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Home My WebLink About2311 ELDEN AVE - Building PermitsC�TY OF a OSTA MESA �o�`""'Fs, BIIILDING D/V/S/ON ��g 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • w�wv costamesaca.aov �� FOR INSPECTIONS CALL: (714) 754-5626 "� PERMIT NUMBER: B11-00352 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 43942105 DATE ISSUED: 10/14I2011 ISSUED BY: RMD JOB ADDRESS� 2311 ELDEN AY CM—'"'� Vicinity: 6UILDING'2 UNITS 22-27 Squares: 1600 Suite/Unit: Valuation: $5,800.00 SCOPE OF WORK: REROOF ONLY APARTMENT BUILDING N2 WHICH CONSISTS OF 6 APARTMENT UNITS 22-27. TEAR OFF EXISTING FLAT ROOF MATERIACS, INSTALL TORCH-APPLIED ROOF SYSTEM WITH WHITE GRANIALS, APPROX 7600 SF. REPAIR AND REPLACE SHEATHING AS NEEDED. COMPLIANCE FORMS ATTACHED TO JOB CARD AND CITY PERMIT. NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted unlil access to dwelling unit(s) is provided for verification of the installaJion of smoke and carbon monoxide alarms by the City Inspector. See Attachment wllnspection Card OWNER: P A POON AND SONS INC PHONE: APPLICANT: NOLTE, FRED PHONE: 714-402-0554 CONTRACTOR: NOLTE ROOFING Address: 1Q812 LA BATISTAUnit: City/StatelZip: FOUNTAIN VALLEY 92708 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $125.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 Address: 18822 BEACH BLV� #103 City/State/Zip: HUNTINGTON BEACH, CA Address: City/State2ip: License No. License No. Unit: Unit: : License No. 418550 PHONE: 7'14•964-0554 r�Y C ELL: � f y) I�ffZ.' O7i � / PHONE: PHONE: TOTAL FEHS $126.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federel New Years Dav. Memorial Dav_ Indeoendence Dam Labor Dav. Thaoksoivino Dav antl Christmas Dav 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; PERMIT EXPIRES 180 DAYS fROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPEC710N5: 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 and final approval must be obtained. Failure to obtain inspeUions and final approval will resWt in the expiration of this permit. cooe +, x v x mE o� iN7IfIALS (iQOF� INSPECiION iYPE pnTe IN7I71AL5 1616 Fized System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final �� 208 Final Plumbing 20o Final Re-Root /��V , o"'� � �� 210 Final Electriwl 201 Fina191ocWRetaining Wall 272 Final Fire Prevention 202 Final FaGory Fire Place 220 Final Planning Appmval 203 Final Sign 222 Final Site 204 Final pemolition 250 Final BuilOinglOccupancy WORKERS' COMPENSATION DEGLARATION: I her y affrm under penalty of perjury one of the following declarations: I have antl will maintain a certifcate of consent to sel(-Insure for workers' compensalion, as pmvided for by section 3700 of the Lahor Code, tor the pertormance of the vrork for which this permit is issued. ❑ I have and will maintain vrorkers' compensation insurance, as required by seclion 3700 of ihe Labor Code, for the peAormance of the work for which this pertnit is issued. My workers' compensation Insurance carrier antl policy number are: �r� Carrier: �� 0 /�' / �� (i�issec(ionneedrrot�emmpktetlAtlr /�rmitisvalue0atonahuM2ddollars(Sf00)orless) Policy Number. ��d%�D�7 ❑ I certiTy that in the pedormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become suhject to lhe workers' compensation laws of Califomia, and agree that if I should � hecome sub'qct to tliq workers' compensation provisions of Section 3700 of the kab r q0e. I ff 1( f rt 'th comply with ihese provisions. 6 � io-/3�� ApplicanCs SIB��ure Date ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business and Professions Code, and my license is in full force and eRecL � Lic. # Class # � �� `�� mr o ignamre Data CONSTRUCTION LENDING AGENCY: ❑ I hereby affrm ihat lhere is a construction lending agency for the peAortnance of the vrork for which this pertni� is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Atldress: oate OWNER-BUILDER DECLARATIONS: I h¢�¢by eKrm Ihai untler penalry o( perjury Ihat I am E%EMPT FROM 7HE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7037.5, Business and Professions Code: Any ciry or county which requires a pertnit to ConS�ruct, al�er, improve, demolish, or repair any stmcWre, prior to its issuance, also requires the applicant for such permil to file a signed statemen� ihat he or she is licensed pursuant to lhe provisions of the Contractors License Law (Chapter 9(commencing with Seclion 7000) of Division 3 of Ihe eusiness and Professions Code) or Ihat he or she is exempt therefrom and the basis for the alleged eaemption. Any violation of Section 7031.5 by any applicant for a permit subjecls Ihe applicant to a civil penalry of not more than five huntlred dollars (5500).): ❑ I, as owner of the pmperty or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is nol intended or oHered for sale (Sec. 7044, 8usiness and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himsel( or herself or through his or her ovm employees, providetl that such improvements are not intended or offered (or sale. If, however, the building or improvement is sold wilhin one year of complelion, the owner-builder vnll have t�e burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am E%CLUSIVELV CONTRACTIN� WITH LICENSED CON7RACTORS to constmct the project (Sec. 7044, Business and Professions Code: The cont2ctors License law does not appy to an ovmer of property who builds or improves thereon, and who conVacls for such pmject with a contractor(s) license pursuaM to lhe Comractors License LawsJ. ❑ I am exempt under sec. Business and Professions Code for this reason: Owner ID verifed by tlriver s ncense. ❑ Yes ❑ No �ver's License No. Expires: Verifcation of Ownership by (rype o( document, i.e. - properry tax bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify thal no excavalion five (5) or more feet in depth into which a person is required to descend, will be matle in wnnection with vrork authorized by this pertnit, and that no building structure, scaffolding, falsexrork, or demolition or dismantling thereo( will be more than thirty-six (36) feel high. (Chap. 3.2, Grp 2, AA 2, Sea 341, Title 8, California Administretive Code). ❑ As owner-builder, I will not employ anyone lo do work which would require a permit from �he Division of Indus�rial Safe�y, as noted above, unless such person has a pertnit to tlo suc� work (rom the division. Apo��wnts Signamre Oaie Division of Intlustrial Satery Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuWre building occupant need to fle and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 0( Ihe Califomia Health and Sa(ety Code requires, with some exceptions, that a Business Plan 6e filed with the Costa Mesa Fire Department 6y every business which has at any one time during a reported year a quantity of hazardous matedals equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature antl pressure). 2. Does or will the applicant or present or (Wure building occupant need to file a registralion tortn for acutely hazardous materials? ❑ Yes ❑ No (Seclion 25533 of the California Healt� and Safery Code, with some exceD�ions, requires registration with the Costa Mesa Fire Depariment by each business which at any one time has on hantl a quantiry of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume o( 55 gallons, or 200 cubic feet of compressed gas at s[andard temperature and pressure). 3. Does or will ihe applicani or present or fuNre building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutey hazardous materials)? ❑ Ves ❑ No (Section 25534 of lhe California Health an0 Safery Code pmvides that the Costa Mesa Fire Department may require Ihe preparation, certification and filing with the Fire Department of an RMPP by businesses which are requiretl lo register acutely hazardous materials with the Fire Department. 4. If an RMPP is presenUy require4 has Section 25534 of the Califomia Health and Safery Code been fully complied vnth? ❑ Yes ❑ No 5. Does or will the applicant or present or (uiure builtling occupanl require (Or the work which is ihe subject of this application a permit for such wnstruaion o� modification from the SouN Coast Air Qualiry Management District or from any other air polWlion contml district or agenty? ❑ Yes ❑ No (Section 658502 0( the Califomia Govemment Code requires lhat the requested informalion be fumished on applications tor non-resitlential builtling permits). 6. Will any part of ihe faciliry lo be constructed under this pertnit be within 1000 teet from the outer boundaries of a school? ❑ Yes ❑ No Qf "yes", the facility must meet ihe requirement of Sections 25534 and 42303 of (he California Health and Safery Code). 7. If a permit from the South Coast Air Qualiry Management Dis[rict or other air polWtion control distnct or agency is required for the work which is the subject of �his application, have all of the disclosures prescribed by California Health and Satery Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes', attach certifcate of compliance from the appropriate air pollution control oKcer). CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury the information given above is correcL I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. SignaWre Dale CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I certi(y under penalty of perjury that I have read this application and state that the information given is correct I agree to comply with all state laws and city ordinances relating to building constmction, and authorire representatives of Ihe Ciry of C s Mesa m enter upon the above-0escribed property for inspection p es. I agree not to occupy or allow occupancy of any builtling authorize is permit until fnal inspection. wr IO �s) Da� Signamre Date /O�/� ��j 305]<6 (3ro]) Antllo�AWho�izetlAppLCan� Oate (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.c�ILDING PERMIT 77 FAIR DRIVE, GOSTA MESA, GA 92626 JobAddress: 2311 ELDENAV Suite: Vicinity: ROOF Primary Occ: MR Parcel Number: 43942105 Applicant: MARSHALL DAVIS Address: 8341 VALLEY VIEW ST BUENA PqRK, CA owner: P A POON AND SONS INC Address 18822 BEACH BLVD #103 HUNTINGTON BEACH, CA Type of Consiruction: V-N Zoning: Phone: 714-827-5371 Zip: 90620 Phone: Zip: 92648-2055 Contractor: CAL COAST ROOFING AND RAINGUTTERS Address: 8329 VALLEY VIEW ST - BUENA PARK, CA � Zip: 90620 Arch : Address: Zip: Phone: License: Phone: 714-827-5371 License: 828394 Eng: Address: ISSUED BY: Status: ISSUED Applied: 11/02/2005 Issued: 71/022005 Phone: License: SCOPE OF PERMIT REROOF FLAT PORTION ON�Y. T/O EXISTING BUR AND INSTALL W/BUR ON APPARTMENT, APPROX 26 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED. FEE SUMMARY Plan Check: $0.00 Permit: $153.25 SMIP Res: $0.72 SMIP Com: $0.00 Other: $O.Op Inspection:. $0.00 Total: $153.87 PLANNING & ZONING SETBACKS MAINSTRUCTURE Front tl-0 ACCESSORY Front 0-0 PARKING Existin : p Calc Valuation: 57,200.00 Claim Valuation: g�,zoo.00 Rear 0-0 LeN 0-0 Right 0•0 Rear 0-0 Lek 0-0 Right 0-0 Reauired: 0 Pr000sed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) 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 authonzed under ihis permit to be considered legal, such work must comply with ell epplicable codes, and all required Inepections and final epproval must be obtainetl. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 zaas�as caroo) WORKERS' COMPENSATION DECLARA710N: I �erehy aHirtn untler penalry ol perjury ona at the tollowing declarations: ❑ I heve end will maintein a ceniticate ol consent to selt-Insure for workers' compensatlon, es pfovided for oy section 3700 at Iha lebor Code, for Ihe pertarmance at the work for which ihis permit I5 issued. 0�-l�heve_� will malntain workors' compensation insurance, as required by section 3700 of ihe La6or Code, for tha pertormance of t�e work for which this pertnit is issued. 'YF1y wo ers' compensatlon Insurence carrier and palicy number ere: Cerrier:�:�'�I�p �tih -��.Poll`cy�yumber. I�.S`�7 �iD�i-l73 (ThF.i�ectlon neetl not be comp/eted Il the permif Is va/uetl e( one hundred dollars ($100) ar /ess.) �->�- / ❑ I ceM1lly t�et in the pertortnance of the work tor which this permit is Issued, I shall not employ any person in any manner so as to become subjecl to ihe workers' compensatlon laws oi Celllomle, entl a9ree that If I shoultl becoma sub�ect Io lhe warkers' compensation provislons ot Sectlon 3700 oi the Lahor Cotle, I shall forthwi[h comply with ihese provlsions. ��% A�plloBflO, 9n e: f� ./"- Date: ��//CJ� WAR : FAI�URE TO SECURE WORKERS' CdAPENSATIIXJ COVERAGE IS UNLAWFUL AND SHALL SUflIECT AN EM �^�^"�' PENq1.T1E5 AND CML FlNES UP TOONE HUNDRED T}IOUSAND DOLIARE (5100.OW), IN AODRION TO THE COST OF COMPENSATION, DAMFGES AS PROVIDED FOR IN SECfION 3IW OF TME UBOR COOE, INTEREST, AND ATTORNE`f5 FEES. LICENSED CONTRACTORS DECLAHA710N: I here6y aHirtn that I am Ilcensed untler provisions ot Chepter 9(commencing with Section 7000) ot Divisio of t� usiness and Profeuions Code, end my license is in full �o��,�,�fla�� . » Sl d 39 y �� '��,5 � �_ a 9 �tracrofsSgrnStu : ��l��fi� De��Q�� //I2 Oj� CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirm ihat ihere is a consiruction lending egency for ihe Derformance ot Ihe work lor which ihis pertnit is issued. (Sec. 3097, CiNI Cotle). Lentle/s Neme: Lentler's Adtlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eflifm t�at under Denelry of perjury thet I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW far the tollowing reeson (Sec. 7031.5, Business end Prafessions Cotle: Any ciry or counry whic� requires e permit lo construcL alter, improve, tlemolish, or repair any structure, pnor to its issuance, also requires ihe applicani for such permit to tile e signed statement t�et �e or she Is Ilcensed pursuam to the provisians of ihe Comrectars Llcense Law (Chapter 9(commendng wiih Sectlon 7000) oi Division 3 of the Business end Professions Cotle) or that he or she is e:empt Iherefrom and the basis tor the alleged ezemption. Any violatlon oi Section 7031.5 by any epplicant for a permit sub�ects Ihe epplicant to e clWl penalry of not more Ihan Ova huntlred tlollars (5500).): ❑ I, es owner of Ihe property, or my employees with weges es their sole compensation, WILL DO 7HE WORK, end t�e s�ructura is not intended or otteretl tor sale (Sec. 7044, Business end Pmfessions Code: The Coniractors Licensa Law does not apply to an owner of property who builtls or impmves thereon, and who tloes such work himself or herself or ihrough his or har own amployees, provitletl that such improvements era not intended or ottered for sale. If, howaver, the building or improvement is sold within one yeer of completion, the owner-builder will have the hurden oi proving ihat he or she tlitl not build or improve for purpose ot sale.). ' ❑ I, as awner at Ihe property, em E%CLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS to construct tha project (Sec. 7044, Business and Professions Code: The contrectors Ucense Lew tloes not flpply to an owner ol proparty who Dullds or Improves thereon, antl who contracis tor such project with e coniractor(s) license pureuant ro the Comractors License Lews.). ❑ I em exempt under sec. Business and Professions Code tor this reason: Signature: Data: Owner ID veritied by drivefs license. ❑ Ves ❑ No Drivets License No. VedBcatlon of Ownere�ip Dy (type oi tlaumem, i.e. - properry tez bill or deed): Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cehify ihat no excavetion five (5) or more feet in depih into which e person is requiretl to tlescend, will be mede in connection with work authonzed by this pertniL and that no building structure, scattolding, falsework, or tlemolition or tlismanUing Ihereof, will be more �han Ihirry�six (36) teet high. (Chap. 32, Grp 2, An 2, Sec. 341, TI11e 8, Celifomia Administrative Code). ❑ As owner-Duiltler, I will not employ enyone to tlo work which would require a pertnil Irom the Division oi Intlustnel Sefery, es notetl above, unless such person has a permit to do such work Irom the division. Signatura: Date: Division ol lndusirial Sefery Permit Numbar: CERTIFICATE OF COMPLJANCE AND AUTHORVJITON OF ENTRY: I cenity under penelry ot perjury t�at I have reaC �his epplication and state thei Iha intormation given is correct I agree �o comply wlth ell stete laws end clty ordlnences relating to building conslrucilon, end authorize represantativas ot iha City of Coste Mesa to enter upon ihe ebove-described property for inspaction purposes. I egree not to occupy or ellow occupancy ot eny building authorized by ihis permit until final inspection. [.b71�1�CF773$IU]iiil79 1616 Fixatl System Final Fire Pravention 1266 Pool Spe Final . 