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Home My WebLink About2822 ELLESMERE AVE - Building PermitsM A T R X II I IINI�I I I I IIII III I I I0111 I I II I I III III II I III I II I IN I III NII I � HII 2 8 2 2 E L L E S M E R E A V • � ' CITY OF COSTA MESA ' , � M ., BUILDING DIVISION >�� 77 FAIR DftIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us : � ° � ' FOR INSPECTIONS CALL: (714) 754-5626 R�� A�' PERMIT NUMBER: E09-00251 PERMIT TYPE E4EC APN: 13933408 JOB ADDRESS: 2822 ELLESMERE AV CM Vicinity: ATTIC STATUS: ISSUED DATE ISSUED: 09/29/2009 ISSUED BY: RMD Suite/Unit: SCOPE OF WORK: ELECTRICAL PERMIT FOR THE RELOCATION OF AN FAU TO THE ATTIC SPACE OF A SFD. REF#: M09-00085 OWNER: MC CLANAHqN MICHAEL C AND MONA R4SCON PHONE: 714-434-7979 APPLICANT: MC CLANAHAN, MONA.RASCON PHONE: 714-034-7978 � CONTRACTOR: OW NER-BUILDER Address: Unit: PHONE: City/State: ZipCode: ELECTRICAL PERMIT FEES Electrical Plan Check F�e: $0.00 Electrical Permit Fee: $25.70 Reinspection Fee $0.00 TOTAL FEES $25.70 Address: 2822 ELLESMERE AVE Unit: CityfStatelZip: COS7A MESA, CA Address: 2822 ELLESMERE AVE Unit: City/State/zZip: COSTA MESA, CA License No. 000000 CELL: .;. ��+ t : •: .�`' ; . '/' �. 1 �' Ii� �,V � NOTICE: The work authonzed by this pertnit shall wmply with all applicable handicap access requiremenls under California statutes and related regulations. (Ord. No. 92-28, § t, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authonzed 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 this permit. CODE R. INSPEGTION TYPE 1676 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roo( 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition OATE INTITIALS CODEk INSPEG710NTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 FinalPlanningApproval 222 Final Site 250 Final BuildinglOccupancy DATE INII_nAlS � WORKERS' COMPENSATION DECLARATION: I hereby aKrm untler penalty of perjury one o( Ihe following declarations: ❑ I have and will maintain a cehifcate oi consent to sel(-Insure for vrorkers' compensation, as provided (or by section 3700 of the Labor Code, for the pedormance of Ihe work (or which lhis permit is issued. ❑ I have antl will main[ain v.orkers' compensation insurance, as required by sec[ion 3700 of Ihe Labor Code, (or the performance of [he wvrk for which Ihis pertnit is issued. My vrorkers' compensation Insutance carrier and policy number are: Carrier. (ihis secYon need irol be cnmpleted dlhe �.eimR u valued af one huntlred tlollars (5100) a less.) Policy Number: (QrPcertify Ihat in the peAormance of the work for which Ihis permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia, and agree [hat if I should become subjecl to Ihe workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith compl with these provisions. �-�'J24it� a i�� %�.2 �'j�0 9 '.�Applir,ant ��SigneNre"^'" - 40a(e�;�, WARNING: 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, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing vnth Section 7000) o! Division 3 of the Business and Pro(essions Code, and my license is in full force and effect. Lic. # Class # Conlratlor's SlgnaWre Date CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrm Iha� there is a construction lending agency for the performance of ihe aork tor wfiich this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: OWNER-BUILDER DECLARATIONS: I hereby aKrm that untler penalty of perjury lhat I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for, the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to consirucC alter, improve, demolish, or repair any shucNre, prior to its issuance, also requires lhe applicaM for such permit to file a signed statement Ihat he or she is licensed pursuant to Ihe provisions of Ihe Contrac�ors License Law (Chapter 9(commencing with Section 7000) o( Division 3 of the Business and Professions Code) or that he or she is exempt there(rom and [he basis (or Ihe alleged exemption. Any violation of Section 7031.5 by any appticant for a permit subjec[s the applicant to a civil penalty of not more than five huntlretl dollars ($500).): ❑ I, as owner of the pmperty, or my employees wi[h wages as their sole compensation, WILL DO THE WORK, and the structure is not intentled or offeretl for sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such vrork himself or herself or through his oi her own employees, provided that such improvements are not intended or ofteretl for sale. If, however, the building or improvement is sold within one year of completioq the owner-builder will have the burden of proving tha[ he or she did not build or improve for purpose of sale.). ❑ I, as owner of Ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to cons[ruct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an ovmer of property who builds or impmves thereon, and who contracts for such project with a contrector(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Cotle for this reason: �'Y��°;� 7��ir�aA, g.�J ��9---��i� `.._ M2 � ��Da�e� 3�5]-46�3I0]) Owner ID verifietl by gn'ver's license. Yes ❑ No �or��ars�Licen3e, G��: S Z 9�/ `i Verifcation o( Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certi(y that no excavation fve (5) or more (eet in depth into which a person is required to descend, will be matle in wnnection with work authorized by this permit, and that no buiiding sWc[ure, scaffdding, falsewnrk, a demolilion or dismantling thereo(, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle 8, Califomia Administ2tive Code). � As ownerbuilder, I will no� employ anyone to do work which would require a permit from the Division o( Industrial Safery, as noted above, unless such person has a permit to do such work (rom ihe division. Applicanfs SignaWre Division of Industrial Safery Permit Number. _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or /uture building occupant need to fle and certify a Business Plan for emergency response to release or Ihreatened release of a hazartlous material? ❑ Yes ❑ No (Section 25505 of the California Heal[h and Sa(ety Code requires, with some eaceptions, ihat a Business Plan be filed vrith [he Costa Mesa Fire Department by every business which has at any one �ime during a reported year a quantity of hazardous materials equal to or greater ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at s[andard temperaWre and pressure). 2. Does or will the applicant or present orluWre building occupant need to fle a registration (orm for acu[ely hazartlous materials? ❑ Yes ❑ No (Seciion 25533 of the California Healih and Safety Code, with some exceptions, requires registration vnth Ihe Costa Mesa Fire Depahment by each business which at any one time has on hand a quantity of acutely hazardous ma�erials equal to or greater �han a weight o( 500 pounds, or a volume of 55 gallons, or 200 cubic (eet of compressed gas at stantlard temperature and pressure). 3. Does or will �he applicant or present or WWre building occupant need to prepare an RMPP (Risk Management antl Preven�ion Progrem (or aculely hazardous materials)? ❑ Yes ❑ No (Section 25534 of Ne Califomia Health antl Safety Cotle provides Nat the Costa Mesa Fire Department may require the prepara[ion, certifcation and filing with �he Fire Departmen[ o( an RMPP by businesses which are required to register acu[ely hazardous materials with the Fire Department. 4. I( an RMPP is presently required, has Section 25534 of Ihe Califomia Health and Sa(ery Code been fully complied with? ❑ Yes ❑ No 5. Does or will �he applicant or present or fuWre builtlinq occupant require for the work which is Ihe subject of lhis application a permit for such constmction or modifcation fmm �he South Coast Air Ouality Management District or fmm any other air pollution control disbict or agency? ❑ Yes ❑ No (Section 658502 of the California Govemment Code requires that the requested intormation be fumished on applications ta nornresitlential building permits). 6. Will any part of Ihe (acili[y to be construc[ed under this pe�mit De within 1000 feet fmm Ihe outer boundaries of a school? ❑ Yes ❑ No (I( "yes", Ihe (acility must mee� Ihe requirement of Sections 25534 and 42303 of the California Health and Safery Code�. 7. If a permit from the South Coasl Air Quality Management District or other air pollution contml district or agency is required for the work which is Ihe subject of this application, have all of the discbsures prescribed by California Health and Sa(ery Code Section 42303 been made? ❑ Yes ❑ No 8. Qf yes", attach certificate of compliance from the appropdate air pollution control oRicer). CERTIFICATE OF COMPLIANCE: I certify tha[ under penalry oi perjury the information given above is correcL I agree to comply with all sta�e laws and ciry ordinances regarding Hazardous Materials and Emissions. Signalure Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correcL I agree to comply with all state laws and city ordinances relating lo building wnstruction, and authorize representatives of the City of Costa Mesa to enler upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy o( any building author�d� ^hi"s� �permi/t unti f� insp ction. C 9� V��Uli4i_ 4_/LC '2 SignaWreo.C�gafQam�e�(3j_% Da�e Antlloi AulM1oriied AOPbcanl Dale � ' ' � CITY OF COSTA MESA ' "'F BUILDING DIVISION >`�� 77 FAIR DRIVE. COSTA MESA. CA 92626 • �714) 754-5273 • Fax (714) 754-4856 • vMnv.ci.costa-mesa.ca.us � � FOR INSPECTIONS CALL: (714) 754-5626 �'°°"°"�� PERMIT NUMBER: M09-00085 PERMIT TYPE MECH APN: 13933408 JOB ADDR�SS: 2822 ELLESMERE AV CM Vicinity: ATTIC AREA , � . SQ. FT: 0 . � � � � STATUS: DATE ISSUED: ISSUED BY: ; Suife/Unit: ISSUED 09/2912009 RMD SCOPE OF WqRK: MECHANICAL PERMIT.TO CHANGE OUT AND RELOCATE FAU < 100 K BTU TO ATTIC SPACE OF A SFD. REF#: E09-00251 . � � � � . . OWNER: MC CLANAHAM MICHAEL C AND MONA RASCOM Address: PHONE: 714434-7979 � � - City/State/Zip: APPLICANT: MC CLANAHAN, MONA RASCON - � - Address: PHONE: 714-434-7979 � City/StatehZip: CONTRACTOR: OWNER-BUILDER Address: Unit: � City/State: . . PHONE: ZipCode: MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: . $38.30 PLAN CHECK FEE: - $0.00 INVESTIGATION FEE: $0.00 REINSPECTION FEE: � $0.00 TOTAL FEES: $38.30 2822 ELLESMERE AVE !lnit: COSTA MESA, CA 2822 ELLESMERE AVE Unit: - COSTA MESA, CA License No. 000000 CELL: i. ; '�. ",�; �. ��•y ��'�'. � s / � � � � . �..� NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under California stalutes and related regulations. (Ord. No. 92-28, § t, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under lhis permit to be considered legal, such work must comply with all applicable wdes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODEO. INSPEL110NrypE OATE IN1111AL5 LOOEt INSPECTIONME DRTE INTITIAlS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pooi Spa Final 208 Final Plumbing 200 Final Re-ROof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Faclory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy a WORKER5' COMPENSATION DECLARA710N: I hereby aftirm under penalty of perjury one of Ihe (ollowing tleclara�ions: ❑ I have and will maintain a certifcate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, (or the pertormance of the work for which this permi[ is issued. ❑ I have and will maintain workers' compensa[ion insurance, as required by section 3700 of the Labor Cotle, (or [he peAortnance of the wnrk for which this pertni[ is issued. My vrorkers' compensation Insurance carrier and policy number are: Carner (This secfun neetl not be mmple(etl AMeOeimR a valuetl at one bvntlietl ddlars (3100) or IessJ Policy Number: d'" I certify tha[ in Ihe performance of the work for which this permit is issued, I shall not employ any person in any manner so as lo become subject b Ihe workers' compensa[ion laws o( California, antl agree that if I should become subject ro the vrorkers' compensation provisions ot Section 3700 of [he Labor Code, I shall �forthvrith c� mply with ihese provisions. �%��1��; -�-�e.aw i/a g /0 9 Appiff,ant s SgnaW re [�(e�.. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIM19INAL 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, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm [hat I am licensed under provisions of Chapter 9(commencing with Section 7000) o( Division 3 of the Business and Professions Code. and my license is in full force and effect. Lic. # Class # Conlrac�or's Signa W re Date CONSTRUCTION LENDING AGENCY: ❑ I hereby affrm tha[ Ihere is a constructbn lending agency for the peAortnance o( the work fa which this pertnit is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: SgnaWre OWNER•BUILDER DECLARATIONS: I hereby affrm tha� under penalty o( perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Pro/essions Code: Any ciry or counry which requires a permit to consVuct, alter, improve; demolish,, or repair any stmcture, prior to its issuance, also requires Ihe applicant tor such permit to file a signed statement lhat he or she is licensetl pursuanl [o [he provisions of Ihe Contractors License Law (Chapter 9(commencing with Section 7000) o( Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and Ihe 6asis �or Ihe alleged exemption. Any violation o( Section 7031.5 by any applicant for a permit su6jecls the applicant to a civil penalty of not more Ihan five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not imended or offered for sale (Sec. 7044, Business and Pmfessions Code: The Contractors License Law tloes not apply [o an ovmer of pmperty who builds or improves thereon, and who does such vrork himself or herself or ihrough his or her own employees, provided that such impmvements are not intended or oftered for sale. If, however, the building or improvemen[ is sold within one year of completioq the owner-builtler will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as ovmer of the property, am EXCLUSIVELY CON7RAC71NG WITH LICENSED CONTRACTORS to construct the projec[ (Sec. 7044, Business and Professbns Code: The coniractors License Law dces not apply to an ovmer of properry who builds or improves thereon, and who contracts for such pmject with a contracta(s) license pursuant to the Cont2ctors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: �'f�R' �%'��t.�� d �amrei�%'' - ("' ��e�-n.., _ 305]-66(JIO]) Owner ID verifietl by driver's license. Yes ❑ No � ' riv�:s.L�cens' G"Ezpies: c2r ��/ Veri(ication of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereDy certify Ihal no excava�ion frve (5) or more feet in tlepth into which a person is required to descend, will 6e made in connection with vrork authonzed by ihis pertnit, and that no building structure, scalfdding, (alsewnrk, or tlemolition or dismanUing Ihereof, vnll be more than thirty-six (36) (eet high. (Chap. 32, Grp 2, Art 2, Sec. 347, Ttle 8, Califomia Administrative Code). ❑ As owner-builtler, I will no[ employ anyone to do work which would require a permit from the Division of Industrial Safery, as noted above, unless such person has a permi� �o do such work from Ihe division. AppLca^I's Signawre Division of Induslrial Safety Permit Number. _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or (uWre building occupant need [o file antl certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Cali(omia Health and Salety Code requires, with some exceptions, that a Business Plan be filetl with [he Costa Mesa Fire Depariment by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic (ee[ of compressed gas at standard lempera�ure and pressure). 2. Does or will Ihe applicant or present or fuWre 6uilding occupant neetl to file a registralion form (or awtely hazartlous materials? ❑ Yes ❑ No (Section 25533 0( Ihe Calitomia Health and Safety Code, with some eaceptions, requires registration with the Costa Mesa Fire Depanmen[ by each business which at any one time has on hand a quaMiry of acutely hazardous materials equal to or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic fee� of compressed gas at standard temperature and pressure). 3. Does or will the applicant or present or (uture building occupan[ neetl to prepare an RMPP (Risk Management and Prevention Program for acutely hazartlous materials)? ❑ Yes ❑ No (Section 25534 of Ihe Cali(ornia Health and Safety Cotle provides that Ihe Costa Mesa Fire Department may require the preparation, certiTcation and filing with Ihe Fire Department o( an RMPP 6y businesses which are requiretl to register acutely hazartlous materials wi[h the Fire Department. 4. I! an RMPP is presen[ly required, has Sec[ion 25534 of �he Califomia Health and Sa(ety Code been fully complied with? ❑ Ves ❑ No 5. Does or will lhe applicant or presenl or future builtling occupant require for Ihe work which is the subject ot this application a permit for such construction or modifcation from the South Coast Air �uality Management Dislrict or (mm any o�her air pollution control district or agency? ❑ Yes ❑ No (Section 658502 of Ihe Califomia Govemment Code requires Ihat the requested information be fumished on applicalions (or non-residential builtling pertni[s). 6. Will any part of the (acility to be constructed under this permit be within 1000 feet lrom the outer bountlaries of a school? ❑ Yes ❑ No (If "yes", the faciliry mus� meet ihe requirement of Sec[ions 25534 and 42303 of the California Health and Safety Code�. 7. If a permit fmm the South Coasl Air �uality Management DisMct or other air pollulion control districl or agency is required for the vroik which is lhe subject of t�is application, have all o( Ihe disclosures prescribed by California Health antl Safety Cotle Section 42303 been made? ❑ Yes ❑ No 8. Qf'j�es", attach certificate o( compliance from the appmpriate air polWtion control oKcer). CERTIFICATE OF COMPLIANCE: I cenify that under penalty of perjury the information given above is correcL I agree to comply with all state laws and city ordinances regarding Hazartlous Materials and Emissions. Signawre CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correcL I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building ut ized b this ermd until inal inspe ion. � �_YYI�e a.�nQ�tiJ a a D�l C:SiqnSWredL gal'O'wner(s) �--.- e�e�,.