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Home My WebLink About2846 ELLESMERE AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTP�.QQj�Q626 Job Address: 2846 ELLESMERE AV Suite No Vicinity: Parcel Nunmber: 13933411 npp�icanc DEATON, BOBBY Address: Owner: ROBBINS, DOROTHY D TR Address 2846 ELLESMERE AVE COSTA MESq, CA Contracror. O C C CONSTRUCTION Address: 72512 CITRUSWOOD AV ISSUE FEE 0 BackFlow irrigation 0 Backflow Preventer 0 Bathtub 0 GARDEN GROVE, CA PLUMBING PERMIT Phone: 714-797-3990 2ip: Phone: Zip: 92626 Phone: 714-7973990 Zip: 92840 License: 835628 SCOPE OF PERMIT CHANGE OU7 WATER HEATER - .. AMT TY $23.50 50.00 , $0.00 $0.00 0 0 0 FEE SUMMARY AMT QTY Laundry Tub / Washer 50.00 Landscape Irrigation 50.00 P-Trap 50.00 Pressure Regulator $0.00 Status: ISSUED Applied: 04I11I2007 Issued: 04/11/2007 ISSUED BV: 0 0 0 0 AMT aTY Sump Pump $0.00 Swimming Pool $0.00 T2p Primer 50.00 Urinal 50.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under Calitornia statutes and related '� regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or ii work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work mus� comply with all applicable codes, and all required Inapeetlone and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 ?64648(N00) �i WORKERS' COMPENSATION DECLARATION: I hereby aflirm under penalry of per�ury ane of ihe following decleretlons: ❑ I heve end will maintain a certifcete of consent m selt-Insure for workers' compensation, es providad for by section 3700 of Ihe Labor Cotle, tor the pertortnance of ihe woAc tor which ihis pertnit is Issuetl. �- � 0 I have end will maintain workers' compensation insurance, as requiretl by section 3700 of Ihe Lebor Code, for Ihe peAortnance of the work tor which ihis pertnit is issuetl. My worker�w�ensatlon Insurence carriar end policy number are: Carrier: S/4/� �� PolicyNumber:0�%�'oQ ��— Obl�� (This section neetl not be complefed i! fhe permif is valued ef one hundred dollars ($100) or less.) � I certity that In the peAormance ot Ihe work For which this permit is Issuetl, I shell not employ any person In any manner so as to become su6ject to the workers' compensation laws of Califomla, entl agree that if I should become subject to the workers' crompensation provislons of Section 3700 of the Labor Coae, I shall torthwit� camply with these provis�L�� ApDlicant SignaNre:... � --� D` a _te: LP� �2 � �� 7 WARNING FAILURE TO SEW WORKERS' COM ENSATIIXJ COVERAGE IS UNLAWFUL AND SHALI SU&IECT AN EMPLOVER TO CR�IMINAL PENAL IES AND qViL FlNES UP TOONE HUNDRED TIIOUSAND DOLLARE (5100,000), IN NDDITION TO THE COST OF CAMPENSATION, OAMAGES AS PROVIDEO FOR IN SECTION 3�O60F THE LABOR CAOE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby effirm that I am force end eHect. IJc. #,_ ConiractoCs Signeture:. 9(commencing with Section 7000) af Division 3 ot Ihe Business�and Professions Code, and my license is in tull Class M _ Date } CONSTRUCTON LENDING AGENCY: ❑ I hereby aNirm thal thera is a constmctlon lending egency tor ihe peAormance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Signawre: _ OWNER•BUI�DER DECIARATIONS: Lender's Address: Date: I hereby eflirtn ihat under penalry ot perjury that I em EXEMPT FROM TTIE CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business end Professions Code: Any ciry or county which requires e pertnit to consirucL alter, improve, demolish, or repair any simcture, prior lo its issuance, also requires the applicant for such permit to file a signed stetement thet he or she is Ilcensed pursuant to the pmvislons oF the Conirecbrs lJcense Lew (Chapter 9(commencing with Sectlon 7000) of Dlvision 3 of the Business antl Prolessions Code) or ihat �e or she is exempt therefrom and the besis for the elleged ezemption. Any violation of Section 7031.5 by eny epplicant for e partnit subjects ihe epplicant to e civil penalty of not more than flve hundred dollers ($500).): ❑ I, es owner ot the property, or my employees with weges as Iheir sola compansation, WILL DO 7HE WORK, and the simcNre Is