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Home My WebLink About234 DEL MAR AVE - Building Permits• y��' j '�ws� I �� CITY OF COSTA MESA BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-5273 • Fax (714) 754-4856 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 254 DEL MAR AV MEDIA ONE CABLE T.V. BOX TPN99051 Applicant: THOMPSON, TOM Address: 7835 WHITTIER COSTA MESA, CA SUITE A-72 . Owner � 'CITY OF COSTA MESA Address ' -77 FAIR DR � � � � ' COSTA MESA, CA Contrecrot THOMPSON AND THOMPSO� � Address: 1835 WHITTIER COSTA MESA,CA ' SUITEA-12 , . Phone: (949)548-1735 Zip: 92627 Phone: Zip: 92628 Bhone: (949)548-1735 � _ . Zip: 92627 License: 550936 PERMIT NUMBER E00-00348 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 04/17/2000 Issued: 04/17/2000 ISSUED BY: � SCOPE OF PERMIT INSTALL ELECTRICAL METER FOR NEW CABLE T.V. POWER SUPPLY FOR "MEDIA ONE" � ISSUE FEE � � Temp service test ' Res. a/c package New Res (t-2 units) ' New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl ' Service to 200a� Service to 1000a Service over 1000a . Molors to thp 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 $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0'00 $30.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 0 0 0 0 0 1' 0 0 0 0 0 0 0 0 0 0 0 0 0 a FEE SUMMARY � i Temp Dist System�/ Lighting" -�Busway/1008 , , _ " - 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 Misc Conduit ' - Misa Conductor � Circus ( gen or ride) � � Circus (mech ride or lights) Christmas Tree Stand � Fireworks Stand Other Electrical Fee Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 Investigation Fee , $0.00 Plan Check Fee . $0.00 ReinspeCtiOn Fee $0.00 TOTAL CALCULATED FEES $54.00 e . 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 for a period of 780 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 n WORKERS' COMPENSATION DECLARATION: � � I hereby eHirtn untler penalry ot perjury one of the tollowing declarations: - � ❑ I have antl will maintain a cenificata of consent to seH-Insure tor workers' compensation, as provitletl for by section 3700 of ihe Wbor Code, for Ihe peAormance of the work for which this pertnit is issued. . . ❑ I hava and will maintain workers' canpensalion insurance, as requiretl by section 3700 ot Ihe Labor Code, for the perfortnance of the work for which this Oermit Is issued. My wo ers' compensation In urence cerrier antl policy number ere: p Carrier: � �M � T��S rtl: Policy Number: �v 7/ �`I %�- O O (This section need no( be comp/efed i! fhe p rmi( is velue0 et one huntlred tlollers ($700) or less.) ❑ I certity �hat in the peAormance of Ihe work for which this pertnit is issued, I shall not employ any person in any manner so as to become subject to Ihe workers' compansation laws ol Celitornia, and agree that ii I should become subiect to ihe workers' compensation provisions of Section 3700 of the La6or Code, I shall fonhwith compl wiih Ihese r ons. /�-� L! / ApplicantSgnawre: -��c)'--��.1 X w.�-� Date: 7� !�^ UU WARNING: FAILURE TO SECURE WORKERS' CAMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREO THOUSAND DOLLARE ($10p,000�. IN ADOITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIOEO FOR �N SEGTION 3]Ofi OF THE LABOR CODE, INTEREST, ANO ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm �hat I am licensetl under provisions of Chapter 9(commencing with Section 7000) of Oivision 3 of Ihe Business and Protessions Code, antl my license is in full force and ettecL Lic: a ��C1 r-( RL.. Class a C-- i ContractoYs Signature: L� Date: �{' / 7- OU CONS7RUCTION LENDING AGENCV: ❑ I hereby aNirtn Ihat there is a construction lending agency for the pertormance ot the work for which this permit is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: SignaNre: Date: OWNER-BUILDER DECLARATIONS: I hereby aflirm that under penalry of perjury �hat I am EXEMPT FROM 7ME CON7RAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which raquires a permit to consWd, elter, improve, demolish, or repair any simcNra, pnor to its issuance, also requires tha applicant tor such permit to file e signetl statement that he or she is licensed pursuant to ihe