� AnOlor AulhorizeG AOP�icxnl Dale (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DFIVE, COSTA MESA, CA 92626 BUILDING PERMIT .lobnddress: 2822 ELLESMEREAV Suite: Viciniry: Parce� Number: 13933408 npplicane MC CLANAHAN, MICHAEL C Address: 2822 ELLESMERE AVE COSTA MESA, CA Owner: MC CLANAHAN, MICHAEL C Address 2822 ELLESMERE AVE COSTA MESA, CA Contractor: � Address: Zip: Arch : Address: Phone: Zoning: R1 R1 Phone: 714309-0200 Zip: 92626 Phone: Zip: 92626 Phone: License: Status: ISSUED Applied: O6/10/2004 Issued: 07/07/2004 ISSUED BY: �� Eng: FOERSTEL ENGINEERING Address: 2377 S EL CAMINO REAL Phone: 949-492-5981 SAN CLEMENTE, CA Zip: License: 92672 License: SE957 SCOPE OF PERMIT ADD 845 S.F. TO EXISTING S.F.D. WORK TO INCLUDE: ADD A FAMILY ROOM AND NEW FIREPLACE, GAME ROOM, CRAFf ROOM AND NEW BATHROOM. INSTALL NEW BAY WINDOW AND REMOVE NON- BEARING WALL AND NONSTRUCTURAL FIREPIACE IN EXISTING LIVING ROOM. RELOCATE ELEC SERVICE.. CONVERT 4 BEDROOM, 2 BATH S.F.D. TO A 4 BEDROOM, 3 BATH S.F.D. 190 SQ.FT. REAR YARD COVERAGE O.K (400 SQ.FT. ALLOWED). Plan Check: $554.94 Permit: $853.75 SMIP Res: $7.91 SMIP Com: , $0.00 Other: $0.00 Inspection: $0.00 Total: $1,416.60 SETBACKS MAIN STRUCTURE Front 0- 0 Rear 10- 0 FEE SUMMARY PLANNING & ZONING LeR 5- 0 Calc Valuation: Claim Valuation: Right , 0- 0 $79,078.00 $65,000.00 9 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 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 inspections and final approval must be obtained. Failure to obtain inspections and tinal approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 Cano�ao Ia W ) WORKERS' COMPEN5y1P.ON.Dv.:LARATION: I hereby aHirtn under penalty oi perjury one oi ihe following decleretions: ��`"'�-�'� ❑ I have and will maintein a certificete ot consent to self-Insure for workers' compen5ation, es provitlad for by section 3700 of ihe Labor Cotlo, tor ihe peAortnance of the work tor which ihis permil is issuetl. ❑ I hava and will maintain workers' compensation insurence, as requiretl by section 3)00 of the Labor Code, for the perfortnance of Iha work for which this permit is issued. My workers' compensation Insurance carner and policy number are: Carner. Policy Num6er: �(Th' secfion need not be completed U the pelmit is velued af one hundred dollers ($100J or /essJ I certify ihat in the performance of ihe work tor which this permit is issued, I shell not employ eny person in any manner so as to become subject to the workers' compensation laws of Celifornla, and a9ree that If I should become subjact to the workers' compensation provisions of Sectlon 3700 of the Labor Code, I shall torthwith comply with Ihes ro 'sions. �i/� - ApplicantSignature: ��eC_�.'L�iw./ , � Date: ��7/CG/ WARNING: FAILURE TO SECURE WORKERS' COMPENSAiION COVERAGE IS UNLAWFUL AND SHALL SU&IEGT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNORED THOUSAND OOLLARE ($100,OW�, IN A�DITION TO iHE COST OF COMPENSATIIXJ, DAh1AGE5 AS PPOVIDED FOR IN SECTION 3]OB OF THE LABOF CODE, INrEREST, AND ATTORNEVS FEES. LICENSED CONTRAC70R5 DECLAHATION: I hereby ettirm ihat I am Ilcensed under pmvisions of Chapter 9(commencing with Section 7000) oi Division 3 of ihe Business end Professions Code, antl my license is in full torce end ettect. Lic. # Class N Contractor's Signature: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby attirm ihat ihere is a construction lending agency lor ihe performance of the work for which this permit is issued. (Sec. 3097, CiNI Code). Lentler's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aflirm that under penalry of perjury Ihat I am EXEMPT FROM THE CON7RAC70RS LICENSE LAW for ihe following raason (SecJ031.5, Business and Pmfessions Cotle: Any ciry or couny which requires a permit to consiruct, alter, improve, demolish, or repeir eny stmcWre, prior to its issuance, also requires the applicant for such permit to file e signed statement lhat he or she Is Iicensetl pursuent to the provisions of ihe Contractors License Lew (Chepter 9(commencing with Section 7000) of Division 3 of ihe Business end Professions Code) or that he or she is exempt therefrom antl the basis For the elleged exempcion. Any violetion ot Sedion 7031.5 by any applicant for a pertnit s�ub�' ts Ihe applicant to e civil penelry of not more than tive �undred dollars ($500).): j� I, as owner of ihe property, or my employaes with wages es their sole compensation, WILL DO T}fE WORK, end the siructure is not intentletl or oflered tor sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves ihereon, antl who tices such work himself or herseN or through his or her own employees, provided ihat such improvements are not intended or ottered for sale. If, however, the building or improvement is sold within one year ot completion, the owner-builder will have �he 6urden of proving ihat he or she did noi build or improve tor purpose of sale.). � ❑ I, as owner ol ihe property, am EXCLUSIVEIV CONTRACTING WITH LICENSED CONTRACTORS to conslmct the prolect (Sec. 7044, Business end Professions Cotle: The contractors License Law does not apply to en owner of property who builds or Improves ihereon, and w�o coniracis for such project wtlh a comractor(s) license pursuant to ihe Conirectors License Laws.). ❑ I am eYempt unde� ec. _ Signature: ��Z%�� Owner ID verified by drivals licensa. Venfication of Ownerehip by (rype ot Professions Codgtor this reason: Ves ❑ No �nvefs License No. it, i.e. - pmperty tex bill or deed�: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Date: Expires: ❑ I hereby cetlity ihat no excavetion five (5) or more feet in depih into which a person is required to descentl, will be mede in connection with work euthorizetl by ihis permit, and ihat no building stmcture, scaHolding, felsework, or demolition or dismantling ihereof, will be more ihan ihirty-six (36) teet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Tl�le 8, Calitornia Atlminisiretive Code). ❑ As owner-buiider, I will not employ anyone to do work which would require e permit from ihe Division of Industnal Sefery, as noted ebova, unless such person has a permit to do such work tram the division. Signeture: Date: Division ot Industnal Safery Permit Number: CERTIFICATE OF COMPUANCE AND AllTMORIZA710N OF ENTRY: I certify under penalry of perjury that I have reatl this application and state that �he infortnation given is correct I agree to comply wilh all state lews and city ordlnances relating to building construdion, end authorize representatives of the Ciry of Costa Mesa to enter upon the �a ve-describetl pro rty tor inspec en purposes. I agree not to occupy or allow occupancy of eny building authorizetl by this permji�`'ntil tinal inspection. /�.vf ��c%va,a�i -7%Z /C� �/ Signeture Of Legal Owner(s) � Date And/Or Authonzed Applicant CQOE 1. INSPEC110NTYPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Rooi 201 Final Block/Retaining Well 202 Final Factory Fire Place 203 Final Sign . 204 Final Demolition jldg IMITIALS �Q.Q�t INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 22o Final Planning Approval 222 Final Site 250 Final Building/Occupancy PAg 1[�Lfi lo -(� Z t� (774) 754-5273 • F� pia> �sa-aase , gUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job nddress: 2822 ELLESMERE AV Suite: Viciniry: Parce� Number: 13933408 App�icant: MC CLANAHAN, MONA Address: 2822 ELLESMERE AVE COSTA MESA, CA Ownec MC CLANAHAN, MICHAEL C Address 2822 ELLESMERE AVE Contractor. Address: Zip: Arch : Address: COSTA MESA, CA Zoning: R1 R1 Phone: 714-434-7979 Zip: 92626 Phone: Zip: 92626 Phone: License: Eng: Address: ISSUED BY: Status: ISSUED Applied: 06/07/2000 Issued: 06/07/2000 Phone: Phone: Zip: License: License: � SCOPE OF PERMIT EXTEND EXISTING BEDROOM BY 42SF, EXISTING PORCH BY 27'4"" AND OPEN EXISTING WALL TO INSTALL NEW " WINDOWS. Plan Check: $72.31 P�rmit: $111.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 7otal: $184.06 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existinq: 0 NOTES: Rear 0- 0 Rear 0-0 Re uired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Pro osed: 0 Calc Valuation: Claim Valuation Rlght 0- 0 Right 0- 0 $4,900.00 54,900.00 NOTICE: The work authorized by this permit shall Comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 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 For the work authorized under Ihis parmi[ to be considered legal, such work must comply with all applicable codes, and all requlred Inapvetlona and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSA710N DECLARA710N: ' I hereby attirm under penalry ot perjury one of the lollowing tleclarations: ❑ I heve antl wlll maintain e certificate of consent to self-Insure for workers' compensetion, as provitled lor �y saciion 3700 of the Labor Code, lor t�e peAormance of the wark for which ihis permit is is5uetl. ❑ I �ave and will maintain wo�kare' compensation insurance, as requiretl by section 3700 oi the Labor Cotle, for Ihe pedormanca of ihe work for which this permit is issued. My workers' compensa4on ��surance cerriar antl policy numbar are: Carder. Policy Number. (This section need nat be compl9ted il the permit is valuetl et one hundred dollers ($100) or less.) ❑ I certity Ihat in tha pertorrtiance of the work lor which this permit is issueQ I shall not employ any pereon In any manner so as to become subject to the workers' compensation laws of Celifomia, end egree Ihet It I should becoma suCject to ihe workere' compensation provisions ol Section 3700 of iha LeDor Code, I shall forthwith compy wit� Ihese provisions. Applicent Signature: Date: WARNING: FAILURE TO SECURE WO�ERS' COMPENSATION COVERAGE IS UNUW FUL AND $MALL SU&IEC� AN EMPLOVER TO CRIMINAL PENALilES AND CNIL FINE$ UP TO ONE HUN�RED T/iOUSAND DOLLARE (5100,000), IN ADDRION TO THE CQST OP GOMPENSATION, OAMAGES A$ PiiOVIDED FOR M SECiION �050F THE IABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm Ihat I am licensed under provisions of Chap[er 9(commencing with Section 7000) of Division 3 of Ihe Business and Professions Cotle, and my license is in full brce and eflect. Lic. # Class x Contrector's SignaWre: Date: CONSTRUCTION LENDING AdENCY: ❑ I hereby aflirtn that there is a consiruction lendinq agency tor iha pedormance of the work tor which ihis permit is issued. (Sea 3097, Civil Code). Lentler'S Name: Lentler's Address: Signatu�e�. Date�. OWNER-BUILDER DECLARATIONS: � I hereby eflirm Ihat under penalry oi per�ury I�at I em E%EMP7 FROM 7ME CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7037.5, Business antl Prafessions Code: Any ciry or counry which raquires e pertnit to consirud, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires Ihe epplicant for such permit to file e signetl statement thet he or she Is licensetl pursuant to Ihe provislons ot Ihe Con�rectors Licensa Law (Chapter 9(commencing with Sectlon 7000) of Division 3 of the Business end Professions Cotle) or Ihat he or she is ezempt therefrom and ihe basis for the allegetl eaemptlon. Any violation oi Section 7031.5 by eny epplicant for a permit sub�ecis ihe appllcant to e civil panelry ot not more than five hundred tlollars ($500).): ❑ I, as owner of the property, or my employees with wages es Iheir sole compensation, WILL DO THE WORK, entl Ihe strutture is not intendetl or ottered for sele (Sec. 7044, Business and Professions Cotle: The Contractors License Law tloes not epply to an owner of property who builds or improves thereon, end who tloes such work himself or herself or Ihrough his or her own employees, pmvided that suc� improvements are not intended or oHered for sale. If, howaver, the bulltling or improvement is sold within one year of completion, ihe ownar-builder wiil hava the burtlon of proving that he or she did not builtl or impwve for purpose of sale.). ❑ I, as ownar of Ihe property. am E%CLUSIVELY CONTRAC7ING WITM LICENSED CONTRACTORS t0 COnstruct the pmject (Sec. 7044, Busineu end ProtesSions Cotle: The wntrectors Llce�se Lew does not epply to an owner of properry who Duilds or improves thareon, end who contracts tor such project with e con[ractoqs) � license pureuant to the Contractors License LawsJ. Business and Professions Code for this reason: by tlnvefs license. � 0 No of Ownership by (typd of document, i.e. - propeny tax bill or DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby certily that no exCavation five (5) or more feet in tlep�h into which a person is required to descen4 will be made in connection with work authorizetl by Ihis permit, antl ihat no building slrucWre, scattolding, falsework, or demolition or tlismantling Ihereol, will �e more than thirry�six (36) feet high. (Chep. 32, Grp 2, Ad 2, Sec. 347, Title B, Califomia Administrative Code). ❑ As owner-builtler, I will not employ anyone to do work which would require a pertnil trom the Division of Intlustrial Sa�ety, as notetl above, unless such person has a permit to do such work irom Ihe division. SignaNre: Dete: Division ol Industrial Safery Permii Number. CERTIFICATE OF COMPLIANCE NdD AUiHORIZA710N OF EN7RV: I certify untler penal�y of perjury ihat I have read this application and state thai �he informa�ion given is correct. I agree to comply with all state lews and ciry ordinances relating to building conswction, and authonze representatives oF the City of Costa Mesa to enter upon the aDove-tle cnbad roperry trn ins ecfion Purposes ,1 flgrea no to occupy or ffibw occupancy ot any buiWing authorized by this pertnit until linal inspection. ��'Q� ' atu O Legal Owner s Dale AnNOr Authonzed Applicant Date CODE Y. INSVECTIONTYPE 1616 1266 Finotl System Final Fire Prevenlion Pool Spa Final 200 Finel Re-Roof 201 FinaI8laWRetaining Wall 202 Final Feciory Fire Place 203 FinaV Sign 204 Final Demolition zaas.as onTe INTRIALS CODE I INSPECTIONTYVE 206 Final Mechenical 208 Final Plumbing 210 Final Eleciricel 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy Q9I.E TjN RIALS 'v i�wi � C��. �� -�c�� g�� ,�� --�� ECEIVE�/�- COSTA MESA BUILDINGSAFETY DEPARTMENT � �✓, � � 31 1901 P. o. aox s�� C08TA M68A. CALIPORNIA FINANCE DEPT. For Applicanf fo Fill In Compleiely APPLICATION FOA �eSiPr�TA. MESA TYPE OR PRINT BUILDING ADDRE88 '�%Z. � F_G - .��tJ /-� COSTA MESA. CALIFORNIA For Offlce Use Only _ _ aeca�rr NO. � P,GRMR no. T.finorca Mesa Verde Builders Ine 1653 Minorca ■ SIZE ■ BCTBACK LIN6 RPON j(1 �i-�, I NO. OP I LEFT fY S I RIGNT ZO DESCRIPTION OF WORK � x �� --- � �� --- Sq.FV. ppOM6 ` EXTERIOR WAL � coveair+c USE OF BUILDING 1 HERBBY ACKNO MID 9iAT8 THAT PLY WITM ALL C BUILDINO CONB SIGNATURE OF ■ AUTHORIZED WORK GE THAT I HAV6 RGD l ABOVe 18 GOpAEGT ANO 25 1 BY o�re COSTA MESA. CALIFORNIA TYPF • GROIIP APPROVEO ZONING ZONH NO. OF U9E OP NEW S'��/ � Q�, I PLAN9 Z I BU�lDIN6A y�/(_'n /W [(M �eaw� [�- l� T�f yua 8 D89CqIPT�ON s. c. nin. �'�-� icermn une ar.> s FRONT � w a�nc l Q Z � �[J �GQ �. Attacnsa garage [,�u sq.rti. �TION 7HE AMOUM BHOWN UNDBH VALUATION IH FOH THE ��M' PURP08E OF EBTABLIBHINO A PERMIT FEE ONLY. T'�� VALUA710N (((777 //��/ � PERMIT FEE $ � 5 $ � PLAN CMECK S (714) 754-5273 • Fex (714) 754-4856 77 FAIFi �RIVE, COSTA MESA, GA 9'L6'L6 PLUMBING PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 2822 ELLESMERE AV 13933408 ,4pp�icant: MC CLANAHAN, MONA Address: 2822 ELLESMERE AVE COSTA MESA, CA owner. MC CLANAHAN, MICHAEL C Address 2822 ELLESMERE AVE COSTA MESA, CA Contractor: Address: Arch / Eng : Address: Phone: 714-434-7979 Zip: 92626 Phone: Zip: 92626 Phone: Zip: License: Phone: Zip: License: Status: ISSUED Applied: 06I07I2000 Issued: O6/07/2000 ISSUED BY: / /IA-`- �� SCOPE OF PERMIT EXTEND EXISTING BEDROOM BY 42SF, EXISTING PORCH BY 51'4" AND OPEN EXISTING WALL TO INSTALL NEW WINDOWS. REF B00-00826, SEWER CONNECTION AND CAP THE EXISTING SEWER LINE. ISSUE FEE BackFlow irrigation Backflow Preventer Bathtub Clarifier Syslem Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roo( Drinking Fountain Expansion Tank Gas Earthquake ValVe Gas (1-4 ouilets) Gas (Over 4 ouUets) Gas Repipe Gas Service Interceplors (Grease. Oip Interceptors (Sand Auto ) AMT $23.50 §0.00 $0.00 $0.00 $0.00 $0.00 50.00 50.00 50.00 $0.00 $0.00 $0.00 30.00 $0.00 $0.00 $0.00 $0,00 $0.00 50.00 50.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEESUMMARY Laundry Tub / Washer Landscape Irrigation P-Trap Pressure Regulator Process Piping (per 10 ft) Recepiors Septic Tank Sewer Cap (or Demo Sewer Connect Sewer Private Line Shower Sink, bar Sink. commercial Sink, Floor Sink, kiichen Sink, service/mop Spa (private) Spa (public) AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 59.80 $24.65 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 QTY 0 0" 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 COMMENTS I SPECIAL CONDITIONS SumpPump Swimming Pool Trep Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.� Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 50.00 $0.00 50.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 TOTAL CALCULATED FEES: 557.95 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calitomia statutes and related regulations. (Ord. No..92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a penod of 1 BO days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapeclione and flnal approval must be obtained. Failure to obtain inspections and final approval will resufl in the expiration of this permit. FOR INSPECTIONS CAIL: (714) 7545626 WORKERS'COMPENSAnON DECLARAnON: I hereby aHirm untler penalry ol perjury one oi ihe following tleclarations: ❑ I have antl will meintain a certificate P� consent to sell-Insure for workers' compensation, es providetl for by section 3700 of Ihe Lebor Cotle, for Ihe pertormance of the work for which this pertnit 15 i55ued. ' ❑ I have end will maintain workers' compensa6on insurence, as requiretl �y seclion 3700 oi t�e Labor Cotle, for the paAormance oi the work tor w�ich Ihis pertnit is issued. My workers' compensation Insurance �mer and policy number are: Cerrier: Policy Number. (Thls section need not be campleteU ll fhe permit is velued et one hundred dollers ($100J or less.) ❑ I cenify t�et in ihe pertortnence of ihe work for which Ihis permit is issued, I shall not employ any person in eny manner so es to become sublect to ihe workers' compensation lews of Calibrnla, end agrea that H I should bernme subject to the workers' compensation pmvislons of Sedion 3700 of ihe Labor Code, I shall forihwith comply with these provisions. Applicent Signature: Date: WAHNING: FnIIURE TO SECURE WORKERS' COMPENSATIIXJ COVERAGE IS UNLAW FUL pND StiALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTES AND CNIL FlNES UP TO OfJE HUNDRED THWSAND OOLLARE (5/00,000), IN A�DRIIXJ TO T�'�E WST OF COMPENSATIIXJ, DAMAGES AS PROVIOED FOR IN SECiION 3]O60F THE IABOR CODE, IMEREST, AND ATiORNEYS FEES. LICENSED CONTRAC70R5 DECLARATI�N: I here6y aRirm ihat I am licensed under pro�isions of Chapter 9(commencing with Section 7000) of �ivision 3 of the Business and Professlons Cotle, and my license is in full lorce antl ettecL Lic # Class a ContrecioYs Signatura: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby attirm Ihat there is a cons�ruG�ion lending nqency lor the peAormance of the work for which ihis permit is issuetl. (Sec. 3097, Civil Cotle). Lentler's Name: Lender's Address: SignaWre: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirm ihat under penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business antl Professions Cotle: Any city or counry which requires e pertnit to construct, alter, improve, demolish, or repair any structure, pnor ta its iuuance, also requires the applicant for such permit to tile a signetl statement ihat he or s�e Is I(censed pursuant ro the provisions of tha Contractors License Lew (Chepter 9(wmmencing wlth Section 7000) ol Division 3 oi the Business and Pmfessions Code) or Ihat ha or she is exempt t�eretrom and the basis for t�e alle9ed exemption. Any violation oi Section 7031.5 by any epp��wnt tor a permit sub�ects the applicant m a civil penalry ol oo� mow than ilve hundrad doRars (55�0).)�. ❑ I, as owner of ihe propeny, or my employees with wages as iheir sole compensation, WILL DO TME WORK, entl the structure is not intentletl or ottered tor sale (Sec. 7044, Business and Professions Code: The Contrectors License Law does not appty �o en owner of property who builtls or improves thereon, antl who does such work himseli or herself or ihrough his or her own employees, provitled that such improvements ere no� in�ended or oNered for sale. If, however, the building or improvement is sold within one year of completion, th� owner-builder will have the 6urden of proving thet he or sha did not builtl or improve for purpose of sele.). ❑ I, as owner of the property, am E%CLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions Code: Tha contrectors Licensa Lew Oces not apply to en owner of property who builtls or improves thereon, antl who coniracts for such projeci with a coniractor(5) license pursuant to the Contredors License Laws.). L7/ I amExemot under sec., __ - i BuS�ness antl pr9�ession5 Code for this reason: _ . �ID verifi�d by driver's license. � C�s ❑ No Verification ot Ownership by (type of document, i.e. - propeny taz bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERM�T CERTIFICATION: ❑ I hereby certity Ihat no excevelion fiva (5) or more lee� in Oepth imo whlch a person Is required to descenq wlll be made in connection with work authonzetl by this permit, end that no building slrucNre, scaRolding, felsework, or demolition or tlismantling iheraof, will be more than ihirty-six (36) teet high. (Chap. 32. Grp 2, Art 2, Sec. 341, Ttle 8, Celifomia Atlministrative Gode). ❑ As owner-builder, I will not employ anyone to do work which would require a permit irom Iha Division of Indusirial Setery, as noted above, unless such person has a pertnh to tlo such work lrom tha tlivisiDn. SignaWre: Date: DivlSion of Indusirial Safety Permit Number: CER7IFlCATE OF COMPLIANCE AND AUTNORIZATON OF ENTRV: I certity under penalty of perjury thai I have reed ihis application antl state that �he information given is correct. I a9ree to comply with all state laws antl ciry ordinances relating to building wnstmction, and authorize represeniatives oi ihe Gity of Costa Mesa to enrer upon ihe above-tlescribad properqior Inspeciion pUrposes..�reeAoi to occupy or allow occyPancy ot any building aui�orized by ihis permii until final inspection. CODE �. INSPECTIONTYPE 1616 Fixotl System Final Fire Prevention 7266 Pool Spa Final 200 Final Fe-Roof 201 Final8lock/Retaining Wall 202 Final Fectory Fire Place 203 204 2a48-d6 Final Sign Final Demolition �r`S, � t�'� Applicant � Dete PAIE �MRIALS CODE� INSPECTIONTYVE 206 Final Mechanical 208 Final Plumbing 210 Final Electricel 272 Final Fire Prevention 220 Final Planning Approval 222 Final Si�e 250 Final Builtling/Occupancy Ij pL NTI RIALS �i ��, F CITY OF COSTA MESA , • � B!/ILDING DIVISION � DEVELOPMENT SERVICES DEPARTMENT °• PERMIT PERMI��/ �� Y 698-01946 (714) 754-5273 • Fax (714) 7543856 77 FAIR DRIVE, COSTA MESA, CA 92626 .IobAddress: 2822 ELLESMEREAV Suite: Viciniry: Parcel Nunm6er: 13933408 Applicant: MCCLANAHAN, MICHAEL Address: 2822 ELLESMERE AVE COSTA MESA,CA Owner. MCCLANAHAN, MICHAEL Address 2822 ELLESMERE AVE Contractor: Address: Arch / Eng : Address: COSTA MESA,CA BUILDING PERMIT Zoning: R1 R1 Phone: Zip: 92626 Phone: 774-434-7979 Zip: 92626 Phone: Zip: License: Phone: Zip: License: Status: ISSUED Applied: 10/27I1998 Issued: 11/04I1998 SCOPE OF PERMIT 100 SQ. FT. S70RAGE CABINET LOCATED INSIOE THE GARAGE, BUT NOT WITHIN THE ZO BY ZO Ff AREA. APPROXIMATELY 7 1/2 FT. UP FROM FLOOR. Plan CheCk: $13.65 Permit: $21.