! the permit is veluetl e( one hundred dollars ($ f 00) or /essJ
❑ I certity that in the ormance of Ihe wo for which this permit is issuetl, I shall not employ eny person in eny manner so as to become subject to Ihe workers'
compensa[ion law 1 elifomia, entl egre iat if I should become sublect to ihe workers' compensation provislons of Section 3700 of the Lebor Cotle, I shell forihwith
comply with Ihes r isions. ` �
Applican� SigneNre: _ Deia: � ��� O
WAAMNG FAIWRE TO SECURE WORKERS' COMPEN A I COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE HUNDRED
TFK)USANDDOLLAqE(5100.000),INADDfTIONTOTHE WMPENSATION,DAM4GESASPROVIDEDf-0RINSECf10N31060FTHEL400RCODE.IMEREST,ANDAiTORNEY'SFEES.
LICENSEDCONTRACTORS
I hereby alfirtn Ihat I am licen�
fome antl eXecL Lic. a_i
CONSTRUCTION LENDING AGENCV:
9(commencing with Section 7000) of Division 3 of the Busine,�s �yd Professions Cotle, antl my licensa is in full
Class a �01.
�!�-O Date: .'i — /( � O
❑ I hereby aHirtn t�at there is a construction lentling agency for the pertormance ol the work br which this pertnit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lentlefs Address:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aHirm t�ai under penalry of perjury ihat I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW br ihe following reason (Sec. 7031.5, Business and Pmfessions
Code: Any ciry or counry which requires a permi� to consiruct, alter, improve, demolish, or repair eny stmcWre, prior to i�s issuance, also requires ihe applicant for such permit
b file e signetl ste�ement that he or she Is licensed pursuent to Ihe provislons of the Contractors Licanse Lew (Chapter 9(commencing with Section 7000) of Divlsion 3 ot the
Business end Protessions Code) or ihat he or she is ezempt therefrom and the basis for Ihe allegetl ezemption. Any violation of Sectlon 7031.5 by eny applicant tor a permit
subjects t�e applicant to a civil penalty of not more than five huntlretl tlollars ($500).):
❑ I, es owner of Iha propeny, or my employees with wages as iheir sole compensetion, WILL DO 7HE WORK, end the siruciure is not intended or oRered for sale (Sec.
7044, Business and Pwfessions Coda: The Coniractors License Ww does not apply to an owner of pmperty who builds or improves thereon, antl who doos such work
himself or herself or thmugh his or her own employaes, provided that such improvements ara not imendetl or oNered for sale. If, however, ihe building or impmvement is
soltl wit�in 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 EXCLUSIVELV CONTRACTING WITH LICENSED CONTRAC70RS to constmct the project (Sec. 7044, Business and Professions
Code: The con�recior5 License Lew dces not appty to an owner oi property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant ro t�e Contractors License Laws.).
❑ I am exempt under sec. Business antl Professions Code for �his reason:
SiqnaNre: Date:
Owner ID veriliad by tlrivefs license. ❑ Yes ❑ No Dnver'S License No. Expires:
Venfication ol Ownership 6y (rype of document, i.e. - property tax 6ill or deed):
DIVISION OF INDUSTRIAL SAFETY VERMIT CERTIFICATION:
❑ I hereby certity �hat no excavation five (5) or more feet in tlepth into which a person is requiretl to tlascend, will be made in connection with work authorized by this
pertni6 and Ihat no building sirudure, scattolding, falsework, or tlemolition or dismantling thereof, wlll be more ihan thirty-siz (36) feet high. (C�ap. 32, Gry 2, An 2, Sec.
341, Ti�le B, Califomia Atlminis�ra�ive Cotle).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safery, as noted above, unless such person has a
permit ta do such work irom the tlivision.
Signature: Date:
Division of Indusirial Sefe�y Permit Num6er:
CERTIFICATE OF COMPLIANCE AND AUlHORIZATION OF ENTRV: I certify under penel�y ot perjury �hat I have raetl this application and state that ihe inlormation given is
correct. I agree to co y with all state laws and ci�y ortlinances relating to Cuilding consimction, end au�honze representatives of the City of Cos�a Mesa �o en�er upon �he
abova-tlescribed p pe lor inspection puryoses. I agree not to occupy or allow occupancy of eny building authorizetl by this permit until final inspection.