200 Final Re-Rool 201 Finel Block/Retaining Well 202 Finel Factory Fire Place 203 Finel Slgn 204 Final Demalition PdjE IMRIALS ' � � GOOE I INSVECTION 7YPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 2/2 Final Fire Prevenllon 220 Final Planning Approval 222 Final Site 250 Finel BuildinglOccupancy �75L�L'utiGi57 � �. .lob nddress: 2311 ' ELDEN AV Suite: Vicinity: CARPORT Parcel Number: 43942105 � �.:�.,� Applicant: MARSHMAN, JOHN Address: 17671 METZLER LN STE B2 HUNTINGTON BEACH, CA Owner: P A POON AND SONS INC Address �18822 BEACH BLVD #103 BUILDING PERMIT Zoning: Phone: 714-969-6053 Zip: 92647 Phone: HUNTINGTON BEACH, CA Zip: 9264&2055 Convactor: COASTAL ROOFING CO SOUTH Address: 17671 METZLER LN STE B2 Phone: 714-969-6053 HUNTINGTON BEACH, CA Zip: 92647 License: 767366 A�th : Address: Phone: Eng: Address: Status: ISSUED Applied: 08I20/2004 Issued: 08/20/2004 �_ . � \ ., � ' ISSUED�BY: / , / Phone: Zip: , License: License: - . . - SCOPE OF PERMIT REROOF CARPORT A7 FRONT OF APT COMPLEX ONLY: T/O EXISTING B.U.R. AND HOT MOP NEW ROOF. 6.3 S�UARES Plan Check: $0.00 Permit: $60.10 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 FEE SUMMARY Calc Valuation: S�,s2o.00 Claim Valuation: S�,s2o.00 Total: $60.60 PLANNING & ZONING SETBACKS ; � � ' � � ' MAIN STRUCTURE Front 0- 0, Rear 0- 0 Lek 0- 0 Right 0. 0� ' ACCESSORY Front 0- 0 Rear 0. 0 Lek 0- 0 Right 0. 0 . PARKING Existinq: p Re uired: 0 Proposed: 0 - / ) ;. _ �.�1 : ' � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regula[ions. (Ord. No. 92-28, § 1, 72-27-g2) � EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections 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 � WORKERS' COMPENSATION DECLARATION: " ' � � � I hereby aXirtn under penalry ot peryury one ot the tollawing dacleretlons: � ❑ I heve end wlll meintain e certlflwte of consent to self-Insure tor workers' compensation, as provided for by sedion 3700 of ihe Lebor Cotle, for the pertormence oi Ihe � work for which Ihis pertnit Is issued. ' @'l I have and wlll mainta woAcers' compe insurance, az required by sectlon 3700 of ihe LeDor Code, for the peAoimance ot tlieWWWppp rk for w�ich Nis pertnit Is issued. My workers' com ti r}�In;u�nce ei �tlr�icy number are: ��J�/h� /J�� Cartier: • ��% ��J _ Polity Number. /� / �J l� (This secfion need not be complefed i! fhe permit is velued ef one hundred dollars ($100) or Iess.) � ❑ I cerlify that in the peAo eeMh rk for which th' permit is issued, I shall not employ any person in eny menner so es to bacome sublect to the workers' compensation lews ol C�yg ntl ag e that If I 5 uld become sub�act to ihe workars' compensetion provislons of Section 37 0 oi th Labp�r Code, I shell forthwith comply wlih �he ovig( Rs. / �� / �j tf- Applicent Signatur � Date: G�n a� WARNINp: FAILU TO S UFE WORKERS' COMPENSAiION COVERAGE IS UNLAWFUL M1D SHALL SUBJECT Ml EMPLOYER TO CRIMINAL P TIES MIO GVIL FlNES UP TO ONE HUNDRED TFIOUSAN� RE(S1 ,000),INAODITIONTOTHECOSTOFCQNPENSATION,DAMAGESASPROVIDEDFORINSECTION31080FTHELABORCODE,IMEREST,ANDATTORNEY'SFEES. LICENSED CO�IIRJ{CTORS DECLARATION: I hereby attirm that I em licensed torce antl ettecc Lia p� Contractofs Signecure: � CONS7RUCTION LENO ❑ I hereby aXirtn that LenGefs Name: Signeture: Chepter 9(co mencing with Saction 7000) ot Division 3 0l the Businass ry�ePr�tb�6ns Cotle, and my license is in tull qass», C� �// Dare: . y'i 2�f1 � construction lending agency tor the peAormanca of ihe work br w�ich this pertnit is issued. (Sec. 3097, Civil Cotle). Lender's Address: Date: OWNER-BUILDER DECLARATIONS: I here6y eHirm Ihet under penalry of perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business entl Professlons Cotle: Any city or county which requires e parmit to construcl, elter, improve, demolish, or repair eny structure, pnor to Its Issuance, elso repuires ihe applicant for such pertnit to ille e signed statement lhet he or she Is licensed pursuanl to ihe prodslons ol ihe Contrectors Llcense Lew (Chepter 9(commencing with Sectlon 7000) of Dlvisian 3 oi the Businoss end Professlons Code) or ihat he or she is exem0� �herefrom and t�e basis for ihe alleged ezemption. Any violetlan of Section 7031.5 by any applicant for a permit subjeds ihe aODlicent to e civil penalry oi not more than five hundred dollers ($500).�: ❑ I, as owner ot the property, or my employees with wages es Iheir sole compensation, WILL DO THE WORK, end the structure Is nol Imentletl or otteretl for sale (Sec. 7044, Business entl Professions Cotle: The Contrectors Licensa Law does not apply to en owner of properry who builds or improves thereon, and who does such work himself or herself or ihrough his or her own employees, providetl thet such Improvements ere not intended or oMeretl for sele. It, however, the building or Improvement is sold within one yeer ot completion, ihe owner-builder will have tha burden of proving ihat he or she di0 not build or improve tor purpose of sale.). ' ❑ I, as owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to con5truct Ihe praject (SeC. 7044, Busine5s end Prafes5ions Code: The contrectors LJcense Lew tloes not appty to en owner ot pmpeny who builtls or improves iheraon, antl w�o comracis tor such projact with a contrector(s) license pureueN to the Contracbrs License Lews.). ❑ I em exempt under sec. SignaWra: Business end Pmlessions Cotle tor Ihis reason: Dete: Owner ID veritied by drivers license. Ves ❑ No DriveYs License No. Expires: Venfication ot Owners�ip by (type ol tla um m, i.e. � property tex bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certity that no exwvetion five (5) or more feet in tlepth into which e person is required to tlescend, will ba mede in connectlon with work authonzed by Ihis permit, end that no building siructure, scallolding, felsewo�lc, or demolitlon or dismantling �hereof, wiil be more then thirty-six (38) teet high. (Chap. 32, Grp 2, Art 2, Sac. 341, Title 8, Celifomla Atlministrative Cotle). ❑ As owner-bullder, I will not employ anyone to tlo work which would require e permit from ihe Division of Intlustdel Sefety, as notetl ebove, unless such person hes e permit to tlo suc� work irom the divisian. Signature: Date: Division of Indusirial Sefery Pertnil Number: CERTIFICATE OF COMPLIANCE AND AUTHORVA710N OF ENTAY: I certify under penalty ot perjury that I have read this epplication and state that the information given is corred. I agree to comply with all state.lews and ciry or iqances relating to builAing consiruction, and euthonze represantatives oi ihe City of Costa Mese to enter uDon Ihe above-descnbed property r inspection purposes. I agr e not to aaDY a� allow occupancy of any building authorized by ihis permit until final insDection. ignat Of Legal ner(s) � �q� i7 •ui` 6 C/ nA/Or Aut�onzed Aoolicant Da�e COOE 1. 1fi16 xed System Final Fire Preventlon 1266 Pool Spa Final 200 Final Re-Roof 207 Final Block/Retaining Wall 202 Final Fectory Fire Placa 203 Final Sign 204 Finel Demolition QAIE U�dLfi lLt7 � �� i % , I � COOE 1 INSPECTION TYPE 206 Final MBchanical 20B 210 212 220 222 250 Final Plumbing Final Electrical Final Fire Preventlon Final Planning Approval Final Site Final BuildingiOccupency 2�g 1t�LS r i -� nov 14 2005 3:20PM HP LFSERJET FR% , 714 84+ 2120 ,• p.2, ` ` . ' � .. � atY OF COSTA MESA, ... ING SAFEfY DlVISwA�.. �� . . POST. IN CO.NSPICUO�PLACE ON. THE JOIB . . ' : � . .._ .. �. . .� � NOTICE ' , ': .��. � �� . . � Schetlule inspacuan one w0�tlay in e0vanca. To stltedule�inspec[bns, call (71A) 754-58$6:�ProJide Me (dla;vl �g infomiatbn: � 1) PermN number, 2) Uob etldress, 3) Inspectan Iterri number, 4) Day en0 data you neatl the inspactbn ',,,�, ��. ^�� BuNi�g �ad�: � . . I . �. y . . Oxner.' I: . BuOd'nOFmrtlt:�� ' � Permei'. ' Coitacbr. . . .. . .:. . , � MMaA[alPeiM� � Romtl�V�amtt � �' . bE - {"� " ///I . 4 ' TYPc ." � � (�Ym�DI ' .' � ' . � .. . : '. �{ // � ' . (/ ' i �. P4nCMr,Mho.'. .. drveDaW' � . � 2 ' -'� . . . ... • tEW Am ' KTEP REPMt � MG -' CE 116M' ! J . i - �. ;, , . "PERMIT841LPIRE„'190.DAYS��6.NAONT.B);FROMi$SUE�ORlABT,INBBE,; IO�i� �...::�.' I � ' Inm� ..''� ' '. STRUCfURAL -. Dr .... '.: msv� � tl�m1 � f'�' 'POOL'B�A� , . �pn . . ..e.p�dor I - 3 JobSitaComull�=..-:�' � �91� PaoIdEWFhlerR-Loca6on �.� i :' 4 `Fao�9�gGrdurW. �_. : :: � ' -- � ' 96 SIeelReqilu �- . � � ( � 6 Slab�.,�, -. � . .. - . 100 Eleclrca�Bonping :..�.'��. �. 8. StucMel Flocr � � - . 702 Rouqli�PlumC d Presswe Test � 11 Pre-mspactRooL��-...� � . .101� ApprovaltoCwx•Gumta ' , iz am+s�mni�y::: .- �os �eccondmc=umererouaa, i � . ;. �a . Tae� aun9smk+�ai �oe : c�e P��u�iae��a res� . , � � .16 Shem PeriBl '. - . . . � � � � 710 Backwash Lines; 0.hap. . � � iB �FrameBFlashing ' -�`,_- �- � � . UndergrounC . � � ' � 20 Lalhi� d Stdmg :_ ' - _ . . 112 Approvol to Datl� :. . � . i' .' 22 ImWaG'an � -- - .. - 176 PootP7umtingS�s�m-F.inal . �� _ 44 �ry.raqNa7mg��. - . . � - � ' 718 'PoolE!ectrical-Fnel . I. . . �:.:��.'� .26 �PlascrBrawnCoffi.. . . - � "�172' Fendng�Aaess�AlazmsAyproval�:�:.'�.._��. ..- . � : . .:: �. 30 , Re-Gmut ' .: �. — -. `- . � . � ` -. - . .- _ .12� Approral fq_Plasiping . . . •. � � j:: . . j'' - � 33� .oisao�ea�amese � - � � ' - +2s �voov , � . - � SpaFy8tems-Finel �. :. . � . . . - � .. I. . , . I. _ � . � . ..� , I� �1610 OierhdNydrNQp.rhARoug�. i � . . . . 1612 Ory CAemi:.a� - � . . � � 1614 Dry Stand{iPe � j � 1616 Final, Faed System � ' � � � ELECfRICAC - i , �. � _ 36 Ufer GmuM . . . � � . � i� 38� Ek�Conduil-UMmgiowd .� . - �• �-�li,�BpL�E�Bp�+NLin :r" _ �: Cail(114�7SFS6i6brMetoPorring". �},� ..'pm' ��Imp�cmr . �L ' �s awar �ec cmd�c -- - " 200 ' F�e�dar-- `.--__ _ _ � 18 98C7BarCedinp 201 Fira'Bloc�JReWhVgWeN i 50 FJet Paver Final 203 �Finai Sign �' � 51 .TmripPowerFnal - - 20d FnalDemoGtim � ,: �.: � 206 Final MBclianicel � � � - 208 FinalPlum6ing �� 210 Flnal Ele-�ical � � , - PLUM91NG6NECHANILAL Ctli(71q727-7400fathefolrowing: � jom m.p�cmr � � - 52 .Spl Pipe-U�Mertyourd - - - 212 Flnal F"ve Revenfbn � � ; -54 1,VakrRpa-UndergmunG Callj714)75458T7two(2)world�daye Ip� E,om«r ! 55: -U�aigmundGas prlorrolinal. . � � 62-. Rough Plumbng � 216 Final Publ:c Svs: DeD��MProval . � ; "% .RouphMechaiical - - � Cel1�714)T545J07forthefdbwing; � �om unpcmr 66 Rough � Fazipry.Fu�iace �� 218 Flnal CMS� Apprpval: ., ( se s�sn�m c.np��>isaswro.�naan�me: ioa. ��.,�, 72 Ga+Plye-Rcuyi7est� "- � 420 FinelPlan,iagAppmvel - � � : � 90 GasPipeTest-Finel � CiI1p1/�75M561bfarNelaOowinB� I� �� 92 WaterSeMae-Fital - 222 FindSite " � . . . � 250 Final BUlkinry0capancy � � NOTE3: SEEPEVERSE � . �I i '4d0+e Imcawl ' . ' , .. . . . �. ' . I. . . , n. . - . . .. . . . . ' . . . . . .. . . i'. I . I i ' , • ; (7�a) 75a-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT .lob Address: 2311 ELDEN AV Suite: Vicinity: UNITS 1-8 Parcel Number: 43942105 Applicant: WEINS, JEFF Address: 18822 BEACH BLVD. SUITE 103 HUNTINGTON BEACH, CA Owner: P A POON AND SONS INC Address 18822 BEACH BLVD #103 Contractor: Address: Zip: Arch : Address: HUNTINGTON BEACH, CA Phone: Zaning: Phone: 714-9656013 Zip: Phone: Zip: 9264&2055 Phone: License: Eng: Address: 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 04/09/2003 Issued: 04/09/2003 ISSUED 8Y: . ,v„ IN3�"� �' Phone: Zip: License: License: SCOPE OF PERMIT REPLACE BALCONY RAILINGS IN 3 DETACHED MULTI-FAMILY BUILDINGS. Plan Check: $0.00 Permit: $60.10 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $60.60 SETBACKS MAW STRUCTURE Front 0-0 ACCESSORY Frant 0- 0 PARKING Existinq: 0 NOTES: Rear 0-0 Rear 0- 0 Required: 0 FEESUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Righl 0- 0 si,sss.00 $i,sss.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 9248, § 1, 72-21-92) EXPIRATION: This permit shall automatically expire antl become void if work Is not commenced within 180 days, or it work is suspended or abandoned for a period ot 180 days. INSPECTIONS: In order for the work authonzed under this parmit to be considerad legal, such work must comply with all applicable codes, end all required Inspections and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 waao law� WORKERS'COMPENSAnON DECLARAnON: I hereby afrirtn under penalry oi perjury one oi the following tletlarations: ❑ I heve end will maintain a cetlificate of consent to selbinsure tor workers' compensation, es proNded for by section 3700 ot Iha Lebor Code, for the peAortnance ot the work for which this pertnit is issuetl. � I have and will maintain workers' comp9ns�Gon insurence, as repppyyyi tl by sec on 3700 of Ihe Lebor Cotle, Por the paAormance ol the woAc lor which this pertnit is issued. Myworkers'cp1m nslio Insuran 6�rnerandpolicynumh�Fare: Cerriar: \ \ % . Policy Number: �This sectlon need no completed il permit is vel�t e hundred llars ($100) or less.) � • !Ai I cenih/ thet in the perto �� compensation laws of C compy with these provi: Appllcent Signature: _ WARMNG: FAILURE TO SEWRE t hi f is permit i ssuetl, I shall not employ eny person in any manner so as to become sub�ect to Ihe workers' at if s oultl be ie subject b t�e workers' compansatlon proNsions oi Section 37Q0 �� e, I shall forthwith ' Date: `-P I ISATION G1�VEMGE IS UMAWFUL AND SFUl15UBIECT AN EMPLOVER TO CRIMINAL�MIp CM� FlNES UP TO ONE HUNDRED COST OF COMPENSATIIXJ, DANAGES PS PPWIDED FOR IN SECTION 3�W OF TME LABOq CO�E, ItJrEREST, qND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATON: I hereby ettirtn that I am licensed untler provisions ot Chapter 9(commencing with Section 7000) ol Division 3 of the Buslness and Protessions CoAe, and my license Is in full fOrCB 0ntl BftOCL LIC. M C1355 k � Conirectors Signature: Date: ' CONSTRUCTION LENDING AGENCY: ❑ I hereby attirtn thallhere is a consiruction lending agency for the pedormance of ihe work br which this permit is Issued. (Sec. 3097, Civil Code). Lendefs Name: lendefs Atltlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirtn ihaCuritler penalry ol perjury that I am EXEMPT FROM THE CONTBAC70R5 LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions Code: Any ciry or oounry:which requires e pertnii to construct, elter, improve, demolish, or repair eny sirucWre, pnor to Its Issuance, also requires the ap0licant for such pertnit to Tle e signetl stateoient,that 6e or she Is licensed pursuant to the proWslons of the Coniradors LJcense Law (C�apter 9(commencing wlth Sectlon 7000) of Dlvision 3 of the B sine nd Professioris Code)�or that he on she is exempt Iherelrom end the 6asis for the elleged exemption. Any violatian of Section 7037.5 by eny appllcant for e pertnit u'e the applicant to a civil penalry of�not more than tive hundred dollars (5500).): I, as owner of the property, or my employees wi�h w s s their sole wmpensation, WILL DO THE WORK, and Ihe strucWre is not intendetl or otteretl lor sale (Sec. 7044, Business and Professions Coae:�The Con ctors cense Law dces not apply lo an owner of property who builds or improves Ihereon, antl who does such work himsetl or herself or through his or hei own e oyees, rovided Ihet such impravemenis are not Intendatl or offered tor sale. If, however, tha bullding or Improvement is sold within one ye�of'3ompletion, the owne uilder I heve ihe burden ol proving Mat he or she did not �uild or improve lor purpose ol sale.). � � I, es owner of� property, a % SIV LY CO RACTING WITH LICENSED CONTRACTORS to con5iruc� �he O�oject (Sec. 7044, Business end Protesslons Cotle: The cn ract s L' en L�w oes Aot appl) o an owner of properry who builtls or Improves thereon, and who contracis tor such project wllh e contractor(s) license purs nt t ihe an tor License La i ❑ I am exempt under s. Business antl Professions Coda tor this reason: Signelure: � Daia: Owner ID verified y dn er/ icen5e. ❑ Yes ❑ No Drivers LitenSe No. Expires: Venficetion of , ner ip ,(rype of dacument, i.e. - property tax bill or tlead): . DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no ezcavation five (5) or more feet in depth into which a person is required to descend, will be mede in wnnaction with work euthorized by Ihis permit, end that no building strucWre, scaHolding, lalsework, or demolition or tlismanUing Ihereol, will he more Ihen thirry-sia (36) feet hiqh. (Chap. 3.2, Grp 2, Art 2, Sec. 341, TiUe 8, Calitomia Administrative Code). 