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $35.15 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0. 0 PARKING Existina: o NOTES: Rear 0-0 Rear 0-0 FEE SUMMARY Calc Valuation: gaoo.00 Claim Valuation: gaoo.00 PLANNING 8 ZONING Left 0-0 Right Left 0. 0 Right Reouired: 0 Proposed: 0 0- 0 0- 0 EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of t 84 tlays. . INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inapectiona end tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 754-5626 WORKERS' COMPENSATON DECLARATION: I hereby affirtn under penalry of perjury one of ihe following declaretions: ❑ I hava entl will meintain a certificate ol consent to self-Insure for workers' compansation, es provitled tor by section 3700 of the Labor Cotla, for ihe peAormence of Ihe work tor which ihis pertni� is issuad. ❑ I have antl wlll mainiain workers' compensation insurance, es required by section 3700 oi �he Lflbor Cotle, tor ihe peAortnance ot the work for which �his pefmit is issued. My workers' compensatian Insurence certiar entl policy number ere: Cartier. Policy Number: (Thls sectlon need not be completed i! the pertnif is valued ef one hundred dollers ($ f00) or less.) ❑ I certify that In the peAortnance ot the work for which this pertnit is issued, I shall not employ eny person In eny manner so as to become sublect to tha woikers' compensetlon lews of Californie, end egree thet if I shoultl bacome subject to the workers' compensetion provislons of Sectlon 3700 of the Lehor Code, I shell forthwith comply with these provisions. Appllcanl Signeture: Date: WARNING: FAILLIRE TO SECURE WORKERS' ODMPENSATION COVEMGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRE� THOUSAND DOLLARE (5100.0OO�.IN AOOITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED WR IN SECf10N 3IW OF THE LABOR CODE.INiEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 1 hereby aflirtn Ihet I em licensed under provisions of Chepter 9(commencing with Section 7000) ol Division 3 0l the Business and Protessions Code, end my Ilcense is in full farce end eHect. Lic. x Cless a Contreciofs Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby eHirm ihet ihere is e construction lending egency for the peRortnence of the work for which ihis permit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eifirm Ihet untler penalry of perjury that I em E%EMPT FROM TME CONTRACTORS LICENSE LAW for the lollowing reason (Sec. 7031.5, Buslness end Professions Cotle: Any ciry or counry which reQuires e permit to construct, alter, Improve, demolish, or repalr eny structure, pdor to Its Issuance, elso requlres the epplicent for such permit ta lile a signed statement that he or she Is licensed pursuanl to the pravisions ol ihe Conirectors Llcense Lew (Chapter 9(commencing with Sedion 7000) ot Dlvision 3 oi t�e Business end Prolessions Code) or that he or she is e:empt iherelrom and the basis for the alleged exempiion. Any violation of Section 7031.5 Dy any epplicant for a permit subjects the epplicant to a dvd penalry ot not more than (rve hundred dollars (5500).): ❑ I, es owner ot the property, or my emD�oyees wit� wages as their sole compensation, WILL DO 7ME WORK, antl the structure is not intendad or oHeretl tor sele (Sec. 7044, Business entl Professions Cotla: Tha Contrectors License Lew does not appty to an owner of property who builtls or improves thereon, and who does such work hlmself or �ereelf or through his or her own employees, provltled t�at such improvements ere not IntendeC or oXeretl for sale. Ii, however, Ihe builtling or improvement is sold within one year of completion, Ihe owner-builtler wlll �eve Ihe burtlen of proving ihat he or s�e tlid not builtl or improve for purpose of sale.). ❑ I, es owner oi lhe property, am EXCLUSIVELY CONTRAC7ING WI7H LICENSED CONTRACTORS to consiruct ihe project (Sec. 7044, Business antl Professions Code: The conlrectors License lew does not epply ta an owner of properry who bullds or Impmves thereon, end who caniracts far such praject with e conirecior(s) license pursuent to the Coniractors License Lews.). ❑ I em e:empt under se Business antl Professions Cotle for this rees n: Signature: �� e/� %M� i*-�� Vedfication of Owners�ip by (rype ot documen�, i.e. - property tez bill or deetl): UIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICA710N: Expires: ❑ I hereby certly that no excavation Ilve (5) or more teet In tlepth inm which e person Is requlred to descend, wlll be made in connectlon with work euthodzetl by this pertnit, anE ��et no �uiltling s�ructure, scattoltling, telsework, ar tlemolition or dismantling Ihereof, will 6e more Ihan lhirty-six (36) feei high. (Chap. 32, Grp 2, Art 2, Sec. 341, 71t1e e, Celitomia Administretive Cotle). ❑ As owner-builder, I will not employ anyone to do work which woultl require a pertnit from ihe Divlslon ol Industriel Sefery, es noted above, unless such person has a pertnit to do such work from the division. Signeture: Date: Division of Indusinel Setery Permit Number. CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENfTiV: I cehify under penalry ol perjury ihat I have read this application and stete that the informetion given is correcC I agree lo comply with all state laws and ciry or0inances relating to building consWction, end euthonze representatives of the City of Cosfa Mesa to enter upon the above-descnbed prop§{ty tor inspec�n purposes. I egree not to occupy or allow occupancy of any building auihonzed by Ihis pertnii un�il tinal inspection. Owner(s) AnNOr Authorized Applicant COOE � INSPE[TIONTYPE 1616 Fized System Final Fire Preven0on 1266 Pool Spe Finel 200 Flnal Ra-Root 201 Final BIocWReiaining Wall 202 Final Fectory Fire Place 203 Final Sign 204 Final Demolition 24t8.96 Qeg. ��$ Lj}7}Fj INSPE[TIONTYPE 208 Final Mechenicel 208 Final Plumbing 210 Finel Electdcel 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy Date � �oonEssaew�ou+c: ZBzz ELLESMERE AV WMERSNAYEIFIQqMN: MC CLANAHAN MICHAEL 'D°"�u' 2822 ELLESM�RE AV � COSTA MESA,CA 92626 .�vv�. yuuxc �ooness: . YKXIfECT ON FNCdlFFA: �qC1l OH FNO: S iNOPE53: wr+rx�crars ru�: ca+m�croxs�uiwo �� UNT: IlC N0: UNT: uc xo_ uxt: IJCENSEU COMHACTONS DECL�NATION: I Mreby ellim uMs penely d pmjury IMt I am licmaed uMw poAtiw d Cheqm B (mmmeev�0 wn� SeUion )OW) d Oiriaion 3 d Ne Bwimae xtl Pedweiw Cole. aM mY licenu u in IW brca enE efletl. cm uc. No.: uc. cuss: uc. No.: EXP : Dab: ��FCa: OW NER BUILDEfl DEC(AflAT10N: 1 hereby �rtn uMx penaly d pmjury �hm I em szemq fmm Ihe Conlretlaa l"xenae Lew fa the IODownB reswn (Saaion ]W 1.5 &nroee vM Adwmoeu COde: MYW a muMY r.l�itli nW'vea e V�e lo mutrue. Mx. imqova. demdsh. a repai eiry awctun, prior ro ila ewenro. ebo'eVu'vee iM epplimN la auch penw lo Ns e apnW etmannN Nm M a she : ccemae w� �o �ne wwi�ian a m. com.man limbe lew ICNw« s(mmmmvro wan ssaon �aoo) d Di.eon a a ue u�ima .ne Rameun coeel « imm �o «.na b uemq �h>a�mm vd ine baw t« in. Nw� exmmqon. Mr vidmnn d saaon 03�.5 by arry appfiraru 1« e permn subq2+iM appiceru �o p� ps�y d na mas �Mn fne himdred do0an �S.AoD. _[� I.esowrorW�MP�Wo�YamYanWWeesvnhwape+aiheiedsmmM��ion.MiAEo�hework.eMNeMruNvaum�'vna�kaE �r oraRmeElaeebl��)�.BummvarMPmleeebneCode:T�eComredonLimnseLewdmenaepplyloenownsdpopMy who buida a inP�'� �naean, vW Ww doee �udi xak himeatl a Mnel vWaM N a nm oxn omW Jw. pw'� �hm wM 'unG�*msas ere nal imeMad a aXaeE la veb. tl. howawr. �M builtliM a inpo.w^eM o wtl wnh"vi an Yaer W mm0�ion. iM uweyr-0uiqar xdl heve ihe pwden d qwirp M a ahs tlid m� Grik a impwe la Ne p�vpwe d We). � I. n ovmer d IM pw„Y. em utlwnwN mrurmn0 �h licenesd caMrsbs ro mwM tM pM� (Senion lwa. &n'vra end Prdeatium Cotla: Tha Caureum L'eeeua lew Eom M NdY �o an oxw d pW�Y v,fio bulde a imV�'w Ihaean enE who conVeds la wN prqxla vmh e mMrodor�s) licenaed p�nuem Io IM Cam�etla� Liume Law). � I em exemp uMar Sec�bn: B. b P.C„ br thn rsemn: o�,: 5-zv-5� � n��,�l�a�..�_ i eo nerenr �enM �nv i em ewve a.m �e.�a,e me r.aw�.w a cvaom�. He.m� m,e sdav coa. s«�u�. nws, zssu..�e 2553a, ad Mel I a eny Muro Wikirp papeni will / wil iwl (aRb me) med io compF/ wih veid ums mAse enE IM mpu'uamanb tor epermAfacamiiuctianamodi&eiionhamiM�i ��iy enapememDietnd.HeeiEeMielcaMrutlionepplce�iomereexemplmmNme prwoben. Date: AVdcam: WOflKEP'S COMYEHSATION DECL�P�TION: I hereby effi��n under penMy d per�w/ an d the blbwinp EWeietbm: � I hew end wil meintein e cenHiwe d conwnt io eaXine�re br vrorkere' compenWion, u pwided la by Seaion 3'!00 d Iha lebor COEe, lor ihe pe�ormenca M �M wak Im which Ihie permN n beuaC. ❑ i ne�e e�a �;� �ma:�..on�.• mma�� s�••�a. d na��rod W seaion aiao a ine imn. eae. r« m. w�eorme�o. d m. wwk la xfiich �hie Wrtnit ie b�ued. MY wrcMeis' mmGemvion Inwrance urrier eM GdkY number ue: c�«: Pd'ry Number: 'This eection need rrot be canpNtee / tM pemid 'u /w we �undied dolkrs �S�ool a Iw J � I centy Ihet in Ihe perlormeMe M Ihe work la r.fikh t�ie permit ie ieauetl, I ehell M emplvy eny pereon in eiry men�wr eo ea to becama .ubjea io IM xaMma' cam0eneaiion lexe a ceNanie. eM e0res ihet Y I tlwuN became ai4� lo iM MWe�a• compenu�ion qwciw d Setlion 3]00 d iM Lebor Code, I WII /anhwnh mnpl� wnh Rm pwisbm. Dete: �VP�GN: Wamlip: FaNun ro sxun woM�ri compxuetlon cov�rep� l� �1��, ��W �II al!/�cf en smploylr ro er/MiW pxWtlu uM clvll flrwa up ro om hundrM Mouund dolNn (SfOq000), pi �lryon b M� cwl o/ compxwtbn Wrrrpu � povlMd Iw In Sxtlon J1G6 0l tM Le4or CoOs, /ntxesS �M �ttomry'� fsu. CONSTtiUCl10N LEHqNO ROENCY: I he�W/ elfum undar penehy W per'Ny ihel ihae u e wMiud'pn Ind�q eperic/ lor tha pMpmace d iM wak W whirA tM pemii e easd I�4n 30�. Civ. CI. LENDEP'S NMIE: LENDEH'S �O�RESS: I cenily 0� I Ma ned Nb epq'r.etian W aele IIW iM ebwa inlamdbn o mnetl. I epna Io mmply x+l� M ary eM wuniy adire�ree aM atela Nvn nle�ip b MriNiq mnsVudion e�d MrabY eWw¢e �spaven�elrvse d Iho ely b rtlw upon IM ebaw�meMioned pivperly fn'u�apeaian WrOma. MICHAEL MC CI,ANAHAN f `�% �yPnnl Neme Q �% �/heCX�P..G✓�✓� Ome: /'Z�'_S7 SqruW�e d PmierlhpenVAppfranUCpM�a (S15t<fi.WP) �'M1��;q 8 Selay:OmeMFb: �ywy-�pp5rem: Rnk-Rewnue:0oldonmd-Avmwr CITY OF COSTA MESA — BUILDING PERMIT PERM NG: b G84849 PERMZT NO; B 084849 PLAN CHECK NO: 03930-97 S GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : 57LF 2FT HLOCK, PILASTERS, WOOD BETWEEN SQ FT: 5� CLAIM VALUE: 1,140.00 CALC—VALUE: 1,140.00 GROUP OCC: R-3 / COMMENTS: BLOCK WALL. PILASTERS W/WOOD IN BETWEEN �**�e��r�r��r�r�r�e*��*�*�r�r**�r�c***��**�r�rat��r�;r**at�ritr**��t*+�*;a*�t�*�r+r*�r*****at3titat�rat**��rx�ar** 2 O N I N G R E Q U I R E M E N T S 5 E T H A C K S ------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDZNG --------- FRNT: FT IN REAR: FT IN FRNT: 50 FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE(J: PROV: PARCEL: 13933408 ZNE: R1 REF NO: � PLANNING NOTES> CONSTRUCT A BLOCK WALL/WOOD FENCE COMBINATION WITH A GATE > ON THE RIGHT SIDE PROPERTY LINE WITH A 10` RETURN. �e***r��**�r�r�*�r**�e**�r;��r+r��r*�*��**�r*�r**��*�*****�*��c**********��;��r.�r�;�*�*�**�: 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 HY �U PDI.L DATE: ��2-� �'�1�) BUILDING APPROVED BY : DATE: � �. �~ APPLICATION ISSUED BY ��*��*********� LEGALIZATION:N BLDG PMT PERMIT 40.25 ISSUE FEE Z6.16 F E E S U M M A R Y PLUMBING ELECTRIC MECHANZC STRUI:TURAL SEGMENT:Y FIRE SMIP/R55� GRADING SMIP/NON—RES BUILDING—DIV—> PERMZT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 40.75 0.00 26.16 60.91 66.91 .00 REVENUE DIVISION TOTALS--> COLLECTED; 60.91 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/Tt�T GRADING PLAN—CHECK 90.25 .50 26.10 iE iE iEiE if it ik if iE if iF if if iF iF if iF iF iF �k iF iF if ie if if 1k iE iE iE if if 1f iF if if iE iE iE iE ik iF if 3k iF �1f if if iF'1f iE iF iF 1F iF if iF'1f iF if iF if iF if iF if sF iE if 1F'k'k if iE'1E if sF if �1F I N D I V I D U A L F E E B R E A R D O W N TYPE QTY D E S C R I P T Z O N UNIT COST TOTAL COST SFR 57 RES—CONCRETE HLOCK WALL / FT. 20.00 1,1�10.00 END OF FEES C3-24-l53J/" •- ..��i t:.,/:.�5.� %ztFii'.d',��1.�. - J.�r�. � LC'l'4��1 3 (:ONSTRUCTION AND PLANNING �'� POOL � ,TA APPROVALS Permit # Date Inspector AppROVALS Permit # Date inspector i. Temporary Electriwl Service or Pole 52. Pool & Equipment Location 2. Soil Pipe•Und�9rnd. 53. Steel Reinforcement •'3.•Etectrical Conduit Utility-Undrgrnd. 54. Forms ' .A:�EJectrical Conduit�Undrgmd. 55. Electrical Bonding �5.;Sieel Relnforcement ' 56. Rough Plumbing & Pressure 7est - -'6'. Electrical UFER Grnd. 57. APPpOVAL TO COVER�GUNITE ' ,7,.yPootings �O�Q�'j j 58. Electrirai Conduit-Undrgmd. -� 8.T! Foundation 59. Gas Pipe, O Undrgrnd., Test ,-8: Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd. �f0. Structural Floor Svstem 67. APPROVAL TO DECK 11. Property Sewer Line & 4ouse Connection � 62. Backwash & Receptor�Final 72. Sewer Cap ' 63. Heater & Vent�Final 13. Roof Drains 64. Plumbing System -�Final 14. Rough Plum6ing r, 65. Electrical-Final 75. Rough ElectricabConduit r 66. Solar SYstem-Final 16. Rough Electric Wiring � G7. Fencing & Access Approval 17. Rough Wirin9 Si9n 6S, APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Ai tConditioning _ �, k " � FIRE QEP7.,(�EQUIREMENT 20. RoughFactor�FiceRtace ', �.Y � k � � 7'�� ".APPFiOVAI.S"',�".Per'Mit# ' ' ... 21. Buctsy in St�u€tura. ! . �• �- _ i _ - �_ 4 ' ' 70. (lndec;JFaund H7dco ' 22 �utts, Vec�tila3ing�� - f-� r � '� ,� 77, product�ping � 6as �Od 23. Gas Pipe-�Raugh & Test i _ � �*1 'x _� � � 7z, Undergroudd FtusFi-' ' ' 24. Roof`�Fram�ng ' ? � ' '" ' � k ` - ,� � � � , 73;y Undergmd. Stora� T�nk�O Gas 'J 0�1 25. Roof>Shegihing • :.R v t _ ^ '-� � � 74: Overhead Hydr ^� � 26. �-Bar Ceillnq (Strutt�rall & Yto{wcaat '- � �� -� b ' 7�x ;Dry.Chemical _ y � . 27. Frame and� Flashing� k �� -. -, rn • 76. Dry StanJpipe " � � - = 28. Lathing �Sid;hg , F '� ,, z.- k - '' + £ .. ..�� 77. FIXED $,�''STE[,VI�INAG � -. - 29. InsWation: - i :-�� I �� 7�FIREPREV.FiNAL �'- i '� 30. Drywall (Q'aiiing �" ; , � � �. '� ';HEALTH'DEP'�. REQi11i�MENT �:. -. - 31. Piaster Brown�Coa�.r ; • - +- •, t. ' �� 79; FINAL I,�1S8ECTtON c � ' . 32. ElectricalPow,er MRt�rFi�al ��; ' � � � 80', P00� CERTIFICATE I$SL1ED., .. , ,n , - 33. Fina�£lectric �. _ i •�; � �r' - � ; �� Noies: - + -� -� � 34. Fina!-Heating & Ai� Co�cfitionin9 = ' _ �-r � � . � ,_'�.� ' ' � . �� ' y � 35. F.inaf Gas.Pipe :Test, ;� - � . ,� � !, ; � ;r n �- . . ^ '+36. Hood�or CanoPY ; ,� V ' � � � ' : _ r. 7�-. � - C.' r � � � �4 M - "r ' 37. Fina�rFactbry FirePla'ce . . _ � [ ^ ;� .. .. � 38. Eanaf.Plumbing T� � ^ �I . . .Y � � . � . ' ' �' 39. 4Nater �Serv�ce:PinaP + ,r � '." � ' .y � � � , -. - -. r 40. Gas Service-Final - . _ .r, � ��,: � _ - - - i I �K � �47.5olarporriestic•final, `� ' . " ! "r , `-. � . - 42. Backflow Preventer � - - i � • _ - '.t I TI ' 43. Backflow irrigation { . - ' � .r - � . . . 44. Landscape Ircigation�System - � ` T' ' � � 'v �' - � � � � 4 45. Sound Attennation' ... , r, r:,; ; � , � 46. Handicap.i3egulations �. n � � � ' � ^--� `_' � � -� � -� i 47. PINq�1STRUCTURE&BUILDING /Z_of�G�`� �'1,��; ' � { 'l 48. FINALPLANNINGi � � r ' �� •' '" L - - 49, 'Elect7ic Release m Etlison , ' � '� i, .� � ' � , ' ' � �0. Gas Release to Soutfiem Califomia Gas Co . � � • ' � � • = w a _ 51. CERTIFICATE OF OCCUPANCY � � ".. . No. Date `�I � � �I PP0.IECTAODflESS: j8z2 ELLESMERE AV OWNEX'SNAME: $Q]�LES� JAMES VAN CARLTUN aooxess: bOYLES, CHERYL LYA]N 282Z ELLESMEP.E AVE COSTA MESA,CA 92626 APCH/ENGINEEH: AUGHESS: NEG.NO.: uNiT: UNIT: PEHMITTEE: LEHMAPI R00£ING, INC, ( 714 } 850-9915 aooeess: 3444 W HARVARD SANTA AP]A CA 92708 UCENSEO CONTHACTON OELLANATION: I hereDy a�lum that I am �icensed untler pmvisions of Chapter 9(cammencing wiM Section 7000� ol �ivision 3 of ihe Business antl Protessions Cetle. and my li[ense is in full force and efleci. ciTxuc.: 042353 srareuc.:49960 cus�s�-39 EXP; O8/95 o��e: /�� %—%� Signa�ure� WOHRENS' COMPENSPTION OECIAflFTION: I �¢r¢by irm �hat I have a Cetlifita�e ot tonsent �o self�insure or a te�ifita�e o1 WOrkers' Compensation In.{u a e o a certdietl copy� thereo��5ection 3800, La6. C. POUCYNO.: L��—a4UPIITUOSJ4 E%P.�RTE: 1/O�/95 COMPaNY: STATE FUND�+. ❑ Cerli�ie0 topy i5 her¢Ey Nm'i/s�eA. Ll CeN�ietl copy i5 'Ie0 wi�A Ihe tity uA/ai/9g OiviSian. Oaie'. �� 4' / ` / '" Applicanl: �"'— — E%EMPTION FPOM WONNEPS'COMPENSpTION DECLAflRTION� hissec�ion neetl natbecomple�e0ifthepermilisforone huntlretl�$100�ar1e55). I certiry ��at in Ihe pedormance o� �he work lor which ihis permit is issueA. I shall not employ any person in any manner so as to become su6lecl to Ihe Workers' Compensaiion Laws ol Cali�omia. �ale: Signalure: NOiICE: Ii. atler making this Oeclaration, you should become sublect to ihe Workers' Compensation provisions of the Labar Code. you musl lotlhwilh comply wit� such provisions or Nis Oermit shall Oe Jeemed revoked. CONSTBUCTION LENOING AGENCY: I hereby altirm �hat there is a con5imc�ion lending agency tor Ihe pedormance o� �he work �or w�lch Ihls permii Is issuetl (Seclion 30W, Civ. G�. LENOEN: aooAess: OWNEB BUILOEH OECIAFATION: I �ereby afhrm t�ai I am exempi Imm Ihe Contractors' State License Law for �he Ioliowinp reason (Sec�ion 703L5 Business antl Pro�essional Cotle: Any ciry oi counry which requires a Oermil to constmct, alier, imD�ove. Aemolish, or repair any stmcNre, prior to its issuance. also repuires �he aDDlican� for such permi� �o lile a 5igneA s�a�ement ��at he/s�e is licensetl pursuam to Ihe pmvisions oi ihe Coniracmrs' Staie License Law (Chapter 9 �commencing wiih Section 7000) of Division 3 of ihe Business antl Pm�essions Cotle) or �hal hehhe is exem0� �here�mm and Ihe basis lor �he alleged eremD�ion. Any viola�ion o� Section 7031.5 by any app6can� �ar a permii su6ject5 ihe applican�io a civil penalty ot nol more lhan �ive hunO�eU tlallars ($500). I. as owner ol the pmOe�Y or my employees wit� waAes as their sole comDensation, will tlo ihe work, and the ❑ stmcWreis notimenaea orolfere0forsalelSection 7044, Business antl ProfessionalCoOe: The Coniractors' State License Law Ooes noi ap01y to an awner oi a D�oOe�Y w� builtls or impmve5 ihereon, and who tlo¢5 Such work himsell/AefSelt or IhwUg� his Or her Own employ¢es, pmviAed Ihai Sut� impravemems are n0i in�ende0 or Ofler¢tl �or Sale. I�, AOwever IAe UuilOing or impmvemenl is sola wMin one year of comDletioq the owner will have Ihe bur0en ol Oroving he/she tlid nol huild or impmve for ihe purpose of sale�. I, as owner oi ihe Omperty, am exclusively contmcting with licensetl contrac�ors �o con5lmci the prolect (Sec�ian 7044, 9usiness ❑ an0 Pmfessions Code: The Contracmrs' S�ate License Law tloes not apply m an owner of Droperty wAo builtls or impmves thereon and who coniratls �ar such O�ole[�5 with a conirac�or(5) license pursuan� ro the Contractors' S�ate License Law). I am aware Ihat pmo� of Iheir Worker'S Compensalion insurance 5�ou10 be providetl to me. � I am exempl untler Section: B. 8 P. C. lor Ihis reason: Oa�e'. Ownec I tlo here�y ceni�y I�ai I am aware of and understantl Ihe requirements oi Calilomia Health antl Safery Code Sec�ions 25505, 25533, antl 25534 antl ihal I or any fuiure builtling occupani willlwill no� (circle one) need �o comply wilh said sta�e cotles antl �he requirements �or a permit for con5lmciion or modibca�ion imm Ihe Pir Duah�y Managemenl DisVicL Re5i0ential con5imclion applications are exemp� imm I�ese pmvisions. Oale: ApPlicanC I hereby cetlily Iha� I have reatl �hls apPlica�ion and s�a�e Ihat the above in�ormation Is correcL I agree Io comply wit� all cl�y antl caunry ortlinances antl sta�e laws rela�ing �o buil0ing consimc�ion antl hereby auihorire repre5entaiive5 oi I�is ciry to enter upan �he above-men�ionetl propeny for inspedmn purposes. /�� `7-� Daie: �� Signalure: � e Diiver's License or Socia� Securi�y t6a1-46 White—Bulltling�, Green—Cotle EnbrcemenC Canary—ApPlican�; Pink—Revenue; Goltlenrotl—Assessor CITY OF COSTA t9ESA — BUILDING FERMIT PERP9 NO; B U7010 PEP.MIT P70: B 0701Q7 FLAN CHECK NO: N GOVT: N SUPF: N CONSTRUCTION TYPE; 5—P7 PERMIT TYI�E: STR PURPUSE: ALT JOB DESCRIPTION ; T/O SHEATH 6 REROOF W/FIP.EP,GLASS SHINGLE SQ FT: 4,70U CLAIM VALUE: 4,700.00 CALC—VALUE: 4,700,OQ GROUP OCC: R-3 /M-1 COBIMENTS: P.EROC�F 2400SF RESIDENCE, SMOKE DETECTOP.� P.EQ PEP, 91USC *****��**��,�*�*�,��**�***�*��*��**��*�**�**��*�,��.��1�1��`�E`1"ECTOR. . Z O A] I N G R E Q U I R E M E N T S E T B P, C K S - � ��iRED---- ----------- MAIN BUILDING ---------- ------ ACCE..SORY �, FP.NT; FT IN REAP.: FT IN FRNT: FT IN REAR; FT IN LEFT; FT IN RGHT; FT IN LEFT: FT ZP] RGHT; FT IA7 PAP,Y.ING P.E • Pk�V; PARCEL: 13933408 ZNE: HEF NO: FLAD]NING N TES> � i �r�*ac*u�*�u-�tx**�r�r�r�-r+r�t,.