HomeMy WebLinkAbout3189 PULLMAN ST - Building PermitsSeptember 8, 2005
To:
CITY OF COSTA MESA BUILDING SAFETY DIVISION
P.O. BO% 1200 • 77 FAIR DRIVE • CALIFORNIA 92828-1200
DEVELOPMENTSERVICESDEPARTMENT
Building Safety Division
Code Enforcement
Communications
County Clerk
County Planning and Dev. Services
County Registrar of Voters
County Tax Assessor
Engineering Divisipn (2)
ESRI
Fire Admin. - Training Officer
Fire Admin.
Fire Prevention
Irvine Ranch Water District
Mesa Consolidated Water District
OLD ADDRESS
3188 Pullman Street
Comcast Cable
Newport-Mesa Unified School. Dist.(2)
Pacific Bell
Police Dept. - Planning & Research
Sanitary District Engineer
Sanitation Division Office
So California Edison Company
Southern California Gas
State Board of Equalization
U. S. Post Office - AIS
U. S. Post Office, Adams
Thomas Brothers
File (2)
NEW ADDRESS
3185 Pullman Street
3187 Pullman Street
3189 Pullman Street
Your cooperation in this matter is appreciated.
Sincerely,
�
Wendy i
Associate Planner
c:
A.P. NO.
427-21 1-03
Kimberly Br�ndt Steven M. Christie/BKM Development Company, LLC
1945 Placentia Avenue
Costa Mesa, California 92627
Buibing Division (714) 754-5273 • Code Enforcemenl (714) 756-5823 • Planning Division (714) 754-5245
FAX (714) 754�4858 • 7DD (714J 754-5264 • www.d.costa-mesa.ca.us
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P�RYKING TAB •ULATION� F
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� SITE PUN
bkm REDHILL BUSINESS PARK - BLDG 'F'
REMODEL OF 3188 PULLMAN
COSTA MESA, CA �,�
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UEVELOIMENT�oN.�1 WAREMALCOMB � ��
v�w r »ruoe�v NOqN
��ia� �sa-sz�s • Fax �»a� �sa-aass • www.ci.cos�a-mesa��DING PERMIT
JobAddress: $1$9 PULLMANST q?�/Z�/ � �3�
Suite: •
Viciniry:
Primary Occ: B EaK50/ Office/ Bai<50 Type of Construction: V-N
Parcel Number: 42721103 Zoning: r� v
Applicant: AGUILAR, MAURICIO
Address:
Owner: B K M REDHILL ASSOCIATES LLC
Address 3188 PULLMAN ST
COSTA MESA, CA
Phone: 714381-5859
Z'ip:
Phone:
Zip: 92626
Contractor. KPRS CONSTRUCTION SERVICES INC.
Address: 2850 SATURN ST
Zip:
Arch :
Address:
Zip:
Phone: 714-672-0800
BREA, CA
92821 License: 751130
NIE STEPHENSON ( WAREMALCOMB) Eng:
Address:
Phone: 949-660-9128
License: C22710
SCOPE OF PERMIT
10,500SF INTERIOR TENANT IMPROVEMENT FOR "D AND M"
NO ADDITIONAL SOUARE FOOTAGE ADDED.
FEE SUMMARY
Plan Check: $1,282.94
Permit: $1,973.75
SMIP Res: $0.00
SMIP Com: $57.75
Other: $0.00
Inspection: $0.00
Total: $3,314.44
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front
ACCESSORY Front
PARKING Existin :
��
�
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 11/18/2005
Issued: 01/12/2006
ISSUED BY: ��
Phone:
License:
Calc Valuation: sz�s,000.00
Claim Valuation: $2�s,000.00
Rear 0- 0 Left 0- 0 Right 0- 0
Rear 0-0 Left 0-0� Right 0-0
Reauired: 0 Pr000sed: 0
NO710E: The work authorized by ihis 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 ii work is suspended or abandoned
for a period o( 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 inspectiona and final approval must ba obtained. Failure to obtain inspec�ions and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
wno-no �aw�
9
WORKERS'COMPENSAPON DECLARAnONA ��
I hereby eifirm under penalty of perjury one of ihe followin9 declarations:
❑ I heve and will maintein a certificate of consent to self-Insure br Workers' compensation, as provitled for by section 3700 of ihe Lebor Cotle, For the pertormence of ihe
work for which this permit is issued.
❑ I hava end will maintain workers' compensalion insurence, es requiretl by section 3700 of Ihe Labor Cotle, for [he peRormance of �he work tor which Ihis pertnit Is iuuetl.
My workers' compensa�igp Insurance carner antl pol� nurpher are;q r� ,�., q_ _ n , �„,..� �, �., �/ j_
Gartiec !
