HomeMy WebLinkAbout2214 ELDEN AVE - Building Permits(7ta) �54-5D3 • Fax p�4) 75a-4856 • w�wi.ci.costa-mesa.ca.us 77 FAIH UHNt, GU51 A Mt.�A, GH 88ti"Lti
BUILDING PERMIT
Job Address: 2214 ELDEN AV
Suite:
Vicinity:
Parcel Number: 42606102
npp�icant: UNKNOWN
Address:
Owner: CEFALIA TR
Address 2214 ELDEN AV
COSTA MESA, CA
Contractor: OW N ER-BU ILD ER
Address:
Zip:
Arch :
Address:
Phone:
Zoning:
Phone:
Zip:
Phone: 949-933-7986
Zip: 92627
Phone:
License: 000000
Eng:
Address:
Status: ISSUED
Applied: 04/22/2004
Issued: 04/22/2004
Phone:
Zip: License: License:
SCOPE OF PERMIT
120 LF, 6' RETAINING WALL TO BE CONSTRUCTED JUST INSIDE THE LEFT SIDE PROPERTY LINE.
FEE SUMMARY
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$99.61
$753.25 -
$0.72
$0.00
$0.00
$0.00
$253.58
SETBACKS
MAIN STRUCTURE Frant 0- 0
ACCESSORY Front 0-0
PARKING Existing: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
PLANNING & ZONING
Left 0- 0
Left 0- 0
Pro osed: 0
Calc Valuation: S�,zoo.00
Claim Valuation: go.00
Right 0- 0
Right 0- 0
NOTICE: The work authoriZed by this permit shall comply with a�l applicable handicap access requiremenis under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-g2)
EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspentled or abantloned
tor a periotl of 180 days.
INSPECTIONS: In order for the work authorized under this permit lo be considered legal, such work must comply with all applicable codes, and all
required Inspections and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (774) 7545626
!ddG461fi/00)
WORKERS'COMPENSAnONDECLARATION: � '
I here6y eXirm untler Denelry of perjury one of the foliowing�declarations: „
❑ I have and will maintain e ceniticate of consent to self-Insure for workers' compensation, as provitled for by section 3700 oi ihe Lebor Code, br Ihe peAormence oi the
woM tor which t�is pertnit is issuetl. � �
❑ I heve and will maintein workers' compensation insurance, as required by section 3700 oi ihe Labor Code, for the pertormenca of the work for which this pertnit Is Issuad.
My workers' compensation Insurance cerrier end policy number ere:
Cerrier. Policy Numbar:
(This sectlon need not be completeO il the permit Is valued ef one hundred dollare ($100J or less.)
❑ I certify thet in ihe peAormance oi the work for which this pertnit is issued, 1 shatl not employ any person in any manner so as to become subject to the workers'
compensetlon lews of California, and agrea thai il I should become sub�ect to the workers' compensetion provisions of Sectlon 3700 oi the Labor Code, I shall forthwith
Comply with t�ese provisions.
Applicant Signature: Dete:
WARNING: FAILUPE TO SECURE WORKERS' �MPENSATION CAVEiiAGE IS UNIAWFUL AND SHALL SUBIECT AN EMPLOYER TO CPIMINAL PENALiIES AND qVIL FlNES UP TOONE HONDRED
hKK15PND OOLLARE (5100,0001. IN ADDIiIIXJ TO iHE WST OF COMPENSATION, DAMAGES PS PPOVIDED FOR IN $ECTION 31080F iHE IABOR COpE, IMEREST, qND ATTORNEY'S FEES.
LICENSED CONTRACTOAS DECLAHATION:
I hereby aHirm that I em litensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business antl Professions Cotle, antl my license is in full �
force and eflect. Lic. N Class a
I Contrectars Signeture: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirm Ihat th re e is.a cons
Londef5 Neme: �� '+�;�`�
Signawre: ���'��
Aion lending agency lor ihe pertormance of Ihe work for which this pertnil is issuetl. (Sec. 3097, Civil Code).
Lender's AtltlresS:
De�9:
OWNEFi-BUILDERDECLAAATIONS: "�tJ,cSj
I hereby eHlrtn that under penalry oi perjury ihat,l em�EXEMP7 FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Busineu antl Professions
Cotle: Any ciry or county whic� requires a periniFto wnsiruc6 alter, improve, demolish, or re0air any strucmre, pnor to ils issuance, also requires Ihe applicant for such permil
to file e signed statement lhal he or she is licensecl pursuant to the pmvislons of Ihe Contractore License Lew (Chapter 9(commendng with Sectlon 7000) ol Division 3 0l the
Business antl Protessions Code) or that he or she is ezempt iherelrom and the basis for the allegeA ezemption. Any Wolation ol Section 7037.5 by any applicant for a pertnit
sublects the applicant to e civil penalry of not more than live huntlretl tlollars ($500).):
❑ I, as owner ol the property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and Ihe struciure is not intendetl or otterad for sala (Sec.
7044, Business and Professions Code: The Coniractors License Law tloes noI apply ro an owner ot property who builds or improves Ihereon, and who does such work
himself or herself or thmugh his or her own employaes, provitled that such improvemenis ere not intentletl or offered for sale. tl, however, the building or impmvamem is
���— ///:::/// Id within one year of completion, Me owner-buiider will have the 6urden of proving ihat he or she did not build or improve for purpose of sale.).
es owner of the property, am E%CWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business antl Professions
Code: The comractors License Law tloes not eppty to en owner o/ pwperty who builds or improves there0n, and who contracls for such prajecl with a conlrector(s)
license pursuant to the Contractors Lic� Lews.).
Businass end Professions Cotle for this reason:
�pN�d by icense.� � No
�— �
of rship Dy Qype ot documenC i.e. - pmper�y tax bill or
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
�
❑ I hereby certity thal no ezcavation five (5) or more feet in de0�h into which a person is required to descenq will ba meda in connection with work euthodzed by �his
permit, antl ihat no building strucWre, scaHolding, falsewo�k, or tlemolition or dismantling Ihereof, will 6a more than thirry-six (36) feet high. (Chap. 3.2, Gry 2, An 2, Sec.
341, 7Ue 8, Califomia Admini5�rative Code).
❑ As owner-builder, I will not employ anyone to tlo work which would require a permit tmm the Division of Intlustriel Sa/ety, es notetl above, unless suc� person hes e
permit to tlo such w0�k �rom the tlivision.
Signature: Date:
Division of Industrial Satety Permit Number:
CERTIFlCATE OF C VL�NdCE AND AUTHORIZATION OF ENTSiY: I cenify under penalry of perjury that I �ave read this application antl state that t�e infortnation given is
correcL I egr co ly with all state lews and ciry ordlnances relating to builGing consiructlon, and euthodza representatives of ihe City ot Gos�a Mes ro enter upon �he
above�de ed pr erty for inspecti urpose a ree' e ccupy or Ilow occupancy of eny builtling authorized by lhis permit un'Nf' F��pectio
� �
at t "
A A/O uthonzetl Aool' ant ale
COOE �, INSPECTIONTYVE PAIE IN7ITIRLS
1676 Fixed System Final Fire Prevention
1266
200
201
202
203
Pool Spa Final
Final Re�Roof
Final8locWRetaining Well
Final Factory Fire Place
Final Sign
204 Final Demolition
CODE 1 INSPECTION TYVE
206 Finel Mechanical
208 Finel Plumbing
210 Final Elecincal
212 Finel Fire Prevention
220 Final Planning Approval
222 Final Si�e
250 Final BuildingiOccupancy
PAIE It�E4$
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ra.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Viciniry:
Parcel Nunmber:
2214 ELDEN AV
42606102
Applicant: CEFALIA, JIM
Address: 2214 ELDEN AV
COSTA MESA, CA
Ovmer: CEFALIA TR
Address 2214 ELDEN AV
COSTA MESA, CA
Con tra ctor. O W N E R- B U I L D E R
Address:
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets
switcnes
Non Res Appl
Res Appl
Service to 200a
Service to t000a
Service over 1000a
Motors to 1hp
Motors to 10hp
MOWrs to SOhp
Motors to t00hp
Motors over 100hp
Communica6on drops
ELECTRICAL PERMIT
ISSUED BY:
Phone: 94&933-7986
Zip: 92627
Phone:
Zip: 92627
Phone:
Zip:
License: 000000
Status: ISSUED
Applied: 05118I2004
Issued: OS/78/2004
SCOPE OF PERMIT
ELECTRICAL PERMIT FOR A TEMPORARY POWER POLE IN CONJUNCTION WITIi THE CONSTRUCTION
WITH A NEW 3,712 S.F. S.F.D. WITH 573 S.F. ATTACHED GARAGE. WORK TO INCLUDE: 1,808
FOR 1ST FLOOR, 1,904 FOR SECOND FLOOR.
REF: B03-01922
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
50.00
$0.00
30.00
$0.00
50.00
$0.00
ao.00
50.00
$0.00
�uantity
FEE SUMMARY
Temp Dist System / Lighling
Busway/t00ft
Standing Sectlon
Misc Electrical Equipment
Transfortners up to 1 kva/kw
................up l0 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low VolWge Equipment
Low Voll Wiring Syslem / Ckt
Misc. Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech nde or lights)
ChrisUnas Tree Stand
Fireworks Stantl
Other Electrical Fee
Investlgadon Fee
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NOTICE: Tha work authorized by ihis permit shall compty with all applirable handicap access requirements under Calilornia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void Ii work is not commenced within 180 days, or il work Is suspended or abandoned
for a period of 780 days.
INSPECTIONS: In order tor the work euthorized under this permil to be considered legal, such work must comply with all applicable codes, antl all
required Inspeetions and final epproval must be obtained. Failure to obtain inspections antl final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 75h5626 �
2446-68 (8�W)
WORKEHS'COMPENSAnON DECLARAnON:
1 �ereby eHirm under penalry ot perjury tlne ol ihe following CeGeretlons:
❑ I have end will malntaln a ceNfiwte of consent to selt-Insure tor workers' compensation, es proWdetl tor by section 3700 at t�e Lebor Code, for Na peAortnance of Iha
work lor whic� this permit Is issueG.
❑ I have arW wlll malntain vroAcers' compensation insuraxe. as reQulretl by secUon 3700 ot Ne Lebor Code, for the peAortnence ol t�e woAc far whkh this pertnit is issued.
My workers' wmpensetion Insuran�e carder and policy number ere:
Cartier. Policy Number.