not imended or oNered for sele (Sec. 7044. Business and Protesslons Code: The Contractors License Law does noI apply to en owner ot properry who builtls or improves Ihereon, and who does such work himsalf ar herselt or Ihrough his or her own employees, provided that such improvemenis are not intended or aHered tor sale. If, however, ihe building or improvement is sold within one year ot completion, ihe owner-builtler wiil have the Durden of proving that he or she did not build or improve tor purpose ot sele.). ' ❑ I, es owner ot the property, am E%CLUSNELV CONTRACTING WITH LICENSED CONTRACTORS to consimct the projed (Sec. 7044, Business end Protesslons Code: The contractors License Lew does not epply to an owner of propeny who builtls or Improves Ihereon, antl who contrec�s for such project with e comraaor(s) license pursuant to the Contractors License Laws.). ❑ I em exempt untler sec. eusiness antl Protessions Code for this reeson: Signature: Data: Owner ID veri(ied by tlnvers license. ❑ Ves ❑ No Oriver's License No. Vedfication oi Ownership hy (type of dwument, i.e. - property teu Dill or tleetl): Expires: DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cetlify Ihet no excavetion five (5) or more teet in depth into which a person is required to descend, will be made in connection with work authorized by Ihis permit, and that no building sWcture, sw8olding, talsework, or demoli�ion or dismantling ihereof, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Tltle B, California Adminisirative Code). ❑ As owner-builder, I will not employ anyone to do work which woultl require a permit irom ihe Division of Industrial Satety, es noted above, unless such person has e permit to tlo such work irom the tlivision. SignaWra: Date: Division ot Indusirial Sefery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AllTHORIZA710N OF ENTRV: I cenify under penelry of perjury Ihet I heve read this application end stete thet the intormalion given is correct. I agree to comply with ell state laws entl city ordinances relating to building conswction, end euthodze reDresentatives of iha Ciry of Costa Mesa to enter upon iha above-descnbed property tor inspection puryoses. I agree not to occupY or allow occupancy of eny building authorized by this permit until final inspection. �� ,� SjyTNyre Of Legal Owner(s) ` Dale O,f�tla��f � AnNOr.Aulhodzetl Applicant Dale COOE I, INSPECTIONTYPE 1616 Fi:etl System Final Fire Preventlon 1266 Pool Spa Finel 200 Final Re-Roof 201 Final8locWRetaining Wall 202 Finel Fectory Fire Place 203 Finel Sign 204 Finel Demolition � �NTIiIRLS 4Qp$� INSYECTIONTYPE 206 Finel Mechanical 200 Finel Plumbing 210 Finel Elecirical 212 Final Fire Prevantlon 220 Final Planning Approval 222 Final Site 250 Finel Bullding�Occupancy uw. I►. (714) 754•5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��MBING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 2846 ELLESMERE AV Suile No Viciniry: Parcel Nunmber: '139334�1 Applicant: JOSH KEATING Address: 30300 PUERTO VALLER7A MENIFEE, CA - Owner: ROBBINS, DOROTHY D TR Address 2846-ELLESMERE AVE � COSTA MESA; CA Phone: 800-727-0977 Zip: 92530 Phone: Zip: 92626 Coniractor. ALL STAR WATER HEATERS INC Address: 30300 PUERTO VALLERTA MENIFEE, CA CHANGE OUT WATER HEATER ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinkinq Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outleis) Gas Repipe Gas Service Interceptors (Grease, Oil), Interceptors (Sand Auto ) AMT 523.50 50.00 50.00 S0.00 50.00 50.00 $0.00 50.00 $0.00 50.00 $0.00 50.00 50.00 50.00 so.00 50.00 50.00 50.00 50.00 so.00 QTY Phone:. 