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Home My WebLink About2441 ELDEN AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 1ob Address: 2441 ELDEN AV Suite No Vicinity: UNIT D Parcel Nunmber: 43928137 Applicant BLYLEVEN, PAM Addrass: 7130 W DEWEY DR ANAHEIM,CA PLUMBING PERMIT Phone: 714.750.5461 Zip: 92802 Owner: DECINCES, DOUGLAS AND KRISTI Address 12 STRAWBERRY FARMS ROAD IRVWE, CA Contractor: BLYLEVEN'S PLUMBING INC Address: 1130 W DEWEY DR Arch / Eng : Address: ISSUE FEE Backflow irrigatlOn BackFlow Preventer Bathtub Clarifier System Connect Qce,Sotla,elc) Dental Units Dishwasher Drain, Floor ANAHEIM,CA Phone: 949.417.4280 Zip: 92612 Phone: 714-750-5461 2ip: 92802 License: 761484 Phone: Zip: License: Status: ISSUED Applied: 04/29/2004 Issued: 04/29/2004 ISSUED BY: SCOPE OF PERMIT BLDG'D NEW 2.712 S.F. S.F.D. WITH 433 S.F. ATTACHED GARAGE. 3 BATHTUBS, 1 ICE CONNECT, 1 DISHWASHER; 1 GAS OUTLET 7-0, 1 GAS OUTLET OVER 5, 1 GAS SERVICE, 1 LAUNDRY TUB/WASHER, 4 SHOWERS, 7 KITCHEN SINK, 2 SERVICE/MOP SINKS, 3 WASH BASINS, 1 WASH BASIN SET, 3 WATER CLOSETS, 7 WATER HEATERNENT REF: 803-02094 - AMT $23.50 $0.00 $0.00 $29.40 $0.00 $9.80 $O.OD $9.80 $0.00 FEE SUMMARY QTY AMT Laundry Tub / Washer $9.80 0 Landscape Irrigation 50.00 0 P-Trap $0.00 3 Pressure Regulator 50.00 0 Process Piping (per 10 ft) $0.00 1 Receptors $0.00 0 Septic Tank $0.00 t Sewer Cap for Demo $0.00 0 Sewer Connect $0.00 QTY 1 0 0 0 0 0 0 0 0 SumpPump Swimming Pool Trap Primer Unnal Vacuum Brkr Bkflow(t-4) Vatuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System AMT $0.00 $0.00 $0.00 $0.00 $0.00 30.00 $29.40 $9.80 $0.00 QTY 0 0 0 0 0 0 3 1 ' 0 NOTtCE: The work authonzed by this permit shall comply with aft appiicable handicap access requirements under Cafifornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe ezpiration oi this permit. FOR INSPECTIONS CALL: (714) 754-5626 2dd6d6 (fY00J WORKERS' COMPENSA710N DECLARATION: I hareby afflrm under penalry ot perjury one of I�e followinq declara�ions: ❑ I heve entl wlll maintaln a cenificate of consent to self-Insure for workers' compensetlon, as provided for by section 3700 of the Labor Cotle, tor iha pedormance ot the work for whiCh Ihis pertnit is i55uetl. ❑ I heva entl wlll maimain workers' compensetlon Insurence, as required by sectlon 3700 of the Labor Code, for the pertormance of the work for which this pertnit is Issued. My warkers' compensa[ion Insurance cerder antl policy number ere: Cerner: Policy Numbec ��(yyThls sectlan need not be campleted i/ the peimlt is velued et ane hundred tlollars ($f 00) or less.) � y� I cenify that in the perfortnance at the work tor which Ihis pertnit is issue0, I shall not emplay any person in any menner sa es to become subject to ihe workers' �' compensetlon laws oi Calitomla, anE egree that If I should become sub�ect lo the workere' compansation provisions ol SecOon 3700 oi the Labor Cotle, I shall lorthwith comply with Ihes i ns. � n � Applicent Signeture: ��'Uu�� L_Q�l)-C.-�--- Dete: y��-� I G WMNINO:FAILURETOSECUREWORNERS'COMPENSA COVERAGEISUNIAWFULANDSMALLSU&IECiANEMPLOVERTOCRIMINALPENALTIESANDCNILFlNESUPTOONEHUNORED THOUSAND DOLURE (5100,000), IN ADDITION TO THE C0.5T OF COA9PENSATION, �AMAGES AS PROVIDED FOR IN SECTION �Ofi OF THE L4BOR CODE, INiEREST, AND NTTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I �ereby aHirtn that I am licensed untler pmvls ns ol Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business end Professions Code, anC my license Is in lull lorce and ettect Lic. N �-iP IU �6� Cless N � Contractofs SigneNre: ��-�. 9.J.J-2iu-- Date: 6 cf CONSTRUCTON LENDING AGENCY: ❑ I hereby aHirm that ihere is a consiruction lending agency tor the peAormance ol the work for which ihis permit is issued. (Sec. 3097, Civil Cotle). Lentle/s Neme: Lentler's Atltlress: SignaWre: Date: OWNER-BUILDER DECLARATIONS: I hereby affirtn thet under penalry of perjury thet I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW far ihe tollowing reeson (Sec. 7031.5, Buslness antl Professlons Code: Any city or county which reQuires e permit to constmct, aiter, improve, demolish, or repeir eny stmcture, prior to its issuence, also requires the applicant tor suc� permit lo ille a 51gneC statement thet he or she Is Ilcensed pursuent to the provisions of the Conirectors License Law (Chepter 9(commencing with Section 7000) ot Dlvislon 3 ai the Business end Professions Code) or that he or she is exempt therefmm and the basis tor the ellegad e:emption. Any Wolation ol Section 7031.5 by eny epplicant for a parmit subjects the applicant to e civil penalry of not more Ihen tiva huntlred aollars ($500).): ❑ i, as owner at Ihe pmperty, or my employees with wages as their sola compensatlon, WILL DO 7HE