HomeMy WebLinkAbout2440 DUKE PL - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa•mesa.��sCTRICAL PERMIT n FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicini�y:
Parcel Nunmber:
Applicant'.
Address:
2440 DUKE PL
14144137
BATLIK, JIRKA
2440 DUKE PL
COSTA MESA, CA
Owner: BATLIK, JIRKA
Address 2440 DUKE P�
COSTA MESA, CA
Contractor: OW NER-BUI LDER
Address:
ISSUE FEE
Temp service lest
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service l0 200a
Service to t000a
Service oJer 1000a
Motors to 1 hp
Molors to 10hp
Motors to SOhp
Motors to 100hp
Motors over 100hp,
Communication drops
Sub panel l0 200a '
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
Phone: 714-785-9502
-Zip 92626 .
Phone: 714-785-9502
Zip: 92626
Phone:
Zip:
License: 000000
ApD 450 SF AND MINOR INTERIOR ALTERATION
REF 606-01727
2 LIGHTS 100UTLETS 8 SWITCHES 1 BATHROOM VENT
Quantity
523.50
50.00
50.00
$0.00
$0.00
$0.00
$2.20
$11.00
$8.80
50.00
$4.75
$0.00
$0.00
$0.00
50.00 ,
50.00
50.00
$0.00
$0.00
$0.00"
$0.00
$0.00
so.00
$0.00
$0.00
0
0
0
z
70
8
0
1
0
0
0
:. �
0
0
0
0
0 .
0
0
0
0
0
FEE SUMMARY
EXPIRES
Temp Dist System / LigMing
Busway /100 ft
Standing Section
Misc Electrical Equipment
Transformers up �0 1 kva/kw
................up to 10 kvalkw
.................up to 50 kva/kw
.................up to 700 kva/kw
.............::...over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
� � Misa Conduit
Misc. Conduclor
Cirws ( gen oi ride)
Cirws (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee ,
Stams: ISSUED
Applied: 12/01I2006
Issued: 12/07/2006
ISSUED BY: `-
Quantiry
50.00 0
50.00 0
50.00 0
50.00 0
$0.00 0
50.00 0
50.00 0
50.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
Investigation Fee � � " � �$0.00 �
Plan Check Fee - 50.00
ReinspectionFee �50.00 �
TOTAL CALCULATED FEES $50.25
. ��
� 1 �� �
� �
� �
�.� ,
N
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 7, 12-21-92) /•�'
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
foca period of 180�days: a
INSPECTIONS: In order lor ihe work authorized under ihis permit to be considered legal, such work mus� comply vnth all applicable codes, and all
required inapectlona end finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALI: (714) 7545626
244G4fi (N00)
WOHKERS'COMPENSAnONOECLARAnON: �
I hereby eHirtn under penalry of perjury one of iha following declarations:
❑ I have end wlll malntein e cenificate of consent to self-Insure for workers' compen5etion, es provitlatl for by section 3700 of the Labor Coda, for the peAormence oi the
work for which this permii Is Issued.
❑ I have and will maintain workers' compensation insurance, as requiretl by secGon 3700 of Ihe labor Code, for the peAortnance ot the work tor which Ihis pertnit a issuetl.
My workers' compensation Insurance carrier and policy number ere: �
Carrier: Policy Number:
(lhis section neetl not be comp/eted il ihe permit is valued at one hundred Uollers ($ f00) or less.)
❑ I certity ihet in Ihe performance of ihe work for which this permit is issued, I shall not employ eny person in any manner so as to become subject to Ihe workers'
compansatlon laws oi Celifomia, end agree that if I should become subject to the workers' compensation provisions of Section 3700 oi the Lebor Cade, I shall torthwith
comply with �hese provisions.
Applicant Signeture: Oeta:
WARNING FAILURE TO SECURE WORKERS' COMPENSATIIXJ COVERAGE IS IINLAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDREO
THOUSAND OOLLAPE (E100,000�, IN ADOITION TO THE COST OF COMPENSATION, DAMAGES AS PFOVIDED FOP IN SECTION 3IO60F THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLAHA710N:
I hereby eNirm that I am licensed untler provisions ot Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
force end eflect. Lia a Class A
Contrectofs Signeture: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn that there is a consWction lending agency tor the pedormance of the work For which this pertnit is issuetl. (Sec. 3097, Civil Cotle).
Lendefs Name: Lendefs Address:
SignOture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby ettirtn that under penelty of perjury that I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or county which reQuires a pertnit to consiruct, alter, improve, tlemolish, or repair any sWcture, pnor to ils issuance, also requires the applicant for such permit
to file a signed statement thet he or she is licensed pursuant to the provisions of ihe Contrectors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business end Profassions Code) oi that he or she is exempt therefrom and the basis for the allegad eaemption. Any violation ot Section 7031.5 by any applicant For e pertnit
subjacts Ihe applicent to e civil penelty o� not more than five hundred dollers ($500).):
❑ I, as owner of the property, or my employees with wages as iheir sole compensation, WILL DO 7ME WORK, and Ihe structure is not intendad or oNered tor sale (Sec.
7044, Business and Professions Coda: The Contractors License Law does not apply to an owner of property who builds or improves Ihereon, and who does such work
himself or herself or ihrough his or her own employaes, pmvitled that such improvemenis are not intended or oHered for sale. If, however, the building or improvement Is
sold within one yeer of completion, ihe owner-builder will have ihe 6urden of proving ihat he or she ditl not build or improve for purpose of sale.).
❑ I, as owner of the property, am E%CLUSIVELV CONTRACTING WITM LICENSED CONTqACTORS to con5tmct Ihe project (Sec. 7044, Business antl Professions
Code: The contrectors License Law does not appty to an owner of propetly who builtls or Improves thereon, and who contracts for such project with a coniractor(5)
license pursuent to the Contrectors License Laws.). _
am exempt untler sec. Business and Professions Code tor this reason: _ i
Owner ID verifietl by tlrivar's license. ❑ No
Venfication of Ownership by (type ot d menL i.e. - property ten bill
No.
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: �
❑ I hereby certify Iha� no excavation tive (5) or more fee� in depth into which a person is raquireC Io descend, will be made in connection with work eu�honzed by this
pertnit, and that no 6uilding siructure, scaHoltling, falsework, or demoli�ion or dismantling ihereof, will 6e more Ihan Ihirty-sia (36) feet hiqh. (Chap. 32, Gry 2, Ar12, Sec.
341, Title 8, Celifomla Adminisirative Code).
❑ As owner-6uilder, I will not employ anyone to do work which would require e permit trom the Division ot Industrial Safery, es noted above, unless such person has a
permit to do such work from the division. -
Siqnature: Date:
Division of IndusMal Safery Pertnit Number:
Will the applicant or present or imure builtling wcupam need to file antl cenify a Business Plan for emergency response to release or threatened releese of e hezartlous
meterlal7 ❑ Ye5 ❑ No '
(Section 25505 of the Celifornie Healih end Satety Code requires, with some exceptions, that e Business Plan be filed with tha Cosla Mesa Fire Depertment by every
business which hes et any one time dunng a reported year a quantity of hazerdous materials equal to or greater Ihan a weight of 500 pounds, or e volume of 55 gallons,
or 200 cubic fee� of compressetl gas at standard tempereture and pressure).
....................................................................................................................................................................................................................................................................................................................... ...................................................
Does or will ihe epplicent or presant or fuNre building occupant need to file e regisiration form for acutely hazartlous materials? ❑ Ves 0 No
(Secfion 25533 of ihe Califomia Health and SateN Cotla, with some exceptlons, requires ragisiretlon with the Costa Mesa Fire Department by aech business which et eny
one time has on hentl e quantiry of acutaly hazardous meterials equel to or greater than e welqht of 500 pounds, or e volume oi 55 qellons, or 200 cubic feet ot
compressed gas at stendard temperaNre antl pressure).
.........................................................................._..................................................................................................................................................................................................................................................................................................
Does or will the applicant or present or tuture building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazerdous materials)?
� of the Calitomia Health
en RMPP by businesses
Fire Depanment may require ihe preparation, certificaiion end filing with tha Fire
� metenals with ihe Fire Department.
........................... ....................................................................................................................
4 If en RMPP is presently required, has Section 25534 ot Ihe California Heelth entl Safery Code been lully wmplietl withl ❑ Ves ❑ N
.................................................................. ........................................................................................................
5 Does or wlll �he epplicant or presen� or future builtling occupant require /or �he work which Is �he subject of this a pliwtion a ermit for su<
irom Ihe Soulh Coasl Air �ualiry Management Distnct or tmm any other eir pollution contml district or agency.� � Yes � No
(Seclion 658502 ot the Califomia Govemment Code requires Ihat the requeste0 intormation be fumished on applications for nomresidentisl
.................................................................................................................. ................................................._.....................................................................................
6 Will any part ot t�e faciliry to �e constructed under Ihis permit be within 1000 feet trom the outer boundanes ot a school? ❑ Yes ❑ P
(N yes", Ihe facility must meet the requirement oi Sections 25534 anA 42303 of the Califomie Health and Safery Code).
...................................................................................._........................................................................._......................................................................................................................................................
7 If e permit From ��e South Coasl Air Oualiry Manegement Disinct or other eir pollution control distnct or agency is required for the woi
aoolicatlon. �ave ell of the disclasures orescnbed bv Califomia Health and SateN Code Section 42303 been made? ❑ Ves ❑ No
or
CERTIFICATE OF COMPLIANCE: I certify ihat under penelty ot perjury lhe information given ebove is correct I agree lo comply with a0 steta laws and ciry ortlinances
regarding Hazardous Matenals and Emissions.
Signeture: Date:
CERTIFICATE OF COMPLIANCE �D AUfHORIZA ON OF ENTRY: I certity under penalty of periury that I have read this application and state that the intormation given is
correct. I egree to comply with all tete laws n � ortlinances releting to bullding consimction, and authorize representatives of Ihe Clty of Costa Mesa to enter upon the
ebave-descnbetl propedy for inspe tii n purpa �es. I ee not to occupy or allow occupency of eny building aut r¢ed by this permit until tinal inspection.
'iz•a�� n�--
Signet ne (s) a
AnA/Or i ' ad Aoolicant Da�e
CODE 1' INSPELTIONTYVE -
1616 Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-Rool
201 FIneI BIocWReteining Wall
i
202 Final Fectory Fire Place
203 Final Sign
204 Final Demolition
o�re � �S INSPECTIONTYGE
206 Final Mechanical
20B Final Plumbing
210 Final Eleclrical
212 Finel Fire Prevention
220 Final Planninq Approval
222 final Site
�250 Final Building/Occupancy
PeIE It�L4
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COS7A MESA, CA 92626
PLUMBING PERMIT
Job Address: 2440 DUKE PL
Suite No
ViCinity:
Parcel Nunmber: 14144137
qpp�icam: BATLIK, JIRKA
Address: 24q0 DUKE PL
COSTA MESA, CA -
Owner:
Address
Contraclor:
Address:
BATLIK, JIRKA
2440 DUKE PL �
COSTA MESA, CA"
OWNER-BUILDER
Phone: 714-785-9502
Zip: 92626
Phone: 714-785-9502
Zip: 92626
Phone:
Zip:
License: 000000
SCOPE OF PERMIT
ApD 450 SF AND MINOR INTERIOR ALTERATION
R�F BO6-01727 '
r�
EXPIRES
1 GAS (1-4 OUTIETS)1 SEWER CONNECT. 1 SHOWER 1 WASH BA$IN SET
AND 1 TOILET - � .
ISSUE FEE
Backflow irrigation
Backflow Preventer
Bathtub
Clarifier System
Connect (Ice,Soda,elc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank,
Gas EaAhquake Valve
Gas (1-4 outlets) ,
Gas (Over 4 outlets)
Gas Repipe '
Gas Service
Interceptors (Grease, Oil)
Interceplors (Sand Auto )
AMT
$23.50
$0.00
$0.00
$0.00
$0.00
50.00
50.00
$0.00
$0.00
$0.00
50.00
so.00
$0.00
$0.00
56.15
50.00
50.00
50.00
$0.00
$0.00
QTY
0
0
0
0
0
0
0
0
0
0�
0
0
0
�
0
0
0
0
0
FEE SUMMARY
AMT
Laundry Tub / Washer � $0.00
Landscape Irrigation $0.00�
P-Trap $0.00
Pressure Regulator $0.00
Process Piping (per 10 ft) 50.00
Receptors 50.00
SepticTank 50.00
Sewer Cap for Demb " $0.00
Sewer Connect 524.65
Sewer Private line $0.00�
Shower $9.80
Sink, bar $0.00
Sink, commercial $0.00
Sink, Floor $0.00
Sink, kitchen $0.00
Sink; service/mop � 50.00
Spa (private) $0.00
Spa (public) � 50.00
QN
0
0
0
0
0
0
0
0
1
0
1.
0'-
0
0
0
0
0
0
COMMENTS / SPECIAL CONDITIONS
SlaWs: ISSUED
Applied: 12I01/2006
Issued: 12/01/2006
ti
ISSUED BY:
SumpPump ,
Swimming Pool �
Trap Primer
Urinal
Vacuum Brkr Bkflow(7-4)
Vacuum Brkr Bkflow(5+)
Wash Basin �
Wash Basin Set
Wasle and Vent System
Waler Closet (Toilel)
Water Heater / vent
Water Piping Qnst or Rep.)