800-727-0977 Zip: 92530 � License: 812894 SCOPE OF PERMIT FEE SUMMARY � AMT Launtlry Tub / Washer 50.00 Landscape I«igation 50.00 P-Trap 50.00 Pressure-Regulator 50.00 - Process�Piping (per 10_H) - - 50.00 Receptors � 50.00 SepliCTank 50.00 Sewer Cap for Demo � "50.00 SewerConnect _� 50.00 Sewer Private line 50.00 Shower � - $0.00 Sink, bar_ • � - 50.00 Sink, commercial $0.00 Sink, Floor ' 50.00 �� Sink,kitchen . $0.00 Sink, servicelmop � 50.00 Spa (p�ivate) 50.00 Spa (public) 50.00 aN , 0 0 0 0 0- �_ 0 0 0 0 0 0 0 0 0 0. � 0 0 0 COMMENTS I SPECIAL CONDITIONS Status: ISSUED Applied: 04I7V2007 Issued: 04I112007 i � . : %'�l/ SumpPump Swimming Pool Trap Primer . Urinal Vacuum Brkr Bkilow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent Syslem Water Closel (ToileQ Water Healer/vent Water Piping (Insl or RepJ Water Re-pipe � Water Service WaterSoftener - OTHER VIOLATION " PLAN CHECK ' ,� REINSPECTION TO7AL CALCULATED FEES: AMT $0.00 50.00 50.00 50.00 50.00 S0.00 50.00 50.00 50 00 S0.00 $12.30 50.00 $0.00 $0.00 50.00 so.00 30.00 50.00 S0.00 535.80 an 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Qrd. No. 9248, § 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 autliorizad under this permit to be considered legal, such work must comply with all applicable codes, and ell required Inapectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of ihis permit. FOR INSPEC710NS CALL: (714) 75q-5626 1 eaco-ao law� WORKEHS' COMPENSATION DECLARATION: � 1 hereby eHirtn untler penalry ot perjury one of iha lollowing tlaclarations: ❑ I heve entl will melntain e caniticote oi consent to self-Insure for workers' compensatlon, es provitletl tor by sectlon 3700 oi the Lebor Cotle, tor the pertormance oi Ihe work for which this pertnit Is issued. �_6hBve antl will maintein workers' compenselion insurenca, as required by section 3700 of Ihe Lebor Gode, for the peAortnance of the work tor which this partnit is issued. � My workers' mp nsation Insuren�% carrier end policy number are: ^ � // ��Car'er._--C.�,�G �/�O� PolicyNumber: -� 1�� Y/i� � secflon need not be comp/efetl i( the permit is velued ef ane hundred dollars ($100) or less.) ❑ I certity thet in the peAormence ol the work for which this permit is issueQ I shall not employ any person in any manner so es to become sub�ect to the workers' compensetion lews of Celifomla, end egree thet if I shoultl become subject to the workers' compensation provisions oi Seciion 3700 of t�e Labor Code, I shall forthwith comply with these provisionsn � / � ...�./�.�� /'...// ,� App6canYSf9nalure: ' - � � Date: ` . WARNINO: FAIL�� IIRE TO SECURE ORKERS' COMPENS WVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPCOVER TO CRIMINAL PENALTIES AND qVIL FlNES UP TO ONE HUNDRED TIKKISAN� OOLURE (E100,000�, IN ADDITIIXJ TO THE CQST OF COMPENSATION, DAMAGES AS PROVI�ED FOR IN SECTIdJ 3/080F THE LABOR COOE, INTEREST, P.ND ATiORNEYS FEES. LICENSED CONTRACTORS DECLARATION: Chapter 9(crommenr.ing with Section 7000) ot Division�t.the�Business antl Pmfessions Code, antl my Ilcense is in full CONSTRUCTION LENOING AGENCV: ❑ I hereby aHirtn that there is e wnsVuction lending agency tor the peAormance of Ihe work for w�ich Ihis pertnit is issuetl. (Sec. 3097, Civil Cotle). Lender'S Neme: Lender's AtlAress: Signature: OWNER•BUILDER DECLARATONS: Date: I hereby eHlrm thet under penalry ot perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor t�e tollowing reason (Sec. 7037.5, eusiness end Profeulons Code: Any city or counry which requires a permit to consWct, elter, improve, demolish, or repair any simcture, prior to its issuanca, also requires �he applicant for such permit b flle a signatl statement ihat he or she is licensed pursuant to the provisions ol ihe CoNractors llcense Lew (Chapier 9(commendng with Section 7000) oi Dlvlsion 3 at the Business end Pratesslons Cade) or Net he or she Is exempt iherefrom anC tha EeSis for ihe elleped enemptlon. Any violation oi Section 7031.5 by any applicant for e Dertnit suDJects the eppllceM lo e civil penalty of not more than five huntlretl dollers ($500).): ❑ I, es owner of ihe properry, ar my emplayees with wages as t�eir sole compensatlon, WILL DO 7HE WORK, antl the swcture is not intended or oMered for sale (Sec. 7044, Business entl Professions Code: The Contraciors License Law does not apply to en owner of property who builds or improves �hereon, entl who does such work himself or herself or ihrough his or her own employees, pmvitled that such Improvements