(This sectlon need noI be con
❑ I cartify that in the perto
compensatlon laws
c o m p l y w i t h t h e s e p v'�
qpplicant SignaNre:
WAqNING: FAILURE TO SECURE
TNOUSAND OOLLARE (5100,000),
of ihe work lor which
, and agree that It I s
CqMPENSATION COVERAGE
UCENSED CONTRACTORS DECLARATION:
I nereby affirm ihat I am
torce end aHecL Lic. N_
Comractor's SignaWre:
Chapter 9 (commencing
CONSTRUCTION LENDING AGENCV: �
[] I hereby affirtn that there is a consiruction lentling
L�ntleYs Name:
Slgnewre:
OWNER-BUILDER DECLARATIONS:
�✓ �-l�!//lJI' • PolicyNumber. (N V `�'rLV 7VC7�
00) orless.) �
I not employ any person in any manner so as to become subject ro the workers'
e workers' compensetion provisions ot Section 3700 oi ihe Labor Coda, I shall forthwi�h
/ oate: �� / / `- �� /
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNORED
i PROVIDEO FOR IN SECTION 3]G6 OF THE L4BOR CADE, INTEREST, AND ATTORNEPS FEES.
of Division 3 of the Business and ProfessJ"Qns Cotle, and my license is in tull
Class # � - 11
_ oece: n �— — .�
performance of �he work for which Ihis permit is issued. (Sec. 3097, Civil Code).
Lentlei s Atltlress:
Date:
I I�ereby ettirm ihat untler penelry ot perjury Ihat I am El(EMPT FROM 7HE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions
Code: My city o� counry wtuch requires a permit to conshuct, alter, imptove, demolish, or repair a�y structure, prior b ils issuanCe, also requires the applicanl tw such permil
to iile e signed statement that he or she is licensed pursuant b the provisions oi ihe Contrecmrs License Lew (Chapter 9(commencing with Section 7000) of Division 3 ot the
Bqsiness antl Professions Code) or that he or she is exempt theretrom and the 6asis for tha allaged eaemption. Any violation oi Section 7031.5 by any epplicant for e pettnit
subjects Ihe applicant to e civil penalry of noI more than five hundred dollars ($500).):
[1 I, as owner oi ihe property, or my employees with wa9es as their sote compensation, WILL DO THE WORK, antl the structure Is not intended or ottered tor sale (Sec.
7044, Business and Professions Cotle: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or harsetl or Ihrough his or her own employees, providetl that such improvements are not intended or oHeretl for sele. If, however, ihe builtlinq or imp�ovement is
soid within one year of completion, the owne�-builder will have the burden ot proving that he or she ditl not build or improve tor purpose of sale.). �
❑ I, as owner of the property, am E%CWSIVELY CONTqACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business antl Professions
Code: The coniractors Ucense Law does not apply �0 an owner of propetly who builds or improves thereon, antl who contrects for such project with a coniractor(s)
license pursuant to ihe Contractors License Laws.�. -
❑ 1 am exempi untler sec.
SignaWre:
Owner ID verified by tlrivefs license. ❑ Yes ❑ No
Busines5 and Professions Code for ihis reason:
ygrification oi Ownership by (typa of tlocument, i.a. - property tax bill or deetl):
DI�ISION OF INDUS7RIAL SAFETY PEHMI7 CERTIFICA710N:
Drivefs License No.
Date:
Expires:
❑ I hereby certify �hat no excavation tiva (5) or more fee� in tlepih into which a person is require0 to descend, will be matle in connection with work authonzed by ihis
permi6 antl that no builtlinq siructure, scalloltling, falsework, or demolition or tlismantling thereof, will be more Ihan ihiny-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
341, TiUe 8, Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone to tlo work which would require a permit from the Division of IndusMal Safery, es noted above, unless such person has a
pertnit to do such work irom the division.
Signature: Date:
Division of Indusl�ial Safety Permit Number:
ICER7IFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTAV: I cenity untler Oenalry of perjury that I have read this epplication and state that the information given is I
corfect. I agree to comply with all siate laws antl ciry ordinences relating to builtling construction, and authorize representatives of the Ciry of Gosta Mesa to enter upon ihe
abo�e-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authonzed by Ihis permi� until final inspection.