(Tfi SecNon need not be comp/efed7! Ure pertrtif !s valued af one hundretl tlW/ers (S100J or Iess.J
I certity Ihat in tha perto�ce ot lhe work lor which this pertnit Is Lqsued, I shall not employ any person In eny manner so es to became subject to the workers'
APvllcant
WARNINO:
�, en� Ihet II t shoultl �eco ub�ect to the workers' compensatlon provlsions oi Sectlon� ��bor Cade, I shall forthwlt�
l
Dete: S
RS' FAOE IS UNIAW FUL M!D SHALL SUBJECT PN EMGLOYER TO CRI P TIES AND GVII FlNES UP TO ONE HUNDRED
1 TME COST OF COMPENSqT10N, OMIAGES AS PROVIDED FOR IN SELTION 3708 OF THE IABOR ODDE, INTERES7, AND FTTORNEV'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby efllrm that I em Iicensed under p�ovislons oi Chepte� e(commencing wit� Section 7000) af Dlvislon 3 of Ihe 8usiness end Professlans Code, end my license Is In full
torce entl efleci. Lic. p Cless q
Conirectors Signature: Dete:
CONSTRUCTION LENDING AGENCV:
❑ I hereby aMirtn Ihei Ihere is a conslN�ion lending agency tor the pertormance ol the work for which this pormi� Is Issued. (Soc. 3097, Civil Cotle).
Lentlers Neme: Lendefs AtlOress:
Signawre: Date:
OWNER-BUILOER OECLARATIONS:
I hereby aHlrtn Ihet under penalry of perjUry Ihet I em EXEMPT FROM TME CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business entl Professlons
Code: Any ciry ar wunry whkh requiees a Pertnit to cortstruct, alter, improve, tlemolish. w repair any structure, pdw to its issuance, elso requires ihe applicaM tor such perm4t
to file e signed stetement Ihat he or she �s Ilcensed pursuent to Ihe provlsions of Ihe Contractors License Law (Chepter 8(commencing with Sedlon 7000) ol DlWsion 3 of Ihe
Business entl Protessions Code) or that he or she is exempt therefram end Ihe basis for the alleped eaemption. Any Nolallon of Section 7031.5 by any appliwnt for e permit
subjects the epplicant to e clvil penalry W not mare than live huntlred dollars ($500)J:
❑ I, es owner of tha properry, or my employees with wages as Iheir sole compensaiion, WILL DO THE WORK, end the siructure Is not intended or oHeretl for sale (Sec.
7044, Buslness and Professions Code: The Conirectors Licanse Lew tloes not apply to an owner of property who builtls or Improves thereon, and who does such work
himselt or herself or through his or her own employees, pravideA thet such improvements ara not intentled or offered lor sale. If, however, Ihe building or improvement is
sold within one yeer ol completioq Ihe owner-builtler vnll have tha burtlen of proving that he or she did not build or Improve lor purpase ol sale.). '
❑ I, as owner of Ihe Oroperty, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTOFS to construcl Ihe project (Sec. 7044, Business antl Profeulons
Cotle: The cyatrqcbrs Licensa LaW does not eppty to en owner ot pm0erty who bullds or improves thereon, antl who contracts for such prqect wit� a conirector(5)
licensa D�sueD«o t�e Contractors ��ense LewsJ. �
❑ I e�p%Yempt'untler sec.
Business end Professions Code for ihis reason:
;� es ❑ No Drivels License
ol tlocument, i.e. - D�aPerry tan bill or deatl):
DIVISION OF INDUS7RIAL SAFE7Y PEAMR CERTIFICATON:
� I here6y ceNly ihet no encavaUon (rve (5) or more leet In deDth Into which e person Is required to descend, will 6e made In cw�oection with work auttindzed by tMs
pertnit, end t�el no builtling structule, scaHoltling, lalsework, or demolition or dismentling ihereof, will be more ihen thlrty-sl: (38) leet high. (Chap. 3.2, Grp 2, Ar12, Sec.
341, Ttle B, Celifomla AtlminiSlratNe CoOe).
❑ As owner-Duiltler, I will not employ enyone to do work w�ich would require e permi� Irom Iha Division ol Indusirial Selery, es noted ebo�e, unless such person has e
permlt ta do such wark trom the diVision.
Slgnature: Dete:
Divislon ot Industnel Sefery Permit Numbec
CERTIFlCA7E OF CO IANCE AND A�ORVATION OF EMRV: I certify under penalry ot perjury thet I heve reed this epplication and siate ihat the informatlon given is
correct. I egree o�9 µ�uit II state laws end city ortlinances releting ro building construction, end euthodze representetives of Ihe Ciry ot Gosta esa to enter upan the
ebove-desc' d p)�e �inspect es� ree not to acupy or allow occupency of any building euthonzed by Ihis permi�unt' � ins e �on.
� s �Cy�I
5� egalOwner(s) Date
GO�E I, INSPECTIONTYPE
1616 Fixetl System Final Fire Preventlon
1268 Pool Spe Finel
200 Flnel Re-Rool
201 FIneI BIaWReIelnlnp Well
202 Finel Factory Fira Place
203 Flnal Sign
204 Final Demolition
QejE �$ COpE1 INSPECIIONTYPE
206 Finel MeChanical
208 Final Plumhing
210 Final ElecMcal
212 Flnal Fire Preventlon
220 Finaf Plann{ng ApP�ova1
222 Finnl Site
250 Finel BulltlingiOccuOency
QAg
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, GOSTA MESA, GA 92626
BUILDING PERMIT
JobAddress: 2214 ELDEN AV
Suite:
Vicinity: PERIMETER WALL
Parcel Number: 42606102
Applicant: CEFALIA, JIM
Address: 2214 ELDEN AV
COSTA MESA, CA
Owner: CEFALIA TR
Address 2214 ELDEN AV
COSTA MESA, CA
Contractor: O W N E R-B U I LD E R
Address:
Zip:
Arch :
Address:
Zoning:
Phone:
Zip: 92627
Phone:
Zip: 92627
Phone:
License: 000000
Eng:
Address:
Stalus: ISSUED
Applied: 04/75I2004
Issued: 04/76/2004
ISSUED BY:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
CONSTRUCT 4 FT HIGH BY 142LF RETAINING WALL ALONG REAR AND RIGHT SIDE P.L. AS PER CITY STANDARDS NO OTHER
CONSTRUCTION ON TOP OF RETAINING WALL IS ALLOWED UNDER THIS PERMIT ALONG REAR AND RIGHT SIDE P.L. 142 LINEAL FEET.
REF: G03-00019
Plan Check: $108.71
Permit: $16725
SMIP Res: $0.85
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $276.81
SETBACKS
MAINSTRUCTURE Fronl 0-0
ACCESSORY Front 0. 0
PARKING Existinq: o
Rear 0- 0
Rear 0- 0
Re uired: 0
FEE SUMMARY
PLANNING 8 ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
58,520.00
so.oa
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 92-28, § 1. 7241-92)
E%PIRATION: This permit shall automatically expire and become voitl if work is not commenced within 180 days, or if work is suspended or abandoned
tor a periotl of 1 BO days.
INSPEC710NS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable cotles, and all
requlred Inspeetions and flnal approval musi be obtained. Failure to obtain inspections antl final approval will result in ihe expiration ol ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
2nn&ae(aroo)
WORKERS'COMPENSAnON DECLARAnON: " '
I hereby eNirm under penalry ol perjury one ol Ihe lollowing tleclarations: ,
❑ I heve end will maintain a certificate of consent to selt-Insure for workere' compensetion, es providetl br by section 3700 of tha Lebor Code, for Ihe peAortnenca ot the
work far whith ihis perrliil IS issued.
❑ I have antl will malntain workers' compensation Insurenca, as repulretl hy section 3700 of the Lebor Code, lor Ihe Oertortnance of the work lor which Nis pertnit is issuqC,
My workers' compensat�on Insurence cerrier entl polity num�er ere:
Cerrier: policy Number:
(Thls secfion nesd not be canp/e(ed il the permi( fs ve/ued et one hundred dWlers (3100) or /essJ
� I cartily that in Ihe peAotmance of t�e work lor which this pertnit Is Issuod, I shall not employ any person In any manner sa as to become subject to lhe warkers'
compensation lews of Celifomia, antl egree that II I shoultl become sub�act to tha warkers' compensetion provislons oi Section 3700 0l the lebor Code, 1 sna11 tortfiwith
comply wi�h �hose OrovlSions.
AppliCenl Signeture: Dale:
WARNINO: FAILURE TO SECURE WORI(ERS' COMPENSATION COVERAGE IS UNLAWFIIL AND SHr1LL SUflIECT FN EMPLOYER TO CRIMINqL PENALTIES AND CIVIL FlNES UP TOONE MUNDPED
Til0U5AND DOLIARE (5f 00,000), IN �DR10N TO THE C06T OF COMPENS/�i1pN, pAMqGES AS PROVIDED FOR IN SECTION 3]OB OF THE LABOR CODE, IMEREST, AND ATTORNEYS FEES.
LICENSED CON7AACTORS DECLARATION:
I horoby aHirm ihet I am Ilcensetl unaer provisions of Chapter 8(commencing with Section 7000) ol Divislan 3 of ihe Business antl Pmfesslons Code, anA my license Is In tull
force end eHec�. Lic, p Class q
Signeture:
Dele:
CONSTRUCTION LENDING AGENCY:
❑ I �ereGy eNirtn that ther6 �s a consWction Iending egency lor Ihe peAortnance ot tha work lor which Ihis pettnl� Is issued. (Sec. 3097, Ci�dl Code).
Lontler's Neme: LonCers Address:
Signeture:
Date:
OWNER•BUILDER DECL'ARA'�10NS ,
�e �� �
I �ereGy eNirm that untler pen8�ry;of:pe,�ury thai l em EXEMP7 FROM THE CON7RACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business an0 Professions
Cotle: Any ciry or counry whic� �eqwres e pertnit to construct, alter, impwve, tlemWish, or reDeir eny sWcture, prior to its issuance, also requires the applicant for such pertnit
m lile e signetl stetemem t�et he or she ISlicensed pursuant to Ne provisions of the Contractors Llcense Law (Chepter 9(commencing with Sectlon 7000) ol Division 3 oi the
Business and Professions Code) or Ihat he or`she i�e�mpi therelrwn enA the basis for the elleged exemption. Any Wolation of Section 703'�.5 by any applicant for a pertnit
sub�ecis ihe eppliwnt to a civil penalry ol not more,tcn five hundred dollars ($500).):
❑ I, es owner of Ihe propeRy. or my employees wiih wages es their sole compensa�ion, WILL DO 7TiE WOHK, end the structure is not inteneeE or oHeretl for sale (Sec.