are not intended or oHered for sele. If, however, Ihe building or improvement is sold within one year ol completion, ihe owner�builder will have the hurden of proving ihat he or she did not build or improve tor purpose oi sala.). ' ❑ I, es owner of the property, am E%CLUSIVELV CONTRACTNG WI7M LICENSED CONTRACTORS to construct Ihe prolect (Sec. 7044, Business end Professlons Code: The contrectors License Law does not epply to an owner of property who bulitls or Improves thereon, end who coNracts tor such project with a contrector(s) license pur5uen� �o �he Conlra[tors LiCense Lews.). ❑ I am exempt unCer sec. Business entl Professions Code for this reason: Signature: Date: Owner ID verilied by dnve/s license. ❑ Ves ❑ No Dnvers License No. Expires: Veritication oi Ownership 6y (type ot Gaument, i.e. - property tau bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenify Ihat no ascavation five (5) or more feet in depth into which a person is required to descentl, will be matle in connection with work authorizetl by this pertnit, entl that no building structure, scattolding, felsework, or demolition or dismantling ihereof, will be mora than Ihirry-siz (36) teet high. (Chap. 32, Grp 2, An 2, Sec. 347, Ttle 8, Celllomle Atlministretive Code). ❑ As ownerbuilder, I will not employ anyone to do work which woultl require e permi� tmm the Division of Industnal Satety, as notetl ehove, unless such person has e pertnit to da such work from the division. Signature: Date: Division ot Industrial Sefety Permit Numbar: CERTIFlCATE OF COMPLIANCE AND AI7TTIORIZATION OF ENiRV: I cenify under penalry of peryury ihat I have read this application and state ihat the informetlon given is correct. I egree to comply wit� ell siate lews and clry ortlinances relating to bWltling construction, end authorize representatives ot the City oi Costa Mesa to enter upon Ihe ebove-descnbetl property for inspecUon Durpases. I agree not to occupy or allow wcupency ot any building authorized by this permit until finel inspection. LOpE I, INSPECTIONTYPE Q� ~�a� S4PE1 INSPEGTONTYPE p�¢ �� 1fi16 Fixetl Sysiem Finel Fire Preven�ion 206 Finel Mechanical 12fi8 Pool Spe Final 200 Final Re-Root 201 Final BIocWRetaining Well 202 Final Fadory Fire Place 203 Final Sign 204 Final �emolilion Finel Plumbing 250 Final Builtling/Occupancy _ October 7, 2009 CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRNE • CALIFORNIA 92628-1200 DEVELOPMENT SERVICES DEPARTMENT BUILDING DIVISION COURTESY NOTICE OF PERMIT EXPIRATION Dorothy D Robbins Tr 2846 Ellesmere Avenue Costa Mesa, CA 92626 PERMI7 NUMBERS: P07-00220 PROJECT 2846 Ellesmere Ave., Costa Mesa, CA FOR: Water Heater Our records indicate the above listed permit(s) were obtained for property improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 980 days from the date of such permit, or the date of the last inspection for the project. Our records do not show an inspection for these permits within the last 180 days nor have they had an approved final inspection. If you have a signed inspection card showing that an inspection was made within 180 days, or that the final inspection was approved, please contact this office so we may correct our records. If you do not have an approved final inspection, your permits will expire on October 19, 2009. Additional fees will be required to finalize expired permits. Requestinp an inspection - If you need to request an inspection, please call our Inspection Request Line at 714-754-5626. Requestinq an extension -If you wish to request an extension, requests must be made in writing addressed to Ed Petros, Chief of Inspection, at the above address, detailing circumstances and listing an estimated date of completion. If you have any questions, please contact the Building Division at 714-754-4871, between 8:00 a.m. and 4:30 p.m., and a staff inember will assist you. The accuracy of records affecting your property is our goal and we appreciate your working with us to resolve this matter. Sincerelyn Barb�J� wart Office Specialist il All Star Water