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Home My WebLink About365 RAVELLO LN - Building PermitsFeb,17 OS 05:03p Su7 . � Prudential February l7, 2005 �van & Rssociates (7�^�965-4335 Mr. Ed Petros Chief of Inspectors City of Costa Mesa 77 Fair Drive, 2°a Floor Costa Mesa, CA 92628-1200 Chris Sweeney, MBA Prudential California Realty 23 Corporate Plaza, Suite 790 Newport Beach, CA 9266� Direct 949 219-2532 Cellular 9a9 500-7188 csweeneyC�pruoc.cam www.ourOChome.com Re: Finalization of permit numbers $00-01293, P00-00485, E00-00882 Mr. Ed Petros, I am currently in escrow as the buyer on the property located at 365 Ravello Lane. I am seeking to have the permits referenced above finalized and determine what, if any, costs would be incurred to do so. The remodeling work in which these permits were applied for has been completed and any plans used to apply for the permits above aze no longer available. Bonnie Kubota advised me to mention that the code changed in 2002. Please contact me at your earliest convenience as I do not want to remove contingencies without being fully awaze of what is necessary to finalize the permits mentioned above. Thank qou for yow time and assistance. Sincerely, l/ ' ..�—�e�vice Chris Sweeney " 949-500-1188 cell phone � 9fMi0Y' P•Z mAn irMeperdenily a.,rt�e�l anJ operatetl member ot itie Nudential Rea� Fs�ate Aflifiamx, fnc. (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa��DING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 365 RAVELLO LN Suite: Vicinity: KITCHEN AREA & GARAGE Parcel Number 43914308 Applicant: ALEXANDER, TIMOTHY Address: BENJAMIN COSTA MESA, CA 365 RAVELLO LN owner: ALEXANDER, TIMOTHY Address ,BENJAMIN COSTA MESA, CA 365 RAVELLO LN Contracror: O WN E R-B U I LD ER Address: Zip: Arch : Address: Phone: Zoning: ISSUED BY: Phone: 949-515-0542 Zip: 92627 Status: ISSUED Applied: 08/24/2000 Issued: 08/24/2000 Phone: �� ZiP: 9262� �� , Phone: �A� License: 0 Eng: Address: �� _ Phone: Zip: . . License: license: � SCOPE OF PERMIT ADD 25 SQ FT TO THE KITCHEN AREA, REMOVE TWO WALLS 8 ADD ONE WALL TO AN EXISTING SINGLE FAMILY � RESIDENCE. ALSO RELOCATE THE WASHER & DRYER TO THE GAR4GE. Plan Check: $35.10 Permit: $54.00 SMIP Res: $0.50 SMIP Cam: $0.00 Other: $0.00 Inspection: $0.00 Total: $89.60 SETBACKS MAIN STRUCTURE �Front 0-0 ACCESSORY Front 0- 0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY � " Calc Valuation: gi,5oo.00 Claim Valuation: go.00 PLANNING 8 ZONING Left 0- 0 Left 0- 0 Pr000sed: 0 Right 0- 0 Right 0- 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a peiiod of 180 days. � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work mus[ comply with au appiicabie coaes, ana au required Inapeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 754-5626 244fi-06 (N00) WORKERS'COMPENSAnON DECLARAnON: — I hareby ettirm under penalry of perjury one of the following tlaclarations: ❑ I have end will maintain a certlficete of consen� to self-Insure for workers' compensation, as provided for by seciion 3700 of Ihe Labor Code, tor Ihe pertortnance of �he work tor which Ihis permit i5 is5ued. ❑ I have antl will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the pedortnance of the work for which this pertnit is issued. My workers' compensation Insurance cerrier and policy number ere: Carne[ � Policy Numher: (This secfion need not be completetl i1 the permif Is velued et one hundred dollars ($ f 00) or less.) ❑ I certity that in the pertormance of the work for whic� this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws ol Californla, end egree lhai it I should hecome sub�ect Io Ihe workere' compensation provisions oi Section 3700 of Ihe Labor Code, I shall iorihwith complY with these provisions. Applicant Signature: Date: WAfiNING: FAILURE TO SEWRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SMrIl1 SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND GNL FlNES UP TOONE