� AnNOr AuthOri:
�QQf,1, INSPECTIONI7PE
7616 Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Well
202 Final Factory Fire Place
203 Final Sign
pp4 Final Demolition
� � �/� l'� ' 'V(� /
int Date
p�ig, � INTI71AL5 CQpE! INSPECTIONTYPE PdIE I��
206 Final Mechanical .
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval n
222 Final Site ��L �
250 Final BuildinglOccupancy
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesaELECTRICAL PERMIT �� FAIF DRIVE, COSTA MESA, GA 92626
Job qddress:
Suite No
Viciniry:
Parcel Nunmber:
Applicant:
Address:
3189 PULLMAN ST
42721103
ROBERTS, BRIAN
1721 COMMERCE ST
CORONA,CA
Phone: 951-817-0181
Zip 92880
Owner: B K M REDHILL ASSOCIATES LLC
Address 3188 PULLMAN ST
COSTA MESA, CA
Contractor. GATEWAY ENERGY INC
Address: 1721 COMMERCE ST
ISSUE FEE
Temp s@rvice tesl
Res. a/c package
New Res (1•2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets .
Swiiches
Non Res Appl
Res Appl .
Service l0 200a
Service to t000a
Service over 1000a
Molors to 1hp
Molors to 10hp '
Motors to 50hp
Motors to t00hp
Motors over 700hp
Communication drops
Sub panel l0 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
CORONA,CA
Phone:
Zip: 92626
Phone: 951-817-0187
Zip: 92880
License: 723709
SCOPE OF PERMIT
10,500SF INTERIOR TENANT IMPROVEMENT FOR "D AND M"
REF.:B05-02089
ISSUED BY:
Status: ISSUED
Applied: 01/192006
Issued: 01I192006
ELECTRICAL TO INCLUDE: 51 LlGHT FIXTURES, 80 OUTLETS, 20 SWITCHES, 33 COMMUNICATION
DROPS AND RELOCATE 2 SUB PANELS UP TO 200 AMPS.
523.50
$0.00
$0.00
$0.00
$0.00
$0.00
$44.63
565.80
522.00
$0.00
$0.00
$0.00
50.00
$0.00
$o.00
50.00
50.00
$0.00
$0.00
$29.49
$67.00
$0.00
50.00
50.00
50.00
Quantity
0
0
0
51
80
zo
0
0
0
0
0
0
0
0
0
0
33
2
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
Busway I100 fl
Standing Section
Misc Elecirical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up l0 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipmenl
Low Volt Wiring System / Ckt
Misa Conduit
Misa Conductor -
Cirws ( gen or ride)
Circus (mech ride or lighis)
Chrislmas Tree Stand
Fireworks Stand
Other Electrical Fee
Invesligation Fee
Plan Check Fee
Reinspection Fee
Quanlity
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
50.00
TOTAL CALCUTATED FEES bZ46.42
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by ihis 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 abantlopeQ;
for a period of 180 days. �r„�<r
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all
requfred inepaetione and finel approval must be obtained. Failure to obtain insDections antl final approval will result in the e:
FOR INSPECTIONS CALL: (714) 7545626
zaas�as�voo�
all
WpRKERS'COMPENSAnON OECLARAnON�� �+ �
I hereby aflirtn under penaly oi perjury one of the following tleclarations:
❑ I have entl will meintain a certificate of consent to seli-Insura for workers' cnmpensation, es provitled for by section 3700 of Ihe Labor CoUe, for Ihe paAormence ot the
�✓� �vork for which this permit is issuetl.
Ip"�:I�ave entl will meintain workers' compensation Insurance, es requlred by sectlon 3700 0l the Labor Code, for t�e peAortnanca of Ihe work lor which Ihis pertnit is issuetl.
�� ers' compensation Insurence wrtier antl poliry number are: 3
G�rrier �C-1�Kk�-P r'�L � Policy Num6er % � z�i� �
,(JJN sec on ne�leted d fhe permrt Is va/ued et one hund�ed dollars ($100) or less.)
❑ I certity t�et in lhe pedormance ot the work tor ich this pertnit is issued, I shall not employ any person in any menner so as to 6ecome sublect to tha workers'
compensation laws oi e i nia, antl a�e�'t�a� I should Decome subject b the workers' compensation provlsions ol Section 3700 of ihe La6or Cotle, I shell fOhhwith
����..,, 4�dC �t` 9a,a. ,. - I q-� G
D SECURE WORKERS' CqMPEN5AT10N CAVEMGE IS UNLAWFUL AND SHALL SUBIECT AN EMPIOY�EP40�vCR INAL PENALTIES AND CIVIL flNES UP TOONE HUNDRED
(E100.000�, IN AD�ITION TO THE COST OF CAMPENSATION, DAhNGES AS PROVIDED FOR IN SECTION 3)W OF THE IABOR COpE, IMEREST, AND ATTORNEV'S FEES.
