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Home My WebLink About282 DEL MAR AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-masa��DING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 282 DEL MAR AV Suite: B Vicinity: NEW SFR WITH ATTACHED GARAGE Parcel Number: 43920122 Applicant: ENGLERT, RAY Address: 2165 S GRAND AVE ' SANTA ANA, CA , Owner: HABITAT FOR HUMANITY Address 2165 S GR4ND AVE � SANTA ANA, CA Contractor: OWN ER-BU I LDER Address: Zip: qrcn : MUSSER ARCHITECTS INC Address: 730 W 17TH ST Zoning: Phone: (714) 434E200 Zip: 92705 Phone: (714)434-6200 Zip: 92705 Phone: License: 0 Phone: (949)574-4987 COSTA MESA, CA Zip: 92627 License: Status: ISSUED Applied: 10/04/2000 Issued: 06/05/2001 ISSUED BY: Eng: •, ' � � , ,- Address: , . . � _' , , Phone: License: � ' ,' "1 SCOPE OF PERMIT' " CONSTRUCT NEW (725SF iST FLOOR; 683SF.2ND_FLOOR) 1408 SQ FT (4 BEDROOM/2 BATH) SINGLE FAMILY � RESIDENCE, WITH 403 SQ FT ATTACHED GARAGE & 721 SQ FT FRONT PORCH FOR "HABITAT FOR HUMANITY" (UNIT � B� REF: DR-0019 . - --_ _ - — ��' -_ - - ' ' _ . ,, . .. . _ : . _ . . ' _ - r' � ' � - FEESUMMARY� �;'r� " � ��; ' Plan Check: �$762.42 � _ = ;;' Calc Valuation: !% j ;' � $i3t,eoz.o2 Permit�. �$1�,172.95 � � �� ClaimValuation`.�i ,_,� � �(So.00 SMIP�Res: $13.14 . � � �;�; " �: - �� SMIP Com: $0.00 �.� ' �" � J; " �' i ' Other: $0.00�' ;�� ;`�,, �� ,- ,� � � ', � Inspection: $0 00= i � . .«s � � � _ h "ti � �;,',-* r 'r%/ � ' , Tota1:��S1;94851 �\�\�`� - � �� % /l�//�(/� /,//�, � o � .�=-. ./�!� _ �_ , _ _ _ - c _�f� /��.�i� %L�/l; ` ; � . PLANNING &�ZONING SETBACKS �� , �, MAIN STRUCTURE Front 20- 0��_ � �Rear 10. 0 . Left 10- 0 �� Right� ;�10- 0� . . � _ _ _ � �i� �. ACCESSORY Front 0- 0 - Rear ,� .0- 0 Left 0--0 �r,��, �-" Righl 0- 0 PARKWG Existin : 0 Reauired: 10 Pr000sed: 10 NOTES: NOTICE: The work authorized by this permit shall compty with all applicable handicap access requirements under Calitornia 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 180 days. INSPECTIONS: In order for the work authorized under Ihis 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 tinal approval will result in the expiration of this permit./ FOR INSPECTIONS CALL: (714) 7545626 �� 2446d6 (N00) WORKERS'COMPENSAnON DECLAAAnON: � I hereby eFtirm under penalry of perjury one of the following tleclaratlons: � ❑ I have entl will maintein a certificaie oi consent to self-Insure for workers' compensetion, es provided for by seciion 3700 of ihe Labor Code, for ihe pertormence of Ihe work tor which thi5 p8rmii i5 issuBd. ❑ I have end will maintain workers' compensetion insurance, es required by section 3700 of Ihe L:ata Cotle, for the peAortnance oF the work for which this pertnit is Issued. My warkers' compenutlon Insurante wrtler and policy number ere: Cartier. PoliC� iJumbec (This sect/on neea nat be comp/eted i! (he permif /s velued et one hundred dollars ($100) or less.) ❑ I certily ihat in the pertormence o1 ihe work for which this permit is issued, I shell not employ eny person in any manner so es to become sublect to the workers' compensation laws oi Celltomla, entl egree thet if I shoultl become subject to the workers' compensatlon provisions of Sectlon 3700 ot Ihe Labor Cotle, I shell forthwith comply with these pmvisions. Applicent Signeture: Date: WARNINO: FAILURE TO SEIXIRE WORKER$' �PENSAiION GUVERAC�E IS UNLAWFUL AND SW1LL SUBJECT AN EMPLOYER TO CRIMINn1 PENALTIES AND CIVIL FlNES UP TOONE HUNDPED hKK15AND DOLLARE (5100.000),IN AODRI(N1TOTiE COST OF COMPENSATIdJ, DAMFGES AS PROVIDED F9R IN SECTIpN 3/O60F TiE LABOq ODDE, IMEAEST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLAHATION: I hareby eftirtn that I am licensetl under Provisions ot Chapter 9(commencing with Section 7000) of Division 3 of the Business end Protessions Code, antl my license Is In tull force antl eflecl Lic. M Class N Contrectofs Signature: Date: CONSTRUC710N LENDING AGENCV: ❑ I hereby aHirm that there is e conS�Nction lending agency for ihe Oertormance oi t�e work for which ihis permit is issued. (Sec. 3097, Civil Cotle). Lenders Neme: LentleYs Adtlress: Signatura: OWNER-BUIL�ER DECLARATIONS: Date: I hereby attirtn thet under penalry of peljury that I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business end Professions Cotle: Any ciry or counry which require5 e permit to construct, alter, Improve, demolish, or repair any sWcture, prior to its issuance, also requires ihe applicant for such permit to tile a signed stetement Ihet he or shd �s Ilcensed pursuant to the pmNsions of the Contrecrore License Lew (Chapter 9(commencing with Section 7000) of Division 3 of the Business flnd Professlons Cotle) or ihat he or she is axempt thereirom and the hasis for the alleged azemption. Any violation oi Setlion 7031.5 by eny applicant tor e pertnit s�bje . he applicani to e cMl penalry o� not more Ihan five hundred dollars ($500).): 1, as�owner of ihe properry, or my employees with wages as their sole compensation, WILL DO TME WORK, and the sWcture is not intended or otteretl for sale (Sec. _✓7044, Busineu antl Professions Gotle: Ttie Coniractore License Law tices not apply to an owner of properry who builtls or improves ihereon, and who does such work himsell or herself or through his or her own employees, provided ihat such improvemenis are not intended or offeretl for sale. If, howeve�, the huiltling or improvement is sold within one year oi completion, Ihe owner-builtler will have t�e burden ot proving that ha or she did not builtl or improve for purpose of sale.). ❑ I, es owner of Ihe property, em EXCLUSIVELV CONTRACTING WIT}f LICENSED CONTRACTORS to construct Ihe praject (SBc. 704d, BuSiness and Professians CoCe: TTe conirec Icensg Law tloes not appy to an owner ol properry who builds or improves t�ereon, and who contraas for such D�ojact with a comrecmr(s) license n to Ih orWbEtofs License Laws.). Business and Professions Code for this reason: Owner ID v�tl by Gn r' ic e� ❑ Yes ❑ No Veritication ol Owners p by (type of do�ment, i.e. - properry tan bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CER7IFICATION: ❑ I hereby certity that no escavation five (5) or more feet in depi� into which a person is requiretl to descend, will 6e matle in connection wlth work euthorizetl Ey this permiL and that no building strucWre, scaHolding, talsework, or demolition or tlismantling thereof, will be more than t�irry-six (36) feet high. (Chap. 32, Gry 2, Atl 2, Sec. 341, Title 8, California Adminisiralive Code). ❑ As owner-Duilder, I will noI employ anyone to tlo work which would require a permit from ihe Division of Industrial Sefery, as noted above, unless such pereon hes a pertnit ta do such work fmm the dihsioa � Signature: Date: Divislon ol InduSMal Safery Permit Number. CERTIFlCATE AN E AND AUTHORIZATION OF ENTRV: I certify under penaly of perjury Ihat I have read ihis application and s�ate ihat the informa�ion given is corre ree ro compl/`� itl II state laws antl ciry o inances relating to builtling consWction, and authorize representatives of the Ciry of Costa Mesa to enter upon the ve-descnb tl ��e�fyjo n�tion purpases. I t to occupy or allow occupancy of any building euthorizetl by Ihis permii until final inspection. r>�s=o � ' W � OLLepal.Owner(s)—��'�'� �Date'. '-'-� y00E �. INSPECTIONTYPE 1616 Fixetl System Final Fire PrevePtion t268 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Faqory Fire Place 203 Finel Sign 204 Final Demoli�ion �A¢� Jj(j�RU S� G9DE1 INSPECTIONTYPE 206 Final Mechanical 208 Finel Plumbing 210 Final Electrical 212 Flnal Fira Prevention 220 Finaf Planning Approval 222 FinelSite 250 FinalBuildincyOccupancy IMrtULS (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vitinity: Parcel Nunmber: Applicant: Address: Owner: Address Contrector. Address: 282 DEL MAR AV B UNIT B 43920122 ENGLERT, RAY 2165 S GRAND AVE SANTA ANA, CA HABITAT FOR HUMANITY 2165 S GRAND AVE SANTA ANA, CA OWNER-BUILDER Phone: (714) 434-6200 Zip: 92705 Phone: (714)434-6200 Zip: 92705 Phone: Zip: License: 0 ISSUED BY: Status: ISSUED Applied: 06/OS/2001 Issued: O6/OS/2001 � ' ' ' � r° SCOPE OF.PERMIT � �: - � � ELECTRICAL PERMILFOR NEW SINGLE FAMILY-RESIDENCE EOR "HABITAT FOR HUMANITY" (UNIT B). INSTALL NEW ELECTRICAL THROUGHOUT-HOUSE AND INSTALL-T CIGHT, 1 OUTLET, & i % SWITCH IN GARAGE. . - REF: B00-01594 , " - ' � - ' FEE S ' - � Quantity ISSUE FEE $23.50 Temp 5ervice test $0.00 � Res. a/c package � $0.00 � � K . ' New Res (1-2 units) ��$78.85 1406 � � . New Res (3+units) $0.00 . i; • � 0-. �.�� ", � ' Pool / Spa , "' $0.00� ` �= 0' � , - � Lighting Fixts � ' � $1 10�� 1 ;- � � Recept Outlets �� ' �i $1%10 ��7�,�c p'' � Switches .�� $1�10,) �t�� .