HUNDRED THOUSANO DOLLARE (51 W.000). IN ADOfTION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECitON �OG OF THE IABOfl CODE, INiEREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm ihat I em licensed under provisions of Chapter 9(commencing wi[h Section 7000) ot Division 3 ot Ihe Business antl Professions Cotle, and my license is in Full torce and eflecL Lic. N Class # Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aMirm thal ihere is a cons�mction lending a9ency for Ihe peAormance ot Ihe work for which ihis pertnit is issuetl. (Sec. 3097, Civil Cotle). Lentlefs Name: Signature: _ Lenders Address: Date: OWNER•BUILDER DECLARATIONS: I hereby aflirmdhat under penalry of perjury Ihat I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business entl Pmfessions Code: Any iity;oi,county which reQuires e permit to wnstmcl, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant tor such permit to tile e signed.stetement that he or she I5 licensed pursuent to the pmvisions of the Contrectors Ucense Law (Chapter 9(commencing with Section 7000) o( Division 3 af the Business andProteSsions.Code) or that he or she is e:empi therefrom and the basis Por the alleged exemption. Any violetion oi Section 7031.5 by any applicant tor e permit subJ'� ts ihe applicant to a'civil,penally ot noI more than five huntlreC dollars ($500).): � I, as owner oi ihe pmperty or my iriployees with wages as thair sole compensation, WILL DO THE WORK, and the sirucWre is not intentled or offered tor sale (Sec. 7044, Business antl Professions'Cbde: The Contrecrors License Law does not apply to an ownar ot pwperty who builtls or improves thereon, antl who does such work himseN or herself or through his or her own employees, provided ihat such improvements are not intentletl or oHeretl for sale. If, however, the building or improvement is sold within one year ot completion, the ownerbuilder will have the burden of pmving ihat he or she did not build or improve tor purpose of sele.). ❑ I, as owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to conslruct the prolect (Sec. 7044, Business antl Professions Code: The contreciors License Lew tloes not gpply to an owner of property who builds or Improves thereon, antl who conirecis tor such project with a contrector(s) license pursuam to the Con�ractors Lice��dws.). ❑ lam Signeiure: Owner ID • Business and Prolessions Cotle for ihis raason: Date: �' .� �f '�' 1J� ❑ Yes ❑ No Drivers License Na. xpires: Venlication ot Ownership by (rype of documem, i.e. - property ta< bill or deed): DIVISION OF INDUSTRIAL SAFETV VERMR CERTIFICATION: ❑ 1 hereby certity Ihat no excavation tive (5) or more feet in depih into which a person is requirad to descend, will be made in wnnection with work authonzed by ihis permii, and ihat no building slrucWre, scaXolding, falsework, or tlemolition or tlismamling thereof, will be more Ihan ihirty-six (36) teet hiqh. (Chap. 32, Gry 2, Ar12, Sec. 341, Tltle B, Califomia Administrative Cotla). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from ihe Division of Industnal Safery, as noted above, unless such pereon �as e pertnit to da such work tmm the tlivision. Signe�ure: Da�e: Division ol Industrial Safety Permit Number: CER7IFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTAY: I cenity under penalry of periury ihat I have read Ihis epplication antl state that t�e informaGon given is correct I egree to comply with all state laws antl ' ordinancas relating to builtling construction, and authonze represematives of the City of Cosia Mesa to enter upon the above-described prope r in ti�purpos gree not ro occupy or allow occupancy ot eny building authonzed by Ihis pe� up�f� I ir�sp� n. ` � � �C% . Sig�ure egalOwner(s) e And/Or Authonzetl Applicant Data GOOE �. INSPECTIONTYPE PdI� LSl➢9L$ �616 Fixed Sys[em Final Fl�e Preventl0/I 1266 200 201 202 203 204 Pool Spa Final Final Re-Roof Final Block/Retaining Watl