+c�xs*+�ir«*��-**�t*�r��su+��*+�*+r-��r*�r*r�***.�**�t�r�+ri�**�***+�«�r-�r*+t*� D E V E,L O F M E N T S E R V I C E S R E Q U I P, E M E N,T S ZONING APPROL'ED BY DATE: BUILUING APPROVED BY ; DATE: APPLICATION ISS.UED HY; DATE: � '�-� 'If if if afiE if'lE i('iE1R i%'lf 1E'if !f 3f')f 1f i1'iE tE')f'iF iE'iF ��('� �$i�'$�'?l��f �`# iE 3!'IE;1'� +� . i!�F'1`'iL{F�F�C'jE 3F if a!'-)("V aM1 i("IE'1F'M�i: aF�i �F ic .�iF iF if iE af af iF * iE iL �f �G iF if �E if+f iF iE 3f 3F i4 iF jf jElf if ff 1F iF if'1f �Y af 1f if iF iF ic i41f �f aE K JR?F i� K if 1F af iE 1f if iF N-jf iE yE if jf iF iF � jF 1f �f jf aE 1F iF if 1f i4 �A #: 4 iF Y iE if LEGALIZATION;P7� F E E S U M M A R Y STRUCTUP.AL SEGMEDlT:Y HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GP.ADING PEP,MIT 72.00 .50 SA9IP/NON—RES PLAr� ISSUE FEE BUILDIPIG—DIL'—> FEP.MIT ISSUE PLAPI—CHECK TOTAL PAID DUE TOTALS----> 72,50 O.QO 0,00 72.50 7Z,50 .00 REVENUE DIVISION TOTALS--> COLLECTED; 72.50 OVER/SHORT: ,00 bLDG Pr1T PLUMBING ELECTP,IC f9ECAAP]IC FIRE SMIP/TOT GRADING PLAN—CAECK �z.o� .�fl if +f lkii ittf 1E'N-iE'IF'lE iE iE'1FiF if it Y V�tF if ie'lfif ifii'/f�lE iF if M'%-'lE V-iF-1E iE iFdE�YiEi('i41f 1i 1F {E#�'�E ihY iFifY�N-i�'-K #' ifif if�lf it iFi(�.F aF if %'lE'1F jE if i.''N-il !fiE if I N U I C' I D U A L F E E B!? E A K D O Sd N TYPE QTY D E S C R I P T 2 O N UNZT COST TOTAL COST SFR 47U0 REROOF HY VALUE RESIDENTIAL NOZc.�NE 1.00 4,700,00 END OF FEES oa ooia'e5�7-p0I73S2E T�?T 7?,.5p D:,7E: ?1/�+9/S4 TTtlE: 54:33 CONSTRUCTION AND PLANNING POOL & SPA APPROVAIS Permit# Date Inspector qPPROVALS Permit?� Date Inspector ! t. Temporary Electricai Service or Pole 52. Pooi & Equipment LocaUon Z. Soi1 Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Ut+lity-Undrgrnd. 54. Forms 4. Electrlcal Conduit-Undrgrnd. 55. Electrical Bonding 5. Sree". Reinforcement 56. Rough Plum6ing & Pressure Test 6. Electr.cal UFER Gmd. 57. APPROVAL TO COVER�GUNITE 7. Pootings 58. Eiectrical Conduit�Undrymd. 8. Foondazion 59. Gas Pipe, O Undryrnd., Test i 9. Water Pipe-Undr9�� 60. Backwash Lines, P�Trap, ��'.. Undrgmd. 10. Struciural Floor Svstem 61. APPROVAL TO DECK 11. Proper2y Sewer Line & House Connection . 62. Backwash & Receptor�Final � 12. Sewer Cap 63. Heater & Vent�Final 73. Roo£ Drains 64. Plumbing System - Finai 74. Rough Plumbing 65. ElectricabFinai 15. Rough Electrica6Conduit 66. Solar System-Final 76. Rougfi Electric'h�iring 67. Fencing & Access Approvai 17. Rough W(ring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical�T E3ar Ceiling 69. POOUSPA SYS7EMS F WAI. 19. Rough Heating & Air Conditiorring FIRE DEPT. REQUIREMENT 20. Rou9n Factory FirePlace APPROVALS Permit # � 21. Dutts, in Strueture 70. Undercround liydro � 22. Ducts, Ventilating 71. Product Piping O Gas u Oii 23. Gas Pipe�Rouqh & 7est 72. UndErground Flush 24. Roof rraming 73. Undergrnd. Smraye Tank G' Gas ❑ Oii 25. Roo` Sheathing /��r�Gj� /!� ^ ,�-pverhead !-lvdro --^'- I � r y�.v 26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Fram2 and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEh4 FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Dryevall Naiting HEALTN DEPT. REQUIREI41ENT 31. Plasrer Brown Coat 79. FINAL INSPECfION I 32. Elzctrical Power MeterF�nal 80. FOOD CERTIFICATE ISSUED `� 33. Finaa Electric Notes: 34. Final Heating & Air Conditioning 35. Finai Gas Pipe-Test 36. Hood or CanopY 37. Final Factory Firepiace 38. Pinal Ptumbing , 39. Wazer Service�Final ^ 40. Gas Service-Final 47. Solar pomesticFinai 42. Backfiow Preventer 43. Backflow Irrigation 44. Landscape Irriqation SYstem 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING �� (/ �//L J N 48. FINAL PLANNING; 49. Electne Release to Edison 50. Gas Release to Southem Catifomia Gas Co 51. CERTIFICATE OP OCCUPANCY No. Date AOOHESS� em�axo: 1822 ELLESMERE AV w�r�aewxEiFp+owr+: BOYLES, JAMES VAN CARLTON • �,00pEss BOYLES, CHERYL LYNN 2822 ELLESMERE AVE COSTA MESA,CA 92626 �vr�. wuuxc �onx�u: APCNRECT Ofl FNtiNFEP: ARCN.OP ENO.'9 AOOHE59: c«irn.crarsu•�. CONfPACTOR3 YYIRlO M�NE44 UNT: lIG NO.: UNT: uc. xo� urn: IJCENSEU CONiNACTOR9 DEC�ARRTION: 1 MnEy elfrm uMs paroty M pm�wy ihtl I em lonsed uMx prwirions d Cheqx B (mmme^dnY �rit� Sxlian )000) ol Divuion J tl Ns Bu�iiwn eM PMasions Coda, and mY Goems is in Iu01au end sfled. cm uc. no.: uc. cuss: uc. xo.: EXP : om.: camm�: OW NEN BUILDEP OECLAR�TION: I Mnby elfmi under penel/ d psrj.vy tlw I em wmq Imm IM Comreaon Lbems Lew la iM tdbwiq �saron (`�bn ]W 1.5 Busiroe� eM 7rWmsioru Code: Mry ctY a aountY �� Wuim e pemiil lo mrotrucl. eller. Imprare. bmd'eh, p ropei eny Nr�clum: p'w lo XO m+�+�, ��a�irp iM epplimM lor ach peimd m fik e epiwd �lelement UW M w eM ficenW punueM lo IM ptomi0n� d Ihe CaNmtlm Liceme Lew ICheple� B(�mendnp Milh SeUion ]000) d DHeon 9 d Ihe .iu'vim enE Proleniona Codal a tMl M ur eha u aaemq �hsehun eM ths bem la iM dbpeE ssemqian. My v'ablion d Setlbn ]W1.5 by ury eppGmni lar e pemN wbpqe �M epplium �o e wY peroEy d nd mps then Me �uMred do0en �5500�. � I. s� ovrtrer d �he propeny a my empbyaee wYh wepea m ihr eob mmpanesiion, wJl do the xoM1, erd Ne svuciure a rw imaiMad w Merad M aeb (5eciion )010. Buzriea eM PmleeaionaGode: TM Conlredon lironse Lew Eoes iwl epply loen ownerd propeM ..+�o a,wa «mv� �n«eon. e�e.no aoe..�n.�ax nm..n «nen.� «w«�M �«na o� amaM�•, a�� nm.�n impowinuua era mi inandeC aWared la eeb. tl.lawevm. iM bwtlieq a inprwemem ie eold xnhin wnY� d mmplmion. Ne �o.,�a�ua�. �n n... m. w� a o�+�m ne «.n. da � d,�u a�mwwe �« me wmo.. a wa�. I. ee awner d iM propeM. � a�tlueHely oonlreaip hilh 4censaE mnireclon �o conwua the prqed (�� . ��inms enE Proleeaione COEe: TM Conireean licame lnw Eoee M eppy lo en owner d propanY �o buiNa a imqoves thereon enE who convazb Iw eudi yol�� h e aoMeetlor�e) licaniad pun o �M Caniropwe L'vanse lew � I am uemp urds Seclion: '� B. 8 P.C.. la ' renwn: �oe„ �— 2 z- 5 S �,,,: Mroby ceMiry �hel I am eware W enE uMeniend �he requirem ie W Celiomie Heellh anE Selety COJa Sediona 25505. 2553�, eM 2553a, eM �hd I a eny lulure Wildirq a¢�pent will / will iat (drcb ons) nead io cwnply w1h veid mme cadea vM ihe rpuiremenb M eoe�millaconaVuclionartwEifKalbnhanlMAi ue�.ly erepemenlOitlriC.Rpidenlieloonelrud'qneppicelbmareuemqlrom�Msa oe�e: nvoiweoc WOflKENB CONPENSATION UECUPATION: I �eroEy e1Nm uMer penMy d pepury om d the bllovneq dedwiona: � 1 heve eM xi1 meinten e cenJicale d coneent io �aX.inwn la warken' canpenution. v pwided /w by Seqion 3]00 d iM lebor COEa, la IM peAaimvice d Ihe xork Iw which ihis pemin ie ia�ued. � I hew end wil mamein woAart oompenuton imurnnce, m repuired by Setlim �>00 d Iha Lebor Lode, lor iM pa�larmence d �he work fw which thie peimil n inued. My waMA mmpenxlim ineurence umer arM pdiq numEar ere: c�.,: vdKrN�mna: (Jhis eection need rrot Es canpbfeJ I Us pemi] ia M orie hundreE Cdlem (Si00/ a/eseJ � I cenAy ihei in Ihe pMamen:e a11M wak la vfich Ihn permn u inued, I ehell iw mmpby eiry pareon in any menrrer w m Io nxmw w4�e m �M .wne.: wmw��, b., a cmnome. .�w eo� uw n �.na,b n«ome wbjed �o ms xwken eompeivalion po.'viom d Seaion 2l00 d IM Lebor COGe. I YWI fathwvA mmp�y wNi Om peovisiau. Waminp: Fs/lun ro��cun woM'en'romp�rwtlon rovenp� b unl�wN( �npWII wtlpct an wIp/oyer fo MMrW pm�Mu eM n.m nn.s w ro an n�na.ed �rou,.ne aaun ls�m.aaol. in .mnro� ro m. co.r or mmv«u.�ron d•�w• u w��wa ror �n Sxtlon ]]06 0/ IM Wor Cole, Inronat, �ntl �rtomsy� fws. CONSTAUCiION LENMNO RGENCY: I lmtry �rtn uMer penelry d pe�ury ilw ihere u a �vnx�uaion kMirq apercy 1« Ne pMwmerca d iM wark Iw xfi'rh �h'v pem�i'v'vauad (Seaion 309], Cv. C�. IENDEF'S NMIE: LENOEfl'S �DDNESS: I ceNh IMt 1 M1eve read Nia epqicaiion ud ama tlw Ne ebove'udametion o conee. I epme lo comply wnh eA iny ud mwiy ordinv� eM alete lex5 �elelip to WiNvq [onF�utlion eM Mroby aNhwae reqeaentqivea d I�ia cily lo enlar upon iM ebo.e.memioneE poperly Ia i�upotlion purpwef. JAMESABOYDS om,: 9 L Z, (5151-IB.WP) WAne-Buikiq 8 Sdery: GreerFle: Ceivuy-�ppirant; Rnk-Rewnue; (bldmro�baeaxr CITY OF COSTA MESA — BUILDING PERP4IT PERM NO: H 0'74 311 PERMIT NO: B 074311 PLAN CHECK NO: 03$04-95 L GOVT: N SUPP: N CONSTRUCTION TYPE: C'—N PERMZT TYPE: STR PURPOSE: CON JOB DESCRIPTION : CONST. 86' BLK WALL BETWEEN 2 PROPERTIES SQ FT: 86 CLAIM VALUE: 3,440.00 CALC—VALUE: 1,720.00 GROUP OCC: R-3 / COMMENTS: WALL TO CONST. HETWEEN 2822 6 2834 ELLESMERE DR iE iF if if 9F 1E if iF �F iF if iFlE iF aF if iF 1E �ElE if jk if if iE iE if jf jF iF iE iE if iE iE iE iE iE iE jE if if !k if !F iE iE iE iE 1E 1E if 1E 9E fE �E �E iE iE iE if 1E iE 3E 3E �ElE �E iE �E if iE jE if iE 3E 1F iE �E Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING -------- FRNT: FT IN REAR: FT IN FRNT: 14 FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN AGHT: FT IN PARKING REQ: PROV: PARCEL: 13933408 ZNE: R1 REF NO: PLANNING NOTES> 86 LF OF 6' HIGH BLOCK WALL ALONG LEFT SIDE PROPERTY�'LINE OF > SF RESIDENCE. PARTY WALL AGMT COMPLETED 14 jF IE iE 1E iF if �IF if iFlf iF tE #!E iE ih 1E 1E iE if ik 1E iE if iE IE iE iE 1h 1E iE 3f �1E iE iE iE iE iElf 1E iE if fE ik �lE iE M- 3E !E IE IE iE-IE iElf 1(� IE �IF �IE iE if if 3ElE 1E iE �E iF i61t iE 1ElF 3E iE �1E 3F -k D E V E L t� 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 (�P DATE: BUILDING AFPROVE6 BY : � DATE: Q_ �_�,_ �) APPLICATION ISSUED BY: DATE; ' ��*��*��**�*�**�*�� «�**�***�*� �� LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SaGMENT:Y HLDG PMT PLUMBING ELECTRIC MECHANIC FIREi SMIP/RES GRADING PERMIT 41.00 .SO SMIP/NON—RES PLAN 26.65 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 41.50 0.00 26.65 68.15 � 68.15 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 68.15 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT.,GRADING PLAN—CHECK 41.00 .50� 26.65 ( if IE if if if jF 1F if 1F if if iE iE iE if 1k iE if iF iF iE 1E if if if iE iE iE iF iF 3E if 3E iE iE iE 1E fElf iE fF 1E iE jE iE iF jf iE iElf iE iE 3E 3E iE 3E 3E iF iE aE if iE iE 3E iE 3E if if IE 3E iE IE �E aE �E 1E iE IE iE 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-C,QST TOTAL COST SFR 86 RES—CONCRETE BLOCK WALL / FT. 20.00 1,720.00 END OF FEES �� f , / Q� ua°ac��-��i9�� r�c�r ea.is GATE: 09r"?+'S iJi�Ft .3:3� / ✓ � CONSTRUCTION AND PLANNING POOI _. oPA • APPqOVALS Permit# Date Inspectar AppROVALS Permit# Date Inspector i t. TemPorary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement 3. EleCtrical Conduit Utility-Undrgr�d. 54. Forms 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding 5. Steel Reinforceme�t l� �� / 56. Rough Pl�mbing & Pressure Test - 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings �Z,^4 �j i�sG✓�' 58. Electrical Conduit�Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Tesi 9. Warer Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Und�g�nd. 10. Structural ffoor SYstem 61. APPROVAL TO DECK 11. Prpperty Sewer Line & House Connection 62. Backwash & Receptor-Final . 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical�Final 15. Rough ElectricabConduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING � 18. Rough Electrical-T Bar Ceiiing 69. POOUSPA SYS7EMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating � 71, Product Piping OGas ❑Oil 23. Gas P�Pe-Rough & Tesi 72, Underground Flusfi 24. Roof Framing 73. Undergrnd. S[orage Tank O Gas ❑ Oit 25. Roof Sheathing 74. Overhead Hydro ' 26. T-Ba� Ceiling (Structurall & Monocoat 75. DrY Chemical 27. Frame and Ftashing 76. Dry Standpipe 28. Laihing & Sidin9 77. FIXED SYSTEM FINAL 29. Insulation � 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 37. Plaster Brown Coat 79. FINAL INSPECTION 32. Elecirical Power Meter-Final 80. FOOD CEFTIFICATE �SSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning , . � 35. Fina� Gas Pipe•Test � 36. Hood or Canopy 37. Fina� Factory Fireplace 38. Fina� P�umbing 39. Wate� Service-Fina1 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer - 43. Backflow Irrigation �� - 6_Gl S� A` � ��,! ^ <<- l 44. Landscape Irriqation System G ti� LL 45. Sound Attenuation 46. Handicap Regulations .� 4Z FINAL STRUCTURE & FIUILDWG `0 /7_�� _ 48. FINAL PLANNING ' �� 49. Electric Release to Edison � 50. Gas Release to Southern California Gas Ca .,,,�_,_ 51. CEFiTIFICATE OF OCCUPANCY -. No Date y' � PARTY WALL AGREEMENT THIS AGREEMENT, made and entered into this _!�� '�'�'� day of S�T�� ' /� , by and between ��"^� � ' C . {30 �/L�.=3 hereinafter referred to as "LANDOWNER;' and �t� �� ^'�"'^� hereinafter referred to as "ADJACENT PROPERTY OWNER" It is hereby agreed that a party wall will be constructed on the property line between a�2v i' 2d�3�f �5(,t,ELma'tE (Address of Adjoining Properties) in the City of Costa Mesa, County of Orange, State of California, as per map recorded in Book , Page of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroach � — �A �� _�i�/�GAGle3 Cx�trrnlCn wooD�l� FE�vc2. IN WITNESS WHEREOF, the parties have entered into this Agreement the day and year first above written. LA OWNER � . ignature) .�n,•�o'3 J C_ (3 o y cZ Name (Typed or Printed) 2e'z Z tzi.t3w��aaF . /-F� (Address) 1906 <6 ADJACENT PROPERTY OWNER /�l �;�� %� (�)r'� ,�r �Gf � (Signature) I�?e�a (-f. J��'P�PrG��'�i �l Name {Typed or Printed) Z� 3 y�l l-�s�vlp��e 1�� (Address) NOTARIZATION RE�UIRED � \\\tt\�t\� �'�\\\\\\t\1\t\ti�\ Stata of ��-�`�-�- � County of e-��i*-y� On /��/�S before me, /'"f-<.�t�r.� /J'' i�7'�X� , DATE _ N/�FICER-EG.,'JANEOOE,NOTA PUBLIC' personally appeared � �� v NAME�S) OF SiGNER(S) ❑ personally known to me - OR � proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) �are subscribed to the within )))'nstrument and ac- knowledged to me that 6je/s#%/they executed the same in ha�/h�r/their authorized � capacity(ies), and that by Fxis/�r/their + KATHERINE L. AAMSTAONG signature(s) on the instrument the person(s), COMM.q1027612 � ortheentityuponbehalfofwhichtheperson(s) U,-a ` NOTARYPUBLIGCALIFORNIA � dCt2d, OXECl1t2CI IF101(75IfUfTIBf1I. Q] ,i., ORANGECOUNTY My Comm. Eapiies May 25. 1998 ! Witness my hand and official seal. � �\ 7 SIGNATURE OF NOTARY CAPACITY CLAIMED BY SIGNER �INDIVIDUAL(S) � � ❑ CORPORATE OFFICER(S) TITlE�S) � PARTNER(S) ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ SUBSCRIBING WITNESS ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) ATTENTION NOTARV: Alihough ihe inlormation requested below is OPTIONAL, it could /pry/a �ni iraudulenl atlachment oi this /c/ertif�iwte to unauthorized document. THIS CERTIFICATE Title or Type of Document V� A/'�e /�y`� MUST BE ATTACHED Number of Pages � Date of Document ��i�9 s� TO THE DOCUMENT DESCRIBED AT RIGHT: Signer(s) Other Than Named Above O 1991 NATIONAI NOTARY ASSOCIATION • 8236 Remmet Ave. • P.O. Bo. ]18a • Canaqa Park. GA 91 JOdqtec +►' - ```" (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRNE, GOSTA MtSA, GA 926'L6 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: Address 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 7000a Service over 1000a Motors to 1hp Motors to 10hp Molors ro SOhp Motors to 100hp Motors over 100hp Communicalion drops Sub panel to 200a Pole Liqht Pkg Sign Circuits Temp Pwr Pole Intermed Pole 2822 ELLESMERE AV 13933408 MC CLANAHAN, MICHAEL C 2822 ELLESMERE AVE COSTA MESA, CA MC CLANAHAN, MICHAEL C 2822 ELLESMERE AVE COSTA MESA, CA OWNER-BUILDER Phone: 774-434-7979 Zip: 92626 Phone: Zip: 92626 Phone: Zip: License: 0 ISSUED BY: Status: ISSUED Applied: 09/78/2000 Issued: 09/18/2000 SCOPE OF PERMIT SUPPLEMENTAL ELECTRICAL PERMIT FOR AN EXTIONSION & REMODEL OF AN EXISTING SFR. 6 FIXTURES, 2 OUTLETS. - REF: B00-00826 & E00-00515 $7.25 50.00 $0.00 $0.00 so.00 $0.00 56.60 3220 $0.00 $0.00 30.00 50.00 $0.00 $0.00 $0.00 $0.00 so.00 50.00 50.00 50.00 S0.00 50.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY Temp Dist System / Lightinq Busway/t00k Standing Section Misc Electrical Equipment Transformers up to 7 kvalkw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 700 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misc. Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas 7ree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantity $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 50.00 0 $o.a0 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 50.00 50.00 S0.00 50.00 TOTAL CALCULATED FEES 516.05 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period ot 180 days. - INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspections 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 2446dfi (6/00) WORKERS'COMPENSAnON DECLARAnON: I hereby aflirm under penalry of perjury one ol tha tollowing detlarations: ❑ I have and will malntain a certiticete ot consen� lo sell-Insure for workers' compensetlon, es provitletl for by sectlon 3700 ot the Lebor Code, for the pertormance oi the wark tor which this pertnit is issued. ❑ I have arM will maintain workers' compensatlon insurance, as required by section 3700 of Ne Labor Code, ta the perfartnance of the work fw whic� this parmit is issued. My workers' compensatian Insurance cartier and policy number era: Carrier. Policy Number: (This section need not be comp/eted i! the pertnif /s velued e( one huntlred tlollers ($700) or Iess.J ❑ I certify that in the pertormence of the work for which this permit is issued, I shall not employ eny person in eny manner so as to �ecome subject to iha workers' compensetion laws oi Celifomia, end egree Ihat II I s�oultl becomo subJect to the workere' compensation pmvisions ot Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Applitant Signature: Dete: WAqNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNUWFUL AND SHALL SUBIECi AN EMPLOVER TO CRIMINAL PENUTIES AND CIVIL FlNES UP TO ONE HUNDRED T/10USFND OOLLARE (E100.000), IN ADDITION TO THE COST OF COMPENSATION, DMNGES AS PROVIUED FOR IN SECTION 31060F THE UBOR COOE, IMEREST, AND FTTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that 1 am licensed under provisions of Chapter 9(commencing with Section 7000) ot DlNsion 3 0l Ihe Business and Professions Cotle, ana my license is in full force and eflect. Lic. N Class a Contrecrors Signature: Date: CONSTRUCTION LENDING AGENCV: ❑ I here�y aMirm that there is e construction lentling agency tor the pedormance of ihe work for which Ihis permit is issuetl. (Sec. 3097, Civil Cotle). Lendefs Name: LentleYs Atltlress: Signeture: Date: OWNER-BUILDER DECLARATIONS: I here6y aHirm that under penalty of parjury Ihet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Businass and Professions Coda: Any ciry or county which requires e permit to consWcL alter, improve, demolish, or repair any structure, prior to its issuance, also requires ihe applicant for such pertnit m file a signed stetement �het ha or she is Ilcensed pursuant to the D�ovisions of Ihe Contrectors License Lew (Chapier 9(commencing with Section 7000) of Division 3 of t�e Business and Professions Cotle) or that he or she is ezempt therefrom entl the basis for Ihe ellegetl ezemption. Any violation of Section 7031.5 by any epplicant for e permit sublects ihe epplicant lo a civil penalty ot not more than five hundred dollars ($500).): ❑ I, as owner oi the propeny, or my employeas wlih wages es their sole compensetion, WILL DO THE WORK, antl �he siructure is not intended or ottered tor sale (Sec. 7044, Business and Professions Code: The Comreaors License lew does not apply to en owner ot properry who huilds or improves Ihereon, and who does such work �himselt or hersel� or �hrough his or her own employees, provided ihat such impmvements are not Intentled or oNereC tor sale. If, however, ihe building or improvement is sald within one yoar of completion, the owner-builder will heva the burden ot praving ihat he ar s�e tlitl not build or improve for purpose ot sele.). I, as owner ol ihe property, em EXCLUSIVELY CONTRACTING WITH LIGENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business antl Professions Code: The coNreclors License Law does not epply �o an owner ol property who builds or Impmves thereon, and who conirects for such project with a cnntractor(s) license pursuant to the Contrectors License Lews.). � I am mpt `un�der sec. y�—�/-- Business end Professions Code tor this raason: Signature: �/�t C� /V � CL�-� _ Oate: - / - zCC�� Owner ID veritietl by driver's license. ❑ Ves ❑ No Driver's License No. Expires: Veelfication of Ownership by (type of documenL i.e. - property tez bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ 1 hereby certiy that no excavetion five (5) or more feet in depth imo which a person is required to descend, will be made in connection with work authonzetl by this pertnit, and that no building sirucWre, scattolding, talsework, or demolition or dismantling Ihereof, will ba more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Celibmia Atlministretive Code). ❑ Ps owner-builtler, I will not employ enyone Io tlo work whic� woultl require a permil Irom the Division of Indusirial Safery, as noted above, unless such person hes e pertnit to do such work irom ihe division. Signature: Date: Division of Intlustnal Safery Permit Number. CEfi71FlCA7E OF COMPLIANCE AND AUTHORQATION OF EMRY: I ceniy under penalry of perjury that I have reatl �his applicetion and slate that Ihe informe�on given is correct. I egree to comply with ell siate laws end city ordinances relating to building consiruction, and euthonze representatives oi the Ciry of Costa Mesa m enter upon the ove-descnbetl propeM for insp o ion purposes. I egree not to occupy or ellow occupancy ol eny building authorize`d �b/y �his, �pe-rtn�it un\1il tinal inspection. C..