7044, Business and Protessions Code: ThdContractors License Lew dces not apply to an owner of property who builds or improves ihemon, end who does such work
himself or hersetl or Ihmugh his or her own employees, provided tha� such impwvements ere not intended or ottered lor sale. It, however, the building ar imprwement is
�sold within one year oi rAmpletion, the ownerbuilder will hava the burtlen of pmving ihat he or she did not buila or improve for purpose of saleJ.
I, es owner of Iha propeM• am EXCLUSIVELY CONTRACTiNG WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business antl Profeuions
Code: The cantraaors Ucense Law does not eppty to an owner ol property who builtls or improves Ihereon, end w�o contracts tor such prqect wiih a contwctor(s)
license pursuan�lfe CANractors License Lew� � �
���
by
by (type ol
antl Professions Cotle for ihis reason: _
�1
To � i i�a� u�� ' ��
property �a< blll or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATION:
❑ I hereby cenify �het no ex�evatlon Ilve (5) or more feet in depth into w�ich e Derson is requiretl to descend, will be matle in connection with work auihorized by this
permil, and that no builtling structure, scaHoltling, falsework, or demdition or tlismantling Iheraof, will be more ihan t�irry-six (36) leet high. (Chap. 3.2, Grp 2, An 2, Sec.
341, Tule B, Califomia Administrative Cotle).
❑ As owner-huilder, I wlll not employ enyone to do work which woultl requlre a perml� Irom Iha Division of Industrial Safety, es notetl eDcva, unless such person has e
permit to do such wark from the division.
Signature: Dete:
Division ot Industnal Safery Pe�it Number:
CER7IFlCATE OF COMPLJANCE AND AIJi}10RIZA710N OF ENTAY: I certily under penelry ot perjury Ihat I have read t�is apDlication and state Ihat the informalion given i5
wrrect. I egree pty wlln ell state I a C ciry ordinances r lating Io building construciion, end authodze representatives o t�e Clt ot Costa Mesa to enter upon ihe
ebove-des ' ed pr � erty lor inspecti rpo gree no cupy or ellow occupancy af any building authorized by this p i� unlil el insp�ction.
�
ature OI
Antl/OrAut�onzetl Aoolicant Date
GOUE I, INSPECiIONTYVE
Fiaetl Systam Final Fire Prevention
1266 Pool Spe Flnal
200 Final Re-Rool
201 Flnal BIocWRetaining Wall
202 Final Fat�ory Flre Pla�e
203 Final Sign
204 Final Demolition
Qd¢, �$ �� INSPELPONTYPE
206 Final Mechenical
208
210
212
220
Final Plumbing
Final Elocirlcal
Final Fire Prevention
Final Plenning Approval
222 Final Site
250 Finel Building/Occupency
P�re 11�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 2214 ELDENAV
Suite:
Vicinity:
Parcel Nunmber: 42606102
ApplicanC CEFALIA, JIM
Address: 930 W OCEAN FRONT
NEWPORT BEACH, CA
Ownec CEFALIA TR
Address 2214 ELDEN AV
COSTA MESA, CA
Contractor:
Address:
Zip:
Eng:
Address:
� Zip:
GRADING PERMIT
Zoning:
ISSUED BY:
Phone: 949-933-7986
Zip: 92661
Phone:
Zip: 92627
Phone:
License:
Phone:
License:
Status: ISSUED
Applied: 11/18/2003
Issued: 03/29/2004
SCOPE OF PERMIT
CUBIC VARDS CUT/FILL 140 CUBIC YARDS FOR NEW 3 712 S.F. S.F.D. W/ATTACHED GARAGE. REF.:
B03-01922.
SITE IMPROVEMENTS TO INCLUDE: NEW DRIVEWAY.
iao
Plan Check: $33.00
$202.00
Permit: $54.50
Other: $325.45
$0.00
Inspection: $0.00
$0.00
Total: $614.95
NOTES:
FEE SUMMARY
PLANNING & ZONING
Calc Valuation: Szo,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 1 BO tlays.
INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inapeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPEC710NS CALL: (714) 7545626
2446A6 (6/00)
WORKERS' COMPENSATION DECLARATION: '
1 hereby aHirm under penalry of perjury one of the following declarations:
❑ I have end will maintain a certifiwte of conseni to seit-Insure for workers' compensation, as provided br by section 3700 ot the Lebar Code, lor the pertortnance of ihe
work for which ihis pertnil is issuetl.
❑ I have end will malnWin workers compen tion insurance, as required by section 3700 of ihe Labor Gotle, for the pedortnance of the work lor which this pertnit Is issued.
My workers' compe�nnsation Insurenca r end policy num�er are:
Carrier: �� y(� /V ' � n.h Policy Number:
�(This sectton needTfoYbe le etl the permiNs va/ued et one hundred tlollars ($100) or less.)
certity that in the per
compensation laws of
comply with these pr
:4ppllcent 31g�a�tu�re�� !�
WARNINp: FAILUHt�KTStKU�
� wark for w�ich t�is permit is issued, I shall not employ any porson in eny manner so as to Dewme subject to the workere'
egree Iha� II I shoultl become su6�ect to ihe workars' compenselion provislons ol Sactlon 3700 of Ihe Labor Cotle, I shall forihwith
THE
LICENSED CONTRACTORS DECLARATION:
Dete:
VERAGE IS U D SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES lIP TO IXJE HUNDREO
COMPENSATION, DAMAGES AS PROVIDE� FOR IN SECTION 3]OB OF THE LABOP CODE, IME:REST, AND AiTORNEI^S FEES.
I hereby eRirm thal I am licensed under provisions of C�apter 9(commencing with Section 7000) of Divislon 3 of the Business antl Protesslons Cotle, end my license Is in full
lorce entl eflecL Lic. a Cless a �
Contrectofs Signawre:
Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby aflirtn ihat ihere is a consimction lending agency lor ihe peAormance of t�e work for which ihis permil is issuetl. (Sec. 3097, Civil Code).
Lendefs Neme: Lenders Address:
SignaWre: Date:
OWNER-BUILDER DECLARATIONS:
I hereby ettirm thet untler penalry of perjury Ihet I em EXEMP7 FROM 7ME CON7RAC70RS LICENSE LAW for the following reason (Sec. 7C131.5, Business and Prolessions
Coda: Any ciry or county which requires e permit to construct, alter, improve, demolish, or rapair eny strucWre, pnor to its issuance, also requi;es the appliwnt br such permit
to tile a signetl statement Ihat he or she Is licensetl pursuant to the provisions oi the Gonhectors License Law (C�apter 9(commencing with Section 7000) oi Division 3 af the
Business antl Professions Code) or that he or she is exempt therefrom antl the besis for the alleged ezemption. Any violation ot Section 7031.5 by any applicant for a pertnit
subjects the epplicant to a civil.penelry of nat more than five hundred dollers ($500).):
❑ 1, as owner of iha propeny, or my employeas with wages as �helr sole compensation, WILL DO TME WORK, end Ihe structure is not intended or oHeretl for sala (Sec.
7044, Business and Professions Cotle: The Contractors License Law dces not apply to an owner of property who builds or improves iheruon, and who does such work
himseif or herself or through his or her own employees, pmvidad that such improvemenis are not intentletl or oflered for sale. If, however, Ihe building or improvemeN is
Id within one year of completion, the owner-builder will have �he burden of proving ihat he or she ditl not build or improve for purpose ol sale.).
I, as owner oi the propeny, am E7(CLUSIVELV CONTRACTING WITH LICENSEO CONTRACTORS to constmct ihe project (Sec. 704d, eusiness antl Pmfessions
Code: The contractor icense Ww does not appty to an owner ot propeny who builds or improves thereon, and who contracts for such p:ojeci with a contrector(s)
license pursuant e ontracrors License Laws.).
❑ lam
dnvefs
antl Prolessions Cotle tor this reason:
� ❑ No Driver's License No.
i.e. - property tax bill or deed):
DIVISION OF INUUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cehify ihat no excavation five (5) or more faet in depih Into which a person is requlred to descend, will be matle in connectlon with work authorized by lhis
permit, antl Ihat no building sWcture, scaflolding, falsework, or demolition or tlismanUing lhereof, will be more then thirty-sis (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tule 8, Calilomia Adminis�retive Cotle).
❑ As ownervhuiltler, I will nat employ enyone to do work which woultl require e permit irom the Divislon of Indusinel Sefety, es notetl abuve, unless such pereon hes e
permii to da such work irom �he tliWsion. �
Signalure: Dete:
Division ol Industnel Sefery Pertnit Numbar:
CERTIFICATE OF COMPIIANCE AND AUTHORRATON OF ENTAY: I cenify under penalry ol perjury ihat I have read ihis epplication end state ihat the infortnetion given is
covact. I egree t ply with ell state laws end ciry ordinences relating to building consiruction, end authotlze representatives of ihe Ciry of Costa Mesa to enter upon the
above-desc � tl pr rty for insDection purposes e oc upy or allow occupency of any builtling authori ed by ihis er it u Il linal inspection.
C. igrreture" - gaiOvmer(s}� Date
COOE11, INSPECTIONTVPE
t61fi Fixetl System Finel Fire Prevention
1266 Pool Spa Finel
200 Finel Re-Roo�
201 Finel Block/Rataining Wall
202 Final Factory Fire Place
203 Finel Sign
204 Finel Demolilion
peg f� �� INSPECTIONTVPE
206 Finel Mechanical
200 Finel Plumbing
210 Finel Electricat
212 Finel Flre Prevemion
220 FinelPlanning Approval
222 Fina15ite
250 Finel Building/Occupancy
PAIE II�E4S
3
(714) 754-5273 • Fex (714) 754-4856 • WVNI.ci.CO5t0-meSa.Ce.uS 77 FAIR DRIVE, GOSiA MESA, CA 92626
BUILDING PERMIT
,lobAddress: 2214 ELDENAV
Suite:
Viciniry:
Parcel Number: 42606102
Applicant: JEFF CHAMLEY
Address: 202 CALLE MARINA
SAN CLEMEMTE, CA
Owner: CEFALIA TR
Address 930 WEST OCEAN FRONT
N.B. CA
Contractor: O W N E R-B U I LD E R
Address:
Zip:
Zoning:
Phone: 949-36E1251
Zip: 92672
Phone: 94&933-7986
Zip: 92661
Phone:
License: 000000
ISSUED BY:
Status: ISSUED
Applied: 11I04I2003
Issued: 0422/2004
Arch : Eng: TAGGART, PHILIP W
Address: Address: 1300 BRISTOL ST
Phone: SUI7E 100 Phone: 949-261-7740
NEWPORTBEACH,CA
Zip: License: 92660 License: 25739
SCOPE OF PERMIT
CONSTRUCT NEW 3,712 S.F. S.F.D. WITH 573 S.F. ATTACHED GARAGE. WORK TO INCLUDE: 1,808 FOR 1ST FLOOR, 1,904 FOR SECOND
FLOOR.