WORK, and Ihe swcture is not intended or oNeretl tor sele (Sec. 7044, Business and Pmfessions Code: The Contracbrs License Law tloes not appty to en owner ot properry who builds or improves Ihereon, and who does such work himself or harsalf or Ihrough his or her own employees, provided that such impravements are not In�ended or offered tor sale. If, however, the building or improvemen� Is sold within one year of completion, the owner�builder will have ihe burden ol proving that he or she did not build or improve for purposa ot sale.j. ' ❑ I, es owner at the pwperty, em EXCLUSIVELY CONTRACTING WITF1 LICENSED CONTRACTORS to construct tha project (Sec. 7044, Business and Professions Gode: Tha conirectors License Law does not epply to en owner ot propeny w�o bulitls or Improves thereon, antl who contracis for such pmject wiih a conirector(s) license pursuent to the Comractors License Lews.). ❑ I am exempt untler sec. Business and Pmfessions Cotle for ihis reason: Signature: Date: Owner ID verifietl by dnvers license. Ves ❑ No Driver's License No. Venficetion ol Ownership by (rype of documen6 i.e. � property tax bill or deedJ: DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICA710N: E:pires: ❑ I hereby cetlity thet no excavetion five (5) or more feet in depth into which a person is required to descenq will be mede in connection with work authonzed by this pertnit, and ihat no building slrucNre, scaHolding, talsework, or demoli�ion or dismantling ihereof, will ba more �han thirty-six (36) tee� high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ttle 8, Celifomla Administrative Code). ❑ As awner-builder, I will not employ enyone lo do wark which wauld require e permit from the Division al Industriel Sefery, as notetl above, unless such persan hes e pertnit to do such work from Ihe division. Signature: �ate: Divislon of Indusirial Satary Permit Number. CERTIFlCATE OF COMPUANCE AND AUTHORIZA710N OF ENTRY: I certity under penalry of peryury that I hava read this application end state ihat the Informetion given is correct. I egree to wmply with ell state lews entl ciry ordinances releting to bulltling construction, and euthoAze represenlatives ot ihe Clry of Cos�a Mesa Io en�er upon the ebove-descnbed property for inspection Ourposes. I egree not to acupy or allow occupency ot eny building authorized Dy Ihis pertnit until final inspection. GO�E �. INSPECTIOHTYPE 1616 Fixed System Finel Fire Prevention 1266 Pool Spe Final 200 Finel Re�Roof 201 Flnel BIocWRetaining Well 202 Final Faciory Fira Place 203 Finel Sign 204 Finel Demolition �{ /�-9 a% �I �ate Qejf, � f�f� INSPECTIONTYPE 206 Final Mechenicel 20B Final Plumbing 210 Final Elecirical 212 Final Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final Building�Occupancy PeIE II�ELfl -f-'�— '¢7t� Job Address: Suite No Vicinity: 2441 ELDEN AV D Parcel Number: 43928137 Applicant: Address: Owner: Address: Contractor: Address: DECINCES,TIM 12 STRAWBERRY FARMS ROAD IRVINE, CA MECHANICAL PERMIT Phone: 949.417.4280 2ip: 92612 DECINCES, DOUGLAS AND KRISTI 12 STRAWBHRRY FARMS ROAD IRVINE, CA OWNER-BUILDER Phone: 949.417.4280 Zip: 92612 Phone: Zip: License: 000000 Status: ISSUED Applied: OB/23/2004 Issued: 08/23/2004 . - .��..� � SCOPE OF PERMIT MECHANICAL TO INCLUDE: 1 INST FAU < 100K BTU, 1 REPA�R/ALT COOLING/HEAT, 1 FACTORY FIREPLACE, 1 HOOD W/MECH EXHAUST AND 3 VENT FANS. UNIT D REF.: B03-02094 ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair / Alt CoolingMeat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Faclory Fireplace Hood w/Mech Exhaust VAV BOx Vent Fan / Single Ducl Appliance Fire Dampers Smoke Dampers ' Inst or Relocate Appl Vent Air Handlers < 10000cfm , Air Handlers > 10000c(m Floor Fumace Floor or Suspend Heater $23.50 $14.80 $0.00 $73.70 $0.00 $0.00 $0.00 $0.00 $10.65 $10.65 so.00 $21.75 $0.00 $0.00 $0.00 $0.00 $D.00 $0.00 $0.00 30.00 Quantity FEE SUMMARY Repair / Alt Absorbtion Unil Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler . Commerciallncinerator - Domestic Incineralor - Compressors / Absorption Svstems Upto3hp/t00kBTU 3 To 15 hp /� 500 k BTU � 15 To 30 hp (1,000 k BTU , 30 To 50 hp / 1,750 k BTU - Over 50 hp / Over 1,750 BTU Boilers . � , Upto3hp " - . ' 3To15hp � , � 15to30hp 30 to 50 hp . , , Over 50 hp Other Mechanical Fee ' - Investlgation Fee Plan Check Fee - ' Reinspectlon Fee � � � Quantity $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 . 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 ao.