pmvisions ot Ihe Contractors License Law (Chapter 9(commencing with Section 7000) of Divislon 3 of the Busineu and Professions Cotle) or that he or she is ezempt t�ereirom antl the basis for the alleged e:emption. Any violation ot Section 7031.5 6y any epplicent tor a permit subjects ihe applicent to e civil penalry ol not more than live hundred dollars ($500).): ❑ I, es owner ol �he property, Or my employee5 with wages e5 their 5010 compensetion, WILL DO THE WORK, and Ihe siructura i5 not in�ended or oHeretl for sale (Sec. 7044, Business antl Professions Cotla: The Contractors License Lew tloes not apply to an owner of property who builds or improves iheraon, entl who tloes such work . himself or herself or through his or her owA employees, provided Ihat such improvements ara not intendetl or oRered for sale. If, however, the builtling or improvement is sold within one year ot completion, ihe owner-builder will have ihe burden of proving Ihat ha or she did not builtl or improve tor purpose of sale.). ❑ I, as owner of ihe property, am EXCLUSIVELY CONTRACTING WITM LIGENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The wntrectors License Lew tloes not apply to en owner of pmperty who builtls or improves Ihereon, and who coniracts for such project with e contractor(s) license pursuam ta ihe Cantreciors License Lews.). � ❑ 1 am e:empi untler sac. Business and Professions Cotle tor ihis reason: Signature: Date: Owner ID varifiatl by tlnvers license. ❑ Ves ❑ No Drivefs License No. Venfication of Ownership by (rype of documen4 i.e. - property tax bill or deed): Ezpires: DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATON: ❑ I hereby certity ihat no exwvatlon five (5) or more teet in tlepth into which a person is required to descend, will be matle in connection wiih work authorizetl by this pertnit, antl that no building structure, scaHolding, talsework, or demolition or dismantling thereof, will be more than Ihirry-six (36) feel high. (Chap. 32, Carp 2, Art 2, Sec. 341, Ttle 8, Califomia Atlministretive Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a permit irom the Division of Industnal Safety, as notetl above, unless such person has e permit to tlo such work trom the division. Signature: Date: Division of Industrial Safery Permit Number: CERTIFlCATE OF COMPLIONCE AND AUTHORVATION OF ENTRY: I certity under penalry of perjury that I have read this application and stale that Ihe intormation given is correCL I egree Io comply wlth all 5lete law5 antl ciry oMinanCes relating to builtling wnSWction, and authon28 repre58ntative5 of tha City of Cwta M85a to enter upon Ihe above-described propeny tor inspectlon purposes. I agree not to occupy or ellow occupancy of any building autharizetl by ihis permit until final inspection. [d�I7��I:Fi93�lb]J�Y9 1616 1266 Oi Legal Fized System Final Fire Prevention Pool Spa Finel 200 Final Re-Rool 201 Finel elock/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition 2a46 48 D�re L�LS ( ?' OU te Date COOE� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 250 Final Site Final Building/Occupancy � 1 .1111 r , -� � � '�i� a� �p M�s9 o � > t J . xam>`� pia� �sa-sz�a • Fau (714) 754-4856 Job Address: Suite No Vicinity: Parcel Nunmber: 234 DEL MAR AV NEW GARAGE 43921107 Applicant: MIKE ACEVES Address: 15025 MAIDSTONE CITY OF COSTA MESA BUILDING DIV/SION DEVELOPMENT SERVICES DEPARTMENT PERMIT NORWALK,,CA � owner: � MOSER, RALPH M TR -�. Address �- 2803 FR4NCIS-CN � . , COSTA MESA, CA ELECTRICAL PERMIT Phone: (562)929-4905 Zip: 90650 Phone: Zip: 92626 Contracror: ACE CONSTRUCTION & PLUMBING Address� '15025 MAIDSTONE •� ' . - � . � . ' � Fhone: (562) 929-0905 , , � ,NORWALK, CA �• . , � � Zip: 90650 � ' r" � � � License: 626421 , ,.; r' .. 0 PERMIT NUMBER E00-00156 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 02/28/2000 Issued: 02/28/2000 , SCOPE OF PERMIT ' , INSTALLING THREE OUTLETS, 1 SWITCH, 1 LIGHT AND 100 AMP SERVICE METER FOR NEW GARAGE. ' " ` � REF:B00-00096 ""� � � 9 ISSUE FEE Temp service test Res. a/c package New Res (1-2 uNts) � New Res (3+units) Pool / 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 $23.50 $0.00 $0.00 + $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 Quantity : � `' J FEE SUMMARY ' If 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 Misc. Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand . Other Electrical Fee -Imestigation Fee Quantity $0.00 0 ' $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 So.00 $0.00 t @ NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned I for a period of 7 BO days. : INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � I WORKERS' COMPENSATION DECLARATION: , I hereby attirm under penalry of perjury one ot the following Declarations: ❑ I have and will maintain a certificate of consent to self-Insure tor workers' compensation, as provitled lor by section 3700 ai tha Lahor Cotla, for ihe peAormence of the or which this permit is issued. I have antl will maintain workers' compensation insurance, as requiretl by section 3700 oi ihe Labor Code, for the pedortnance of the work for which Ihis pertnit is issue0. My workers' compensation In�suraInc'e carrier and policy number are: Carner. �� !"�"'� PolicyNumOer. (This sectian neetl nof be completetl il lhe permit is valuetl a( one hundred dollars ($100J or less.) ❑ I certiy that in the peAormance of e w tor which this permit is issued, I shell not employ any person in any manner so as to become subject to the workers' compensation laws of Calit` ia, e at if I should become sublect m the workers' compensation provisions of Section 3700 ot the Labor Code, I shell fonhwith comply with ese pro ApplicantSignaWre� � Date: Z —2�P'� WARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWPUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVI� FINES UP TO ONE HUNpRED THOUSAND DOLLARE (310D,000�, �N ADDITION TO THE CAST OF COMPENSATIOtJ, DAMAGES AS PROVIOED FOR IN SECTION 310G OF THE LABOR CODE, INTEREST, ANO ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm that I am licensed untler provisions of Chapter 9(commencing with Sedion 7000) of Division 3 of the Business and Professions Code, and my license is in full force antl ettecL Lia # 6 � Class # — � � Contracror's Signature: ,� Date: 4- LP - I CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that there is a construction lending agency for ihe pedormance of the work for which this pertnit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARA710NS: I hereby aNirm Ihat under penalty of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (SecJ031.5, Business and Pmfessions Code: Any ciry or counry which requires a permit to consiruct, after, improve. demolish, or repair any sWcture, pnor to its issuance, also requires the applicant for such permit to tile a signed statement that he or sha is licensetl pursuant to the provisions of the Coniraciors License Law (Chaptar 9(commencing with Seciion 7000) of Divlsion 3 of ihe Business antl Professions Cotle) or that he or she is exempt Iheretrom and the basis for �he allegetl ezemption. Any violation of Section 7031.5 Dy any eOPlicant for a permit subjects the ap0�icant to a civil penalty of not more than tive hundred dollars (3500).): ❑ I, as owner ot the property, or my employees with wagas as their sole compensation, WILL DO THE WORK, antl ihe structure is not intentletl or oHeretl for sale (Sec. 7044, Business and Protessions Cotle: The Contrectors License Lew does noi apply to an owner of property who 6uiltl5 or improves Ihereon, end who does such work himself or herself or through his or her own employees, provided that such improvements are not intentletl or oHeretl for sala. If, howaver, the builtling or improvement is sold within one year of completioq the owner-builder will have the Durtlen of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the properry, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sac. 7044, Business antl Protessions Code: The comractors License Law tloes not apply to an owner of properry who builds or impmves thereon, and who comracis tor such projeci with a coniractor(s) license pursuant to ihe Contractors License Laws.). ❑ I am e:empt under sec. Business and Professions Code for ihis reason: Signature: Date: Ownar ID venfied by tlrivefs license. ❑ Ves ❑ No Drivefs License