Water Re-pipe
Water Service
Water Softener
OTHER
VIOLATION .
PLAN CHECK
REINSPECTION
AMT
50.00
$0.00
$0.00
$0.00
$0.00
50.00
50.00
i9.80
$0.00
$9.80
$0.00
$0.00
50.00
$0.00
$0.00
50.00
50.00
so.00
$0.00
TOTAL CALCULATED FEES: $83.70
� �"`; <
;�; .� _
', �!;
.i.
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California
regulations. (OM. No. 92-28, § 1, 12-21-92) !/
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspl
for a period of 180 days. ��"
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applii
requlred Inspectlona and }Inal approval must be obtained. Failure to obtain inspections and final approval will result in the expiratii
FOR INSPECTIONS CALL: (714) 7545626
24l&d8 (8�00)
QTY
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
and related
orabandoned
ile codas, and all
of this permit.
WORKERS'COMPENSAnON DECLARAnON:
I hereby eftirm under penelry ot per�ury one oi t�e following declaretions: •
❑ I heve entl will meintaln e certiflcete at consent ro selt-Insure for workers' cnmpensatlon, es proNtletl tor 6y sectlon 3700 0l the Lebor Cade, tor the pertortnence oi the
work for which this permlt is issued. �
❑ I hava and will maintain workers' mmpensation insurance, as required Dy sectlon 3700 of ihe LeDor Cotle, br ihe Aortnance ot Me work for which this ,
pe pertnit is issuetl.
My workers' compensatlon Insuren�e cartier antl pollcy number ere:
Cartier. Policy Number.
(Thls sectlon neee nof be comp/etetll! fne pertnif is velued e( one nuntlred tlollars ($ l00) or IessJ
❑ I certity that in the pertortnance af t�e work for which Ihis permit is issued, I shell not emplay eny person in any manner so as Io become subject to the workers'
compensatlon law5 of Celtlomia, end agree that if I should Eecome sub�ecl to tha workers' compansatlon proWSions ot Section 3700 oi the Lebor Catle, I 5hell forthwith
compty with these provisians.
Applicant S18nature: -'y � Date:
WARNINCa�. FAIIURE TO SECURE WORKER5 �P�1SAT10N CQVEPAGE IS UMAWFUL MIO SNPLI SUB.IECi AN EMPIOYER TO CRtNdNAL PENAL�IES AND CMl FlNES W TOONE M1INDPED
TMOUSAND DOLLARE (t100,000), IN ADDfiION TO THE C0.ST OF COMPENSATION, UAMAGES AS PROVIOED FOR IN SECfION 31O80F TME LABOR CODE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTAAC70RS DECLARATON:
I hereby eHirtn Ihat I am licensed under p�ohsions of Chapter 8(commencing with Section 7000) ol Division 3 ot Ihe Business entl Professions Code, and my license is in tull
force an0 eNect. Lic. a Class a
Con[rectors SignaNre: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby aMirtn that there is a const�+ction lending egency lor the Dedormance ot the work tor which ihis partnit is issueC. (Sec. 3097, Civil Cotle).
Lendefs Name: Lendefs Atltlress:
Signature: Data:
OWNER-BUILDER DECLARATIONS:
I hereby ettirm ihat untler penelry of perj�ry ihet I am EXEMP7 FROM TME CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Busineu and Profassions
Code: Any ciry or counry which repuires a Dertnii to consirucl, elter, improve, demolish, or repair any struclure, prior to Its issuance, elso requires Ne eppliwnt for such permi�
ta tile e signetl statement thet he or s�e �5 Iicensed pursuent to Ihe praWsions oi Ihe Contrectors License Lew (Chapter 9(commancing with Sectlon 7000) oi Divfsion 3 of ihe
Business and Professions Code) or Ihet he or she is e:empt theretrwn end the 6a5i5 lor Ihe ellegetl exemption. Any violatian ot Section 7031.5 6y any applicant for a pertnit
subjecis ihe eOPlicant to e civil penalry c� not more than live huntlretl dollars ($500).):
❑ I, as owner at the pwperty, or my employees wlt� wages es their sole wmpensatlon, WILL DO THE WORK, end the structure Is not intendad ar aHered for sale (Sec.
7044, Business antl Professlons Code: Tha Conirectors License Law does not epply to an owner of propeny who builds or improves thereon, end who tloes such work
himself or herself or thraugh his or her awn emplayees, providetl Ihet such improvemenis ere not intendetl or oNered lor sele. If, �owever, Ihe building or improvement is
sold within one yeer ol completion, ihe owne�-builder wi�l �eve ihe burden ol proving thet ho or she did not build or improve for purpose of sale.).
❑ I, es owner Of lhe property, am EXCLUSIVELV CONTRACTINC WITH LICENSED CONTRACTORS Io construct lhe pro�ecl (Sec. 7044, Business an0 Professions
Cotle: The contrectors License LeW tloes not apply to en owner oi property who bulltls or improves thereon, and who conirects tor such p�oject wit� a conirecror(s)
� license pursuant to �he Con�ractor9 Ucensa Laws.).
under 5ec. Busines5 and Prolessions Code for �hi5 reason:
Owner ID verified by tlriver'S1ltense.
Verlficelian ol Ownership by (type ot
❑ No
i.a. - property tax blll or deetl):
DIVISION OF INDUSTRIAL SAFETV PHAMIT CER7IFICATION:
—� .
... :. �� r ,
� :,-. �IiL.'/�/
❑ I hereby certily ifiet no excavation 4�e (5) or mwe teet in Cepth Into which a person Is requVred to dascand, will be made fn connedion with work euthorized by this
permit, entl that no Duilding strucNre, scattolding, felsework, or tlemolition or dismentling ihereot, will be more than thirty-slx (38) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tl�le 8, Califomla Adminisirative Code).
❑ A5 owner-Duilder, I will not employ anyone to do work w�ich would require e permil lrom tha Division ol Indusinal Sefery, as noted ebove, unless such person has a
pertnit to do such work from Ihe div�sion.
SignaNra: Date:
Division ol Indusirial Satery Permit Number:
1 WIII Ihe epplicant or present or IUNre building occupant need to file entl cenity a Business Plan tor emergency response to release or ihreatened release ot e hezardous
metedal? ❑ Yes ❑ No '
(Section 25505 ot the Calilomia Health and Satery Code requlres, wilh some ezceptions, that a Business Ptan 6e filed with the Costa Mesa Fire Department 6y every
Dusiness which has at eny one time tlurinq a reportetl year a quantiry ol ha=ardous matarials equal to or greater than a weighi o1500 pounds, or a volume ot 55 gallons,
or 200 cubic feet of compressed qas et standard tempereture en0 pressure).
Does or w111 the appllCeni or present or N[ure I
(Secilon 25533 oi the Celllornie He91ih end Si
one time has on hand e quentlry 01 ewtey
compressed gas et stantlerd tempereture end
. .................................................................................................
Does or will the appliwnt or present or fuNre I
en
wlih some ezceptlons, requires reglstretlon wiN the Costa Mesa Fire Department by each husiness which at any
meterlels equal to or greeter Ihen e weight of 500 pounds, or a valume of 55 gellons, or 200 cubic feet of
en
25534 of the Califomie Healih end Safery Cotle proviCes ihat Ihe Costa Mesa Fire Department may requlre the preparation, certification and tiling with the Fire
ent of an RMPP 6y businesses which are requlre4 io register acutely hezerdous meterials with the Fire Depertment.
Ye5
Does or will Ihe epplicam or present or future builtling occupant require tar the work wNch b the sub�ect of �his a,pplication e Pertni� for su�
irom the South Coast Air Oueliry Menagement Distdct or Irom eny other air polWtion camrd distdct or egency.� LJ Yes LJ No
(Section 658502 of the Califomia Govemment Cade requires t�at the requesietl inlormation ba fumished on epplications lor nomresitleNial
._............_—._ .......................""""._......,.............._......._......................_"._................_—.............._......__._..............."_'............................._...... �_......
W ill any part ot Ihe faciliry to be conStructed under this permll be wlthin 1000 feet Irom tha outer bountlatlas ot a school7 ❑ Yes ❑ 1
(Ii yes', the faciliry must meet the requirement at Sections 25536 entl 42303 of the Califomie Heallh entl Safery Cotle).
have all ot t�e tl15c10.5ur85
SignaWre: _
CERTIFlCATE OF COM
correct. I agree �o com�
above-descnbed proper
COOE 1. INSPECTON TYPE
or agency is reduired for Ihe work
an made7 ❑ Yes ❑ No
COMPLIANCE: I certify that unAar penalry ol perjury the Intormation given above is correM. 1 egree to comply with all state laws and dty ordinances
is Materials end Emissions.
n Date:
E ANO AV pRVA710N OF ENTAV: I certity under penalry ol perjury thai I have reatl this epplication and state that the infortnation given is
ell 9I0IB 6�o d ciry ordinances releting to building consiruction, end authonze representatives of the Ciry oF Costa Mesa to enter upon Ihe
�pec' pury � se . I egree not to occupy or allow occupency of eny building authonzed by this pertnit until final insDection.
i� �''�0( - �
,�a� +p� ow�a�c:, �' c o
1616 Fixetl System Final Fire Preven�ion
1266 Pool Spa Final
200 Finel Re-Rool
201 Flnal Block/Retalning Well
202
203
204
Final Factory Fire Place
Final Sign
Final Demolition
Q�jf. �¢ COpEI INSiEGfIONTYPE
208 Final Mechaniwl
20B Finel Plumbing
210 Finel Elec�ncal
212 Finel Fire Prevenllon
220 Final Plannin9 ApDrovel
222 Final Site
'250 ' Final Buiiding/Occupenry
a� u�eu
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DfiIVE, COS7A MESA, CA 92626
JobAddress: 2440 DUKE PL
Suite No
Vicinily:
Parcel Number: 14144137
npplicane BATLIK, JIRKA
Address: 2440 DUKE PL
COSTA MESA, CA
Owner: BATLIK, JIRKA
Address: 2440 DUKE P�
' COSTA MESq, CA
Contrector OWNER-BUILDER
Address:
MECHANICAL PERMIT
Phone: 714-785-9502
Zip: 92626
Phone: 714-785-9502
2ip: 92626
Phone:
Zip:
License: 000000
SCOPE OF PERMIT
� .ADD 450 SF qND MINOR INTERIOR ALTERATION
REF BO6-01727
1 BATHROOM VENT AND 1 ALT DUCT SYSTEM
ISSUE FEE
Insl FAU <100 k BTU
Inst FAU >700 k BTU
RepairhAit Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping
Faclory Fireplace
Hood w/Mech Ezhaust
VAV Box
Venl Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
AirHandlers> 10000cfm
Floor Furnace
Floor or Suspend Heater
523.50
$0.00
$0.00
513.�0
$0.00
$0.00 _.
$0.00
$0.00
$0.00
50.00
50.00
57.25
$0.00
50.00
$0.00
$0.00
$0.00
50.00
50.00
50.00
Quantity
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
FEE SUMMARY
Status: ISSUED
Applied: 12/01/2006
Issued: 12/012006
ISSUED BY:
EXTENSION
����
PER �
EXPIRESt��--
Repair / Alt Absorblion Unit
Repair / Alt Refrigeration Unit
Ventillation System
Evaporetive Cooler
C ommercia l I n ci nerato r
Domestic Incinerator
Comoressors / Absorotion Svstems
Uplo3hp/100kBTU
3To15hpI500kBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
3To15hp
15 l0 30 hp .. ,
30 l0 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee .
Plan Check Fee
Reinspection Fee
Quantity
$0.00 0
50.00 0
50.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00
50.00
50.00
TOTAL CALCULATED FEES 544.45
COMMENTS I SPECIAL CONDITIONS
_ �� � 1 �
_ ., a �
� ��
� .3
..,..�
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under;Califomia statutes and related
regulations. (ON. No. 92-28, § 1, 12-21-92) ., i;
a
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 day� o_�rk,if � k is suspended or abandoned
for a penod of 180 days.
INSPEC710NS: In order for the work authorized under this permit to 6e considered legal, such work must-comply with all applicable codes, and all
required Inspectiona and tlnal epproval must ba obtained. Failure to obtain inspections and tinal approval�will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626 .� ��
zusee (doo)
WORKERS' COMPENSATION DECLARA710N:
I hereby ettirtn under penalry oi per�ury one ol the following tleclaratlons: ,• '
❑ I heve end wlll melntein e certlticate of consent to setl-Insure lor workere' compensetlon, es providad for Ey section 3700 of the Lebor Cotle, for Ue peAarmance of the
work fof WhiCh lhis pertnil is luUetl.
❑ I have antl will maintain workers' compensation insurance, as requiretl by section 3700 of the Lebor Cotle, tor the perfortnence of the work for whkh Ihis permit is issued.
My workers' comDensatlon Insurence carner antl policy num6er are: .
Cerrier. Policy Number.