� . Non Res Appl � ��`$0:00 - � 0�' . - � Res Appl � � $0.00 " % � , 0 , � Service to 200a � � �$0.00 `� `';"," 0 � ' , Service to 1000a _$0.00� ' ' 0 , � - Service over 1000a $0.00' � 0 � Motors to ihp $0.00� - . _ - 0 - . Motors to 10hp $0.00 � 0 , - Motors to SOhp $0.00 0 . -_ � Motors to 100hp $0.00 0 � Motors over t00hp $0.00 0 Communicalion drops $0.00 0 Sub panel to 200a $0.00 0 Pole Light Pkg $0.00 0 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 Intermed Pole $0.00 0 A UMMARY _ - . ;' � ��; - � � � • � Quantity��/ _ � Temp Dist System / Lighting $0.00 ,% 0 �� . ' � , Busway� /100 ft $0.00 , ";4 0 , �- Standing;Section. $0.00 � "- 0 � ,. Misc Eiectrical Equipment _ $0.00�� 0 � ^ . -.Transformers up'to t;ikJa%kw"`-7'r ';$0.00% 0 � � ', �c.:......_.....upto70kva/kw j`�-��$0.00, 0 % � .?� .:.upto50kva/kws��j:$0.00%��0 i�i: - %' ...up to'100 kva/k�v% � $0.00 � � �0 ! J ,� � � - over�700�kvalkw� $0.00-� �0 i J % Low Voltage Equipmenf �� $0_00�' 0 ; � Low Volt Wiring System / Ckt��` '$0.00 �; 0 i� Misa Condult � � �� $0.00 i. " -0 - Misa Conduclor ;'� � ''} �• � $0:00 , � � 0 Cirws ( gen or ride) '� ,�% $0.00 0 � Cirws �(mech ride or lights). ��' ", $0.00 0 Christmas Tree Stand� � �::, - $0.00 0 Fireworks Stand - $0.00 0 Other ElecGicel Fee $0.00 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES E705.65 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire antl 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 the work authorized under ihis 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 2446-48I8/00) WORKERS' COMPENSATION DECLARATION: � I hereby aHirtn under penalry of perjury one of lhe following tleclera�ions: � ❑ I heve and will maintain e ceriificate of conseni to self-Insure for workers' compensation, as providetl for by section 3700 of the Labor Cotle, br Ihe peAortnence of Ihe work for which Ihis pertnit is issuatl. ❑ I have end wlll mainWip workers' compensalion insurance, as required by secUon 3700 of the Labor Code, for the peAortnance of t�e work for which this pertnit Is Issued. My workers' compenSation Insurance carner and polity number are: Cernec Polia� iJumber. , (T61s section need not be comp/etetl il the permit is valued at one hunOretl tlollars ($700) or less.) ❑ I certity that in the pertortnance ot tha work lor which this pertnit is issued, I shell not employ eny person in any manner so as to become subject to the workers' campensation laws of Calitomia, end egree that ii l should becoma su6jact to the workers' compensation provisions of Sectlon 3700 of the Lebor Code, I shall torthwith comply with t�ese provisions. Applicant Signature: Date: WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL PND SHP1L SUBIECT AN EMPLOYER TO CFIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED TLIOUSMID OOLLARE (E100,000), IN ADDITION TO THE CQST OF COMPENSATIIXJ, DAMAGES AS PROVIOED FOR IN SECTION 3]Ofi OF THE IABOR CADE, IMEFEST, AND ATTORNEYS iEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm that I am licensetl under provisions ot Chapter 9(commencing with Section 7000) of Division 3 ot Ihe Business antl Professions Coda, antl my license Is in full torce antl eHect Llc. q, Contrectors SignaWre: Class M Date: _ CONSTRUC710N LENDING AGENCV: ❑ I hereby aflirtn that there is a consWction lentling agency tor ihe pertortnance of ihe work tor w�ich ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lenders Name: Signelure: _ OWNER•BUILDER DECLARATIONS: Lentle/s Atltlress: Date: I hereby eHirtn ihat under penalry of perjury Ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business an0 Professions CoOe: Any ciry or counry which requires e pertnit to construct, alter, impmve, demolish, or repair any structure, prior to its issuance, also requires the epplicant for such permit to file e signed stetement that he or she is Iicensed pursuant b Ihe Orovisions of iha Coniractors Licensa Law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business end Profeuions Gode) or thet he or she is e:empt therefrom and the Gasis for the elleged exemption. Any violation of Section 7031.5 by any applicent far e pertnit sub�e e applicant to e civil penalry oi not more ihan five hundred dollars (5500).): I,-es owner oi the properry, or my employees with wages as their sole compensation, WILL DO 7HE WORK, an0 the siructure is not intended or oHered for sala (Sec. 7044, Business and Professions Code: The Coniraciors License Law does not epply to an owner of property who 6uilds or improves Ihereon, and who tloes such work himsetl or herself or through his or her own employees, providad that such improvements are not Intended or oHeretl for sale. If, however, the 6uiltlinq or improvement is sold within one year of completion, the owner-builder will heve the burden of proving �hat he or she did not builtl or improve for purpose of sale.). ❑ I, es owner ol lhe pmperry, am E%CLUSIVELY CONTPACTING WITH LICENSED CONTRACTORS to construct the pmject (Sec. 704G, Business and Profeuions Cotle: The contrectars Licens@ Lew does not appty to en owner of property who builtls or improves Ihereon, antl who comracts for such project with a con[racmr(s) license pucswai�toyhe C�jictors License Laws.). Business and Pmlessions Cotle tor ihis Ow'ne� ID vyfitietl by tlri4eraYicensr� p Yes ❑ No Veritication of Ownership by (type o menL i.e. - property las bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cartify Ihet no excavetion tive (5) or more feet in depih into which e pereon is required to descentl, will be made in connection with work authorizetl by this pertnit, and that no building structure, scettolding, talsework, or demolition or dismantling ihereof, will be more ihan thirty-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Ttle B, Celitomla ACministrative Cotle). ❑ As owner-builder, I will not employ anyone to do work which would require a permit From the Division of Indusirial Safery, as noted ebove, unless such person has e pertnit to tlo such work irom the division. Signawre: Date: Divislon ot Industrial Satety Permit Number: CERTiFlCATE OF COMPLIAN AND AUTTfORVATON OF ENTRY: I cenify under penalry of perjury that I have reatl this epplication antl state thet ihe information given is correcL I agree�o�e y with all s te la , and ciry ordinances relating to building construction, and authonze represen�atives of ihe City ol Costa Mesa to enter upon ihe ebova-describedAroperty to in p ctid ses. I agree n aeupy or allow occupancy of eny 6uilding authorized bY this psrmit until final inspection. / S� / Sign �u . �Owner(s) LDele And/Or Authorized Applicanl Date �I�(, INSPECTIONiYPE i 1618 Fixetl System Final Fire Prevention � 7288 Pool Spa Final 200 Final Re-Rool 201 Final Block/Retaining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition QC¢ INi1TIRL COOEt �SPECTIONiYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Si�e 250 Final Building/Occupency OATE INTffI�LS J� � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 282 DEL MAR AV Suite No B Vicinity: UNIT B Parcel Number: 43920122 npp�icant: ENGLERT, RAY Address: 2165 S GR4ND AVE SANTA ANA, CA Owner: HABITAT FOR HUMANITY Address: 2165 S GRAND AVE SANTA ANA, CA Contractor: Address: OWNER-BUILDER MECHANICAL PERMIT Phone: (714)434-6200 Zip: 92705 Phone: (714)434-6200 Zip: 92705 =Phone: Zip: License: 0 ISSUED BY: Status: ISSUED Applied: O6/05/2001 Issued: O6/05I2001 SCOPE OF PERMIT _ MECHANICAL PERMIT FOR NEW SINGLE.FAMILY RESIDENCE FOR "HABITAT FOR HUMANITY" (UNIT B). INSTALL 1 FAU, 1 GAS PIPING,-& 3 VENT FANS. .0 ; �_ REF: B00-01594 � �� ' FEE SUMMARY - � — - - •t � " - . ' �'" �Quantity :- • � _ - - — - � ' Qu�antity � ISSUE FEE - $23.50 Repair / Alt Absorbtion Unit i., ,$0.00 � 0,, Inst FAU <100 k BTU $14.80 1 Repair / Alt Refrigeration Unit '�� $0.00 ,-0 :. l;, Inst FAU >700 k BTU - $0.00 0 Ventillation System �;/� $0.00 0� �. Repair / Alt Cooling/Heat ` $0.00 0 Evaporetive Cooler ;(/': �„$0.00 � 0 Inst / Rep. Recess Wall Htr $0.00 0 -- • '�'= Commercial Incinerator . ' j'� � .' $0.00 0 � � -� ��;:.� - ,�•� �$0.00;',0� Refrig Sys <100 k�BTU ` • $0.00 0 , ,�s�, , � �Domestic Incinerator , , � Refrig Sys >700 k BTU � �' � $0.00 0 - � � Compressors / Absorption Svstems /%,' , � ' -' Gas Piping ` . � $6 15 . 7 � � � � ; Up to 3 hp /,100 k BTU -.. . � � " . $0.00 0 Factory Fireplace ��$0 00 0' � �� 3 To 15 tip / 500 k BTU�" �� 50:00 ,� 0 Hood w/Mech Ezhaust � _�$0 00� 0-, , �-,�15 To 30 hp / 1 000 k BTU i j� ,� -�. 50.00 � 0 VAV Box �� / r� $0 00�`0 `, �. ,30 To50 hp / 1 750�kBTU �� j ) ri$0.00 0 Vent Fan / Single Duct��, `�� i$21 75 3�.�� , ' ��Oyer 50 hp / Over,1,750'BTU'"�! -� � �`$0.00 0 Appliance . � � � _ . ; $0'00, 0 V`_ �`'� �� . ° Boilers - � ; �/�' �.: ��..�i ; �:i j Fire Dampers � � $0.00`�� 0 � - � �� - �Up to 3 hp �`�, ; � ��" �� !