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $95.05 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) � EXPIRATION: This permit shall automatically expire and become void it work Is not commenced within 780 days, or if work is suspended or abendoned for a panod of 1 BO days. // INSPECTIONS: In order for the work authorized under Ihis permit to be considered legal, such work must comply with all applicable�codes, and all required Inspactions end final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of'this permit. FOR INSPECTIONS CALL: (714) 7545626 2646d8 (N00) WORKERS'COMPENSATON DECLAPAnON: I hereby aHirtn untler penalry of perjury one of ihe following declaratlons: ❑ I heve and wlil maintein e cenificete of consent to sell-Insure lor workers' campensatlon, es provided for by section 3700 at the Labor Code, lar t�e pedortnence of Ihe work �or which Ihis pertnit Is issued. ❑ I heve end wlll meintain workers' compensation Insurance, as requlretl 6y section 3700 of ihe Lebor Coae, for the performence of the work for which this permit Is Issued. My workere' compensation Insurance carner entl policy number ere: Cerder: (Thls sectlon need nof be completetl veluetl et one hundred dollers ($f00) or less.) Policy Number: �I certity t�et In the peAortnence of ihe work for which this pertnit is issuetl, I shall no� employ eny parson in eny menner so es to become subject to the workers' compensatlon laws of Celifomia, end eqree that it I shoul0 become sub�ect to the workers' compensatlon proNsions ol SecHon 3700 of the Labor Cotle, I shall torthwith comply wit� t�ese proNsionTs. p Applicnnt SlgneNre: �--� �. J � � Dete: / � % �� WARNINO: FAI�URE TO SECURE W ERS PE ION COVEM6E IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED TF10USrWD DOLLARE (5100,000), IN ADDITION TO THE 00.5T OF COMPENSATION, DPM4GE5 AS PHOVIDE� FOR IN SECTION 3108OF TNE LABOR CODE, IMEREST, AN� ATTOf WEV'S FEES. UCENSED CONTRACTORS DECLARATION: I �ereby eHirm thet I em licensed under Dmvisions of Chapter 9(commencing with Section 7000) ot DiWsion 3 of the Businass antl Pmtessions Code, and my license is in full force ond eHecL Lic. a Class p ConlrectoYs Signeture: Date: i CONSTRUCTION IENDING AGENCY: ❑ I heraby eHirm ihet there is a consiruction lending agency for the pedormance oi lhe work tor which ihis permit is issued. (Sec. 3097, Civil Code). Lender's Neme: Lender's Address: i SigneWre: Date: ' OWNER-BUILDER DECLARATIONS: I hereby ettirtn ihat under penalry oi perjury ihal I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business flntl Professions Code: Any ciry or counry whic� requires e pertnit to construd, elter, Imprave, tlemolish, or repair any strucWre, pdor to its issuanca, also requires the applicant for such pertnit to lile a signetl stetement thet he or she Is licensed pursuant to the D�oNsions of the Conirectars Licsnse Lew (Chepter 9(commencing with Section 7000) ot DlNsion 3 ot Ue Business antl Professions Code) or ihet he or sha is a:empt t�ereiram end Ihe basis tor the elleged e:emption. Any vialatlon oi Section 7031.5 by any eppllcenl for e pertnit sub�ects the appllcent to e clvll penalry of not more ihan live hundred dollars ($500).): ❑ I, es owner of ihe properry, or my employees with wages as their sole wmpensetion, WILL DO 7HE WORK, and Ihe siructure is not IntendeC or ottered tor sele (Sec. 7044, Business and Professions Cotle: 7Te Contractors License Law tloes not appy to an owner ot pmperry who builds or improves thereon, and who does such work himself or herseN or through his or her own employees, provided Ihat such Improvements are not Intended or oflered for sele. If, however, ihe building or Improvement is sold within one year ol completion, the owner-builder will have the burden ot proving i�at he or she did not build or improve tor purpose of sale.). ' �I, as owner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consirucf Ihe pro�ecl (Sec. 70a4, Business end Professions Code: The contrectors License Law does noi epply to en owner ol property who bullds or improves Ihereon, entl who coniracts for such projact wllh e cOntraclar(s) license pursuent to ihe Coniractors Ucense Lews.). ❑ I em exempt untler se Signatura: � Owner ID veritiad by dnvers Ilcense. Vedflcellon ot Ownership by (type Busine5s end Professions Code fOr this reeson: T- Date: - Z - OU ❑ No orivers License No. Expires: �"I -% .L-04 property tex bill ar tleetl): DIVISION OF INDUSTRIAL SAFETY PERaIR CERTFICATION: ❑ I hereby cetlity �het no excavation tive (5) or more teet in tlep�h Into which a person Is required to descend, wlll be made in wnnection with work authorized by ihls permit, and I�et no building structura, scaXolding, falsework, or tlemolitlon or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle B, Califomia Adminisirative Code). ❑ As ownerbuilder, I will not employ enyone to tlo work whic� woultl requlre a permit trom the Division ot Indusirial Salety, es notetl ebove, unless such person hes e permit �o do such work from ihe