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Home My WebLink About2925 PEMBA DR - Building Permits� - q�� i •.:..::: ; : � CITY OF COSTA MESA � BIIILpIM6 DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-5273 • Fax (714) 754-4856 JobAddress: ZJZS PEMBA DR Suite No Vicinity: Parcel Nunmber: 13926305 npp�icant: LALIDERTE, ROLAND Address: Owner: GORDON, JACK J Address 2925 PEMBA DR COSTA MESA, CA Contractor: MASTERSERV INC Address: 2804 HONLULU AV VERDUGO CITY, CA Arch/Eng: Address: GAS REPIPE OF EXISTING SFD. ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifer System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roo( Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 ouHets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $22.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.ao $0.00 $0.00 so.00 50.00 $0.00 $0.00 $0.00 3875 $0.00 $0.00 S0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 PLUMBING PERMIT Phone: Zip: Phone: Zip: 92626 Phone: 818-957-8965 Zip: 91046 License: 580017 Phone: Zip: License: SCOPE OF PERMIT FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop �$0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS NUMBER T7 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: O6/09/1999 Issued: O6/09/1999 ISSUED BY: 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 (Toileq Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOL4TION PLAN CHECK REINSPECTION TOTAL CALCULATED FEES: AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 50.00 $0.00 $30.75 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap accass requirements under California statutas 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 tor the work authorized under this permit to be considered legal, such work must comply wi�h all epplicable codes, and all requlred Inapeetiona end final approval must be obtained. Failure to obtain inspections and final approval will result in tha expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSATION DECLARATON: . I hereby attirm under penelry oi perjury one of the following declarations: ❑ I have antl wlll maintein e certiticate oi consent lo sel4lnsure lor workers' compensation, as provided for by sectlon 3700 of the Lebor Cotle, for the peAortnance oi the work for which this permii i5 issuetl. ❑ i I have antl wlll maintain workers' compensaiion insurance, as require� Oy SecGon 3700 oi the Lebor Cotle, tor the peAormance oi the work tor which this pertnit is issued. My workers' compensatlon Insurence carrier antl policy number are: ca��a�: (�vllrl��r7 �.9f�(f-� POIicyNumber. �iLCG%L' ,SCI.� �%U-C7I (This secNon neetl nat be comp/eted it fhe permit is velued et one huntlred dollers ($100) or /ess.) ❑ I certity that In the peAormance of the work for which thls permit is Issued, I shall not employ any pereon in eny manner so as to become subjact to ihe workers' compen5ation laws ot Celifomia, entl agree Ihet if I shoultl 6ec me sub�ect to ihe workers' compensation provisions of Section 3700 0l Ihe Lebor Code, I shall foRhwith comply with ihese provi ' s / �+ Applicenl Signature: 1/Q��_ -�/�i� Da�e: !O —�'�/ "�� WAPNINO: FAILURE TO SECURE WORKEFiS' COMPENSATION CAVERAGE I$ UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES ANO CIVIL FINES UP TO ONE HUNORED THOUSAND DOLI.ARE (5100,000), IN ADDRION TO THE COST OF COMPENSATION, �AMAQES AS PROVIOED FOR IN SECTION 3/O60F THE LABOR CODE, IFf�EREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLAiIATION: I hereby attirm thel I em licensed untler provisions oi Chepter 9(commencing with Sectlon 7000) of Divislon 3 of iha