['T'II����6i9S41I.PJ�/'J3
1616
126fi
Fizetl System Final Fire Preventlon
Pool Spa Final
200 Final Re-Root
201 Final BIocWRetaining Wall
202 Final Fectory Fire Place
203 Finel Sign
204 Final Demolition
2aa6 46
pATE INiIfIAlS
3 /L, - c7-C�
Date
COOE I INSPECTION TYPE
206 Final Mechanical
208 Final Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Finel Planning Approval
222 Final Site
250 Final Builtling/Occupancy
� �NTRIA�S
�e'� • r /I,��
CITY OF COSTA MESA
CALIFORNIA 92628-1200 P.O. BOX 1200
DEVELOPMENTSEFVICES DEPARTMENT
MINOR MODIFICATION
Reference No.: B00-00173
Status: APPROVED
Applied Date: 02-10-2000
Approved Date: 02/10/Z000
Denied Date:
MINOR MODIFICATION NO.: MM-00�07
Project•Address: 227 PAULINE PL
Suite:
Parcel Number: 42614108
Project Applicant: SLOMAN,AARON
PROPOSED MINOR MODIFICATION: A MINOR MODIFICATION TO ALLOW A 16.5 FOOT FRONT YARD
SETBACK FOR SECOND STORY ADDITION. EXISTING FIRST STORY HAS
14.5 FOOT FRONT YARD SETBACK.
REQUIRED FINDINGS:Y The improvement will not be materially detrimental to the health,
safety and general welfare of persons residing or working within the
immediate vicinity of the project or to property and improvements
within the neighborhood.
PROJECT PLANNER:
NOTES:
The improvement is compatible and enhances the architecture and
design of the existing and anticipated development in the vicinity.
This includes the site planning, land coverage, landscaping,
appearance, scale of structures, open space and any other
applicable features !elative to a compatible and attractive
development. '
BOUWE_W
SEE DESCRIPTION
77 FAIR DRIVE
ie Enforcemen� (714) 754-5623 • Planning Division (714) 754-5245
� 75d-4856 . TDD (714) 754-5244
4�,�'`� MF q CITY OF COSTA MESA
° BlIILDING DIVIS►ON
>
� DEVELOPMENT SERVICES DEPARTMENT
� PERM
Existin : 0 Required: 0 �Troposed: 0
��ia) �sa-szia • Fax (714) 754-4856
Job Address: 227 PAULINE PL
Suite No
Vicinity: SECOND STORY ADDITION
Parcel Number: 42614108
Applicant: DENNIS SIGGINS
Address: 1313 MILLER STREET
ANAHEIM, CA
Owner. 8LOMAN,AARON
Address: 227 PAULINE PL
COSTA MESA, CA
Contractor: DENNIS SIGGINS
Address: 1313 MILLER STREET
ANAHEIM, CA
Arch I Eng :
Address:
REF:B00-00773
MECHANICAL PERMIT
Phone: (714)961-1878
Zip: 92806
Phone: 714-961-1878
Zip: 92627
Phone: (714)961-1878
Zip: 92806
License: 327341
Phone:
Zip:
License:
SCOPE OF PERMIT
1 FAU, 7 A/C UNIT AND 7 VENT FAN FOR 777 SF SECOND STORY ADDITION.
ISSUE FEE
Inst FAU <700 k BTU
Inst FAU >100 k BTU
Repair/AII CoolinglHeat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >700 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
AirHandlers> 10000cfin
$23.50
$14.80
$0.00
$0.00
$0.00
$14.80
$0.00
$0.00
$0.00
$0.00
$0.00
57.25
$0.00
50.00
$0.00
$0.00
$0.00
so.00
Quantity
FEE SUMMARY
NUMBER
M00-00110
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Repair I Alt Absorbtion Unit
Repair / Alt Refrigeration Unit
Ventillation System
Evaporative Cooler
Commercial I ncinerator
Domestic Incinerator
Compressors / Absorotion Svstems
Upto3hp/t00kBTU
3To15hp/500kBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilere
Up to 3 hp
3To15hp
75 t0 30 hp
30 to 50 hp
we� so nP
Status: ISSUED
Applied: 03/16/2000
Issued: 03/16/2000
Quantiry
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
�
�
�
�
0
0
0
0
0
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia 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 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order fo� tha work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inapectlons and final epproval must be obtained. Failure to obtain inspections and final approval will resutl in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WOfiKERS' COMPENSATION DECLARATION:
I hereby affirm untler penalty of perjury one ol ihe following tlecleralions:
❑ I have and will maintain a certiticate oi consent to seli-Insure tor workers' compensation, es provided tor by section 3700 of ihe Labor Code, tor the pertormance of the
work for which Ihis permi� is issued.