(This section need nof be comp/eted I! fhe permit is valuetl at one hundred dollars ($100) or less J
❑ I certity that in Ihe pertortnance of tha work for which this permit is issued, I shall not employ eny person in any menner so as to become wbject to Ihe workers'
compensation laws oi Celifomla, and egree that il 1 shoultl become sub�ect to [he workers' compensation provisions ol Secilon 3700 of the Lebor Catle, I shall forthwiN
compy with these proWsions.
Applicant Signature: Date:
WARNINO: FAILURE TO SECURE WORKERS' COMPENSAiION OpVERAGE IS UM.AWFUL AND SHP1l5U8JEGT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TOONE HUNDRED
THOUSAND DOLLARE (E100.000), IN A�DRION TO TME CQST OF COMPENSATION, DAMAGES 0.S PFiOVIDED FOR IN SECTION 3%O60F THE UBOR ODDE, IMEREST, AND ATTOfiNEY'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby affirm that I am licensetl under provlsions of Chepter 9(commencing with Section 7000) of Division 3 of ihe Business entl Professions Code, entl my license is in full
tarce end ettect Lic. A Class p
Concractofs Signemre: Date:
CONSTRUCTION LENDING AGENCV:
❑ I �ereby aHirm that thare is e consiruction lending egency for ihe performance of Ihe work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Neme: Lende/s Address:
Signeture: Dete:
OWNER-BUILDER DECLARATIONS:
I hereby eHirtn Ihet undar penelry of par�ury thet I em EXEMPT FROM 7HE CONTRACTORS IICENSE LAW for the fallowing reason (Sec. 7031.5, Business entl ProFessions
Code: Any ciry or counry which reQuires a parmit to cronstruct, alter, improve, demolish, or repair any slrucNre, pnor to its issuance, also requires the appllcaN tor such pertnit
to file e signetl statement thet he or she is Ilcensed pursuant to the provisions ot the Contraciors License Lew (Chepter 9(wmmencing with Secilon 7000) 01 Division 3 of the
Business end Professions Code) ar Ihet he or she is e:empt t�erefrom and the basis for t�e elleged exemption. Any Woletlon ot Section 7031.5 6y eny epplicant for e pertnit
subjects the applicant to a clWl panelry o� not mora than five hundretl tlollars (5500).):
❑ 1, as owner ot the properry, or my employees with wages as their sole compensation, WILL DO 7HE WORK, end the structure Is not intanded or oHered for sale (Sec.
7044, Business entl Prolesslons Code: The Contrectors License Law dces not apply to an owner oi property who builds or improves Ihereon, end who tloes such work
himself or herself or through his or her own employees, providetl that such improvemenls ere not intended or ottered lor sale. If, however, tha building or improvement is
sold within one yeer of comDletion, Ihe owner-builder will have t�e burtlen ot proving that he or she did noi build or impmve lor purpose of sale.�.
❑ I, as owner at the property, em EXCLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to conslruct the proJect (Sec. 7044, Business end Professions
Code: The contraciors Llcense Lew tloes not appty to en owner of property who builtls or Improves Ihereon, and who contracis for such pm�ect with e contracbr(s)
license pursuant to the Contractors License Lews.).
I em exempt under sec. Business and Professions Cotle lor ihis reason:
Si ture:r. . Date� _ '
erified by drivers license. � ❑ No e No. ^ �� ues� _
Venfication of Owners�ip Dy (type oi dau ent, i.e. - property tex bill ar tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cenify that no escavetion five (5) or more teet in dep�h into which a person is required to descend, will ba me0e In connectian with work euthonzea by Ihis
permit, and that no building structure, scaMolding, telsework, or tlemolition or dismantling thereoi, will be mora then thirty-sl: (38) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle B, Calitomia Adminisirative Code).
❑ As owner-builder, I witl not employ anyone to tlo work w�ich would require e permit trom t�e Division of Indusinel Safety, es noted ebove, unless such person has a
pertnit to tlo such work from ihe division.
Signature: Date:
Division ot Indusirial Sefety Permit Number;
COOE I, INSPECTIONTYPE
1616 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Final Fe-Rooi
201 Flnal BIocWRetaining Well
202 Final Fectory Fire Place
203 Final Sign
260 Final Demolition
P� 1�17�RL5
COOE 1 INSPECTION TYPE
206 Final Mec�anical
208 Final Plumbing
270 Final Electrical
212 Finel Fire Prevention
220 Final Planning Approval
222
250
Final Site
Final Building/OCCupenCy
0 0� �
(714) 754•5273 • Fax (714) 754-4856 • www.ci.costa-mesa.�lqLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 2440 DUKE PL
Suite:
Vicinity: FIRST FLOOR
Primary Occ: R3
Parcel Number: 14144137
Applicant: BATLIK, JIRKA
Address: 2440 DUKE PL
COSTA MESA, CA
Owner: BATLIK, JIRKA.
Address 2440 DUKE PL
COSTA MESA, CA
Contractor. .
Address
Zip:
Arch :
Address:
Phone:
Zip:
License:
Type of Construction: V-N
, Zoning:
Phone�. 714-785-9502
Zip: 92626
Status: ISSUED
Applied: 10/72/2006
Issued: 12/01/2006
ISSUED BY: �—
I r:-.
Phone!. (714-785-9502
i
Zi��' 9267�6 ��
�
Phone: �ja� ' 1 N ... ..
License: �����ED �
� n
Eng: K
Address: 18 �
�X�d��
92612
ENGINEERS
Pfione: 949-252-1022
License: S3866
SCOPE OF PERMIT
ADD 450SF TO THE 1ST STORY AND MINOR INTERIOR REMODEL TO A 2ND STORY SFD. WORK TO INCUDE: NEW BEDROOM, LIBRARY,
BATHROOM, REMOVAL OF INTERIOR WALLS IN HOUSE AND 2 INTERIOR WALLS IN GARAGE.
EXISTING 5 BEDROOM, 3 BATHROOM SFb TO BE CONVERTED INTO A 5 BEDROOM, 4 BATHROOM SFD.
PLNG. - PA-O6-03 APPROVED FOR 10 FT. FRONT SETBACK
Plan Check:
Permit:
SMIP Res:
SMIP Corr%
Other:
Inspection:
Total
$366.24
$563.45
$4.16
$0.00
$0.00
$0.00
$933.85
SETBACKS
MAINSTRUCTURE Fronl 10-0
ACCESSORY Front 0-0
PARKING Existina: o
Rear 0-0
Rear 0-0
Required: 0
FEESUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Pr000sed: 0
_�'
,�
Calc Valuation: sai,5eo.00
Claim Valuation: sis,000.00
Right 0-0
Right 0-0 �
�
�.�
' � CY
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia ststutes 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 penod oi 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
required Inspecllons and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2466d8I8�00)
WORKERS'COMPENSATON DECLARAnON:
I hereDy eNirtn un r penalry of per�ury one o1 the lollowing declarations:
❑ I heve end ill meinteln e cenllicate af consenl to sell-Insure tor workers' compensation, es provlded tor by sectlon 3700 oi tha Lebor Cale, tor the Rarfortnence of the
� wark for whi h t�is oertnR Is Issued.
❑ I certity Ihat in e perfoi
com tion s ot C
pl ' ese ovi;
Appli �
W ING:FAILURETOSEWRE
TFKKISAND DOLLAfiE (E100.mB1.'
/
LICENSEDCONTRACTORS
I here irtn that I am licens
compensatlon insurence, as required by section 3700 of the Lebor CoOe, for the peAartnanca of the work for which Nis pertnit is iswed.
ance caMer enC policy number are:
wark for whi<
mree ihet if I
ILLp ���
DECLARATION:
CONSTRUCTION LENDING AGENCY:
e hundred dollers ($100) or less.)
�ertnit is issueQ I shall not e�9 eny person in any menner so as to hecome subjact to ihe workers'
become subject to the v�WrKers' compensetion provislons of Section 3700 ot the Labor Code, I she0 fort�with
Dete:
SHAII SUBJECT AN EM�IMINAL PENPLTIES MID dVIL FlNES UP TOONE HUNDRED
3 PROVI�EO FOR IN SEC710N 3]OB OF THE LABOfi CODE, INrEREST, AND ATTORNEV'S FEES.
(commencing with Section 7000) of Divis' uslness and Professions Code, and my Iicensa is in full
Cless M
� I hereby eHirtn that there is e consiruction lending egency for the performance ot t�e work lor which this permit is issuetl. (Sec. 3097, Civil Cotle).
Lenders Name: Lentlers Atltlress:
Signeture:
Date:
OWNER-BUILDER DECLARA710NS:
I hereby aNirtn Ihet untler penalry of perjury thet I em EXEMPT FROM THE CON7RACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions
Cotle: Any ciry or county which requires e permit to consiruct, alter, improve, Cemolish, or repeir eny siructure, prior to its issuance, also raquires ihe epplicenl lor such permit
to file e signetl statement that he or she is Ilcensetl pursuent to the provisions of the Contrectors License Lew (Chepter 9(commencing with Saction 7000) oi Divislon 3 ot the
Business and Professians Cade) or thet he or she is exempl therefwm and the besis tor the allegetl e:emption. Any violation of Section 7031.5 by any appllcant tor a Oermit
subjects the applicent to a civil panelry ef not more then tive hundred dollars ($500).): '
❑ I, as owner of the properry, or my employees with weges es their sole compensation, WI�L DO THE WORK, entl the structure is not intended or oHeretl for sale (Sec.
� 7044, Busin�s and Protessions Code: The Contractore License Law tloes not apply to en owner of pmperty who builds or improves thereon, end who tloes such work
himself or hel3elf or ihrough his or her own employees, provided that such improvemenis are not intended or oHeretl br sale. If, however, t�e builtling or improvement is
soltl within one year of c pletion, the owner�builder will have ihe 6urtlen of proving that he or she did not build or improve for purpose ol sale.).
❑ I, es owner of Ihe prope em E%CLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to construci the project (Sec. 7044, Business and Professions
Cotle: The coritract ' a Lew does not epply to en owner of propeny who 6uiltls or improves ihereon, end who contracts tor such project with e contwctor(s)
_�.license pursuaqt to t C lra tors License Lews.).
exemp�
Vedfiwtian oi
BuSiness and Prolessions Code for IhiS rea5on:
_ C— �a4ie' i _
license. �.1(� ❑ No e icense No. ,� %� I' ' o�. _
(rype of documem, i.e. - property laa bill or deetl): ��
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION:
❑ I hereby ceRily �hat no excavation Ilve (5) or more teet in depih into which a person is raquiratl ta descenq will be mede in connection wit� work authorized by Ihis
permit, and that no building structure, scattolding, felsework, or demolition or tlismantling thereof, will be more Ihen Ihiity-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Calitornia Administretive Cade).
❑ As owner-bulltlar, I will not employ enyone to tlo work which woultl require a permit irom ihe Division of Industnal Safery, as noted ebove, unless such person hes e
pertnit to do such work irom the division.
Signature: Date:
Division of Industrial Safety Permit Number:
CO�E l INSPECTIONTYYE
1616 Fixetl Sys�em Final Fire Prevention
1266 Paol Spe Final
200 Final Re-Roof
207 Final BIocWRetaining Well
202 Final Feciory Fire Place
203 Final Sign
204 Final Demolition
QejE �Q f�Q$f�( INSPECTIONTYPE
206 Flnal Mechanlcal
208 Final Plumbing
210 Final Electncal
212 Flnel Fire Preventlon
220 Final Planning Approval
222 Final Site
250 Finel Building/OCcupenq
�g
�
��
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa,ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
Parcel Nunmber
Applicant:
Address:
Owner:
2440 DUKE PL
SIDE OF HOUSE
14144137
BATLIK, JIRKA
2440 DUKE PL
COSTA MESA, CA
BATLIK, JIRKA
Address 2440 DUKE PL
COSTA MESA, CA
Contractor. • OWNER-BUILDER
Address:
ISSUE FEE
Temp service test
Res. alc package
New Res (1-2 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
Motors to 7 hp
Motors to 10hp
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
ELECTRICAL PERMIT
ISSUED BY:
Phone: (714)785-9502
Zip: 92626
Phone: (714)785-9502
Zip: 92626
Phone:
Zip:
License: 0
SCOPE OF PERMIT
CHANGEOUT EXISTING ELECTRICAL SERVICE PANEL:
Quantity
$23.50
50.00
$0.00
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.ao 0
so.00 0
�; / $0.00 : , 0
- `��,$30.50 � _ 1��
.� �� $0.00�� �-0� � ,.
$0.00 ' 0
� � $0.00 0
so.00 0
$0.00- 0
$0.00 0
$0.00' _ 0
$0.00 0
so.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
FEE SUMMARY
Status: I SS U E D
Applied: 03/15/2001
Issued: 03/15/2001
, Quantity � .