0 As owner-builder, I will not employ anyone to do work which would require a permit irom ihe Division of Industnel Sefery, as noted above, unleu such pereon has e permit to do such work trom the division. Signature: Division af Industnal Safery Permit Number: Date: WIII ihe applicant or present or IuWre builtling occupant neetl to lile entl certily a Business Plan tor emerqency response to releese or threatened releese of e ha¢ardous meteAal7 ❑ Yes ❑ No (Seciion 25505 of the Califomia Healih and Safery Code requires, with some exceptions, thet e Business Plan be filetl with the Costa Mese Fire Depanment by every business which has at eny one �ime tluring a reponetl year a quantiry of hazardous materials equal to or greater than e weight of 500 pountls, or e volume of 55 gallons, uoes or wai me appiicant or presem or wwre ounaing occupam neeo [o me e regis[rauon rortn tor acutery naramous metenais't U res LJ No (Section 25533 oi the Califomia Heelih and Safery Code, wlth some exceptions, raquires registretion with the Costa Mesa Flre Depariment by each business which at any one time has on hand e quantiry of acutely ha�rtlous meteriels equal to or greeter then e weight of 500 pounds, or e volume of 55 gellons, or 200 cubic feet ol compressetl gas at stantlard tempereture and pressure). .........................................................................................................................................................................................................................................................................................................._.................................................................. Does or will ihe applicant or D�esent or future builtling occupant neetl to prepare an RMPP (Risk Management antl Prevention Program tor acutely hazardous matenals)7 (Section 25534 of ihe California Healt� and Safery Code provides that ihe Casta Mesa Fire Department may require ihe preparalion, cetlification and tiling with ihe Fire Departmant ot an RMPP by businesses which are required to register acutely hazardous matenels with ihe Fire Depanment. ..................................................._........................................................................................................................................................._........................_................................................................................................................................... It an RMPP is presently required, has Section 25534 ot the Califomie Health end Safety Code been tully complied with7 ❑ Ves ❑ No __ ..................._................................................_....................................__............................_..................._.._..........................................................._....................................................._......_............_._................_....................._...... Does or will Ihe applicant or present or fuWre building occupani require br ��e work w01ch is t�e sublect ot lhis a pllcaUon a permi� tor such wnsiructlon or motlifration trom Ihe South Coast Air �ueliry Menagemenl Dis�nci or from any other air pollution conirol dlsldcl or agenc�? � Ves �J No (Section 658502 ot the Califomia Govemment Code requires thet t�e requestetl intortnetion be lurnishetl on applications lor non-resitlential builtling permits). ............................................................................................................................................................................................................................................................................ ....................... ................................................................. Will eny pah of Ihe faciliry �o ba cons�ructed under Ihis permi[ be within 10001aei from Ihe outer boundanes ot a school7 ❑ Ves ❑ No (If "yes", the faciliry must meet the requirement of Sections 25534 and 42303 of ihe California Healih antl Safety Cotle). ............................................ ...... .... .................................................................... .................................................................................................................................................................................. If e permit from ihe South Coast Air Oualiry Management Districl or other air pollution contml disirict or egency is requlred for the work which is the subject ot this epplicelion, have ell of the tlisclosures prescribed by Celltornia Health antl Safery Cotle Sectlon 42303 been matle9 ❑ Ves ❑ No ............................................................................................................................................... ............... ....... .... ... ...................... ....... ... .. .. .......... .................... .. ............................... (If "yes", adach certificate of compliance from Ihe eppropn av pollution control oflicer). CER7IFICATE OF COMPLIANGE: I certify ihat und en Ity of perjury ihe information given above is correc�. I agree to compy with all state laws and ciry ortlinances regarding Hazardous Ma�enals antl Emissions. Signature: � ,q / / Data: CERTIFlCA7E F CO PLJ E D VA71 OF ENTRY: I certily under penelty ot perjury �hat I have read �his epplica�ion ana stale lhet the informatlon given is wrrect. I egra to c ply ith t e� s nd c ordinances relating to building conslmdion, antl aNhonze representa�ives of the Ciry of Coste Mesa to enter upon tha ebove-descnb d p peA or i e io ryo e. agree not to occu y or allow occupancy f any building authorized by thi permit ntil finel inspection. �� C� -� Sianeture Ot Leoal Owner(s1 �ate COOE �. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 204 Finel Sign Final Demolition PAIE INiR1AL5 �ODE� 206 208 210 212 220 INSPECTIONTYGE � Final Mechenical Finel Plumbing Finel Electrical Final Fire Prevention Final Planning ADProval 222 Final Site 250 Final Building/Occupancy Data QL� I[�lfl C ' �:i� ., i. (714) 754-5273 • Fax (714) 754-4856 • v+ww.ci.cos�a-mesa.��LDING PERMIT �� FAIR DRIVE, GOSTA MESA, GA 92626 Job nddress: 2311 ELDEN AV Suite: Vicinity: UNITS 9-18 Parcel Number: 43942105 Applicant: WEINS, JEFF Address: 18822 BEACH BLVD. SUITE 103 HUNTINGTON BEACH, CA Owner: P A POON AND SONS INC Address 18822 BEACH BLVD #103 Contractor. Address: Zip: Arch ; Address: HUNTINGTON BEACH, CA Phone: Zoning: Phone: 714-965-6013 Zip: Phone: 714-965-6013 Zip: 9264&2055 Phone: License: Eng: Address: ISSUED BV: . _f.P"_'f � Status: ISSUED Applied: 04/09/2003 Issued: 04/09/2003 Phone: Zip: License: License: SCOPE OF PERMIT � I REPLACE BALCONY RAILINGS IN 3 DETACHED MULTI-FAMILY BUILDINGS. � Plan Check: $0.00 Permit: $66.20 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $66.70 SETBACKS MAIN STRUCTURE Fronl 0- 0 ACCESSORY Fron� 0- 0 PARKING Ezistinq: 0 NOTES: Rear 0-0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 51,863.00 $1,863.00 NOTICE: The work authorized by this permit shall comply wiih all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order tor 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 of this permit. FOR INSPECTIONS CALL: (714) 7545626 ,�� WORKER5'COMPENSAnON DECLARAnON: I hereby ett�� under penelry of perjury one ot t�e following tleGarations: � I heve and will maintein a cenificate oi consent to self-Insure tor workers' cwnpensation, es providetl tor by section 3700 0l Ihe Lebor Code, for the peAortnance of Ihe work �or which this permit Is issued. I hev9 antl witl maintain workers` compensati n insurence, as r d by section 3700 of the Labor Code, for the pedormance o� the work for which this pertnit Is issuetl. My workers' comp�atyen Insurance carr)a�ptl policy nu r er : Cerrier: �I certi�y that in the per compensa[ion laws ol comply with t�ese pra .ApplicantS�9�eture: _ WARNINO: FA��URE TO SECUI THOUSAND D�LLARE ($1 W,Op the ve/ued COST Policy Number: nit is issued, I shell not employ eny person in eny manner so as to become sub�ect to the workers' nme sub�ect to the workers' compensation provisions oi Section 3700 at Yie ^LeW Cod/e, iI shall torthwith � Date: �I - f l v ✓ ISUNI.AWFULANDSHALLSUBJEGTANEMPIOYERTOCRIMINALPENALTIESA DCIVILFlNESUPTOONEHUNDRED 1TION, DAMqGES AS PROVIDED FOR IN SECTION 31O60F THE LABOq CODE, INrEREST, AND ATfORNEY'$ FEES. LICENSED CONTRACTORS DECLAFiATION: I hereby aHi� Ihat I am Ilcensed undar provisions at Chaprer 9(commencing wlth Section 7000) of DlWsion 3 ot Ihe Business enA Professions Cotle, antl my license is in full force entl eflect. Lic. q Class x Contrectofs Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I herepy aHirtn thai thera i5 a consiruction landing egency for ihe OeAortnance ol iha work lor w�ich this permit is issued. (Sec. 3097, CiNI Cotle). Lentlers Name: Lentlefs Atltlress: Signature: Date: OWNER-BU�LDER I hareby aHiR� thei under penalty of perjury Ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following rea5on (Sec. 7031.5, Business anA Protessions Code: Any ciry or counry which requires a permit.to construct, elter, impmve, tlemolish, or repair eny strucmre, prior to Its Issuance, aiso requires the applicant tor such pertnit lo flle a signed stetament thet he or she Is Ilcensed pursuant to ihe provisions of the Contractors License Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 of Iha Business and Pmlessions Code) or that he or she Is exempt therelrwn entl the 6asis for the allegetl axemption. Any violation ol Sectlon 7031.5 �y any epPlicant for a pertnit subjects the applicant to a civil penalry oF not more than fNe hundretl tlollars ($500).): ❑ I, es owner of the property, or my employees with weges as thelr sole compensation, WILL DO 7HE WORK, and t�e structure Is not intentled or oHered for sale (Sec. 7044, Business and Prolessions Code: The Con� 2ctors Licensa Law does not apply to an owner of properry who builAs or imprwes thereon, and who does such work himsed or harsalf or through his or her own9rfrpimyee5, provided that such improvements ere not imentletl or ottered for sale. If howevar ihe builtling or improvement Is soltl w�ihin one yea ❑ I, e5 owner of pr Cotle: The ntracty IicensP pu uant t t ar will have the burden ot prwing that he or sha did nat build or Improve for purpose ot sale.). � NTRACTING WITH LICENSED CONTRACTORS to wnstruct ihe pmject (SecJ04i, Business and Professions to en owner ol property who builtls or Improves thereon, antl w�o contracts for such pmject with e coniractor(s) ❑ I em exe pt er s.� Business and Professions Code lor this reason: �SipnaWre: Date: i Owner ID ve�f� y dr�e s license. ❑ Ves ❑ No Drivers license No. E:pires: Vedtication o1ff/lwnar�ti�by (type ol document, i.e. - pmperry ta�c bill or tleetl): DIVISION OF INDUSTRIAL SAFET' PERMIT CERTIFICATION: ❑ I hereby certlty ihet no excava�ion Five (5) or mo�e feet in tlepth into which a person is required to descenQ will be mede in connac�ion with work authorizetl by this permit, and ihat no building st�ucNre, scattolding, falsework, or demolition or dismantling theraof, will he more Ihan thirty-sla (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Calltomia AdministraUve Code). ❑ As owner-builder, I will not employ enyone to do work which would require a permit trom the Dlvlsion ol Intlusinal Sefery, as noted above, unless such person hes a permit to do such work fmm Ihe division. SignaWre: Date: Division of Industnal Safery Permit Number: SODE �. INSVECTONSYPE Q� L�iS 1676 Fixed System Finel Fire Prevention 1266 200 pool Spe Final Fin91 Re-Rooi CODE1 NISiECTIONTrPE � 206 Finel Mechanical 20B Finel Plum6ing 210 Final Electrical 201 Finel BIaWRetelning Wall 212 Final Fire Prevention 202 Final Fectory Fire Place 220 Final F'lanning Approval 203 Final Sign 222 Final Site 204 Final Damolition 250 Final BuiltlinryOccupency � w . � ♦' i (714) 754-5273 • Fax (774) 754-4856 • wv+w.ci.costa-mesa.��LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job nddress: 2311 ELDEN AV Suite: Vicinity: UNITS 19-27 Parcel Number: 43942105 Applicant: WEINS, JEFF Address: 18822 BEACH BLVD. SUITE 103 HUNTINGTON BEACH, CA Owner: P A POON AND SONS INC Address 18822 BEACH BLVD #703 Contractor: Address: Zip: Arch : Address: HUNTINGTON BEACH, CA Phone: Zoning: Phone: 714-9656013 Zip: 0 Phone: Zip: 92648-2055 Phone: License: Eng: Address: StaWs: ISSUED Applied: 04/09/2003 Issued: 04/09/2003 ISSUED BY: "e('l Phone: Zip: License: License: SCOPE OF PERMIT REPLACE BALCONY RAILINGS IN 3 DETACHED MULTI-FAMILY BUILDINGS. � 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 Existin : 0 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 �z,o�o.00 sz,o�o.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 180 days, or if work is suspended or abandoned tor 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 applicabla codes, and all requlred Inspectiona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 754-5626 ue-sa �e�oo� WORKERS'COMPENSATON DECLARAnON: I hereby eXirm under penalry ot perjury one of the following tleclarations: ❑ I have end wlll maintain e certifiwte of wnsent ro self-InSure lar workers' compensallon, es proNdetl tor by section 3700 oi �he Lebor Code, tor ihe pertortnence of the work Itl� which this pertnit is issued. ❑ 1 have dnd wifl maiMain workers canpensali I rance, as requiretl 6y seclion 3700 oi Ihe Lebor Cotle, tor Ihe peAortnance ot Ihe work for which Ihis pertnit is issued. My workers' compQns�n �nsyyan�e c�r " d policy number are: Carner: l cenity Ihat in the pedormence oi the wark compeAsetlon lews ot Califoml�, and e re comply with these provisi9ns� , �� WARNINO: FAILUPE TO SECUFE TIIOUSPND DO�VIRE (S10p.000), one or Iess.J Policy Number: hich his permit is issued, I shall not emplay eny parson in any menner so es to become subject to the workers' Ii I oulC become subject to Ihe workere' compansation provislons ol Seclion 3700,ot ihe Lebor Code, I shell forlhwilh �---- _ � � -/ � �� Data: NJ WV£RAOE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOYER i0 CRIMINAL PENALT ES AN qVIL FINES UP TO ONE MUNDRED OF COMPENSFTION, DAMNGES AS PRW IDED FOR IN SECiION 3IO60F THE UBOR CODE. IMEFEST, qND ATTORNEV'S FEES. LICENSED CON7RACTORS DECLARA710N: I here6y aHirm Iha� I em Ilcensed under provisions ol Chapter 9(commencing with Section 7000) of Dlvlsion 3 of lhe Business antl Professions Code, and my license Is in full torca and eflecL Lic. q Class a Comrectofs Slgnatura: Date: CONSTRUCnON LENDING AGENCV: ❑ I hereby aXirm that ihare is a co�siruction lending agency for the pedormanca of the work br w�lch this pertnit is issued. (Sec. 3097, Civil Code�. Lendefs Neme: Lentler's Addrass: SlgneWre: Date: OWNER-BUILDERDECCARATIONS: .� . 