LICENSEO CONTRACTORS DECLARATION:
9(commencing with Section 7000) af
Professians Gode, end my license is in full
CONSTRUCTION LENDING AGENCY:
� I hereby attirm that ihere is a constmction lentling aqency for ihe pedormance of the work for which this permit is is5ued. (Sec. 3097, Civil Code).
Lender's Neme:
Signawre: _
OWNER-BUILDER DECLARATIONS:
Lender s Address:
Date:
I h9reby ettirm Ihat unGer penelty ot perjury that I am EXEMPT FROM TME CON7RACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business antl Professions
Coda: Any ciry or county which requires a permit to consimct, elter, improve, demolish, or repair any simcmre, prior to its issuance, also �equires tha appliwnt tor suCh permit
to file e signeC statemem that he or she is licensetl pursuant to the pwvisions oi Ihe Contradors License Lew (C�epter 9(commencing with Section 7000) of Dlvision 3 0l Ihe
Bu4ine55 end Protesslons CoOe) or thal he or she is exempl iherefrom antl ihe basis for ihe alleqetl ezemption. Any violation oi Section 7�31.5 by any flpplicent lor a permit
su6jects the epplicant to e civil penalry of not more then fiva hundred tlollars (5500).):
❑ I, as owner of Ihe properry, or my employees with weges as Iheir sole compensation, WILL DO THE WORK, antl the structura Is not intentletl or oMeretl tor sale (Sec.
7044, Business and Professions Code: The Comractors �cense Law dces not apON �o an owner of property who b�iltls or improves lhereon, and who Coes such work
himself or herselt or Ihrough his or her own employees, providad thet such improvemems are not imendetl or oflered for sale. It, however, the building or improvement is
soltl within ona year of completion, the owner�Duilder will heve ihe burden of proving that he or s�e did not build or improve for purpose ot sale.j. '
❑ I, as owner oi Ihe property, am EXCLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to construct Ihe project (Sec. 70a4, Business antl Professions
Cotle: The contrectors License Law tloes not epply to an owner ol pwpeny w�o builds or Improves ihereon, entl who contrects for such project with a contractor(s)
license pursaant to the Contractors License Lews.).
❑ I am exempt under sec. Business and Pwfassions Code for this reason:
Signature: Date:
Ow�er ID veri�ied Oy tlrivefs license. ❑ Ves ❑ No Driver's License No. Expire5:
Verification of Ownership hy pype of documeni, i.e. - property �aa bill or tleed):
DIV�SION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby cenify ihat no excava�ion five (5) or more leet in depth into which a person is required to descend, will be matle in connection with work euthorized by t�is
permit, and that no building structure, scalloltlinp, talsework, or demolition or tlismamling thereol, will 6e more ihan t�irty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, 7tle B, Galifomia Atlminisiretive Code).
❑ As owner-builtler, I will not employ enyone ta tlo work which would require a permit from ihe Division ot IntlusMel Sefery, es notetl a6ove, unless such pereon has e
permit to tlo such work trom the division.
Signature: Date:
Division of Intlusinal Salety Permit Number:
CER'nFICATE OF COMPLIANCE AND AI7T}IORW710N OF ENTRV: I certity untler penalry of perjury ihat I have read �his epplication antl stete t�a� ine Infortnation given is I
correct. I agree to wmply with ell state laws and city ordinances relating to building consiruction, enA euthonze reD�eseNatives of the Ciry ol Coste Mese to enter upon ihe
above-descnbed proparty tor inspeciion puryase5. I agree not to occupy or allow occupancy ol eny building authorizetl by tnis pertnit until finel inspection.