NEW 4 BEDROOM, 3 BATH S.F.q.
Plan Check: $1,581.42
Permit: $2,432.95
SMIP Res: $35.69
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $4,050.06
SETBACKS
MAIN STRUCTURE Front 0. 0
ACCESSORY Front 0-0
PARKING Exfstinq: 0
Rear 0. 0
Rear 0- 0
Re uired: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0. 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Righl 0• 0
Righl 0. 0
$356,912.70
so.00
NO710E: The vrork authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-g2)
EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or it work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, ana ail
requiretl Inspections and final approval must be obtained. Failure to obtain inspections and final approval will resutl in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2dd&46 (8/00)
WORKERS'COMPENSAnON DECLARAnON:
I hereDy eHirtn untler p6�alry of perjury one of Ihe following tlaclarations:
❑ I heve end will me�ntain a certificate of consent ta selt-Insure for workers' compensation, as provitletl for by sedlon 3700 0l the Labor Cotle, lor the peAormance of the
�ork lor which this permil is issuetl.
ave and will maintain workers' compensation insurence, az required by secUon 3700 of the Labor Cotle, for the pertortnanca ol Ihe woAc br w�kh NIs pertnit is iswetl. �
orkers' compensation Insurence cerrier antl policy num�er ere:
0�1 � Poliry Number:
et one nundred dollars ($100) or less.)
❑ I certily ihat in the Pe�nDo ol the work lor which this permit Is issueQ I ahell not employ any porson in eny mannor so es to bewme subjectJp the workers'
compensetion laws alify fnie, ec4 ��paFil•f• e sub�ecl to Ihe workers' compensation provisions of Section OD of tha Le eiCode, I shall lorihwith
comply wlih ihese ovi 6ns.
Applicent SipneWre: Dete: % 1�!� �
WARNINO: FFI�U kCURE W ' COMPENSAiION GE IS UNLAWFUL AND SW1LL SUflIECT AN EMPLOYER TO INAL PENA 5 AND IVIL FlNES UP TOONE HUNDRED
TMOUSAND E(SiW. i1D0�T10NTOTHECO6TOFCOMPENSrITKN�,DAMAGESASPROVIDEDFORINSECTION3I08OFTHEIABOflCODE,IMEREST,ANDATiORNEV5FEE5.
LICENSED CON7RAC70R5 DECLARATON:
I hereby aHirm that I em licensatl untler provisions of C�apter 9(commencing wit� Section 7000) of Division 3 ot Ihe Business end Professions Code, and my license Is in full
foma antl eflacL Lic. a Closs q
Contreclors Signemra:
Dele:
' CONSTRUCTION LEND�NG AGENCV:
❑ I heroby eHlrm iha� �here i9 B cor�slruction Iendinp agency for Ihe pedormance ot lhe work lor which ihi5 pertnll IS 155ued. (SBc. 3097, Civil Code).
Lontler's Neme: Lentler's Atldress:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eflirtn ihat und6� penelry ol perjury t�ai l em EICEMPT FROM 7HE CONTRACTORS LICENSE LAW lor ihe tollowing reason (Sec. 7031.5, Business end Professions
Cotle: Any ciry or counry which requires a permi� to conswct, alter, improve, tlemolish, or re0eir eny stmcWre, pnor to Its Issuance, also requires Ihe eppliwnt for such pertnit
to file a signetl statemanl ihat he or she is Ucensetl pursuant ta the provisions of the Coatractors licease law (Chapter 9(commencing with Seclion 7000) ot DiWsion 3 of tfie
Business and Pmfessio�s Code) or �het he ar she is ezempt therelrom entl the Oasis lor ihe alleqed exempNon. Any violatlon of Section 7037.5 �y any epplicant for e pertnit
subjacts Ihe epplicant m a civil penalty of not more than five hundred dollers ($500).):
❑ I, as owner oi �he pmperty, or my employees with wages es their sole compensaiion, WILL DO THE WORK, end the structure is not intended or ottered for sale (Sec.
7044. Business and Professlons Coda: T�e Contractors License Lew does not apply to an owner of propeny who builds or improves thereon, and who tloes such work
himsalf or herself Pr through his or her own employees, provided Ihat such improvements are not intended or oHered for sale. If, however, ihe builtling or improvement is
soltl within one yea� of wmpletion, the ownerbuiltler will have the burden of proving that he or she did not build or improve for purpose ot sale.j.
1, as owner ot the p�operty, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the projact (Sec. 7044, Business end Professions
Code: The coniraGtor ' nse Law does not appty to an owner of property who hullds or improves thereon, end who cnntracts for such project with e coniractor(s)
license pursuant}o e ntrectors License LawsJ. � �
�
Bu5in855 and ProfB55ion5 COde �or Nis r885on:
of documem, I.a. - pmperty ta: blll
CERTiFlCATE 0�-G6 PL�ANCE AND AUITIOFiVA710N OF ENfTiV: I cenify under penalry of perjury thal I have reetl this applicalion end state t�et the inlortnation given is
correcL I ee to co pN M'��� all steie lews end ciry ordinances relating to bullding constructlon, antl euthodze representatives of Ihe Ciycot Costa Mese to enter upon the
above- scnbed p erty �or inspection es_ or ellow occupancy of any builtling euthodzed by l�is permi lAfnal inspe 'oh�
� fJ
ur 1 Le ner(s e
AnNO� Autfiorizad Aoolicant Date
CODE 1. INSPEGTIONTYPE
1676 Fixed System F�nal Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Finel BIocWRetaining Well
202
203
Final Factory Fi�e Place
Final Sign
204 Finel Demolition
P�7E ItIIIDELi
CO�E 1 INSPECTION TYPE
206 Finai Mochenicel
208 Final Plumbing
210 Final Electrical
212 Final Fire Preventlon
220 Final Planning Approval
222 Finel Sile
250 Finel Bulld'mgiOccupan[
PLUMBING PERMIT
Job Address: 2214 ELDEN AV
Suite No
Vicinity:
Parcel Nunmber: 42606102
Applicant: MCVAY,MARK
Address: 1760 MONROVIA
COSTA MESA
Owner. CEFALIATR
Address 2214 ELDEN AV
COSTA MESA, CA
Status: �SSUED
Applied: 04/30/2004
Issued: O4/30/2004
ISSUED BY:
Contractor: WATERTIGHT PLUMBING INC.
Address: 1760 MONROVIA
COSTA MESA
Arch / Eng :
Address:
ISSUE FEE
BackFlow irrigation
Backflow Preventer
Bathtub
Clarifer System
Connect Qce,Soda,etc)
Dental Units
Dishwasher
Drein, Floor
Drein, Rainwater
Phone: 949-764-0014
Zip: 92627
Phone:
Zip: 92627
Phone: 949-764-0014
Zip: 92627
License: 818021
Phone:
Zip:
License:
SCOPE OF PERMIT
REF 803-01922 FOR NEW SFO. 3 COMBINATION BATHTUB AND SHOWER, 2 ICE CONNECTORS, 2
DISHWASHERS, 1 GAS (1-4 OUTLETS) 2 GAS (OVER 4 OUTLETS) 1 GAS SERVICE, 2 LAUNDRY
TUBlWASHER, �
1 SEWER CONNECTION,2 KITCHEN SINKS, 4 WASH BASINS, 3 TOILETS, 1 WATER
HEATER, 1 WATER SERVICE. 8 HOSE BIBBS AND 2 GARBAGE DISPOSALS.
AMT
$23.50
30.00
50.00
$29.40
50.00
319.60
ao.00
$19.60
50.00
$0.00
FEESUMMARY
QTY AMT
Laundry Tub / Washer $19.60
0 Landscape Irtigation $0.00
0 P-Trap $0.00
3 Pressure Regulator $0.00
0 Process Piping (per 10 ft) $0.00
2 Recepiors $0.00
0 Septic Tank $0.00
2 Sewer Cap for Demo $0.00
0 Sewer Connect - $24.65
0 Sewer Private Line 50.00
QTY
2
0
0
0
0
0
0
0
1
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 (foilet)
AMT
$0.00
50.00
50.00
$0.00
50.00
50.00
539.20
50.00
50.00
$29.40
QTY
0
0
0
0
0
0
4
0
0
3
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire antl become void if work Is not commenced within 1 BO tlays, or il work is suspended or abandoned
for a period o( 180 days.
INSPECTIONS: In order for the work authonzed under this permit to be consideretl legal, such work must comply with all epplicable codes, antl en
requlred inspectlone and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
zaas-+e lerool
WORKERS'COMPENSAnON DECLARAnON:
I hereby aHirm under penalry oi perjury one ol ihe lollowing tleclaratlons:
❑ I have end will maintain a certilicata of consent to self-Insure far workers' mmpensetion, as D��tled for by sectlon 3700 of the Lebor Cotle, lor Ihe pertormence oi Ihe
„ wark for which Ihis pertnii is issuetl.
n insurance, as requiretl by section 3700 of ihe Labor Code, tor t ormance of Ihe work for whlM this pefmit is issuetl.
anC pdiry number are:
'-t CornV�ui�r-rza� L�S co. n�y��:RYIPo.�o�2�R_o2
; valued ar one hundred dollers ($100) or less.)
❑ I certify thet in Ihe pertortnance of the work for which this pertnit is IssueQ I shell not employ any person In any mnnner so es to become sub�ect to the workere'
campensatlon lews, Cel m, en gre �et If I should become suD�ec1 to Ihe workere' compensetlon prod ' of Sa on 37 of the LaDor Code, I shall forthwlth
,has � �'� y� by
plcentSign e: Date: _
AILUfiE TO SECUR ERS' COMPENSATION COVEMGE IS UNLAW FUL rWD SNALL SOBIEC� rW EMPLOYER i0 CFIMINAL PENALTIES MI� CML FlNES UP TO ONE HUN�RED
THOUSAND DOUARE (5100,OW), W AODRION TO THE W5T OF COMPENS4TION, DMt4�E5 AS PROVIUED FOR IN SECTION 31080F THE IABOR WOE, INTEREST, AND ATTORNEY'S FEES.
LICENSED
INTRAC70R5 DECLARATION:
the�G�ns�d under provisions of Chapter 9(commencing wit� Section 7000) of
Professions Cotle, enC my Iicense Is in full
CO UCTION'LENDING AGENCV:
❑ I hereby eNirtn that there is a wnsiruction lending egency lor the pedormence oi Ihe work tor which ihis permit is Issuotl. (Sec. 3097, Civil Code).