Final Factory Fire Place Final Sign Final Demolition CODE 1 INSPEGTION TYPE 206 Final Mec�anital 20B Final Plumbing 210 Final Elecirical 212 Final Fire Pravention 220 Final Planning Approval 222 Finel Sita 250 Finel Builaing/Occupancy Q�iE 1ti�L5 (714) 754-5273 • Fax (714) 754-4856 • www.ci.co5ta-mesa.ca.us 77 FAIR DFiIVE, COSTA MESA, GA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 365 RAVELLO LN 43914308 Applicant ALEXANDER, TIMOTHY Address: BENJAMIN COSTA MESA, CA 365 R4VELL0 LN Owner: ALEXANDER, TIMOTHY Address BENJAMIN COSTA MESA, CA 365 RAVELLO LN Coniractor Address ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool I Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a � Service to 1000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole Phone: 714-5155-0542 Zip: 92627 Phone: Zip: 92627 Phone: Zip: License: SCOPE OF PERMIT REF B00-01293 2 LIGHTS, 2 OUTLETS AND 2 SWITCHES. � $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $1.10 $2.20 $2.20 $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 Quantity FEESUMMARY Temp Dist System / Lighting Busway /100 ft Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw ......:..........up to 50 kva/kw ............... �up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment . - - Low Volt Wiring System / Ckt � Misa Conduit Misc Conductor � Circus ( gen or ride) - Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Eledrical Fee Investigation Fee Plan Check Fee Reinspection Fee Status: ISSUED Applied: 09/OS/2000 Issued: 09/052000 ISSUED BY: �� X��Y-�� "G[/ � D DAT� � 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 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $29.00 COMMENTS / SPECIAL CONDITIONS NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califo ia 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 wo is suspended or abandoned for a panod of 180 days. � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must compl with all applicable coaes, ana an requlred' Inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will res in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2a46-6fi(N00) WORKERS' COMPENSATION DECLARATION: � I hereby aHirm under penalry ot perjury one of the tollowing declarations: ❑ I have end will mainWin a certifiwte af consent to self-Insure tor workers' compensation, es provided for 6y section 3700 of Ihe Labor Code, tor Iha peAortnance of the work for which this permit is issued. ❑ 1 have and will mainlain workers' compensetion In5u2nce, es required by seCtion 3700 of Iha Labor Code, for the perfortnance of the work for which this pertnil is issuetl. My workers' compensation Insurance carrier antl poliry number are: Carrier: Policy Number: (This secfion need not be completed il the permit is valuetl at one hundred dollers ($700) or /ess.) ❑ I certify Ihat in the peAormance oi the work tor which Ihis permit is iuueQ I shall not employ eny person in any manner so as to becoma subject to the workers' compensatlon laws ot Calitornie, end agree that ii I should become subject to the workers' compensation provisions of Section 3700 oi the Labor Code, I shell farthwith comply with these provisions: Applicent Signature: � Date: WARNING: FAILURE TO SECURE WOiiKERS' COMPENSATION CAVERAGE IS UNUWFUL AND SHALl SUBJEGT AN EMPLOVER TO CRIMINAL PENALTIES AND pVl� FlNES UP TOIXJE HUNDRED TFIIXISAND DOLLARE (5100,000�, IN ADDITIIXJ TO THE WST OF COMPENSATIpJ, DAMAGES AS PROVIDED FOR IN SECiION 3]O6 OF THE LABOR CODE, IMEFEST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm ihat I em licensad untler provisions of Chapter 9(commencing with Section 1000) of Division 3 of the Business antl Professions Code, and my license is In full force and ettecL Lic. a Class N •GontractoYs Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aNirm that there is a consiruction tending agency tor the pertormance of ihe work for which this pertnit is issuetl. (Sec. 