division. SignuWra: Date: Divislon of Indusirial Satery Permit Number. CERTIFlCATE OF COMPl1ANCE AND AUTHORIZATON OF ENTAV: I certify under penalry of perjury ihat I have read ihis application and state ihet ihe intormation given is correct. I egree to comply with all state laws end cily ordlnances relating to building consiruction, antl euthonze representetives of the Ciry ot Coste Mesa to enter upon tha above-tlescribed properry tor in n purposes. I egree not to acupy or allow occupancy of any 6uilding authorized by this permit until (inal inspection. ��Or 9-23—��c Sign'd�ure galOwner(s) Date AnNOr Authonzed Applicent CDDE t. INSFECTONTYPE 1616 Fi:etl System Finel Fire Prevention 7266 Pool Spa Finel 200 Finel FB-ROof 207 Final Block/Retaining Wall 202 203 Final Feciory Fire Place Final Sign 206 Final Demolition P9IE INTRIALS GODE♦ INSPECTIONTYPE 206 Final Mechanical 20B Finel Plumbing 210 Finel Elecldcal 272 Finel Fire Prevention 220 Final Planning Approval 222 FinalSite 250 Final Builtling/Occupancy o�re ix*�m, �y� f�(� �i� (714) 754-5273 • Fa�c {714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT ,lob nddress: 2441 ELDEN AV Suite: D Viciniry: Parcel Number: 43928137 Zoning: Applicant: EDGARDO J. GELSANO Address: 20351 IRVINE AV SUITE 1C Phone: 714-641-1505 SANTA ANA, CA Zip: 92707 Owner: DECINCES, DOUGLAS AND KRISTI Address 12 STRAWBERRY FARMS ROAD IRVINE, CA Contractor: O W N E R-B U I LD E R Address: Zip: Arch : Address: Phone: Phone: 949.417.4280 Zip: 92612 Phone: License: 000000 Eng: Address: ISSUED BY: Sfatus: ISSUED Applied: 12/04/2003 Issued: 04/22/2004 Phone: Zip: License: License: SCOPE OF PERMIT LOT 4 UNIT D PLqN 2 ' NEW 2,712 S.F. S.F.D. WITH 473 S.F. ATTACHED GARAGE. WORK TO INCLUDE: 1 ST STORY (1,297 S.F.) AND 2ND STORY (1,415 S.F.), 3 BEDROOMS ANq 3 BATHS. ALSO INCLUDES 114SF FRONT PORCH. REF.: 603-02096/2097/2098 AND G03-00021, PA-03-08, PM-03-243 Plan Check: $1,242.90 Permit: $1,912.15 SMIP Res: $26.39 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $3,181.44 SETBACKS MAINSTRUCTURE Front 33-0 ACCESSORY Fronl 0- 0 PARKING Existin : 0 Rear 20- 0 Rear 0- 0 Re uired: 4 FEE SUMMARY PLANNING & ZONING Left S 0 Lek 0- 0 Pr000sed: 4 Calc Valuation: Claim Valuation: Righl 26- 0 Right 0- 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirer regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically explre and become void if work is not commenced within 180 for a period of 180 days. INSPECTIONS: In orqer for the work authorized under this permit to be considered legal, such work u required inspections end flnal epproval must be obtained. Failure to obtain inspections and tinal appr al FOR INSPECTIONS CqLL: (714) 754-5626 2666d6 (fiN0) $263,920.38 so.00 Califomia statutes and related or if work is suspended or abandonetl st comply with all applicable codes, and all will result in the expiration of Ihis permit. WORKERS'COMPENSATION DECLARAnON: I hereby affirm untler penalty�i perjury`flne of the following declarations: •r- ❑ I have end will maintein e cenilicate at consent to self-Insure lor workers' campenseHon, es provided for by section 3700 of ihe Le6or Code, for the peAortnence oi the work tor which Ihis permit Is issued. ❑ I have and vnll meintain workers' compensation insurance, as required 6y sectlon 3700 0l the Lebor Code, for the peAortnance of ihe work br whic� ihis pertnii is issuetl. My workers' compensatlon'Insurance cerner end policy number are: Carrier: Policy Number. (lhis soction neetl nol be cromp/efe4ll [he permit !s velued at ane hundred dollars (5/00) or /ess.J � ❑ I certity that in Ihe peAormenca of the work for which this pertnit is Issueq I shell not employ any pereon in any manner so es to become subject to the workers' compensation lews of Califomia, end agree that if I should become subject to Ihe workers'rnmpensation provisions of Section 3700 of the Lebor Cotle, I shall forthwith camply with these provisians. Applicant SigneWre: Dete: WMNING: FAILURE TO SECUFE WORKERS' COMPENSATION WVEM6E IS UNLAW FUL AND SHAL� SUBJECT AN EMPLOYER TO CRIMINPL PENALTIES AND CML FlNES UP TO ONE HUNDRED TMOUSNJD OOLLAFE (E100.OW), IN ADOITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3IO60F THE LABOR CODE, INTEREST, AND ATTOPNEI"5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby atfirtn ihat I am licensed undar provisions ot Chapter 9(commencing with Saction 7000) of Division 3 of ihe Business and Profeuions CoAe, arC my license Is In full tarce end ettect. Llc. x Cless x ContractoYs Slgnature: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby ettirm thet there is e consWClion lending agency br ihe pedormence ot the work for which ihis permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lentlefs Atltlress: Signetura: Date: OWNER-BUILDER DECLARATIONS: I herehy eNirm �hat untler penalry of perjury that I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for lhe tollowing reason (Sec. 7031.5, Busineu end Professions Cotle: Any ciry or county which requires a pertnit to conswct alter, improve, tlemolish, or repair eny strucWre, pnor to its iuuance, elso requires the eppliwnt tor such pertnit to file a 51gneA statement that �e or she is Ilcensetl pursuent to tha proNsions oi ihe Conirectors Llcense Law (Chapter 9(commencing with Secllon 7000) of DiWSion 3 ot the Business and Protessions Code) or that he ar she is exempt therefrom entl the Desis for the alleged exemption. Any violation of Section 7031.5 Dy any epplicant for a pertnit subjects the epplicant to e civll penalry of no1 more than tive hundred dollers (5500)J: ❑ I, as owner of Ihe propeny, or my employees with wages es Iheir sole compensatlon, WILL DO TME WORK, and t�e s�ructure Is not Intentletl or oNerad for sale (Sec. 7044, Business end Prolessions Code: The Contraciors License Lew does not apply to an owner ol property who builds or improves thereon, entl who does such work �imsell or herself or through his or her own employees, provlded ihat such improvements are not Intended ar oHeretl for sale. N, howave�, iha 6ullding or improvemeni is �sold within ona year ol completion, the ownerbuilder will have the burden oi proving ihat ha or she did not build or improve for purpose ot sale.). ' I, as owner al Ihe property, am EXCLUSIVELV CONTRACTING WIIH LICENSED CON7RACTORS to consiruct the project (SecJ044, Business and Pmtessions Cotle: The contreaors Ucense Law does not epply to en owner of propeny who bullds or Improves ihereon, and who contracts for such project with a conirector(s) license pursuent t0 the Conirectors LiCen58 Laws.). Bu5ine55 end Prolessians Coda for thi5 ree5on: � ID verilied by'dri�license. � ❑ No VeriFlcetlon ot Ownership by (type ot document, i.e. - property tax bill ar daed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation fve (5) or more feat in Depth into which e person Is required to descend, will 6e made In connection with work euthodzed by this permit, entl that no building siructure, scattolding, felsawork, or demolition or dismentling ihereof, will be more ihan thirty-sis (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title B, Celifornia Administrative Code). ❑ As owner-Duiltler, I will not employ anyone to do work which would require e permit from the Division ot Indusirial Safery, es notea ebove, unless such person hes e pertnit to do such work Irom the division. Signeture: Date: Divislon oi Indusinal Safery Permit Number: CEFiT1FICATE OF COMPLIANCE AND AUTMORIZATION OF ENTRV: I ceniy undar penelty of perjury ihat I have reatl Ihis epplication and stete ihat the intormation given is correct I agrae to comply with all state laws and ciry ordinances releting to building construction, entl euthorize representatives ot the Ciry ol Coste Mesa to enter upon the ebove-described property for inspection purposes. I egree not to occupy or ailow occupency ot eny building authonzed by this permit until finel inspection. COUE �, INSPECTOHTYPE 1616 Fized System Final Fire Prevention 1266 Paol Spa Finel � 200 Finel RaRooi 20t Finel Blak/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Finel Demolition P4IE UiiID�SS COOE1 INSGECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final EleC�riCal 212 Final Fire Prevenlion 220 Final Planning Approval 222 Final Site 250 Final BuildinryOccupanq ' -0� z-ze-ar .mi_ (714) 754-5273 • Fan (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Viciniry: Parcel Nunmber: Applicant: Address: Owner: Address 2441 ELDEN AV D CSkY.I:3K�/ DECINCES,TIM 12 STRQWBERRY FARMS ROAD IRVINE, CA ELECTRICAL PERMIT ISSUED BY: Phone: 949.417.4280 Zip: 92612 DECINCES, DOUGLAS AND KRISTI 12 STRAWBERRY FARMS ROAD IRVINE, CA C o n tra cto r. O W N E R-B U I L D E R Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) . Pool / Spa � � Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a � Service to 1000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Phone: 949.417.4280 Zip: 92612 Phone: Zip: License: 000000 , SCOPE OF PERMIT ELECTRICAL TO INCLUDE: 2712 S.F. NEW S.F.D., 6 LIGHT FIXTURES, 4 OUTLETS AND 2 SWITCHES. REF.: B03-02098 UNIT D $23.50 $0.00 ( $0.00 ' $151.87 ' $0.00 $0.00 $6.60 $4.40 $2.20 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0:00 $0.00 $0.00 $0.00 Quantity 2712 0 0 6 4 2 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway /100 ft Standing Seclion Misc Electncal Equipment Transformers up l0 1 kva/kw , .� '-' .............:..up to 10 kva/kw .................up to SO.kva/kw ............