Lentler's Nema: Lender's AAtlress:
Signature:
OWNER-BUILDER DECLARATONS:
Dete:
I hereby eHirm t�et under penalry of perjury Ihet 1 em EXEMP7 FROM THE CONTRACTORS LICENSE LAW tor the lollowing reason (Sec. 7031.5, Buslness anC Professions
Cotle: Any ciry ar counry which requires e permil to canstruct, elter, improve, tlemolish, or repair any 5trucWre, pnor to its Issuanca, also requires the epplicant 1or such pertnit
la flle e signed statemeni that �e or she Is Ilcensed pursuem to the pravisbns ot I�e Contractors License Lew (Chepter 9(commencing with Section 7000) ot DMsion 3 ot the
Business end Pmfessions Code) or Ihat he or she is e:empt iherelrom and the basis for �he alleged exemption. Any vloletlon ol Section 7037.5 by eny applicant for e pertnit
subJects ihe epplicant to e civil penalry of not mare than fve hundreA Collars ($500).):
❑ I, es ownar ol ihe pmperty, or my employees with wages as their sole compensation, WILL DO 7HE WORK, antl Ihe strucNre Is not intentletl or oMeretl for sale (Sec.
7044, Business and Professions Code: The Contractors License Lew tloes not epply to an owner ot property who builtls or improves thereon, entl who does such work
himself or herself or through his or her own employees, provided that such improvements ere not intended or oNeretl for sele. If, howevar, the building or improvement is
sold within one year of wmpletion, t�e owner-builder will have iha burden al proWng that he or she did not 6uild or improve tor purpose of sale.�. �
� I, es owner oi the propeM. em EXCWSIVELV CONTRACTING WITM LILENSED CONT(iACTORS lo construct t�e prolect (SecJ044, Business and Profeuions
Code: The contraaors License Lew tloes not eppy to an owner of pmDeny who builds or impmves t�ereon, end who contrects for such pmject with e conirector(s)
license pursuant to the Conirectors License Lews.).
❑ I am exempt under sec.
Signe�ure:
Owner ID verified by drivefs license. ❑ Yes ❑ No
Business entl Pmtessions Code tor this reason:
Verificetlon ol Ownerehip by (rype af document, i.e. - Oroperty tu blll or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Drivers License No.
Date:
Expires:
❑ I hereby certify t�et no excavetlon tive (5) or more teet in de0�h into which e person Is required to descen0, wlll be made in connection with wark euthodze0 by this
pertnii, end that no building structure, scaMoltling, falsework, or tlemolitlon or Oismentling thereof, will 6e more then t�irty-siz (36) leet high. (Chap. 32, Grp 2, An 2, Sec.
341, Tltle 8, Celifomia AdmiNstrative Cotle).
❑ As ownar�builtler, I will not employ enyone to tlo wark which would require e pertnit from t�e DlNsion ot Indusirial Selery, as noted flbove, unless such person has e
permit to tlo such work trom t�e tlivision.
Signature: Data:
Divlslon ot Industnal Satery Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF EMRV: I certity under penalty ot perjury thet I heve reatl ihis application and state Ihat the information given Is
correct. I agree to comply with ell stete laws end ciry ortlinances relating to bullding construction, end euthodze representatives of the City ol Coste Mese to enter upon the
above�descdbetl property for inspection purposes. I agree not lo occupy or ellow occupancy of any building euthorized by this pertnit until final inspection.
COQE I. INSPECTIONTYPE �
1616 Fized System Final Fire Preventlon
1286 Pool Spe Finel
200 Flnel R8-Root
201 Final BIacWRetelning Well
202 Flnal Fectory Fire Place
203 Final Sign
204 Finel Demolition
�
�L�S�i�• �: :
� �. :
�$ �� INSPFCTIONTYVE
206 Finel Mechanical
20B Final Plumbing
270 Finel Electrlcal
212 Finel Fire Preventlon
220 Finel Planning Approval
222 FIneI5lte
250 Final Bullding/Oaupenty
�
(714) 754-5273 • Fax (714) 754-4856 •�w+w.ci.costa-mesa.ra.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 2214 ELDEN AV
Suite No
Vicinity:
Parcel Number; 42606102
Applicank BRIAN
Addresa: 26752 VIA LINARES
MISSION VEIJO. CA
Owner: CEFALIA TR
Address: 2214 ELDEN AV
MECHANICAL PERMIT
Status: ISSUED
Applied: 08/OS/2004
Issued: 08/OS/2004
ISSUED BY:
Phone: 94&768-4675
Zip: 92691
Phone:
COSTA MESA, CA Zip: 92627
Contractor: PLAYA HEATING 8 AIR CONDITIONING
Address: 26752 VIA LINARES
Phone: 949-76&4675
MISSION VEIJO, CA Zip: 92691
License:735483
SCOPE OF PERMIT
CONSTRUCT NEW 3,712 S.F. S.F.D. WITH 573 S.F. ATTACHED GARAGE. WORK TO INCLUDE:
1,808 FOR 7ST FLOOR, 1,904 FOR SECOND FLOOR. -
NEW 4 BEDROOM, 3 BATH S.F.D.
2 INS7 FAU < t00K BTU, 2 COMPRESSORS 3-15 HP/500K BTU
REF: B03-01922
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k 8TU
Repair/All Cooling/Heat
Inst I Rep. Recess Wall Hv
Refrig Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Ven[ Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers �
Insl or Relocate Appl Vent
Air Handlers < 10000cfm
Air Handlers > 10000cfm
Floor Fumace
Floor or Suspend Heater
$23.50
$29.60
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
50.00
$0.00
$0.00
$0.00
50.00
Quantiry
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair I Alt Refngeration Unit
Ventillation System
Evaporative Cooler
Commercial I ncinerator
Domestic Incinerator
Compressors I Absorption Svstems .
Upto3hp/t00kBTU
3 To 15 hp I 500 k BTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU �
Over 50 hp ! Over 1,750 BTU
Boilers
Upto3hp
3To15hp
15to30hp � .�
30 to 50 hp - .
Over 50 hp . '
Other Mechanical Fee "
Investigation Fee
Plan Check Fee
Quantily
$0.00 0
50.00 0
$0.00 0
50.00 0
50.00 0
30.00 0
50.00 0
$54.30 2
$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
30.00
NO710E: The work authorized by this permit shall comply vrith all applicable handicap access requirements under Calilornla statutes and related
regulations. (Ord. No. 92-28, § 1, 12•27-92)
EXPIHATION: This permit shall automatically expire and become void it work is not commenced withln 1 BO days, or if work is suspended or abandoned
lor a penod of 1 BO tlays.
INSPECTIONS: In order tor the work euthorizetl under this permit to be considered legal, such work must comply with all appliceele cotles, and ell
required Inapectlqna and final approvel must be obtained. Failure to obtain inspections and tinal approval will result in the ezpiration of ihis permlt.
FOR INSPECTIONS CALL: (714) 7545626 .
24d&d8 (8�00)
WORKERS'COMPENSAnON DECLARAnON:
I hereby eMirm under penalry ol0erjury ane oi the lollowlnq deUaratlans:
❑ 1 heve end will maintain a cenificate of consent to self-Insure for workers' campensatlon, es pmWdetl lor by aectlon 3700 of the Lebor Code, lor t�e Dedortnance of the
work for whic� thi5 permit 15 issued.
I heva end will maintain workers' compensetbn insurence, es required by sectlon 3700 of Ne Lebor Code, lor t�e peAortnance of Ne work for whlch ihis pertnit is issued.
My wa �� pensetionJpsurence carrler end polcy number are: I I l(
Cerrler. 1 a'F�e t'�/✓�i Poliry NumEer: d� `'�� S` O 1
(l'M5 SecHon need not be cwnplefetl il Ne pertrW Is val�ed af one hu�red tldlars �$100) or less.)
❑ I cenity that in the pe ance ol ihe work lor which ihis pertnit is issued, I shell not employ eny person in eny manner so es to becnme sub�ect to t�e workers'
compansation lews o Iltomie, entl epree that it I should bewme sub�ect to the workers' compensetlan provislons of Section 3700 ot t�a LeDor Code, I ahall toMwlN
comply wlih these sions. � �
� S-oY
�Applicent Sipneture: Dete:
WARNINO: FAILURE TO SECURE WORKER$' COMPENSATION WVEMOE IS UNLAWFUL NJD SHALL SUBJECT AN EMPLOVER TO CFIMINAL PENALTIES ANO CNIL FlNES UP TOONE HUNDRED
TNOUSAND DOLLARE (5100,000�, IN ADDRION TO TME COST OF �MPENSATION, OMMOES FS PiiOVIOED WR IN SECTION 3100OF THE UBOR CODE, IMEREST, AND A170RNEV5 FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eHirm thet I em lic r sians oi Chapter 9(commencing with Sectlon 7000) ol DMsion 3 0l ihe Busineu n rolessions Code, antl my license is In full
fOfCO end BHeCI. LiG. M" J Cless M ���
ConlreIXofsSigneWre: r� �— Date: '�J=�
CONSTRUCTION LENDING AGENCY:
❑ I horeby aHirm ihat ihere Is a wnsiruction IenOing egency lor ihe peAormance oi t�e work tor whlch this permlt Is issue0. (Sec. 3097, Civll Code).
Lander's Neme: Lender's Address:
Signatura: Dete:
OWNER-BUILOER DECLARATIONS:
I hereby eHirtn thei under penalry ol perjury Ihet I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW tor the lollowing reeson (Sec. 7031.5, Busineu flnd Profeuions
Cotla: My ciry ar counry which requires a pertnit to construct, alter, Improve, tlemolish, or repair any strucNre, D�or to iis issuance, elso requires the epplicant for such permit
to file e signed stetement thet he or she Is Iicensed pursuant to the pmNsions oi the Contradors LJcense Law (C�epter 9(commencing vrith SecUon 7000j of Divisim 3 of the
Business end Professions Cotle) or Ihel he or she is exempt therefrom end the 6esis for the elleged exemplion. Any violetion of Section 7037.5 by any epplicanl for e pertnit
subjecis the epplicflnt to a chril penelry ot not more t�an frve hundred dollarg (5500)J:
❑ I, es ownar ol ihe Oroperry, or my employees wlth waqes es Nelr sole compensatlon, WILL DO THE WORK, end t�e structure Is not intentletl or otferetl tor ule (Sec.
7044, Business and Professions Cotle: The Contractors License Lew does not apply to an owner of properry who builtls or Improves thereon, and who does such work
himsell or herself or ihmugh his or her own employees, provided Ihat such improvemems ere noI Intended or ofleretl for sale. II, however, Ihe building or improvement is
sold within one year ol completion, t�e owner-Guilder will have �he burden of proving tha� he or she did not build or improve for purpose of sale.). '
❑ I, es owner ol lhe properry, em E%CLUSIVELY CONTRACTNG WITH LICENSED CONTRACTOHS to construct the prqect (Sec. 7044, Business and Professions
Cotle: The contrecrors License Lew does not apply to an owner ot propehy who builds or Improves thareon, end who contrects for such prqact wlth e contractor(s)
license pursuant to ihe Contraaors License LewsJ.