- � � $OAO 0 Smoke Dampers � � $0.00 : , 0 - 3 To 15 hp, , � � � ,!i / $0.00 0 Inst or Relocate Appl Vent ` , -$0.00 � I ,0 ' ' - - - -�15 to 30 hp` � � % _ - $0.00 0 Air Handlers < 10000cfm - $0,00 � �0 . � � � , 30 to�50 hp�'. � - ,' � � �' $0.00 0 AirHandlers> 10000cfm ' $0:00��0 . , ."Over50,hp� - � � = $0.00 0 Floor Furnace $0.00 0� . � Other Mechanical�Fee � Floor or Suspend Heater $0.00 � 0 � � � � , ; Investigation"Fee. -- $0.00 - ' '� Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $66.20 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a periotl of 180 days. INSPECTIONS: In order tor ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required inapectiona 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 2446d6I6/00) WORKERS'COMPENSATION DECLAHATON: - I hereby ettirm under penalty of perjury one oi ihe tollowing declaration5: ❑ I heve and wlll maimain e cenificate ot consent to seN-Insure tor workers' compensetlon, es provitled for by section 3700 of the Labor Code, tor ihe peAormence ot Ihe work for whith Ihis pertnit is issuetl. ❑ I have end will maintain workers' compensatlon insurance, az requiretl by section 3700 of ihe Labor Coda, for the pertormance of the work for which Ihis pertnit is issuetl. My workers' wmpensation Insurance cartier end policy number era: Cerrier: Policy iJumber: (Tlris sactlon need nof be Comp/eted i/ the permit is velued at one hundred dollars ($100) or /ess.J ❑ I certify that in the peAormance of lhe work for which ihis permit is issued, I shall not employ any person in any menner so as to hecome subject to ihe workers' compensetion laws of Calitomla, end agree Ihat it I should become subject to the workers' compensatlon provisions ot Section 3700 oi the Labor Cotle, I shall forthwit� camply with the56 pmvi5ion5. Applicant Signawre: Date: WARNINO: FAILURE TO SECURE WORKERS' COMPENSATIIXJ WVERAGE IS UNLAWFUL AND SMALL SUBJECT AN EMPLOVER TO CFIMINAI PENALTIES AND GVIL FlNES UP i00NE HUNDRED T/qUSAND Dd1ARE (E100,000), IN ADDITIIXJ TO iHE COST OF COMPENSATION, DAMAGES AS PROVI�ED FOR IN SEC7IIXJ 3'lOfi OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirtn ihat I am IicenseC untler provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force efM ettecf. Lic. x .__ __ Gass N ... Conirector's Signature: Date: CONSTRUCTION�LENDING AGENCV: ❑ I hereby aHirm thai Ihere is a construction lending agency for the peAormance ot ihe work for which t�is permit is issued. (Sec. 3097, Civil Cotle). LenGer's Name: Lendels Address: _. Signeture: OWNER-BUILDER DECLAFiATONS: Date: I hereby ettirtn that under penalry ot per�ury Ihat I am EXEMP7 FROM 7HE CON7RACTORS LICENSE LAW tor the tollowing reason (Sec. 7037.5, Business end Professlons Cade: My ciry or counry which requires e Oermit to construct, alter, improve, tlemolis�, or repair any structure, pdor Io it5 issuance, also reQuires the appliwN tor suc� pertnit to file e tl statement that he or she Is Ilcensetl pursuant to ihe provisions of Ihe Contractors License Lew (Chapter 9(commencing wlth Section 7000) ol Division 3 ot the Bu ' ss and Professlons Cotle) or thet he or she is exampt theretrom entl the basis for iha elleged eaemption. Any violetion of Section 7031.5 by any epplicent tor e permit s Jects the epplicent to a cMl penalry oi not more than five hundred dollars ($500).): �I, sa rnvner ol the properry, or my employees with wages as their sole wmpensation, WILL DO THE WORK, and iha structure is not intentleG or otteretl for sale (Sec. 7044, Business and Professions Code: The Contractors Licensa Law dces not apply to an owner of property who builds or improves thereon, and who does such work himself or herselt or ihrough his or her own emplqrees, providetl ihat such improvements are not intended or offeretl for sale. tl, however, the building or improvement is sold within one year of completioq the owneo-builder will have ihe burden of D�oving ihat he or she did not build or improve tor purpose of sale.). ❑ I, as owner oi the properry, em EXCLUSIVELV CONTRAC7ING WITH LICENSED CONTRAC70RS to construct the project (Sec. 7044, eusiness antl Professions Code:7t�g�m�traeIon�Licenyy Lew Ooes not epply m an owner oi proparry who builds or improves thereon, and who contracts for such pmject with e coniracror(s) li�ursuant to W4 CoMf2ctors License Laws.). eu5in855 and Pmfessions Code tor thi5 reason: Owner IDDeNflBQby dri r�'� p ves ❑ No ( Vedflcation oi Owners ip by (type ol tl ment, i.e. - propeny teu bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ 1 hereby certily Ihat no excavation flve (5) or more �eet in depth into which a person is required to descend, will be ma0e in connaction with work euthorizad by this pertniL and thet no 6uilding siructure, scattolding, lalsework, or demolition or Cismantling thereof, will be more ihan thir�y-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Titla e, Calitamia Administretive Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a pertnit from the Division of Indusirial Sefety, as notetl ebove, unless such person hes a permit to do such work from the division. Signature: Date: Division af Indusinel Sefety Pertnit Number: CERTIFlCATE'�F COMPLIANCE AND AUTH IZA710N OF ENTTiY: I certity under penalty of perjury that I have read ihis application antl state that the information given is correct. I agree to comply with II state laws d 1 rdinances relating to builtling wnstruction, and authorize representatives of the Ciry of Costa Mesa to enter upon the ebove-descnbed property for i pecti os . g(ee noi to occuDY or Ilow occupancy of any building authonzed by this permit until final insDection. Q',�i ��r (� �i � •S = O / gnaNre_ Leg I r( �---� Date - And/Or Aulhonzed Applicant SODE I. INSPECTION TYPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition I93��I'J1i17.149 CO�F 1 INSPECTION TYPE 206 Final Mechanical 208 Finel Plumbing 270 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Buildin<yOccupancy (714) 754-5273 • Fan (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 282 DEL MAR AV Suite No B Vicinity: UNIT B Parcel Nunmber: 43920122 Applicant: ENGLERT, RAY Address: 2165 S GRAND AVE SANTA ANA, CA Owner: HABITAT FOR HUMANITY Address 2165 S GRAND AVE SANTA ANA, CA Contractor: OWN ER-BU I LD ER Address: Arch / Eng: �-'_ Address: �. PLUMBING PERMIT Phone: (714) 434-6200- Zip: 92705 Phone: (714) 434-6200 Zip: 92705 Phone: Zip: License: 0 y : � - . ' ..Phone: - --_ - --ZiP�� - --'- - - .._ _ _ _. � � � � � ' ` %� ' - --' Lioerise' � PLUMBING PERMIT FOR NEW SINGLE , . INSTALL 2 TUB/SHOWER COMBOS, 4( - 2 WASH BASINS, 2 WATER CLOSETS;�„ , _ SERVICE.� _ �� - .� � ' REF: B00-01594 �� , '� ` . �� _ A %ii . �-A ,� , . / � �- � � . i , �. - ��V AMT ' QTY -� ISSUE FEE - ' $23 50 � � / ,` ' �� Backflow irrigation $0.00. � 0 ' ' � � Backflow Preventer $0.00,_ �`�- 0 � , � Bathtub $19.60 � '2 . Clarifier System $0.00 � -0 �_ Connect (Ice,Soda,etc) $0.00 0 �' . Dental Units $0.00 0 Dishwasher $0.00 0 Drain, Floor $0.00 0 Drain, Rainwaler $0.00 0 Drain, Roof $0.00 0 Drinking Fountain $0.00 0 Expansion Tank $0.00 0 Gas Earthquake Valve $0.00 0 Gas (1-4 outlets) $6.15 1 Gas (Over 4 outlets) 50.00 0 Gas Repipe $0.00 0 Gas Service $9.80 1 Interceptors (Grease, Oip $0.00 0 Interceptors (Sand Auto ) $0.00 0 Status: ISSUED Applied: O6I05/2001 Issued: 06/OS/2001 ISSUED BY: DPE OF PERMIT ' ' r FAMILY RESIDENCE FOR "HABITAT FOR HUMANITY :ASOUTLETS, 1 GAS SERVICE, 1 WASHER, 1 KITCH I.WATER HEATER:_1 PRIVATE SEWER LINE 8 1'-WAT . . _'�•�, s� � �/ �"a w 7 � � �'�i: = , � �n � � '.�� < .y, �� -� �. , ��/ .i� i iJ '' �� ,.. . ;,.' (UNIT B). � � . � °NBWK;-/ ' , °R �. ! . �� i � � � / ; : i , � � � FE6SUMMARY , ' � �j ' /% v�� `, , C�,� \`. , ,. , AMT ' :QTY-/ i ._; ` �� % � / � Laundry Tub / Washer - - � =$9:80- 1 ��` Sump�Pump ;- , %� Landscape Irrigation $0.00 .. -0 �� .