f�tf� INSPECTIONTYPE Q�IE �NiIf1AL5
i616 Fizod System Final Fira Prevention �
1266
200
201
202
203
204
Paal Spa Final
Final Re-Rooi
Final Block/Retaining Wall
Final Factory Fire Place
Final Sign
Final Demoli�ion
eooe� iNsvetnoNTvve
206 Finel Mechanical
208 Finel Plumbing
210 Finel Electrical
212 Final Fire Pravention
220 Final Planning Approval
222 Final Site
250 Final euilding/Occupancy
PSIE It�ELi
� ,�
(714) 754-5273 • Fax (714) 754-4856 • Www.ci.costa-mesa.ca.us 77 FAlii DRIVE, GOSTA MESA, GA 92626
JobAddress: 3189 PULLMAN ST
Suite No
Viciniry: D AND M
Parcel Number: 42721103
Applicant: OCHOA, LARRY
Address: 884 N MAIN ST
ORANGE,CA
MECHANICAL PERMIT
Phone: 714-744-9688
2ip: 92868
Owner: B K M REDHI�L ASSOCIATES LLC
Address: 3188 PULLMAN ST
COSTA MESA, CA
Contrector. AIR SERVICE pARTNERS
Address: 884 N MAIN ST
ORANGE,CA
Phone:
Zip: 92626
Phone: 714-744-9688
Zip: 92868 �
License: 589572
SCOPE OF PERMIT
t0,500SF INTERIOR TENANT IMPROVEMENT FOR "D AND M:'
REF: BOS-02089
Status: ISSUED
Applied: 01/182006
lssued: 01/18/2006
ISSUED BY:
6 REPAIR/ALT COOLINGMEAT, 1 INST FAU < 100K BTU WITH 1 COMPRESSOR UP TO 3
HP/t00K BTU (SPLIT SYSTEM)
ISSUE FEE
Inst FAU <100 k BTU
Insl FAU >100 k BTU
Repair/Alt Cooling/Heat
Inst! Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan I Single Duci
Appliance
Fire Dampers
Smoke Dampers �
Inst or Relocate Appl Ven�
Air Handlers < 10000cfm
AirHandlers> 10000c(m
FloorFurnace
Floor or Suspend Healer
$23.50
$74.80
$0.00
$82.20
$0.00
$0.00
$0.00
50.00
50.00
$0.00
50.00
50.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
Quantiry
FEE SUMMARY
Repair I Alt Absorblion Unit
Repair 1 Alt Refrigeration Unit
Ventillation System
Evaporative Cooler
C o m m e rc i a l I n c i n e rato r
Domesiic Incineralor
Comoressors / Absorotion Svstems
Uplo3hp/100kBTU
3To15hp/SOOkBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp I Over 1,750 BTU
Boilers
Up to 3 hp
3To15hp
i5to30hp
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
Quantity
$0.00 0
50.00 0
$0.00 0
$0.00 0
50.00 0
50.00 0
$14.70 1
50.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00
$0.00
50.00
TOTAL CALCULATED FEES $135.20
COMMENTS I 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•27-92)
EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 1 BO days.
INSPECTIONS: In order lor lhe work authorized under this permit to be considered Iegal, such work must comply with all applicable cotles, and all
required Inapectlone and finel approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permiL�
FOR INSPECTIONS CALL: (714) 7545626 „//
LOObi6 �W W�
WORKERS' COMPENSATION OECLARATIO�J� �
1 herehy aNirtn under penalry ol pequry one at the lollowio9 tleGarations'.
❑ I have and will meintein e certificate o� consent to self-Insure for workers' compensation, as provided for by section 3700 of the Lebor Code, for the peAortnence ot the
ork for which ihis permit is issued.
t I have and will malntain workers compensation Insurance, as reQuired by sectlon 3700 of the Labor Cotle, for the pedortnance ot the work br which Ihis pertnit is issued.
My workers' wmpensatlon Insurance carrier and policy number are: � f
Carrier., ._�- � A(! PolicyNumEer: iNt �%Hq r'C �O�(p7 %�% �
(This secfion need not 6e comp/eted i/ Ihe rmil /s valued et one hundied tlollars ($100) or less.) �'^
❑ I certiy that in tha peAormence of t work tor which thi�an' ue , 5 11 not employ any person in any manner so es to becoma subject lo the workers'
compensa�ion laws ol Cellfam , d a9ree the ' ould become subjact �o Ihe workers' compenseiion provisions ol Section 3700 ot ihe lebor Cotle, I shall forthwifh
comply with Ihese provisions.
hcenYSi�naNre a�A /% � �ete '-'
nPP' 9�..�n /i -/6Ql-O�c
WARNING: FAILURE TO URE WO ERS' COMPENSATIO CAVEfiAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
TNOUSANDDOLLARE(5100,000),IN DITIONTOTHECOSTOFCOMPENSATION,DAMAGESASPROVIDEDFORINSECTION3]C60FTHELABORCODE,INTEREST,ANDATTORNEYSFEES.
L�CENSED CONTRACTORS DECLARATON:
I hereby aNirm iha�em I�censatl ur1de� r�io� of Chapter 9(commencing with Section 7000) of �Ivision 3 of the Business antl Pmtessions Cotle, entl my license is in iNl
force antl ettecL Lic: N J� Cless�#-'- �' Z G
Convecto,r'�s�signamre:�-' �� �t G_-�N,Ya� �. dES . oeteG-' D�-/c`h-v6
CONSTRUCTION LENDING AGENCY:
Q I hereby a%irm ihat ihere is e consiruction lentling agency tor ihe peAormance of ihe work for w0ich this permi� is issuetl. (Sec. 3097, Civil Code).