❑ I am exempt under sec. Business entl Professions Code for thls reason:
SigneWre: � Date:
Owner ID veAfietl by tlrivefs license. Yw ❑ No Drivers Licensa No. Expires:
Vedllcetlon oi Ownership by (rype oi dacume , i.e. - property tax bill ar tleetl):
DIVISION OF INDUSTRIAL SAFETY VERMR CER7IFICATION:
0 I heraby certity that no exwvation iNe (5) or more feet in tlepth Into which a person is requlretl to descend, wlll he matle in connectlon wiih work euthorized by thls
permit, entl that no building sWCWre, scaflolding, falsewark, ar demolition or Oismantling thereoi, wlll be more ihen thirty-six (36) leet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Tl�le 8, Celifomia Adminlslretive Cade).
❑ As owner�builder, I will not omploy enyone �o tlo work which woultl requlre e Oermit from lhe DIvlslon of Intlustriel Sefery, es noted ebave, unless such persan hes a
permit to tlo suc� work from Ihe division.
SlgnaNre: Date:
Divislon ol Industnal Safery Pertnit Number:
CEHTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTAY: I certity under penalry of Derjury tha� I have reed this epplicetlon end stete that the inlortnation given Is
wrrect. I agree to wmply with ell slete laws entl Gry ordinances reletlnp to builtling consiructlon, and authodze reD�esenta�ives of �he Clty of Costa Mesa to enler upon Ihe
ebove-descnbed 0� erly lar ins0ection puryoses. I agree nol to acupy ar allow accupency ol eny building eulhonzed by Ihis permit until finel inspectlon.
S'q(ieture 01 Lepal Owner(s) �J �tp� �
Ani� `�/`' �� U
" Antl/Or Authorized Applicant Oale
COpE �. INSVECTIONTYPE p�g, fl4IIIAL$
1fi16 Fixed System Final Fire Prevention
1288 Pool Spa Final
200 Finel Ra-Roat
201 FIneI Block/Retalning Well
202 Final Factory Fire Place
203 Final Sign
204 Finel Demolitlon
COOE 1 INSVECTION TYPE
208 Final Mec�anlcel
208 Finnl Plumbing
210 Final Electrlcal
2tt Final Flre PrevenUon
220 Flnal Plenning Approval
222 Final Site
250 Finnl Building/Occupancy
11-I1-e`i �
(�14) 754-5273 • Fax (714) 754-4856 •�wiw.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Viciniry:
Parcel Nunmber:
Applicanl:
Address:
Owner:
2214 ELDEN AV
42606102
CEFALIA TR
2214 ELDEN AV
COSTA MESA, CA
CEFALIA TR
Address 2214 ELDEN AV
COSTA MESA, CA
Contractor: OWNER BUILDER
Address: •
ISSUE FEE
Temp service test
Res. a/c package
New Res (1•2 unils)
New Res (3+unils)
Pool / Spa
Lighling Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to t000a
Service over 1000a
Motors to 1hp
Motors to 10hp
ISSUED BY:
Phone: 949-933-7986
Zip: 92627
Phone:
Zip: 92627
Phone:
Zip:
License: 000000
Status: ISSUED
Applied: OSI05/2004
Issuetl: 05IOSI2004
SCOPE OF PERMIT
CONSTRUCT NEW 3,712 S.F. S.F.D. WITH 573 S.F. ATTACHED GARAGE. WORK TO INCLUDE:
1,808 FOR 1ST FLOOR, 1,904 FOR SECOND FLOOR.
NEW 4 BEDROOM, 3 BATH S.F.D. REF: 803-01922.
ELECTRICAL FOR NEW RESIDENCE. GARAGE TO INCLUDE: 4 OUTLETS, 1 LIGHT FIXTURE, 1
SWITCH.
$23.50
50.00
50.00
$207.87
50.00
$0.00
51.10
$4.40
$7.10
50.00
34.75
50.00
50.00
50.00
50.00
50.00
�uantity
3712
0
0
1
4
1
0
1
0
0
0
0
0
FEE SUMMARY
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 Volfage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Quantiry
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 92-28, § 7, 12-21-92)
EXPIRATION: This permit shall automatically expire anA become voitl 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 For the work authorized under Ihis permit to be considered legal, such work must comply with all applicable cotlos, end all
required Inspectlons and tinel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
zaawc�vao�
WOflKERS' COMPENSATION DECLARATION:
I hereby attirm untler penalry ot perjury ane of the following declarations:
❑ I have end will maintein e certificete ot consent to salbinsure tor workers' compensetlon, es pravitletl lor by section 3700 ot the Lebor Cotla, for tha peAormance ot the
work lar which this permit Is issued.
❑ I have antl will maintein wwkers' compensatlon ins rance, as required 6y section 3700 of tha Labor Coda, far Ihe partormance ot the work br whlch ihlg pertnit i5 issued.
My workers' com ensati� In ur nce carrler o" num�er ere:
Certier: Poliry Number:
(fhls sectfon need not be c plef 6e ermlf ve/ueC et ane huntlred tldlars (S100J oNess.)
� cenity thel in Ihe peAormance of t�e work or which tMs permlt is issueq 1 shall not employ eny person In any menner so as to become sub�act to t�e workers'
wmpensatlon laws ot Celif ai nQ,9 8 that il d bacame sublect to the workers' compensetion provislons of Section 3700 ot Ihe Lebor e, I ahall toMwii�
comply with t�ese pr ons. I(,
Appllcen�Slpne�ure: Dete: ��� �-/�
WARNINO:F CU ERS'�MPENSATIONCOVEMOEISUNUWFULAN�SHALLSUBIECTANEMPLOVENTOCRIMIW�LPENALTIESANDGVILFlNE UPTOONEHUNDRED
THWS RE�510q ),INADOfilplTOTNECQSTOFCOMPENS4TIqJ,DAMAGESASPROVIDEDFORINSECTION3]OBOFTHEIABORCO�E,IMEREST,ANDATfORNE`fSFEES.
LICENSED CONTRACTORS DECLAFiATION:
I hereby eNirm that I am IlcenseA untler DroNsions oi Chapter 9(commendnp with Section 7000) ol Dlvision 3 of the Busineu end Prafessions Cotle, antl my Ikense Is in tull
fOrCB 8ntl BHBC�. L1Q M C1859 M
Contrectofs Signeture: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby aMirm Ihat ihere is e construction lending egency tor t�e poAormanco ol Ihe work for which Ihis permit Is Issued. (Sec. 3097, Civil Code�.
Lenders Neme: Lendefs Atltlress:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereDy altirtn t�at under penelry ol per�ury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE W W tor lhe following reason (Sec. 7031.5, Business end Prafessions
Code: Any ciry or counry which reQuires e pertnit to consWct, elter, improve, tlemolish, or repair any structure, pdor to its issuence, elso requires the epplicant br such permit
ro Illa e signetl statement that he or sha is Iicensed pursuani ta the provisions of the Contrectors License Lew (Chapter 9(commendng vrith Section 7000) ot Division 3 of the
Business end Pmfessions Code) or Ihet he or s�e Is ezempt theretrom end Ihe besis tor the allegetl e:emption. Any WWeNon oi Section 7031.5 by eny epplicant for a pertnit
ub s ihe applicant to a cidl penelty ot not more than five hundred dollero ($SOOjJ:
I, es owner ot Ihe pmperty, or my emplayees wlih wages es thelr sole wmpensatlon, WILL DO 7HE WORK, end tha structure Is not intendetl or oNeretl for sele (Sec.
7044, Business and Professions Code: The Contrac�ors License Lew does not apply to en owner of property who builds or improves Ihereon, and w�o does such work
himsell or herself or Ihrough his or her own employees, provltled that such improvemenis ere not intended or oHered for sale. If, however, the 6ullding or improvement is
sold within one year of wmpletion, the owner-builder will have the burden of proving that he or she did not build or improve tor purpose ot sale.). �
❑ I, as owner ot the property, am EXCLUSIVELY CONTRAC7ING WI7F1 LICENSED CONTRACTORS Io con5tmcl lhe projecl (Sec. 704a, BuSiness antl Profession5
Code: The contreciors LJcense Law does not epply to an owner ol pwperty who builtls or improves ihereon, end who contracts for such projact wl�h e contractor(s)
licensa pursue�ttath� Comraciors Lice�Laws.).
❑ lam
Signature:
Owner ID
Business end Pralessions Cotle for �his reason:
sfrTCg� �1'es ❑ No Dnvels Licanse No.
by (typa al tlocument, i.a. - property tau bill or tleetl):
Expires:
OIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I �ereby certity thet no excavatlon Ove (5) or more teet in tlepth Into whlch e person Is requiretl to descond, wlll be mede In connection with work euthodzed by Ihis
permit, and that no building siructure, sceMoltling, talsework, or Oemolltlon or tlismantling thereot, will bo more then thirty-six (36) teet high. (Chap. 32, Gry 2, An 2, Sec.
341, Title 8, Califomia Atlminisirative Code).
❑ As owner-bulltler, I will not employ enyone to do work whic� wwltl reQWre e parmit Irwn the Divislon of Inaustdel Satery, as noted ebove, unless suc� person has e
pertnit ta do suCh work tmm the division.
SignaNre: Date:
Dlvision ot Industnal Safety Permit Number:
CER7IFlCATE OF COMPUANCE ANO AUTHORIZATON OF EMAY: I certlfy under penelty of perjury thet I have read this epplication end sfate ihet the Infortnation given is
carrect. I agre mp with ell 5tete laws enC ci ordinances relating ta bullding consiruction, end authorize representatives ot ihe Gry of Costa Mesa to emer upon Ihe
ebove-des ed D�ope or �nsp n pu gree not ta accupy or ellow occupancy of eny builtling euthorized by ihis permit until Tinel inspectlon.