� Swimming Pool - P-Trap � , , $O.W� 0, , �� "Trap Primer PressureRegulator , $0.00-.'0 ". �Urinal: ProcessPiping(per70ft)� � $0.00 0 . �j� VacuumBrkrBkflow(1-4) � Receptors � � � $OAO _ Or� l � � � - -�Vacuum Brkr Bkflow(5+) � -SepticTank - ,$0.00'� �0 � � � Wash Basin Sewer Cap focDemo: �_ -�$0.00� 0 Wash Basin Set Sewer Connect $0.00 0 Wasle and Vent Syslem Sewer Private Line $24.65 1 Water Closet (Toilet) Shower $0.00 0 Water Heater / vent Sink, bar $0.00 0 Water Piping (Inst or Rep.) Sink, commercial $0.00 0 Water Re-pipe Sink, Floor $0.00 0 Water Service Sink, kitchen $9.80 1 Water Softener Sink, service/mop $0.00 0 OTHER Spa (private) $0.00 0 VIOLATION Spa (public) $0.00 0 PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $19.60 $0.00 $0.00 $19.60 $12.30 $0.00 $0.00 $9.80 $0.00 $0.00 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 2 0 0 2 1 0 0 1 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related � � COMMENTS I SPECIAL CONDITIONS EXPIRATION: This permit shall automatically expire an ecome voi i wor is no commence wi in 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 Inspeetions 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 � 244G46(N00) WORKERS'COMPENSAnON DECLARAnON: — I hereby aHirtn under penalry of perjury one oi Iha tollowing declarations: ' ❑ I heve enC will mainiain e canificate ot consent ta self-Insure for workers' compensation, as provided for by section 3700 of the Lebor Code, tor the pertormance of ihe work for which this permit is issued. ❑ 1 have ana will maintain workers' compensetion insurance, as requiretl by section 3700 oi the Labor Code, for ihe perfortnance ot the work for which this pertnit is issuetl. My workers' compensatlon Insurence carder and policy number are: - � Certier. � Policy iJumber. (This secUon need not be comp/eted i/ the permit /s velued at one hundred dollars ($700) or /ess.) ❑ I certity Ihat in the pertortnence of the work for which ihis pertnit is issued, I shall not employ any person in any manner so es to become subject to the workers' compensation laws of Calitornia, end agree that tl I shoultl becoma subject to the workers' compensation provisions of Sectlon 3700 of Ihe Lebor Coda, I shell fotlhwith comply with these pmvisions. ApO��ent Signature: Dete: WARNING: FAIWRE TO SECURE WORKERS' WMPENSATIIXJ CWERA(3E IS UNLAWRIL AND SHALL SUBJECT PN EMPLOYER TO CWMINAL PENALTIES AND CIVIL FlNES UP TOONE MUNORED THOUSAND DdJARE (5100.000), IN ADDITION TO THE COST OF COMPENSATION, DPMAGES AS PROVIDED FOR IN SECTION 3IOB OF THE LABOR CO�E, IDREREST, AND ATTORNEI"5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm that I am licensetl untler provisions at Chapter 9(commencing with Section 7000) ot Division 3 0l ihe Business and Professions Code, and my license is in full torce and effect. ltc. M ' Class A Contractors Signature: Date: CONSTRUC710N LENDING AGENCV: I ❑ I hereby aHirtn that there is e conswction lending agency lor the performance of the work for which ihis pertnit is issued. (Sec. 3W7, Civil Code). ��, Lendefs Name: Lender's Atldress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eflirtn thet under penelry at perjury Ihet I em EJ(EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires a Dermit to construct, alter, improve, demolish, or repair eny structure, pnor to its issuance, also requires the appliwnt tor such pertnit to tile a signed statement Ihat he or she Is Ilcensetl pursuant to the provisions of �he Conirectors License Law (Chapter 9(commencing wit� Sectlon 7000) of Division 3 of the Business antl Protessions Code) or thet he or sha Is exempt therefrom and the basis for the alleged ezemption. Any violation oi Section 7031.5 by any epplicant for e permit s e epplicent to a cMl penalty of not more than five hundred dollars ($500).): _I, as owner ot the property, or my employees wl�h wages es their sole wmpensation, WILL DO 7HE WORK, and the s�ructure is not intended or oHeretl tor sale (Sec. 7044, Busineu antl Professions Code: The Contractors License Law dces not apply to an owner of properry who builds or improves thereon, anC who does such work himself or herself or ihrough his or her own employees, provided ihat such improvements ere not intended or oHered for sale. If, however, the building or improvement is sold within one year ol completion, Ihe owner-builder will have ihe burden of proving that he or she did not build or improve for purpose of sele.). ❑ I, as owner ol the Droperry, em EXCLUSIVEIV CON7RAC71NG WITH LICENSED CONTRACTORS to cons�ruct Ihe praject (Sec. 7044, Business and Protessians Code: Th ye pt�License law does not apply to an owner oi property who builds or improves Ihereon, and who contracts for such project with a contractor(s) licensao�suant to 067�tractors License Laws.). Vedtitation of Business and Profeuions Code for this reason: ❑ Ves ❑ No D'r'rvefs License No. tlocument, I.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CER7IFICATON: ❑ I hereby cenih/ that no excavetion five (5) or more feet in depth into which e person is required to descend, will be made in connection with work euthonzed by this pertnit, and that no building structure, sceMolding, falsework, or demolition or tlismantling ihereof, will be more than thirty-six (36) tee� �igh. (Chap. 3.2, Grp 2, Art 2, Sec. 3a7, Title 8, Celifomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which woultl require a permit Irom the Division oi Indusirial Safety, as notetl ebove, unless such person has e permit to tlo such work from the division. Signeture: Date: Division oi Industnal Safery Permit Number. CERTIFlCA ANCEM1 D AUTHORIZATON OF ENTRY: I certity under penalry ot perjury that I have read this epplication and state that the infortnation given is co . agree to coj�ply with 13'tatg�I3ls end ciry ortlinances relating to Duilding construction, and authorize representatives of the City of Costa Mesa to enter upon the ebova-described pr be insp�elioS �Dses. I agree not to ccu or allow occupancy ot eny huilding authorized by this rmit until al insDection. � - ��--o / igna Oi Owner(� Data � � And/Or Amhonzed Applicant Data CQOE I. INSVECTIONTYPE 1818 FixeO System Final Fire Prevention 1286 Pool Spe Final 200 Finel Re-Roof 201 Final BIocWRataining Wall 202 203 Final Factory Fire Place Finel Slgn 204 Final Demolition p�g ixnn� COOE� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 272 Final Flre Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy D�TE � ( ZS_� INSULATION CEF. �ICATE IC-1 Site Address Permit Number B00-01594 282 Del Mdr Avenue,lfB _ Costa Mesa, CA 92627 Number and Street � lty Oranee _, PM 2000-179 1 Countv � Subdivision LotNumbe! DescriFtion of Installation L ?.OUF Material N/A Thickness(inchzs)_ Brand Name Thermal Resistance (R-Value) 2. CEILING Batt or Blanke[ Type Fiber Glass Brand Name Thickness (inches) 6" Thermal Resistance (R-Value) R-19 Loose Fill Type Brand Sohns Manville Contractor's min installed weiehdft� Ib tilinimum thickness 6 inches Manufacrurer's installed weight per square foot to achieve i'hermal Resistance (R-Value) 3. EYTERIOR WALL Frame Type Wood — 2x4 A. Caviry Insulation N[aterial Fiber Qlass batt Thickness (inches) 3-1/2 B . Esterior Foam Sheathing Material Thickne5s (inches) 4. RAISED FLOOR Nfaterial N/A Thickness (inches) �. SLAB FLOOR/PERIbiETER Material N/A Thickness (inches) Perimeter Insulation Depth (inches) 6. FOUNDATION WALL Material N/A Thickness (inches) Brand Name Johns Manville Thermal Resistance (R-Value) R-13 Brand Name Thermal Resistance (R-Value) Brand Name Thecmal Resistance (R-Value) Brand Name Thermal Resistance (R-Value) Brand Name �I'hermal Resistance (R-Value) Declaration [ hereby certify Ihat the above insulation was installed in the building at the above location in conformance with the current Ener�.� EJf+ciencv Stnndnrcfs for residential buildings (Tit(e 24, Part 6, Califomia Code of Regulations) as indicated un the . Certificate of Compliance, where pplicable. Mark Korando, V.P. — Site Development (��/ �l HABITAT FOR HUMANITY OF ORANGE COUNTY (OWNER) Item �s Signature. Date [nstalli�g Subco�tractor (Co. Name) OR General Contractor (Co. Name) OF. Owner I[em �s f[em �s Sienature. Date $i�naNre. Date [nstalling Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Insta(ling Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owr�er Compliance Forms August 2001 A-36 CITY OF COSTA MESA BUILDING DIVISION ROOF COVERING CERTIFICATION Permit No. 800-01594 PropertyAddress 282 Del MAr Avenue, IIB Owne��Builder HABITAT FOR HUMANITY OF ORANGE COUNTY Contractor �BZTAT FOR HUMANITY OF ORANGE COUNTY State Contractor License Number Classification I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 15, and Appendix 15 of the latest adopted edition of the Uniform Building Code, and the installation instructions of the manufacturer. � I further certify that I am the owner of the property. (Owner-Builder permittee only). ❑ I further certify that I am: ❑ Owner of sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Received by Building Division By: �� j'- 3 Intlial Dete - 098Pa6MW6A0 White-Buildin9Div.;Canary-Cmlrxmr.Pink-Owner HABITAT FOR HUMANITY OF ORANGE COUNTY . Compeny or Corporate Neme 2165 South Grand Avenue Address Santa Ana, CA 92705 � / 29-G3 Signature Dete Mark Korando, V.P. - Site Development Printed or Typed Nema CITY OF COSTA MESA BU�iD1611G DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT {�ia� �sa-sz�s • Fax (714) 754-4856 • www.a.cosca-mesa��,�LDING PERMIT Job Address: 282 DEL MAR AV Suite: A Vicinity: NEW SFR WITH ATTACHED GARAGE Parcel Number: 43920122 npp�icant: ENGLERT, RAY Address: 2165 S GRAND AVE SANTA ANA, CA owner: HABITAT FOR HUMANITY Address 2165 S GRAND AVE SANTA ANA, CA Contractor: OWN ER-BU I LDER Address: Zoning: Phone: (714)434-6200 Zip: 92705 Phone: (714) 434-6200 Zip: 92705 Phone: NUMBER B00-01590 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 10/04/2000 Issued: O6/OS/2001 Zip: � License: 0 - , Arch : MUSSER ARCHITECTS INC Eng: Address: 730 W 17TH ST � . Address: . � COSTA MESA, CA Zip: 92627 Phone: (949) 574-4987 License: . Phone: License: � � � . ' JCVYt Vh F'tKlVlll, '- � CONSTRUCT NEW 1227 SQ FT(635SF iST FLOOR,-592SF 2ND FLOOR) P-STORY SINGLE FAMIIY RESIDENCE (3 BEDROOM/2 BATH), WITH 403 SQ FT ATTACHED GARAGE 8 121 SQ FT FRONT PORCH FOR "HABITAT FOR HUMANITY" � (UNITA). ' , -� � - � REF: DR-00-79 _—__ - _ —__ __�. ,.