�n GI %' / GI - / O - �s-'� / �L C.�C SigneNre OI Legal Ownar(s) Date AnNOr Authonzed Appllcant GO�E 1, INSPECTONTYFE PAIE II�LS 1616 Fi:etl System Final Fire Prevention � 1266 200 Pool Spa Final Final Re-Raof 201 Final BIocWRetaining Well 202 Finel Factory Fire Plece I 203 Finel Sign e 204 Final Demolilion CO�E� INSPECiIONTYPE 206 Finel Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy BATE �uu. (7t4) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.ca.us // rHIIY Unl VC, I.VJ i/+ mwn, i.n nmm PLUMBING PERMIT Job Address: 2822 ELLESMERE AV Suite No Vicinity: Parcel Nunmber: 13933408 Applicant: MC CLANAHAN, MONA Address: 2822 ELLESMERE AVE . � COSTA MESA, CA Owner: MC CLANAHAN, MICHAEL C Address 2822 ELLESMERE AVE � COSTA MESA. CA Contractor: O W N ER-B U I LD ER Address: ISSUE FEE BackOow irrigalion BackFlow Preventer Balhtub Clarifier System Connect pce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 oullets) Gas (Over 4 outlets) Gas Repipe Status: ISSUED Applied: 06/15/2005 Issued: O6/15/2 OS ISSUED BY: Phone: 714-434-7979 Zip: 92626 Phone: Zip: 92626 Phone: Zip: License: 000000 SCOPE OF PERMIT INSTALL 336 S.F. GUNITE SWIMMING POOL AND 64 S.F. GUNITE SPA LOCATED IN REAR OF PROPERTY. REF.: BOS-00987 PLUMBING TO INCLUDE: 1 GAS (1-4 OUTLETS), 1 BAR SINK, 1 PRIVATE SPA, AND t SWIMMING POOL AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0;00 $0.00 $0.00 $0.00 $0.00 $0.00 $6.15 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 FEE SUMMARY Laundry Tub / Washer LandsCape Irrigalion � P•Trap Pressure Regulator Process Piping (per 10 k) Receptors Septic Tank SewerCapforDemo. Sewer Connecl Sewer Private Line Shower ` Sink, bar Sink, commercial Sink, Floor Sink, kitchen , Sink, service/mop Spa (privale) AMT $0.00 so.00 $9.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 S0.00 $0.00 59.80 $0.00 $0.00 $0.00 $0.00 $30.25 QTY 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(14) Vacuum Brkr BkFlow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Cbset (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION AMT $0.00 sso.�s $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 $0.00 $0.00 on 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremanis under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) 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 for Ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapectione end flnel approval must be obtalned. Failure to obtein inspections end final approval will result in the expiration of this permit:� FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSAnON DECLARAnON: I hereby aflirtn under penelry of perjury one of the lollowing declarations: ❑ I heva entl will melnteln e ceniticete oi consent lo self-Insure for warkers' compensetlon, es provlded for by sectlon 3700 of the Lebor Code, for the perfortnence of the work for which Ihis permit i� Issuetl. ❑ I have antl wlll malntaln workers' compensation Insurance, as required by sectlon 3700 0l Ihe le0or Code, lor Ne pertortnance ot the work br which this pertnit is issued. My workers' compensetlon Insurence certler end policy number are: Cerrier: Policy Number: � i s sec on neea not oe comp�ereo n me permu �s va/uetl et one nuntlren tlollers (S /00) ar less.) -- rtity Ihet in tha paAormence of Ihe work far which Ihis pertnit is issued, I shell not emplay eny person In eny menner so es to become subject to t�e woAcers' compensation laws of Cellfomie, entl egree Ihat if I shaultl becoma su6Ject lo t�e warkero' compensetlon provisions o1 Section 3700 of the Lebor Cotle, I shell forthwith comply wilh �hese �_ ons. I� �/ n� D � � _ � gnat re. �r,/�s � oeie::: : — - WARNING: FAILUFE TO SECU WORKERS' WMPENSATIO WERAGE IS UNLAWFUL AN� SHALL SUBIECT AN EM R TO CRIMINAL PEWILTIES AND CIVIL FlNES UP TOONE MUNDRED TKKISNND DOl1ARE (E100,000), IN FDDrtICN TO THE COST OF COMPENSATION, DAMAGES 0.S PROVIOED FOR IN SECfION 31080F THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn �het I em Iicensed under proWsions of Chapter 9(commencing with Section 7000) of Divislon 3 ot the Business antl Protessions Code, and my licensa Is in full force entl etted. Lic. # Cless q CoNrector's SlgneWre: Dete: CONSTFiUCT10N LENDING AGENCY: ❑ I hereby eHirm theuhere Is a consWction lending egency for ihe peAormance oi t�e work tor which this permit is issued. (Sec. 3097, Civil Cotle). Lentlef5 Name: Lentler'S Addre55: SigneWre: Date: OWNER-BUILDER DECLARATIONS: I hereby eHirm thet under penalry ol per�ury ihet I em E7(EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7037.5, Business end Professlons Code: Any ciry or county which requires a pertnit to construct, elter, improve, tlemolish, or repeir eny stmcture, prior to its iuuance, also requires the applicant for such pertnit lo file a signed stetement �het he or she Is Iicensed pursuant to Ihe provisions of tha Contrectors LJcense Lew (Chepter 9(commencing with Section 7000) oi DiWslon 3 of Ihe Business and Professions Cotle) or Ihai �e or s�e is exempt Iheretrom and the besis tor the elleged exemptlon. Any vloletlon of Section 7037.5 by any epplicent for e permit �sub�ect the eppllcant to e civil penelty of nol more then five huntlretl dollere ($500).): a4owner oi ihe praperry, or my employees wlth wages es iheir sole compensatlon, WILL DO THE WORK, entl ihe structure Is not intended or oMeretl for sale (Sec. ��;. _7D34, Business and Professions Code: TTe Contractors License Law dces no� appty to en owner ot pmperry who builtls or improves ihereon, and who does such work �imselt or herself ar through his or her own employees, pmvitled that such improvements ere not intendetl or oHereO lor sele. If, however, the 6uiltling or improvement Is saltl within one yeer of wmplation, the owner-6uilder will heve ihe 6urtlen oi proving ihat he or she did not build or imprava for purpose of sele.). ' ❑ I, as owner ot Iha praperty, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sac. 7044, Business flnd Professions Code: The contraaors Llcense Law tloes not apply to en owner of property who builds or Imprwes thereon, entl who contracts tor such pro�ea with e contractor(s) liten5e pursuen� to Ihe Contrectof5 L1CBnse LBwS.). ��ivner ID v Venlication by drivers license. ❑ Ves ❑ No by (rype of documenL i.e. - property �ax bill entl Pmfesslon5 CodO for this reason: DIVISION OF INDUSTRIAL SAFETV PERMR CERTFICATON: ❑ I hereDy ceNfy thet no excevation (ve (5) or mora teet in depih inta which a person is requlratl to Aescen0, will be maGe in connecUon with work authorized by t�ls pertnit, end that no building structure, scattolding, falsework, or demolition or tlismantling thereoi, vnll be more �han ihirty-six (36) icet high. (C�ap. 32, Grp 2, Ah 2, Sec. 341, Ttle 8, Celifamla Adminlstrative Code). ❑ As owner-buildar, I will not employ anyone lo do work which would require e permit Irom Ihe DivLslon of Indusinel Sefary, as notad ebove, unless such person hes a pertnit to tlo such woAc irom the division. Signature: Dete: Division oi InOusirial Sete�y Pertnit Number: CERTIFlCATE OF COMPLJANCE AND AUTHORIZATON OF EMRV: I certity under penalry ot perjury thet I heve read this epplicatlon end state that the infortnetion given Is wrrect. I agree to comply with ell stete lews entl ciry ordinances relating to building constructlon, enA euthorize representetives ai Ihe Ciry ot Casta Mese to anter upon Ihe e e-d scri ed property tor in�s'y(�ction ases. I egree not to occupy r ellow upency of eny building euthonzed by th/isy ertnit until fnal ^ins`pgFtion. /"\..�aA K/ lS�=_-W $f�neiuie,;01, : "' - wnerj5l �.� 'Date • -'r' / � And/Or Authorized Applicant Date COUE I. INSPELTIONTYPE 1616 Fi:ed System Final Fire Prevention 7266 200 201 202 203 204 Pool Spe Finel Finel Re-Roo1 Flnel BIacWRet0lning Well Finel Fectory Flre Place Finel Slpn Final DemWitlon � I�� Qp� iNsvernoxrrve 208 Finel Mec�anical 20B Finel Plumbing 210 Final Electdcel 212 Finel Fire Prevention 220 Finel Planning Approval 222 Final Site 250 Flnel Builtlinp/Oaupancy PAg V�ELB y� � - _ _ - �_ - ,._;._; . ' - .._ . . , _ . _ � �. � .i _i�l. � � . . . � . _.. . _ _i_ --�1-- - - '-- ' ' . �ti� ��►�"f� '- . �, . `._._ , " ' _' ' _.' _ ,�' ' �� `' � -E��f�-� � . i..: -: r _. w 1 . ��.��,��1 `�; � . _ �� . . . .� ...- i . .. . .. ._.. .:." "_ I r -�a_; Y `�� .^. .�_i y _. l,..l..� i_ --. , - > -_ ..._.I ._._t __ ' _ :�- in ..-_.. �. _ _' ."_. _ . � . � ! '__' ""_. �'i "", j.�.- ._�_� . w L : ._.' 1�4... ... . ��'r1J 7t97 <PFrp�iN AND �OMi�kCS:;:�" �, ��F'��;`':!'�r.: n. 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"' ' .. ._..- �.- _ . .. , _.._._ . _._ ' ' . _ . .. - _ _ -.. .�__. - " " ; i _ ' I 4.._.__"._.�......_ ._.._._.__'_._."' _ _"""" ""'__' "' "` " "' _ ' _ ' .._._... ....... _. _. _ . � _..._1 i ; � � 1': u , �D ' � 1 : _. ..�.s�'_ __ ".__ _...._._.__ `" "__'. ��..��.... __ _ _.. _ ... _ _ .. "" __ .�.. _ . . � "..'" _ _ ""_. . .....-� �.. " '_ ' �....��._ � <] �.m�:.�.�„�J... .�...-�.a^:.�-.....p�_.....�. �._�n-.. .. _�. . a.r� . , . ... c ..s....e�l?:9"ti.o^: -. . . _�. . .::: . n . ... .. . .. . . ..v :-_ � .� .� .ORIGi.iLN..PYP��.,cFf� i . "..N. :(PQt/.-•. . . . _ _ ti• . / '��_! r ! ''L .. J— ._... ' ,A"'` • . . . : . .:: i" ^Ji-.i{A'11:."'n�RNr�I�W. .�_ ..�_ 1-0:':i ��ia> �5a-sz�s • Fax (�ia� �sa-aess • www.ci.cosca-mesa.ca.us 77 FAIR DRIVE, GOSTA MESA, GA 9'L6'Lti MECHANICAL PERMIT Job Address: 2H22 ELLESMERE AV Suite No Vicinity: Parcel Number: 13933408 Applicant: MC CLANAHAN, MONA Address: 2822 ELLESMERE AV� . COSTA.MESA, CA Owner: MC CLANAHAN, MICHAEL C Address: 2822 ELLESMERE AVE . COSTAMESA,CA Contrecror. OWNER-BUILDER Address: Phone: 714-034-7979 Zip: 92626 Phone: Zip: 92626 Phone: � Zip: License: 000000 Status: ISSUED Applied: 06/15/2005 Issued: 05 ISSUED BY: SCOP-E OF PERMIT INSTAl.L 336 S.F. GUNITE SWIMMING POOL AND 64 S.F. GUNITE SPA LOCATED IN REAR OF PROPERTY. REF.: BOS00987 - - -" - � � � MECHANICAL TO INC�UDE: INSTA 1 FAU > 100K BTU ISSUE FEE Inst FAU <100 k BTU . Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace � Hood w/Mech Exhaust . VAV Box Vent Fan / Single Duct � Appliance Fire Dampers � Smoke Dampers Inst or Relocate Appl Vent Air Handlers < t0000cfm Air Handlers > 10000cfm Floor Furnace Floor or Suspend Heater $23.50 $0.00 $18.20 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0:00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 Quantity 0 1 0 0 0 0 '0' , 0 0 0- 0 0 0 0 0 0 0 0 0 FEESUMMARY Repair / Alt Absorbtion Unit Repair ! Alt Refrigewtion Unit Ventillation System , � Evaporalive Cooler Commercial I nci n erator Domeslic Incinerator � Compressors�IAbsorplionSvstems . Upto3hp/100kBTU� ` . � 3To15hp/500kBTU , " 15 To 30 hp / 1,000 k BTU , 30 To 50 hp / 1,750 k BTU �Over 50 hp / Over 1,750 BTU ,. Boilers Upto3hp . 3To15hp 15to30hp 30to50hp Over 50 hp � � - Other Mechanical Fee ' " Investigation Fee Plan Check Fee Quantity $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 �$Q00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorizetl under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. POR INSPECTIONS CALL: (714) 7545626 � 244fi3fi (6/00) WORKERS'COMPENSAnON DECLARAnON: I hereby affirtn under penalry ot perjury one of the following decleretions: ❑ I have entl will meinlein a certificate of consent to sel�-Insure for workere' compensation, es provided for by saction 3700 of ihe Labor Code, for the performence of the work tor which Ihis permit Is 15suea. ❑ I have and will maintain workers' compensatlon insurance, as required by section 3700 oi ihe Lebor Cotle, for tha pertortnance ot ihe work for w�ich this pertnit is Issued. My workers' compensatlon Insurence carner and policy number are: Carrier: Policy Number: (fhls section neetl not 6e completed il the permit is velued af one hundred dollars ($100) or less.) thet in Ihe perfortnance of the work tor w�ich this permit is issueq I shall not employ any pereon in eny manner so as to become subject to the workers' setion laws ot Californie, and egree ihet II I shoultl become sub�ect to the workers' compensetion provisions ot Section 3700 ot ihe Lebor Cotle, I shell forihwith ..-'--..,e�-;-i:��. ��i�� ale:�` Fl��l� —�V �igneWre:; - :...s= �AILURE TO SEW E WORKERS' COMPENSATIqJ COVERAGE IS UNLAWFUL AND SHAIL SUBJECT AN E�P'�'IDVER-iOCRIMINNL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED pOLLARE (5100.000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN S�CTION 3]O60F THE LABOH CApE, IfJrEREST, AND ATTORNE`f5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm ihat I am licensed under provisions of Chapter 9(commencing with Saction 7000) oi Divislon 3 0l the Business and Professions Cotle, antl my license is in full force entl eHect. Lic M Cless N Contrecmr's Signature: Data: CONSTAUCTION LENDING AGENCV: ❑ I hereby aNlrm ihat Ihere is a consiruction lending egency for the perlormance oi Ihe work for which this permit is issued. (Sec. 3097, Civil Cotle). LentleYs Name: Lenders Address: Signature: Date: OWNEH-BUILDER DECLARATIONS: I hereby affirm thet untler penalty of perjury ihat I am EXEMPT FROM TME CONTFiACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or counry which requires a permit to construct, elter, improve, demolish, or repeir eny structure, prior to its issuance, also requires the applicant for such permil to flle e signed stetement that he ar she is Ilcensetl pursuant m the provlsions oi Ue Conhactors License Lew (Chepter 9(commencing with Sectlon 7000) of DiWsion 3 of Ihe Business and Protessions Code) or that he or she is exempt therefrom end the �esis for the elleged e:emption. Any violetion of Saction 7031.5 by any applicent for e pertnit subject the epplicent to a civil penelry of not more Ihan five hundred dollers ($500).): I s owner of ihe property, or my employees with wages es their sole compensatlon, WILL DO TME WORK, antl the structure is not intended or oNered for sale (Sec. . 044, Business end Professions Cotle: The Contradors License Lew dces not aOPly to en owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provitled that such improvemants ere not intended or otteretl lor sale. If, however, iha building or improvement Is soltl wit�in one year of compietion, tha ownar-builder will have ihe 6urden of proving Ihat he or she did not build or improve tor purpose of sale.). � ❑ I, as owner of the property, am EXGLUSIVELY CONTRACTING WITH LICENSED CONTRAC70RS to construct ihe prqact (Sec. 7044, Business antl Professions Cotle: The contrecmrs License Law does not epply to en owner ot pwperry who builtls or improves thereon, end who contrads for such prolect with a contractor(s) _Ilcense pursuant to the Contrectors License Lews.). Verification ot sec. by dnvef5licen5e. � Ves ❑ No by (type ot documen�, i.e. - property tax hlll ar end Pmfession5 Code tor �his reason: DIVISION OF INDUSTRIAL SAfETV PERMIT CERTIFICATON: ❑ I hereby certity that no excavation five (5) or more feet in tlepth into which e person is requiretl to descend, will be made in connection with work authorized by this pertnit, end that no building siruIXure, scallolding, falsework, or tlemolition or tlismantling thereot, will be more than thirty-siz (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Califomia Adminisirativa Coda). ❑ As awner-buiider, I will not employ anyone to tlo work which would require a permit from the Division af Industrial Sefery, es noted above, unless such persan hes e permit to do such work from Ihe division. SignaNra: Dete: Division of Indusirial Safery Permil Num6er: CERTFlCA7E OF COMPLIANCE AND AUTMORIZATION OF EN7FiY: I cenify under penalry of peryury ihat I have read ihis apPlication and stale that ihe infortnatlon given Is correcl 1 agree to wmply with ell slate laws and ciry ordinances relating to 6uilaing constructlon, antl euthorize representatives ot Ihe Ciry ot Coste Mesa to enter upon Ihe a �v�e-d,�esc/nb/e,.d� D'�operty tor i ec pu oses. I e ee not to oauy y or ello occupancy oi eny building authonzed by this permit until final insDection. � —��—��'y�p�`y`�/J� ��tir�no��c9� �.=/S'- OS / �3ig,nyetureOfL ga�Owner(s), c,.�'�,a'—.. �'�te '':.��.:_ 'a .�= �. , CODE �. INSPECTIONTYPE 1616 Fizetl Syslem Final Fire Pravention 7266 Pool Spa Final 200 Final Re-Roo1 201 Final BIocWRetaining Well 202 , Finel Factory Fire Plece 203 Flnal Slgn 204 Flnel Demolition PdIE I[�19L$ COOEI INSGECTIONTYPE 206 Flnal Mec�enical 208 Final Plumbing 210 Finel Elecirical 212 Finel Flre Prevention 220 � Final Planning Approval 222 Finel Site 250 Finel BuildinglOccupancy �. � .�m. ' � � � \ (714) 754-5273 • Fax (71d) 754-4856 • v+ww.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suile No vciniry: Parcel Nunmber: Applicant Address: Owner: Address Contractor. Address: ISSUE FEE Temp service lest Res. alc package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fi#s Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a �� Motors to 1 hp Molors to 10hp Molors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole 2$22 ELLESMERE AV R�AR OF PROPERTY 13933408 MC CLANAHAN, MONA 2822 ELLESMERE AVE COSTA MESA, CA MC CLANAHAN, MICHAEL C 2822 ELLESMERE AVE COSTA MESA, CA � . OWNER-BUILDER a � Status: ISSUED Applied: O6/15R005 Issued: O6/152005 ISSUED BY: Phone: 714-034-7979 Zip 92626 Phone: Zip: 92626 Phone: Zip: License: 000000 SCOPE OF PERMIT R�VISED 12/28/05: ADD 4 OUTLETS. INSTALL 336 S.F. GUNITE SWIMMING POOL AND 64 S.F. GUNITE SPA LOCATED IN REAR OF PROPERTY. REF.: B05-00987 ElECTRICAL TO INCLUDE: 1 POOUSPA, 7 LIGHT FIXTURES, 2 OUTLETS, 2 SWITCHES, 3 MOTORS TO 1 HP AND 1 LOW VOLTAGE EQUIPMENT. . $23.50 $0.00 $0.00 $0.00 $0.00 $49.50 $7.70 $6.60 $2.20 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $36.90 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 Quantiry FEE SUMMARY Temp Dist System / Lighting Busway /100 ft Standing Section Misc Eleclriwl Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ............::....over 100 kva/kw Low Voltage Equipment Low Volt Wirin9 Syslem / Ckt Misc. Conduit Misa Conductor Cirws ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1820 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES E144.60 COMMENTS / SPECIAL CONDITIONS Quan�ity 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12•21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned. for a period of 180 days. // INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable cod and all requlred Inepectiona and finel approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of t' permit. FOR INSPECTIONS CAL�; (714) 7545626 zeas-as ��vao� WtlAKERS' COMPENSA710N DECLARATION: . , 1 hereby ettirm under penalry ot perjury one of lhe toUc,..mg declarations�. " ❑ I �ave end will maintain e cenificate of consent to selt-Insure lor workers' compensatlon, es providetl for by section 3700 of the Lebor Code, for the pertormance of the work for whlch t�is permit is issuetl. ❑ I have antl wlll maintain workers' compensation insurence, as required by sectlon 3700 of the Labor Code, for the peAortnance of the woB for which this pertnit is issued. My workers' compensation Insurence ca�ner and policy number ere: Carrier. Policy Numbec (lhis section need nof be wmp/eted i! Ne permit is valued at one hundretl tlollars ($100) or less.) Qrl certity.ihat in the peAormance of Iha work ior which this permit is issueA, I shall not employ any person in eny manner so as to become subject to Ihe worke�s' compensetlon laws of Calilamia, end agree that il I should becoma sublect to the workers' compensation provisions oi Section 3700 of the Labor Code, I shall forthwith c�plywith.ihe � rah� �� AppGca� nature:- � f �rG pete;—� _Z ZS��p��' MJAPNINQ: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SMALL SU6IEGT AN EA WER TO'CRIMIWIL PENALTIES ANO GVIL FlNES UP TOONE HUNDRED THIXISAND DOUAflE (5100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVI�ED FOR IN SECTION 31O80F THE LABOR COOE, IMEREST, AND ATTORNE`fS FEES. LICENSED CONTRAGTORS DEGLARAr10N: I hereby attirm