1 hereby eflirm thet under penelty of perjuryShaAfam EXEMPT FFOM THE CON7RAC70R5 LICENSE LAW Por lhe tollowing reason (Sec. 7031.5, Buslness end Professions Cotle: Any ciry or county which requires e�permit.lo construct, aller, improve, demolish, or repair eny siructure, pnor to its issuance, also requires Ihe applicam tor such permit to Ille e signetl 5tatemeN Ihat he or she Is licensetl pursuant t0 ihe provislons ol lhe Contrectors Llcense Lew (Ghepter 9(commencing with Section 7000) ol Dlvision 3 oi the Business end Pmfessions Code) or thei he or sha is e:em0� t�eretrom and t�e basis for Ihe elleqed exemption. Any violetion of Section 7031.5 by any epplican� for a permit ub�e e 9Pp��ent to a civil penalry of not more than Nve hundred tlollars (5500)J: I, as owner ot the property, or my employees with wages es their sole wmpensation, WILL DO THE WORK, end Ihe siructure Is not intentled or oNered lor 5ale (Sac. 7044, Business and Professions Code: The Co tractors License Law dces not apply to en owner of properry who builds or improve5 ihereon, and who does such work hlmself or herself or through his or her ow mp yees, provided that such improvemenis are not Intendetl or oflered for sale. It, however, the builtling or improvement is sold within one year oi completion, ihe ner- ilder wlll heve Ihe burden of proving ihat he or she did not build or improve for purpose of sele.). � ❑ I, a5 owner oi lhe OSW�rtY. am EXC SNE CONTRACTING WITH LICENSED CONTRACTORS to construct lhe prqect (Sec. 7U44, Busi�ss antl P�ofessions Cotle: Yhe wntr io Llcense w oes n apply to en awner of property who bullds or Improves Ihereon, entl who contrects for such prolect wit� a cantractor(s) license pureu to e Con ac rs icen Laws.). ❑ I em exampt ntl se Business and Professions Code for this reason: ,Signature_ � Data: Owner ID veniie tlnv r5� Cense. ❑ Ves ❑ No Dnver's LiCense N0. Ezpires: Varllicatlon of Ovinership b� (type of document, i.e. - property tex blll or deetl): DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTIFICATION: ❑ I hereby certity that no ascave�ion five (5) or more faei in tlepih into which a person is requlred to descend, will be made in connection with work eut�orized by Ihis permil, dnd that no building structure, scattolding, falsework, or damolition or tlismantling thereof, will be mora ihan thirry-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title B, Califomia Adminisiretive Code). ❑ As owndr-builder, I will not employ enyone �o do work which would require a permit Irom the Division of Intlustnal Safery, es notetl above, unless suc� person has e pertnit ro do such work trom the divisian. Signature: Date: Division of Industnal Safery Parmit Number. [;j7�jj;�LbPii193 7616 Fixed System Final Pire Preven�ion 1266 Paol Spe Final 200 201 202 203 Final Re-Raol Final Block/Retaining Wall Final Factory Fire Place Finel Si9n 204 Finel Demalitian �g IMffIALS �,d INSPECTIONTYPE � 206 Finel Mechanical 20B Finel Plumbing 210 Finel Electncal 212 Flnal Fire Preventian 220 Final Planning Approval 222 Final Site 250 Final BuildinglOccupancy QaIE INTRLILS �Si {714) 754-5273 • Fax (774) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT ,lobAddress: 2311 ELDEN AV Suite: Vicinity: CARPORT Parcel Number: 43942105 Applicant: MARSHMAN, JOHN Address: 17671 METZLER LN STE B2 HUNTINGTON BEACH, CA Owner: P A POON AND SONS INC Address 18822 BEACH BLVD #103 ConVactor: Address: Arch : Address: Zoning: Phone: 714-969-6053 Zip: 92647 Phone: -HUNTINGTON BEACH, CA Zip: 9264&2055 COASTAL ROOFING CO SOUTH 17671 METZLER LN STE B2 Phone: 714-9636053 HUNTINGTON BEACH, CA Zip: g2647 License: 767366 Phone: Eng: Address: Status: ISSUED Applied: 08/20/2004 Issued: OB/20/2004 ISSUED BY: Phone: Zip: License: License: SCOPE OF PERMIT REROOF CARPORT AT FRONT OF APT COMPLEX ONLY: T/O EXISTING B.U.R. AND HOT MOP NEW ROOF. , 4.2 SQUARES Plan Check: $0.00 Permit: $41.80 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 � Inspection: $0.00 Total: $42.30 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: o Rear 0- 0 Rear 0- 0 Re uired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Prooased: 0 Calc Valuation: Si,oao.00 Claim Valuation: 3T,oe0.00 Right 0- 0 � Right 0- 0 � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and relatetl regulations. (Ord. No. g2-2B, § 1, 1241-92) EXPIRA710N: This permit shall automatically expire antl become void if work is not commenced within 180 days, or if work is suspended or abandonetl for a period of 180 days. INS�ECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inspections and fl�al approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of �his permit. FOR INSPECTIONS CALL: (714) 7545626 ....�.,. ,.r� WORKERS'COMPENSAnON DECLARAnON: � - I hereby attirtn under penalry of perjury ona of the following declarations: ❑ I have end wlll maintain a certitiwte oi consent to seN-Insure for workere' compensation, es provided for Ey sectlon 3700 of the Lebor Code, for ihe pertortnence of the /work tor which this pertnit i4 issued. {� f have entl wlll maintain woMers' cpcpensation I urance, es required by sec0on 3700 of the LaOor Code, for ihe pedortnance of tha woAAA��MMM r which Uis pertnit Is Issued. My warker�v'L�omp�tGo�n InsujEn�� r'er d policy number ere: J�� /]�—�� Carriar: 7yIi7 / %�� Policy Number: � � (This section need nof be completetl il the permit is velued ef one hundred dollere ($100J or less.) ❑ I cenity t�et in the perto e work for which ih permit Is Issued, I shall not employ any person in eny menner so es to become sublect to the workere' compensetlon lews ot Cal' le, en ree ihet II I s uld become sub�ect ro ihe workars' compensetion provislons of Saction 3 0 of t Le6qqqrrr Code, I shell torthwith comply with t rovi ' . ' � �� Applicant Signetur �ate: WAqNING:FAILU TO5 CUREWO�ERS'COMPENSATIONWVERAGEISUNLAWFULqNDSHALLSUBIECTPNEMPLOVERTOCRIMINALPENALTIESANDCNILFlNESUPTOONEHUNDRED hKKl$ANO E(51 ,000),INADDITIONTOTHEWSTOFCOAIPENSATION,OAMAGESASPROVIDEDFORINSECTION31080FTHEUBOROODE,IMERE5i,ANDATTORNEI"SFEES. LICENSED ON ACTORS DECLARA710N: I hareby aflirtn Ihat I am IltenSed und (p '� force end eflact. lJc. q� ConlrectorsSigneWre: ��R � CONSTRUCTION LENDING I ❑ I here6y aHirm that there Lender's Neme: Signatura: OWNER-BUILDER DECLARATIONS: Section 7000) of Oivision 3 of the Business� Prof�a5fmns Code, and my Ilcense is in full ` Cless M o� � Date: lending egency for ihe DeAormence of the work for which ihis permit Is issued. (Sec. 3097, Civil Cotle). Lentlers Address: Date: I hereby aHirm Ihat untler penalry ot perjury thet I em E%EMPT FqOM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business entl Professions Cotle: Any ciry or counry which reGuires e pertnit to construc�, alter, impmve, demolish, or repair eny sirucWre, pdor to its Issuanca, also requires Ihe applicant for such pertnit to flle e signetl statement that he or she is licensed Dursuant to the proNsions oi Ihe Contraqors License Lew (Chepter 9(commencing with Seaion 7000) ot DlWsion 3 of the Business entl Professlons Code) or thet he or she Is exempt tharefrom antl the basis for the elleged exemption. Any vloletlon of Section 7031.5 by any epplicant br a permlt sublecls the epplicenllo a civil penalry of not more then tive hundred dollers (5500)J: ❑ I, as owner ol t�e properry, or my employees wl�h wages es Iheir sole compensation, WILL DO 7HE WORK, entl ihe structure Is not intentleG or otteretl tor sele (Sec. 7044, Business and Professions Cotle: The ConVactors License Lew does not apply lo an owner ot pmperty who builds or improves thereon, and who does such work himself or herself or througn his or har own employees, provided thal such improvements ere not intended or oflered for sale. If, however, Ihe building or improvemenl is sold within one year of completion, iha owner-bullder will have the burden of proving that he or she did not build or improve for purpose of sale.). � ❑ I, as owner of tha property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Prolesslons Code: Tha contracbrs License Law does not epply lo an owner oi property who builds or improves thereon, entl who contracts tor such pro�ect with e cnntreaor(s) litense pur5uani �o the Con�rectors License Laws.). ❑ I am eaempf under sea � Signature: Owner ID verified by driver's license. Venfica�ion of Ownership by (rype ot Business and Professions Code for this reeson: ves ❑ No i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAfkT' PERMR CER7IFICATION: Driver'S LiCense No. Dete: Ezpires: ❑ I hareby certlty Ihat no exca�ation !ve (5) or more leet In depih into which e person is reQulred to descen0, will be matle in connection with work euthorized by thl5 pertnit, and thel no building sirucWre, scaHolding, falsework, or demolition or dismantling Ihereot, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Atl 2, Sec. 341, Ttle B, Calltomie AdmlPisirative Code). ❑ As owner-builtler, I will not amploy anyone to tlo work which would require a permit trom the Division of Industriel Sefery, as noted above, unless such person has e pertnit to do such wark fram iha division. Siqnature: Date: Division of Intlustrial Sefery Permi� Numher: CERTIFlCATE OF COMPLIANCE �1ND AllTHORIZATION OF ENTRY: I certity untler penalry of perjury that I have reaG this application antl state that the Information given is correct I agree Io comply with all state laws entl ci �ordinences relating to builtling construction, end authorize representatives of the Ciry ot Costa Mesa to enter upon the abova-descnbedy�iry5pection purposes�gree not to wcupy or allow occupanry of any building authonzed by Ihis pertnit until linel inspection. System Final Fire P�eventlon 1288 Pool Spe Finel 200 Finel Re-Roof 201 FInaI BIocWRetaining Wa�� 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition � � � LO�E� INSPECTIONTYiE 206 Final Methanlcal 20B Final Plum6ing 210 Final Electricel 212 Finel Fire Preventlon 220 Final Planning Approval 222 FinalSite 250 Final BuildingiOccupency � �D O Date . P9IE II�E4fl • i ' (714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job qddress: 2311 ELDEN AV Suite: Vicinity: GARAGE Parcel Number: 43942105 Applicant: MARSHMAN, JOHN Address: 17671 METZLER LN STE B2 . . HUNTINGTON BEACH, CA Owner: P A POON AND SONS INC Address 18822 BEACH BLVD #103 Zoning: Phone: 714-969-6053 Zip: 92647 Phone: HUNTINGTON BEACH, CA Zip: 92648-2055 Contrector. COASTAL ROOFING CO SOUTH Address: 17671 METZLER LN STE 82 Phane: 714-96&6053 HUNTINGTON BEACH, CA Zi❑: 92647 License: 767366 ArCh : Addr�ss: Phone: Eng: Address: ISSUED BY: Status: ISSUED Applied: 08/20/2004 Issued: OB/20/2004 Phone: 2ip: License: License: SCOPEOF PERMIT REROOF GARAGE AT REAR OF APT COMPLEX ONLY: T/0 EXISTING B.U.R. AND HOT MOP NEW ROOF. - 27SQUARES Plan Check: Permit: SMIP Res: SMIP Com: Other: lnspection: Total $0.00 $139.25 $0.69 $0.00 $o.00 $0.00 5139.94 SETBACKS MAIN STRUCTURE Front 0- 0 ACC6SSORY Front 0-0 PARKING Existina: 0 FEE SUMMARY Rear 0- 0 Rear 0- 0 Required: 0 PLANNING & ZONING Calc Valuation: Claim Valuation: 0 Left 0- 0 Right 0- 0� Left 0- 0 Right 0- 0 , Proposed: D ss,s�o.00 ss,sio.00 NOTICE: The work authorized by this permit shall comply with afl applicable handicap access requirements under Calitornia statutes and related regulations, (Ord. No. 92-28, § 1, 12•21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or i( work is suspended or abandonad tor a periotl of 180 days. .. INSPEC710NS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepections and final epproval must be obtained. Failure to obtain inspections and tinal approval will result in tha expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2666fia (N00) .�. WORKERS' COMPENSAY�ON DECLARA710N: � ' I hereby eNirm under penalry a� perjury one af the tollowinp declarations: , ' ❑ I heve and will maint9in e certificete of consent to selbinsure for workers' compensetion, es provided for by section 3700 of the Lebor Code, for the pertormence oi ihe �ork for which Ihis permit is Issued. have and will malntai� workers' com nsalion insurance, es required by sectlon 3700 ol the Lebor Cada, for ihe peAortnance of the work for wh�ch this pertnit is Issued. My workers�'p}� Inp�e�ns�atyionnInsu wrrier/gt/�tl pollry number ere: /c '—�//_ /%� Cartior: �f/�J / L 'u% PolicyNumber.� ///!/J7�D'-W�/ � (Thfs section need not be cw�plefed i/ the permit is va/ued e( ony'M�nOred dollars ($100) or Iess.J , ❑ I cetliy Ihat in the peAormacp�nL� rk ia which ih pertnit is issued, I shall not employ eny person in eny manner so as to becom subjec[ to Ihe workers' compensetion law o} Celif (n h, alg e Ihet II I sh Id hecome su��act to the workers' compensetion provlslons of Saction 700 o h�bor Code, I shall fotlhwlth complywiththese d io � '�/J Applicant Signature: -�� Q�� Dete: "' D WARNING: FAILUHE T SEC E WORKERS' COAAPENSATIqJ COVEMGE IS UNLAWFUL qNU SMALL SUBJECi AN EMPLOYEP TO CRIMINAL EW�l.TIES AND CIVIL FlNES UP TO dJE MUNDREO THOUSANDOOLLAR (5100, ),INAODfTIIXJTOTHEWSTOFCOMPENSAiION,DAMAGESASPROVI�EDFORINSECTIqJJ]OfiOFTHELABORCODE,IMEFEST,P.NDATTORNEY'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm that I am li lorce entl eHecc Lia u? Contrector's Slgnamre: _ CONSTRUCTION L' ❑ I hereby attirm Lendefs Name: Signature: _ wilh Section 7000) of Division 3 of ihe Business anQ Pr ns Coda, and my license is in full _ Cless M � l '�� _ Date: (,�„/J�� _// is a consWction lentling egency for the pedormanca ol the work for which this permit is Issued. (Sec. 3097, Civil Code). LendeYs Adtlress: Dete: OWNER-BUILDER DECLAAAnONS: I heroby aHirtn thet untlar pd�elty ol Der�ury ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sac. 7031.5, Business end Professlons Code: Any city or county wnich requires e permit to consimct, elter, improve, demolish, or repair any slrucNre, prior to Its Issuance, elso requiies the applicant for such permlt to tile e signed stetement tnet he or she Is licensed pursuent Io Ihe provislons of Ihe Contrectors License Lew (Chapter 8(commencing wllh Sectlon 7000) ol Divlslon 3 of Ihe Business enC Professions Ca1e) or thet he or she is exempt t�eretrom end the basls for the allegetl e:emption. Any violation oi Section 7031.5 by any applicant for a permit subJects the applicam to a c�hl penelry of not more ihan live hunCred dollars ($500).): ❑ I, es owner of the property, or my employees wilh weges es iheir sole compensation, WILL DO THE WORK, end the siructure is not Intended or oRered for sale (Sec. 7044, Business and P�o�essions Code: The Conirectors Licanse Law tloes not apply to an owner of property wha builtls or improves thereon, antl who does such work himselt or herself or tl+�ough his or her own employees, provided Ihat such improvements ere nol intended or oflered lor sale. If, however, ihe building or improvement Is sold within one yeer o� completion, Ihe owner-builder will �ave ihe burden of proving ihat he or she tlid not build or Improve for purpose ot sele.). ' ❑ I, as owner of the property, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, BuS�ness antl Professions Code: The conirectors Licensa Law tloes not apply to en owner of pmperty who bullds or Improves ihereon, ena who contracts for suc� pm�ect wii� a wntractor(s) license pursuent to thd COntraCbrs License Laws.). ❑ I em exempt undar sec. _ Signeture: Owner ID verified by tlnvels licensa. Vetlficatlon oi Ownership by (rype of Business and Professions Code for this reason: Yes ❑ No i.e. - properry tax bill or deed): DIVISION OF INDUS7RIAL SAFE7Y VERMIT CERTFICATION: Driver's License No. Date: Expires: ❑ I hereby certify that no excevation live (5) or more teet in tlept� into which e person Is required to descend, will be mede in connectlon with woM authonzetl by this permit, end that no bu�ltling simcture, scattdding, falsework, or demolition or dismaMling thereof, wiN be more tfien ihirty-six (36) feet hlgh. (Chap. 32, Gry 2, Ar12, Sec. 341, Title 8, Celifomla Atlminlslretive Code). ❑ As ownerbuilder, I will not employ anyone to do work which would require e permit from Ihe Division oi Industnel Sefery, es notetl above, unless such person hes e pertnit to do such worK ��om the division. Signature: Daie: Division of Intlustrial Sefery Permit Number. CERTIFlCATE OF COMPLIANCE AND AIJfHORVA710N OF ENTFiV: I cenify under penalry of perjury that I have read t�is application and state ihat the intortnation given is correcL I agree to comply wilh ell steie laws entl city ortllnences relating to Ouiltling construction, end authonze representetives of the City of Costa Mesa to enter upon Ihe ebove-descnbed properry fof inspec�ion purposes. I�gree not to occupy or ellow occupancy ot any building authorized 6y this permit until (inal inspection. 