Heaters. Inc. Building Division (714) 754-5273 • Code Entor�¢ment (714) 754-5623 • Planning Division (714) 754-5245 FAX (714) 754-4856 • TDD (714) 754-5244 • vmav.ci.cos�a-mesa.ca.us � � CITY OF COSTA MESA • � BUILD/NG D/VISION � DEVELOPMENT SERVICES DEPARTMENT 69&00775 �• PERMIT PERMIT NUMBER �� (714) 754-5273 • Fgx (774) 754-4856 77 FAIR DFIVE, COSTA MESA, CA 92626 BUILDING PERMIT Jobnddress: 2846 ELLESMEREAV Suite: Vicinity: ParcelNunmber: 13933411 Applicant LUKE, GARY Address: Owner: ROBBINS, DOROTHY D TR Address 2846 ELLESMERE AVE COSTA MESA,CA Contractor: LUKE ROOFING Address: 00448 S MONTGOMERY Arch I Eng : Address: Plan Check: Permit Other: Inspection: Total: ORANGE CA $0.00 $149.75 $0.00 $0.00 $150.65 SETBACK$ MAINSTRUC7URE Front 0-0 ACCESSORY Front 0-0 PARKING Existing: o NOTES: Zoning: R1 R1 Phone: Zip: Phone: Zip: 92626 Phone: Zip: 92667 License: 672569 Phone: 2ip: License: SCOPE OF PERMIT T/O EXISTING & REROOF W/COMP' SHINGLE. Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING 8 ZONING LeR 0- 0 Left 0- 0 Proposed: 0 Status: ISSUED P,pplied: OS/O6I1998 Issued: OS/06I7998 � 0 Calc Valuation: So.00 Claimed Valuation: as,000.00 Right�- 0- 0 Right 0-0 IEXPIRATION: This permit shall automatically expire and become void ii work is not commenced within 180 days, or if work is suspended or abanGoned for a period of 780 days. INSPECTIONS: In order tor the work authorizetl under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inapeetlona and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 754-5826 WORKERS' COMPENSATION DECLARATION: I hereby etfirm untler penalry of pe�ury one oi t�e following declaratians: . . � ❑ I have end will meintaln a cert�cate o1 consent to aelFlnsure far workers' compensatlon, es proviCed for by section 3700 oi the Lebor Cade, for ihe pertormflnce of Ihe work tor which this permit is Issued. ❑ I �ave arW will maintein workers' compensatlon insurenca, az requireA by section 3700 of the Lebor Code, tor the peAortnence oi ihe work tw w�ich Nis pertnit Is issued. My workers' campensation Insurflnce cartier end poliq number are: Certier: Policy Number. (Th/s secHon need not be cam0/eted i! the peimlt fs ve/ued et ane hundred dollars ($100) or /ess.) ❑ I cenly ihet In the peAormance at the work br which ihis pertnit is issued, I shall not employ any person in any mannar so es to become subject ro t�e workers' campensetlon laws of Gellfomla, end egree thet if I shoultl become subJect to the workers' compensation provislons of Sectlon 3700 ai t�e Lehor CoOe, I shell lorthwith comply wlih these provisions. � Applicent Signatur � Daf�'J s-.�•- g? � WARMNO: FAILURE O SECURE CEqS' COMPFIJ'9� T10N ODVEMGE IS UNLAWFUL AN� SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTES AND GVIL FlNES UP TO ONE HUNDREO TFqUSAND OOLLARE (E100,000), N ADDfiION TO THE COST OF COMPENSATION, DAA4IGES AS PROVIDED FOR IN SECiIIXJ 3]O60F THE LABOR CODE, IPRERESf, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: ` I I hereDy ettirtn thet I am licensed undar proNsions ol Chapter 9(crommencing with Sectlon 7000) ol Division 3 of the Business end Professions Code, and my license is In tull force end eMect. Lic. u Class # Contractors Signeture:,�-1 � Dat¢r'] S 6.� 9p CONSTRUC710N LENDING AGENCV: � ❑ I hereby aMirm ihat ihere is e construc0on lending a9ency for the peAortnance of the work for which this permit is issued. (Sec. 3097, Civil Cotle). Lendels Neme: Signeture: _ OWNER-BUILDER DECLARATIONS: Lenders Atldress: Date: I hereby eHirtn thet untler penalry oi pehury t�at I em El(EMPT FROM 7HE CONTRACTORS LICENSE LAW for the tollaving reasan (Sec. 7037.5, Business end Professions Cotle: Any ciry or wunty which requires e pertnit to consiruct, eltar, Imprwe, demolish, or repelr eny strucWre, pnor to its Issuance, elso reqWres the applicant tor such partnit to Ole e slgned statement ihat he or she is Iicensed pursuant to ihe provisions ot Ihe Contractars LJcense Lew (Chapter 9(commencing with Sectlon 7000) oi DNLslon 3 0l �he Business end Pmfessions Code) or ihe� �e or s�e