_...up to 100 kvalkw _ ..................over 100 kva/kw Low Voltage Equipment Low Volt Winng System / Ckt � Misa Conduit � . ' . Misa Conductor . , Circus ( gen ar nde) Circus (mech nde or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Imestigation Fee - - Plan Check Fee Reinspection Fee Status: ISSUED Applied: 08/23/2004 Issued: 08/23/2004 Quantity $0.00 0 $0.00 0' $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 . 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 , 50.00 0" � $0.00 'A� $0.00 "; ' 0 $0.00' 0 $0.00 $0.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-92) �" i EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspenGed or abandoned for a period of 180 days. �: ,� INSPEC710NS: In order for Ihe work authorized under this permit to be considered legal, such work must comply with al pplicable codes, and all required Inapeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2406-98IN00) WORKEAS'COMPENSATON DECLARArON: ' I hereby aflirtn under penalry of perjury one ot ihe following declarations: ❑ I heve end will melntein a cartlficate oi consent to self�lnsure for workers' compensatlon, es Drovided tor by section 3700 of the Lebor Code, tor the pedormence of Ihe work for which this parmit Is issued. ❑ I have end will maintain workers' compensation insuranca, as requirea 6y section 3700 of ihe Labor Code, for the pertortnance oi the work for which this permit is Issued. My workers' compensation Insurance carner end policy number ere: Carner. Policy Number. (Thls section need not be compleled il the permit is valued et one hundred dollars ($100) ar less.) �FK—I certily thet in Ihe performance of ihe work for which this permit is issued, I shall not employ any person in any manner so as to become subject ro the workers' � compensation laws ot Calitomia, and egree that If I should bacome subject b the workers' compensation provisions oi Section 3700 of the Labor Coda, I s�all forthwith comply wit� Ihesa provisions. �� // AppllcantSlgnature: �`�lf� Date: �—ZZ-b V' WARNIN(1: FAILURE TO SECURE WORKERS' PEN ION WVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED THOUSAND DOLIARE ($100,000). �N AODITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECiION 3]O6 OF THE IABOR CODE, INTEREST, AND ATTOFW EY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions oi Chapter 9(commencing with Section 7000) of Division 3 of the Business and Protessions Code, and my license is in full forCe antl BttecL Lic. N Cless # Coniractors Si9nature: Dete: CONSTPUC710N LENDING AGENCY: ❑ I hereby aHirtn ihat ihere is a consiruction lending agency tor the peAormance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: . __ __ Lendefs Address: Signature: OWNER•BUILDER OECLAHATIONS: Da�e: I hereby eNirm iha� under penalty of perjury ihet I am EXEMPT FHOM THE CONTHACTORS IICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business and Professlons Code: Any ciry or county which requires a permit to construct, alter, improve, demolish, or repeir any sWCNre, pnor to its issuance, also requires the applicant tor such pertnit to lile e signed stetement that he or she is Ilcensed pursuant to ihe provisions ot the Gontractors License Law (Chapter 9(commencing with SecUon 7000) of Division 3 oi the Businoss and Professions Code) or thai he or she is exempt tharefrom and the besis for ihe elleged exemption. Any violetion of Section 7031.5 by any applicant for a pertn% subjects the epplicant to e civil penalty of not more then tive hundratl dollers ($500).): ❑ I, as owner ot ihe property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, end Ihe structure is not intentletl or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves ihereon, anC who does such work himseN or herself or through his or her own employees, provided thet such improvements are not Intendetl or ottered for sale. If, however, the building or improvement is �sold within one year ot comp�etion, the owner-builder will heve the burden of proving that he or she tlid not build or improve for purpose of sale.). ' I, as owner of ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to con5truct the project (Sec. 7044, Busines5 and Professions Code: The comracbrs License Law does not apply to an ownar of propeny who builds or improves thereon, antl who contrads for such project with e contractor(s) license pursuant to ihe Contractors License Laws.). ❑ I am e:empt undar sec. �Signeture: � Owner ID verified 6y driver's license. Venfication of Ownership by (type of _ eusiness and Professions Cotle tor this reason: Date: - 2 - o ❑ No Driver's License Na � Expires: y- Z6 -v � properry tex bill or deetl): DIVISION OF INDUSTRIAL SAFETV PEi�.71T CERTIFICATION: � ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authonzed by Ihis parmit, and Ihat no building