Temp Dist System I Lighting $0.00 0�
Busway I700 ft $0.00 0 ' � , ,
Standing Seclion � $0.00 0 :� � �
Misc Electricat Equipment $0.00 0 �: �
Transformers up to 1 kva/kw $0.00 0� / -
...............up to 10 kva/kw $0.00 0' ' �� , �
.................up to 50 kva/kw $0.00 �0 �
...........:.....up to 100 kvalkw 50.00 0 � -� ,
......:...........over 700 kva/kw � $0.00 0 ' ; � , �
Low Voltage Equipment $0.00 . 0 � , � ,
Low Volt Wiring System / Ckt ,'-$0.00: .; 0 ��, /
Misa Conduit -'" %� $0.00� '0, / ' �
Misc: Conductor '�� ,$0,00. � C0� �� �
Circus ( gen or ride) " �'.$0.00 �" 0, � j
Circus (mech ride or lights) � $0.00 � �0 '
Chdstmas Tree Stand � �, �50.00 � �� 0'
Fireworks Stand $0.00 0
Other Electrical Fee , $0.00'
Investigation Fee . $0.00
Plan Check Fee $0.00
Reinspedion Fee 50.00
TOTAL CALCULATED FEES 554.00
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. 92-28, § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
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
required inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration.ot this permit.
FOR INSPECTIONS CALL: (714) 7545626
2d464fi (fi/00)
WORKERS'COMPENSAnON DECLARAn4T �
I herehy aNirtn untler penalry ot perjury one of the �ollowing declaretions: �
❑ I have end will maintain a cenificate of consent to self-Insure for workers' compensation, as pwvidetl for by section 3700 0l Ihe Lebor Code, lor ihe peAormence of the
work for which this pertnil Is 15sued.
❑ I have antl will maintain workers' compensati� Insurance, es required by section 3700 of the Labor Code, for ihe peAortnance of the work for whic� Ihis pertnit is issued.
My workers' compensation Insurance carrier and pollcy number ere:
Cartier. PWity Number.
(This sectlon need no( be completed i! f�e permi( Is ve/ued et ane hundred dallers (5100) or /ess.)
❑ I certity t�at in the performance ot Ihe work �or which t�is pertnit is issuetl, I shall not employ eny person in any menner so as to become sublect to t�e workers'
compensation laws ot Calitomie, antl agree that It I should become sublect b t�e workers' compensation provisions of Section 3700 0l t�e Labor Code, I shall lonhwith
comply with these provislons.
Applicant Signature: Date:
WAFWING: FN WFE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAW FUL AND SHALL SUBIECT AN :1+IPLOVER TO CRIMIWIL PENALTIES rW D CML FlNES UP TO ONE MUNORED
TFKK15AN0 DOLLARE (5100.000), IN ADDfiION TO THE CQ+T OF COMPENSATION, DAA41GE5 AS PROVIDED FOfi IN SECTIqJ �O6 OF THE UBOR CO�E. INTEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm thal I am licensed under provisions of Chepter 9(mmmencing with Section 7000) of Division 3 of the 8uslnass and Profassions Code, antl my license is in full
force and eHect. Lic. a Cless N
Contraaofs Signawre: Da�e:
CONSTRUCTION LENDING AGENCY:
❑ I hereby attirm that there is a consimction lending agency for the peAormance of ihe work for which ihis permit is issuetl. (Sec. 3097, Civil Code).
Lender's Name: Lender's Address:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aHirm ihat untler penalty of per�ury Ihet 1 em EXEMPT FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Pmfessions
Code: Any ciry or county which requires e permit �o construct, alter, impmve, demolish, or repair any simcture, prior �o its issuance, elso requires the epplicaN tor such permit
to file a signed statement ihat he or she Is Ilcens9tl pursuent to tha proWslons ol the Contrectors Licanse Law (Chapter 9(commencing wilh Sectian 7000) ol Divislon 3 ot the
Business antl Professions Code) or ihet he or she is exempt theretrom antl the besis for iha ellegetl e:emption. Any violation of Saction 7031.5 by any epplicent lor e permit
su6jects ihe applicant to a civil penalry ot not more then tive hundred dollars (5500).):
'�—I, as owner ot the properry, or my employees with weges es Neir sole compensation, WILL DO THE WORK, an0 the structure Is noi Intended or oHeretl tor sale (Sec.
�--�Od4, Busines and Professions Cotle: The Contractore License Law does not apply to an owner o( pwperty w�o 6uilds or impmves thereon, and who tloes such work
himseH or hers 1 or through his or her own employees, provided ihat such improvements ere not intended or oHered lor sele. If, however, the builtling or Improvement Is
sold within one eer of completion, ihe ownbr-builder will have t�e 6urden of proving ihat he or she did not builtl or improve for purpose ol sale.).
❑ I, as owner ot t operty, E%CIUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct ihe projec� (Sec. 7044, Business and Prolessions
Cotle: The cont rs Li nse w tloes no� epply to an owner ol proparty who builds or Improves thereon, and who contrac�s tor such prolect with e contractor(s)
license pursuan to t Co Iracto Licanse L.aws.).
�_�_ _I am exempt un er sec. Business and Protessions Code for ihis reason:
� SignaWre:--'� !-�Date: -.
Owner ID ve'fied b ' e. ❑ Yes ❑ No rDrlveYs'Cicense No. �� ��-- -� �pires _�-. �Z
Verification oi Ownersh propert taz bill or deetl :/�"-- �
y(type ol G ment, i.0. - y )
DIVISION OF INDUSTRIAL SAFETY PERMIT CffAnFICA710N:
❑ I hereby cenity Ihat no excavetion Ilve (5) or more feet in dapih into which a person is required to tlescend, will be matle in rqnnectlon with work authorizetl �y �his
pertnit, and that no 6uilding structure, swHolding, telsework, or demolition or Oismantling thereof, will be more then thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
34 i, Title B, Califomia Administre�ive Code).
❑ As owner-builder, I will not employ anyone �o tlo work which would require e permit trom the Division of Intlustrial Safety, es notetl ebove, unless such person has e
permit to do such work irom the tlivision.
Signature: Date:
Division of Indusirial Safety Permit Number:
1 Will �he applicant or present or fuNre building occupent need to file end cenity e Business Plen lor emergency response to releese or threetened releese of e harardous
matenal? ❑ Yes ❑ No
(Section 25505 of the Califomia Heelih and Safery Code requires, with some exceptions, ihet a Business Plan De filed with ihe Costa Mesa Fire Depanment by every
business which has at any one time during a reponetl year a quan�iry of hazardous materials equal b or greater ihan a weight of 500 pounds, or e voluma o155 gallons,
or 200 cubic feet of compressed ges at standard tempereture and pressure).
������buildin occu ant neea to file s re istration form for ewtel �hazardo m��� ��� �����������������������������������������
...................................................................................................... ...................... ........... ......... .........
2 Does or will the applicant or present or imure 8 P 9 y us aterials9 ❑ Yes ❑ No
(Section 25533 of Ihe Calitornle Healih end Safery Code, wilh some exceptlons, requires registretion with ihe Costa Mesa Fire Deperiment by each buslness whic� at any
one time has on hand a quantiry oi acutely hezertlous matenals equel to or greater than a weight of 500 pounds, or a volume ol 55 gellons, or 200 cubic feet oi
compressad gas ei siantlartl tempereWre and p�essure).
..._ ......................................._......................................._....................................................._..........................._.........................__..........................__...................._...........__._........._._......__......._......._................_.................._._.............
3 Does or will the applicant or present or future building accupant neetl to prepare an RMPP (Risk Management antl Prevention Program for aately hazardous ma�erials)7
❑ Yes ❑ No
(Sedion 25534 of the Califomia Healih end 5afary Code provides that ihe Costa Mesa Fire Depariment may require the preparation, certdication and tiling wi�h �he Fire
Departmem of an RMPP by businesses whicp ere requirad to ragister ecutely hazardous materials with ihe Fire Department.
....................................................................................._...........................................................................................................................................................................,.................................................,...................................................................
4 II an RMPP i5 presen�ly required, h85 SeC�ion 25534 ot ihe Celi}ornie Heelth end Safety Cotla been fully complied wi�h? ❑ Yes ❑ No
................_..................................................................._.........................................................................................................................................................................._....._._._..__._.................................................._.....................'""............
5 Does or will the eppliwnt or present or tuWr2 building occupant require lar Ihe work which is �he sublect ot ihis a plication a ermit br such construction or modifica�ian
fmm lhe Souih Coast Air �uality Managemen� Distdct or trom any other eir pollution wntwl tlisitict or aqancyl � Ves � No
(Section 658502 of Ne Califomia Govemment Cotle requires t�et the reduested information be fumishetl on applications br nornresiCen�lel building parmils).
any
the taciliN must meet the
Signature:
have all of ihe Oisclosures
ier this permi� be within 1000 feet trom t�e outer boundanes of a
of Sections 25534 end 42303 of t�e California Heelih and Satery
ol dis�nct or egency is requiretl tor the u
42303 been matle? ❑ Ves ❑ No
mce irom the appropdate air polWtion wnirol oflicer).
1 certity tnat under penalry of perjury the infortnation given ebove is wrrecc I agrae to comply with all state laws end ciry ortlinances
Emi5si0nS.
Date:
CERTIFlCATE OF COMPLJANCE D ORIYA �[J OF ENTAY: I certity under penalty of perjury ihat I have read this epplication and stale ihat ihe information given is
correct. I agree to comply wi�h all Iate I s an ciry orif'nances relating to bullding consimctlon, and au�horize reD�esentatives ot �he City ol Cosia Mesa to enter upon Ihe
ebove-descnbetl property for inspe tion pu se 1 agree ot to occupy or ellow occupancy of eny building authorized by Ihis permit u nel inspection.
��/S-�/
�t re O � oal ner(s) � ' �Dete-- ._ - >
COOE �. INSPECTIONTYVE
1616 Fized System Final Fire Preventlon
1266 Pool Spa Final
200 Final Re-Rool
201 FinalBlocWRetainingWalf
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
PdIE" IMRIALS
GOpE� INSPECTIONTYPE
206 Final MeChanical
208 Final Plumbing
210 Final Electrical
2t2 Final Fire Prevention
220 Final Planning Approval
222 FinalSite
250 FinalBuilding/Occupency
�.1. tW .
�,0 I�/�
(71a) 75a-5273 • Fax (714) 75a-aB56 • www.ci.costa-mesa.c�ySILDING PERMIT �� FAIH UHIVt, GUJIA MtJA, GA `JZtiLO
V
.IobAddress: 2440 DUKEPL
Suite:
Vicinity: FRONTOFRESIDENCE
Parcel Number: 14144137
Applicant: BATLIK, JIRKA
Address: 2440 DUKE PL
COSTA MESA, CA
Owner: BATLIK, JIRKA
Address 244D DUKE PL
COSTA MESA, CA
Contractor. D�� _ �t �
Address:
2ip:
Arch :
Address:
Phone:
Zoning:
Phone:
Zip: 92626
Phone:
Zip: 92626
Phone:
License:
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: 10/13/2000
Issued: 10/13/2000
Phone:
Zip: License: License:
SCOPE OF PERMIT
70 LINEAL FEET OF BLOCK WALL PLUS WOOD FENCE AT FRONT PROPERTY LINE, TOTAL HEIGHT OF 5 FEET.
Plan Check: $33.12
Permit: $50.95
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $84.57
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0-0
PARKING Existin : 0
NOTES:
Rear p- p
Rear 0-0
Required: 0
FEE SUMMARY
PLANNING 8 ZONING
Left 0. 0
Lek 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation
Right 0- 0
Right 0-0
si,aoo.00
so.00
NO710E: 7he 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 antl become void if work is not commenced within 180 days, or ii 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 tinal approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2a6&661fi100)
WORKERS' COMPENSA710N DECLAflA710N:
I hereby attirtn untler penalry ot perjury one of the tollowing deGaraiions:
❑ I have and will maintain e certificata ot consent to selt-Insure br workers' compensatlon, as provitletl for by section 3700 of tha Lebor Cotle, lor the peAortnance ot the
work for which I�is partnit iS issue0.
❑ I have antl will maintain worKers' compensation insurence, es requiretl by section 3700 of tha Lebor Code, for the perfortnance of the work for which Ihis pertnit is issued.
My worker5' wmpensa�ion Insurente carner antl policy number are:
Carner. Policy Number:
(This secfion need not be canple�ed i! fhe permi( is valued et one huntlred dollars (S100J o� /ess.J
❑ I certify that in the peAortna�ca of the work for whic� this permit is issued, I shall not employ eny person in eny menner so es to become subject to Ihe workers'
compensation laws ot CalifO�nla, end agree Ihat it I s�aultl bewma subject to the workere' wmpensation proWslons of Sectlon 3700 ot the Wbor Cotle, I shall to�hwith
comply with thesa provisions.
ApplicaN SignaWre: Date:
WARNING FAILURE TO SECURE WO�ERS' COMPENSATION COVEMGE IS UNIAWFUL AND SHALL SUBIECT Ml EMPLOYER TO CRIMINA� PENALTIES lWD CNI� FlNES UF TO ONE HUNDRED
TMOUSAND DOLLARE (5100,000�, IN ADORION TO THE C0.ST OF COMPENSATIIXJ, �Ah1AGE5 AS PROVI�ED WR IN SECfIIXJ 31080F THE LABOR CODE, INiEREST, AND NTTORNEY'S FEES.
LICENSED CON7RACTORS DECLARATION:
I hereby attirm that I am licensatl under provisions ol Chapter 9(commencing with Sectlon 7000) of Division 3 of the Business antl Professions Cotle, and my license is in full
fome and eflecL Lic. & Class x
Comractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aflirm that ihere is a consVuction lending agency lor �he peAormance of Ihe work for which ihis permit is iss�etl. (Sec. 3097, Civil Code).