No. Verification of Ownership by (type of daument, i.e. - property tau bill or deed): Expires: DIVISION OF INDUS7RIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity Ihat no e:cavation five (5) or more teet in depth into which a person is required to descend, will be made in connection with work euthorizetl by �his permit, antl t�at no building sWCNre, scaMolding, falsework, or demolition or dismaNling thereol, will be more than thirry-six (36) leet high. (Chap. 32, Grp 2, Atl 2, Sec. 341, Title B, Califomia Atlminisirative Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a pertnit from the Division of Intlustrial Safety, as notetl a6ove, unless such person has a permit to Oo such work from the tliNsion. SignaWre: Date: ' Division of Indusinal Safety Pertnit Numhec CERTFICA7E OF COMPUANCE AND AIJT}iORIZATION OF ENTTiY: I cehify untler penalty of perjury ihat I have read this application and state Ihat the intormation given is correcL I agree to wmply with all siate laws and ciry ortlinances relating to huilding constmction, and authorize representatives of ihe Ciry of Costa Mesa to enter upon Ihe above-tlescribed propeny for inspectiorypqrposes. I agree not to occupy or allow occupancy oi any building authorized hy this permit until final inspection. ��"/�i�l� v��s �� AnNOr Authori COpE 1. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Placa 203 Final Sign 204 Final Demoli�ion 2446-46 QAj� IMRIR� CODE� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 250 Final Site Final Builtling/Occupency �. : J / ' �� l•]ilL�luiY1L1S'. CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-5273 • Fax (�ia) �sa-aass � Job Address: 234 DEL MAR AV Suite: Vicinity: REAR OF HOUSE Parcel Number: 43921107 Applicant: ACEVES, MIKE Address: 15025 MAID STONE AVE. NORWALK,CA . Owner: Address Contrac[oc Address: BUILDING PERMIT Zoning: Phone: (562)929-4905 Zip: 90650 MOSER, RALPH M TR 2803'FRANCIS LN - � � � � � �, Phone: �� COSTA MESA, CA � Zip: 92626 ACE CONSTRUCTION & PLUMBING 15025 MAIDSTONE NORWALK, CA � Zip: 90650 Arch : ' Address: - � . � � �� Phone: Phone: (562)929-4905 License: 626421 , Eng: � � Address: _ NUMBER B00-00096 77 FAIR DRNE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 01124/2000 Issued: 02/07I2000 Phone: ,Zip: � License: ��License: SCOPE OF PERMIT , CONSTRUCT A NEW TWO CAR DETACHED GP,RAGE BEHIND AN EXISTING SFD. 671 SQ:FT. OF TOTAL GARAGE AREA � PROPOSED (1 CAR ATTACHED GARAGE EXISTS AT FRONT OF SITE.) . 720 SQ.FT. REAR YARD COVER4GE ALLOWED; 200 SQ.FT. PROPOSED. GARAGE WILL ACCESS FROM DEDICATED ALLEY. � FEESUMMARY Plan Check: ' Permit: SMIP Res:, SMIP Com: Other: Inspection: Total: $117.81 $181.25 $0.00 $0.00 $0.00 $0.00 $299.06 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 77-6 Calc Valuation: $9,ses.00 Claim Valuation: $s,sas.00 PLANNING & ZONING Rear 0- 0 Lek 0- 0 Right Rear 10-0 Left 5-0 Right 40- 0 NO710E: 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 for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inapectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: , � I hereby aHirm under penalry of perjury one oi Ihe tollowing declarations: ❑ I have and will maintain a cenificate ot consent to self-Insure for workers' compensation, as provided tor by section 3700 of the Lebor Cotle, tor tha peAortnance ot the work For which this permi� is issued. � �1 have antl will maintain workers' compensatlon insurance, as requirad by section 3700 oi the Labor Catle, br Ne pedortnance of the work for which this pertnit is issued. —1My work�eCrs' com ensation Insuranca carner antl policy number are: ,�,/) �r/� Carner: S /�' �/�� Policv Numb J:/L M'QG�(T w � 7 37� .(fhis.section need not be completed i/ the permit is va/ued af one huntlretl dollars (3100) or less.) ❑ I certiry Ihat in the peAormance oi the wo tor v{j c this permit is issued, I shall not employ any person in any manner so as m Decome suDject to the workers' compensation lews ot Califomia agr � that Y oultl become su6jad to the workers' compensetion pmvisions of Saction 3700 of the Labor Cotle, I shall fonhwith comply with these provision � �-7 � �APPlicenPSgnelure:— c Date:_ � 2 ' / — � WARNWG:.FALLLFEJO SECURE WQ KERS' COMPENSATION COVERAGE IS UNIAWFUL MID SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA�ilES AND GVIL FWES UP TO ONE HUNDRED �TMOUSAND DOLLAFE (5100.000I. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 31W OF THE LABOR ODDE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby aHirtn Ih�l.l.am.li ensed und pmw n of Chapter 9(commencing with Section 7000) oi Division �o61ha�Buslne a Professions Code, and my license is in tull force and eHecL t�c..xf �2� �� /7 ciess a� '� 36 Contractols Signatura�� ,�� Date: �7 -"7 �� CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that there is a construction lending agency for the pedortnance of ihe work tor which Ihis permit is issued. (Sec. 3097, Civil Cotle). LentleYs Name: Lenders Address: Signature: Date: OWNER•BUILDER DECLARATIONS: I hereby attirm ihat under penalty ot perjury that I am EXEMPT FROM THE CON7RAC70RS LICENSE LAW for ihe following reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or county which requires a permit to consWct, alter, improve, demolish, or repair any simcture, prior to its issuance, also requires ihe applicant for such permit Io tile a signed statement Ihat he or she is licensed pursuant b Ihe provisions ot the Contracmrs License Lew (Chapter 9(commencing wlth Section 7000) of Division 3 of the Business antl Professions Cotle) or that he or she is ezempt therefrom and the basis for the allegea exemption. Any violation of Section 7031.5 Dy any applicant tor a permit su6�ects Ihe ap0�icant to a civil penalry ot not more than five hundred tlollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO TME WOHK, antl the structure is not imended or oHered br sale (Sec. 7044, Business antl Professions Cotle: The Contraaors License Law tloes not apply to an owner of properry who builds or improves thereon, and who does such work himself or herselt or �hrough his or her own employees, provide0 �ha� such improvemen�s are not intended or oHered for sale. If, however, Ihe building or improvement is sold within one year oi completion, tha owner-builtler will have the burden of proving that he or she ditl not builtl or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to construct the pmject (Sec. 7044, Business antl Professions Code: The comractors License Law does not appty m an owner of property who builds or improves ihereon, and who coniracis for such project with a comractor(s) license pursuant to the Contractors License Laws.). ❑ I am eaempt under sec. Signature: bwner ID verifietl by drivels license. ❑ Ves ❑ No Business and Professions Code for this reason: Verifiwtion of Ownership by (rype of tlocumem, i.e. - property tan bill or tleed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: Driver's License No. Date: Expires: ❑ I hereby certify ihat no eacavation tive (5) or more feet in tlepth into which a person is required to descend, will be made in connection with work authonzetl by ihis permit, entl Ihat no builtling stmcNre, scatfolding, falsework, or demolition or dismantling Ihereoi, wiil be more ihan ihirty-si: (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Title B, Califomia Administra�ive CoGe). ❑ As owner-builder, I will noi employ anyone �o tlo work which would require a permit from �he Oivision of Intlus�rial Safety, as noted above, unless such person has a permil to do such work fwm Ihe tlivision. Signature: Date: Division of Intlusirial Sa�ety Permit Number: CERTIFICA7E OF COMPLIANCE AND AIfTHORIZATION OF ENTFiV: I ceniry under penalry of perlury that I have read this application antl state that the information given is correct. I agree to comply with all s�ate laws and ciry ordinances relating to building construction, and authonze representatives ot �he City of Costa Mesa to enter upon ihe above-tlescribetl pmperty for inspeaion purposes. I agree not to ocapy or allow occupancy of any building amhorizetl by this permit until final inspection. 40�E �. INSGEMIONTYPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Fectory Fire Place 203 Final Sign 204 Final Demolition 2G46 46 DATE I pL �i -7 0 O n (,v CODE� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy 1}�AJF INiRIRLS