COUE A, INSPECTIONTYPE PAIE lI1�ELS
1616 Fi:etl System Finel Fire Prevemion
1288 Pool Spe Finel
200 Finel Re-Roof
201 Finel Block/Reteining Wall
202 Final Fectory Fire Place
203 Final Sign
204 Finel Demolition
�Fj INSpECTIONTYPE
206 Finel Mechenicel
208 Final Plumbing
270 Final Eleciricel
212 Finel Fire Prevention
220 Final Plenning Approval
222 Final Site
250 Final Building/OCCupency
���
�.:
�. I .1111' "
�� I•.'�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
Job Address: 2214 ELDEN AV
Suite No
Vicinity:
Parcel Nunmber: 42606102
ISSUED BY:
Applicant: ROSENTHAL, KARLA TR KYLE KEVIN ROSENTHAL TRUST
Address: °hMCALISTER INVESTMENTS INC
LAGUNA HILLS, CA Phone: 949-494-8652
25283 CABOT RD STE 279 Zip: 92653-5510
Owner: ROSENTHAL, Kf;f2LA TR KYLE KEVIN ROSENTHAL TRUST
Address %MCALISTER INVESTMENTS INC
LAGUNA HILLS, CA Phone:
25283 CABOT RD STE 219 Zip: 92653-5510
Contractor.
Address:
Arch / Eng :
Address:
ISSUE FEE
BaCkflow irrigation
BackBow Preventer
Bathtub
Clarifier System
Connect (Ice,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Phone:
Zip:
License:
Phone:
Zip:
I:icense:
SCOPE OF PERMIT
PLUMBING TO INCLUDE: CAP SEWER CONNECTION FOR DEMO. REF.: B02-01920
AMT
$23.50
so.00
30.00
50.00
50.00
50.00
50.00
50.00
50.00
50.00
50.00
$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
0 Pressure Regulator $0.00
0 Process Piping (per 10 k) $0.00
0 Receptors 50.00
0 Septic Tank $0.00
0 Sewer Cap for Demo $9.80
0 Sewer Connect $0.00
0 Sewer Private Line 50.00
0 Shower $0.00
0 Sink, bar $0.00
0 Sink, commercial $0.00
0 Sink, Floor $0.00
�TY
0
0
0
0
0
0
0
1
0
0
0
0
0
0
Status: ISSUED
Applied: 11/25/2002
Issued: 11/25/2002
SumpPump
Swimming Pool
Trap, Primer
Urinal
Vacuum Brkr Bk9ow(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
Water Service
AMT
$0.00
50.00
50.00
50.00
$0.00
50.00
50.00
50.00
50.00
$0.00
50.00
$0.00
$0.00
50.00
QTY
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 access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: This permlt shall automatically expire and become void it work is not commenced within 180 days, or it work Is suspended or abandoned
tor a period of 180 days.
INSPECTIONS: In order for the vrork authorized untler this permit to be considered legal, such work must tomply with all applicable codes, and all
requlred Inapectiona end final epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
zaas�ae l�l
WpRKERS'COMPENSAnON DECLARAnON:
1 here6y aXirm under penalry oi peryury ane ol the �albwing tleclaratlans:
❑ I heve end wlll maimain e cortificate of consenl to self-Insure for workers' compensa0on, es provltlea for by sectlon 3700 of Ihe Lebor Code, tor the pertormence ol the
work tor which thls pertnit Is Issuetl.
❑ I heva entl vnll malntain workers' compensatlon insurenca, as requiratl by section 3700 of the Labor Cotle, Por the pedortnance of the work for which this Oertnit is issued.
My workers' compensatlon Insurance cerrier entl policy number are:
Ce(�er. Policy Number.
(This sectiar need nat Oe cromp/efed ll fhe permif Is velued et one hunOred dollers ($100) or /ess.)
I cortily thet in Ihe pertormance ot the work for which this pertnit is Issuetl, I shell not amploy any person In eny menner so es to become sub�eci to the workers'
compensetlon laws of III mla, e pree Ne� If I should become suD�ect to Ihe workers' compensetion provislons ol Se tlon 3700 at the Lebar Code, I shall forthwith
wmply with t es o —7
an4Stgrt�re:_� Oat-3 �/ G��/Q Z
IIN(i FAILURE TO SECURE WOPKERS' ODMPENSATION ODVERAGE IS UMAWFU� ANO $HALL SUBJECT AN EMPLOVER TO CRIhUNAL PENALTIES Ml� CML FlNES UP TO ONE HUNDRED
SAND DOILApE (5100.000), IN FDDff10N TO THE OOST OF COMPENSATIqJ, DAMAGES AS PHOVIDED FOR IN SEGTON 31O80F THE UBOR CODE, IMEREST, AND ATTORNEY'S FEE3.
LICENSED CONTRACTORS DECLARATON:
I hereDy afllrm thet I em Iicensetl u�tlar pmWsions of Chapter 9(commencing wit� Sectlon 7000) ol Divlslon 3 ot lhe Busineu entl Professions Cotle, and my Ilcense is in tull
force antl eNea. Uc. M Class M
Conirectofs Signature: Data:
CONSTRUCTION LENDING AGENCV:
❑ I hereby aXirtn thac there is a cansWciion lentling epency for t�e pertortnance of ��e work lor which t�is permit is issued. (Sac. 3097, CiNI Code).
LenAefs Name: Lentlers Addreu:
Signeture: Date:
OWNER•BUILDER DECLARATIONS:
I hefeby eNirtn lhet untler penelry o� per�ury thet I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for ihe tollowing reeson (Sec. 7031.5, Busine55 end Professions
Code: Any clty or county whlch reduires e permit to cons�ruct, alter, Improve, demolish, or repelr eny structure, Prlor to its issuance, elso requires ihe applicant tor such pertnit
to lile e signetl stetement that he o� she is Ilcensed pursuent �o �he provisions of Ihe Contrectors License Lew (Chepter 9(commencing with Section 7000) ol Division 3 0l the
Business and Protessions CoCe) o� lhat he or she is eaempt theretrom and lhe basis br the allegetl ecemptlon. Aoy vbletion ot Section 7031.5 by any appltcant fo� a permlt
subjecis the epplicant to e clvll penelty ot not more ihen ilve hund�ed dollars ($500).):
❑ I, es owner of the property, ar my employees with weqes as Iheir sole compensetlon, WILL DO 7HE WORK, end the structure Is not intendetl or otfered lor sale (Sec.
7044, Buslness and Professions COCa: The Contractors License Lew tloes no1 appy to an owner of properry who builds o� improves Ihe�eon, antl who tloes such work
himseli or herself or through his or her own employees, provided that suU Impmvemenis era not Intended or ottered tor sale. If, however, Ihe building or improvement is
soltl within one year ol completion, the owne�-builder will have the burtlen oi proving that he or she tlitl not builtl or improve lor purpose of sale.). �
�a/I, as owner of Ihe property, em EJ(CLUSIVELY CONTRACTiNG WITH LICENSED CONTRACTORS to construC� the project (Sec. 7044, Business and Protession5
� Code: The contractors LicenSe Lew does not apply to an owner of pmperty who builtls or impmves thereon, entl who mmracts tor such project with a contrattor(s)
licensa pur�suant to the Con�rectors License LawsJ.
0
Owner ID verified by driver's license.
VeriOce�lon ol OwnereMp by (rype of
Business antl Pmfessions Code for lhls reason:
Yes ❑ No �
qL i.e. - pmperty taa 6ill or Aeetl):
DIVISION OF INDUS7RIAL SAFETV PERMR CER7IFICAiION;
❑ 1 hereby certiFy ihat no axcavation fne (5) ar more feet In depih inio which e persan is requ��e0 to descend, will be mede in connection with woM authoAzad by this
permit, entl thet no builtling slruMure, scaMoltling, falseworN, or demolition or tlismantling Ihereot, will be more then thirry-six (36) leet high. (C�ap. 32, Grp 2, Art 2, Sec.
3d1, Tltle 8, C911fomla AtlminlstretNa Code).
❑ As owner�Dullder, I wlll not employ enyone to do work which would require e permll Irom Ihe Divislon of Industnel Setery, es noted ebove, unless such person hes e
permit ta do sUch work trom the tlivi5ion.
Signature: Date:
Divis�on o� Industrial Salory Permit Numbec
CERY�FICATE OF COMPLIANCE AND Al7iHORIZATION OF EMRY: I certity under penelty of perjury that I have read this ep0�ication end state thet the informatlon given is
c rrect. I agree to comply wlth ell state laws entl ciry ordinances releting to building constructlon, entl authotlze represantatives of ihe Ciry ol Coste Mesa to enler upon Ihe
bov0-d ' ed \ tor inspection purposes. I agree not to occupy or allow occupency of eny building authodzed b ihis pertn until tinal inspeclion.
� ���Z.� l� Z _
( Signature Of Legal Owner(�� Date f
\
AnG/0�.4uthodzed Applicant Date
�J� INSPECTIONTYPE PAIE 1[II�dLS
tsie Fixetl System Final Fire PreveNion
12fi6 Paol Spe Finel
ppp Flnel Ro-Rool
201 FInelBbcWRetaininqWall
202 Final Fectary Flre Place
203 Flnel Slpn
204 Finel Demolltion
COOEI INSVELTONTYPE
206 Final MeGhenical
20B Finel Plumbing
210 Flnal Elec��cal
212 Flnal Fire Preventlon
220 Finel Plenning Approval
222 Finel Si1e
250 Finel BulldinyOccupancy
� It�
1=3-�s �;�/-
i
(714) 754-5273 • Fax (774) 754-4856 • v+ww.ci.cos�a-mesa.BUILDING PERMIT � FAIR DRIVE, COSTA MESA, CA 92626
,1obAddress: 2214 ELDENAV
Suite:
Vicinity:
Parcel Number: 42606102
Zoning:
Applicant: ROSENTHAL, KARLA TR KYLE KEVIN ROSENTHAL TRUST
Address: °/ MCALISTER INVESTMENTS INC -
LAGUNA HILLS, CA Phone: 949-494-8652
25283 CA60T RD STE 219 Zip: 92653-5510 ,
Owner: ROSENTHAL, KARLA TR KYLE KEVIN ROSENTHAL TRUST
Address %MCALISTER INVESTMENTS INC
� LAGUNA HILLS, CA Phone:
25283 CABOT RD STE 219 Zip: 92653-5510
Convactor: O W N E R-B U I L D E R
Address:
Zip:
Arch :
Address:
Zip:
Phone:
License: 000000
�" Eng:
' Address: �
Phone:
License:
SCOPE OF PERMIT- , -
DEMOLISH EXISTING 600 S.F. S.F.D. DETACHED GARAGE WILL REMAIN ON LOT. �
PROPERTY OWNER HAS CONTACTED AQMD PRIOR TO DEMOLITION. ���
FEE SUMMARY
Plan Check: $0.00
Permit $97.25 '"
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $97.75
SETBACKS
MAIN STRUCTURE Fronl 0- 0
ACCESSORY Front 0-0
PARKING Existin : 0
Rear 0- 0
Rear 0-0
Requiretl: 0
PLANNING & ZONING
Left 0- 0
Lefl 0- 0
Proposed: 0
ISSUED BY:
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0-0
Status: ISSUED
Applied: 11/25/2002
Issued: 11/25/2002
Phone:
License:
a
$3,300.00
$3,300.00
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 7, 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 periotl of 1 BO days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicabla codes, and all
requlred Inapeetlona and Iinel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
t406d8I8/00)
WORKERS'COMPENSATION DECLARATON: ' '
I hereby aHirtn untler Penalry oi perjury one of ihe following tleclarations: '
❑ I have end will meintain e certNicate ot consent to self-Insure for workers' compensetion, as providetl for by section 3700 of the Labor Code, for ihe peAormance of the
work far which this parmit is issuetl.