�. I have and will maintain workers' compensation insurance, as required by section 3700 of the labor Cotle, for the peAormance oi the work for which ihis permit is issuad.
My workers' compen5ation InSurenca Carrier end policy number are:
Cerrier: Policy Number.
(This section need nof be comp/efed il the permif is valuetl ef ane hundred dollers ($100J or less.)
❑ I certify that in the peA {mance of ihe work for which ihis permit is issued, I shell not employ eny person in any manner so as to become subject to Ihe workers'
compensetion lews oi alitomle, and egree at if I shoultl become subject to the workers' compensetion provisions ot Section 3700 of ihe Labor Cotle, I shall forthwith
compty with these p vi (ons. � �
ApplicaniSignature: Date: �����
WARNING: FAILURE TO SECURE WORKERS' COPAPENS OVERAGE IS UNIAWFUL AND SHALL SUBIECi AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDiiED
THOUSANOOOLLARE�S100,OW),INA�DRIONTOTHE COMPENSATION,DAMAGESASPPOVIOE�FORINSECTION3IWOFTHELABOR��E,INrEREST,ANDATTORNEYSFEES.
LICENSEDCONTRACTORS
I hereby aHirtn that I am licen;
lorce and eflect. Lic a�
ConiracroYs Signature: �
CONSTRUCTION LENDING AGENCV:
9(commencing with Section 7000) of Oivision 3 of the Business and Pro(essions Code, and my license is in full
Class N !� �
�.Y Date: .3— /�—
❑ I hereby aNirm Ihat there is e conswction lending agency for Ihe pedormenca of t�e work tor which this pertnii is issuetl. (Sec. 3097, Civil Code).
Lendefs Name: Lendefs Atltlress:
Signalure:
OWNER-BUILDER DECLARATIONS:
Dare:
I hereby aHirtn thet undar penalry of perjury ihat I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7037.5, Business antl Professions
Cotle: Any ciry or counry which requires a permit to consiruct, elter, impmve, demolish, or repeir eny strucWre, prior to its issuance, also requires the applicant (or such permit
to tile a signed statement Ihat he or she is licensed pursuem to the provisions ol the Contractors License Law (Chapter 9(commencing with Section 7000) ot Division 3 oi the
Business and Professions Cotle) or ihat ha or she is exempt therefrom antl Ihe basis for ihe allagetl exemption. Any violation of Saction 7037.5 by any epplicant for a permit
subJects tha applicant to e civil penalry ol not mora i�an five huntlred tlollars (5500).):
❑ I, as owner of tha properry, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the structure is not intended or oHeretl for sala (Sec.
7044, Business and Professions Code: The Contrectors License Law does no� appty to an owner ol pmperry who builds or improves Ihereon, antl who does such work
himself or hersetl or through his or her own employees, providetl t�at such improvements are not intended or oNered for sale. If, however, iha building or improvement is
sold within one year oi completion, the owner-builder will have ihe burdan of proving ihat he or she tlitl not builtl or improve for purpose oi sale.).
❑ I, as owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, eusiness end Professions
Code: The coniractors License Lew does not apD�Y �o en owner of property who builtls or improves thereon, and who contracts tor such project with a contracbr(s)
license pursuent to Ihe Contractors License Lews.).
❑ I am e:empt under sec. Business and Professions Code tor this reason:
Signature: Date:
Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No.
Verification oi Ownership by (type of tlocumeni, i.a. � property tax bill or daed):
Expires:
DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIFICA710N:
❑ I hereby certity Ihat no eacavation live (5) or more feet In tlepth into which a person is requiretl to tlescentl, will be matla in connection with work authorized by ihis
permi�, and that no Duiltling stmcture, scaflolding, talsework, or tlemolition or dismanUing ihereoi, will be more ihan t�irty-six (36) feet high. (Ghap. 3.2, Grp 2, An 2, Sec.
341, Title 8, California Atlminisiretive Cotle).