Lenders Name: Lender's Address:
Siqnawre: Date:
OWNER-BUILDER DECLARATIONS �
I hereby aflirm thet under penalty of perjury ihat I em EXEMP7 FROM THE CONTRAC70RS LICENSE LAW for ihe following reason (Sec. 7031.5, Business antl Professions
Code: Any ciry or county which requires e permit to construct, elter, Improve, tlemolish, or repair any structure, pnor to its issuence, also requires t�e applicant for such pertnit
m file e signed statement ihat he o� she Is licensed pursuem lo Ihe provisions of ihe Contrectors License Lew (Chepter 9(commendnq with Section 7000) of Division 3 oi the
Business antl Professions Code) or thel he or sha is exempl iherelrom anA the basis for Ihe alleged axemption. Any violation ol Section 7031.5 by eny applicant for a pertnit
subjects Ihe epplicant to a civil pe�elty of not more ihan live hundred dollers (5500).):
� I, es owner of the pmpetly, or my employees with wages es lhalr sola compensation, WILL DO 7ME WORK, end the struc�ure is not intentletl or oMeretl tor sale (Sec.
7044, Business and Profes5ions Code: The Coniractors License Lew tloes not apply to en owner of property who builds or improves Ihereon, end who tloes such work
himself or h selt or �hrougn his or her own employees, providetl ihat such improvements are not intended or ofleretl br sele. If, however, Ihe builtling or improvement is
sold within year of completion, Ihe owner-builder will have lhe burtlen oi proving ihat hn or s�e did not build or improve tor purpose oi sale.).
❑ I, es owner 1 iha ropetly, 9m E%CLUSIVELY CONTRACTING WITH LICENSED CONTqACTORS to cons�mct I�e pro�oct (Sec. 7044, Business entl Protessions
Cotle: Th a �o Icar�sa Lew does no� epply to en owner ol property who builds or Improves Ihereon, antl who conirects for such project wl�h e conirac�or(5)
license p rs ani t the ntractors Licensa LawS.).
❑ I am exem nd sec. Business antl Professions Code tor Ihis reason:
Signaiure: Date: '
' Owner ID v nfietl dn ers li nse. ❑ Ves ❑ No Drivefs Licanse No. Expires:
Venfication oi O ne hi by ( e ol tlocument, i.e. � pmperry tex blll or deetl):
DIVISION OF INDUSTRIAL SAFEn' PERMIT CER7IFICATION: �
❑ I hereby cetlify ihat no exca+'a�ion five (5) or more leet In depth into which a person Is required to tlescend, will be mede in connectlon with work euthodzed by ihis
pertnit, and that no building structure, swHolding, falsework, or demolition or tlismantling thereof, will be more ihan ihirty-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec.
341, Title 8, Califomia Adminisirative Code).
❑ As owneo-builtler, I will not employ enyone to tlo work w�ich would require e permit from t�e Division of Industnal Setery, es notetl ebove, unless such parson has e
pertnit to da such work from the tlivision. '
Signature: Date:
Division ot Industrial Sefeiy Permi� Number:
MAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 W III Ihe applicant or present or fuNre builtling occupant need lo lile end certify a Business Plan tor emergency response lo release or lhreatened releese oi a hazartlous
material? ❑ Ves ❑ No
(Section 25505 of ihe CalifoMa Healih antl Saley Cotle requires. with some exceptions, that a Business Plan be tiled with the Cosia Mesa Fire Department by every
business which has at any one time during a reponed year a quan�ity of hazarAous matenals equal to or greater then a weight o1500 pountls, or e volume of 55 gallons,
or 200 cubic teef ot compres5etl gas at standard temperature end pressure).
__ ......................_...................'_'.........._..................._�_.._........................_._._...__........................'_'...........................__._...........................�_._�...... ..........._.......... _..............__...........__..
2 Does or will the applicant ar present or future buil0ing occupant neeU to file a re9isiration lortn lor acutey hararAous meterials7 ❑ Yes 0 No
(Section 25533 0l Ihe CalitorNa Healih and Safery Cotle, wilh some exceptions, requires reglstretion with Ihe Casta Mesa Fire Depariment Oy each business which at any
one time has on hand a quentiry of ecutely hezartlous meterials equel to or greeter lhen e weight of 500 pountls, or a volume of 55 gellons, or 200 cubic feet oi
compre55ed gas at stentlarA �empereWre and pressure).
.........................................................................................................................................................................................................._........................................................................................................_..............................................._.................
3 Does or will �he applicant or p�esent or tuWre builtlinq acupant need to prepare an RMPP (Risk Management end Pre�emion Proqrem tor acmely hazertlous matenals)7
❑ ves ❑ No
(Section 25534 of the Califomia Health and Satery Code provides Ihat tha Cosla Mesa Fire Department may require Ihe preparation, certifiwtion and tiling with the Fire
Oepertment ot en FMPP by businesses w�ich ere requiretl to register aatety hazardous meterials with the Fire Departmem.
......._ ....................... .'__'........._.............................___.......................................__.._........................."'................................__............................... .............._.._._. _...�.............._.._............._............._
4 If an FMPP is presently repui�ed. has Sectian 25534 0l Ihe Celitomie Health entl Safery Cotle been lulty complied withl ❑ Yes ❑ No
5 Does or will Ihe applicant or p�esent or tuture bulitling occupent requtre br tne work wnic� I5 t�e SUD�ec� of this e plicetlon a permit br such consiruction or motlificaGon
frOm ihe Sou�h Coes[ Alr Ou6�lty Menagemen� DisidCt Or Irom eny o�her eir pollu�lan conlml tllsidct or egenc�? � VBs �J No
(Section 658502 of Ihe CelifOmia Govemment Code repuires thet Ihe requested infortnetian be fumished on epplicetions lor non-resitlential building pertnits).
............._................._..................................._..,...............................................................""'..................................._................................._............................._...—........._..... ...................... .................._..............._.............._.........
6 Will any parl of tha taciliry to be conswcted under Ihis pertnit be within 1000 feet trom t�e outer boundanes ot e school7 ❑ Yes ❑ No
(It'�jes', lhe facility mu5i mee� �he requirement ot Sactions 25534 antl 42303 of 1he Galilornia Healih and Safety Cotle).
..............................._..............................._........................ ......................................................_..........................................._..........................._..................._.................................._...................................__................_.........
7 II a permit from ihe South Caast Air Qualiry Manegemenl Disiric� or other elr pollution contml tlis�rici or egency is requirad far Ihe wark which is ihe subject of this
applicatian, have all ol the di8closures prescribed by California Healih and Salety Code Sectlon 42303 been made9 ❑ Ves ❑ No
..............................._..................................................................................................................................__...........................................__.............................................................._..._........................_..................._.................................._......
B (tl yes', attach certificata of compliance fmm the appropnete air polWtion wntrol otticer).
CERTIFICATE OF COMPLIANCE: I certity that untler penelry ot perjury the information given abova is correct. I egree to compty with all state laws entl ciry ortlinances
regarding Harardous Matenals antl Emissions. �
Signature: � Date:
CERTIFlCATE OF COMPLIANC AND A ZATION OF ENfAV: I cenify untler penalry ol perjury ihat I have read this application antl state that the information given is
correci. I agrae ro comply wilh e s�� w antl R ortlinances relating to builtling consiruction, antl aut�onze representatives of the Ciry of Casta Mesa to enter u0on ihe
eba+e-described property tw in5 lion pury sas. I e tee �ot la accupy or ellow occupancy ot eny building authorizad by this pbc�it u� til t�tian.
lM1l
I .T V
c�n re Of Lea wne sl .�&el�
Date
GOUE �' INSPELTIONTYVE �
7616 Fixed System Final Fire P�evention
1266 Pool Spa Final
200 Final Re-Rooi
201 Final BlocklRetaining WB��
202 Final Fectory Fire Place
� It�
COOE� INSiECT10NTYPE
206 Final Mec�anical
208 Final Plumbing
210 Finel Elec�rical
212 Final Fire Prevention
220 Final Planning Approval
203 Finel Siqn 222 Final Site
204 Final Demolition . 250 Final Building/Occupancy
P� INIIDd45
• TI-IIS SKEfd-I LS FOR INFORMATIONAL PURP066
ONLY. APPLICN7f IS RFSPONSIBLE FOR PROVIDIIJG
AN ACNRATE RFPRFSFNfATION OF 7}�Qt PROPFR7Y
QJ GSE 7HE SfiAPE AND S77F DO NOT OORRESPOND
WffH 77-� INFORMAi70N PROVIDID ON 1iff55}�t.
�������
CI7Y OF COSTA MESA
p�ANNING DIV.
SUBJC�T BL G. DEPT• REG.
DITION�
BE AP
(V OT���a
)NS. GR CORREC.TIOfJ
S4ALL
' S0[]D WAL15/FiNQ�S BEIWEIN 2'6' s 6' QJ }�]CtfT SHALL
BE Sh7BAIX A7IFAST 10' FROM FRONI PROPERTY llNE.
• SOI.Q) WALIS/FENQ�S StIALL N07 SX� 2' 6' PI FIDCHT
N7IF�J ld OF 7HE FRONL PROPFR7Y IWE Q�107 NR6 LIIJE).
• VERR�Y DSI'AN� FROM CURB TO PROPERI'Y IINE
AND 9iOW ON PIAN. VFRII7GIION FAOM T}ff QIYS
HdGINEOiING DIV6ION S REQUIRED. GLL (71Q 751�S34i
aox wFoxHunoca.
�, i
8
APPRON�D
� � gy �� E
� � This set of plans an spedfications MUST ke�
meke any dimiges n� aP,eralbn on same w�lwm vn
aM Safety, Ciry of Oosla Idesa.
� fthi; plari; �i �u: AL
� ol the violatl n af ny pr ��isions of �m C y of
� :
� These pians nd imA ° u�ll �rpire oy cimif 1'�n
�g �.n�i r nrl r.. � a. m�imairC 5qn ; ae
� RE9DEMCE RE9DCNfl
I I
I
�`.
.
�` '•._ .................. ••-'----. a_ p!_��.�4
�--- _ ,
u
m an times and'n is wlewlul tt•
�mommeo aeua�rc
�
�� obe
9 Ordinance nNo Sta �aw
�nu➢andvo' itM buiMr;�.
(�Ivrilhin+pn �,� �;�y �.n�
�SSOFI�Q RC90ENCC
I
1
STREET
BLOCK WALL LAYOUT FOR BUlLD1NG PERMlT
PLANNING DIVISION
u
TYPICAL
Cement Copi� Opt�onal �
ChanMlBbck With 7-3/8�
Hori:ontal Top o/ all
Fencn
For Fences 5' or Less
Vert. Bars 3/8"yS at 4' �0" O.C.
FOr Fences Higher Than 5'
Ve�t. Ban 3/8"� at 32" O.C. �
F��I Cells Solid With Grou1
Where Steel Occurs
qcin/nrcing S1eel Shall
('pnlorm to Sec.A�15�39
A.S.T.M.
qll Steel to be Lapped
Z4" ol to Cod!
NATURALGRADE
TWO 7/B"Q BAqS �
CONTINUOUS TOP �
6 BOTTOM
c
Hpf;MiSTEEI MUST BE TIEO IN I
pLACE AT TIME OF TFENCM
INSPECTION. p
a x
1� F
V
� W
Q
> i
e
i �
W O
u '-
V
��
A 'Q N
, n - -
e
�f K'IDTH
SEE CM�
� BEIOW
�
6�� CONCRETE BLOCK FENCE
GENERAL- NOTES
MORTAR; p�e pa�� plastic Cement, and
GROUT; Three Pa�ts Sand
One Pc�t Cement TMee ana
One Half Parts S�and
COPING: pne Part Cemenl, Three
POffS $O�d
CONCRETE: Weil M1aed 1:2-I/2:3-I/2
Moti of 7- I/2 Gallcns ot
Wafer Per Sack of Cemenl
GROUT MAV BE POUNEO FROM THE TOV
Oi THE FENCE IN CElLS WMERE S�EEI
OCCURS.
CEILS ANO AREASOF MOR120HTAL NE�N
FORCEMENTSHALLBECLEAR,CLEAHB
FREE OF ALL MORIAR OEBRIS, ETC.