Is exempt therefrom and Ihe besis for tha ellegetl exemption. My vidatlon of Section 7031.5 by any eppliceni for e partnit su6jacis the epplicent to e Uvil penalry ot not more Uan five huntlretl tlollars ($500).): ❑ I, es owner at Ihe properry, or my employees wlth wages as iheir sole compensetlon, WILL DO THE WORK, antl the structure Is not Intended or oHered tor sale (Sec. 7044, eusineu entl Protessions Code: The Contrectors License Law does not ep01y to en owner oi property who bullds or improves thareon, and who tloes such work himseN or herself or ihrou9h his or her own employees, provided that such Improvements ere not Intended or oXeretl for sele. tl, however, Ihe builtling or Impmvement Is soltl within one year oi completion, the owner-builder wi0 heva ihe burtlen ot proving Ihet he or she tlitl not Dulld or improve tor purpose ol seleJ. ❑ I, es owner o1 the property, am EXCLUSIVELV CONTRACTING WITH LICENSEU CONTRACTORS to consiruct the project (Sec. 7044, Business and Profassions Coda: The conirectors License Lew tloes not apply to en owner of property who bulitls or Improves thereon, entl who coniracis tor such project with e coNrecbr(s) license pursuent ta the Contrectors License Lews.). ❑ I em exempt under sec. Business end Prafesslons Cotle tor this reeson: Signeture: Date: Owner ID veritled by driver's license. ❑ Yes ❑ Na Driver's License No. Vedticatlon ot Ownerehip by (rype of document, I.e. - properry tac bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: Expires: ❑ I hereby certity Ihat no excevatlon five (5) or mora leet In tlepth into whic� e person is required to descend, wlll De matle in connedlon wlth work authorizetl by this pertnit, end that no building siructure, sceHoltling, falsework,-or demolitlon or tlismentling ihereof, will be more then t�irry-sls (38) ieet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tillo B, Califomla Atlminlstretive Cade). ❑ As owner-bulltler, I will not employ anyone to tlo work which woultl require a permit irom the Divislon of Industriel Safery, es noted ebove, unless such Oerson hes e pertnit to do such work from the divisian. SigneNre: Date: Division ol Industrial SaFery Pertnit Number: CERTIFlCA7E OF COMPLIANCE AND AUTHORVATION OF ENfAY: I certily untler penalry oi perjury that I heve read ihis epplicetion and stete that Iha infortnetion qiven is cortect. I egree to comply with all stete laws flnd ciry ordlnances relatlng to builtling consWction, end au�horize representetives ot lhe City of Costa Mesa to enter upon the above-dexribetl property ior inspecllon purposes. I egree not to occupy or allow occupan�y of any 6uilding authorized by this pertnit until final inspeclion. COOE 1. 1616 1266 200 201 202 203 Fixed System Finel Fire Prevention Paol Spa Finel Flnel Re-Root Finel Block/Retaining Wall Final Fectory Fire Place Final Sign 204 Final Demolition 2a&4s uag u�e�s �A��1K F,P l � � �_6 4 COOE• INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Electricel 212 Final Fre Prevention 220 Final Planning Apprwel 222 Final Si�e 250 Final Building/Occupency OAg II�EW Applieant to fill in all s0acei exce0� t�ose wit�in heavy EorOer Iines anG sign all apOropriate Oeclarations. -^ CITY OF�oS7A mESA CON RUCTION PERMIT flrOjett AAdre55 � � Applicant's Mai�in ddrRs ' t� Owner'sNa�n ��Jn Phone�(1J Add�ess KA/L/ Arch/Eng. Licenu No. Address ��r J Convactor's Name Q � honeQS2�lllli Addresslma'1' ol !� � rV� City License No Q, .�. LICENSED CONTRACTOR DECLARATION I hereby a/firm that I am licensetl unde� provislons of Charter 9(mmmencing wI[h seclion �000) of �ivision 3 of the BuSiness antl Professlons Cotle, antl my Iicense is in to a antl eRect. �License I � ce o Date Si9nature � WORKE 5' C MPENSATION DECLARATION I hereby al�irm that I have a cer[ificatE of conSent lo self-in5ure or a certificat¢ ol Workers' Compensatiom Insurance, or a certifietl copy thereof (Section 3800. Lab. C,��%% 3R�,� ��,�1t/79��:5 �n�.