Busine�sj antl Professions CoCe, antl my license is in full . torca entl etteci. Lia a / Clau a C' 3�i ComractoYs Signeture: "�� oate: �, -i -�'i 5 CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn that there is a construction lending egency for the peRortnence of the work for which this permit is iuuetl. (Sec. 3097, Civil Cotle). Lender's Name: Lentlefs Atltlress: �� SignaWre: Date: OWNER-BUILDER DECLARATIONS: I hereby aflirtn thet under penelty of peryury ihat I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW tor Iha following reason (Sec. 7031.5, Business and Professions Code: Any city or counry which requiras a pertnit to construct, alter, improve, demolish, or repair any structure, pnor to its issuence, also requires the epplicant tor such permit to lile e slgnetl stetement Nat �e or she Is licensed pursuant to ihe provlslons of ihe Contractors License Lew (Cheptar 9(commencing wlth Sec�ion 7000) of Divlslon 3 of Ihe Business end Professions Code) or that he or she is exempt therefrom and the basis tor the allagetl e:emption. Any violatlon of Section 7031.5 by eny epplicant for e permlt subJects the applicant to a civll penalry oi not more than flve hundred tlollars ($500).): ❑ I, es owner ol the property, or my employees with wages es iheir sole compensatlon, WILL DO THE WORK, and the siructure is not intended or oHeretl for sale (Sec. 704a, Business entl Prolessions Code: The Contrectors License Ww does not apply to an owner oi propeny who builtls or impmves therean, entl who does such work himself or hersalt or through his or her own employees, provitlea that such Improvemenis are not intendetl or oflered lor sale. If, howaver, iha building or improvement is sold within one year of completion, ihe owner-builder will heve the burden of proving �het he or sha did not �uild or improvo for purpose of sale.). ❑ I, as owner ol Ihe property, am EXCLUSIVELY CONTRACTNG WITM LICENSED CONTqACTORS to construct the pro�ect (Sec. 7044, Business and Professians Code: The contrectors License Law dces not apply to an ov.•ner of properry who builtls or improves ihereon, and who contracis lor such project with a contractor(s) license pursuant to the Contrecmrs License Lews.). ❑ I am exempt under sec. Business antl Prolessions Code for ihis raason: Siqnature: Data: Owner ID venfied by drivers license. ❑ Ves ❑ No Drivers License No. Expires: Venficetion of Ownership by (type of daument, i.e. � property tax blll or deed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby certify Ihat no ezcavation five (5) or more teet In depih into which e person is required to descend, will be matle in connectlon with work authonzetl by Ihis permil, antl ihat no builtling sirucNre, scettolding, felsawork, or demolitlon or dismantling ihereot, will be more ihan Ihlrty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Callfomie Atlministretive Code). ❑ As ownerDulltler, I will not employ anyone to tlo work which would requlre e pertnit from the Division of Intlustnel Safery, es noted ebove, unless such person has a permil to do such wark irom the tlivision. Signeture: Date: Divisian of Industrial Safery Permit Number: CERTFICATE OF COMPLIANCE AN� AUT}IORIZATON OF ENTRV: I certify under penelry ot perjury that I have read ihis epplication antl stata that Ihe intormation given is correct. I agree ro comply with all state laws end city ordinances reletinq to buildinq constmction, and authorize representetives of Ihe City ot Coste Mesa to emer upon the above-descnbed pro0erty for Inspaction purposes. I agree not to occupy or allow occupancy of any