�
M CV' C4RTHTCOiH
V! frlE NEiGTM O( fENCE
�LOW BOTTOM OF �OGTiNG
SCALE: 1/2��= I'
FOOTING REQUIREMENTS CHART
WALL HEIGHT 6� 5 4� , I
WIDTH . . 14�� . . . . . I4" . . . . . 12�. . . 12�
7HIGKNESS . . .10" . . 10" . . 9 ` e "
DEPiH OF EARTHTOOTM 24� 20" 16�� 12�
SPACING OF EARTHTOOTH i2' 14' . 16� 16�
BUILDING DIVISION
�
(774) 754-5273 • Fax (714) 754-4856 • vr.vw.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
JobAddress: 2440 DUKE PL
Suite:
Vicinity: LEFT SIDE PROPERTY LINE
Parcel Number: 14144137
Appliwnt: BATLIK, JIRKA
Address: 2440 DUKE PL
COSTA MESA, CA
owner: BATLIK, JIRKA
Address 2440 DUKE PL
COSTA MESA, CA
Contractor: OWN ER-BUI LDER
Address:
Arch :
Address:
Zip:
Phone:
Zoning:
Phone: (714)540-0722
Zip: 92626
Phone: (714)540-0722
Zip: 92626
Phone:
License: 0
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: 03/15/2007
Issued: 03/15/2007
Phone:
Zip: License: License: �
SCOPE OF PERMIT
CONSTRUCT 80 LINEAL FEET OF�6' HIGH BLOCK WALL ALONG THE LEFT SIDE PROPERTY LINE OF EXISTING SINGLE ,
FAMILY RESIDENCE. . �
Plan Check: $37.08
Permit: $57.05
SMIP Res: $0.00
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
7'otal: $94.13
��; , i;
SETBACKS - � � � -
MAIN STRUCTURE Front� 0- 0 -
ACCESSORY Front 0- 0 � �
PARKING Existin : 0
NOTES:
Rear 0-0
Rear 0- 0
Reouired: 0
FEE SUMMARY
LeN 0- 0
Left , 0- 0
Proposed: 0
- Calc Valuation: i
Claim Valuation: "
-�
� � .. �-
,;�
� � /
.
; iC // �
."� '� ��/
Rlghh "0=0�� � '
� Right 0- 0 -
si,soo.o0
so.00
. '/
�,
i
/
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 1 BO 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
requl�ed Inspectiona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiratlon.oi this permit.
FOR INSPECTIONS CALI: (714) 7545626
2saaae �aroo�
WORKERS' COMPENSAnON DECLARATION:
I hereDy eHirtn under pen8lry ot perjury one of the following tleclaretions:
❑ I have and will mainlain e certificate ot consent to self-Insura tor workers' compensatlon, es providetl for by section 3700 at the Lebor Code, lor the peAormance oi lhe
work �or which Ihis pertnii is issuetl.
❑ I �ave and will maintain workers' canpensation insurence, as required by section 3700 of Ihe Lebor Code, for ihe peAortnanca ol Ihe work for which this permit is issued.
My workers' compen5atlon Insurance carrler and policy number are:
Cerrior: Policy Number:
(This section need nof be completed il the permif is valuetl et ane huntlretl tlollars ($100) or IessJ
❑ I cartity Ihat in the p�dormence oi ihe work tor which t�ls permit is issued, I shall not employ eny person in any mennor so es to become subject to the workers'
compensation laws 0� Celifomia, entl egree Ihat It I should become sub�ect b Ihe workere' compensetlon prodslons ol Sectlon 3700 of the Labor Cotle, I 5hell forthwith
comply with t�ese ptovisions.
AOp�icant Signatura: Date:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNL4WFUL AND SHALL SUBIECT AN EMP�OYER TO CRIMINAI PENALTIES AND GVIL FINES UP TOONE HUNDREO
TMOUSAND OOLLARE �5100,0�). IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SEGTION 3]OB OF THE IABOR COpE, INTEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARA710N:
I here6y eHirm that I am IiGensed untler provislons of Chapter 9(commencing with Section 7000) ol Division 3 of ihe Business end Professions Code, and my license is in full
force end eflect. Lic. k Cless q
Coniractors Signeture: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby attirm that tpere Is a construction lending agenty fo� the peAormance of ihe work br which this permit is issuetl. (Sec. 3097, Civil Code).
Lentlefs Neme: Lender's Address:
Signeture: Data:
OWNER•BUILDER DECLARATIONS:
I hereby eNirtn that untler penalty of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business ena Protessions
Code: Any ciry or counry Which requlres a Dermif to construct, alter, improve, demolish, or repelr eny strucWre, pnor to its issuance, also requires the epplicant for suc� pertnit
to file a signed statement thei he or she Is Iicensed pursuent to the pravisions of Ihe Contractore LJcensa Lew (Chepter 9(commencing with Sectlon 7000) of Division 3 ot ihe
Business antl Professions Code) or Ihet ha or sha is exempt iherelrom entl tha 6esi5 for the elleged ezemption. Any Wolatlon ol Section 7031.5 by any ap0�icant for e permit
subjects the applicant to a civil penalry of not more ihan live huntlretl tlollars (5500).):
�� _I,-es owner of the prOperty, or my amployees with wages as their sole compensatlon, WILL DO 7HE WORK, entl ihe sWCWre Is noi intendetl or ottered tor sale (Sec.
7044, Business and Professions Code: The Coniractors License Law does not epply to an owner of propeny who buiids or improves Ihereon, and who does such work
himselt or herselt or Ihrough his or her own employees, provided thet such improvemems ere not intandad or oNeretl for snle. If, however, Ihe building ar improvement is
sold within o year ol completion, the owner-Duiltler will heve ihe burden of proving thet he or she did not build or improve lor purpose of sale.).
❑ I, as owner o ihe prOPerty, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to con5iruct the prolecl (Sec. 7044, Business end Protessions
Code: The c ir License Lew does not apply to en owner of pmpeny who bulltls or Impmves thereon, end who contracts br such projec� wlih e contredor(s)
license pursu t to I e tracrors License Laws.).
❑ I am exempt n r c. Business and Pmfessions Code tor this reason:
Sivneture: - P , . . . . . I� Data: � '� , , i
Owner ID ve s li nse. ❑ Yes ❑ No IDrivefs License No:
Venfiwtion of rship by ( e of document, i.e. - pmpeny tax �III or deed):
�� —
DIVISION OF INDUSTRIAL SAFE7Y PEAMtt CER7IFICATION:
❑ I hereby cetlify ihat no excavetion five (5) or more lee� in dep�h into which a person Is required �o descend, will be matle in connectio� with work euthonzed by this
permit, end ihat no building structure, scaHolding, falsework, or demolition or dismantling thereof, will be more than thirty-si: (36) leet high. (Chep. 32, Grp 2, Art 2, Sec.
345, Title 8, Califomia Adminisiretive Code).
❑ As owner-Duiltlar, I Will not employ anyone to do work whic� woultl require a permit fram t�e Division of Industrial Selety, as notetl above, unless such person has e
permit to do such wo�k from the diNsian.
SignaWre:
OiviSion of InduS�nal Safe�y Permit Number:
Date:
ARDOUS MATERIALS AND EMISSIONS CEp71FICA710N:
Will ihe epplicant or p�eseN or future building occupam neea to file antl certify a Business Plen br emerqency responso to release o� threatened relaese oi a hazerdous
meterial9 ❑ Yes ❑ No
(Section 25505 0l ihe Califomia Health and Sefery Code requires, with some exceptions, thet a Business Plan be filed with ihe Costa Mesa Fire Depariment by every
business which has al any one time tluring a reponed yeer a quentiry of hazartlous mateAals equel to or greater Ihan e weight of 500 pounds, or e volume o155 gallons,
or 200 cubic feet of compressed gas at siandard temperaNre end D�essure).
,_..._.._ ............._...__............................_..._..............""".........................__......................__................__......._............__........................................................... ............_......... ..__............_..............._._.....
Does or will Ihe applicenl or present or future 6uilding occupant nead to lile e registratian torm for eately hazarAous metenel99 ❑ Ves ❑ No
(Section 25533 0l the Calitomia Healih end Salery Cotle, wit� some exceptions, repuires registretion with t�e Coste Mese Fire Depanment by each business which et flny
one time has on hantl a quantity oi ecutely hazartlous meterials equal to or greater than e weight ot 500 pountls, or e volume ol 55 gellons, or 200 cubic leet of
present or tuWre building occupant neetl to prepare an RMPP (Risk
(Section 25534 ot the Califomia Health and Safety Code pmvides that the Costa Mesa Fire Department may require ihe preparetion, certifiwtion and tiling with ihe Fire
oepariment of an RMPP by 6usinesse5 which ere required to register acutely hezertlous materlels with Ihe Fire Depertment,
_. ..................................__................................................................................__.............................._......................_.........................._..........................._.............................................................._.._.........................................._................
4 If en RMPP is presenUy requireQ has Section 25534 0l tha Celilornie Health end Sefety Cade �een fulty complied with9 ❑ Ves ❑ No
....................................................._. .........................._................................._..........................._�....................._.....................__._.....................__....................................................�_........_........._.................__..................._...._.
5 Does or will the epplicent or present or future huilding occupent require br the work which Is the subjeci of Nis e plication e Pertnit for such constmction or modification
Irom Ihe South Coast A�r Quality Manegemant DisMct ar Irom eny other eir polNtlon contrW tlistdct or egencyt � Yes u No
(Section 658502 0l Ihe Celifamie Govemment Cade roquires that �he reQuested inlormetion be tumishetl on epplica�lons tor non-residential builtling pertnits).
.............._._..................""._.._..................................._..................................................._.........................._....................._..........................___................................................. ........................ _....................__..................._..................
6 Will any pert ot lhe fac��iry to he construded under Ihis permit 6e within 1000 fee� Irom �he outer boundaries of a school7 ❑ Yes ❑ No
(II'yes", the facilitv must meot ihe requiremeni ot Sections 25534 end 42303 ot the Calitornie Health antl Safery Code).
e
hava all
or egency
an metle9
t�e subject of
CERTIFICATE OF COMPLIANCE: I certify ihat untler panalry of perjury the intormetion given ahove is correct. I agree to comply with all state laws end ciry ortlinances
regartling Hazardous Materials antl Emissions.
Signature: r Data:
CER71FlCA7E OF COMPLIANCE D AUTHORVA710N.OF ENTRV: I certity under penalry ot perjury that I have read this epplication and state Ihat ihe information given is
correct. I agree to comply wilh all ete rdinences releling to building conslruction, end authorize representatives ol Ihe Ciry of Costa Mesa to emer upon �he
above-descnbed propetly for inspec ion pur e I eg e not to occupy or allow occupency ol eny building euthonzed by this permit uryiJ fip al inspection.
- J%l.1`�.b�
1 na a wne (s) !��ate_ _. �
COOE I. INSPECTIONTYPE
1676 Fiaed System Fin81 Fire Prevention
1266 Pool Spe Final
200 Final Re-Rool
201 Fina181ocWRetaining Wall
202 Final Factory Fire Place
203 FinalSign
204 Final Demolition
�_1 J11'.
j %. "f%� �
COOE I INSPECTION TYGE
206 Final Mechanical
20B Final Plumbing
210 Final Elecirical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Finel Building/Occupency
19.\I�
�
��IIIG�4'�
�
' TtpS SKECQ-I IS FOR INFORMATIONAL PURPOb'FS
ONLY. APPLIGNT LS RFSPONSfBLE FOR PROVIDING
AN ACCURA'fE RFPRFSFNI'AIION OF TF�Qt PROPERIY
QJ CaSE i}ff StiAPE AND SIZE DO NOi CORRFSPOND
YVC[H TFIE IIJFORMA170N PROVIDID ON T}fl5 Sf�f.
_`'3���i'�= '_ �'�
�:�;y �,r �.r,�T? ��i�SA
FL;�d�11?:G DI`J.
SU�r=�T TOc�uG. DEPT. R�G:
I
`��'�����
• SOLID WALLS/Fi�N�S BEIWEFN 2'fi' k 6' IN FIDGHTSHALL
BE SEIHAIX A7IiASf 30' FROM FRONT PROPERTY ISNE
• 90[� WALIS/FFNQ�S SHAI.L NO'I FX� Y 6• W Fff1GHT
WR7�J 10 OF'il¢ FRONf PROPFRTY IlNE �107 NRB LAIEj.
• VERIf•Y DStAN� FROM CVRB TO PROPFR�Y LAtE
AND 9-(OW ON PUN. VERII�7GIION FROM THE Q7Y5
INGQJEII2IIJG DIVSION S REQUIR�. GI1. (714) 754-5343
pox urFoxrtnnor�.
p1^+�'
i''d lJ ! �—
ADDIT!C��I n � �;,,�� _ �„-��r_,,,. � �,,,
'S, ,EL T,,� , ur; �..�nn_,•i��_•�I. S,.��
_.Bi �1PPn'��VFD 3Y TnE Pi_i;iJ�iiNG ui�'_iD�Y
�
R
� � asa.a
� &�
fi�
�p
-- C
�
� � Y
is set of plans
make am/ change
3 fld S r
�
�bl -IoU
CI Y OF COSTA ME:
PPROVED
�_ I
and speci,. fiqns MUST be kep� on t.^.is �05
� e st� mping of Ihis plan
• f the ialalion ot any E
,ff hese lans and partnA
� AE90EMfY Ofkl I10��'�Rd
1
I
o( �ny City of Costa
_ �i �h�
_F STREET
8
3•�S�o I
e _� ,
II!ime and � is un:a�xful to
�n irom Ihe Division of 6uiWing il
10 m�ortoMan fOV'al�' G
• Or;i ance anNor Stat la�kk �
od a id void if the 6uild ng � a
� wi� n 15J deys of iss c.�
RE$IDEMCi I
� J
I �
____________________� � /
_ _ //
BLOCK WALL LAYOUT FOR BUILDING PERMIT
PLAfVNI(VG DIVISION
TYPICAL 6�� CONCRETE BLOCK FENCE
Cement Coping Optional —
Channel8bck With 1�3/B�
Horitonlal Top ol all
f encea
For Fencef 5' or Leu
Vert. Bars 3/8"yS a� 4' �0" O.C.