18 Fixed System Final Fire Prevention 1266 Paol Spe Flnal 200 Final Ra-lioaf 201 Finel Block/Retainin9 �'�'ell 202 Final Factory Fire P�ace 203 Final Sign 204 Final Damolitian �.1 W / � '1m /,� � � 2�te0� D e - COOE� INSPECTIONTYVE 206 Final Mec�anical 208 Final Plumbing 210 Final Elecirlcel 212 Final Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy Q� �$ (714) 754-5273 • Fax (714) 754-4856 • www.ci.wsta-mesa.cBUILDING PERMIT �� FAIR DRIVE, GOSIA MESA, GA 92626 �ob Address: 2311 ELDEN AV Suite: Vicinity: LAUNDRY ROOM Parcel Number: 43942 i 05 Applicant: JEFF Address: Owner: P A POON AND SONS INC Addregs 18822 BEACH BLVD #103 HUNTINGTON BEACH, CA Contractor: O W N E R-B U I L D E R Address: 2ip: Arch : Atldress: Phone: Zoning: Phone: Zip: Phone: Zip: 92648-2055 Phone: License: 000000 Eng: Address: Status: ISSUED Applied: 08/14/2003 Issued: 08/14/2003 � -�i . - /'v Phone: Zip: License: License: SCOPE OF PERMIT LEGALIZE WORK IN PROGRESS. WORK TO INCLUDE: REPLACE DRYWALL IN LAUNDRY ROOM, ELECTRICAL AND PLUMBING WORK. REF.: CD3-2332 SUBJECT TO FIELD INSPECTION. Plan Check: $0.00 Permit: $23.50 SMIP Res: $0.50 SMIP Com: $0.00 Other: $23.50 Inspection: $0.00 Total: $47.50 SETBACKS MAIN STRUC7URE Front 0- 0 ACCESSORY Front 0-0 PARKING Existinq: 0 Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY Calc Valuation: $zoo.00 Claim Valuation: 5200.00 PLANNING & ZONING Lek 0- 0 Right Lek 0- 0 Right Propased: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-20, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a penod of 1 BO days. INSPECTIONS: In order for Ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable cotles, and all required Inapections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2d46-06 (N00) WORKERS,COMPENSATION DECLARATION: � � I hereby eifirm under punalty of perjury one ot Ihe following declarations: ❑ I have entl will malntain e certificate of consent to salf-Insure lor workers' compensation, as provitleC for by section 3700 of the Labor Cotle, tor the pert6rtnence o(ihe work for which Ihis pertnit is issued. ❑ 1 have anC will maintflin workers' compensatlon insurence, as requiretl by sectlon 3700 of Ihe Labor Code, for the pertortnance of the work br which this pertnit is issued. My workers' wmpensatlon Insurence carner and policy number are: Cartier: Policy Number: (�Th�is section need no! be completetl i! the pertnif is valued et ane hunOreC dollars ($f 00) or /ess.J 0' I certity that in the pertorm ce of the wo lor which this permit is issueQ I shall not employ eny person in eny manner so as to 6ecome sublact to t�e workers' compensetion laws ol i mia, end agre thet if I should become sub�ect to �he workere' compensation provisions ot Section 3700 0l the Labor Code, I shall fort�wlth comply with these pr "s' ns �j ApplicenlSigneWre: Date: !7'�«�'�G3 WARNING: FAILURE TO 5 RE O ERS' COMPENSATION COVERAGE IS UNLAW FUl AND SNALL SUBJECi PN EMPLOYER TO CRIMINAL PENALTIES AND dVIL FlNES l/P TO ONE NUNORED TFIOUSANOOOLURE�51 ,OOO�,INADDITIONTOTHECOSTOFWMPENSATIqJ,DAM.AGESASPROVIDEDFORINSECTI0N3lO60FTHEUBORCOOE,INTEREST,ANDATTORNEYSFEES. LICENSED CONTRACTORS DECLARATON: I here6y eHirm that I em licensetl untler provisions of ChaO�er 9(commencing with Section 7000) of Division 3 0l the Business and Protessions Cotle, end my license is in lull torce end eflect Lic. q Class M ConlrectoYs SlgnaWre: Da�e: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm ihet there is e construction lending agency tor the peAormanca of the work for which �his permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lendels Atltlress: Signature: Date: OWNER-BUILDER DECIARATIONS: I hereby aHirtn t�et unCer penalry ot perjury that I am EXEMPT FROM T}1E CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business end Professions Code: Any dry or counry which requires a permit to conslrucL alter, impmve, tlemolis�, or repair any sWciure, prior to its issuance, also requires the applicant for such permit to file e signed statement Ihat he or s�e is Iicensed pursuant b the provisions al Ihe ContrecPors Llcense Lew (Chapter 9(commencing with Section 7000) ot Division 3 0l the Business end Prafesslons Cade) or thet he ar she is exempt therefrom and the basis for tha allagetl axemption. Any violation of Section 7031.5 by any applicant for a permit subjacts the epplicent to a civil penelry ot not mora lhan tive hundred dollers ($500).): ❑ I, es owner ot Ihe propeny, or my employees with waqes as their sole compensatlon, WILL DO TME WORK, antl Ihe siructure is not intendetl or ottered tor sele (Sec. 7044, Business and Profassions Code: The Contrac�ors License Law tloes not apply to en owner ot proDerry who builds or improves thereon, and who does such work himselt ar hersetl ar thmugh his or her own employees, pmNtled that such impmvemems ere not intended or affered for sale. Ii, however, Ihe building ar improvemenl is �oltl within one year oi completioq the owner-builder will have Ihe burden of proving that he or she ditl not build or improve tor puryosa ot sale.�. � � 1, as owner ot the propeny, am EXCLUSIVELV CON7RACTING WI7M LICENSED CONTRAC70RS to construct the project (Sec. 7044, Business end Pmtesslons Code: The conirectors Licensa Lew tloes not apply to en owner of propehy who bullds or ImO�oves Ihereon, antl who con�racts for such prolect with a contrector(s) license pursuaM to ihe Coniraclors License Lews.). ❑ I am eaempl under sec. Business entl Prolesslons Coda br Ihis reason: Signature: Date: Owner ID veriliad by ddvefs license. ❑ Ves ❑ No Ddvefs License No. Veniication of Owners�ip by (type of daument, i.a. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: Expires: ❑ I hereby cetlity Ihet no axcavation five (5) or mora teet in depth imo which e person is required to Cescend, will be made in connection with work eu�hodzed by Ihis permit, and I�aI no builtling siruciure, swttolding, falsework, or demWition ar tlismentling thereoi, will he more then thirty-six (36) teet high. (Chap. 32, Grp 2, An 2, Sec. 341, Tltle B, Celifomia Atlmini5tretive Code). ❑ As owner-6uilder, I will not employ anyone to do work which would require e pertnit trom Ihe Division oi Industrial Safery, as noted ebove, unless such person hes e permit Io tlo such work irom the tlivision. Signawre: Date: Division at Industrial Salery Pertnit Number: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cenity under penalty of perjury that I have read this application and state that the information given is correc�. I agree to comply wit� all ste�e laws entl ciry ordinances relating to buil0ing consiruction, and euthonze represeniatives ot the Ciry of Coste Mesa to enter upon the above-descnbed properiy lor insyegtion purposes. I egree not to occupy or allow occupency ol any building authonzed by this pertnit until (inel inspection. COpE 1, INSPECTIONTYPE PPddIE IHfRIALS 1616 Fixetl Syslem Final Fire Prevention 1266 zoo 201 202 203 200 Pool Spa Final Final Re-Roof Final BIocWRetaining Wall Final Factory Fire Place Final Sign Finel Demolllion 40DE� INSPECTONTYPE 206 Final Mec�anical 200 Final Plumbing 210 Final Electriwl 212 Final Fire Prevention 220 222 250 Date �-r�-o3 Dato Final Planning Approval Final Site Final Building/Occupancy � lt� (�14) 754-5273 • Fax (71a) �5a-ae56 • www.ci.costa-mesa.ca.us 77 FAIF DRIVE, GOSIA MhSA, GA 9'Lti'Lti �ob Address: 2311 ELDEN AV Suite No Vicinity: Parcel Nunmber: 43942105 Applicant: JEFF WEINS Address: 18822 BEACH BL SUITES 101-103 HUNTINGTON BEACH, CA Owner: P A POON AND SONS INC Address 18822 BEACH BLVD #103 HUNTINGTON BEACH, CA Contractor: OW NER-BUILDER Address: Arch / Eng : Address: ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof PLUMBING PERMIT Phone: 774-965-6010 Zip: 92648 Phone: Zip: 9264&2055 Phone: Zip: License: 000000 Phone: Zip: License: SCOPE OF PERMIT LEGALIZE WORK IN PROGRESS IN LAUNDRY ROOM. REF.: 603-01376 Status: ISSUED Applied: 08/14/2003 Issued: 08/14/2003 ISSUED BY: PLUMBING TO INCLUDE: 1 GAS (1-4 ) OUTLETS, 3 LAUNDRY TUB/WASHERS, AND 1 WATER RE-PIPE. AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 So.00 FEE SUMMARY QTY AMT �aundry Tub / Washer $29.40 0 Landscape Irrigation $0.00 0 P-Trap $0.00 0 Pressure Regulator $0.00 0 Process Piping (per 10 ft) $0.00 0 Receptors $0.00 0 Septic Tank $0.00 0 Sewer Cap for Demo $0.00 0 Sewer Connect $0.00 0 Sewer Private Line $0.00 0 Shower $0.00 �TY 3 0 0 0 0 0 0 0 0 0 0 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Sel Waste and Vent System Water Closet (ToileQ Water Heater / vent AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 NO710E: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 754-5626 zaae-as �doo� WORKERS'COMPENSAnON DECLARATON: � I �ereby affirm under penelty of perjury ono of ihe following Ueclarations: ❑ I have end wlll maintain a cenificate of consent to self-Insure for workers' compensation, as pmvitled for by section 3700 ot Ihe Labor Cotle, for ihe peAormance of ihe work tor which this permit is issued. ❑ I have ana will maintain workers' compensation insurance, as requiretl by sectlon 3700 of Ihe Lebor Cotle, for the pertormance of tha work lor which this pertnit is issuetl. My workers' compensation Insurence cerder and poliry number are: Carrler. Poliry Number. �(Tliis s tion need nat be comp/eted i/ fhe permit is veluetl a! one handred dW/ers ($100) o� less.) nity that in the pedortnance oi the rk or which this pertnit is issue0, I shall not employ any person in eny manner so as to �ecome subject lo Ihe workers' compensatlon laws of Calilornis, en gre Ihat Ii I shoultl hecome sub�ect to Ihe workers compensation provislons ot Section 3700 oi the Labor Code, I shall forthwith comply with these pra ' n. � Applicant Signeture: Date: ��C� �3 WARNING FAILURE TO 5 R KERS' COMPENSATION COVERAGE IS UNLAWFUL AND SNALL SUBJECT AN EMPLOVER TO CR�MINAL PENALTIES AND GVIL FlNES UP TOIXJE HUNDRED TFIIXISANDDOLURE(51 ,OOO.IN ODRIONTOTHECOSTOFCOMPENSATION,DAM1NGES0.SPROVIDEDfORINSECTION31080FTHELA80RWDE,IMEPEST,ANOATTORNEY'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirtn Ihat I am licensetl untler provisions of Chepter 9(commencing with Sectlon 7000) of DiNsion 3 of ihe Business and Professions Code, end my Iicense is in full fofCe entl BHBCL LiC. q CIBSS M Contrectors Signawre: Date: LONSTRUCTION LENDING AGENCY: ❑ I hereby eHirm ihat Ihere is a constmction lending egency lor ihe perlormance oi Ihe work for which ihis permit is issuetl. (Sec. 3097, Civil Code). Lenders Name: Lendor's Address: Signature: Date: OWNER-BUILDER DECLARATONS: I hereby eMirtn Ihat under penalry ol perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions Cale: Any city or counry which requires e permit to construct, alter, improve, demolish, or repair eny StmcWre, pdor to its issuance, also requires the epplicent for such permil to file a signetl stetement that he ar she Is Iicensetl pureuent to ihe provisions oi the Contractors License Lew (Chaptar 9(wmmencing wilh Section 7000) 01 Division 3 ot ihe Business and Proleuions Code) or thet he or sha is axempt iherefrom entl the basis for the alleged eaemption. Any violation of Section 7031.5 by any epplicent for e permit subjecis ihe appliwnt to a civil penelry of no� more than tive hundred dollars (3500)J: ❑ I, as owner of Ihe properry, or my employees wilh wages es their sole compensation, WILL DO 7ME WORK, antl the structure is not intendetl or oHeretl tor sale (Sec. 7044, Business and Professions Code: The Comracrors License Lew tloes not appty to an owner of property who builds or impwves thereon, entl who tloes such work himself or herselt or ihrough his or her own employees, provided thet such improvemen�s are no� intenCetl or otfered for sale. It, havever, the building or Improvement is sold within one year of completion, the owner-builder will heve the burden of proving that he or she tliA not 6uild or improve for purpose of sale.). � ❑ I, es owner oi ihe property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, BuSiness and Protessions Cotle: The contractors License Law does not epply to en owner ol pmpeny who bulltls or Improves thereon, entl who coniracts tor such pmlect with a contrector(s) license pursuant to the Coniractors License Laws.). ❑ I em e:empt untler sec. Business entl Prolessions Code for this reason: Slgnature: Date: Owner ID venlietl hy tlrivefs licensa. ❑ Yes ❑ No Drivefs LiCenSe No. Verilicetion oi Ownarship by (typa oi document, i.e. - pmperry tex bill or deetl): Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity t�at no excavation five (5) or more feet in tlepth into whic� a person is requiretl to Oescentl, will ba matle in connection with work euthodzed by this permit, antl that no building strucWre, scaflolding, talsework, or demolition or dismantling thereof, will 6e more than thirry-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Title B, California Adminisirative Code). ❑ As ownerbuilder, I will no� employ enyone to do work which woultl require a pertnit imm the Division of Intlustriel Sefety, as noletl ebove, unless such person has e pertnii to tlo such work irom ihe division. SignaWre: Date: Division of Industnal Safery Permit NumDer: CER7IFICATE OF COMPLIANCE AND AUh10 N OF ENTRV: I cenify undar penalry of perjury that I have reatl ihis application end state that ihe information given is correct. I egrae to comply with ell state lew nd ciry rdinances relaling to bullding construclion, end euthodze represematives ot ihe Cl�y of Costa Mesa lo enter upon �he ebove-descnbed propeny�spec�ion p oses. I ree not ro occupy or ellow acupancy ot eny building authorized by ihis permit until finel inspection. CODE �. INSPECTIOIfTYVE " 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Finel Re-Root 201 Finel Block/Retaining Well 202 Final Fectory Fire Place 203 Final Sign 204 Final Demdition �g �5 �QQ[1 INSPECTIONTYYE 206 Final Mechanical 200 Finel Plumbing 210 Final Electdcal 212 Final Fire Preventlon 220 222 250 oate � !c(-Q 3 Dale Final Planning ApDroval Final Site Final Building/Occupancy �.1 .IIII. /�' y /. (714) 754-5273 • F�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIH UHIVt, GVJ IA MtSA, l:N 82tiLti ELECTRICAL PERMIT JobAddress: 231'I ELDENAV Suite No Viciniry: Parcel Nunmber, 43942105 ApplicanC Address: JEFF WEINS 18822 BEACH BL SUITES 101-103 HUNTINGTON BEACH, CA Owner: P A POON AND SONS INC Addregs 18822 BEACH BLVD #103 Contractor. 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 Motars to 1 hp Motors to 10hp Motors to SOhp Motors to 100hp Motors over 100hp Communicauon drops Sub panel to 200a HUNTINGTON BEACH, CA OWNER-BUILDER Phone: 714-9656010 Zip: 92648 Phone: Zip: 9264&2055 �9�.T7S:� Zip: License: 000000 SCOPE OF PERMIT IEGALIZE WORK IN PROGRESS IN LAUNDRY ROOM. REF.: 803-01376 ELECTRICAL TO INCLUDE: 7 OUTLETS. $23.50 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $7.70 $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 FEESUMMARY Temp Dist System / Lighting Busway /10o ft Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up l0 50 kva/kw .................up to 100 kva/kw ..................over 700 kva/kw Low Voltage Equipment Low Volt Wiring Sysiem / Ckt Misc. Conduit Misa Conductor Circus ( gen or nde) Circus (mech ride or lights) ChrrsGnas Tree SWnd Fireworks Sland Other Electrical Fee Inves6gation Fee Plan Check Fee Status: ISSUED Applied: OB/14/2003 Issued: 08/14/2003 ISSUED BY: Quantity 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 531.20 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRATION: This permit shall automatically expire and become voitl ii work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 qays. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetiohs and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration oi this permit. FOR INSPECTION$ CALL: (714) 7545626 zaae-ae Is�ool WORKERS' COMPENSATION DECLARATION: I here6y ettirm under ponalty of perjury one of the following declerations: ❑ I have and will meinteln a certificate ol consent to sel4lnsure br workers' compensation, as provided tor 6y seclion 3700 of tha Labor Code, (or lhe peAortnence of ihe work for which this pertnit is issued. ❑ I have flntl will malntain workers' compensation insurance, as required by section 3700 of Ne Lebor Code, for the peAortnance of the work lor which this permit is issuetl. My workers' compensatlon Insurance cerrier antl policy number are: Cerriar: Policy Numher: (This secfion need nof be comp/eted il fhe permit /isy a uetl af one hundred dollars ($f 00) or /essJ � I cerlity that in t�e pertormance of ihe wo lfor ich this pertnit is iuuatl, I shall nol employ any person in any manner so as lo become subject lo lhe workers' compensation laws of Celit ntia, entl e r a th If I should become su6�ect to Ihe workers' compensation pmWsions of Section 3700 of the Labor Cotle, I shall fotlhwith Comply wi�h �he5e provis' � � ApplicanlSigneWre: Date: v��k'6� WARNINO: FAILURE TO SECUR O ' COMPENSATION COVEFiAGE IS UNLAWFLL AND SHALL SUBJECT qN EMPLOYER TO CRIMINAL PENALiIES AND CIVIL FlNES UP TOONE HUNDRED THIXISANDOOLLARE(5100,000 N DI pJTOTHECOSTOFGI�MPEN5AT10N,DMMGESA$PROVIDE�FORINSECTION3]O60FTMElABORCODE,IMEREST,MIDATTORNEY'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm ihat I em licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, end my license is in full torce end eflecL Lia a Class u Comractofs Signaiure: Da[e: CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrm that there is a consirudion lending egency For the pertormance of the work tor which this pertnit is issued. (Sea 3097, Civil Code). Lendefs Neme: Landafs Atltlress: Signature: Date: OWNER•BUILDER DECLARATIONS: I hereby eHirtn that untler penalty of perjury ihat I am EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions Code: Any GN or county w�ic� requires e permit to construct, alter, improve, demdish, or re0air any simcture, prior to its issuance, also requires the applicant br such pertnit to fila a signetl statement I�et he or she Is licensed pursuent to the provisions of the CoNractow License Ww (Chapter 9(commencing with Section 7000) of Division 3 of the Business end Professions Code) or Ihel he or she Is exempt therefwm end the basis tor tha allegetl axemption. Any violation oi Section 7031.5 by any applicant tor e pertnit subjects I�a epD�� to e dvil penalry of not more then five huntlretl tlWlers ($500�.): ❑ I, as owner of the properry, or my employees wlih weges as iheir sole wmpensation, WILL DO TNE WORK, entl the structure is not intentleG or oHered lar sale (Sec. 7044, Business and Professions Code: The Contractors License Law dces not epply to an owner of property who builds or improves �hereon, and who does such work himsalf or herself or through his or her own employees, providad that such improvemenis ere not intended or oNered for sale. If, �owever, iha building or improvement is sold within one year ol completion, the owner-builder will have�ihe burden ol proving that he or she did not build or improve for purpase oi sale.). � ❑ I, as owner ot Ihe properry, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construcl the project (Sec. 7044, Business and Prolessions Code: The contracbrs License Lew Aoes not apply to an owner of pmperry who huilds or improves �hereon, and who coniracts for such project with a contractor(s) license pursuant ta the Camractars License Lews.). ❑ I em exempt untler sec. Business antl Professions Cotle for this reason: Signature: Date: Owner ID veritiad by dnve(s licensa. ❑ Ve5 ❑ No DriverS Licen58 No. Venfication of Ownership by (type ol tlocument, i.e. - properTy tae bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTFICATION: F�cpires: ❑ I hereby certify thal no excavetion five (5) or more leet in depih into which a person is required to descend, will be made in connection wit� work au�honze0 by Ihis pertnit, entl thet no builtlinq structure, scaHolding, IalsewoAc, or demolition or dismantling thereot, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle B, Calitomie Adminisirative Gode). ❑ As ownerbuilder, 1 will no� employ anyone to tlo work which would require e pertnit fwm the Division ot Indusirial Safery, as noted ebove, unless such person hes a permit to do such work irom the divisian. Signature: Date: DiviSion oi Industnal Sately Pertni� Number: ICERTIFlCA7E OF COMVLIANCE AND A IZA�N OF EMAY: I certify under penalry of perjury t�at I have read Ihis application and state that Ihe information given is I correct. I agree to comply wil� ell stat ws end city ordinances releting to building consiruction, entl euthorize representa�ives of the City of Costa Mesa to enter upon the ebove-described properyy4qr inspeai purposes. I groo not to occupy or aliow occupancy of any building authonzed by this permil until final inspection. FODE r. INSPfl2fI0N 7YPE ✓ 7616 Fi:ed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIaWRetaining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition PAIE 1IIIID�Lff Date � r(`! G3 Date COOEI INSPELTIONTYVE P� LHmIALS 206 Final Mechanical 208 Final Plumbing —''1'f7-��— 210 Final Electncal /� ! / 212 Final Fire Prevention 220 222 250 Final Planning Approval Final Site Final Builtlinq/Occupancy _ ; ' _ „ . ., ^. ; _ . .;. : ... . -Cy_..�;-.,.�... • - ' . . . . � � -. �� - n,;. ... - , ,- a"' . . . . .. �'":�� Jln JJvd��Gl��ai� . - : ' ^��'7��._" . �.� ,� �� . .. ." , . , .� "� � � COSTAMESA�BUILDING-SAFETYDEPARTMENT � , - -��P(,�� `-. f-9��. '� ` ' �� - � P.O. BOX 1200 �� WSTA MESA„CALIFORNIA 92626 ' " � - � � � �� , � .� - - . , � APPIICATION EOR BUILDING_FERMIT^-' � �� - For Applic , t fo Fil/ in � etely - . . - -. FECEIVED- V DATE� C/E/IV D �DATE IS�SUiEO ' • BUILDING' �q,p � - , �/ � y - ADORESS � /�lly . �c - �'p" �� . ^ . ' PERNjA7-W(d� . ' �OWNER:' .,� . Cf_L', : G � OI/ . .' A.P.•NO:� I -Ql�-�fJ i2Z t.% : PS,� MAic � �J�r C�J' ., qo�oRess a3i( l 2'�'37 �� ,. ..• ADDRESS' � : �� F / .V/ •' ' ' ': .� / a U"� . CITY` � � �' /Q/�fS y�'. rypL �g �Z.�S .' ' .TRACT, � �UT�� BLOCK � z ' � EW ADD �ALTEP PA • Z Q ' CANSTRUCTION � � ` � ' [� � � .� . .. .. • O N ' LENDER . ' . . • . . . a-m . ' .. _ , . . . ,, . . . '. J 7 BRANCH ' ' :' ," � � - • . . . � .. : „ .OWNER :c_P�-' . � AD�RESS . _ .. �,'. ,.'.: ' , '. , ' , �,o"�./ -VALUE , .JQ ARCHITECT�.%/// � �G'�OQ�GatQY NOL' �/ SE�'-' �ii�+`� "'S� -.� - D• . . OR ENGINEER w Stlq O _ �� fn.. . '} �y /,f/ - - . .. /] ./� q ' . � .' � AZ a' e{�O / �/ (sJ/'�/Gus�`�N C'V •"1-� �20NE �� TVPE . V �"GROUP ' w �: ADDRESS' . , d w � � ' � ' - ' APPqOVED �.._. . (� W Z �.CONTRACTOR �,•' e?Q�JL�//� .i' '. ' •.0�' DATE�''lJ��. - _ ' J Q - . J^. . .�j - . . -. , . . . , . . J � - � ADDRESS' �.YJ YA. . ,�+��T �, . .� - !` ' . �'�� " w w � ' .:;TEL/�j ' �ZON ' NO.�OF � � USE OF NE '�dx.Y•�� •� � �z �5 CITY .� � CS � � ., .. NO. {i /� ' y PL'ANS %� �BUILDING ' � � � ,W ��_� '� STATE ' ' ' CITY' -YARDS APPROVED` - YAR APPR V � ' : N�fL' LIC. NO. .'(y�y��.� R/ LIC. NO ' •MAIN BUIL'DING 1ACCE SORV BUILDING � . � O � � - � �. - - • � � - -•- -• (FROM GL STREET) ' ' , ' . .. SIZE ( ',' �. . NO.OF BLDGS �- . - , - ,.,� ' , OF;LOT. .� p� ' �- � (�-�J '- , NOW ON LOT � O FRONT-`' � FT: - � FT. -. � -USEOF.. . . . - � ... " ^ .. ' �...., '- , �., - � .. � . ` EXISTING BLDG . "i� , �R' SIDE O FL I! FL ' ' � „ 'F.. SIZEOF.-.. .. -�-NO.�OF ' - ,:�s ,. . . �.,: , ; , . "Z NEWBLDG. ' �ROOMS 1�'��:-STOFilES. ^LSIDE I�fT, �-�FT. y .� . . �w' Q. . -. . , .. . . ,. - . . . . , U EXTERIOR WALL . . ,. ROOF •.. ' �:. �. , ' /J ' ,.,- ' -� COVERWG - COVERING" 'REAR'�. /FT:� ' � FT � VSE�OF�eUILDING�AND WOftK TO BE PERFORMEP ' '^:DI5TANCE BET. �- . BET. MAIN & �' , � .' „ '.t , •. . .; �� i.' `.. � +.-._ �. '. ' �'- 'MAIN BLDGS: . =�:.'., . ACCE55. elIX'v^. > . "' Q - .VAR.# "p' -. ..`..�DATE q , ,O C.U.P:�Ep% �U APPftOVED/ , , � � . ,�{ p- t , . .Vi � . �V .`�' APP E '-�/ . . z HOLD FOR. �. L REQUIR�MENTS o -- , - ,V Lhereby acknowletlge-ffiat-I have'reatl.this_application and state �� -��i � . ,. � .that the"aboveyinformation is�correc{ and:agree m comply with - � ' , ' . '� all laws regulating�builtling construci�on, arid-'1 shall not employ .�',�i-�� 1,; /'O 4 v�� r w-�o� V ' r any pe�son in. violatibn ot the workmadr'compensation laws of ��-�� _ .- 7 . ,. . y the'State ot Califomia.' �, ,' � .�' , , �'� ' � - . � ' ' ' - ' / (j � z� I hereby cerLty ffiat I am properly�licensetl as a contrector untler D �SQ: FT. � �b � o. = . � the State'ot California eusiness antl�.Professions Code, Divisicn 3, �THE AMOUNT SHOWN N g41 VALVATION IS FOR ' , ' Chapter 9, antl that such licensesare'iatull to�ce antl�etfect, or I' THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: � 'amexempttromthe'prowsionsoftheState'afCalifornia8usinessF�. �VAWATION - - - - . .�j� �/�' - �_ antl'Professions Code, �iv�sion.3; Chapter 9.- : .. � . , '�pERMIT FEE $` � t . ' �` , Si9natuie`oflY1 ��.�-�/..G'LU�C1.�.. � ,. -. „ . . ,_.. - . _ ,� m ' Permittee '� ' .$�� D� �y.. PLAN CHECK $.' � �/ . _ o . � (� �( � V !J' LL . . Auffiori Agent � ✓ � _ � TOTAI FEE..� l /� , ^ . ,. . ,�?��?5. - � " �ya J :��,'�;;��*d(��;__ „',}��j . '� T COSTA MESA BUILDINGSAFETY.DEPARTMENT � .�;��IP �,- IJ%� P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 . - � � � � APPLICATION'FOR BUILDING PERMIT � � ' For App/icant to Fill,in Completely� " � ' ' A RECEIVEO B DATEjFE EIVED DAT�E IJ$S�J.lE�D7'- � . BUILDING • JI/' � GJ� _/1✓'G � _ c2� �" _.� C/—Cl/� ADORESS / PE IT NO - OWNER /C S�L'CJ�C�(� � A.P.NO. (' — II'.ZC7W- � - � MAIL � � ^" � (�?' BUILDING 5..,� p _ � ADDRESS r c��e_i� Z . ADDRE55 �J V � — . d U CITV 't� �l�Sf�� .' NO�.(�y�y7 TRACT �� 6��" BLOCK - . Z Q CAN5TRUCTION ' . - ' N W ADD A R P O � LENDER � ' am � ' J � BRANCH � • .' . .. . ' OWNER C. P � LL� �. �`a '� ADDRESS " ' �� . . " -ARCHITECT /', TEL `Gp � S � ��" VALUg� �,�' J N� OR ENGINEER SO✓/ WQC /HAW N E`/ O o I , . . W 2 ADDRESS �� G/ // HCC�S�/�N JvI ZONE U TVPE GROVP �/ . aw, � . 3!`�n " . W Z / . APPflOVED JO CONTRACTOR /� t(�J�/ , BV DATE 0 / - m z `�3 � E � � ' _ J � ADORESS - ' ',/ ' w w 1 NOL.E�7/� 7 r W 20N ,/ , PLANS � BUILDING EWi�f' � � ciTv �OS /4 �rS4 � z� w� STATE (� n �� CITV. . � VARDSAPPFOVED �VARDSAPPflOVED • ,j O � LIC: NO.�� TS��Y, '(J/ ' LIC. NO. MAIN BUILDING ACCESSORV BUILDING SI2E �� ' -- � NO.OF BLDGv - (FROM GL STREET) . OF LOT 3�, O.O NOW ON LOT FRONT � FT. FT. USE OF - . � ' ' ' EXISTING BLDG. � - � I FT. � FT. � . � F— SIZE OF NO. OF Z NEW BLDG. ROOMS STORIES L. SIDE' � FT. FT.' � U EXTERIOR WALL ' � � ROOF , -� _, COVERING COVERING REAF FT. O FT. USE OF BUILDING AND WORK TO BE PERFORMED � � DI5TANCE BET., BET. MAIN & � MAIN BLDCS. ' ACCE55. BLDGS. ' ' O : _ l .. . C URP. a{'sZ - — O .4P ROVED �S — G:• APPR VED y . /` ..,, . � ` '� � ` � ~ I hereby acknowledge that 1 have read this aDP�ication antl state �L � ffiat the above intormation is correct and' agree to wmply with' �'"U � all laws regulatin8 buildin8 consttuction,�antl I shall not employ � . � r any person in violation of the workman's compensation laws ot the State of Calitomia. � ' m � zI hereby certify that I am properly licensetl as a convactor untler �� SQ: FT. ' � o the State ot Calitornia Business antl Professions Coda, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chaprer 9, antl"that such licenses are in full torca antl effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: � d � am eaempt trom the provisions of the State of California Business ¢ VALUATION � "�' antl Prof¢zsions Cotle, Divizion 3, Chapter 9. . - ./" � � � � � � PERMIT FEE $ �/ ' � . SiBnaiure of ' ' ] ` , �., m � Pe�mittee d/ $/�y M PLAN CHECK $, i E. '/ % 0-n . 0% : � ,° Authorix Agent J • \TOTAL FEE $ � ^ � . . . � 33 I 78 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BVILDING ,? !� ADDRESS J � OWNER �� PAfO JUN 18-71cns;.�0 943^ ***L34.50 APPLICATION FOR BUILDING PERMIT iiECE1VEDB,V DATERECEIVED ne�rciceiivn MA I L BUILDING ADDRESS � / ADDRESS � d U CITV � NOL6y�yyof TRACT ��('/ ZZ Q CONS�RUCTION O N LENDER am J � BRANCH OWNE a ADOPESS /�y��,� J Q ARCHITECT TEL�G/ 6�� 5 F�'�/✓�'��1 � U N OR ENGINEE N FIRE � Wa 5 �(J! ZONE � ADDiiESS d w APPROVED J O CONTRACTOR BV �J � ADDFESS/ (�/ O"K.� -37.za G /� � PEFMIT NO. BLOCK VALU$ �G � �C' / ^ \ - F1"'+ \ / � DATE W W / L ZONE NO.OF. USE OF NEW �_' CITV NOL �u /"'��/ � Z P�� Z BUILDING Z � w � STATE 7 CITY YARDS APPROV y� LIC. NO. �/ LIC. NOa I MAIN BUILDIN 7� S12E NO.OF BLDGS. (FROM C/LSTREEI OF lOT NOW ON LOT ROM FT. VSE OF � EXISTING BLDG. F� SIZE OF NO. OF Z NEW BLOG. ROOMS STORIES L. SIDE FT. UEXTERIOR WALI ROOF _, COVERING COVERING REAR FT. USE OF ILDING ANO WORK TO BE PERFORMEO OIS7ANCE BET. MAIN BLDGS. Q � VAF. qN' O C.U.P.qW '� 1 T � APPROVEP�+Ly N Z O UI heraby ecknowlatlpa Ihat I have read this apO��ation antl sta[a � thet [h0 abOvo info�mation is cOrract antl eBree to comply with � ell laws reBulating builtlinp eonztruciion, antl I shall not amploy F eny permn in vloletion of tho workman's compansation lawz ot L �� FT. ��T /� FT. V FT. pLTr BET. MAIN & ACCFSS. BLDGS. DATE APPROVED „�,� �'�1K�7/ y the Smta of Colifornla. � ZI hereby certify that I am properly licensetl as e contrector unCer SQ. FT. o the Sta[e of Californin usinezs entl Protauions Cotle, Divisicn 3, THE AMpUNT SNOWN UNDER VALUATION IS FOR � Chapter 9, ontl tho �c licen ara In f�ll torce antl eftact, or I THE PURC06E OF ESTABLISHING A PERMIT FEE ONLV: o am ezumpt iro a pr vlzlon f the State of California Businesz � entl Protasslons atla, visio r 9. VALUATION J� QO ' m . PERMR FEE 5 �1� • � 7 SIO�aturo ot ) °1 Pormitteo =t"� $� A% PLP.N CHECK $ // � E B '�� 3�i s=- o Authorizetl A ant LL TOTAL FEE S i ` F�yy7a io�a8%9 ' .., COSTA MESA BUILDINGSAFETY DEPARTMENT APPLI ATIOI�FQR;$,�R1l�Cj�,I;�F}A�, PERMIT •4�.50 TL •- ' '-'�P.O.BOX 1200 COSTAMESA,CALIFORNIA92626 _ , REC D PERMIT �j0 4 8 9 2 4 For Applican[ [o Fill in Completely — Use Ink Only i` ADIDRESS ELD -N Sf.' A�P�NO —� — � BUIL�I G i/' OWNER OR A�DRE55 �J� TENANT UNIT OR MAIIING c SPACE NO. ADDRESS — v TR �OT BLK. TEL �[ CITV NO. NEW ADD ALTER REPAIR MOVING DEMOLISH CAN5TFUCTION LENDER BRANCH � �� R ADDRESS �E � VALUEg� �IOO ARCHITECT TEL V OR ENGINEEIi N . ADORESS � ZaN TVPE GFOVP .� APPROVED �O � CONTRACTOR C� BY DATE ADDRE55 �7� /C�IWE � TEL. CITV S � C NO. � � STATE CITV %�PPROVEDSETBACKS LIC. NO. LIC. NO. {a� SI2E NO.OF BLOGS. 4FROM CllSTREET� 4 OF l0T NOW ON LOT R M FT. a VSE OF � EXISTING BLDG. 7 _ y G FSepBrate permits are required for �. si E FT. Q electric, plumbing and heating work. qEAR Fr p,- F,W. USE OF BUILD�NG AND WORK TO BE PERFORMED PWryNING ACTION �� DATE � APPROVED � APPRO r a � w O I hereby ecknOwlsdge that I have reetl this appllcation end state m y� Mat t�a above informacion is correct antl aB�eo to comply with � a all laws re0ulat��B builtling consVuctlon, nnd I shall not employ � Z any person in �iolatlon of the workman's compensation lews of : W the State of Ce��fornie. .: x SQ. FT. � ,; I hereby certify ffiat I em properly licensetl as a conirector under � tha Stace of Cd�ifornia Business antl Professfons Code, Diviaion 3, THE AMOUN7 SH�WN UNDER VALVATI�N IS FOR m Chapter 9, antl thai such licensas are In full torce antl etfett, or I THE PUFPOSE OF ESTABLISHING A PERMIT FEE ONLY: � am exempt (rom the provisions of the Stata ot California 8usiness VALUATION q antl Profassion5 Cotle, Oiv' ion 3, Chapter 9. PERMIT FEE 3 32 0 � m � Pl_AN CHECK 5 `^ Signawra of OQ • �� LL Perm�`ttee g� sOO TAX S • S� U D ? � � Auffiorize Agdnt Date TOTAL PAIO g S� VPOJECT AOOflE55: � j 1 S nLD EN FiV OWNEfl'S NAME: dRAN .11 2�A}ZIiY Y nooeess: � 790 P%.NAY CIR , COSTA N.n5A, CA AflCMIENGINEEfl: 9 6 S� 6 0 1 0 �DOflE55: uNiT: 97676 flEC.NO.: UNIT: PENMITTEE:B 6 C WE:LAING 6 iRON (714)636-5486 nooaess: 117 2 9 CF1itD I NAL C I GARDEN GROVE CA 92643 LICENSEO CONTPAC70N DECLAflATION: I �ereDy allirm Ilwi I am lic¢nsea unae visions ot ChaD�er 9(wmmencing wii� Seclion IjIB(1� ol �rvivon 3 0l iAe Business an0 Pmiessfons Coae, an0 my license is i� I o� G eilecl. B /cirr uc.: �sYyK�>,uc..