Ihat I em licensed under provisions of Chapter 9(commencinq with Section 7000) of Division 3 of Ihe Business entl Professions Cotle, and my license is in tull force and attect. Lic. a Class k CONractor's Signature: Oate: CONSTRUC710N IENDING AGENCY: � I hereby eflirm that Ihere is a conswction lending agency for the peAormance of ihe work lor which ihis permit is issued. (Sec. 3097, Civil Coda). Lender's Name: Lender's Adtlress: SignaWre: Date: OWNEfi-BUILDER DECLARATIONS: I hereby eHirtn thel under penelry ot perjury ihai I am E%EMPT FROM 7HE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7037.5, Business end Professions Cotle: Any ciry or counry which requires a pertnit to construct. alter, improve, tlemolish, or repair eny slrucWre, pnor to its issuance, also reQuires the epplicant for such pertnit to file e signed statemeni that he or she I5 licensetl pursuant ro t�e provisions ot Ihe Contrectors License Law (Chaptet 9(commencing with Section 7000) of DIWSIon 3 oi the Business an0 Pro�essions Cotle) or Ihat he or she is exempt �herefrom and the Dasis Por tha alleged aaemption. Any violation oi Sectlon 7031.5 6y eny applicant for a pertnit suhjects tha applicant to a civil penalry of not more Ihan live hundred tlollars ($500).): ❑ I, as owner of Ihe properry, or my employees with wage5 es Iheir sole campensatlon, WILL DO THE WORK, and Ihe siructure is not interMetl or ottereG for sale (Sec. 7044, Business end Professions Code: The Contrectoro �cense Law does not appty to an owner of properry who builds or improves thereon, and who tloes such work himsetl or �erselt or Nrough his or her own employees, providetl lhat 5uch imqmvements are aot intendad o� oHeretl lor sale. tl, �owever, tha building ar improvament is soltl within o�e yeer of completion, the owner-builtler will heva the burdan of proving t�at he or she did not builtl or improva for purpose of saleJ. ' ❑ I, es owner of Ihe property, nm EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTOflS ta canstruct ihe prolect (Sec. 70dd, BuSiness and ProleSsions Cotle: The contrectors License Law does not apply to an owner ol proparty who bulltls or improves Ihereon, and who contrects for suc� projaa with a comractor(s) f.license.pursuent to the Coniractors License Laws.). sec. BuSiness antl P�^�^-^�^^^ ^^a^ �^• ��^ --^^^^� Owner ID venfietl by dnver's license. �s ❑ No Vedflcation of Ownership 6y (type of tlocument �.e. - pmperty laa �ill DIVISION OF INDUS7RIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenify thei no exca�ation five (5) or more teai in depih into which a pereon is require0 to descend, will be made in connection wlih work authonzed by lhis permit, anG �hat no huiltling sWCWre, scai�olding, talsework, or demoli�ion or dismantling Ihereot will be more than thihy-six (3fi) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, TiOe 8, Celilornia Atlminis�rative Code). ❑ As ownervbuilder, I will not employ enyone to tlo work which woultl require e permit from the Division of Indusirial Satery, as notetl ebove, unless such person has e pBrtnii to tlo 5uch wofk trom �he divi5ian. Signeture: Dale: Division at Intlustnal Safery Permit Number. CERY1FlCATE OF CoMPIAANCE ANO AUTHORIZATION OF ENTAY: I certiry under penelry oi periury Ihal I have read this epplicelion entl state �hat ihe infortnation given is correFt I agree to comply with ell state laws and city ortlinances relating �o building constmction, and au�honze represantatives of the City of Coste Mesa to ente� upon ihe ehqvU-described propeny for inspection purposes. I egree not to occupy or allow occupancy ot eny building authorized by this permit until finel inspection. ��`�i�'l'-��/�,��- ---- i z/�os-� SigrietureOfLegal;Owner(s)::��= I:�Date � , L/�.... —`-�t: . And/Or Authorized Applicant Date COUE L INSGECTIONTYPE QaIE INTIDALS 1616 Fixed Syslem Final Flre Prevention 1266 200 201 202 203 204 Pool Spa Final Final Re-Rool Final BIocN/Retaining Well Final Factory Fire Place Finel Sign Final Demolition GOOE� INSPECTIONTVPE 206 Final Mechanical 20B Final Plumbing 210 Fina� Electrical 212 Finel Fire Prevention 220 Final Planning Approval 222 FinalSite 250 FinalBuilding/Occupancy QAg 1t�9kS 1 ♦ ��'� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR OFlIVE, GOSTA MESA, C:A 926Z6 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 2822 ELLESMERE AV REAR OF PROPERTY 13933408 Applicant: MC CLANAHAN, MONA Address: 2822 ELLESMERE AVE - COSTA MESA;�CA � Owner: MC CLANAHAN, MICHAEL C Address 2822 ELLESMERE AVE COSTA MESA, CA Contractor: OW N ER-BU I LD ER Address: „ " . . . � Phone: 714-434-7979 Zip - 92626 � Phone: Zip: 92626 Phone: Zip: " License: 000000 ISSUED BY: i Status: ISSUED Applied � 06/15/2005 Issued: O6/15/2005 SCOPE OF PERMIT. INSTALL 336 S.F. GUNITE SWIMMING POO� AND�64 S.F' GUNITE SPA LOCATED IN REAR OF PROPERTY. REF.: B05-00967 ELECTRICAL TO INCLUDE: 1 POOUSPA, 7 LIGHT FIXTURES, 2 OUTLETS, 2 SWITCHES, 3 MOTORS TO 1 HP AND 1 LOW VOITAGE EQUIPMENT. ' FEE SUMMARY . � Quantity ISSUE FEE � $23.50 - Temp service test � $0.00 Res. a/c package $0.00 New Res (1-2 units) $0.00 0 -' New Res (3+units) ` $0.00 0 � Pool / Spa � $49:50: 1-; -` 1•--' � `. Lighting Fixts, � � $770�� 7� Recept OutleGs " $220� � ., c 2 - Switches - �� •;� $220 . ��c2�.,. NonResAppl ��:�� „$000.', � 0�'-�` -- Res Appl . $0.00 � , , 0 �. Service to 200a � . $0.00 . 0, Service to 1000a � $0.00 � - 0 Service over 1000a �� $0.00 0 Motors to 1 hp $0.00 0� Motors to 10hp $36.90 3 Motors ta 50hp $0.00 0 Motors to 100hp $0.00 0 Motors over 100hp $0.00 0 Communication drops $0.00 0 � Quantity ' . Temp Dist System / Lighting $0.00 �0 - , ' „ Busway /100 ft $0.00 - 0 � • StandingSection $0.00 . �. 0 ` Misc Electrical Equipment $0.00 , 0 � Transformers up;to�t kva/kw _ $0.00�- - 0 � � . ........:.......up to 10 kva/kw-" �i � `� $0.00 0 � . . � ...........:.....up to 50 kva/kw $0.00 0 � � ...... . :.......up to 100 kva/kw - ; � - $0.00 - 0 , � � ........:.........over 100 kva/kw` � " $0.00 == 0 � .� - � LowVoltageEquipment� "� r�$18.20- � 1,�, � � ' �' `"Low'Volt Winng System / Ckt �- $D:00-' 0 � "Misc.Canduit . � �',�$0.00 � '.0 Misc. Conductor $Q00 0 � Circus ( gen or ride) $0,00 0 ,� Circus (mech ride or lights). . $0.00 0 ' �Christmas Tree Stand - "$0,00 0 .FireworksStand.- $0.00 0 �OtheF Elecfrical Fee � $0,00 Investigation Fee $0,00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. g2-28, § 1, 12-21-92) . EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 180 days. � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable cotles, antl all required Inspaetions 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 zaaaw (wao) � WORKERS' COMPENSATION DECLARqTION: `� � ._ � I hereby ettirm untlar penalry of perjury one of the following tleclarations: . ❑ I have antl wlll maintein e certificate of consent to setl-Insure for workere' compensation, as provided for by section 3700 ot the Labor Code, for t�e pertortnence of ihe work for which ihis permit Is issued. ❑ 1 have and will melntaln workers' compensation insurance, as required by section 3700 oi the Lebor Cotle, for the perfortnance of Ihe work for wMch Ihis pertnit is issuetl. My workers' compensatlon Insurance carder end policy number are: Certier: Policy Number: (This section need not 6e completetl i/ the permit is velued af are hundred dollars ($100) or leu.) �jT�f certi]y Ihat in the performenco o� ihe work br which this permit is issued, I shall not employ any pereon in eny manner so as to becoma su�ject to the workars' ��campensetlan lews of Cellfornia, end agree thet If I should become su�ject ro ihe workers' campensetion provisions at Sectlon 3700 oi the Labar Cotle, I shell fonhwith comply with these p�q i s. � iw.u�� re:-a-�j� a. a�-�A�.,c�.. � oa,a: �-�s -� +�G• . Z y WARNING:.FAILURBTOSECUR WORKERS'COMPENSATIONCOVERAGEISUNLAWFLLANDSHALLSU&IECTANEM OVERTO'CRIMINALPENALTIESAN�CIVILFWESUPTOONEHUNDRED h10USM10 OOIJ.FRE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES A$ PROVIDED FOR IN SELTION 3708OF THE LABOR CADE, INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm ihat I em licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of tha Buslness entl Professlons Code, antl my license is In full farce end eflecL Lic. q Cless # Contradors SignaWre: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby aflirm �het there is e wnstruction lending agency for Ihe performance ot the work for which Ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lendels Name: Lendefs Adtlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirm t�et under penelry oi perjury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the follaxing reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or counry which requires a pertnit to consiruct, alter, improve, demolish, or repair eny strudure, pnor to its issuance, elso requires the applicant for such partnit to flle a signed statement that �e or she is Ilcensed pursuant to the provisions ai �he Contrectors License Lew (C�epter 9(commencing with Sectlon 7000) of Division 3 of the Business end Professions Code) or thet �e or she is exempt Iherefrom and Ihe basis for Ihe alleged exemption. Any violetlon of Section 7031.5 by any epplicant for a pertnit subj s iha applicant to e civil penalry of not more ihen fiva huntlred dollars ($500).): '� � as owner af ihe property, or my employees with weges es iheir sole compensation, WILL DO THE WORK, end the siructure Is not intended ar aHeratl for sele (Sec. �',.:✓7044, Busineu and Pmfessions Code: The CoNractors License Law tices not apply to an owner oi proDerty who builds or improves ihereon, end who does such work himself or herself or ihrough his or her own employees, providetl that such improvements ere not intendetl or oNered lor sele. If, however, t�e building or improvement is sold wi�hin one yeer of completion, ihe owner-builtler will have ihe burden of proving that he or she did not build or improve tor Durpose of sale.). � ❑ I, as owner of t�e property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions Code: The conirectors License Lew tloes not appty to an owner ot property who 6uiltls or Improves ihereon, end who contracis for such project with a con�rector(s) license pursuent to the Contractors License Laws.). sec. license. ❑ Yes ❑ No Verification of Ownership Dy (type of dxument, I.e. - property tex bill and Professions Code for this reeson: DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certify ihet no excevatlon Five (5) or more faet in depth into which a person is required to descend, will be made in connectlon wlih work euthonzed by ihis permi�, antl thet no DuilGing structure, scaffolding, falsework, or demolition or dismantling ihereof, will be more than thirty-six (38) leet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Tltle B, Calitornla Administretive Cade). ❑ As owner-builder, I will not employ enyone �o tlo work which would require a permit from the Division of Industnal Sefery, es notetl above, unless such pereon hes e pertnil to do such work from the divisian. SignaNre: Date: Division oi Indusinal Safery Pertnit Number: CEHTIFlCATE OF COMPLIANCE AND AUITIORVATON OF ENTRV: I certify under penalty of peryury the� I heve reatl Ihls epplicetion end sta�e that the information given is conect. I agree to comply with ell stele lews end ciry ordlnances relaling to building consiructlon, entl euthorize representetives ot the Ciry ot Costa Mesa to enter upon ihe above-descnbed roperty for inspeclion pu ses. I agree not to occupy or allaw ofc u�pancy gf any building euthonzetl by t Is pertnit until finel inspection. �,rxs�__ .� �i'Y)��'�r��c ✓ �--i� —as� I�Sipuetuce.Ot:L'epal Owner(s ` � Date; �---..�,�. AnNOr Authorized Aoolicent D2IB CODE t. INSPECTONTYPE 1616 Fixed System Finel Fire Preventlon 1266 Pool Spe Finel 200 Finel RB-Roo1 201 Flnel BIxWRetelning Wall 202 Finel Factory Fire Place 203 Flnel Slpn 204 Finel Demolitlon � �Qpp� INSPECTIONTVVE ` 206 Final Mechanical - 2 i I Plumbi \ 210 Fin eciri � 212 Final Fire eve 220 Finel PI ing Approv I 2 SI�e 250 Finel Bullding/Oxupency Ps1E 1t�A44 (714) 754-5273 • Fa�c (714) 754-4856 • www.cl.costa•mese.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 2822 E�LESMERE AV Suite: Vicinity: REAR OF pROPERTY Primary Occ: R Type of ConsWction: V-N Parcel Number: 13933408 Zoning: R1 Applicant: MC CLANAHAN, MONA Address: 2ffi2 ELLESMERE AVE COSTA MESA, CA Owner: MC CLANAHAN, MICHAEL C Adtlress 2822 ELLESMERE AVE - COSTA MESA, CA Co n tra ctor: O W N E R-B U I L D E R Address: Zip: Arch : Address: Phone: Phone: 714-434-7979 Zip: 92626. Phone: Zip: 92626 Phone: License: 000000 Eng: Address: ISSUED BV: Stalus: ISSUED Applied: 06/15/2005 Issued: O6/15/2005 Phone: Zip: License: License: SCOPE OP PERMIT INSTALL 336 S.F. GUNITE SWIMMING POOL AND 64 S.F. GUNITE SPA LOCATED IN REAR OF PROPERTY. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $254.31 $391.25 $2.50 $0.04 $0.00 $0.00 ssda:os SETBACKS MAIN STRUCTURE Front 0- 0 Rear 0- 0 ACCESSORY Front , 0- 0 Rear 0- 0 PARKING Existinq:' o Required: o NOTES: FEESUMMARY Calc Valuation: Claim Valuation: PLANNING & ZONING Left 0- 0 " Right 0- 0 Left 0- 0 �� Right ' 0- 0 Proposed: 0 � � s2s,000.00 $25,000.00 � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 7 BO days. / INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and II requlred Inspections and final approvel must be obtained. Failure to obtain Inspections and final approval will result in the expiratlon of this pe� FOR INSPECTIONS CALL: (714) 7545626 zuws (erool WORKERS' COMPENSA710N DECLARA710N: � I hereGy ettirtn under penalry of perjury one of ihe following declarations: � ❑ I heve entl wlll meintain a certiticete ot conseN to sel4lnsure for workers' compensetlon, fls proNded tor by sectlon 3700 ot Ihe Lebor Code, far the pertormence of the �ork lor whlch this permit Is issuetl. � tleve antl wlll meintain workere' compensetlon Insurance, as required hy sectlon 3700 of ihe Labor Code, tor ihe pertortnance of the work for which this pertnit I5 Issuea. My workers' compensatlon Insurence carriar end policy number are: Cerrier. Policy Number: ��(This s tlon need nof be comp/eted il U�e permit is ve/ued et one hunCred dollars (S100J oi less.) 'ecehily Iha� in the pedortnance ot Ihe work tor w�ich �his pertnit is issueQ 1 shall not employ any person in eny manner so es to become subject to ihe workera' �compensetlon laws ot Califomia, entl egree thet II I shoulA become su��ect to the workers' comDensetion provlslons of Sectlon 3700 of the Lebor Code, 1 shell lanhwlih ComP�Y.?�'�N. se vi5lons. � M^�� ,e� � �� `�`7/ —/ -- � cent SI �natug "rex ,. _ f{�D'ete.; n J �� ARNINO: FAILURE TO SE � RE WORKEfiS' COMPE � TION COVERAOE IS UNUWFUL AND SHALL SUBIECT AN EMPIDYER TO CRIMINAL PENALTIES PND CIVI� FlNES UP TO ONE NUN�RED TFKK15MlD DOII.ARE (S10D, ), IN ADDITION TO THE COST OF COMPENSATIIXJ, OAMAOES PS PFlWIDED FOR IN SEC110N 3]OB OF TME UBOR OO�E, INiEREST, AND FTTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby effirtn thet I em Ilcensed under provislons of Chepter 9(commencing with Sectlan 7000) of Divislan 3 of the Business end Professlons Code, and my license Is In lull torte en0 etteCt LIC. # Cless p ContrectoYs Signeture: �ete: CONSTFiUCT10N LENDING AGENCV: ❑ I hereby atfirtn that there is a consiructlon lendinp egency for the peAortnance oi t�e work tor w�ich this pertnit Is issuetl. (Sec. 3097, Civil Cotle). Lentlefs Neme: LentleYs Atldress: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby eHirtn �het under penelty of peQury Ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business and Pratesslons Code: Any ciry or counry which requires e Dormit to construct, alter, improve, demolish, or repair any strudure, pnor ro its iuuance, also requires the epplicant tor such pertnit to file e slpned stetement Ihat he or she is IlcenseO Dursuant ta the provisians ot Ihe Contrectors lJcense Lew (Ghapter 9(commencing wlth Sectlon 7000) of DlWsion 3 of Ihe Business entl Professions Code) or that he or she Is exempt iheretrom and Iho besis tor t�e elleqed exemption. Any violetlon of Sectlan 7031.5 by any epplicent for e pertnit su�ts ihe appllcant to a civil penalry of not more ihen five hundred dollare ($500).): �-�`�aas owner oi lhe property, or my employees wlih weges es Iheir sole wmpensatlon, WILL DO THE WORK, end the structure Is not Intended or oNered for sale (Sec. 044, Business and Professions Catla: The Contractors License Law does not appty to en owner oi property who builds or improves Ihereon, antl who does such work himsalt or hersetl or �hrough his or her own employaes, provided that suc� Impmvemems are not intended or ottered for sele. It, however, the huiltling or Impmvemen� is sold within one year oi completion, ihe ownerbuilder will have Ihe 6urtlen of proving that he or she did not build or improve br purpose of sale.�. � ❑ I, es awner at the pmperty, am E%CLUSIVELY CONTRACTING WITH LICENSED CON7RACTORS to consiruct the projea (Sec. 7044, Business anA Professions Code: The coniractors Ucense Lew tloes not eppty Io an owner of property who builtls or ImpmveSlhareon, entl who wntrect5 tor such projact with a contrectar(s) ,� liqense pursuent to the CoNractoro LJcense LEws.). sec. ID veritied by tlnvefs license. [}i'es ❑ No Vedllcation of Ownership by (lype ot dwument, i.e. - properry tau bill antl Pmfessions Code for Ihis reason: DIVISION OF INDUSTAIAL SAFEfY PERMR CERTIFICA710N: ❑ I hereby cartity Ihat no excavation five (5) or more feet in depth into which e person Is required to descentl, wlll be made In connedion wit� work euthorizetl by thls permi�, and �hel no building slrucWre, scaflolding, talsework, or demolition or tlismantling thereot, will be more ihan thirty-six (36) tee� high. (Chap. 32, Grp 2, Ah 2, Sec. 341, Title B, Califomia Administretive Coda). ❑ As owner-builtler, I will not employ anyone to do work which would require a permit from the Division of Industrial Sefery, es noted ebova, unless such pereon has e pertnit to do such work from the division. Signatura: Date: Division o1 Intlusinel Sefery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I certily under penalry ot perjury ihat I �ave reatl Ihis applicetion and stete that the IntortneNon given Is carrect. I egree to camply with ell stete laws end clry ordinances raleting to building constructlon, end euthorize representetives of ihe Ciry of Coste Mesa ta enter upon ihe ebov -tle cnbed prope or ins ection purposes. I egree not to occupy or allow occuDency ot eny building authorizeA by this permit until finel inspection. � i� �'I �� a � ys=o,s� �8lgnat Of�LegelOwner(s) � Dat9�,�,_-P_ '+�.cv.a3 gx.' ~`� AndlOr Authadzed Applicenl �-'S` - Date COUE �. INSPELTIONTVPE GA7E 1H�SL$ 1616 Fixed System Final Fire Preventlon 1266 200 201 202 203 Pool Spa Finel Finel Re-Roof Flnel BIocWRetaining Well Final Fectory Fire Place Finel Sign 204 Flnal DemWitlon CODE 1 INSPECTION TYPE 206 Finel Mechenicel 208 Final Plumbing 210 Final Electricel 272 Final Flre Prevenlion 220 Finel Planning Approval 222 Finel Site 250 Flnel Buliding/OccupenCy Q� b� �� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 2822 ELLESMERE AV Suite No Vicinity: Parcel Nunmber: 13933408 Applicant MC CLANAHAN, MICHAEL C Address: 2822 ELLESMERE AVE COSTA MESA, CA Owner: MC CLANAHAN, MICHAEL C Address 2822 ELLESMERE AVE Contractor: Address: Arch / Eng : Address: ISSUE FEE BackFlow irtigation Backflow Preventer Bathtub Clarifler System Connect Qce,Soda,etc) Dental UniLs Dishwasher COSTA MESA, CA Phone: 714-434-7979 Zip: 92626 Phone: Zip: 92626 Phone: Zip: License: Phone: Zip: License: Status: ISSUED Applied: 07/07/2004 Issued: 07/07/2004 � ISSUED BY: SCOPE OF PERMIT ADD 845 S.F. TO EXISTING S.F.D. WORK TO INCLUDE: ADD A FAMILY ROOM AND NEW FIREPLACE, GAME ROOM, CRAFf ROOM AND NEW BATHROOM. INSTALL NEW BAY WINDOW AND REMOVE NON- BEARING WALL AND NONSTRUCTURAL FIREPIACE IN EXISTING LIVING ROOM. RELOCATE ELEC SERVICE. REF.: 604-01071 _ PLUMBING TO INCLUDE: 1 GAS (1-4 OUTLETS), 2 P-TRAPS, 1 SEWER PRIVATE LINE, 1 SHOWER, 1 WASH BASIN AND 1 WATER CLOSET. aMr $23.50 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 FEESUMMARY QTY AMT Laundry Tub / Washer $0.00 0 Landscape Irtigation $0.00 0 P-Trap ' $19.60 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 QTY 0 0 2 0 0 0 0 0 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1A) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $9.80 50.00 Qn 0 0 0 0 0 0 1 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 9248, § 7, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permil to be considered legal, such work must comply with all applicable codes, and all required inspectlona end (inal epproval must be obtained. Failure lo obtain inspections and final approval will result in tha expiration ot ihis permit. FOR INSPECTIONS CALL: (714) 7545626 2446d6 (6/00) WORKERS' COMPENSATION DECLARATION: I hereby aHirm under penelry of perjury one ol the following declara�ions: ❑ I have end wlll melnlain a certllicete ot consent to sell-Insure for workers' compensation, es O�o�ided lor by sectlon 3700 of the Lebor Code, for the peAormence of the work for w�ich ihis pertnii Is Issued. ❑ I have and will mainWin workers' compensation insurence, es requiretl by sectlon 3700 oi ihe Lehor Catle, for ��e parfortnance oi the work for which this pertnit is issued. My workers' compenution Insurence carrier and policy number are: Cartier: Policy Number: �(This ection need nat be comp/eled ll fhe permiNs va/uetl et ane hunCied Oollars ($ f00) orless.) certity thet in the peAortnenca ot Ihe work tor which this pertnit is issued, I shall not employ eny person in eny manner so es to become suhject to the workers' compensetion laws of Celitomia, antl agree iha ,II I should become su6�ect to Ihe workers' compansatlon provisions of Section 3700 0l lhe Labor Code, I shell lorthwilh comply wiih thes�e Pmvisions. �/J � AppliwnlSlgnature:�M�`?