❑ 1 have and will malntain workers' compensation insurance, as required by sectlon 3700 of the Labo� Cotle, tor tha peAortnance oi the woB tor which this pertnit is issued.
My workers' ctlmpensation Insurance carner and policy number ere:
Carrier �
Policy Number.
(Th75 ection need not be compiefed if fhe permif is velued at one huntlretl dollars ($700) or less.)
�
� I cehify ihat in the peAormence oi ihe work for which this pertnit is issued, I shall not employ eny person in eny manner so es to become subject to ihe workers'
compensatlon lews of Califomia, agree that If I s�oultl becoma subject to tha workars' compensation provislons of Section 3700 of the Labor Coda, I shell fonhwith
Comply with`h �3�e ��rov�'5��m/sy��
-Ap=icanl5ignaNre:r ;Ly / / �jB; ���j /(J z�
"WARNING FAILURE TO SECURE WORKERS' CAMPENSATION COVERA�E IS UNLAWFUL NND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PE ALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND DOLLARE (5100.000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PFiOVIDED FOR IN SECTIIXJ 3]06 OF THE LABOR CAOE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I herehy ettirm that I am licensed untler provisions of Chapter 9(commencing with Section 7000) ot Division 3 of ihe Business antl Professions Code, and my liceose is in full
force entl eflect. Lic. � Cless N
Cantractor's Signetu�a: Date: -
CONSTRUCTION LENDING AGENCY:
❑ I hereby eftirm that there is e constmction lentling agency for the pedormance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: LendeYs Address:
Signature: Date:
OWNER•BUILDER DECLARATIONS:
I hereby attirm ihat under penalty of perjury thet I em EJ(EMPT FROM TME CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business entl ProFessions
Code: Any ciry or coVnty whic� requires a permit to Consiruct, elter, improve, demolish, or repeir any stmcture, prior to its issuance, also requires the applicant for such pertnit
to flle a signed statement that he or she Is Iicensetl pursuant to ihe provisions oi ihe Contredors License Law (Chapier 9(commencing with Section 7000) ot Divislon 3 of tha
Business and Professions Code) or t�at he or she is exempt tharefrom end the besis for the elleged exemption. Any violation af Section 7031.5 by eny applicant tor a permit
subjects the epplicant to e civil penalry of not more than flve huntlred dollars ($500).):
❑ I, as owner of Ipe property, or my employees wlih wages as their sole compensation, WILL DO 7HE WORK, and ihe siructure Is not intentled or oHered tor sele (Sec.
7044, Business and Protessions Code: The Coniractors License Law dces not apply to en owner of property who Guilds or improves ihereon, antl who does such work
himself or herso�� or through his or her own employees, provided that such improvemenis are not Intendetl or oHered tor sale. If, however, Ihe 6uiltling or improvement is
soltl within one yeer of completion, the owner-builder wili have ihe burden of proving ihat he or she did not build or improve for purpose of sele.). '
�as owner of the property, em EXCLUSIVELV CONTRACTING WITH �ICENSED CONTRACTORS to construd the project (SecJ044, Business end Professions
Code: The conUectors License Law does not apply to an owner ol property who builds or Improves thereon, and who contracis tor such project with e comractor(s)
license pursuan<<o the Co�tractors License �aws.).
0
Owner ID verlfied by drivers license.
Verification of OwnerRhip Dy (type of
Business entl Professions Code tor ihis reason:
s ❑No �iiver's.l.icenseNo.
i.e. - propeny tex bill or daed):
�Expir ,e6:
DIVISION OF INDUSTNIAL SAFETY PERMI7 CERTIFICATION:
❑ I hereby certity Ihat no excavation five (5) or more feet in depth into which e person is required to descentl, will ba made in connection with work euthonzed by ihis
permit, and Ihat no building sirudure, scaffolding, falsework, or tlemolition or dismantling thereoi, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Calitomle Atlminisirative Code).
❑ As ownerbuilder, I will not employ anyone m do work which would require a permit trom the Division of Indusirial Sefery, as noted ebove, unless such person hes a
permit ta do suGh work tram the division.
SignaWre: Date:
Division of Industnal Bafary Permit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORVJITON OF EMRY: I certity untler penalty of Derjury ihat I have read this epplication and state tha� the information given is
correcc I agre � omp�y with all state laws end ciry ordinances relating to building construction, and authonze represematives ol the Ciry of Costa Mesa to enter upon Ihe
abov c' d pr erty tor i pection purposes. I egree not to occupy or ellow occupency of eny building au�horized y ihis/p�e rmit until final inspection.
%/ 2�/ U2
' �ignature�Of�LegalOwner(s)� ��—�Date�,
And/Or Authorized Applicant
i S�4p€.i. IaSreCnontt7E
1616 Fixed System Final Fire Prevention
1266
200
201
202
203
204
Pool Spa Fina�
Final Re-Roo�
Final Block/Retaining Wall
Final Factory Fire Place
Finel Sign
Final Demoli�ion
9ATE irmru�s
« �
CQ�E� INSPECTIaNTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Elecirical
212 final Fire Prevention
220 Final Pianning Approval
222 FinalSite
250 FinelBuilding/Occupancy
os a esa t�epartment
�! � 111 EAST 20th STREET
�' COSTA MESA� CALIFORNIA
FOR APPLICANT TO �II.L IN
e�uai�g ,f
Addresa
Costa Mesa, California
Nearest
Cross St.
Owner r
Mail
Address
or
1 Lot
tlon No.
Metes and
Setback
New
Repair
Buflding
Size
'erior
erinc
�se of N
Of
� �Y�c�iriuN rvn r�nivu'r
0� BUILDiNG �
FOR ON'FICE USE ONLY
Costa Mesa, California
� e�. ''�`
S No. i8 �.e�� Zone I No.ot I Type ,/ G
LiC. Plans Y
No. Approved
b Date
_,._ . ,_ CORRECTIONS
�//d'-D�/- %�
No. of Bldga w
Now on Lot oi,
No.of No.oT
Families Rooma
Rear Yard
Side Vard �i"' �
�F woRg
II Addition I
II Demolish I/�
-I coveri__ n9��,� m' APPROVALS
Foundation Location Inspecto
Forms, Materials,
Under-Pinning
� Frame: Fire Stops,
Bracing, Bolts
I hcreby acimowledge that I have read this Application
and state that the above is rnrreCt and agree to mmply Lath. Int.
with all City 6rdinances and 5tate Laws regulating
building rnnstruction. �ath. ext.
Signatureof /�] Q� /���/y� /�� ,
Permittee _[� ,�/.i_(' /X� � �v��Q� Plaster, Int.
Authorized Agt. Plaster, Ext
Valwallon peRnit Fee $ /�o, °� Masonry Relntorced
/ � 0 O� Plan Check $ 3. �� Bond Beam
$ ((/� Total 0 O
Fee $ FINAL
RM 204 5-HP 2M B-55
uosta lviesa 13aituing liepartment
� 711 EAST 20th STREET
_ COSTA MESA, CALIFORNIA
FOR APPLICANT TO FII.L IN
nacre� � ,..,�7^� �,C, f, � /i� _ k
Costa Mesa, California
Address
Add
Size of Lot
Use of
Existing BI
Setback Lii
Center ot S
Size aG
�"Lerior Wal
:ring
, __ ot New
S
'LLS
,a-v � .
Tract
� �,�/_
� �Now on Lot
No.ot No.
� � Famillea Ra
oi
0
�' APPLICATION 1+'UK YL�'tctYu'r
p� BUILDiNG �
FOR OFFICE USE ONLY
Receipt No. Pertnit No.
� � ad,���
Receiv�e� by Date Rec'd. Dah Issued
— �,e.,, I ii a-i-� 1"I i/-ai-r
Costa Mesa, California
Nearest
Cross St.
Date
CORitECTIONS
APPROVALS
Forms, Material:
Under-Pinning
�/ Frame: Fire Stops,
Bracing, Bolts
I hereby aclmowledge that I have read khis Application
and state that the above is correct and agree to comply Lath. Int
with all Clty Ordinances and State Laws regulaling
building rnnstruction. Lath. Ext.
SignatureoT � A/J�Q pr����
Permittee a.(f' U _�) Plaster, Int.
Authorized Agt, plaster, Ext
Valu,ation Permit Fea $ p�� O O Masonry Reinforce
��
_� Plan Check $ Bond Beam
$ Total � v
Fee $ FINAL
RM 204 S-HP 2M 8-53
O
z
�
Z
D
r
Costa Mesa Building Department ,� �/'/ APPLYCATEON FOR PERMI�
r, -t 171 EAST 20th STREET %//��' g U I� D i� N G
" COSTA MESA, CALIFORNIA Q'-
FOR APPLICANT TO FII.L IN FOR OFFICE USE ONd.Y
Receipt No. Permit No.
3ullding 9„" � � �7� �
�ddreu ��
�i05� �ZOS&� ri3��OPII18, Recei d by' Date Rec'd. Date Issued
Vearest „/' c � . v'� �- -`� � � �S�'
Owner
Architector�,_ � _
No.
Lic.
No.
Building
Address
Costa Mesa, California
Nearesk
Cross St.
Zone /�, . I No. of I Trpe .,
Date
New
.egal I Lot �
:ription No.
ach Metes and Bou
of Lot � % � �s
of
1:FlI
I hereby ac}
and state th
with all Ci��
building con
Signatureof
Permittee
[
t/"//d-/J[��
No. of Bldgs
% Now on Lof �
r INo.of I No.o1 �/
F,amilies Room��
Rear Vard
� Covering (�P��,Q`7AL�'
Foundation Location Inspector
Forms, Materials,
Under-Pinning
Frame: Fire Stops,
Bracing, Bolts
I have read this Application .
mrrect and agree to comply Lath. I nt.
and State I.aws regulating
, A „ „ , „ Lath. Ext.
Valuatlon Permit Fee $ �, O O M
�y/ � Pian Cheek $ � B
$ / "� Total C p —
Fee F
FORM 2U4 S-HP 2M 6-55
s� I