-_. �./ �- - . ) FEE SUMMARY ' %�f � Plan Check: $704.18 � = `,,' CalcValuation:s�T% � ,_ g��s,szs.sz Permit: $1,083.35 "� Claim ValuatioH:�; , �� $o.00 SMIP Res: � $11.59 ` � ? �� ' � SMIP Com: $0.00 ^'. � � � �'" �� - '� Other: $0.00; . � � ?- ' �" < " � Inspection: $0.00 �� ' -.� <-. � �, � � .� ,- :-� �;�j' / � �;�� - % j j� ��j., �' . Total: .A$1,79912 ��' � _� '� � ' t�i� <�� C� � � .. ', _ �� >� i� ��\: �. ��`� - ' � P SETBACKS :�,'` � ' MAINSTRUCTURE Front 20-.0�: - �Rear 10-0 ACCESSORY Front 0- 0 -, , Rear, : 0- 0 PARKING Existin : 0 Required: 10 � NOTES: ANNING'&�ZONING_ , "` ��' �� \ -'i � � � � . \ � \ .. �. i - � � � - /�/. � � Left 10-0� ��, � Righf��10-0 _ •/»' . ;�- Left A- 0�.;%" Right � 0- 0 `.:, ��="�'�'�"- - - ��Proposed: 10 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 780 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapectiona 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 �� 244&b81d�) WORKERS'COMPENSAnON DECLANAnON: — I hereby aMirtn under penalry of parjury one oi tha tollowing declarations: � � , ❑ I heve antl will maintain e ceNtic3te of consent to seN-Insure for workers' compensetion, as provided for by section 3700 of the Lebor Code, for the pertortnenca of the wotk for which IhiS permii i5 issuBtl. ❑ I have and will maintain workers' c�mpensation insurance, as required by section 3700 of the Labor Code, for the pertortnance of the work for which this pertnit is Issuetl. My workers' compensetlon Insuw��e cerder and policy number are: . Carrier. Policy iJumbar: (Th/s section neetl nof be comp/etetl il the permit is valued at one hundred dollers ($100) or less.) ❑ i catlify that in the peAortnance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to ihe workars' rqmpensation laws ot Califomia, enC agree that ii I shoultl bewme subject to Ihe workers' wmpensation provisions of Section 3700 oi �he Labor Cotla, I shell forthwlih compy with these provisions. Applicant Signature: Date: WARMNO: FAILURE TO SECURE WORKERS' �.�P�1S1TIOf! COVERAGE IS UNLAWRIL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TOONE HUNDRED TMq1SAND DOl1ARE (5100,000), IN ADDITIOr170 THE C�T OF COMPENSATON, DAMAGES AS PROVIDED FOR IN SECiION 3]060F THE LABOR CODE, INiERE5i, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aNirm that I am licensetl under p�ovisions of Chapter 9(commencing with Section 7000) oi Division 3 of the Business end Professions Code, and my license Is in full force and eflect. Lic. a Class k ConiractoYs Signature: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby aMirm thal ihere is a conSiruclion lentling agency for iha peAormance of the work tor which ihis pertnil is issued. (Sec. 3097, Civil Cotle). Lentlers Name: Lenders Address: Signawre: Date: OWNER-BUILDER DECLARATIONS: I hereby aKrm that unGer penalty of pellury that I am EXEMPT FROM TXE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business entl Protessions Cotle: Any ciry or counry whic� require5 e permu ro construct, alter, impmve, demolish, or repair eny sWdure, pnor to its issuance, also reqwres the applicant br such permit to file e signetl stetement t�et he or sha �s Iicensed pursuant ta Ihe provislans oi Ihe Contrectors License Lew (Chapter 9(commencing with Section 7000) at Division 3 at Ihe Busineu olessions Code) or tha� he or she is eaempt therefrom and the besis tor the allegetl exemption. Any violation ot Section 7037.5 by any aDGlicant for e pertnit 6�e applicant to a civil penalry oi not more ihan five hundretl dollars ($500).): 1 as owner of the property, or my employees with wa9es as Ihelr sole compensation, WILL DO 7HE WORK, antl the simcture is not intendetl or oNered for sale (Sec. 7044, Business and Pmfessions Code: The Coniractors License Law does noi apply to an owner oi property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provitled ihat such improvemems are not Intended or ottered lor sale. If, however, the builtling or impmvemeN is sold within one yeer of completion, ihe owner-builder will have ihe burden of proving that he or she did not build or improve for purpose ot sale.). ❑ I, as owner oi the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construci the project (Sec. 7044, Business end Professions Code: The License�.�Bw tloes not apply to en owner ot property who builds or improves thereon, and who contracis lor suc� project with e conirector(s) licens suam to Comrgb(o4s License Laws.). o �`a.a a�sa�. �. 'Sfgneture: ' Owner ID ritie0 by dnv s lite Veritication of Ownershi by (rype of entl Protessions Code for this reason: �s ❑ No i.e. - properry taz bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby canify that no excavetion �i�e (5) or more feet in dep�h inio which a person is required to descend, will Ce mede in connection with work euthorized by this permit, end that no building structure, scattolding, falsework, or demoli�ion or tlismantling thereof, will be more ihan ihirry-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ttle B, Celifornia AdministraMe Code). ' ❑ As owner-builder, I will not employ enyona to do work which would require a permit from t�e �ivision of Industnal Sefety, es noted abave, unless suc� person has e permit to tlo such work from Iha division. Signature: Date: Division ot Industnal Sefery Permit Numbar: CERTIFlCA7E OF COM�yAdCF AND A�'�F)bRILU10N OF ENTHV: I certiy under penalry of perjury that I have read this epplication and stata that the information given is correci.�ei�ply with�IPst �a�s and ciry ordinanc relating to building consWction, and authorize representatives ol the Ciry of Costa Mesa to enter upon the abo escnbed pro rt arnspeet rQbses. I agre �supy-or�allow occupancy of any building authorized by t�is pgrmil until final inspection. O �"'� I ure galOwner(s)' -Date - � _ �--�-_ _ ntl/Or Au�horized Applicant Date COpE;I, INSPECTIONTYPE 1616 Fiaed System Final Fire Prevention 1266 Pool SOa Final 200 Finel Re-ROoI 201 Finel BIocWRetaining Wall 202 Finaf Padory Fire Place 203 Final Sign 204 Final Demolilion P�S€ 1I�Ja45 CODE� �Nsaecnoxnve 206 Final Mechanical 20B Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Finaf Planninq Approval 222 Final Site 250 FinalBuildincyOccupancy OATE �¢ (714) 754-5273 • Fan (7/4J 754<856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber. Applicant: Address: Owner: 282 DEL MAR AV A UNIT A 43920122 ENGLERT, RAY 2165 S GRAND AVE - SANTA ANA, CA HABITAT FOR HUMANITY Address 2165 S GR4ND AVE SANTA ANA, CA Contractor: OWN ER-BUI LDER Address: ISSUED BY: Phone: (714) 434-6200 Zip: 92705 Phone: (714) 434-6200 Zip: 92705 Phone: Zip: License: 0 Status: ISSUED Applied: 06/OS/2001 Issued: O6/05/2001 ' ' �' SCOPE OF PERMIT j� , � - - - � ELECTRICAL PERMIT FOR�NEW SINGLE FAMILY RESIDENCE EOR .'HABITAT FOR HUMANITY" (UNIT �� A). INSTALL NEW ELECTRICAL THROUGHOUT NEW RESIDENCE & INSTALLI LIGHT, 7 OUTLET,;&� 1 �-- �. �° � SWITCH IN GARAGE. , � � � � , , � REF: B00-07590 - - - - � �= . �� : ; ;, ' - , ". _--- ' _ - '.- „ : �.� _ � �� . �- � � . ISSUE FEE Temp service test Res. a/c,package New Res (1�-2 units) New Res (3+umts) ' Pool / Spa Lighting Fixts ` � \ Recept Outlets Switthes ; ; � Non Res Appl Res Appl Service to 200a Service to 7000a Service over t000a Motors to ihp Motors to tOhp Motors to SOhp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole � FEE SUMMARY � ; � � Quantity - = _ ��-"- - Quantity`� � . _ ' �," ' $23.50 .r7emp Dist System / Lighting =$0.00 i%,0�� '' � � , $0.00 .�. J��+; �. � Busway /100 ft $0.00 iG'0 '� ' � . �, ,.,' � $0.00 ' , �"f-' - �- ' Standing,Seclion $0.00%j�� 0 ' �' ��$68.71 1227 , MiscElectrical�Equipment _ $0.00�/ 0, ' � - $0.00 � � : � 0;; ,_ , �� _ � -Tranaforrriers�up'to"1 kva/kw^,;"q �$0.00' 0 � � � � `$0 00�. 0� �- up to 10 kva/kw $0 00 / 0 �� //� $1 10•� A��1 - . ` � %� �up,to 50 kva/kw{ �;�� $0 00��0 , '- i , _ � `� ; $1�10, �� 1 �; ? - �up to 100 kJa/kw�� $0 00.' 0 ,51�10� 1��'�,`� ... �: ...over.100kva/kw -$0�00;�,�0 � � �j $0.00 � 0 �'�� - � Low Voltage Equipment �1 � � $0 00; � -0 � � . $Q00 � � . � 0� � Low Volt Wiring System / Ckt�. �$0.00 . � - 0� -� � - $0.00 � � �, ," 0- � �, Misc. Conduit - � A ' �: ��$0.00'' ' 0 $0.00�. � � 0 . , . Misa Conductor i' ' '� � , $0.00 �. 