3097, Civil Coda). Lentlefs Name: Signawre: _ OWNER-BUILDER DECLARATIONS: Lender's Atltlress: Date: I hereby atfirtn lhat untler penalry oi perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe tollowinq reason (Sec. 7031.5, Business end Protessions Code: Any ciry or county which requires a Dermit to construc6 alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicaN for such permil to file a signed sletement ihat he or she is licensetl pursuant to Ihe pmvisions of the Contrectors License Lew (ChaDter 9(commencing with Sectlon 7000) of Division 3 ot ihe Business end Protessions Code) or lhat he or she is exempt theretrom antl the basis for t�e alleged exemption. Any violation of Section 7031.5 by any applicent for a pertnit subjects tha applicaN to a civil penalry oi not more ihan five hundred doltars ($500).): 'y'2 I as owner of the properry, or my employees with wages as iheir sole compensation, WILL DO 7HE WORK, end ihe structure is not imende� or ottered for sale (Sec. 7044, Busineu and Pmfessions Cotle: Tha Contractors License Law dces not apply �o an owner of property who Duilds or improves thereon, and who tloes such work himself or herself or through his or her own employees, providetl ihat suc� improvements are noi intentle0 or oHered for sale. If, however, tha building or improvement is sold�wit6in one year of completion, Ihe owner-builtler will have the burden of proving that he or she did not build or improve tor purpose ot sale.). ❑ I, as oviner.ol Ihe property, am E%CLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct Ihe prolect (Sec. 7044, Busine55 and Protessions Coda:�The conirectors license Law does not appty to an owner oi property who builtls or improves thereon, antl who contracts tor such prolect with a contractor(s) license pursuent to the.Coniradors Lic§pS� Laws.). � lam Business and Aw�wclB'�ieri(ed by dnvers licen9e. ' ❑ No Veritication of Ownership by pype of tlocument, i.e. - perty tax bill or deetl): License reason: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenity that no excavation five (5) or more feet In depth into which a parson is requiretl to descend, will be made in connection with work euthorized by ihis pertnit, and ihat no builtlinq strucWre, scattolding, felsework, or demolition or dismantling ihereoi, will be more than Ihirry-six (36) feet high. (C�ap. 32, Grp 2, Atl 2, Sac. 341, Title 8, Califomia Administretive Code). ❑ As owner-builder, I will not employ enyone to do work which would require a permit imm the Division oi Indusidal Setery, es notatl above, unless such person hes a permit to do such work from ihe division. Signature: Data: Division of Intlusinal Safety Permit Number: CERTIFlCATE OF COMPLJANCE AND AIfTHORIZATON OF EI : I certify under penalry of perjury that I have read ihis application and state that the information given is correct. I egree to comply wit II te I end ciry ortlina relating to building conslruction, antl authonze representatives of Iha Ciry of Coste Mesa to en�er upon ihe above-described pmpeny fo io e r o occupy or ellow acupancy of any building authorized by this per it til in inspect n. S g vner(s) te And/Or Authorized Appliwnt - Date CODE �, INSPECTIONTYPE 1616 Fixatl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIaWRetaining Well 202 203 Final Facmry Fire Place Final Sign 204 Final Demolition Q�i¢, IMRIpLS CODE� INSVECTONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention � 220 Final Planning ApDroval 222 FinalSite 250 Final Building/Occupancy Q�7E II�L� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 1ob Address: 365 RAVELLO LN Suite No Vicinity: Parcel Nunmber: 43914308 Applicant: ALEXANDER, TIMOTHY Address: BENJAMIN COSTA MESA, CA 365 RAVELLO LN Owner: ALEXANDER, TIMOTHY Address BENJAMIN COSTA MESA, CA 365 RAVELLO LN Contractor: � � ��Address: Arch / Eng : Address: s REF 800-01293 PLUMBING PERMIT Phone: 714-5155-0542 Zip: 92627 Phone: Zip: 92627 Phone: Zip: License: Phone: Zip: License: SCOPE OF PERMIT RELOCATE LAUNDRY TUB AND WASHER, AND 1 HOSE BIB. ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Connect (Ice,Soda,etc) ' Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roo( Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oip lnierceptors (Sand Auto ) AMT $23.50 $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 $0.00 $0.00 so.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY `' AMT Laundry Tub / Washer $9.80 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 SewerConnect �$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 Qn. j '- 0 0 0 0" 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: 09/OS/2000 Issued: 09/05/2000 ISSUED BY: `/ �h �4ig�� Q) pAS� Sump"Pump � Swimming Pool Trap Primer - " Urinal - - � Vacuum Brkr BkFlow(i-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 Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION 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 $9.80 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES; 543.10 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and 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 ba for a period of 180 days. QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applic le codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expv n of this permit FOR INSPECTIONS CALL: (714) 7545626 zaas�as(doo) WORKERS'COMPENSATON DECLARATON: — I hereDy aHirm under penalry of perjury one of the following declarations: � I have entl will maintain a certificate of conseni lo self-Insure tor workers' compensation, as provitletl tor by section 3700 oi the Labor Cotle, for the pertortnance at ihe work tor which lhis pertnit is issued. ❑ I have antl will main�ain workers' compensation insurance, as required by section 3700 of tha Lahor Code, tor the pedortnance of the work for which this pertnit is issued. My workers' compensation Insurance carner ana policy number are: Cerrier: Policy NumDer. (This section neetl no( be completed i! fhe permit is ve/uetl af one hundred tlollare ($100) or IessJ ❑ I canity Ihet in ihe peAormance oi the work for which ihis permit is issued, I shall not employ eny person in any menner so as to become subject to tha workers' compensation laws of Califomia, antl egrae Ihat It I should become subject to Ihe workers' compensation pmvisions ot Sectlon 3700 of Ihe Labor Code, I shall torthwit� comply with ihese provisions. Applican� Signature: Da�e: WARNINO: FAILURE TO SECUFE WORKERS' COMPENSATIqJ COVERAGE IS UNLAWFUL AND SMALL SUBIECT AN EMPLOYER TO CRIMINAL PENPLTIES AND GVIL FWES UP TOONE HUNDRED T}qU$PND DOLURE (5100,000�, IN ADORIdJ TO iHE W5T OF COMPENSNTIIXJ, DMIAGES AS PflOVIDED FOR IN SELTON 3IW OF THE LABOR CODE, INiEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby aMirm lhat I am licensed untler provisions ot Chapter 9(commencing with Section 7000) of Division 3 of the Business and Profeuions Code, antl my license is in full force antl etteci. Lic. a Class # Coniractors Signawre: Date: CONSTRUC710N LENDING AGENCV: ❑ I hereby affirm t�at ihere is a constmction lending agency tor ihe pedormance ot Ihe work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby attirm that untler penalry of perjury Ihat I am E%EMPT FROM 7ME CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business entl Professions Coae: Any ciry or county which requires e permit to construct, alter, improve, tlemolish, or repair any structure, pnor to its issuance, also requires ihe epplicanl tor such permit to tile a signed statement that he or she is Ilcense0 pursuant to Ihe pwvisions of ihe Contractors License Lew (Chapter 9(commencing with Section 7000) oi Division 3 oi the Business antl Protessions Code) or Ihat he or she is ezempt therefrom antl the basis for the elleged exemption. Any violation oi Section 7037.5 by eny applic�ant for e pertnit subje the epplicant to