❑ As owner-builder, I will not employ anyone to tlo work which would require a permit from �he Division of Indusirial Sefety, as noted above, unless such person has a
permit to do such work from lhe division.
Signeture: Date:
Division oi Industnal Safety Permit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENfFiV: I cenity under penalry of perjury that I have read ihis application and state that �he information given is
correci. I agree to comply with all stele laws and ciry ordinences relating to huilding construction, and authonze representatives of the Ciry of Casta Mesa to emer upon Ihe
above-tlescribed property for inspection purposes. I agree not to occupy or allow occupancy ol any �uiltling authonzed by this permit until final inspection.
GOOE I, INSPECTIONTYGE �" P9IE INTRI�LS
1676 Fixed System Final Fire Prevemion
1266
200
201
202
203
Pool Spa Final
Final Re�Roof
Final BIaWRetaining Well
Finel Factory Fire Placa
Final Sign
204 Final Demolition
2496-98
3—l1-,- ��e
COpEr �NSPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Flnal Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
�O
Lot D
oWN�R EXTEN5IUN I� INC. DATE 12-5-61
JOB ADDRESS 2p7 Pauline Place (LOt D� BUILDING PERMIT NO. 1 a9d
GENERAL CONTRACTOR QOth Century Homes VALUE $ 9,Y40.00 �
AY No.118-112-Ob LOT TRACT PIRE ZONE DESCRIPTION OF WORK Res.w�att.
INSPECTIONS � Signature � DATE GROUP I&�j TYPE p 7.ONE g_�
�
coat �'S f'I� 1�— I 7_
OCCUPANCY
ORM FI14 � 5M -
SUBCONTRACTOR
, ���� ; �
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 8�7 COHTA MEBA. CALIPOflNIA
For Appiicant +o Fili in Completely
1/'� f'f fll TYPE OR PRINT
� ARCHITECT
MESA. CALIFQRNIA-t— �
__r��/ � r��_t�__C
� '%� i„ i r
— �% t�lru�t=�l
�,l,c UAK�IE o:
1.I 1 "i'1�'l� t A�NEO.
..i,i±�ll�(`G��i iai.Rx1
CITY `��i � t L h��. �(J � h � I .
STATE � � LE c�;7 TE � "
LIC. NO. NO. b
SIZE /� � I NO. OP lLDGB.
OF LOT �-� _�." x 7 r. x �7 )�.t` Now ox Lor
UBE OF
EXIBTING BLDG �J_
BETBACK LINB FRON
cetRBR o� aTx[ei REAR YARD �/
61DE YARD LHFT �� IRIGHT
DESCRIPTION OF WORK
���J X •3��/�ROOMS "-� STOF
WALL IROOP
COVERING
i1LDING AND WORK TO BH PERPORMHD
� xeneer �cKnowus�
ANO 9TATH TNAT THB
PLY WITX ALL GIiY O
BUILDINU CONBTROGn
SIGNATURH OF �
PERMITTHF.��
AUTHORIZED AGENT
�
�
x.ve xv�a n+�e �rruunon
CORPBCl�AND �OIiHB TO LON-
AND 8TAT6 L+�WB N86ULATINO
FEE RECEIVED
�NOV 27 t961
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
� BUILDING
' ' For Office Use Only
HELHIPT NO. PHNMI
�.�
MEC8IVHD SY DAT£ qECH1VED DATB 188UED
��..�so // /! - C/ I ! 2' J � �e /
a, �. 7 7�a��C%., ,.,
COSTA MESA. CALIFORNIA
FIRE
ZONING '
20 NO.OP U8H OF NEW f/Y� ��
�+� IPLAN9 � BUILDINI��r� �
HBCPIPTION �� '��" Zr� �!-�h'� �'C
A. P. NO.
/�� - //L-O�
YARDS EVES
APPROVED ALLOWED
lC6NTHR LINe OTJ
FRONT � FT. IN.
R. SIDE S FT. IN.
L. SIDE `s� FT. -- IN.
o�.e r � �_ -- ..,
r�/:�/�,
'320 a�.� � %i �/
TH8 AMOUM BHOWN UNOeH V�LUATION 18 POq TNe
PUftP09H OP EHTABLI8NIN0 A P¢qMIT F8¢ ONLY.
VALUATION '/
PERMIT FEE $ �i'• 6�
S C/ % y�U PLAN CHECK $ �� •�
/� � '
/ M
TOTAL FEE 3 b.