Ld�Oers Name: Lentlers Atltlress:
SIBnaWre: Date:
OWNER-BUILDER DECLARATIONS:
I pereby ettirm IM1at under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions
Cotle: Any city or coonty which raquires a permit to conslmct, aller, lmprove, demollsh, or repeir eny slmcture, prior ro its Issuance, elso requires the aOD�icant ior such permit
to ��le e signed statement that he or she ISlicensea pursuant to the provislons of t�e Contractors Licensa Law (Chaptar 9(commencing wiN Section 7000) ot Division 3 oi the
BUsiness antl Profeuions Code) or that he or she is exempt therefrom antl Ne basis for t�e allegatl exemption. Any violetion of Sec�ion 7031.5 by eny epplicant for a pettnit
sUbjects the eppliwnt to a civil penalry of not mora Ihen five huntlred tlollers ($500).):
[] I, as owner ot the property, or my employees wi�� wages as their sole compensation, WILL DO THE WORK, and Ihe siructure is not intended or oHered for sale (Sec.
7044, Business entl Professions COUe: The Contractors License Law tloes not apply to an owne� at propeRy who builtls o� improves thereon, and who does such work
himself or herself or Ihrough his or her own employees, provided that such Improvements are not Intendetl or offered lor sale. If, however, Ihe building or improvement is
soltl within one year of completion, ihe owner�0uiitler will heve Ihe burtlen ol proving ihe� he or she did not build or improve br purpose ot sale.). �
❑ I, as owner of the propedy, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct ihe pmject (Sec. 7044, 6usiness antl Pmfessions
Code: T�e comracmrs License Law tloes not epply to en owner of property who builds or Improves thereon, antl who coniracts tor such pmlea with a contractor(s)
license pursuant lo the COniractws LicenSe Laws.).
❑ I em o:empt untler sec. 8usiness ana Professions Coda for Ihis reason:
Signawre: Date:
pWner ID veritied by tlrivets licen5e. ❑ Yes ❑ No DnveYs License No. Expires:
Verifiwtion of Ownership by (type of dwumem, i.e. - propeny taz 6ill or deetl):
DIVISION OF INDUSTRIAL SAFETV VERMIT CERTIFICA710N:
❑ I hereby tertity ihat no excevation five (5) or more feet in depih into which e person is requiretl to descenq will be metle in connection with wark eu�honzetl by this
pertnit, and that no builtling siructure, scafloltling, falsework, or demolition or dismantling thareo�, will be more than thirty-six (38) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttlle H, Calitomia Atlmfnisirative Code).
❑ As owner-builtler, I will nol employ anyone to tlo wo�k which would require e permit Iwm the Division ot Indusirial Sefery, es notetl above, unleu such person hes e
pertnit to do such work irom tha division.
SignaWre: Date:
DiVision of Industnal Sefety Pe�mit Number:
CERnFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENiAY: I cenity under penalty ot perjury �ha� I have read this epplicalion and state that tha information given is I
cor�ect. I agree to comply with ell state laws antl city ordinences rela[ing to building consiruction, end euthonze representatives of t�e Ciry ol Gosta Mesa to enter upon ihe
ebo�e-described propeny lor inspection purposes. I e9ree not to occupy or allow acupancy of eny building authorized by Ihis permit until final inspection.
�ff�j, INSPECTONTYPE
1876 Fizetl System Final Fire Prevention
1266
200
201
202
203
2oa
Pool Spa Final
Final Re-Rool
Finel BIocWRetaining Well
Final Factory Fire Place
Final Sign
Final Demolition
�
� 1. .1111l.IF9
LODE� INSPECTIONTYPE
206 Finel Mechanical
208 Finel Plumbing
210 �Finel Electrical
212 final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Builtlin<yOccupency
(714) 754-5273 • Fax (714) 754-4856 • www.ci.cos�e-mesa.ca.us 77 FAIFi DFiIVE, GOSTA MESA, (:A 92626
, PLUMBING PERMIT
., �•
. , �.
.lob nddress: 3189 � PULLMAN ST ' Status: �SSUED
Suite No Applied: 01I172006
Issued: 01I17Y2006
viciniry:
Parcel Nunmber: 42721103
App�icant: WILLIAM PALMQUIST
Address: 208 TECHNOLOGY
STE A
IRVINE, CA
Phone: 949-450-0495
Zip: 92618
Owner: B K M REDHIL.L ASSOCIATES LLC
Address 3188 PULLMAN ST
COSTA MESA, CA
Contractor: DYNASTY PLUMBING, INC.