a civil penalty of not more than five hundretl tlollars ($500).): _ �_rPl.,�� I, as ownei of the p�operty/or my employees with wages es iheir sole compensation, WILL DO THE WORK, and ihe stmcture is not intended or o%eretl for sala (Sec. 7044, Business and Protessions Coda: The Contractors License law tices not apply to an owner of pmperty who builds or improves Ihereon, and who doas such work himself or hereetl or through his or her own employees, provided that such improvements are not intended or ottered for sale. If, howaver, ihe building or improvement is sold within one year ot completion; iha ownerbuilder will have the hurden oi proving that he or she did not build or improve tor purpose oi sale.). ❑ I, as owner of Ihe pmperty, am EXCLUSIVELV CONTRACTING WITM LICENSED CONTRAGTORS to construct the project (SecJ044, Busine55 and Professions Code: The contrectors License Law does no pply to en owner of property who builds or improves Ihereon, entl who contracis For such project with a contractor(s) license pursuan� to Ihe ConiractOrS Liten ws.�. ❑ 1 am azemp n s Siqnature: Owner ID ven ietl bv dnvefs Business and ❑ No � Vedfication oi Ownership by (type of document, i.e. - proDerty tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: �ii/[1!✓ r � i� ❑ I hereby certiy Ihat no excavation tive (5) or more feet in depth into which a person is required to descend, will be made in wnnection with work eu�horized by ihis permil, and that no building sWdure, scattolding, falsework, or tlemolition or tlismantling thereoi, will ba more ihan thirry-six (36) teet hiqh. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, California Atlministrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a pertnit from the Division oi Indusirial Satery, as noted above, unless such person hes e permit to tlo such work from the division. SignaWre: Date: Division of Indusinal Selery Permit Number. CERTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF Y: I cehify under penaly of perjury that I have reatl this application antl state Ihat ihe intorma�ion given is correct. I agrea to complyy 't II�QIe laws entl ciry or i nces relating to building constmction, end authonze represantatives oi ihe Ciry oi Coste Mesa to enter upon the above-descdbetl pmpe y cti purpo s. I a not to occupy or ellow occupancy oi any Duilding euthonzed by ihis pe � umi��l iqspection. lJ ignetu eg Owner(s) �T� Date COUE t. INSPECTIONTYFE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root 201 Final Block/Retaining W ell 202 Final Factory Fire Placa 203 Final Sign 204 Final Demolition Applicant Date O�TE �MRI�LS COOE I INSPECTION TYYE 206 Final MeChanical 208 Final Plumbing 270 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency OWNER DOYLE & SHIELAS aoa nnnaEss 3 5 Revello GEN�RAL CONTRACTOR DOY Forms unr n Co.�Inc. DATE 6-3-63 BUILDING PliRM1T NO. iev.Co. ,Inc. vAi.uE S 16,905•00 SUBCONI'RAC'i'OH N ., � • � � 9�9� � COSTA MESA BUILDING-SAFEfY DEPARTMENT P.O.'BOZ i1] COSTA M69A, GALIPORNIA Fo► Applicant fo Fill In Completely TYPE OR PRINT COSTA MESA, CALIFORNIA � MAIL eETB/�CK LINt FROM � � � cENTEIt OF 8TRH6T �O /L RHAR� SIDHYARDI LEPT NONE I R16Ij_T DESCRIPTION OF WORK F E RECEI��ED � APPLICAT FINANCE DEPT. s�� 'P� MESA For Office Use Only �� `� � L�a o - T1'PE � 6ROU DATE ZONINa r NO.OP U860 NE PLANB � I BUIL ` / .? Si3 �--' /E OVERHAN6 BHALL B6 LESS THAN r ^` YARDSAPPROVEO MAIN BUILDIN6 (FROM C/LSTREET) ��e PRONi pQ� FT. V � R. SIDfi FT. L.91D4 � �. REAR C.� FT. DIbTANCB BET. MAIN BLD6S. VAR. # �t HEREBY ACKNOWLEOOB TH�T 1 N�VE pE�D TH19 APPLICATION ANO 6TATE iHAT THE ABOY6 IB CORR6CT ANO AOFE6 TO COM. PLT WITH wLL CITY ORUINANCHB ANC BTAiQ�.�yY9 P6OUlATINO euuo�rvo coHarxucr�. / %/ � AUTHORIZED THE AMOUNT 9 PUwPOBe.OR VALUATION $ /� 9�'S9= YARDSAPPROVED ACCESSORV BUILDING BET. M AGCES DATE � '� � Q / VALl1AT10N 18 FOR TH6 A PERMIT FEE ONIY. IT FEE $ � ' CHECK s a 7 ` ___ .. .�f �