�.p PI'olli,c.y No..L(/�, COTpany ✓ l�J Certitietl coAY is herebwithrtheht ty/g/� I/qy/p9/9� v/i)i�p////�( �y/I E%`EM N F OM WORKERSCOM�'ENSATION DECLARA7� (This se[lion neetl not be completetl it the pe�mil is �o� one huntlretl (5100) or lesz). I certity that in the p¢rfo�mance of the wo�k tor which thls p¢�m�t i5ls5ue0, I snall not employ any parson in any manner so as to become subject to the Workers' Compensa[ion LawS Ot Califomia. �ate Signdture �NOTICE: If, aftrr making this tleclaratlon, you 5houltl become Subjec[ to [be Wo�keri' Compensa[ion provisions ot [ne Labor Cotle, y0u mus[ �orthwith compty wllM1 Such p�ovisions or tbis p¢rmR 5M1a11 be tleernetl revoketl. CONSTRUCTION LENOING AGENCV 1 hereby aHirm �hat there is a mnstruction lentling agency for the performance at the wOrk ror whiCh this permit is izsu¢tl ($ection 3097 Civ. CJ Lentler's Name Lentler's Atltlre;s - OWNER BUILbEH DECLARATION I hereby affirrr� tha[ I am exempt from [he Contractor's Ucense Law for the followin9 reason (Section 7031.5 Business antl Professlonal Cotle: Any city or county wt9<h requires a Oermit to con5truci, alt!/, imprOve, �emolisn o� repai� any structure, prlor to It5 issuance, also requires tne applicanl for such permit t0 file a siqnetl slatemen[ tbal he/she ii licensetl pursuant to [he provisions ot ihe ConVactor's Litense Law (Cnapter 9(commencin9 witn Section 7000) of OiviSion 3 Ot the BuSiness antl Professions Cotle) or tnat he/She I5 exemp[ therelrom dntl tne basB tor [he allegetl exemption. Any violaHon ot Section 7031.5 by any applican[ tor a permit subjects tne applicanl [o a civil �enalty of not more than five nuntlretl tlollars (E500�. lJ I, az owner oi the property or my employees with wages as their sole ComO¢nsation, will tl0 the work, antl the struc[ure IS not Intentletl or offeretl lor ule (Section 7044, Businezs antl Profe55ional COtle: Th¢ ConVattor's Licens¢ law tlDes nol apply to an owne� of a property who builCs or imOroves tbereon, antl Who tloes Suth work hlrt�self/Iterself oi IhrOu9h his or her own emD�oyCes, p�qvitletl that such imOrovEmentS are not Intentletl or offeretl fo� Shce. It, M1Owev<r, [he bWltling or imprOvemen[ i5 Soltl withln one year ot com� plelion, the OWner will have the burtlen Of provinq M1e/she tlitl nol builtl or im- p�ova lor the purpose of Sale). � ❑ 1. as Owne� o/ Ihe O��Perty, am exUusively contracting wlth licensetl con- baclorSto conStructthe prolect (Section ]044, BuSinesS dntl PrOfessiOns Cotle: The Conlractor's License law tloes n0[ apply to an owner of property who bui�ds or improves thereon, antl who conVactS for such projeGts with a con- � tractor(s license pursuant�to the�Contractoi's �icense Law). I am aware that proof o� titei� Worker'S Compenw[ion insurance shoultl be provltletl to me. ❑ I am exemp� uneer 5ection B. & P. C. for tnis reason Date Owner I hereby certity tnat I have rea� Siqnature /N�,v//!(/ cMF above _.. , . ..... .._. . - — -- .,..,, ,..,. aag3g TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR — ❑ CONVERSION ❑ OEMOLISH ❑ OTHER p�.p..(k - DESCRIPTION OF WORK/USE OF BLDG. - S Main Buildi E TVPEOFPERMIT GRADING OUNDATION STRUCTVRAL T Front ❑ TENANT ❑ ELECTRICAI PLUMBING ❑ MECHANICAL B qeaf Q OTHER A' PROJECT DESCRIPTION 5q. F7. oCCUVArvCv C Right K Left CONSTRUCTIONTYPE VP.LUATION$ $ ZONE GRADIIVG GU.YDS. ACRES - PIOg. R2f, �/' Remarks: ' Planning Notes: Sink Preventer Irrigation Drinking Fountains Floor Dreins Floor Sinks Gas Service Outlets Interceptors Kitchen Sink '- Lavatories P—Trap Roof Drains Reinspection Fee I $15 Boiler Duct � Under Ground . Duct -SVuctural Duct � Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. IC80 # Heatin9 System & Ducting ❑0.100,000 BTU 0100,OOOBTI Reinspection Fee � $15 rev. S D/H6 Wbite � BuiltliAg; Canary - APPIIWn4 Pink - A[coun[ing; GoltlenrOtl - ASsesso� VLUMBING $hOwQfS Service Sink Sewer Cap Sewer Connection $O!d! i�.0112C[OIS Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater � Water Service Auto�Wesh Issue Fee Hoodor Typel ❑ Canopy Type I I ❑ Refrigeration System ❑o-ioo,000eru ❑ioo,000 System Repair/Alteration Fire Dampers Registers Issue Fee FEES $ 3 Automatic Washer