Address: 208 TECHNOLOGY
STE A
IRVINE, CA
Phone:
Zip: 92626
Phone: 949�50-0495
Zip: 92618
License: 570186
ISSUED BY:
SCOPE OF PERMIT
PLUMBING PERMIT FOR 10,500SF INTERIOR TENANT IMPROVEMENT FOR "D AND M"
REF#:BOS-02089
WORK TO INCLUDE: 2 BAR SINKS, 1 FLOOR SINK, 1 WATER HEATER.
ISSUE FEE
Backflow irrigation
Backflow Preventer
Bathtub
Clarifier System
Conned (Ice,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (1-4 outlets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptors (Grease, Oil)
Interceptors (Sand Auto )
AMT
$23.50
$0.00
$0.00
$0.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$O.OD
$0.00
so.00
$0.00
50.00
$0.00
$0.00
��
FEE SUMMARY
AMT
Laundry Tub / Washer $0.00
Landscape Irrigation $0.00
P-Trap $0.00
Pressure Regulator $0.00
Pracess 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 $o.00
Sink, bar $79.60
Sink, commercial $0.00
Sink, Floor 59.80
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
2
0
�
0
0
0
0
COMMENTS / SPECIAL CONDITIONS
Sump Pump
Swimming Pool
Trap Pnmer
Urinal
Vacuum Brkr Bkflow(1-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater I vent
Water Piping (Inst or Rep.)
Water Re-pipe
Water Service
Water Sokener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$12.30
$0.00
$0.00
$0.00
so.00
$0.00
$0.00
50.00
$0.00
TOTAL CALCULATED FEES: 565.20
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes
regulations. (Ord. No. 92-28, § 1, 1247-92) ,
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is
for a period of 180 days.
INSPECTIONS: In order (or ihe work authorized under this permit to be considered legal, such work must comply with all
required inspectlona antl final epproval must be obtained. Failure to obtain inspections and final approval will result in the eM
FOR INSPECTIONS CALL: (714) 7545626
zaac�a� (rvoo�
QTY
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
C
orabandoned
�le codes, antl all
of ihis permit.
WORKERS'COMPENSAnON OECLARAnO�� ��
1 hereby attirm under penalry of pe�ury one oF Ihe tollowing daciarations:
p I have entl will maintain a cartificate ol conseN to self-Insura for workars' compensation, es providetl for by seqion 3700 of the Labor Code, for Ihe pertormence of the
wark lor which ihi5 permit is issued.
.�: I'have antl�wlll maintain workers' compensation Insurence, as repuiretl by section 3700 0l the Labor Cotle, for the petlormance ol the work lor which Ihis pertnit Is Issuetl.
�My workers' \compensation`Insura�nTce c�a�rfner and policy num6e are: �� �� ��Q� �
Carrier: Y.N� , l— G L� L �� (+�{ /{.� � P�NumGer.. _
.(rhis'secti n nee t be comp/etetl il the pelmit is value e one hundretl dollers ($ f 00) or /ess.)
p I cenity t�et in the peAormence of the work for which this permit is issuetl, I shell not employ eny person in any menner so as to become subject to Iha workers'
compensation laws of Californla, enE agr thet It I should become suD�ect lo iha workers' compensation provislons of Section 3700 of ihe Labo� Code, I shall forihwith
comply with ihesa pr isiy s. � O) �/�/� �
qppli_` Signefure: � Da�g:_
WARflINO-FAIWRETOSECUPEWORKERS'COMPENSATIONCOVE E UNUWFULrWpSHALLSUBIECTAN�O TOCRIMINALPENALTIESANDGVILFlNESUPTOONEHUNDRED
T}10USAND OOLURE (S10J,C00), IN ADDITION TO THE WST OF G7�MP TION, DAMAGES AS PROVIDED FOR IN SECiION 3]W OF THE LABOR CO�E, IMEREST, ANO ATTOHNEI^5 FEES.
LICENSED CONTRACTORS DECLARATION:
I dere6y aHirm Ihat I am licensed under ro�3i ions of Chepter 9(commencing wllh Section 7000) of Division 3 oLlhe Busin� ^o�Pro`sions Coae, and my licanse �s in full
fo�e'anB eNecL Lic. N,�i%A I� b CClass»
CmllfeCiOr'S S{gn&Uie: �qi .�� n De� tB _
CONS7RUCTION LENDING AGENCY:
❑ I hereby effirm Ihat �here is a consimc�ion lentling agency tor ihe petlormance of the work for which this permi� is issued. (Sec. 3097, Civil Cotle).