0 $0.00 \�'-- 0- .Circus ( gen or ride) ' � � $0.00 0 $0.00 �� -� 0- ' ``' Circus�(rtiech'ride or lights)�% i$0.00 0 $0.00 - � 0 �:, ; Christmas Tree�Stantl� ; � $0.00 0 $0.00 0 - ' � , Fireworks Stand � - $0.00 0 $0.00 0 - Olher Eledrical Fee $0.00 $0.00 0 $0.00 0 Investigalion Fee $0.00 $0.00 0 Plan Check Fee $0.00 $0.00 0 Reinspection Fee $0.00 $0.00 0 $0.00 0 TOTAL CALCULATED FEES $95.51 $0.00 0 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days. or it work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permit �o be considered legal, such work mus� comply wi�h all applicable codes, and�� required Inspeetions and final approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this perrtiit� FOR INSPECTIONS CALL: (714) 7545626 2446-4fi (fi/00) WORKERS' COMPENSATION DECLARATION: ., ' I hereby atfirm untler penalry of perjury one of ihe following declerations: • ❑ I heve antl will maintain e ceRiticate of consent to setl-Insure for workers' compensation, as provitled tor by section 3700 ot Ihe Lebor Cotle, tor Ihe pertormance oi the work for which this pertnit is issued. ' ' ❑ I have aM will maintain workers' compense�on insurance, es required by section 3700 ot ihe Labor Code, for tha perfortnance of ihe work tor which ihis pertnit is Issued. My workers' wmpensatian Insurance carner end palicy number ere: Carrier: POlity Number: (This secNon need not be cwnplefed il Ne permit is velued et one hundred dol/ers ($100) or IessJ ❑ I certify that in ihe pertormance of Ihe worlc tor which t�is pertnit is issued, I shall not employ any person in eny manner so as to become subject to ihe workers' compensation laws oi Califomia, antl agred that il I shoultl �ewme subject to the workers' compensatlon provisions of Section 3700 of the Labor Co�e, I shall toRhwith comply wi�h these provisions. Applicant Signature: Date: WARNINO: FAILUHE TO SECURE WORKEFS' COMPEN�n� �ERAGE IS IINLAWFUL PND SHALL SUBIECT AN EMPLOYER TO CFIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED TFIOUSAND DOLLARE (E100,000�, IN ADDRION TO THE �T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 31O80F THE LABOR CODE, IMEREST, AND ATTOfiNEY'S FEES. � UCENSED CONTRACTORS DECLARATION: I hereby eHirm that I em licensetl under provisions of Chapter 9(commencing with Section 7000) ot Division 3 of the 8usiness and Protessions Code, end my license Is in tull rorce ena enect. Lic. a class s Comrecmfs SigneWra: �ate: CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirtn that there is a consiruction lending agency for che pertortnance ot the work for which this pertnit is issued. (Sec. 3097, Civil Code). Lentlefs Name: Lendefs Address: Signelure: Date: OWNER-BUILDER DECLARATIONS: I hereby etllrtn iha� under Denalry of perjury �hat I em EXEMPT FROM TME CON7RAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions Coda: Any ciry or counry which requires a permit �o construct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires ihe epplicant for such permit lo tile a signetl atetement ihat he or sha Is licensetl pursuent to the provisions af t�e Conirectors License Lew (Chapter 9(commencing with Section 7000) af Dlvision 3 at the Business end Profeulons Cotle) or that he or she is exempt theretrom end the basis for tha alleqed e:emption. Any violetion ot Section 7031.5 by any epplicant for e permit ubJe e epplicant to e civil penalry of not more then five hundred dollers ($500).): I, as owner ot ihe property, or my employeas with wages es their sole compensa�ion, WILL DO THE WORK, and Iha stmcWre is not intentletl or otterad tor sele (Sac. 7044, Business end Professions Code: The Coniractors License Law dces not apply to an owner of Droperty who builds or improves ihereon, end who tloes such work himself or herself or through his or her own employees, provided �hat such improvements are not in�ended or oNaretl for sale. If, however, ihe building or Improvement is sold within ona year ol completion, the ow0erbuiltler will have the burden of pmving ihat he or she tlid not build or improve for purpose of sele.J. � I, as owner oi the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the pmject (Sac. 704a, Business end Professions Cotle: The nse Law does not apply to an owner ol properry who builds or improves thereon, antl who coniracis for such pmject with e comractoqs) licen rsuant ro th ontja�tors License L.aws.� Owner ID vd��ietl by tl' efs 116err Venlicetlon of Owners 'p by (rype 8usiness and Professions Code for this reason: ❑ Ves ❑ No i.e. - propeny tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cenify thet no excavation five (5) or more feet in depth into which a person is required to descend, wlll be made in connection with work euthorized by Ihis permil, end ihat no building sWcture, scaHolding, talsework, or demolition or dismaniling ihereof, will be more �han thirry-six (36) feet high. (Chap. 3.2, Grp 2, Ar12, Sec. 341, Tltle B, Celifornia Adminisirative Code). ❑ As owner-builaer, I will not employ anyone to do work which would require a permit from the Division of Indusirial Satery, as notetl ebove, unless such person has a pertnit ta do such work fram the division. Signature: Date: Division of Intlustnal Satery Permit Number: to AUT�1 ORW1710N OF ENTRV: I cenify under penalry of perjury ihat I have read this application and state Ihet ihe information given is with all st �L end ciry ordinances relating to building construction, and euthorize representatives of the City of Costa Mesa to enter upon ihe for i tio ase5. I egree no wpy-o�.allow.occupancy of any building euthonzed by ihis pertnit un �I final ins�tion. � r� � - S at e I��(s) Date '�. Authonzed COOE I. INSPECTIONTYPE 1616 Fized System Final Fire Preven�ion 1266 Poal Spe Finel 200 Finel Re-Roof 201 Final BIocWRetaining Wall 202 E��k'. Final Fectory Fire Place Final Sign 204 Final Demolition Qaj( NTIfIRL �QQ�e INSPECTIONTYPE 206 Final MechaniCal 20B Final Plumbing 210 Final Eleciricel 212 Final Fire PreveNion 220 Final Planning Approval 222 Final Site 250 FinalBuiltlingiOccupancy Q�¢, IHiIiIRLS _Z/ 9 3 � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: ZHZ DEL MAR AV Suite No A Vicinity: UNITA Parcel Number: 43920122 Applicant: ENGLERT, RAY Address: 2165 S GRAND AVE SANTA ANA, CA Owner: HABITAT FOR HUMANITY Address: 2165 S GRAND AVE SANTA ANA, CA Contractor: OWNER-BU ILDER Address: MECHANICAL PERMIT Phone: (714) 434-6200 Zip: 92705 Phone: (714) 434-6200 Zip: _ 92705 "Phone: Z.P: License: 0 ISSUED BY: Status: ISSUED Applied: 06/05/2001 Issued: O6/OS/2001 i SCOPE OF PERMIT MECHANICAL PERMIT FOR NEW SINGLE FAMILY RESIDENCE FOR�HABITAT FOR HUMANITY" ' � , -(UNIT A). INSTACL 1 FAU, 1, GAS PIPING; AND 3 VENT�FANS:: , - , �- > �JL_. .. 1/., _.. .._1 . � . . i r - ' . . � � .' ._ i ' REF: B00-01590 \ <-�� - - - ' 'Quantiry— - ISSUE FEE - $23.50 Inst FAU <100 k BTU $14.80 1 Inst FAU >700 k BTU $0.00 0 Repair / Alt Cooling/Heat � � �' $0.00 0 Inst / Rep. Recess WaII Htr $0.00 0 Refrig Sys <100 k BTU $0.00 0 Re(rig Sys >100 k BTU ,$0.00 0 ' Gas Piping `, $6.15 1 Factory Fireplace � �, $0.00 '-' 0 �k' � � Hood w/Mech,Exhaust � � $0 00� 0 - VAV Box , �� $0 00 �0� ; Vent Fan I Single�Duct� '/ : i$21 75 3 \� Appllance . / �,'$0.00, 0� ., �"� Fire Dampers � . _��$0.00� `0_ `� - FEE SUMMARY � � ; � �'`� `. �� ; �_ -_ . . > '' . - . _ . �t Quanfiry�; Repaii / AIt�Absorbtion Unit �� $0�00 � 0- , � Repair I Alt Refrigeration Unit �, ,/ $OAO ��_ 0. Ventillation System - j �; i,$0:00 � 0� � EvaporetiveCooler -. !ii ,$0_00� 0' - �' - Commerciallncinerator �i:�% � $0.00� -0 ' �.�i.;.'�.. �.• Domesticlncinerator � ��i ��$0.00 � 0 � - , Compressors / Absorption Svstems % � � , � �; Up to 3 hp /-700,k BTU-.4_ . ' %� � -. $0.00 0 � �-� 3To15hp/�SOO��k'BTU�"',r�-/';� � $0.00 � 0 ,' � > 30 To"50 hp�/ 1 750 k�BTU i� �/ j%//, �!$0,00 0 _�Over 50 hp / Over 7,p5UBTU C r„' �� $0.00 0 .. . Boilers.� t - %'j' /, `,� %/ � l ; Smoke Dampers � �'$0 00 " 0 l. Inst o� Relocate Appl Vent '; $0 00' � 0 �' _ -- Air Handlers < t0000cfm ��. $0.00 "0 . . � � AirHandlers> t0000cfm �-$0:00�_r-0 ' �- : Floor Furnace $0.00. � 0�---.; _ � Floor or Suspend Heater $0.00 l�0 _�� - � ' � Up to�3 hp'. � � ' ' ` `! �%" � $0.00 0 - 3To15hp �� . �� $0.00 0 ._ . i5to30hp��' '\ � � $0.00 0 �� 30to50hp=� ��! ��'� � $OAO 0 � .Over50,h ��.--� ��. \ - P� �','i��,i $0.00 0 � � Other Mechanical Fee' �,. � - Investigation'Fee.