For fencef Higher Than 5'
Vert. 8an 7/8"¢ at 32" O.C. �
Fill Cells $olid Wilh Groul
WAere Sleel Occurt
Rcmiorcing Steel $hall
fw>nlorm to Sec.A�15J9
A.S.T M.
qll S�eel to be Lappe<1
24" oi to Code
NATURAIGRADE
TWO 7/B"dBARS 'L'I
CONTINUOUS TOP �
6 80T TOM
HOR�ZSTEEI MUST BE T1E0IN
PLACE AT TIME O: TRENCN
INSVECTION.
a
a x
� �
u
r W
a i
> i
l > -
i �
w O
u �
Z
w n
4
��
n 'p N
o n - -
D
/-� K IDTN
p SEE CN�
I = BELOW
D
WIDTH . . 14"
THICKNESS . . . 10��
DEPfH OF EARTHTOOYH 24�
SPACING OF EARTHTOOTH i2'
FOOTING HEQUIREMENTS CFiART
5. 4.
. . . . 14" - . _ . . 12"
=10" : B"
. .20" _; - �6�,
14' � 16'
BUILDING DIVISION
GENERAL- NOTES
MORTAF: One Pn�f Plastic Cemenl, and
Three Parts Sond
GROUT: One Part Cement Tlvee an0
One Half Ports �and
COPING: One Parl Cement, T�ree
Parts Sond
CONCAETE: WlII M�xed f.2-t/2:3-i/2
Ma■ ol 7-I/2 Gallcns of
Water Per Sack ot Cemeni
GROVT MAY BE POURED FPOM THE TOV
OF TNE FENCE IN CELLS WHENE SiEEI
OCCURS.
CELlS ANO AREASOF NORIZONTAL NEIN
FORCEMENi SHALI BE CLEAR, CLEAN b
iREE Of ALL MORTAq OEBRIS, ETC.
ll Cf" C.4RTMTCOTN
V! irlE ME�GTH Of fENCE
B�IOW BO�TOM OF �OGTiNG
SCALE: I/2"= I
12
B�
12`
16'
. . ::«;ti
(714) 754-5273 • Fan (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 2440 DUKE PL
Suite:
Vicinity: HOUSE & ATTACHED GARAGE
Parcel Number: 14144137
npp�icant: BATLIK, JIRKA
Address: 2440 DUKE PL
COSTA MESA, CA
owner: BATLIK, JIRKA
Address 2440 DUKE PL
COSTA MESA, CA
Contractor: OWNER-BUILDER
Address:
Zip:
Arch :
Address:
Phone:
Zoning:
Phone: (714) 785-9502
Zip: 92626
Phone: (714)785-9502
Zip: 92626
Phone:
License: 0
Eng:
Address:
Status: ISSUED
Applied: O6/14/2001
Issued: O6/14/2007
ISSUED BY:
• '
�
, u��� ,
� /
Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF EXISTING 2-STORY SINGLE FAMILY RESIDENCE 8 ATTACHED GARAGE. TEAR OFF EXISTING ROOFING,
RESHEATH, 8 REROOF WITH COMPOSITION SHINGLES.
Plan Check: $0.00
Permit: $83.25
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $83.75
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0-0
PARKING ExiStinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0. 0
LeR 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation
Right 0- 0
Right 0-0
$3,000.00�
$3,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related
, regulations. (Ord, No. 92-28, § 1, 12-21-92)
EXPIRA710N: This permit shall automatically expire and become void it work is not commenced within 180 days, or i( work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
ta4w6lrvoo)
WORKERS' COMPENSA710N DECLARATION:
I hereby aHirm undar penalry of perjury one ot ihe following daclarations: �
❑ I have and will maintain a ceniticate of consent to seH-Insure tor workers' compensetion, as provided tor by section 3700 of the Labor Code, for ihe pertormance ot ihe
work tor which this permit is issued.
❑ I have antl will maintain workers' compensetion insurance, as requiretl by section 3700 of the Labor Code, for the peAortnance of the work for which this pertnit is issued.
My workers' compensation Insurence carner antl policy number ara:
Cerrier: Policy iJumber:
(This section need not be completed il the permit is valued et one hundred dollers ($f 00) or IessJ
❑ I certify that in Ihe performence of ihe work for which this permit is issued, I shall not employ any parson in eny manner so as to become subject to ihe workers'
compensation laws oi Calitomia, and agree that if I shoutd become subject b the workers' compensation provisions of Section 3700 ot ihe Labor Code, I shall fonhwith
comply with Ihese provisions.
Applicant SignaNre: Date:
WARNING: FAILURE TO SECUFE WORKERS' CAMPENSATION CAVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES ANO QVIL FINES UP TOONE HUNDRED
THOUSMID DOLLARE ($100,000), IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]O60F THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES.
UCENSED CONTRACTORS DECLARATION:
I hereby aNirm Ihat I am licensetl untler provisions oi Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Code, and my license is in full
force and eflect. Lic. a Class N
Contrectors Signeture: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby affirm that there is a consimction lending agency for the pedormance of the work for which ihis parmit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aftirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires e permit to constmci, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires the applicant for such pertnit
to file a signetl statement that he or she is licensed pursuani to ihe provisions of the Contrecmrs License Law (Chapter 9(commencing with Section 7000) of Division 3 ot the
Business and Professions�Code) or that he or she is exempt therefrom and the basis tor the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjecis ihe ep0licanLto a civil'penalty of not more ihan tive hundred dollars ($500).):
❑_,I,.as owner of the property�or�my employees with wages as their sole compensation, WILL DO THE WORK, and the strudure is not intendetl or ottered tor sale (Sec.
7044, Business and ProfessionsAode: The Contracbrs License Law does not apply to an owner ot property who builds or improves thereon, and who does such work
himself or herself or ihrough his o7her:own employees, provided Ihat such improvemenis are not in�ended or oNered for sale. If, however, �ha buiiding or improvement is
soltl within one year of completion,lhe owner-builder will have ihe burden o( proving that he or she tlid not build or improve for purpose of sale.).
❑ I, as owner of ihe property, am E%C�USIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolec! (Sec. 7044, Business and Professions
Code: The conirectors License Law tloes not apply to en owner of property who builtls or improves thereon, and who wniracts for such project with a contrector(s)
license pursuant to the Coniractors License Laws.).
❑ I am ezempjt �der se . ° Business end Professions Code br ihis reasore —.
Signature: = d�'�%�
`Expires_ O
Verificetion of Ownership by (type of tlocument, i.e. - property tax bill or deedj:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify Ihat no excava�ion five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by ihis
permit, and �hat no building siructure, scattolding, falsework, or demolition or dismantling thereof, will be more than ihirty-six (36) feet high. (Chap. 32, Gry 2, Ar12, Sec.
341, Title 8, Califomia Atlminisirative Cotle).
❑ As owner-builtler, I will not employ anyone to do work which would require e permit irom the Division of Industrial Safety, as noted above, unless such person has a
pertnit to do such work irom Ihe tlivision.
Signature: Date:
Division of Industrial Satety Permit Number:
CER7IPICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRY: I certify under penalry of perjury that I have read Ihis application and state that ihe information given is
correct I agree to comply with all sSate laws antl city ordinances relating �o builtling consiruction, and authorize represantatives of the City of Costa Mesa to enter upon the
above-describetl prope for ins ection purp� s. I� to occupy or allow occupancy of any building authorized by Ihis permit un�final ins�� on.
� L% �i OE /7/
SignaNre Of Legal Owner(s) �Date----�
. —� - .
And/Or Authorized Applicant Data
COOEN. INSVECTIONflPE � INTITIALS
1616 Fixed System Final Fire Prevention
1266
200
201
202
203
Pool Spa Final
Final Re-Root
Final Block/Retaining Wall
Final Factory Fire Place
Fina� Sign
204 Final Demolition
OEN INSPECTIONTYPE
20fi Final Mechanical
208 Final Plumbing
210 Finai Electrical
212 Final Fire Prevention
220 Final Planning Approval
222
250
Final Site
Final Builtling/Occupancy
DRTE INTRIALS
� t � CITY_ OF COSTA MESA .�
� BUILDING DIVIS/ON
f ' �. � DEVELOPMENT SERVICES DEPARTMENT _
� PERMIT PERMIT NUMBER
'>awico `�
(714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 926�
BUILDING PERMIT �
�obnddress. 2440 DUKEPL Status: ISSUED
Suite: Applied: 05/29/1998
Viciniry: Issued: OS/29/1998
Parcel Nunmber. 14144137
App�icant BATLIK, JIRKA
Address: 2440 DUKE PL
COSTA MESA CA
owner BATLIK, JIRKA .
Address 2440 DUKE PC
Contrector:
Address,
Arch / Eng :
Address:
Plan Check:
Permit:
Other:
Inspection:
Zoning:
Phone:
Zip: 92626
. Phone:� � . . .,
COSTA MESA CA _ _ Zip: 92626 " � � �
• , ' � `� � i-: �. ' ' � .
. . . .__ ; : ,, . . .
� . Phone�. . � .
. " Zip: ` . . , .
License" ' � ,
. r'.
' Phone: , ` . , , � _ ,
, � .Zip�. _. . - .
, ". - Licensei - - - � ' . , , . ,
SCOPE OF PERMIT
129 SQ FT SOIID-ROOF PATIO COVER (WITH 2 SKYLIGHTS) TO BE ATTD TO FRONT OF SF RESIDENCE AND SIDE OF
GARAGE. install 2 skylights icbo#393 , � �
. FEE SUMMARY
540.46 �� ' � "Calc Valuation: 5z,o�s.aa
562.25 � . Claimed Valuation: S2,000.00 �
S0 00
\
50.00
Total: $103.21
SETBACKS
MAINSTRUCTURE Front 20-0
ACCESSORY Front 0-0
PARKING Existinq 2
NOTES:
PLANNING & ZONING
Rear 0-0 Left �� 0-0 �
Rear 0- 0 Left 0- 0
Required: 0 Proposed: 0
Right 32- 6
Right 0- 0
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 this permit to be considered legal, such work must comply with all applicable codes, and all
required inspeetlona end 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 eHirm under penalry of per�ury one of the tollowing dacleretlons: �
❑ I heve and wlll mainteln e ceniticete af consent to seN-Insure tor workers' compensatlon, es provitled tor by section 3700 of ihe Labor Code, tor ihe perfomi ica of the
work for which Ihis permit Is issued.
❑ I have and will meintein workers' compensatlon insurance, es required by section 3700 of ihe Lebor Cotle, for Ihe parfortnence o� the work for which this pertnit i: issuetl.
My warkers' compensatlon Insurence certler enG policy number are:
Cartiar: Policy Number:
(Thls sectlan need not be complefed il the permlf is veluetl et one hundred dollars ($100) ar /ess.)
❑ I certity that in Ihe peAormence of the work for which this permit is issued, I shall not employ any Derson in any manner so as to become subject to the workers'
compensetlan laws ai CelHarnie, end egree that ii I should become subjecl to the workers' compensation provisions of Sedian 3700 of the Lebar Cotle, I shall forthwith
comply wlih thesa provislons. -
Applicent Signeture: Dete:
WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL ANO SHALL SU&IECT AN EMPLOVER TO CflIMINAL PENALTIES AND CIVIL FlNES UP TO IXJE HUNDRED
THOUSAN� WLLARE (§100,000), IN AODITION TO TME COST OF COMFENSATION, DAMAGES AS PROVIDEO F9R IN SECfION 3]O60F THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby atfirm thet I am Ilcensed under provisions oF Chepter 9(commencing with Section 7000) of Division 3 of ihe Business antl Professions Cotle, and my license is in full
force and e8ed. Lic. # Cless tt �
Coniractors Signeture: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aXirm that Ihere is e consiruction lending egency for the peAortnance o� ihe work tor which this permit is issued. (Sec. 3097, Civil Code).
Lender's Neme: Lenders Address:
Signeture:
Date:
OWNER-BUILDER DECLARATIONS:
i
I hereby eXirm that under penalry oi pehury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Busineu antl Professions
Coda: Any ciry or county which requires e permit to consiruct, elter, improve, demolish, or repalr eny structure, pnor to its issuence, also requires Ihe applicant for such permit
to file e slgnetl statement that he or she is Ilcensed pureuant to the proNsions of lhe Conirectors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business end Protessions Code) or thet he or she is exempt therefrom and ihe basis for Ihe alleged exemption. Any violatlon ot Sadion 7031.5 by eny applicant for a,pertnit
subjects the epplicant to e clvil penelry of not more Ihen Tive hundrad dollars ($500).):
❑ I, es owner of the property, or my employees with wages as iheir sole compansation, WILL DO T}fE WORK, entl the siructure is not intended or oHeretl for sale (Sec.