� 4 0 9 7 3 cus �- o,ne: �"� �— Signa�ure: _ . _ WOHNER LOMPENSaiION oECIAflaTION: I nere�y aHirm that ave a c � ate of mnsent t etf-insure or a cenificate of Workers' Compensatio� insurance. or a cenilietl mpY Ihereol (Section 3800. LaG. POLICY NO.: E%P. ORTE: COMPANY: � Cenifie0 copy is hereGy tum¢�eA. ❑ Certitiea capy ¢ IileE wilA Ihe nty BuiWinA a�n. Daie: Applicani: E% TION FpOM WOXKEPS' fAMPENSRTION OECLIMTION: (ih¢ secGon nCeO noi Ge co etM i Ihe permt is �a ane �uMreO (511p) or less�. ertdy Oul in Ine oeilormance of the wotle iar wnkh tnis ce�� s �ssuetl. I shau not �o ! ce o' a`ry manner so as ro 6ecome suU�eci Io !!I�e Wor�MerS' COm�ppnsai)ion LavS of Cdlifomia. Oale: �� SignaNrt: NO IC�: I�. a�le� makin � rs attlaration. yau snoula Eecome yi CI l0 5' Comp atpn D«�ons o� lhe LaGor COE¢, y00 n1U5i IOM1hWllll fArt10�Y �� SOC� plOVISbM1S 0� INS pCf1111i II De OeemeG re a. COKSiBUC7lON LENOING ACENC7: I nereoy affirm Ihat inere is a consiruction lentlinp agenLy lor ine Dedormance of ihe vrork lor wnicn Inis oermn is issue0l�Ciion 3W7, Civ. CI. LENUEN: FODNE55: OWNEfl BWLDEB OECLAHRTION: I �ere0y atlum I�ai I am ¢xem0� ��Om tlle Conlratlar5' State License Law for t�e follovrinA reason (Section 7071.5 Business an0 Pwlessional Code: Any tity ol rAunty w�ich reQuires a Dermil lo conslmct, alter, im0�o�e. Uemolish, or renair any simciw0. prior lo ils issuance. alm reQuires Ine aOVlicanl lor sucn permil to lile a signed stalemenl I�a� he/she is licensetl pursuant IO IM1e pmvi5ion5 0l I�e CAnlratlOrs' 9ate License Law �ChaO�er 9(commencinq unth Section 7000) ol 0ivision 3 0l ihe Business and Prolessians CoOe� or I�al �e/she is exempl IheBirom an0 I�e Uasis for t�e alle0e0 eaemption. Any violaiion o� Seciion 7031.5 Uy any appli[anl lor a Oermii 5u01e[I5 I�e aDPliwnt l0 a civil penalty al nol mom Ihan live �wGr¢G dollars (f500). i❑ I, as owner al i�e DmOeny oi my emyloyee5 wit� waq¢S as t�eir 501e compen5ati0n. will tlo t�e wOfrc. an0 ihe slmcmre is no� inlenGeG or oilereU lar ule (Seclion 70a4. Business anG Pmleuional Catle: TAe Conlraciors' Sia�e License Law Goes noi aODN �o an owner ol a D�oDerty wtp OudGs orimprwu IMreon, anG w1ro does suc� work Aimseti/�ersell ort�roupll �is or ner own emDlayees. pwviG¢G IIIdi suc� improvemenls are nol intenEeG or ollere0 lar Sale. II, �owever I�e 6uiltlinp or imOrovement is soltl vnt�in one year ol campletion, t�e O�mer will luve t�e Ourtlen o� O��A ��s�e tli0 noi Ouila or impwve lor Ihe purpose ol Shce1. I, as awner ol t�e pmperty, am exclusiveI� contraninq wi�� Iicense0 contracmrs m wnstmct t�e O�ojed (Sectbn 70aa. Business ❑ aM Prolessims CaOe: T�e tontranors State Lice�ae Law Qoes ipt a0W �o an ovmer al D�oceM ��Os w imprwes t�erean anU wll0 COniratl5 lOt wC11 projtt6 h'iill a fAnlrattor(S� IifRilSe Dur5Ydn1 10 lll¢ fAnVat�atS Siate License Law). I am awarc iha� p�ool al I�eir Wodcr's Lampensation insmance 51pu10 Oe provi4e0 la me. � 1 am exempl uMer Section: B. 8 P. t. tor Inis �eason: Oa�e� Uvner. I Oo �ereUy cetlily ��al l am aware ol anG untlers�antl 1�e �eduirem¢nis oi Calilamu Mealt� anG Salery Catle Seciions 25505. 25533, antl 2559a antl I�al I or any fuiure builtlmg occupanl wilVwill noi (circle one) neea Io comD�Y wiN saia slale coaes and Ihe requiremenis lor a peimit loi conslmc�ion or mo0ilicalion Iwm I�e Air Ouabiy Managemeni DiSVici. FesiQenlul tonslruclion applicalions are exempi �mm Ihese D�ovisions. Oal¢: ApPlitanl: I here y Cetiily Uai I �ave rBa4IN5 applitalion an0 Stale Ilu� �h2 a0ov¢ oi ncesanOSlalelawsrelalingtoUuiltlmgconsimctionanOnereUyaNO oDeriy lorinsDec�ion purpOses. I �ate: �� SignaNre: _ IOriver's License or Social Securi� i6at�a6 Wbne—BwWing:Green—CaOeEnforcemem; nary—A, is corrtci. I agree io camply vnlh all ciiy anJ county nla� ol �his ciry to enter upon ihe above-men�ioned GolOenrotl—Assessor �� CITY OF COSTA MESA – HUCLDING P�RN:T PERN DIO; d 06i6:'i PERMIT NO: B 061627 PLAN CHECK NO; N GOV"�: .+1:;CPP: N CONSTRUCTION TYPE: V–N PERN.I'i TYPE; S1R PLAPOit: U'�'A JOB DESCRIPTiON : 5' HIGH POOL FENCE SQ �"; ^,07'/ CLAIM VALOE; 1,077.00 CALC–VALOE: 1,077,00 GRO(:P OCC; R-1 / CUMMEN'CS: FENCE AROUND PUOL/WROUGHT IRON iE iF k� iE it iE iE 1( iE JF if )f #�%'lE it if -1F 1E �If if %% 1(� #�1(� �1F iFlf iE iE iE �% �l( %# i( 9( �%if ih �( %�( i( iC� �%iE i( lE lE i! K N#�)E iE IE �A iE �% if %� �% �lE iC i( if # ib k iE 1E 1f ii !l �x q# Z O N I N G R E Q U I R E M E N T S s s•r s A c x s ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT ZN FRN1': FT IN REAR; FT –N LEFT: FT IN RGNT: FT IN LEFT: FT !N HGHT; F'; IN PARKING RE(� • PROV; PARCEL; 43927116 ZNE; }72 REF NO: PLANNZNG Nt51'ES> 5 FOOT HIGH WROUGHT IRON FENCE AROUND POOL– ALL k'I'fHIN INS:D > E TAE PROPERTY LINES–TO THE REAR OF THE HOUSE. �**rr�r*****xrt�x***�x�*#*�*u##�r*x�*�*rt#*it*it�*it�##**��u�itx�rftitftfr*#rt**it##**x�*�u x x �#cert D E V E L O P M E '/N T S E R V I C E S R E Q iJ I R E M E N T S ZONING APPROVED BY !� / n'� — -r—�T ,-- DATE; � 3 BUILDING APPROVED BY : DAiE: � APPLICA'PION ISSUED BY. DATE. 1tftlEkiElFiFit1l�iEitklElE1E#ft#it##i! .. . r,titttii� e�it t%� t �t i��Z1FiF#il�##i(##f4itlx ��iittY.�lE K� # iF 1f 3(� # 1F 1F # iF iE fE if iE IE iF iE ## 1E if iF # fE #!t # if� if 1E if� %� # iE 1� k# lklE 1F# �E 1E ik 1(� ## iF k�H� 3f # iE i4 # lE # k%%1E fE it ik #-Ih �1F 3E 1E # iF iE # ItlE G'•f N� � LEGALI2ATION;N F E F S U M M A R Y S"TRUCTDRAL SEGMEN�;Y BLDG PMT PLUMHING E ECTRIC MECHANIC FIRE SMIP/RES GRAt)ING PE:RMTT 27,00 .50 sMipinoN-aes PLAN ISSUE FEE BUILDING–DIV–> PERMIT ISSUE PLAN–CHECK TOTAL PAID Di.= TOTALS----> 27.50 0.00 0.00 27,50 27,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 27.50 OVER/SHORl; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/TOT GRADTNG PLAti–CHECK 27.00 ,50 kiEif/Fk#kifiFk#if#iliElFiFlEihkiF#iliE#iFx�t(�i4it#iE##fliFllx�###if�1Fi(�#!l�####'lt#tFitifk##!t#iE#3F�)(��)filiE?h1F#itki(�iiM##{ffe I N D I V I D U A L F E E B R F. A i( D O W N TYPE QTY D E S C R I P T I O N UNIT COST `iOIAL COST SFR 1077 STRUCTURAip BY VALUENDP F fiEE50 � ],00 1,077,00 EXPIRED T �11CM11 �Yt@ �RSpQCi10Rf o.to � �� 1 � . G .� CONSTRUCTION ANO PLANNtNG APPROVALS Permit � t. TemporalY Elecincal Se�v�cea� Pote 2, Soil Pipr�Undrgmd. 3. Eiectncal Condurt Ut�hty�i,nd�gmd. 4. ElectriCal Condurt•U�•d_�'�na.^_ 5. Steel Reintorcemenc 6. Elettrital UFER Gr�d � 7, Foot�ngs 8. Foundatio� 9. tVater P�pe�Undrgrnd. 70. Structural Floor System ` 11. Property $��+Er Lin: Fn Yrv : Connrction 12. Se:ver Cap � , 13. Roof Drains 14. Rough Plumb�rt3 - 15. Rough Elactrica6Condurt 16. Rough EIBCcriC �Niring 17. Rqugh VYinng Sign ' 78. Rough Elect�iw6T B_r ^x�i�^g 19. Rough HBating & Au Co�d�t�Oning 20. Ro�gh Factory Frep'acc 27. Ducts, in Structure 22. Ducts, VentilaUrg 23.'Gas Pipa�Rou3h 8� i es: 24. Roo( Fram�ng 25. Rooi Shratl,��.�a 26: T•Bar Ceding IStrutturall &• '.�onocoat 27.;Frameand Flashing 28. Lathing & Siding 29. Insulat�on _ 30. Drywali Nailing 37. Pl�sjer BrD�vn Co.;t _ 32. Eleetriu�l Por.cr ',-r.tc: F��c., 33. Final E�eGtric 34. P�nal HtaLng Rl A�r C�-�.t'on�.r.g 35. Final Gas PiPe�Test 36. Hood or Canapy 37. Final Faetory Fireplace 38. Finai Plumb�ag 39. LVater Ser��ce�Finai 40. Gas Service-Final t _ _ 41. Solar poriiesticFina: • 42. Backflow Preventer 43. Backflow Irrigation 4q. Landseape trnqation SYstem 45. Sound Attenuation 46. Handicap Regulatio�s 47. FINAL STRUCTURE U� BUILDING 48. FINALP1.AtVNING 49. Electric Release to Edi,on 50. Gas Release to Southern California Gas Q 51. CERTIFICATE OF OCCUPANCY Date Date � Inspector s f'O� 6 SPA , APPROVALS Permit,',`- Date I Inspector ; 52. Pool & E4uipment Locat�on i 53. Stecl Reinfarcrment � � 54. Forms -'}-�-�� '~� 55. EIe�Vical B�nding � I i ' 5�. Rough Plumhirq & P�es:uro Test I I ---�-1- 57. nPPROVAL TO COVER�GI'�!iTE � ! __ _______ --_.r--___r_--_ -' 58. E�ecU�eal Cund�i.!-;:�d�,ma. � ', - - ---- ---�----- ----+--- - 59. Gae P�pe, L] Undrqmd., Test I I ---- -�-- ---- �--- - � E0. Qac'.:t�ah I.ir.c., P.Tr;,n,', ,�_�,�.., �- ----'-- --��-----� *---- - 61. APPROVAL 70 UE CK � I� • � - -F--- - 62. t3idcttcsh & 7rczptcr Fr�.:i � �' ___ _-_ i -_-___ 63. Heatci & Vent�Final G4. ?lumbing SY'�tcm F��al G5. Electrlcal�F�nal 66. Solar SVStem�Fina� _ 67. f-encing & Access Apu�uoal 68. APPROVED FOR PLASTERIf�G 69. POOL/SP,�SYST�'"SFINAL FIRE DEPT. REQUIREMENT APPROVALS P��rmit ,� 70. UndergrounC Hyu,o � 71. Product Pip;ng �: G.�s ' `O�! � 72. Undergrounri Flu. � - - ----- ��' `--- - 73. Undergrnd. Stor�g-' Ta�!: � Gn .' O�I i ' -- --- -'--- .. 74. C�erhead Hy�irn 75. D�y Chemicdl 76. Dry StanJpipe --- - - -� � 1 77. FIXEDSYSTEMFINAL � 78. FIRE PFEV. FINAL _L_ HEALTH DEPT. REQUIREMENT -t 79. FI�'AL I�ISPECTION I � 80. FOUD CER_TIFICATE ISSUED__�_, L_ • �L� L Notes: �� - - --- --- -- -----1 -r - �i I _I -� I ---i i �' � /I PHOJECT RO�HESS: Z 3 I S ELDEN AV uNiT: i OWNEH'SNFME: HRANIN BARRY F aooaess: 1790 Pf:NAY CIR COSTA MESA,CA 92626 662-0550 AflCNIENGINEEP: NEG.NO.: ADdhESS: I1NIT: PEXMIiTEE: CAL—CUSTOM ROOFING ( 714 ) 974-3542 aonyess: 1442 E. LINCOLN 372 ORANGE CA 92665 LICENSEO CONTBALTOB OEQAPRTION: I hereby aliirm that I am IicenSeA under O�ovisions ol CAapler 9(commencinp wi�� Seclion 7000) ol Division 3 of Ihe B ess an0 Pr leuions CAtle. anG my license is in full torce and e��eci. cinuc.:0 sTa 925 �cIussq:C-39 Da�e'. Signature: _��.Ld_�, � w0 CO NSATION OECIAflATION: I here0y a��irm lhal l have a Cerii�iGa�e o� tOn5en1 �O Selt�in5ur¢ Or a Certilitat00� WOders' Compensalion I�s}�r�� q( g�nihyQ pppY ��e�ro� �Seciion 3800, laE. L�� 0/ 9 3 PoLICY NO.: 1 L 9 1 y L E%P. ORTE: U cornraxr: STATE � Cenilietl coOY �s nereGy tumisAea. L� Certilie0 copY is lile�tl Jw/p' ��1 ciry Bmltlin vision. Oate: /� ��`� / � Applita_:7%'!%/1.�� E%EMFTION FNOM WOPREBS' COMPENSRTION OECUflI1TI0N: is sttlian neeU noi �e [ompleietl if Itie permii is lor one Aurbre0 (5100) a less�. . I teriify Ihal in the pedOrmance oi Ihe work fOr whit� I�is permii is i55ue0. I S�all nol employ any p¢r5on in any manner 5o as Io betom2 SUEIetl to t�e WarkeK Compensaiion Laws o� Cah�ornia. Date: Signaiure: , NOTILE: It. alier making t�is tleclaration, you S�aula become subject ta the Warkeri Campensation provisions of Ihe LaGor Coae, you must fonnwilh campty witn sucn mvisians or ihis permit snall 6e AeemeO revoketl. CONSTBUCTION LEN�ING R . I hereGy atiirm ihat ther - onsimction IenGinp aAenry lor t�e Derformance ol the work for whicn I�is permil is iss tttion 3097. Civ. C�. �� RDOfl s: REROOF 3 APARTMENTS ON SAME LOT OWNEB BUIL EN DECUNRTION: I �ereEy affirm IMI I am exempt im e Caniractors' State License Law tor tAe followinA �eason (Section 7037. usineA2a� Pmlessional Catle: Any city al counly ch Rpui25 a permit ta tonsiNct. altet, improve, aemolisn. or repai� any Sirutture. pri0r IolSiesu�e, als0 reqUir¢5 Ihe ay ' lOr SUCh permi� Io lile a SiAneG Sial¢meni IAai he/5he i5 liCens¢tl Dursuanl lo t�e pmvisions ol l�e Contractars STtfEi(LEI�w (Chapi¢r 9(commencinA �� Sectian 7000) ol DiWsion 3 0l l�e Business anG PmiesSions Code) or I�al �e/s�e is exempl t�erolrom anG Ihe Ga5i5 far Ihe allepe0 exemption. My vioWtion o� Sttlion 7031.5 Gy any aDO��ni fOr a Dermil 5ubjecl5 Ihe ap0licanl to a CiWI penalry of no� more ltwn �ive hunGr¢d G011ars (5500�. I, as owner of Ihe o�aPeny or my employees witA waqes as lneir sole campensalion, will do I�e wark, and me ❑ slmcture is nol intentletl or offered lor sale (Seclion 70da. Busineu anU Prolessianal Code: The Coniractor5' Slate License Law aces not aOPly lo an owner ol a pmperty who builtls or impmves ihereon. antl who Caes such work himself/herseV or throuAn his or her own emoloyees, orovideA ihat sucn improvemenis are not inten0e0 ar atleretl lor 5ale. II, hOweve� Itle OuilUing or im0�ovemeni is Sold wilhin one year of fAmpleiion. I�e awner will tWve ihe burtlen o� pwving he/s�e Gi0 noi Uui10 ar improve - lor Ihe purpose of Sale�. I, as owner al I�e property, am exclusively conVa[�ing with licensetl tonlraciors �o cons�mcl lhe D�ole�� (S¢clion 7044, BusineSs ❑ anC Pmfessions CoOe: The Comracmrs' S�ate Lkense Law Ooes not apply m an ovmer oi DropeM who bmWs or impmves ttrereon antl w�o conUacis for such prolecls wit� a coniractar�s) li[ense pursuanl to Ihe CAnlrattOR' Sia�e LicenSe Law�. I am aware IAaI D�� oi their Worker'S fAmpensation insurance 51rouIC be pmviae0 Io me. � I am exemp� un0er Section: B. 6 P. C. b� Nis reason: Da�e: �e�: I tlo hereby ceNty t�at 1 am aware ol anA un0ers�ana IAe reQuiremenls of Califomia Healih anC $atery CaCe Seciions 25505, 25533, an� 25534 and �hai I or any future �uiltling occupant willlwill not (circle one) neeA lo compty wiih 5ai0 s�ale coUes and lhe repuiremenis �or a permil lor consimction or modilication imm t0e Air Oualily Managemen� DiSlrici. fleSiEen�ial conSlmciian aDDlica�ions are exempt Imm ihese pmdsions. Oa�e'. ApPlicanL I here0y cetlilytha� I havereatl this applica�ion antl siale�hal��e aboveiniorma�ion is cDrrecL IaA�Qeia comply wilh all ci�y and coun�y or0inance5 an� sia�e laws relating to builtlmg mnstmc�ion and M1ereUy aNhariie r� ive ol �Ns ciry la eNpon the above-mentioneA pmperiy for inspeclion Durposes. � Date: �J �- / + � �� ISigheWre: oriver's �icense or Socia� Securi� �-� t641-46 Wbne—Buildmg; Gre¢n—CoEe Enlorcemem: Canary—Aoollcanl; Pink—Pevenue: GolOenrotl—Assns.cnr CITY OF COSTA MESA — BUILDING PERMTT PERM NO; � PERMIT NO: B 060446 PLAN CHECIC NO: N —i,'�pT�T3IIPF� CONSTRUCTION TYPE; V—N PERMZT TYPE: STR PURPOSE: ALT JOB DESCRIPTION : REROOF 10000SF 3—APARTMENT BUILDINGS SQ FT; 18,800 CLAIM VALUE; 18,800.00 CALC—VALUE; 18,800,0.0 GROOP OCC: R-1 / COMMENTS• AEROOF 6000SF W/HOT MOP 4000SF W/COMP SHINGLES p� �y�p��q.� *�r�r�t�t*�r�tir*�e�r�r�r**+r�r�r�r�r*�r��r�r*�r*�r��r*�rx**�r�*�r�r*�rx*�t�rx*�rx***�r**�IVIVf�C VC 1 �� Z O N I N GS ERTEBQAUCIKRSE M E N T S � ' ____ �EQ UIRED FRNT: FT��IN HUILDING ---------- ----- ACCESSORY BUILDING --------- • IN REAR; FT IN FRNT: FT IN REAR; FT IN LEFT: FT ' IN RGHT: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ• � PROV; PARCEL: 93927118 ZNE: REF NO; PLANNING NOTES> i it it iF ik iF iF!! ik if if iF 1E it iE iE iF!! iF if if if iE if iF iF i! if iFlF 1E if iF 1F 1E if iE 1E if !! if iE if iF if if i! ib �F * iE if iF 1E 7E if if If 1FiE iE 1E 1F if iF iF 1! iF iE iEit iF 1f iE ik it iE if 1E 1F D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY ; DATE; APPLICATION ISSUED BY; DATE; �'i-I L3i5 �- ' iF i:lf iF iE iE i(� iF 1f If if if if if iE 1E if if ik if if if IE iF iE iE iF if� �F iF iE M��{f�E if iF if M if if ik iF ff if iF if ik 1t if if if if iE i! iE iF iE if k iF iE iF if iE it if iE if k k if 1f iE if iE iF ff iF # iE 1E iF iE k iE if k iE if iF iE if iE fF iE iF iF if i(� if if if iE iE iE if iFlf iF if� i! 1f iF ik LEGALIZATION:N F E E S U M.M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 198.00 - 1.88 PL� . • SMIP/NON—RES ISSUE FEE ' BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK /''TOTAL PAID DUE TOTALS----> 199.88 0.00 0,.00�. 199,88 199.88 ,00 . .- - REVENUE DIVISION TOTALS--> COLLECTED;.-, ! 199,88 OVER/SHORT; 00 BLD98PM�T� PLUMHING ELECTRIC MECHANIC.-�-FIRE SMIPiT88 GRADING PLAN—CHECK J i . !f k iF ik ik ik i! ik 1f if ik iE iE 1E if i! if iF if 1E it i! ik if iE iE iE iE if iF 1t M iE ik ik if iE �! if if IE.iFiE iE if iE iE iF k iF iE iE if ik if i! 1f iElt �F itlt if iF iE iF k# if iE iE i! iF i!!k it �F k iF I N D I V I D U A L 'F E.E B R E A K D O W N TYPE QTY D E S C R I P T I O N ' ' ' UNIT COST TOTAL COST SFR 18800 REROOF BY VALUE RESIDENTIAL- NOZONE 1,00 18,800,00 END OF FEES . .