--� � $0.00 " ' ''�PlanCheckFee $0.00 � Reinspection Fee $0.00 TOTAL CALCULATED FEES $66.20 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: 7his permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapections 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) 754-5626 � 244fi-46 (W00) WORKERS' COMPENSAnON DECLAfiAnON: � � t hereby ettirm under penalry of perjury one of the following tleclarations: ' � ❑ I have and will mainiain e certitiwte of consent to self-Insure tor workere' compensatlon, as provided for by section 3700 of tha Labor Code, tor the padormence of Ihe work tor whith ihis pertnil is i5suetl. ❑ I have and will maintain workers' compensation insuranca, as requiretl �y sectlon 3700 oi Ihe Labor Code, tor the peAo�nance of the work for whic� this pertnit is issued. My workers' compensation Insurance carrier enC policy number ere: Carrier. Policy i4um6er: (This sectlon need not be comp/eted il the permit is velued et one hundred dollers ($100J or IessJ ❑ I certiy ihat in t�e peAortnance of ��e work tor which t�is permit is issued, I shall not employ eny parson in eny menner so es to become subjed to the workers' compensation laws of Calitornie, end egrae Ihat if I shoultl become sub�ect to Ihe workers' compensatlon provisions ot Sectlon 3700 of the Labor Cotle, I shall fonhwith comply with Ihese provisions. Applicant Signeture: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOILARE (5100.000�, IN A�DfTION TO THE COST OF COMPENSATION, DAMAGES AS PHOVIDED FOR IN SECTION 3]O6 OF THE LABOR CODE, IMEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirtn that I am licensed under provisions of Chapter 9(commencing with Section 7000) oi Division 3 of the Business end Professions Code, and my license Is in full torce antl eHect lic. k Glass �t Contracto/s Signature: Dete: CONSTRUCTION LENDING AGENCY: ' ❑ I �ereby aNirtn that there is a wnsiruction lentling agency for the performance oi Ihe work for which this pertnit is issued. (Sec. 3097, Civil Cotle). Lenders Name: Lendefs Atldress: Signalure: Dale: OWNER•BUILDER DECLARATIONS: I hereby affrtn Ihat untler penalry ot perjury thai I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for the tollowing reason (Sec. 7037.5, Business entl Protessions COCe: Any ciry or counry which requires e pertnit b construc6 alter, improve, tlemolish, or repair any structure, pnor to it5 issuance, also requires the aDPlicant for such permit to file a signed sWtement Ihat he or she is licensed pursuant to the proNsions of the Conirectors LJcense Lew (Chepier 9(commencing wilh Sectian 7000) of Division 3 oi the Business a Professions Code) or thet he or she is exempt iherefrom and the basis far tha elleged e:emption. Any violetion of Section 7031.5 by any applicant for a permit s bTe appliCant to a civil penalry oi not more than five huntlretl tlollars ($500).): I,-es owner of ihe properry, or my employaes with wages as their sole compensation, WILL DO TME WORK, antl tha structure is not intendetl or ottered for sale (Sec. �_7064!Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves iheraon, and who does such work himsetl or hersetl or through his or her own employees, providatl t�at such improvamenis are not intentlea or offered for sele. If, however, the building ar improvement is sold within one year of wmpletion, the owner-builder will have the burden of proving ihat he or she did not build or improve for Ourpose of sale.). ❑ I, as owner of the pwperty, am EXCLUSIVELV CONTRACTING WITH LICENSED LON7RACTORS to consiruct the pwject (Sec. 7044, Business and Pmtessions Cotle: The comra tors License Law does not epply to an owner of propeny who builtls or Improves thereon, antl who comracts for such pmlect with a wntracior(s) licen uant to t ContraCtors License Laws,1. ❑ I�mexem tu rsec.� Signature: ` �Owner ID v fied by tlriv fs Vedfication o1 Ownership by (type Business antl Profeuions Cotla for ihis reason: ❑ Ves ❑ No i.a. - pmperty tax bill or tleed�: DIVISION OF INDUSTp1AL SAFETY PERMR CERTFICATION: ❑ I hereby ceNfy that no excavation five (5) or more �eet in depth into which e person is required to descentl, will be made in connection wit� work euthorized by this permit, and that no building siructure, scattolding, falsework, or tlemolition or tlismantling thereof, will be more ihan thirry-six (3fi) leet high. (Chap. 32, Grp 2, Atl 2, Sec. 341, Ttle 8, Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from Ihe Division of Industrial Safety, as notetl above, unless such person has a permii to tlo such work trom Ihe tlivision. Signature: Date: Division oi Indusirial Safery Pertnit Number: CERTIFlCATE OF CO AND A ORVATION OP EMAY: I certity under penalry ol perjury ihat I have read ihis epplication and stale thet the intormation given is correct. I o c mpty wit�l staV� and city ordinances relating to building constmction, and authorize representatives of the City ot Costa Mesa to enter upon the ab scnbed pr pe orinsp pu oses. I agree not to en�llow occupancy o� eny building authorized by ihls pertnit until linal inspection. Ll -�i=-�-/-, ign re� e Owner(s)"--" �— - 4Date t, ' _ �--�"' And/Or AUNorized Applicam Date COOE I. INSPELTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Rooi 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition . Pdg 1l�Lff yODE� INSPECTIONTYPE /—� Q�g,�� 206 Finel Mechanical �� 20B Final Plumbing 2�0 Final Eledrical 212 Final Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final euiltling/Occupanty (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT lob Address: 282 DEL MAR AV Suite No A Vicinity: UNITA Parcel Nunmber: 43920122 Applicant: ENGLERT, RAY Address: 2165 S GRAND AVE SANTA ANA, CA Phone: (714)434-6200' Zip: 92705 Owner: HABITAT FOR HUMANITY Address 2165 S GRAND AVE SANTA ANA, CA Phone: (714)434-6200 Zip: � 92705 Contractor: OWNER-BU ILDER Address: , , � Arch / Eng : Address: Phone: Zip: License: 0 .: . � � Phone: ` �`. . - - - Zip: .�_ . Status: ISSUED Applied: 06/05/2001 I ssued: 06/05/2007 ISSUED BY: License: . �- �� ' � i/ ) . SCOPE OF PERMIT ' .. � �' ' � PLUMBING PERMIT FOR NEW SINGLE FAMILY RESIDENCE FOR "HABITAT FOR HUMANITYI'�(UNIT A). ' r� � INSTAIL 2 BATHTUB/SHOWER COMBOS; UP T0�4 GAS OUTLETS, 7 GAS SERVICE, 1 WASHER,'] �- � � �' KITCHEN SINK, 2 WASH BASINS,,2.WATER`CLOSETS,^1 WATER HEATER, 1 PRIVATE.SEWER LINE &.' : -1 WATERSERVICE. �-. , " � �,-�j' ,. � � _ " w . REF: B00-01590 .� - �x.� ' , , - ` , � � .`�' � _5� / %� � ` / " � / i i � . A� ., ., _ , - � �'.� , , . . . _ ��/ <. . . /.' . �� // �� A� ISSUE FEE BackFlow irrigation Backflow Preventer Bathtub Clanfier System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) $0.00 $0.00 $19.60 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $6.15 $0.00 $0.00 $9.80 $0.00 $0.00 i� . � �� QTY ' / i ;. . 'p, , 0 ' .- 2 _, � p ' 0 0 ' 0 0 0 0 0 0 0 1 0 0 1 0 0 �" `FEE-SUMMARY' �:�= �' %� ��% ' ��/ �'':�� ` . , � �AMT _:QTY �/i ;\�� .0 .i; Laundry Tub / Washer � � $9.80 � �1 `. SumprPump" rf �� t' �Landscape Irrigation � " $0.00 ..0 � � �� Swimming Pool � P�Trap $O.OQ _. . 0 � - "Trap�,Primer � Pressure Re9ulator � ' $0.00 _' 0 / . -Urinal. � Process�Piping(per70ft) . $0.00- - 0 '�.!VacuumBrkrBkFlow(1�) Receptors � � $0.00 , - 0� :l , � Vacuum Brkr Bkflow(5+) SepticTanK : $0.00- "0 WashBasin Sewer Cap for Demo" �..:. �$0.00 � 0 Wash Basin Set Sewer Connect $0.00 0 Waste and Vent System Sewer Private Line $24.65 1 Water Closet (ToileQ Shower $0.00 0 Water Heater / vent Sink, bar $0.00 0 Water Piping (Inst or Rep.) Sink, commercial $0.00 0 Water Re-pipe Sink, Floor $0.00 0 Water Service Sink, kitchen $9.80 1 Water Softener Sink, service/mop $0.00 0 OTHER Spa (private) $0.00 0 VIOLATION Spa (public) $0.00 0 PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $19.60 $0.00 $0.00 $19.60 $12.30 $0.00 $0.00 $9.80 $0.00 $0.00 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 2 0 0 2 1 0 0 1 0 C NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related � � COMMENTS / SPECIAL CONDITIONS EXPIRATION: This permit shall automatically expire an ecome voi i wor is no commence wi in 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In orde� for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and�� required inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this p�'t� FOR INSPECTIONS CALL: (714) 7545626 2446381fY00) WORKERS' COMPENSATION DECLAHA710N: — I �ereby aflirm unGer penalry oi perjury one of ihe tollowing declarations: ❑ I have entl will maintain a certitiwte ot wnsent to selt-Insure for workars' compensation, es provided for by seciion 3700 ot tha Lebor Code, for ihe peAortnance of ihe work for w�ich ihis permit is issued. ❑ I have ar�d will maintein workers' compensation insurance, u requiretl by section 3700 of Na LaDw Code, for the perfortnance ot tha work for which this pertnit is issued. My workers' compensatlon Insurence cartier and policy numher are: . Cerrier: Policy iJumCer: (This secHon neetl not be comp/eted il the permit is valued et one huntlretl dollars ($100) or less.) ❑ I certify Ihat in the peAormance of �he work tor which this pertnit is issued, I shall not employ eny person in any manner so as to become suhject to the workers' wmpensation laws oi Califomie, and egree thet If I should become sub�ect to the workers' compensation provisions of Sectlon 3700 ot the LaDor Cotle, I shall forthwlth compty with Uesa provisions. Applicent Signature: Date: WARNING: FPILURE TO SECURE