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Home My WebLink About3076 DONNYBROOK LN - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 3076 DONNYBROOK LN Suite No Vicinity: Parcel Nunmber: 14104308 Applicant: ELLIS, E J, JR. Address: Phone: Zip: 84301779 Owner: FREGOSI, FRANCIS Address 3076 DONNYBROOK LN COSTA MESA, CA Contractor: Address: Phone: Zip: 92626 ORANGE COUNTY SERVICES INC DBA GEORGE BRAZIL PLU 3801 LENAWEE AVE . CUWER CITY. CA Phone: (310)253-5229 Zip: 90232 License: 679898 SCOPE OF PERMIT INSTALL CLEAN OUT ON SFD FOR SEWER LINE ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifer System Connect (Ice,Soda,etc) Denlal Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking FOuntain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas(Over4 outlets) Gas Repipe Gas Service Interceprors (Grease, Oiq Interceptors (Sand Auto ) AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY FEE SUMMARY Laundry Tub / Washer Landscape Irrigation - P-Trap Pressure Regulator . . Process Piping (per 10 ft)� Receptors Septic Tank , Sewer Cap for Demo � Sewer Connect Sewer Private Line Shower Sink, bar Sink, commercial . Sink, Floor Sink, kitchen Sink, service/mop Spa (private) . Spa (public) AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $24.65 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 Status: ISSUED Applied: OZ/09/2005 •. � �• �� / �I�� ► � - ��/ SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr BkFlow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet)- Water Heater / vent Water Piping (Insl or Rep.) Water Re-pipe Water Service Water Sokener OTHER VIOLATION PLAN CHECK REINSPECTION AMT 30.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 50.00 30.00 50.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $48.75 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 180 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 requlred Inapections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration oi this permit. FOR INSPECTIONS CALL: (714) 75M5626 244fM6 (8/00) WORKERS' COMPENSATION DECLARATION: I hereby elfirtn under penalty of perjury one of the Followlnq declarations: ❑ I have end will maintain a certificate ot consent to self-Insure for workers' compenselion, as providetl for by section 3700 oi Ihe Labor Code, for the pertormanca ot ihe work for which this pertnil is issued. ��ave and will maintain workers' compensation insurence, as required by section 3700 ol the Labor Code, for ihe pertortnance of the work lor which t�is pertnit is issued. y workars' compensation/I�nsurance carrier poli�j n�u%�ber ara: % / /� /�/�' CarrfS�:� .—.^- �T(7� �i�/ V LJ PblicyNumber:'� .r�rJ<G/ ✓�i� C l�'7 Q,his�"section�need not be completed il fhe permif is veluetl et ane huntlretl tlollars ($100) or IessJ �"""'"� ❑ I certify that in the pedorman� compensation laws of Calitori camply with ihese pravisions. 'A&URE TO SECURE WOFKERS' OOLLARE (510p,000). IN ADDITIOI LICENSED CONTRACTORS DECLARATION: CONSTRUCTION LENDING AGENCY: I shall not employ eny person in any manner so as lo become subject m the workers' b Ihe workers' compensation provisions of Sectlon 3700 oi the Labor Cotle, I shall f6rthwith �" D��ate: �" 4 `� V � AND SHALL SUBJECT AN EMPCOVEF TO CRIMINAL PENALTIES AND CIVIL FMES UP TO ONE HUNDRED ES AS PROVIDED WR IN SEC�ION 3]W OF THE LABOR CODE, INTEREST, AND FTTORNEY'S FEES. 9(commencing with Section 7000) ol antl my license is in full ❑ I hereby attirm thal there is a constmction lending egency for the pedormance of ihe work for which Ihis permit is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signelure: OWNER-BUILDER DECLARATONS: Date: I hareby affirtn Ihat under penalry ot perjury thet I em EXEMVT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business entl Professions Code: Any city or county which requires a permit lo construct, alter, improve, demolish, or repair eny structure, prior to its issuanca, also requires the applicant for such pertnit to file e signad statemant Ihat he or she Is Ilcensed pursuant lo the provisions of �he Conlraciore License Lew (Chap�er 9(commencing wlih Section 7000) of Division 3 of Ihe Business antl Professions Code) or that ha or she is exempt theretrom anA the Gasis for ihe elleged exemption. Any violation of Section 7031.5 by any applicant for e permit subjects Ihe epplicant to a civil penelry ol not more ihan five hundred tlollars ($500).): ❑ I, es owner of ihe properry, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and the structure is not Intended or oNered tor sale (Sec. 7044, Business and Professions Code: The Contracbrs License Law does not apply to an owner ot propetly who builds or improves thereon, and who does such work himself or herseN or Ihrough his or her own employees, provided that such improvements ere not intentled or oftered tor sale. H, however, �he building or improvement is soltl within one year of complelion, the owner-buiider wil� have the burden of proving ihat he a she ditl not build or improve for purpose of sale.). ' ❑ I, as owner of the property, am EXCLUSNELV CONTRACTING WITH LICENSED CONTRACTORS to consimcl ihe project (SecJ044, Business antl Pmfessions Code: The conirectors License Lew does not apply to en owner of pmparty who builtls or Improves ihereon, antl who contrecis for such projeci wit� a contractor(s) license pursuent to ihe Conlractors Licensa LewS.). ❑ I em Bxempt under Sec. Busine55 and PrOteSsions Code for thi5 rea5on: Signature: Date: Owner ID ventied by dnvers license. � Ves ❑ No Drivers License No. Venfiwtion of Owners�ip by (type of documen6 i.e. - property tau bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Expiras: ❑ I hereby certify that no excavation five (5) or more feat in depth into which a person Is required to descend, will be made in connection with work authonzed by this permit, antl ihat no building siructure, scaflolding, falsework, or demolition or dismantling thereot, will be more than thirty-siz (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Califomia Adminisirative Code). . ❑ As ownerbuiltler, I will not employ enyone to tlo work which would require a permit Irom the Division of Industrial Safaty, as noted ebova, unless such person hes a permit to do such work from tha division. Signature: Date: Division of Intlustnal Satery Permit Number: CERTIFICATE OF COMPLIANCE AND AUTHORVJ1710N Of ENTRY: I certiry under penalty of parjury that I have read this application antl state that ihe information given is correct. I egree to comply with all state laws end ciry ordinances relating to builtling consiruction, end authonze rapresentatives of the Ciry of Costa Mesa to enter upon the ebove-descnbetl property for inspec6on purposes. I egree not to occupy or allow occupancy of any building au�horized by this permit until tinal inspection. COOE �. INSVECTIONTYPE 1616 Fized System Final Fire Prevention 1266 Pool Spa Final ' � 200 Finel Re-Root 201 Final Block/Retaining Well 202 Final Factory Fire Placa 203 Finel Sign 204 Final Demolition OATE �1T196@ 44PES INSPECTIONTYPE 206 Finai Mechanica� 208 Final Plumbing 270 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy RT INTRIpLB • � \ OWNER COIS��F hsF4A �nt�A*rv DATE� Sent A� IOKR _ JOB ADDRESS 3076 Donn.ybrook Lane BU[LDING PERMIT NO. �51� GENERAL CONTRACTOR The Hala Cmm��n�r � VALUE $ l9_Ron AP. No. LOT %1 TRAC'I�(� � PIRE ZONE DESCRIPTION OF WORK $� pu� P�t,,p ,/ 7 _ lling ��, a��:oe�. GpnUP T_FiJ. TYpE p ZONE � � PLAN NO. Ih_!ECTIONS I DATE I SUBCONTRACTOR I DA Steel browu � � � \ _' 1.Y j � �7�h�9 �� s.,� u��.r�l�. J ,�_ COSTA MESA BUILDING DEPARTMENT �(�S` IS S P.O.B0X31] F �'n�� f��7! COSTA MESA. CALIFORNIA "�•�"'�'� � -.. n � � FOR APPLtCANT TO FILL IN APPLICATION FOR PERMIT .enooa°es"s 3076 Donnybrook Lane BUILDING COSTA� MESA. CALIFORNIA FOR OFFICE USE ONLY OWNER COLLEGE MESA COMPANY pE�E�PT ��. P� ��I.Q MAIL AECE�VlD �Y �aTE PECEIVEO OPTE ISSUED ADDRE55 P•0. Box 2277, Brookhurst SCation ^ S S� cirr Anaheim No: KE 3-3161 nooRe�ss ARCHITECT $ULO U� 12j� �� 1 1 COSTA MESA. CALIFORNIA � ' NEER_ � - - - NO. FIRE �,coNrAncrort Th0 Hale COn nooRess 1777 W.Lincoln, !�ecn� LOT 7 �� OESCRIPTION NO. • � B� an o. - I A.P. NO. iT� `r�'o: 7350 KE 3-3161 e.,.r 2671 �1 X .�'�/� I�o.or eiocs. I USE OF EXISTING BI.OG. �� SETBACN �INE FNOM SO1 CENTER OL $TREET RIGHT �� LEFT �� 35' DESCRIPTION OF WORK NEW X ALTEftAT10N ADOITION REPAin � I �MOVING__ � DEMOLISH BUILDING1ZS3� �L1V. NO.OF SIZE � ROOMS STORIES EXTERIOR WALL,,, ROOF � a ST/�TE THAT TME �BOVE IS CORflER �ND �GREE TO COMPLV WITX >LL CITY ORD�NANCES �ND ST1TE L�WS NEGULITING BUILOING CONSTNUC� *��. COLIyF�g MESA COMPANY VALU/TION SIGNATURE OF �r ��'he Hale Company,Gen,�'ar ner AUTHORIZE g 12,890 ::�8 �, .� v DATE CORRECTIONS PERMiT FEE S 30.00 PLAN CHECN $ �.00 TOTAL FEE 5 �FS.00 �6M{ �