�:� � �CONSTRUCTION AND PLANNWG POG . SPA APPROVALS Permit # � Date Inspector qppROVALS Permit # Date Inspector 1. Temporar� Electr�al Service onPole � . 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgmd. 54. Forms 4. Electrical Conduit-Undrgrnd�. 55. Electrical Bondmg ' 5..Steel Reinforcement " 56. Rough Plumbing & Pressure Test . 6. E�ectrical UFER Grnd. S7. APPROVAL TO COVER�GUNITE ' . �. Pootings � � 58. Electrical CqnduibUndrgrnd. � 8. Foundation �59. Gas Pipe, O Undrgrnd., Tesi , 9. Water Pipe-Undr9rnd. � '60. Backwash Lines, P�Traq, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer �ine & Hou;e Connection 62. Backwash & Reteptor�Final 12. Sewer Cap � i 63. Heater & Vent-Pinal �� 13. lioof Drains • 64. Plum6in9 System • Final 14. Fough Plumbing 65. Electrical�Final � 15. Rough Electrical-Conduit 66. Solar System-Final 76. Rough Electric Wiring 67. Fencing & Access Apuroval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Eiectrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Cond�tioning FIRE DEPT. REQUIREMENT 1, rr� : _ � , 20,�RoughFactoryFireplace ' �' •� � `� '�" �• APPRAVAj'S�" Pedmit# ` i�•�. � �� • �� • . , ' . , � � • � 21 � Dutts, in Structure �.. . • .;7p, Undergrovnd Hytlro 22. Ducts. Venti�ating . ' �' -� � �_ `� � .'! �. _�77. Product PiQi�g d'Gas 17�,`Oil 23.'�Gas.Pipe-Rough &'test - �� ,. ,' � ' � � � . ' - .�.i � •. + J2. Undergrov,nd Flust�, . 24,. Roof Framing � � . •� � - :'� : F, • -73rUndergmd. Stor9g�17a7ik'�] Gas ❑ OA 25. Roqf Sheathing ' ", �'� .� � rL �� 74,.� Overhead Hydro �' � . 26. T-Bar Ceiling (Structuraq & Monocoat � t �+ • % 75.� Dry Chemical , � ' ° 27.:Frameand Fiashing ' ` . „ 76. Dry Standpipe ' � , 28. Lathing& Siding �� . 77.� FIXED SYSTEM EINAL '29. Insulation , . - _ -� � " � 78..FIRE PREV. F�NAL > 30. Drywall Nailing � � ��HEALTH DEPT. FiEQUIREMENT 31. Plaster Brown Coat � 79` FINAL INSPECTION � 32: Electrical Power MeterFinal� � ,80. FOOD CERTIFICATE 155UED y _� � . 33. Final Electric ; ; '� j � ' Notes: � Z-, �34. Final Heating & Aic Conditionin4� . . � � � / _ o �/� � �/L � � �.��((- .� - ,- - t- �-�/-}' ✓ `�' f'41 35. Final Gas Pipe-Test , _ , _ /f _ _ ,�q- �� , (/}�- 36. Hood or Canopy � �,'Im 3 J� �'"' ,� �--- ' 37.-'Pinal Factory Fireplace . f yyi,�-�'; 'Z �'�P _j�J��K-,� � _� 38. Final Plumbing � • � - -C�� 1�� 39. Water Service•Final � S3 �- -� `_ y,f�/� c.�.iv, �vV - 40. Gas Service-Fina� . � 41. Sol r pome ' -'n�l �. ' � , • 42. Ba kflow� ei � � . � � i 43. Backflow Irrigation � . � � , , 44. LandScape Irripation SYstem - . _ � , - 45. Sound Attenua[ion � � ' � '46. Handicap Regulations - � '� 47,-.FINAL STRUCTUAE &•BUILOING . . �- 48. FINALPLANNING' � � . 49. Electric Release to Edison- � 50. Gas iielease to Southern California Gas Co , ( � . 51. CERTIFICATE OFOCCUPANCY � . , NO. Date - ' : s�sk,:� .COST'A "MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f7 COSTA MEBA. �L�FORNIA For Applicanf fo Fill In Compleiely TYPE OR PRINT ^ BUILDING �1 '�II ��D�'N / (��. ADDRE86 0'- COSTA MESA. CALIFORNIA � MAIL 1 ARf•••TEGT I 81ZE � 68iBACK LIN6 PROM FEE RECEIVE� � JUL 181961 fiNANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only R6C81PT NO. b VUfNR(NO.^ � q$C8{Y8D BY � /�� [NeU I pA / � (` /� �/ ([' 0 7 M G f� NOLI 'O % AOO E'SS �Z..� I� Q•�� iLL�. ��' COSTA ME6A. CALIFORNIA vn ^�/Q�' L P OK' APPROVED��'•Y��v �cl. n�, v�. < BY /J's — G� DATE vlcr a ZONING / ZO � I NO. 01 � I U86 OP NCW 3 / J� PLANg 6UILDINO TEL. OQ L LlaAL NO. D68CR1�lION INO, OP BLD68. � NOW ON LOi. A. P. NO. A�� VARDB EVES ' •��' APPROVED ALLOWED ccermn uHe er.� . DESCRIPTION OF WORK � IROOF COVERII WORK TO BE � 1 H6R8BY ACKNOWL¢D06 TMAT 1 HAVB NBA� TXIB A�PLIGTION THH AMOUNT lHOWN UNDHR VAlUAT10N IB IOR THH AND BTATE THAT TH6 ABOVE 19 CORRCGT A�'ID AGRHB TO COM• pUMOBH OF lBTAlLIBHIN6 A PERMIT PEe ONLY. PLY WITH ALL CITY OROIN�NC88 M!O BTATe L�WO R60UL�TINO Bu1LDINo CONBTRurnON. OMG /M��'Y V%�LUATION a-0 81GNATURE OF �CGUk'9 f'E hi .,y�, PeRMIi PEE $� PERMII"fEs//� S `C�I �V ' PLqN CHECK $ AUTHORIZED AGENT � TOTAL FEE �tr- �7'7�/ • ' • ;i%�� FEB �3-7lcnsa00 747 o*aaa�5.00 . • CUSTA MESA BUILDING-SAFETY DEPARTMENT " P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely FECEIVEDBV DATERECEIVED nnrcicciu BUILDING / �{ G�. �— ADDFESS OWNER � PCi�.P�� y A.P. NO. � Ol ' MAIL c �/ 7 C/ AD'DRIE S Z ADDRESS / l �� dU CITV � �CS' NOL��<7T:� TRACT Z Z Q CANSTFUCTION W AD A F a m LENDER J � BRANCH J N OWNER � ADDRE55 0 J Q AqCHITECT /,/ TEL. S � OR ENGINEER / G� W � U Q FIRE W 2 ADOFESS 20NE T aw . W Z APPROVED J O CONTRACTOR , e� m Z �/ 7 J � ADDRESS (� � ('� w w .y ! ��" TEL. ZON NO.OF � F CITV �QS / !,•—� N06�y24� O / " •� PLANS w� STATE CITV VARDSAPPROVED N Q LIQ NO.�ys ��y � 3� LIC. NO. MAIN BUILOING 7O (FROMGLST ET) SIZE NO.OF BLDGS. OF �OT NOW ON LOT ROM T. USE OF EXISTINGBLDG. Q f L3Y4 tS FT H SIZE OF O. OF Z NEWBLDG. FOOMS STORIES I.SIDE FT. U EXTERIOR WALI ROOF COVERING COVERING REAR F . USE OF BUILDING AND WOFK TO 8E PERFORMED DISTANCE BET. MAIN BLDGS. O .�/C6N0/S` � UPG!� C.UP.qW � ,�y5 — /�r es+ APPROVED � z O VI hareby acknowletlge iha[ I have read [his apPlication and stare � thnt the above information is corract entl ugre¢ to comply wiN � all lews reg�laiing buildin8 construc[ion, entl 1 shall not employ r any person in violation of the wo�kmon's compensation laws ot .OTe'�. � BLOCK G� //� VALUE � . $ �f.� '�. TGROUP � DATE —�ry E OF NEW �.yK� LDINGi h� �/ � y (�L VARDS APPROVED � BET. MAIN & ACCESS. BLD DATE APPROVED y r�e State ot Calitomia. m � zI hareby certity that I am Oroperly licensed as a coniractor untler SQ. FT. o tho Ste[e ot California Business antl Pro(essions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOF m Cnapte. 9, antl that such licenses are in full force antl effect, or I THE PURPpSE OF ESTABLISHING A PERMIT FEE ONIV: ¢ am ea¢mpt trom the provisions of tne5tete of California Business VALUATION antl Professions Coee, Division 3, Chapter 9. ""�(/� � PERMIT FEE 5 � 7 SIB^atura ot � � m Permittee S�/Q J� ✓ PLAN CHECK S �� E V-1/ �i�� LL Authori Agent TOTAL FEE 5 � i. _ - ---- - ' • . �.� — _ �:.i.. ... �_..a.. .�. ..).J � , COSTAMESABUILDING-SAFETYDEPARTMENT �-�� - �g�� P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 �' - APPLICATION FOR BUILDING PERMITj ForApplicanttoF' inComplefely RECEIVEDBV DATE.RECENED o eJi�{}�eo BUILDING , ? � / H G �r i `- � Z� - � `�-��/ ADORESS V OWNER A sPLV C// A.P. NO. �-OII-�!��' .PE�o��(/ � MAIL LI �. !� AODRIE S ��II �� ADDRESS V �j� dU CITV S'�� NOL67ZTlO� TRACT�/� ��OT BLOCK ZZ Q CANSfFUCTION W ADD A T R P O N LENDER d m J � BRANCH J.:.'w? OWNER �1 (A %1- � l /- �'�"�'�g ADDRESS /� .y� �"'.+,'.� �y��,�J V W E /jn �` Q ARLHITEC7 / ' TEL/�{ �^ USEO^"-"✓ � S%/ b7o'� J N OR ENGMEEq '�/.(O - Ol N.07`�y00 / v V Q ��O � ( � � I�� FIRE w� ADDRE55 G ZONE TVPE � GROUP �' w ' APPROVED g % J O CONTRACTpR � ({/Q/ BY i-- DATEJ�� / m Z � / r J� AD�RESS S ' �4�'�^ W w � TE� ZONE ^�� NO.OF USE OF NEVC ^� i'e � Z= CITV Ca� �u ��S f( NO. �/- PLANS� BUILDIN . / � , ,"' ' - � STATE �r� U�� )� ^ /> / CITV VARDS APPROVED VAPDS APPRO� ED y� �IC. NO. O� 7 � �U LIC. NO. MAIN BUIL�ING C S RV B I D NG � � SI2E NO.OF BLDGS. (FROM GL STREET) /� ' � � '0/ � OF LOT � '� �j Q s NOW ON LOT Q FRONT '•� FT. - O FT G USE OF � p EXISTINGB4pC., SI �FT. CnFT,. 7v/�S^ F SIZE OF NO. OF C' {� O� Z NEWBLDG. ROOMS STORIES L.SIDE •�FT. C•FT. V COVERINGAL` CO�ERING REAR •�FTJ�. ��' FT. ��6�a.3L' USE OF BU��pING AND WOFK TO BE PEFFORMED DISTANCE BE ��k'�O"� BET. MAIN & MAIN BLDGS. � ACCESS. BLDfdS. O C UA. �`-,�� p '��i APP OVED �`p -�O . N ✓7 ' APP ,\ / � ` S- I d` l7-" z � + ! U I hereby acknowledge that I have read this application and stare ��. � � that the abp�e information is correct antl aeree to comply with � all laws reg��ating building construc[ion, antl I shall not employ F any person in violation of the workman's compensation laws of ffie State ot Calitornia. P � zI hereby cer�{fy that I am properly licensed as a conRactor untler � �+ SQ. FT, D� �%li � O tha State of Calitornia Business antl Protessions Code, Divisicn 3, THE AMOUNT SHOWN UNDE,B VA�VATION IS FOR Chapter 9, antl ffiat such licenses are in full force antl effect, or I THE PURP�E OF ESTABLISHING A PERMIT FEE ONIV: d am exempt From the provisions o4 the State of California B�siness � VALUATION m antl Profassipns Cotle, Division 3, Chapter 9. Ov PERMIT FEE $ �� 7 Sig^awre of � � �..p m Pa�mittee $/+, /y � P�.4N CHECK $ E � �� w 0 LL Authori; Ag¢�t TOTAL FEE $ �� , I '- .. : _,.. ,. - - - - , .., �. . - ' . '�7?R� � ,- ---�� ' . ' i S71 ' COSTA MESA BUILDING-SAFETY DEPARTMENT � P.O. BOX 120Q COSTA MESA, CAIIFORNIA 92626 APPLICATION'F For Applican Fill i C mpletely ' RECEIVEDB — �Al BUIIDING ��// �`�. �^� ADDRESS � //�{� v OWNER d r �+L / A.P. NO. �—O /.— ADDRESS 3 fi E/�� S'T ADIDRE S 2 . ./- (/ d U CITV � S/Q C ry�L JZ�S TRACT� -Z Z Q CANSTRUCTION N W AD� A 7 R F O N LENDER / ✓ am J � BRANCH OWNER ,/�/J�� ADDRESS Ja ORENGINE R O ��O' NtqN NEL.�li/�jyy/ / , J! N �(e /00 U Q / / J FIfiE W 2 ADORESS �S�J/, `� (JSC/�H C�� z�NE T d W APPROVED J O CONTRACTOR '� P .( // eV J� ADDRESS 3y� r �7 �sT � z� �,T� �� f �sa NOL�i�yQ Z°� P° °� w � STATE CITY �'ARDS APPROVED N� LIG. NO. �� y�J LIQ NO. MAIN BVILDING � O (FROM GLSTREET) SIZE � � NO.OF BLDGS. O OF LOT �3 � 3 6—(`J NOW ON LOT FRONT FT. � USE OF EXIS�ING BLDG. S E d FT. I"' $12E OF NO. OF L Z NEW BLDG. ROOMS STORIES �. SIDE O FT, 6 U EXTERIOR WALL ROOF �J' COVERING COVERING REAR �/�FT. USE OF BVILDING qND WORK TO BE PERFORMED DI5TANCE BET. MAIN BLOGS. Q � VARaF` O I� � C.U.P.#�� %—' F APPR VE V] �` Z � O � VI hereby acknowleqge that 1 have reatl this application antl ztate � ffiat ffie above information is correct antl agree to compty wiffi � all laws regulating huiltling construction, and I shall not employ F„ any person in violation ot the workman's compensation laws of y the State of California. /j /i zI hereby certify thai I am properly licanzetl as a contracior untler �d SQ, fT. the State of Calitorh�a Business antl Protessions Code, Divisicn 3, THE AMOUNT SHOI Chapter 9, antl that such li<enses are in full force antl effect, or 1 THE PURPC6E OF ES am exempt from the provisions of the State of California Business VAWATION antl Protessions Cotle, Division 3, Chapter 9. Signawre ot / � _ /�/� Permittee/ �i�di � (>CZ a.�. $ Authori�tl Agent /�/J � . : � BUILDING'PERMIT ECEIVE� _DATE-IS�E -� 3 J-'- YE�/ Y!').•. n q—al)�e.�, `�COT��y BLOCK � PiC�1C�.�-�-�- VALUE /�i ) .n TE� USE OF NEW BUILDING VAR�S APPR FT BET. MAIN & ACCESS. BLIX'�S. DATE n APPROVED 7 �._� �� % / l iry�`°�i o /N UNDER VAIUATION IS FOR ABLISHING A PERMIT FEE ONLV: m ¢ � 5� m PERMIT FEE � _ ] m PLAN CHECK 4/��' �'; E � `o /n// LL TOTAL FEE 5 � /J City of Costa Mesa Building Safety Department ; C E R T I F I C A T E O F O C C U P A N C Y � �� =� �` '�' P.o. eox i2oo � � � � ' " Costa Mesa, California The Building located at � " ' "� - -- -' " � � has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Occupancy. Use of Building :i ' � _ ^ " ' '/ �� .' � '- - Legal Description � --`'-�=� • - � (See reverse side for Metes and Bounds) Building Permit No � '�' �'� � Electrical Permit No.3 �' ' � Plumbing Permit No. ISSUED TO: Number of apartments � and/or guest rooms Building Official bY , Date - '�ti- ''� � This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form BU 34 Rev. 11/70 /� . . � � COUNTY OF OR.^AVGE y � �- � , ' (y - BUILDING DEPT. �� d� ' 63G No. Broadway Permit No .......................... ... s��.v,a,c�com;a Application for Building Permit � Phone: KI 2-6211 AND FOR A . Certificate of Use and Occupancy � � ---�� y.�.��-----��----.. Date. 1. OWNER'S NAME -- -- -..t/ /.....✓.... �......!�.�.. ..G.L ...................�J -�� -......- --................ � - rx E:.� �.. �I.� �� MAILING ADDRESS..-----?�/.L -`C�.c�%��4.�..fZ`✓__.�� .................. CITY.... -.�.�'._..�!�a''..�.�..��_�.....��..... Name .................-�---------...._.. Name .......-----�--..........---�-------�-----.......-------------�--._.._. ----------' ................................'�--�-' ---"---`-' (ArcAitect or Engineer) (Contractor Addre=_s --'--------- ................... .......-'--- -........--' ----------....... Address ......------------'--'----....... ------...._...---=-�'---......"-----'------'------- City................. ....'-----......_..-------............---------------......_........ City .....--'-'---- --.....---.....-----'---"----------'---...-`----`-'---'-'---'--- State State �- Lic. No.-------------'----'-.._......._ Phone......_....--�--------'-----'--'---- Lic. No.------ ............._.------------'-'-- Phone.....------'-"-'--.......-------- .. . _ PROPOSED USE:----�rl/l/.... �'S'-T/1:y��d.:.... �U--- ��.i �_ iiv �i . _.�w . 2. JOB LOCATION - - "7�/I.--�� . � ......- --- � - �...�l4'�`�. .. - -�--- � - � (House No.) (Name of Streec) (Town or School Disnice) 3. LEGAL DESCRIPTION: Lot-� --'� � -._....Block _ '-- -- - "- - --- - Tracc- -3.40......._-- --'� ' (Meces and Bounds Description—Use reverse :ide of form) 4. CORNER LOT ( ) INTERIOR LOT ( ) Ti-IROUGH LOT ( ) SLOPE OF LOT ( ) i. SIZE OF BLDG.:--_��_--k..L/-------AREA:.......-fP��'---SIZE OF LOT:LAGo.._>4�.�L�..AREA:.-----------_---------------.. 6. HEIGHT OF BLDG----------- --------------_-.---_-.......CEILING HEIGHT:....._.---.-------_-_----------NO. OF STORIES-_--------(.........--.-----. i 7. NO. FAMILIES.._....._.-_. /•-----------_....._Size of Smallesc Eedroom:_........_._.__ ..................... Size of Kitchen------------.__-.--__........... '.� 9. i� EXTERIOR WALL CONSTRUGTION :............................................INTERIOR WALL COVERING....._......_...............__._..__........ (Frame, Stucm, Etc.) � . -_ (Plas� Dry,wall, Etc.) SETBACKS: Front Yard From Centec ;Line of Str � � ...... .� ,;�--/.:�-�' G , ............... � - ..... V..... . ...... � .....------ -� .._.....- -� ��--�-----�- -- ,�o � r � Neamst Side Y rd. __/.r._._,__.__ Rear Yard.....�.-�..Di<_tancc in Fcet Betwecn Bldgs��on Same Lot....._..._..��.../.d.�r�� A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. _ / ii I1. For (1) Foot:ng: Width........... �� ..............Dcpth in Ground----"--�y--//'-'--Width of Wall-----....._�2....._--..... Acceesory � Bldgs. and b Si+e of Studs:.._2X..�.__..._S acin '' �.�� ._ Similar ' �) ` �- P 8---......��.-'---...'CC Material of Floor-- .__'--�r4�!�?._�,, r�'...f.�'.t�dC v � � Structures: i� ,. (c) Size af Ploor Joists:......._ ��.........._.---------Spacing--........l�a ........................ CC (d) ISize of Raftcrs:.--......:.. S'. �..�f-..__ ...............Spacing---.._.�--`----..-----....._"CC 12. VALUATION OF PROPOSED WORK: Including al] labor, plumbing, electrical wiring, heating, fire =_prinklers, painting and mo sewage disposal $..---- -- --:f.?.._..�..._:.----__ 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS �' APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. Signed:-�-- />/f1'4. �:.......��-�...':?'Y_+�=��i-- (Owner) PlansFiled:.---------' .....................:.......�----'-'--------- ' ----..... _---By:-...----...._-- ................`-"--'------------"-`--'--------------��--------------'--�----._.......... (Authorized Agent) FEES: �� Bldg. Pcrmit - 5.---._-�-.-- Plan Check - S.�1 Total - - ��o S-. ...../�:� Receipc No. / C�.....r...�_,� . Paid to � • ---'--.. ._ ----- Daze ' ....... ......__ ' - - - -y..S FOR DEPARTMENTAL USE ONLY GROUP.........� ... TYPE.._..... � - - DIST. MAP........... ................... SHEET NO......�............ �� DATE ..................��.5 ...5/ SM-251 CHECI�NG BY APPLICATIO�� xEnLTx..__ ...................... ZONING...��. FIRE PLANS AND� MARSHAL ......................... SPEC'5..........GdLl7.1o... STATE...... - ----- ----- --- CORRECTIONS ENGINEER V ERIFIED - ... ................ CAL..----...---- - �- - - - - --- PERM T�S� I�y��# , jUE� COUNTY BUILDING, � Ul'I� I INSPECTOR n/ ........_.. - -. . �-.. ..... . . SEPL51951 . ..........AS513TANT....." '....._...... � ,Q�� i �.�j �,`�� .-