WORKERS' COMPENSAiION CL�VERAGE IS UNLAWFUL PND SHPLL SUBIECT AN EMPIOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED TFKKISPND DOLLRRE (E100.000), IN ADDfTIIXJ TO THE WST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN $ECTION 3106 OF THE IABOR CO�E, IMEFEST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirtn that I em Ilcensed under Drovisions of ChaO�er 9(commencinq wi�h Section 7000) ot Division 3 of the Business end Professions Code, end my license is in full torce end etfecL Lic. x Class q i ContrectofsSignaWre: Date: � � CONSTRUCTON LENDING AGENCC . ❑ I hereby aHirtn �het there is a construction lentling agency for the peAormance of the work for which ihis permit is issued. (Sec. 3097, Civil Code). Lentlels Nama: Lenders Address: Sipneture: Date: OWNER-BUILDER DECLARATIONS: I hereby affirtn ihat untler penelry of perjury �het I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Professions Code: Any dry or counry which requires a Oermit to consiruct, alter, improve, demolish, or repair eny strucWre, prior to its issuance, also requires the applicaN for such permit to file a signed statement that �e or she is licensetl pursuent to the provislons oi ihe Conirectors License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 of ihe Business entl Prolessions Code) or that he or she is exempt therelrom and Ihe basis tor the ellegetl exemption. Any violatlon of Section 7031.5 by eny epplicant for e permit syub�ject the applicant to a civil penalry of not more then five hundred dollars ($500).): �I,�as�owner ot the property, or my amployees with wages as Iheir sole wmpensation, WILL UO THE WORK, and Ne siructure is not intentletl or ofleretl for sele (Sec. � 7044,-Busineu and Protessions Code: The Contractors License Law does noi ap01y Io an owner of property who builds or improves Ihereon, and who does such work himsetl or hersetl or through his or her own employees, providetl that such improvements are not intentled or oflered tor sale. If, however, ihe building or impmvemeni is sold within one year ot completion, the owner-builtler will �ave the Durden of proving that ha or she tlitl not build or improve for purpose of sale.). ❑ I, as owner of t�e property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consWct the project (Sec. 70d4, Business entl Professions Cotle: The conire License Law does not apply to an ownar of pmperty who builtls or Improves Ihereon, antl who contrects for such projeci with e contractor(s) licens nt Io �h onirati0r�en5e LawS.). „ 0 �Owner ID venfi4tl by dnvefs Vedficatlon oi Ownership by and Professions Code for this reason: �e.�(] �s ❑ No oi documem, i.e. � property tax bill or tleea): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity t�et no excavation five (5) or more teet in tlepih in�o which e person is requiretl to descend, will be made in connection with work euthorized by this permit, and ihat no building strucNre, scalloltling, talsework, or demolition or dismanUing t�ereot, will be more than thlrty-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec. 341, TiUe B, Celitomla Atlminislrative Cotle). ❑ As owner-builder, I will not employ anyona to do work which would require a permit irom ihe Division of Intlustnal Safety, as noted above, unless such person hes e permit to do such work from ihe division. Signawre: Data: Division ot Industnal Safery Permit Number: CERTIFlCATE � AND AUTyOjiVJ1TION OF EMAY: I certity under penalry of perjury that I have read this epplication and state ihat the information given is wrrect I a ree to comply with I state aGis 6d ciry ortlinances relating to Duilding consWdion, and euthonze representatives ot the Ciry of Costa Mesa to enter upon the ebove-described prop y to pecti ses. I agree not t oaupy or allow occupancy ot any building authorized by this peTr it until tinal ins ection. - -' _" _ (��i� �� 9 g�nat_`e __g� wner(s)_. � =��' iData. � � ( 1� And/Or ANhorized Applicant Date COpE I. INSPECTONTYPE � INTIfULS 1616 Fixed System Final Fire Prevention 1266 200 201 202 203 204 Pool Spa Final Final Re-Rool Final BIocWRetaining Well Final Factory Fire Place Final Sign Final Demolition COUE� INSGECTIONTYPE 206 Final MeChanical 208 Final Plumbing 210 Final Elecincal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency PSIE I[�15 /-2Y -3 .� INSULAT[ON CEI �ICATE IC-1 -- --Y=— Site Address Permit Number B00-01590 282 Del Mar Avenue, �iA� , Costa Mesa, CA 92627 Number and Street Citv Oranee Countv Descri�tion of Installation 1. ?OOF Material N/A Thickness (inches) _ PM 2��0-174 2 Subdivision Lot Numbe� Brand Name Thermal Resistance (R-Value) 2. CE[LING Batt or Blanket Type Fiber Glass Brand Name Thickness (inches) 6" Thermal Resistance (R-Value) R-19 Loose Fill Type Brand Sohns Manville Contractor's min installed weighdft� (b Minimum thickness 6 inches Manufacrurer's installed weight per square foot to achieve Thermal Resistance (R-Value) 3. EXTERIOR WALL Frame Type Wood — 2x4 A. Cavitv lnsulation �vlaterial Fiber Qlass batt Thickness (inches) 3-1(2 B . Exterior Foam Sheathing Ma[erial Thickness (inches) �. RAISED FLOOR Nlaterial N/A Thickness (inches) 5. SLAB FLOOR/PERIMETER Material N/A Thickness (inches) Perimeter Insula�ion Depth (inches) 6. FOUNDAT[ON WALL Material N/A Thiekness(inches) Declaration Brand Name .Tohns Manville Thermal Resistance (R-Va(ue) R-13 Brand Name I'hermal Resistance (R-Value) Brand Name Thermal Resistance (R-Value) Brand Name Thermaf Resistance (R-Value) Braad Name Thermal Resistance (R-Value) I hereby certify that the above insulation was installed in the buildiag at the abuve location in conformance with the current Energ}� Efficrenci� Standnrds for residwtial buildings (Tide 24, Part 6, Califomia Code of Regulations) as indicated on the Certificate of Compliance, w e applicable. M2�k KO�ando, V.P. — Site DevelOpment �-Z ��d� HABITAT FOR HUMANITY OF ORANGE COUNTY (OWNER� Item »s Si2nature. Date Installing Subwntracror (Co. Name) OR General Contractor (Co. Name) OF. Owner Item �s Item ns Signarure, Date Signamre. Date [nstalling Subconnactor (Ca vame) OR General Contractor (Co. Name) OR Owner Installing Subcontrac[or (Co. Name) OR General Conhactor (Co. Name) OR Ownec Compliance Forms August 2001 A-36 Property Address ,� CITY OF COSTA MESA �J BUILDING DIVISION . ROOF COVERING CERTIFICATION 282 Del Mar Avenue, lkA Owner/$uilder HABITAT FOR HUMANITY OF ORANGE COUNTY Contractor �ITAT FOR HUMANITY OF ORANGE COUNTY State Contractor License Number I hereby certi(y that I have installed, or caused to be installed, above address in conformance with Chapter 15, and Appendix 15 of Building Code, and the installation instructions of the manufacturer. Permit No. 800-01590 Classification a minimum Class C roof covering at the the latest adopted edition of the Uniform 0 I further certify that I am the owner of the property. (Owner-Builder permittee oniy). ❑ I further certify that I am: ❑ Owner of sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Received by Building Division By: -24 :3 Ini Date 099Pe6MW6W WAi�e-BuiidngDiv.:Canary"ConVxWr:Pink-Owner HABITAT FOR HUMANITY OF ORANGE COUNTY . Campany or Corporete Neme 2165 South Grand Avenue Address Santa Ana, CA 92705 ,� / -Z � v� Sigo�ature Dsta Mark Korando, V.P. - Site Development Printed or Typed Name � �� W.47'��ISTRICf Ill l'�li 11:�!!, �11! 11.�1J11, DIST1iICT 15600 Sand Canyon Ave., RO. Box 57000, lrvine, CA 92619-7000 (949) 453-5300 May 2, 2002 R282De1MarAve SD1.40IO1P Mr. Rick Brown City of Costa Mesa Planning Department 77 Fair Drive Costa Mesa, CA 92628 Subject: Release for Residential Use Dear Mc Brown: Irvine Ranch Water District hereby releases Unit Nos. A, B, & C(282 Del Mar Avenue) for the following: REL,EASE FOR OCCUPANCY - Water meter has been installed by developer. Yours truly, i��`—� w� Mike Jack Construction Inspection anager MJ/mp cc: Developer — Habitat far Humanity IRWD Inspector — Craig Ervin IRWD Developmental Services IRWD Customer Service (2) Chron Total number of units for buildings released this date is 3 .. : . . �- �'�s.! ��;f�.° C� J �■ M. Petyo & Associates, Inc. Surveying - Ma pping April 11, 2002 Mr. Mark Korando HABITAT FOR HUMANITY 2165 S. Grand Avenue Santa Ana, CA 92705 SUBJECT: Final Grading Certification for your project at: 282 & 286 Del Mar Ave., Costa Mesa, California Deaz Mr. Korando, Please be advised, that, based upon a field survey on 4/10/02, the Fina] Grading on the subject project has been constructed substantially in conformance with the approved grading plan for this project. Yours very truly, M. PETYO & ASSOC., iNC. .� �, By: Michael Petyo, .S. 4316 President MP: mrc * MICHAEL PETYa . LS. 4316 \R �N� wa � = �/}_ 6�30%� ��r/ i 79A2 �ky Park Ci�cle, Sui[e 6• livine, �:alifa�nia 9"l61 �• (949� ?SO-02; �' a� Fax: (J49) ',?50-0?75 .-, : ,%' 7 0