siructure, scaifolding, falsework, or demolition or dismantling ihereof, will be more than ihirry-six (36) feet high. (Chap. 3.2, Gry 2, Art 2, Sec. 341, Tltle B, Califomia Adminisirative Cotle). ❑ As owner-builder, I will not employ enyone to tlo work which woultl require a pertnit from the Division ol Indusirial Safery, es notetl above, unless such person has e permit to do such wark from ihe division. Signature: Date: Division of Industnal Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORRATION OF ENTRY: I certify under penalry of perjury that 1 have read this applicetion and state ihat Ihe information given is correct. I egree to comply with ell state laws end ciry ordinances ralating to building construction, and euthorize representatives of the Ciry of Costa Mesa to enter upon the above-described property for i pedion purposes. I egree not to ocwpy or allow occupancy of eny 6uilding authorized by this permit until finel inspection. � �� 9-Zi- 0�{ Sign LegalOwner(s) Date And/Or Authonzed Applicant Date COOE t. INSiECTIONTYPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spe Final 200 Final Re-Roaf 201 Final Block/Retaining Well 202 Final Factory Flre Place 203 Final Sign 20a Finel.Demolition Ql�� INTRIALS �Qp� INSPECTIONTYPE 206 Final MechaniCal 208 Finel Plumbing 210 Final Eleciricel 212 220 Final Fire Prevention Final Planning Approval 222 FinalSite 250 FinalBuilding/Occupency P� I[fflileL$ (714) 754-5273 • Fax (714) 754-4Q56 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626 FIRE SUPRESSION PERMIT Job Address: Z441 ELDEN AV Suite: D Vicinity: i Parcel Number: 43928137 Zoning: Applicane READ, MARC Address: P O BOX yg4 Phone: SURFSIDE, CA Zip: Owner: DECINCES, DOUGLAS AND KRISTI Address 12 STRAWBERRY FARMS ROAD Phone: IRVINE, CA �� Zip: Contractor: READ FIRE PROTECTION Address: P O BOX 1g4 949-337-9679 90743 949.417.4280 92612 Phone: 949337-9679 SURFSID�, CA� Zip: 90743 .License: 837553 SCOPE OF PERMIT INSTAL� 25 OVERHEAD FIRE SPRINKLERS. REF.: 603-02094 FEE SUMMARY Plan Check: $45.01 Permit: $69.25 Other: $0.00 Total: $114.26 , �'� J � o!U cr�✓� g� � � � Stalus: ISSUED Applied: 08/25/2004 Issued: 09/01/20 ISSUED BY: Calc Valuation: 32,000.00 Claimed Valuation: S2,Ooo.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall aUtomatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the Work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required inspectlone and final approvel must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 rrs��un.a:n� WORKERS'COMPENSAnON DECLARAnON: I hereby attirtn under Oenalry of perjury one ol the tollowing deGaretions: ❑ I have and will melntein a ceniticate of consent to salf-Insure tor workers' compensatlon, es provitled tor by section 3700 ot Ihe Labor Code, lor the Dertortnance of Ihe work for which this pertnli Is issuetl. ❑ I heve antl will malntain wo�lcers' compensation insuranca, as requiretl by sectlon 3700 of ihe Lebor Catle, for the paAortnance oi Ne work far which ihis peimit is Lswed. My workers' compensatlon Insurence carrier entl policy number are: Cartier: Policy Number. �soction neetl nof be comp/etetll/ the pertnit is ve/ued ef one hundred dW/ars ($100) or I ss.) ��ertify thet in Ihe pedormance of the work tor ' MM pS�e h is issued I noi employ any person in eny menner so es to Decome subjaq to ihe workers' �-cnmpensation lews oi Califomie, end e at if I I com ect to the workers' compensation provisions at Sectlon 3700 ot t�e Labor Cotle, I shall torthwit� camply with these provisions. �M;S�9�a,��a: o�:. 9 —� — � y �W _AfUJWO�'fA1LURE TO SECURE W RKERS' MP SAT fAVERAOE IS UNIAWFUL ANO SHALL SUBJECT AN E��'ER TO CRIMINAL PENALTIES FND CIVIL FINES UP TO dJE HUNDRED YFO�ISANDDOLLARE�E100,000),INADDITIONTOTl/E TOFCAMPENSATION,DAMAGESASPROVIDEDFORINSECTION3'lO60FTHELABORCODE,IMEREST,MIDATTORNEPSFEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirtathat I em Ilcensed under pmvisions of wit� Section 7000) of Division 3 o Business end Professions Cotl , end my license is in tull _ Class:B, �'i� G' � h i 19�atas� �i�! —t) V CONSTRUCTION LENDING AGENCY: � ❑ I hereby aftirm Ihet Ihera is e consWction lending agency for Ihe peAormance of the work tor which Ihis permit is issue0. (Sec. 3097, Civll Cotle). Lendefs Name: SigneWre: _ OWNER-BUILDER DECLARATIONS: Lenders Atltlress: Dete: I hereby eflirtn Ihat under penalry ot perjury Ihet I am E%EMPT FROM THE CONTRACTORS LICENSE LAW br ihe following reason (Sec. 7031.5, Business antl Professlans Code: Any ciry or county w�ich requires a pertnit ro construct alter, improve, demolish, or repair eny strucWre, pnor to its issuance, elso requires the epplicaN tor suc� permlt to flle e signetl stetement ihet he ar sha is Ilcensed pureuent to the provislons