�G`4�.! oa�e: i�7lb�i WAqNING: FAILURE TO SECURE WORKERS' OOMPENS4ilON COVERAGE IS UMAWFLL AND SHALL SU&IEGT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TOONE HUNDRED T/Iq15AND DOLLARE (5100,000), IN FDDRION TO THE WST OF COMPENSATION, DAMACaES AS PROVIDED FOti IN SECiION 3]OB OF THE IABOR CODE, IMEREST, AND ATTORNEI"S FEES. LICENSED CON7RACTORS DECLARATION: I hereby affirm ihat I am Ilcensetl untler provisions of Chapter 9(commencing with Section 7000) ot Division 3 of Ihe Business and Protesslons Cotla, ar,C my licensa is in full lorce ena eHect Lic. N qass a Contractofs Signature: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby eNirm thel there is a constmction lending agency for the peAormance of the work br which ihis permit is issuetl. (Sec. 3097, Civil Cotle). Lentlefs Name: Lender's Atltlress: Signature: Date: OWNER-BUILDER DECLARATIONS: . I hereby ettlrm �hai untler penelty of perjury ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires e permit to consiruct, alter, improve, demolis�, or repair any sWCNre, prior to its issuance, elso requires ihe applicant for such pertnil to fila e signetl statement that he or ahe is Ilcensetl pursuent to the provisions of the Contractore llcense Lew (Ghepter 9(commencing with Sectlon 7000) ol Dlvision 3 oi ihe Business and Pwlessions Code) or that he or she is ezempt therefrom and tha basis br the elleged exemption. Any violetion of Section 7031.5 Dy any epplicent lor a permit �subJ'� ts ihe appllcant to e civil penalry at not more Ihen tive hundred dollars (5500).): � I, es owner ot the property, or my employees with weges as their sole compensatlon, WILL DO THE WORK, and the swcture Is not intended or otteretl tor sale (Sec. - 7044, Business and Protessions Code: The Coniractors License Law tloes not apDly to an owner of property who builds or improves thereon, and who does such work himsalf or herselt or through his or her own employees, provided that such improvements are nol Intended or oHered for sale. If, however, ihe building or improvement Is sold within one year ot completion, !he owner-builder will have the 6urtlen oi proving that he or she tlid noI builtl or improva tor purpose of sale.). ' ❑ I, as owner oi Ihe praperty, em E%CLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to con5trutt Ihe prolecl (Sec. 7044, Business and Prolessions Cotle: The wmreaors License Lew tloes nm apply to an owner of propeny who builds or Improves ihereon, entl w�o contracis tor such project with a contractor(s) licensa pursuant to the Contrectors License Laws.). rjil am axempt under sec. Business and Prolessions Code for this reason: SlqnaWre:lYJ7�C��! st Date: z/ � � Owner ID verilied by drivers license. ❑ Yes ❑ No Drivers License No. �� Expire5: � ljS Venilcation ol Ownershlp by (type ot tlaument, i.e. - propeny taz bill or deed): DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTIFICATION: ❑ I hereby certity thet no excavetion five (5) or more leet in tlepth into which e person is requiretl to tlescenq will De metla in connec�ion wlih work authorized by this permit, antl t�at no building simcture, scaflolding, falsework, or demoli�ion or dismantling thereol, wiil be more then �hihy-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, 71t1e B, Callfornla Adminisiretive Cotle). ❑ As owner-hullder, I will not employ enyone to tlo work which woutd requlre e permil from ihe Division of Industrlal Satety, as noted ebove, unless such person has a pertnit to da such work from ihe division. Signeture: Date: Divisian of Industriel Safery Permit Number: CERTIFlCA7E OF COMPLIANCE AND AUTHORIZA710N OF ENTRY: I cenity under penelty ol perjury t�at I have read this application and state that ihe infortnation given is correct I egree to comply wlth ell state lews end ciry ordinances relating m building consiruction, end euthodza representatives ot the City of Costa Mesa to enter upon Ihe ebove-descnbed erop for inspe n purposes. I egree noi to occupy or allow occupency of eny building euthonzed by thy'� Lpe�rmit until finel inspectian. �%YJC'��%L��.2— — '%�?�/ Signeture OI Le9al Owner(s) Date AncllOr Authonzed Applicent Date SOpE �. INSPECMN TYVE PAIE 1616 Fixed System Final Fire Prevention 1266 Pool SDe Final 200 201 202 203 204 Finel Re-Roof Final Block/Retaining Wall Final Factory Fire Place Final Sign Final Demolition IMIfIALS �,1 INSPELTIONTYPE 206 Final Mec�anical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupency o"re IH�MLS 6��-a6 � (714) �54-5273 • Fax (��a) 75a-a85s • wv+w.ci.costa-mesa.ca.us 77 FAIH UHIVt, GU51A Mt.�'A, l:A tl262ti Job Address: Suite No Vicinity: 2822 ELLESMERE AV NEW ADDITION PLUMBING PERMIT Parcel Nunmber: 13933408 Applicant MC CLANAHAN, MONA Address: 2822 ELLESMERE AVE COSTA MESA, CA Owner: MC CLANAHAN, MICHAEL C Address 2ffi2 ELLESMERE AVE COSTA MESA, CA Contractor: O W N ER-BU I LD ER Address: ISSUE FEE Backflow irrigation BackFlow Preventer Bathtub Cladfer Syslem Connect Qce,Soda,etc) DenWl Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 oullets) Gas (Over 4 outlets) Gas Repipe Gas Service Status: ISSUED Applied: 02/17/2005 Issued: 02/17I2005 ISSUED BY: /' „' Phone: 7�4-034-7979 Zip: 92626 Phone: 714-434-7979 Zip: 92626 Phone: Zip: License: 000000 SCOPE OF PERMIT PLUMBING PERMIT FOR ADDITION TO EXISTING SINGLE FAMILY RESIDENCE. INSTALL 1 GAS LINE & 1 TANKLESS WATER HEATER. REF: 804-01071 AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $6.15 $0.00 $0.00 $0.00 QTY FEESUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floar . $0.00 Sink, kitchen � $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 orv 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SumpPump Swimming Pool T2p Primer Urinal Vacuum Brkr Bkflow(1-0) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent Syslem Water Closel (Toilet) Water Heater / venl Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK AMT 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 orv 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 NO710E: 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 for a period of 180 days. INSPECTIONS: In order for �he work authorized under �his permit to be considered legal, such work mus� comply with all applicable codes, and all requlred Inspectlona 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 _ 2448d6 (8I00) WORKERS'COMPENSAnON DECLARAnON: I hereby efflrm untler penalty of perjury one of t�e following declarations: ❑ I heve end wlll maimeln a certificete ol consent b self-Insure for workers' compensetion, es provided tor by sectlon 3700 0l tha Labor Code, for the pedormence ot the work tor which this pertnit Is issued. ❑ I heve end will meintain workers' compensetion insurance, as required by section 3700 of tha Lebor Code, for Ihe pedortnance oi the work tor which this permit is issued. My workers compensetlan Insurence carrier end policy number are: Cerner: is velued et one hundred dallers ($100) or /ess.J Poliry Number. g f certity that in the pertortnence ot the work for which this pertnit is issuad, 1 shall not employ eny person in eny menner so es to become subject to Ihe workers' compensation lews ol Califomia, entl egree thet ii I should become subject to t�e workers' compensetlon provisions ol SecOon 3700 of the Lebor Code, I shall forthwlth comply with Ih'es�e ,v�is,l,o^ns.�/ ('�. —�� A�p.pl'tC�nt.Sk�netuie:" / Y(.C� 1 Ll % 7�. �it-% Dal� �—� 7 �— — WARNING: FAILURE TO SECURE WOFKERS' COM NSATIIXJ COVERAGE IS UNLAWFUL ANO SHALL SUBJEGT rW EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL FlNES UP TOONE HUNDRED T}IOUSFND DOLLARE (3100,000), IN ADOITION TO THE COST OF COMPENSATION, DMMGES AS PqOVIOED FOR IN SECTION 3]W OF TME LABOR CODE, IMEREST, ANO ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATON: I hereby afl'�Gcensed under provisions of Chapter 9(commencing with Sectlon 7000) of Division 3��5 and Pmfessions Code, and my license is in tull torce and aHec . c. a Cless x ��79htC@:�� Da�C�t�l� CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirm �hat there is a construction lending agency for the perfortnance oi I�e work tor whic� this pertnit is issuetl. (Sec. 3097, Civil Code). Lender's Neme: Lender's Adtlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby effirm thet untler penelry ol Derjury ihat I em EXEMPT FROM THE CONTRAC70RS LICENSE LAW tor the following reason (Sec. 7031.5, Business antl Protesslons Cotle: Any city or counry which requires a permit to consimct, alter, improve, demolis�, or repair eny sirucNre, prior to its issuance, also requires the applicant for such pertnit to tile a signetl statement thet ha or s�e Is Ilcensetl pursuant lo ihe pmvisians of Ihe Conirectore Licanse Lew (Chepter 9(commencing with Sectlon 7000) oi Divislon 3 oi the Business and Professlons Code) or thet ha or she is exempt iherafrom end the basls for Ihe allaged ezemption. Any violation ot Sedion 7037.5 by any epplicant for e pertnit suhlects.t e applicent to e civil penelty of not more then five hundred doilars ($500).): ��, es owner of ihe property, or my employees with wages as thelr sole compensatlon, WILL DO THE WORK, antl the simcture is not Intended or oHered for sale (Sec. 7044, Business and Professions Code: The Coniractors License Lew does not apply to an owner ot propeny w�o huilds or impmves ihereon, and who tloes such work himself or herself or �hmugh his or her own employees, provided that such improvemenis ere not intendetl or oHered for saie. tl, however, the builaing or impmvement is sold within ono year of comple�ion, ihe ownerbuilder will have tha burden of proving that he or she did not build or improve for purpose of sale.). � ❑ I, es owner ol ihe property, em E%CLUSIVELV CONTRACTING WITH LILENSED CONTRACTORS to wnstruct tha project (Sec. 7044, Business and Protessions Code: 7Te contractors License Lew does not epply to an owner of pmpeny who builds or Impmves thereon, and who contracts for such proiect with a comractor(s) license pursuant b Ihe Contrectore License Laws.). Owner ID ventietl by anver's ❑ No and Pmfessions Code tor this reason: Verification of Ownership by (type oi daumeni, i.e. - pmperry tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I �ereby cenity Ihat no ezcevation five (5) or more Faet in depih into which a person is required to tlescend, will be mede in connection with work authorized by Ihis permit, and ihat no building s�ructure, scalloltling, falsework, or demolition or dismantling Ihereoi, will be more ihan Ihirry-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Ttle 8, Califomla AGministrative Cotle). ❑ As owner-builder, I wlll not omploy anyone to tlo work which would require e permit trom lhe Division of Intlustrial Setety, es noted above, unless such person hes e permit to do such work from the division. Signature: Date: Division ot Industnel Sa(ery Permit Num6ar. CER7IFlCATE OF COMPLIANCE AND AUTHORI7IUION OF ENTAY: I cetlity untler penelry ot perjury thet I heve read ihis application and state that the infortna�ion given is corred. I egree to comply wlih all stete lews end ciry ordinances relating to building conslrucilon, end euihorize represeNatives ot ihe City of Costa Mesa to enter upon ihe ov f s' ed property� inspecti n pury es. I a�gree nyo� 0 �occupy or allow acupency ot eny building euNorized by ihis permit un�il final inspection. _ �i'�/J-/%tR1�L�Ci/t/ 0�-=/7_US '(�ig � [a�ObLegal�Owner(s) �Dale�i' Antl/Or Authorizetl Applicant Date COUE I. INSPECiIONTYPE 1616 Fixetl System Final Fire Preveniion 1266 Pool Spe Final 200 Flnel Re�Rooi 201 Final BIocWRetaining Wall 202 Flnal Fectory Fire Place 203 FinalSign 20a Finel Demolition Ihg 7�$ j�� INSPECTIONTYPE 206 Final Mechanical 208 Final PlumDing 210 Finel Elec�riWl 212 Final Fire Preventlon 220 222 250 Final Planning Approval Final Site Finel Building/Occupancy �0-7�6 � (714) 754-5273 • Fax (714) 754-4856 � www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT Job Address: 2822 ELLESMERE AV Suite No Vicinity: NEW ADDITION Parcel Number: 13933408 Applicant MC CLANAHAN, MONA Address: 2822 ELLESMERE AVE COSTA MESA, CA Owner: MC CLANAHAN, MICHAEL C Address: 2822 ELLESMERE AVE COSTA MESq, CA Contractor: OWNER-BUILDER Address: Phone: 714-034-7979 Zip: 92626 Phone: 714-434-7979 2ip: 92626 Phone: Zip: License: 000000 Status: ISSUED Applied: 02/17/2005 Issued: 02/17/2005 ISSUED BY: �C7v SCOPE OF PERMIT MECHANICAL PERMIT FOR ADDITION TO EXISTING SINGLE FAMILY RESIDENCE. INSTALL 1 FACTORY FIREPLACE 8 1 VENT FAN. REF: 804-01071 ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Re(rig Sys <100 k BTU Re(ng Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cfm Floor Furnace Floor or Suspend Heater $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.65 $0.00 50.00 $7.25 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY Repair / All Absorbtion Unit Repair I Alt Refrigeration Unit Ventiltation System Evaporative Cooler Commercial I ncinera tor Domestic Incinerator Compressors / Absorption Svstems Upto3hp/100kBTU 3To15hp/500kBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Upto3hp 3To15hp 1510 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Quantity $0.00 0 $0.00 0 30.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-g2) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or ii work is suspendetl or abandoned for a period of 180 days. INSPECTIONS: In order for the work aulhonzed under this permit to be considered legal, such work must comply with all applicable codes, end all requlrad Inapectiona and flnal approvel must ba obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 zawe la'oo7 WORKERS'COMPENSAnON DELLARAnON: I hereby eNirm under penalry oi per�ury one o� the following declarations: ❑ 1 heve end will maintain e cenificete of consant to self-Insure lar workers' compensetion, as provided lor by section 3700 0l ihe Lebor Cotle, for the peAortnance ot the work for which this permit Is issued. ❑ I heve and will mainfain workers' comp9�tlon insurance, as requiretl by sectlon 3700 of [he Lebor Code, for the pedortnance of the work for which this pertnit is issued. My workers' compensation Insurance Cerner and pollcy number ere: Cerner: Policy Number: (This sectiar neetl nof be com0leted il the pa�if is valued e( one huntlred dd/ars ($100) or /ess.) +�� Fcertify thet in Ihe pertortnance of iha work for which this permit is issueQ I shall not employ any persan in any menner so es to become sub�ect to the workere' compensation laws of Celilomle, enC eBree thet if I shoultl become suD�e t to Ihe workars' compensation provislons of Seciion 3700 0l ihe LeDor Code, I shall fonhwlih comply with th �e�} v�i on%}� �y l ,�pplicentSlgnet ru e �— / ,Yil !' ,( LL �� : y p � . . �� — � �� WAAWNO AF ILURE TO SECUR WORKERS' COMPENS i10N COVEPAGE IS UNUWFUL AND SHAII SU&IECi AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNORED i1qUSAND DOLLARE ($100,OW�, N AODITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIIXJ 3]O6 OF THE LABOF CADE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eflirm that I m licensed under provlsions of Chapter 9(commencing wit� Sectlon 7000) of DiNslon 3 the Business end Prolessions Code, antl my license is in tull � brce entl ettect Li'?I( �- — / Comraaofs Signa ure: ti. CONSTqUCTION LENDING AGENCV: ❑ I hereby aHirtn �hat there is a consiruction lending agency for ihe pedormence of the work br which Ihis permit is issued. (Sec. 3097, Civil Cotla). Lender's Name: Lender's Atltlress: SigneWre: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirtn that untler penalry of perjury thei l em EXEMPT FROM THE CON7RACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions Code: Any ciry or counry which requires e pe�mit to wnsirucL alter, improve, demdish, or repair eny strucmre, prior to its issuance, also requires the epplicsnt for such pertnit to file e signed statement Ihet he or she is IlGenseA pursuant to tha provisions of Ihe Contractors License Lew (Chaptar 9(commencing with Sealon 7000) of Divislon 3 0l the Business entl Professlons Cotle) or thai he P� she is exempt therelrom entl tha Casis lor the ellegetl exemption. Any vlolation oi Sectlon 7031.5 Dy any epplicant For a permit sub' cts �he epP��nt to a civil penalry of not more than five hundretl tlollers (5500).): �j„es.twner of [he property, or my employeas with wages as Ihefr sole compensation, WILL DO THE WOR%, and Ihe siructure is not intentled or oflered for sale (Sec. 704d, Business and Pmfessions Code: The Contwctors License Law does not apply to an owner of property who builds or impmves thereon, and w�o dces such work himseli or herself or ihrough his or her own employees, provided ihet such improvements ere not intentletl or oHered tor sale. It, however, the builtling or improvement is sold within one year of completion, the ownerbuilder will have tha bmden of proving that he or she did not build or improve for purpose of sele.). � ❑ I, as owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business and Protessions Code: The conirectors License Law tloes not epply to en owner of pmpetly who builtls or Impmves Ihereon, and who contracis for such project with e contrector(s) license pursuant to ihe Coniractor5 LItb�Se Lews.). ❑ I e e n s smess entl Professions Coda lor this reason: s��`�'1'�� —�ti� /' Own ler D vedfied y driver5license. '�Q6� ❑ No D e[sll4cense�No. � —/ Venfication ot Ownership by (type ot document, i.e. - pmperry tax �ill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify ihat no excavetion five (5) or more feet in depih into which e person is requiretl to descend, will be made in connection with work au�honzed by �his permit, and tha� no building s�rucNre, scaHolOing, falsework, or tlemolition or dismamling �hereof, will be more Ihan �hirty-six (36) teet high. (Chep. 32, Grp 2, Art 2, Sec. 3a7, Title B, Califomia Adminisiretive Code). ❑ As owner-builtler, I will not employ enyane to do work whic� woultl require e permit fmm Ihe Division of Industdel Sefery, as noted ebova, unless such person hes e permii to do such work trom �he division. Signawre: Date: Division of Indusirial Safety Permit Number: CERTFICATE OF COMPLJANCE AND AUiNORVATION OF EMRY: I cetlity untler penal�y of perjury that I have read this apDlication end state ihat the information given is correcL I agree to wmpty wit� all stata laws entl clry ordinences relating to builtling construc�ion, an0 eu�hodze representatives oi the Ciry ot Costa Mesa to enter upon Ihe e ve-des bed properry for inspection purposes. I agree no� o occupy or ellow occupancy of any builtling authorized by this pertnif until final inspection. �Q ��iC('.(JlI o�`(7�U.S^ Slgna "reOf�LegafOwnei(s) - D e AnNOr Authoriietl Applicant Dala COUE �. INSPECTIONTYPE 1616 Fixed System Final Fire Provention 1266 Paal Spa Finel 200 Finel Re-Rooi 201 Finel BIocWRelaining Well 202 Final Fectory Fire Placa 203 Finel Sign 204 Final Demolition pATE I��j SODE• INSPECTIONTYPE 206 Finel Mechanical 20B Finel Plumbing 210 Finel Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Finel Site 250 FinalBuildinryOccupancy IO1: � • � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Viciniry: 2822 ELLESMERE AV NEW ADDITION ELECTRICAL PERMIT Parcel Nunmber: 13933408 App(icant MC CLANAHAN, MONA Address: 2822 ELLESMERE AVE COSTA MESA, CA Owner: MC CLANAHAN, MICHAEL C Address 2822 ELLESMERE AVE COSTA MESA, CA Contractor. Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool I Spa Lighting Fizts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over t000a Motors to 1 hp Motors to 10hp Motors lo SOhp Motors to 100hp Motors over 100hp Communication dropa OWNER-BUILDER Phone: 714-434-7979 Zip 92626 Phone: 714-434-7979 Zip: 92626 Phone: Zip: License: 000000 Status: ISSUED Applied: OZ17/2005 Issued: 02/17/2005 ISSUED BY: "'- SCOPE OF PERMIT ELECTRICAL PERMIT FOR ADDITION TO EXISTING SINGLE FAMILY RESIDENCE. INSTALL 8 LIGHTING FIXTURES, 24 RECEPTACLE OUTLETS, 7 SWITCHES, & UPGRADE ELECTRICAL PANEL TO 200 AMPS. 1:7�7�:LL•IDi[�Yfl $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $8.80 $24.92 $7.70 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 8 24 7 0 0 1 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway /100 ft Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ...:............up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Winng System / Ckt Misc. Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand . Other Electrical Fee � Investigation Fee Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 , 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § t, 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 ior a period ot 780 days. INSPECTIONS: In ortler for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, 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) 7545626 . zaao�no �aw� WORKERS'COMPENSATON DECLARAnON: I hereby affirm under penalTy of perjury one oi the following declarations: ❑ I have end will maintain a certificate of consent to self-Insure for workers' compensation, as providetl for by sedion 3700 of the Lebor Code, for the pertortnance of the work tor which ihis permit is issuetl. ❑ I have and will maintain workers' compensation insurance, as reQulred by section 3700 of ihe Lebor Cade, for ihe pedortnance ot Ihe work for which Ihis pertnit is issued. My workers' compensatlon Insurance carner antl policy numbar ere: Carrier: Policy Number: (Thi section neetl not 6e completetl it the permlf is valued af one hundred dollars ($100) or less.) - • I cetlity Ihet in Ihe performance of the work for which ihis permit is issued, I shell not employ any person in any manner so as to become subject to the workers' compensation laws oi,�elifornie, d egree that if I should become subject to ihe workers' wmpensatlon pmvisions of Sectlon 3700 oi the Lebor Code, I shell iorihwith comply wilh l��h�e t�rovi n5. � �1 % �/ aApp�icant'SI9neNr9 � �/ ('�� s(p:�nv�s.—. � / – iJ S^ WARNING: FAILURE TO SE URE WORKERS' COM NSATION CAVERAGE IS UNIAWFUL AND SHPLL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED T/iOUSANDDOLLARE�5100 ),INAODITIONTO COSTOFCOMPENSATIIXJ,�AMAGESASPROVI�EOFORINSECTION3lO60FTHELABOqCO�E,IMEREST,ANDATTORNEV'SFEES. LICENSED CONTRAC70FS DECLARATION: I hereby eHirm that I am licensed under provisions oi Chapter 9(commencing with Section 7000) of Division 3 oi the Business and Professions Code, and my license Is in full farce end ettect. Lic. N Class N ConlrectoYs Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirm ihat there is a construction lentling agency for the peAormance of ihe work for which this pertnit is issued. (Sec. 3097, Civil Cotle). LentleYs Name: Lenaers Address: Signature: Date: OWNER-BUILOER DECLARATIONS � I hereby eHirm ihet under penelty of perjury ihat I am EXEMPT FROM THE CONTHACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Protessions Code: Any city or counry which requires e permit to constmct, alter, improve, demolish, or repair any siructure, prior to its issuance, also requires the applicant tor such permit to ille a signetl statement ihat he or she Is Ilcensetl pursuant to the provisions of the Conirectors License Lew (Chepter 9(commencing with Section 7000) of Division 3 of the Business antl Proteuions Code) or that he or she is exempt iherelrom end the basis for the alleged ezemption. Any violation of Sectlon 7031.5 by eny applicant for e permit sub�'ecis the epplicant to e civll penalry of not more than five hundred dollars ($500).): �-0"'9, es owner ot the properry, or my employeas with wages as their sole compensation, WILL DO THE WORK, and Ihe structure is not intentletl or otteretl for sala (Sec. 7044, Businass and Professions Code: The Coniractors License Law does noi apply to an owner of property who builds or improves thereon, and who does such work himself or herself or ihrough his or her own employees, providetl thet such improvemenis are not intendetl or oHered for sale. If, however, the building or improvement is sold within one year of completion, iha ownerbuilder will have the burden of proving that he or sha did not builtl or improve tor purpose ot sale.). ' ❑ I, as owner of the property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Busines5 and Profes5ions Code: The contrecrors License Lew tloes not apply to an owner oi property who builds or improves thereon, end who contrects lor such prolect with a coniractor(s) license pursuant to ihe Coniractors License Laws.). Owner ID venfied by dnver's Business and Professions Code for this reeson: ❑ No Drive licen98 No. Verification of Ownership by (type oi tlwument, i.e. - properry tax bill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cenify that no axcavation five (5) or more feet in dep�h into which e person is required to descend, will be made in connection with work authonzetl by Ihis permit, and ihat no building structure, scaHolding, falsework, or demoli�ion or tlismantling thereol, will 6e more Ihan Ihirty-sis (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Cotle). . ❑ As owner-builtlar, I will not employ enyone to tlo work whic� would require e permit from ihe Division oi Industrial Safery, es noted above, unless such person hes e permit to do such wo�k irom ihe division. Signature: Date: Division ot Industrial Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF EMRY: I certify under penalty of perjury tha� I have read this applica�ion and state ihat Ihe infoimation given is orrect. I agree to comply with ell stete laws and ciry ordinances relating to building constmction, end authorize representatives of the City of Costa Mesa to enter upon Ihe - c' ed propert5* � s9¢l,c��i�on//p}Jrposes. I agre ot to occupy or ellow occupancy ot any building euthorized by this p�ey�/ it until finel inspeclion. � / (^-it= �%%/%�� V �� Si natIIfg'O(' egal Owner(s) a e °`^r., And/Or Authorized Applicanf �ate COOE �. INSPECTIONTYVE 1616 Fized System Final Fire Prevention 1266 Pool Spa Final 200 Finel Re-Root 201 FInaI BIocWRetaining Well 202 Final Factory Fire Place 203 Final Sign 204 Finel Demoli�ion Q�jE �$ $�QQf�( INSPECTIONTYiE 20fi Final Mechanical 20B Finel Plumbing 210 Pinel Electncal 212 Final Fira Prevention 220 Final Planning Approval 222 FinalSite 250 Final Buildin<yOccupancy pRTE �� ,�w: � (714) 754-5273 • Fax (714) 754-4856 77 FAIF [7RIVE, GOSTA MESA, GA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: Applicant Address: Owner: Address Contractor. Address: ELECTRICAL PERMIT 2g22 ELLESMERE AV 13933408 MC CLANAHAN, MONA 2822 ELLESMERE AVE � COSTA MESA, CA MC CLANAHAN, MICHAEL C 2822 ELLESMERE AVE COSTA MESA, CA Phone: 714-034-7979 Zip: 92626 Phone: Zip: 92626 Phone: Zip: License: Status: I SSU ED Applied: O6/072000 Issued: O6/07/2000 ISSUED BY: rll� ` SCOPE OF PERMIT EXTEND EXISTING BEDROOM BY 42SF, EXISTING PORCH BY 51'4" AND OPEN EXISTING WALL TO INSTALL NEW WINDOWS. REF B00-00826. 1 LIGHT, 5 OUTLEYS. ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+uniis) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to t000a Service over 1000a Molors to thp Molors to 10hp Motors to SOhp Motors to 100hp Motors over t00hp Communitalion drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole $23.50 50.00 50.00 50.00 50.00 50.00 $1.70 $5.50 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantiry 0 0 0 7 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway /100 k Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................uP to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misc Conduit Misa Conductor Circus ( 9en or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee $0.00 50.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $30.10 COMMENTS / SPECIAL CONDITIONS Quantity 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NO710E: The work authonzed 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 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inepeetione and final approval must be obtained. Failure to obtain inspections and final approval will resul� in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby ettirm under penelry ol perjury one oi Ihe tollowing declarations: ❑ 1 heve entl will meintaln e certilicate ol consenl to setl-Insure for workers' compensation, as proNded for by sactlon 3700 at the Labor Cotle, for lhe pertortnance of the work tor which this Dermit IS iuued. ❑ I have end will maintain workers' compensation insurance, as requiretl by section 3700 of Ne Labor Cotle, tor the peAortnance oi ihe work tor which this parmit is issued. My workers' compensation Insurence carner and policy number are: Carrier: Policy Number: (This seclion need no! be comp/eted ll the permit is velued ef one hundred dollars ($100) ar less.) ❑ I certiy t�et in the peAormance ol the work for which this permit is issued, I shall not employ eny person In eny menner so es lo becama subject to the workers' compensation laws of Californla, and egree that il I should become subject to the workers' compensation provisions of Sectlon 3700 of the Labor Cotle, I shall fonhwith comply with these provisions. Applicant Signature: Dete: WARNING: FAILURE TO $ECURE WORKERS' WMPENSATIIXJ COVERAGE IS UNL4WFUL AND SHALL SU&IEGT AN EMPLOYER TO CRIMINAL PENA�TIES AND CIVIL FINES UP TOIXJE HUNDRED THOUSAND DOLLARE (5100,000�, IN ADOITIqJ TO THE COST OF COMPENSATION, DP.MAGES AS PFiOVIOED FOR IN SECTION 3106 OF THE LABOR CODE, IMEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm Ihat I em licensetl un0er provisions of Chap�er 9(commencing with Section 7000) of Division 3 of the Business antl Professions Cotle, and my license is in full force and effecL Lic. q Class q Coniractor's SignaWre: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby aNirtn Ihat there is a cons�ruction lentling agency tor the pertortnance ol the work for which this permit is issued. (Sec. 3097, Civil Code). lentler's Name: Lendefs Address: SignaWre: Dete: OWNER-BUILDER DECLARATIONS: I hereby aNirm that under penelty of parjury Ihat I em EXEMPT FROM 7HE CON7RACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Coda: Any ciry or counry which requires e pertnit to construct, alter, improve, tlemolish, or repair any structure, prior to its issuanca, elso requires the applicant for such permit to file a signetl statement Ihei he or she is licensed pursuan� to ihe provisions of ihe Caniractors License Lew (Chapter 9(commancing with Sectlon 7000) of Division 3 of the Busineu entl Pmfessions Code) or that he or she is a:empt therelrom and the basis tor the allegetl exemption. Any violatlon of Section 7031.5 by any appliwnt tor a pertnil subjects the applicant ro e civll penalry oi not more than tive �undrad dollars (5500).): ❑ I, as owner of the praperty, or my employees with wages as iheir sole compensation, WILL DO THE WORK, end the siructure is not intentletl or oHeretl tor sale (Sec. 7044, Business anU Professions Coae: The Coniractors License Law dces not epply to en owner of property who builtls or Improves thereon, and who tloes such work �imself or hersell or Ihrough his or her own employees, provitlad that such improvements are not intendetl or oNered for sele. If, however, ihe builtling or improvement is sold wlthin one year oi completlon, Ihe ownervbuiltler will have the burden of proving [hat he or she did no� build or improve lor puryose oi sale.). ❑ I, es owner of the pmperty, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS �o rnnstruct t�e project (Sec. 7044, Business flntl Pmfessions Cotle: The contractors license Lew tices noi aDPly to an owner of property who builds or impmves thereon, and who contrects tor such projeci wi�h a coNracror(s) �/' license pursuant to Ihe Contrectors License Lews.). �\I erP e�t untler sec. n.1� �, n�q �Business�and Professions Code br this reason: Owner ID veri�i d by driver'S liCenSe. �1Les ❑ NO Venfication of wnershlp by (rype of daument, i.e. - properry taz bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: � ❑ I hereby cehify that no ezcavation five (5) or more feet in depth into which e person is reqWretl to descend, will be matle In connection with work authorizetl by this permit, end that no building sirucWre, scattoltling, falsework, or tlemolition or tlisman�ling Ihereol, will be more than �hirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle B, Californie Administretive Code). ❑ As owner-builder, I will not employ anyone �o tlo work which would require a permi� irom �he Divlsion of Indusirial Safe�y, es noted above, unless such person has a permit to do such work imm the Civision. Signature: Data: Division of Intlustnal Safety Permit Number: CER7IFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTAV: I certify under penalty of perjury that I have reed this application and state Ihat the information given is correct. I agrea b comply with all state laws and ciry ordinances relating to building consimction, and authorize reDresentatives of tha City of Costa Mesa to enter upon tha aho e-described propeny tor ins ection purposes. I ree not �o cupy or allow occupancy of any bullding euthorized by t's permit until tinal inspection. � , �-7-0� S1 ure f eg�alOe� ertsj oa�e ` C AnNOr Authorized Applicant Date CODE�. INSiELTIONTYPE PAI� ��ALS 7616 Fisod System Final Fire Prevention 1266 200 201 202 203 Pool Spa Final Finel Re-Rool Final BIocWReteining Wall Final Factory Fire Place Finel Sign 204 Finel Demoli�ion 2646<6 4o0E� INSPECPONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 FinalSita 250 Final Builtling/Occupancy DqTE �Ni1TIaL5 - CITY OF COSTA MESA � BUILDIN6 DIVISION ✓ F .� DEVELOPMENT SERVICES DEPARTMENT 698-00778 �• PERMIT PERMIT NUMBER �� (714) 754-5273 • Fax (714) 754-4856 gU1LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 ,lobAddress: 2822 ELLESMEREAV Suite: Vicinity: Parcel Nunmber: 13933408 Applicant: MCCLANAHAN, MICHAEC Address: 2822 ELLESMERE AV COSTA MESA, CA Owner: MCCLANAHAN, MICHAEL Address 2ffi2 ELLESMERE AVE COSTA MESA,CA Contractor: DAVID KHORRAM Address: 3176 PULLMAN AV #105 Zoning: R1 R1 Phone: 714 434-7979 Zip: 92626 Phone: Zip: 92626 Phone: 714-979-0606 COSTA MESA, CA 2ip: 92626 License: C42380 Arch / Eng : , � Address: Phone: Zip: License: SCOPE OF PERMIT CHANGE FLAT ROOF TO HIP ROOF Plan Check: Permit Other: Inspection: Total: $64.84 $99.75 $0.00 $0.00 $165.09 SETBACKS MAINSTRUCTURE Front 20-0 ACCESSORY Frant 0-0 PARKING Existinq: 2 NOTES: ' �� Rear 20- 0 Rear 0-0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 5- 0 Left 0. 0 Pr000sed: 0 Status: ISSUED Applied: 05IO6I1998 Issued: OSI0811998 0 Calc Valuation: $o.00 Claimed Valuation: Ss,000.00 Right 5-0 Right 0- 0 �� EXPIRA710N: 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 periotl of 780 days. INSPEC710NS: In order for the work aulhorized under this permit to be considered legal, such work must comply with all applirable cales, and all required Inapections and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545628 .� WORKERS' COMPENSATION DECLARATION: I hereby effirtn untler penalry oi per�ury one ol Ihe lollowing tleclare�ions: ❑ I heve end wlll maintain e certtlicete o1 consent to self-Insure tor workero' compensetlan, es proNtletl for by section 3700 of ihe Lebor Code, for ihe pertormance of ihe work br whlc� this pertnit Is IssueA. ❑ I have entl will meintain woflcers' compensetion insurence, es required by section 3700 of ihe Lebor Code, for the peAormance of ihe woAc for which Ihis pertnit is issueC. My workers' compensation Insurance cartler entl policy number ere: Cartier: Policy Number. (Thls secGon need not be completed i/ (he pe�mit is valued et one hundied dollars ($100) or /ess.) ❑ I certiy that In the peAortnance ot Ihe work tor which this pertnit Is Issueq 1 shall not employ any person In eny manner so es to become subject to tha workere' compensatlon laws of Calitomia, and egree that ii I shoultl become sub�ect to ihe workers' compensatlon provlsions of Seccion 3700 oi Ihe Lebor Catle, I shall farthwit� wmply with these provislons. Applicant Signeture: Dele: WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS IINLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNORED T/IOUSAND DOILARE (E100,000), IN ADOITION TO TME COST OF WMPENSATIIXJ, �AMAOES PS PROVIDED FOR W SECTION 3]OB OF THE LABOR CODE, IMEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS DECLARATION: I hereby eflirtn t�et I am licensetl under proNslons of Ghepter 9(cammendng wit� Section 7000) ot Division 3 of the Business and Prateulons Code, entl my license is in full force end eHecL Lic. N Class M Comracrors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm ihat ihere is e consiruction lending egency for the pertortnance of tha work for which this permit is issued. (Sec. 3097, Civil CoOe). Lentler's Name: Lentler's Atldress: Signeture: Date: OWNER-BUILDER DECLARA710NS: I hereby effirm that untler penelry o1 per�ury thet I em EXEMPT FROM THE CON7RACTORS LICENSE LAW tor the tollowing reasan (Sec. 7031.5, Business antl Profeuions Code: Any ciry or counry which requlres e parmit to consiruct, alter, impmve, tlemolish, or repair any structure, pdor to its issuance, also requlres tha epplicant for such permlt ro file e slgned statament that he or she is Iicensed pureuant ro the provisions of tha Cantreccors License Lew (Chapter 9(commencing wit� Sectlon 7000) ot Division 3 ot ihe Buslness end Proteuions Code) or Ihel he or sha is exempt Iheretrom and Ihe basis for t�e alleged exemption. Any violation of SeMion 7031.5 by eny applicant for a permit subJecls the epD��ent to a civil penalry oi nat more Ihen five hundred dollars ($500).): ❑ I, es owner ot Ihe proDerry, or my employees with wages as Iheir sole compensatlon, WILL DO TME WORK, end ihe struqure is nat Intended w otteretl for sale (Sec. �044, Business antl Professions Cotle: T1ie Contractors License Law tloes not epply to an owner ot proparry w�o builds or improves thereon, end w�o tloes such work hlmself or harself or through his or her own employees, provided Ihet such Improvemenis ere not Intended or oXered for sale. It, however, the bulltling or Improvament Is soltl within one year of completlon, the owner-bullder will have the burden ol proving that �e or she ditl not bulld or improve for purpose of sale.). ❑ I, es owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construd tha pro�ect (Sec. 7044, Business and Protessions Cotle: The contractore License Law tloes not appty to an owner of properry who 6uiltls or Improves thereon, and who crontracts lor such project with a contractor(s) Iicensa Dursuant to the Coniractore License Lews.). ❑ I am� m,, �t yun�der sec Business antl Professions Code for this reason: SigneNre: /q. /'� Date: Owner ID verifietl by drivers license. ❑ Yes ❑ No Drivers License No. Venficatian of Or.nership by (type oi tlocumeni, i.e. - properry tex bill or dead): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ExO�res: ❑ I hereby cenly ihat no excavetlon live (5) or more feet In tlepth Into whlch e parson is requlretl ro tlescen4 will be made in connecNon wit� work authodzed by Ihis permlt, entl ihat no building structura, scaXolding, telsework, or demolitlon or dismantling thereol, will be more ihan Ihirry-sia (36) feet hlgh. (C�ep. 32, Grp 2, Art 2, Sec. 341, Title B, Celifomia AtlmiNstretive Code). ❑ As owner-bullder, I will not employ enyone to do work whic� would requlre e pertnit from the Divislon of Industrial Safery, es noted ebove, unless suc� pereon hes a pertnit to tlo such work from ihe division. Signeture: Date: Division of Induslrial Safery Permit Number: CEHTIflCATE OF COMPLIANCE AND AUTMORIZAl10N OF EMRV: I certify untler penalry of perjury that I heve reed this epplicetion end stete that �he infarmation given is conect. I agree to comply with all state lews antl ciry ordinances releting Io bullGing construction, end euthorize representatives of the City of Costa Mesa to enter upon the va4euribedy�operty for in;pqction purposes. I egree not lo acupy or ellow occupancy of any building authorized by this pertnit until final inspection. �/' I And/OrAuthodzetlADPlicant COOE /. INSVECTWNTYPE PATE IIQmALS L4pE( INSVECTIONTYPE 1676 Fixed System Finel Fire Preventlon 206 Flnal Mechenical 1266 Pool Spa Final -��''�/"�]---�2 OB Finel Plumbing � 200 Finel Re-Roof �� C__i�— z10 Final Electricel 201 Final BIocWRetaining Well 212 Final Flre PrevenGon 202 Final Fectory Fire Pleca 220 Final Planning Approval 203 Final5lgn 20a Fnal Demolitlon 2M&4e 222 Final Site 250 Flnel BuilAing/Occupancy Date