7044, Business entl Professions Cotle: The Contrectors License Ww does not epply lo en owner of property who builds or improves Ihereon, antl who does such work
himself orrr���hhherself or ihrough his or her own employees, provided that such Improvements ere not Intended or otteretl for sale. If, however, the bullding or improvement is
soltl withl�ne year of completion, ihe owner-builtler will hava the buraen oi provinq ihat he or she ditl not bulltl or improve for purpose of sale.).
❑ I, es owne of Ihe property, am EXCLUSIVELV CONTRACTNG WI7H LICENSED CONTRACTORS to cons�ruct Ihe projed (Sec. 7044, Business antl Professions
Code: The onire License Lew does not epply to en ownar ot propeny who builtls or Improves ihereon, antl who contracts for such project with a contractor(s)
Ilcense pur an o ih �ontractors Licensa Lews.).
❑ I em exE
•-�y Signeture: �
Owner ID veri
Vanticatlon of
�
Business anC Professions Code for Ihis reeson:
Dete: ' —
❑ Ves ❑ No Drivers License No. Expires:
by (rype oi dwumem, i.e. - pmperry tau bill or tleed):
DIVISION OF INDUS7WIAL SAFE7Y PERMR CERTIFICATION:
❑ I hereby certlly t�et no excavatlon five (5) ar more feet in tlept� Into which e person Is required to descenQ will be mede in connection with work autharizad by Ihis
pertnit, entl �het no huilding strudure, scettolding, felsework, or demolition or tlismantling Ihereoi, will be more then thirty-six (36) feet high. (Chap. 32, Gry 2, An 2, Sec.
341, 71t1e e, Celifomia Atlministrative Code).
❑ As owner-builder, I wlll.not employ anyone to tlo work whic� would requlre a permit from Ihe Division of IntlusMal Sefey, as noted above, unless such person has a
permit to do such work irom the division.
Signature: Data:
Division oi Industnel Safery Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF EHTRV: I certify under penalry of perjury thet I have read this application and state that the intortnation given is
correct. I egr e to comply with ell state laws end city ordinances relating to building construction, and authorize representatives ot Ihe City of Costa Mesa lo enter upon ihe
above-descn d propeCy for inspection purposes. I agree not to occupy or ellow accupancy of any building authorized by ihis pertnit until Tinal inspeclian.
cooe �.
1616 FixeA Sys m Final Flre Prevention
1266 Pool Spe Finel
200 Finel Re-Roof
207 Final Block/Reteining Wall
202 Final Fectory Fire Plece
203 Final Sign
204 Flnal Demolition
24i6d8
�-LR- 48 �"���
Date
Qd¢ �{$ j�Qp(� IXSPECTIONTYPE
206 Finel Machanical
208 Final Plumbing
210 Final Elettriwl
212 Final Fre Preven6on
220 Final Planning Apprwal
222 FinalSite
250 Final Builtling/Occupancy
��
�MPIN QFFICE
1635 WEST GAYLOf1D ST.. - P.O. 90% 90E�
LONG BEwCH 10, C/�LIFORNIA
XEMLOCI( 5-�499
SPRUCE 5-2081
�wi�ina
� ,
' August 19. 1959
Examination No.
Project
Sampie from
Architect
Contractor
Nfix
4�'ater, gal./sk. cement
Slump
Date cast
Date tes[ed
BHANCH OFFICES
83] SANTIAGO ST.. •vANTA AN•
KIMBEflLY ��E690
9"lBI9 N. ETM ST. EAST - P.O. BO% OJB
P4LMD�LE - WINDSOR'l�S011
�nc.
GUNITE
REPORT OF �R�TEST CYLINDER
c59-3809
SWIF"J�tING POOL - Hal 1•ihitacker, L�.jO jlst Me�:�port Beach, Calif.
Sa�inming Pool - 21a4.0 Duke, Costa Mesa, Calif.
7-22-59
7-29-59
Cylinder No. I
COMPRESSION TEST % Days
Total ]oad to destruction, lbs. ��,000«
Pounds per square inch �,p25
; . .
2
28 Days
��i.,G00s
�,774
Cylinder made by
Cylinder delivered by Newport �C
f
Cylinder received by q_�3_59
*Note; Low break probabiy due to inclusion of a layer qf rebound ln
,cc: Coste Mesa Bldg. Dept.
' SA Lab
Wh i tackdr TWINING LABORATORIES OF SOU'fHERN CALIFORNIA, INC.
����
/ ALL REPORiS RFE SVOMrtTE� FS !HE CONFIOENTGL PROPEFTY OF CUENTS, AIITHORIZATfON FOft PU9LIGTION OF Offfl flEPOpTS, CONCWSIONS, OR E%-
( (-. TRPCTS FflOM ON FEGAHDING THEM IS RESERVEP PENOINO OIIR WFITTEN APPROVRI AS � MVTUAL pROTECT101� TO CLIENTB, TNE PVOLIC �NO OUR9ELVE9.
Y��/ �/
a�� ai��.�5
j11�''$ DATE 11�5�E
��OWNER PtJLASKI, ROLLY H.
JOB ADDRESS 2 Duke Place BUILDING PERhiIT
GENERAL CONTRACTOA Oriner-Builder .- vni.UE g
� AP No,l 1- 1-i7 LOT TRACT FIRE ZONE 3 DESCftIPTION OF WO
INSPECTIONS Signature DATE I GROUP I TYPE V 2
� Soil Z� SUBCONTRACTOR ,,.PE
" � 20883
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 91] GOSTA IAEBA, CALIFORNIA
For Applicant to Pill' In Complefely
TYPE OR PRINT
BUILDINO
ADDRE53 O
COSTA MESA, CALIFORNIA
I OR EN'GENEER Vi)II �A H.}TIIG.Sc I N�L ��
OP BLDO9.
■ 6ETBACH LINE FPOM
EtT f U�"��� I R16HT
DESCRIPTION OF WORK
'BUILDIN6 /_.�,� � NO.OF
SIZE [�,CJ ROOMS
EXTERIOR WALL�/ , . I ROOF
' •� �,�r���� �
1 HEREBY ACKNOWLCOOB TXAT 1 HAVH RBAO TH�B APPL�CATION
AN� STNT6 THAT THE ABOVH IH CORflECT AND AOHEE TO COM.
PLY WITH ALL CITY ORDINANC6 ANO 9T�.i��l�W e0U1.�TINO
e rnOnrO peN 'qUCT10 � 1\ i/ /� �
n r �: i .
0 AUTHORIZEO AGENT
FEE ��ECEIVED
oc r a z �s�a
FINANCE DEPT.
AFRLTGA11b�7'�Sk- P�RF1R
BUILDIN6
For Office Use Only
�
FIRE
��
ol 6�/ I PLANB L I BUILDIt
\ � 1
LeOAL I ..-I- / 1 T
A. P. NO. I � � � � �L_
NOTE: NO EAVE OVERHAN6 SHALL BE LE6S THAN
90' TO SIDE @ REAR P. L
EAVE3
ALLOWE� (U.B.Q REQUIREMENTI
YAROS APPROVED YARDSAPPROVED
MAIN BUILDIN6 ACCESSORY BUILDING
[FROMGL6TREET) �t
FRONT L Ff. � PT.
�O 7 i
VAR.SF I DATE
� L(.C�U/� w �o ,
� 3�0 54. �.
THE AMOUNT BHOWN UNOHq VALUATION 19 pOfl TNE
PURPOBH OP EBTABLIBf�INO N PEflMIT PHE ONLY.
VAW TION
PERMIT FEE e3 ��
$�360, � � , c�
�/ DO
�Pa � � 1960
OWNER ANTHONY� JOHN
JOB ADDRESS 2LL0 Duke Street
7-16-59
GENERAL CONTRACTOR P0019 bY Whitaker VALUE $ 3:000,0�
INSPEGTIONS eb�( jµ-07� n E � GROUP TYPE ZONE
U�dergroUnd ^ :G. Water �I I pERMIT5155U1
SUBCONTRACTOR
.' 4 � ' 5+90�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 317 COSTA MESA. CALIFORNIA
fOR APPC/CANT TO F/LC /N COMPLETELY
TYPE OR PRINT
BUILDING
ADDRE55 D I � �
COSTA MESA. CALIFORNIA
OWNER V!� H I�� A i7I�W O N 1 I
QTY —�- NC
ARCHITECT LIC
OR ENGINEER �L � p/ NC
ADDRESS / � � • I �' / V �I'6
ADDRESST�o J S
�«ao,e_,�v I N°T G 3 I A,
flf'IC
SIZE rvo. ov e�oce.
OF LOT NOW ON LOT
USE OF
E%ISTING BLOG.
SETBACK IINE FPOM
CENTER OF STHEET REAR YARD
SIDE YARD ILEFT IRIGHT
DESCRIPTION OF WORK
REPAIR I IIMOVING I
S ZIE D' (G X� 7 X �ROOMS
EXTEHIOR WALL IROOF
COVERING COVERIN
U9E OF BUILDING AND WORK TO BE
I HEftEBY ACKNOWLEDGE TNAT I HAVE READ THIS APPLICATION
AND 6TATE THAT THE ABOVE I6 COR AND AGREE TO COM-
PLY WITH ALL CITY OROINANCES AN 5 TE LAW REGULATING
eUILOING CONBiR C ON.
SIGNATUREO � �L'�' —� /r
PERMITfEE V
AGENT
�
,=EE �ECti!!EG
'7_ /.5 -,5'�'f �/ l.�-
FINANCE DEPT.
CIiY OF COSTA PflESA
APPLICATION FOR PERMIT
BUILDING
FOR Off/CE USE ONLY
I RECEIPT NO. I P�R(AIT
Y
YVEO BY D TE RECEIVED OATE I8:
. . �_ic--C -� _//
COSTA MESA. CALIFORNIA
RE
APPROVED�A�� 1
BV � f,J DATE /
T
ZONING
ZONE NO. OF q USE OF NEW
p, PLFN6 1 BUILDING
� 7
APPROVEp /� r1./, . OATE ,
BY l/[/ l7
YARDS EVES
REqIJIRED ALLOWED
ICENTER LINE BT.) � �
TNE AMOIINT SHOWN UNOER VALUATION �8 FOfl TXE
PURPOBE OF ESTA9LISMING A PERMIT FEE ONLY.
VALUATION
PERMIT FEE $ `�J ( —
S ���U(Jr PLANGMECK $ y /'
TOTAL FEE 8 J / -
owNER Colwnbia Homes, Inc. uA't'E $-29-58
---- -- - - —
]OB ADDRPSS 2�i0 A�11ce Pl. ' BUILDING PERMIT NO. 7�V0%
GENERALCONTRACTOR Dike & Colearove� Inc. VALIIE$ 16,168.00
AP. No. ___ LOT 6� TRACT 2954 FIRE ZONE DESCRIPTION OF WORK ReS. W�att. garage
and
coat
Final
Final Gas Test
� �,��r;..� �
I & J TypE
PLAN NO.
DATE � gUBCONTRACTOR I
�`�_ DATE NUMBER
. .
. 4 - '7��7
<-
COSTA MESA BUILDING DEPARTMENT
P. O. BOX 31]
COSTA MESA. CALIFORNIA
BUILDING
ADORE55
FOR APPLICANT TO FILL IN •
yV LLLlCC rydl:C
COSTA MESA. CALIFORNIA
OWNER �+��-1$lt%18HORIE$� IS1C•
ADDRE55 �g F+• 1/yh St• �
QTY C�$ta TSesa, Calif• NO.++-�•
ARCHITECT CITZSOSI FL ����
OF ENGINEER1L;.l,it..t......1. NO.
ADDRE55
LEGAL L
OESCRIpT1pN N
A.P. NO.
g,�^lrpi �C. CITV
b '�
E. 17th St.
BLOCK
s'=E 74 x 142
OF LOT
.� ' V a. u J re
:iG� 27 1958
• -��- ��-�
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
�%/�.� .l X ���1] L
COSTA MESA. CALIFORNIA
FIRE
ZONE
ZON
Li . 6—ll59 BYPROVED
NO.OF BLOGS.
NOW ON LOT none
CORRECTIONS
USE OF
E%ISTING BLOG.
SETBACK LINE FROM n
ccNrcn or sin[[r SQ� REAR YARD GO�
SIDEYARO RIGHT2O� LEFT 1S�
DESCRIPTION OF WORK
NEW X ALTERATION ADOITION
REPAIR MOVING DEMOLISH
S�ZELDING 1LO1 S •S�t. ROOMS 6 STORIES 1
V
COVERINGWALL St.UCCO COV�ERING comp•
USE OF NEW c� �
BUI�DING �]ZjIP e es'.d C
with attached doublA garage.
P1an750D
� MEREBV ACNNOWLE�GE THAT 1 H1VE PE.�O TMIS APPLIC�TION 1Np �
STwTE TNnT THE wBOVE IS CONNECT I.NO �GREE TO COMPLY WITN wLL
CITY ONOINnNCES AND $T L�WB REGUL.�TING BUILDING CONSiRUC�
nOrv. VALUATION [f
SIGNATURE OF PERMIT FEE S 3p�OO
PERMITTEE
, S 16,166��0 PLAN CHECN 5 19�0�
AUTHORIZEO AGENT D1IC@ FC COI.P.�TOVO� II1C• TOTAL FEE $ S7�OO
v��
n