building authorized by this pertnit untll final inspection. Sigry�ture Of ag wn � l _ `/Dete ' ' � �r Aut�onzed Applicant � `�� Date CODE I. INSPECTIONTYPE 1676 Fizetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Finel BIocWRetaining Wall 202 Final Fectory Fire Place 203 Final Sign 204 Finel Demolition 2aa8<6 CODE� INSPECTIONTYPE 206 Finel Mechanicel 208 Final Plumbing 210 Final Electncal 212 Final Fira Preven�ion 220 FinalPlanning Appro�al 222 Finel Site 250 Final BuiltlingiOccupancy PAIE � Itl�1BL9 OWNER KOLL, IC.W, --- �----- �� n-- AP.No. 113-661—OZ LOT THACT FIRE ZONE INSPECTIONS I DATE I GROUP SUBCONTRACTOR OCCUPANCY VALUE Form 210—SM-11-59 5-8 P � 13762 �; . ��2 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f7 COBTA MEBA. CALIFORNIA For Applitanf to Fill In Complefiely YYPE OR PRINT BUILDING ^�y! fi6ml� ADDRESS / .cJ r 6 COSTA MESA. CALIFORNIA � ARCHITEGT Glacb�na ,OH3GI� NO. YI' �6 w• LIQ�NO. /GI O NO./�i'.Q��OI 6IZE NO. OF BIDGB. OF LOT �+oW orv Lor USE OF EXI9TING BLOG. BEfBACK LINE FROM cerviaw oF aipeer REAR YARD SIDE YARD I LEFT I RIGH7 DESCRIPTION OF WORK BUILDING SIZE EXTERIOR WALL NO. OF ROOMS IROOF COVEF iK TO E FEE R�C�IV�� . JAN 3 O igg) l7 �INANC� ��': CIfiY d� C6�fiA M��A APPLICATION FOR PERMIT BUILDING For Office Use Only RECEIPT NO. e {I�{FN�1� � JLU �Jy RECEIVED BY pATE NEC6IVED OATE I66UED �_�-,-�✓ �- �0-6� /-3o-Er_ BUILDING AODRE55 COSTA MESA. CALIFORNIA FIRE 2,pJ�� I NO. OP rl XUSE OF NEV y� PI.ANB f� I BUILDING 1 ! LEGAL OT _ � / / .� � 1'L OJ9 � n o //J A.P.NO. �/ —G�iI—/�d UJ QI'C YARDS EVES O APPROVED ALLOWED (CENTEq LINH 6TJ / �C �ii' �� 1 HEREBY ACKNOWLEDGQ THOM 1 HAV6 R¢AD TH19 APPLIGTION THe AMOUNT BXOWN UNDER VALUATION IB FOR THE AND BTATE THAi THE �eove'Ss GORREGT ANO AGRE6 TO COM- pUPPO6E OF EBTABLI9HING A PERMIT PEE ON�Y. PLY WITX AIA. GITY OROINANCEB ANO eTATE LAW9 REDUI.ATINO ewi.olxa coNeiaUcilPN. VALUATION �� SIGNATURE OF PERMIT FEE $ �D� PERMITfE ^� $ '�COUI`�O PLAN CHECK $ S. � AUTHORIZED AGENT ^ B'� TOTAL FEE /S . OWNER DATE GENERAL CONTRACTORI{,_j�(, Koll VALUE S iA 1�,5_�n AP. No. LOT l7k THACT 7S?O FIRE ZONE DESCRIPTION OF WORK ,.o� ../„++ ,..,,. INSPEC710N5 OCCUPANCY Form 21�SM-11-59 5-e P GROUP SUBCON7RACTOR 12215 d' Lot�174 - Tract 3529 � ' ' l�ti� 5 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 C087A MEBA. CALIPORNIA For Applieanf fo Fill In Completely TYPE OR PRINT AD RE68 2925 Pemba Drive COSTA MESA, CALIFORNIA OWNER Elken Develo ment Co. Inc MAIL - A�DRE65�'ZSSS Placentia Avenie _ ,.,�.....,...+ n,,.,,.�, _ rE�. MI K.w. KO11 1555' Placenti a Avenie I ��TNo. •61195 - No: MI b-3227 SIZE ,., � ' " . . . . . _ � no. on e�.00s. 66TBACK LJNB FROM SO i REAR YARD CENTER OP BTiHET 61�E YARD I LEFf v� I RIGHT lO � DESCRIPTION�OF WORK - BUILDING i8oOSF NO. OF 6 SIZE RtlOMS STORIES 1 EXTERIOR WALL �_ . I R�OF OOD SH I NGL E9 BUILDING AND WORK TO BE PERPORMED 1� � P—FATl1 ��PCI flPTl[`P ttached Garage p�AN 218 FEE tGtiV�.0 ' ,� b��3�(�0 FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only RECEIPT NO. 4!0!(Ij1i0� F nece��I �(._/ '�CO I i��i�"1 7 iSFI em�oiNc ADDRESS COSTA MESA. CALIFORNIA ZONING ZONE I NO. OF I O8E OF NEW R� PLAN6 a Bf1�LO1NG W LEOAL � - YARDS APPROVED ' fC8NT6R LIN[ 8TJ _ PRONT EVES i H6PEBY ALKNOWLEDOH THAT 1 XAVH pQAD TH�B APPLIWTION }N6 AMOUNT BXOWN UNDER VALUATION IB FOR TH¢ �1ND BTATE THI1T TH6 ABOV6 I6 CORNCCT AND A6qE8 TO C04- pUPPOBC OP EBThBL16HING A PERMIT FEE ONLY. PLY WRN ALL CITY OPCINANCEB ANU HTATB L.AWB REOULATNO BUILDING CONBTRURION. VALUATION �p' SIGNATURE OF �J PERMIT FEE $ l7 (J PERMITTE S/�J �J � PLAN GHECK $ I/ AUTHORIZED AG T _ C7