Constructian Pole Cooking Unit Disbwasher Dryers ❑Gas ❑ Fan F.A.U. fixture5 Device Boxes Outlets 9763 2/21/96 �n_ . J 2one Parking Req./Provided ELECTRICAL Transformer ❑ 15�50 KW ❑ 50+KW _ Merer ❑up to 700 amps Meter []over 1008mps ._ Electric Sub Panel Motors �0.1 HP O 1%� 8 Inc.Solar 09-15 HP �16-15+ Microwave Pole Light � ' Garbage Disposal ' Generator 065 KW �5-15 Sign Standing Sections Trash Compacror FEES Z O N I N G R E Q M T S � � Reinspection Fee �$15 � � Issue Fee � $ 3 � DEVELOPMENT SEfiVICES REQUIREMENTS: 2oning Approved By Date Building Approved By Data� '� —,, Appliwtion Issued By Date o+–�'__ /=�A'/ ' SUMMARV OF FEES _BUILDING PEfiM1T $ SMIP $ PLAN CHECK 5 � PEFMIT PLUMBING $ �SSUANCE S PLAN CHECK 25% 5 ENERGY P.C. $ ELECTRICAL S � GRADING S � PLANCHECK 50% S MICROFILM $ MECHANICAL 3 TOTALFEE S �U ' PLAN CHECK 25% $ - 1 /� / l / rONSTRUCTION AND PLANNING POOL ,,. �PA APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector .1. TemporarY Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcemen[ 3..Electrical Conduit Utility�Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd: 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines. P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK ii. Property 5ewer Line & HouseConnecYion 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 74. Rough Plumbing 65. Electrical-Final . ]5. Rough Elec[riral-Conduit � 66. Solar SYstem-Final ' 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiiing Sign 6S. APPROVED FOR PLASTERING 18. Rough Electriral-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Fattory Fireplace APPROVALS Permit # 27. Ducts, in 5tructure . 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL � 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:3-Z,7.�G (�� Gq.eV q:j�-- L,r�� 34. Final Heating & Air Conditioning $�$!-!ib l�.�FT C.�lLp (�p, �'3Y 35. Final Gas Pipe-Test Z,7-�� C'��L QS �rr2 20.3 VFC L. zn 36. Hood or Canopy 37. Final FactOry Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final ��; 42. Backflow Preventer ' 43. Backflow Irrigation ,_- 44. Landscape Irriqation System 45. Sound Attenuation - 46. Handicap Regulations ... 47. FINALSTRUCTURE&BUILDING c� 48. Special Requirements Complet8d 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date MBrch 19, 1968 � Mr: William Unger _ 2846 Ellesmere Avenue ' Costa Mesa, California Dear Sir: • An inapector from this depa ment inspected the structure lo�ated at 2846 Ellesmere enue and found' it to be stntcturally s nd as of thls date. , Youra truly, - RICHARD HANHART " � Director oP Building 3aPetyf RH:dh � . 1\� - i�C��' �+�',c�`� � C lr �C�C�h'c� �� L /' ,p JUL 311961 �� COSTA MESA BUILDING-SAFETY DEPARTMENT fINANCE OEPT. P. o. Box 9,� C06TA MEBA. CALIFORNIA �ITY Of COSTA MESA For Applieanf to Fill In Complefely APPLICATION FOR PERMI7 TYPE OR PRINT 8��N� BUILDING ADDRE66 ��'«fM�t Z��/ � COSTA MESA. CALIFORNIA For Office Use Only � 1iCCHIPT NO. �� JLNO. OWNER Pacesetter Jt. Venture r� MAIL RECB�1leo BY DA'y REC81V[O DATE IBSUHD . ADDRESS 1653 Minorca (/G �J��` S-�/ � _ ^;�_� � CITY Ci0$t8 �e$fl TEL. Kl BUILDING NO. AODRESS ARCHITECf TEL. � 6TATE Mesa Verde Builders Inc. COSTA MESA. CALIFORNIA ZONING Cos�a Mesa ZONE NO.OF U8H OP N¢W S> . 1 � �' I PI.AN9 � BUILDIN6 W�'� l Rl 2(z4 _ _ "o---K�9-039 `:o"` � #- l � � ioo 8 . ORRI'CIMI/�N 7500 Sq.Ft. � N��„°�„e��a. 0 ' 86TBACN LINB FROM SO ILEF'� 5 IRIGHT J DESCRIPTION OF WORK % 'CO ERINGWAL 1'100"CCVICOVERII USE OF BUILDING AND WORK TO BH Standard Plan No. 800 CH 1 H8RlBY �CKNOW Ge THAT 1 HAVE ReAD TH19 AND BTATE THAT � ABOV 18 LOM ND AG PLY WITN ALL CI RDI CEe AND T LA� BUIlDINO CONB O /j SIGNATURE OF /�J� n , 1 AUTHORIZED c� 7 �cexTea uxe ¢r.i FRONT .i—Q FT. IN. R. SIDE � FT. �� IN. L. SIDE � FT. IN. S I REAR � FT. IN. IAPPROVED �� DATE 7/Z//�l BY 1 � �G./ i� _ y,�yp , Attached garage l,50 Sq.Ft. 1TION THE AMOUNT BHOWN UNDER VALUAT�ON 18 FOP TXE COM- pUliP09E OP E9TABL19H�NO A PHRM�T FE4 ONLY. 1TIN0 I VALUATION ? 9 � PERMIT FEE $ J / N /9 /%� o a $ ✓ J �/ PLAN CHECK $ T Z TOTAL FEE �s" 4