ol the Contrectors License Lew (Chapter e(commencing with Sectlon 7000) of Division 3 of the Businoss entl Prafessions Code) or that he or she is exempt therefrom end the besis tor the alleged exemption. Any violation of Sectlon 7031.5 by any applicent for a pertnit sublects the epplicant to e clvil penalry W not more ihan five hundred tlollars ($500).): ❑ I, as owner of Ihe property, or my employees with wagas as iheir sole compensatlon, WILL DO 7HE WORK, antl ihe structure Is not Intentletl or oflered tor sele (Sec. 7044, Business and Professions Code: The Contractors License Lew does no� apply to an owner of properry who builds or improves ihareon, an0 who does such work himself or herseN or through his or her own employeas, provided thet such Improvements ere not Intended or oHered for sale. N, however, Ihe building or improvement Is solC wit�in one yeer ot wmplation, the owner-builder will heve the burden ol proving that he or she did not build or improve lor Ourpose of sale.). � ❑ I, es owner of Ihe property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRALTORS to construct iha project (Sec. 7044, Business and Protessions Coae: The camrectors Llcense Lew does not epply Io en owner oi proDetly who builds or improves Ihereon, antl who coMracis for such project with e coniracbr(s) . license pursuant to ihe Coniractors License Lews.). ❑ I am exempt under sec. Business end Professions Code lor Ihis reason: Signature: Date: Owner ID venfied by dnvefs Iicense. ❑ Yes ❑ No Drivers License No. Verificetlon of Ownarship by (type ot document, i.e. - properry tax DIII or tleed): DIVISION OF INDUSTRIAL SAFETV VERMIT CERTIFICATION: Expires: ❑ I hereby certity thet no exwvation five (5) or more feet in depih into which e person is required to descend, will be made in connection with work euthorized by Ihis permit, and ihat no bullding sirucWra, scaHalding, falsework, or demolition or dismantling thereoi, will be more then thirty-sis (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Tltle 8, Callfornia Adminisirative Code). ❑ As owner-bullder, I will not emplay anyone to do work which would require a permit from Ihe Division of Industriel Sefety, es noted ebove, unless such person has a pertnit to do such work trom the division. Signeture: Date: Division of Industnal Satery Permit Numbar. CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I certity under penalry ot perjury that I have reatl this epplication and state thai ihe intortnation given is correct. I agree to comply with ell state laws end ci�y ordlnences relating to bulltling consWciion, antl authonze represen�atives oi the Ciry of Costa Mesa �o enter upon ihe ebove-described property for inspection purposes. I egree noI to xcupy or ailow occupancy of any �uilding authorized by this permit until finel inspection. GO�E I, INSPECTONTYPE 7616 Fiaed System Final Fire Pi 1266 Pool Spa Finel 200 Flnel Re-Rool 201 Final Blak/Retaining Well 202 Finel Fectory Fire Place 203 Finel Sign 204 Finel Demolition (1� ��j �[ INSPECTIONrYPE 206 Flnel Mechanlcel 20B Finel Plumbing 210 Final Eledrical 212 Final Fire Prevention 220 Final Planning Approval 222 Finel Site 250 Final BullAinyOccupancy December 9, 2003 To: CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-7200 DEVELOPMENTSERVICES DEPARTMENT ✓ Building Safety Division Code Enforcement Communications County Clerk County Pianning and Dev. Services County Registrar of Voters County Tax Assessor Engineering Division 12) ESRI Fire Admin. - Training Officer Fire Prevention - Mark Brown (Station 61 Fire Prevention Irvine Ranch Water District Mesa Consolidated Water District AT &T Broadband Newport-Mesa Unified School Dist. (2) Pacific Bell Police Dept. - Ping. & Research Sanitary District Engineer Sanitation Division Office Southern California Edison Company Southem Califomia Gas Company State Board of Equalization U.S. Post Office, AIS U.S. Post Office, Adams Avenue Thomas Brothers File (2) The below address change has been made. Piease make any necessary changes immediately to reflect the new addresses with the corresponding Assessor Parcel Number. OLD ADDRESS NEW ADDRESS A.P. NUMBER 2441 Elden Avenue � 2441 Elden Avenue�Units A Thru� D� 439-281-37 Your cooperation in this matter is appreciated. Sincerely, //� � MEL LEE, AICP Associate Planner Attachments C: Kimberly Brandt Tim and Doug DeCinces 12 Strawberry Farms Road Irvine, CA 92612 Building Division (774) 75d-5273 • Code Enlorcement p1a) 754�5623 � Planning Division (774) )5q-52a5 FAX(71a)75a<e5fi • TDDp14)754-5244 • v✓ww.a,wsla-me5a.ta.u5 ;" l� 2441 D ELDEN AVENUE vwiw�rr r�r MOTE! 2441 C ELDEN AVENUE 2441 B ELDEN AVENUE oe. ooua om.<n cu.cee r�o�unu a m��.�ener r�e�e eo. is.n .n•.x�o zaa, a ELDEN AVENUE t� : d