LPntler's Neme: Lender's Adtlress:
Signature:
Da�e:
ON�NER-BUILDER DECLARATONS:
I nereby ettirm that under penalry of perjury thet I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for Ihe following reason (Sec. 7031.5, BUsiness and Professions
Cotle: Any city or county which reQuires a permit to constma, alter, improve, tlemolish, or repair any stmcfure, prior to its issuance, also requires tha epplicant for such permit
b tile a signed statement Ihat he or she Is Ilcensed pursuam ro t�e provisions ol the Contrecrors License Law (C�epter 9(commencing with Section 7000) ol Division 3 of the
BUsiness end Professions Code) or Ihet he or she is exempt therefrom entl the besis for the alleged axemption. Any violation of Section 7031.5 by eny applicant to� e pertnit
sUbjects the epplicent ro a civil penalry of not more then five huntlretl dollars ($500)J:
❑ I, as owner of Ihe property, or my employees with wages as iheir sole compensetion, WILL DO 7ME WORK, and ihe structure is not intentled or oHered tor sale (Sec.
7044, Business and Professions Code: The ConVactors License Law does not apply to an owner of property who bui105 or improves Ihereon, and who does such work
himself ot herself or through his or her own employaes, provided ihat such impmvements ere not Intanded or oflered f0� sale. If, however, the builtling or impro�ement is
sold within one year of completion, the owner�uilder will �ave the burtlen of proving ihat he or she tlid not builtl or improve for puryose of sale.). '
❑ I, as owner ot Ihe properry, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTflACTORS to Gonstmcl the Orojecl (Sea 7044, 9usiness and Pmtessions
Cotle: 7tie coniractors License Lew does not apply to an owner ot pmpeny who builtls or Improves Ihereon, and who comracts for such project with a contrecto�(s)
license pu�suam to the Contrectors LJcense Lawa�.
❑ I em exempt untler sec. Business and Pmfessions Code br this reason:
SignaWre: Date:
Owner ID veriiled by Orivers license. ❑ Yes ❑ No Driver s License No. Expires:
Verifiration of Ownership by (type of tlocumem, i.e. - propeny tax bill or tleed):
DI�ISION OF INOUS7RIAL SAFE7Y PERMI7 CERTIFICATION:
❑ I hereby cenify that no excavaiion live (5) or more feet in depih iNo which a person is require0 to descend wlll be metle in connection wi�h work euthodzed by Ihis
permi�, antl that no building structura, scaftoltling, falsework, or demolition or dismantling t�ereof, will 6e more ihan thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tule B, California Atlminis�retive Code).
❑ As ownerbuilder, I will not employ enyone to tlo work which would require a pertnit from the Division of Inauslnal Safery, as notetl ebove, unless such person has e
permit ta do such work trom the division.
Signature: Date:
Division ot Industrial Safery Pertnit Number:
ICERnFICATE OF COMPLIANCE AND AUfHORIZA710N OF EMAY: I cenity under penalry of pe�jury that I have read this epplication antl stata that the informetion given is I
correct. I agree to comply with ell state lews entl ciry ordinences relating to building consiruction, end euthonze representatives of the Ci�y of Costa Mese Io enter upon the
ebo�e-descnbetl p�operry for inspection purposes. I agree noi to occupy or allow occupancy of any building authorizetl by t�is pertnit until finel inspection.
�Qpf,1, 1NSPECiWNTYPE V 4AIE V�6:5
1616 Fixetl System Final Fire Prevention
1266 Pool Spe Finel
200 Final Re-Root
201 Final Block/Retaining Well
202 Final Fectory Fire Placa
203 Final Sign
204 Final Demolition
� /rJ� ��---`�
Date�
CQUE I Iti5PEC110N 7YPE
206 Final Mechanical
20B Finel Plumbing
210 Final EleC�riCal
212 Finel Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupency
[73i�1:iwL1S�i
, -li-O�. UtV
CIT� � OF COSTA ME` '1 C
Development Services, Division of Building ai�d Safety
L�
CERTIFICATE:OF OGCUPANCY
This cerHficate is issued pursuant to the requirements of the Uniform Building Code, SecHon 308 adopted by the City
of Costa Mesa cectifies thatat the time of its issuance the building structure herein below described was inspected and
approvedforoccupancyasfollows: ' � ' '
Building Address
Use Commercial
3189 Pullman St.
` BIdg.PermitNumber $OS-02089
i.
� �+
.-.,,r -.-.—.r . : , t,:., - �.
Group B TypeofConstruction' � V�-N '�'� �-`�j{�;�q,pe � UseZone MD
BKM Re8 Hill Aesociates LLC';� . D''& M
Owner of Building 'I enanC _
�
Address
BUILDING OFFICIAL-K1ldrill Q. NgUy@Il, C.B.Q:.
By: �
D3/29/06
- Date
REQUIRED TO BE POSTED IN A CONSPICOUS PLACE
[/�
