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HomeMy WebLinkAbout2897 ELLESMERE AVE - Building PermitsCITY OF COSTA MESA � BI/ILDING DIVISION F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us . - �.�� FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B09-00009 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 13926112 DATE ISSt1ED: 01l20/2009 ISSUED BY: BJK JOB ADDRESS: 2897 ELLESMERE AV CM Vicinity: RESIDENCE AND ATTACHED GARAGE Squares: 3000 � " � � SuitelUnit: Valuation: $13,900.00 SCOPE OF WORK: REROOF'�RESIDENCE AND ATTACHED GARAGE: T/O EXISTING WOOD SHAKE ROOF,�7/16" OSB SHTG, 1 LAYER 30# FELT, APPLY "GAF 50-YEAR GRAND SEQUOIA COMP SHINGLES). PITCH 5:12 3000 SQ FT . � � OWNER: BUDDE, LOU . � . Address: 2897 ELLESMERE AVE � Unit: PHONE: . � ' � . City/StatelZip: COSTA MESA,CA ,- , A�PLICANT: AKIL, ABDO � � -� Address: 2737 S CRODDY WAY - Unit: : PHONE: 714-641-1440 � .- City/State/Zip: SANTA ANA, CA �� "- . CONTRACTOR: DKAM ROOFING - �-- • � License No. - 841611 � Atldress: 2737 S CRODDY WAYUniC UNIT A PHONE: 714-641-1440 City/State/Zip: SANTAANA,CA 92704 CELL: � ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: Bldg Std Admin Fund TOTALFEES License No. � : License No. $o.00 ..$23725 - " . - $0�.00 . � ` $1.00 523825 PHONE:. - PHONE: NOTICE: The work aulhorized by lhis permit shall comply with all applicable handicap access requirements under California staNtes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) � . EXPIRATION: PERMIT EXPIRES 180 OAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. . INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all �equired inspections and final approval musl be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODER INSPEC710NME DAIE INTITqL CODEp INSPECTIONTYPE U� INTlnus 1616 Fixed System Final Pire Prevention 206 Final Mechanical 1266 Pool Spa Final 7 p � 208 Final Plumbing 200 Final Re-Roof �'LG� ( 210 Final ElectRcal - 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolilian 250 Final Builtling/Owupancy � WORKERS' COMPENSATION DECLARATION. � I hereby affrm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consenl lo self-Insure for workers' compensation, as provitletl for by section 3700 of lhe Labor Code, for the r� peA ance of the work for which ihis parmit is issued. � � I have and will maintain v,orkers' compensation insurance, as required by section 3700 of the Labor Cotle, tor the peAormance of the vmrk fw which this permit is issued. My vrorkers' compen5ation Insurance cartier and policy number are: ��, 'Carrier: iJ L K}� 'rl��� `i� (This secfpn neetl iwt be comp'efetl Ftne permA is va��etl at are hundietl �llars (Sf 00) w less ) PolicyNumber: � "(i0(>�-�.,-Z _�-OC� ❑ I certify that in the performance of the work for which this permil is issuetl, I shall not employ any person in any manner so as to become subject fo the wodcers' compensation laws oF Califomia, and agree tha[ if I should become subject to the workers' compensalion provisions o( Seclion 3700 ot the Labor Code, I shall fo hwith comply wi�h these pmvisions. ��,`.•.> � - 2�. ,C�9 Appllrants nahre .Date J WARNING FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE 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 YHE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force antl effect. r� Lic '� Class # �L -3 -1 P �'Z-C�� i , ContranorsSign re" —` �,_�a�e�' CONSTRUCTION LENUING AGENCY: ❑ I hereby affum that there is a construction lending agency for the perfortnance of Ihe v.ork fa vfiich this permit is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Dale OWNER-BUILDER DECLARATIONS: I hereby aKrm that under penalty of perjury tha[ I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for tpe follovnng reason (Sec. 7031.5, Business and Professions Cotle: Any city or county which requires a permit to consWct, alter, improve, demolish, or repair any slrucWre, prior to ils issuance, also requires the applicant for such pertnit to fle a signed statement that he or she is licensed pursuant lo lhe provisions of the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt [herefrom and Ihe basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalry of nol more Ihan fve hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl ihe stmcture is not intended or offered for sale (Sec. 7044, Business and Protessions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himselt or herSelPor through his or her own employees, provided that such improvemenis are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have tPe burden of proving that he or she tlid not build�or improve for purpose of saleJ. . ❑ I, as ovmer of the property, am EXGCUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business and Pro(essbns Code: The contractors License Law dces not apply to an owner of property who builds or improves ihereon, and who coniracts for such prqect with a cmhactof(s) license pursuant to the Cont2clars License Laws.�. ❑ I am exempt under sec. Business and Professions Code (or this reason: SgnaWre Da�e 305]-a6 (3I0]) F , Owner ID venTed by tlrio. .ense. ❑ Yes ❑ No Driver's License No. Ezpires: Verifica[ion of Ownership by (type of document, i.e. - property [ax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � ❑ I hereby certHy that no excavation Frve (5) or more feet in tlepth into vfiich a person is requiretl to descend, will be made in conriection with work authorized by �his pertnit, and Ihat no building slructure, scaffdding, falsework, a tlemolition or dismantling thereof, will be more Ihan thiAy-six (36) feet high. (Chap. 32, Grp 2, Art 2. Sec. 341, Title 8, Califomia Administrative Cotle). ❑ As owner-builder, I will no� employ anyone to do vroAc which would require a permit from the Division of Industrial Safery, as noted above, unless such person has a pertnit ro do such work from the division. Appliwnfs SignaWre Division of Industrial Safe[y Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will ihe applicant or presen[ or future building occupant need lo file and certiry a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safery Code requires, with some exceptions, tha[ a Business Plan be fled with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quan[ity of hazardous materials equal to or greater than a weigh� of 500 pountls, or a volume of 55 gallons, or 200 cubic feet o� compressed gas at standard temperature and pressure). 2. Does or will [he applicant or presen� or tuNre building occupant need [o Ne a registration (ortn for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Heallh and Sa�ety Code, with some exceptions, requires registration with the Cos[a Mesa Fire Deparimenl by each business which a[ any one time has on hand a quantity of acutely hazardous materials equal to or greater Ihan a vreight o( 500 pountls, or a volume o( 55 gallons, or 200 cubic feet of compressed gas at standard lemperature and pressure). 3. Does or will the applicant or present or future building occupant neetl to prepare an RMPP (Risk Management and Prevention Prog�am for aculely hazardous materialsj? ❑ Yes ❑ No (Section 25534 ot the Califomia Health and Safery Code provitles that lhe Costa Mesa Fire Department may require ihe preparation, certification and filing with the Fire Department of an RMPP by businesses which are requiretl to register acutely hazartlous materials with ihe Fire Department. 4. I( an RMPP is presently requireQ has Section 25534 of [he Cali(omia Health and Sa(ety Code been fully complietl with? ❑ Ves ❑ No 5. Does or will the applicant or present or future builtling occupant require for the work which is the subject of ihis ap0�iwtion a permit for such construction or modification fmm the South Coast Air �uality Managemenl District or from any other air pollution control disMct or agency? ❑ Yes ❑ No (Section 658502 of the Califomia Govemment Code requires ihal the requesletl infortnation be fumished on applica[ions fv non-residential buildng pertnits�. 6. Will any part of the facility to be constructed under Ihis permil be wi[hin 1000 tee[ from the outer boundaries of a school? ❑ Yes ❑ No (If "yes", the faciliry musl meet the requiremen[ o( Sections 25534 and 42303 of the California Health and Sa(ety Code). 7. I( a permit from Ihe Sou[h Coast Air Quality Management Disirict or other air polWtion control disMct or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Satety Code Section 42303 been made? ❑ Yes ❑ No 8. (If'yes", attach certifcate of compliance from the appropnate air pollution control officer). � � � CERTIFICATE OF�COMPLIANCE:�I certify lhat under penalty of perjury lhe information given above is covect I agree to comply with all stale laws and cily ortlinances regarding Hazardous Materials and Emissions. SignaWre �Dale CERTIFICATE OF COMPLIANCE AND AUTHORI2ATION OF ENTRY: I ceAiiy under penalty oi perjury [hat 1 have reatl this appliw[ion antl slate iha[ ihe information given is correct. 1 agree to comply with all state laws and city ortlinances rela[ing ro building consWction, and authorize representatives of the Ciry ot Costa Mesa to enter upon the above�escnbed property for inspection purposes. I agree not to occupy or�allow occupancy of any building authorized by this permi[ until final inspection. .. _ SignaWreoiLe9 �++�eqs) pate ��� � �7,��..•��� Antl/orA zeE Od��nl Da�¢�� (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Adqress: 2897 ELLESMERE AV Suite No Vicinity: Parcel Nunmber: 13926112 Applicant: KEITH DAIGNAEAULT Adcfress: 8182 CENTRAL. AVE � GARDEN GROVE, CA - . Owner. BUDDE, LOU Address 2897 ELLESMERE AVE � COSTA MESA, CA Phone: 714-231-9773 Zip_ � 92844 . Phone: Zip: ,926263650 Contractor. KEIMA CONSTRUCTION INC '� " Adtlress: 8182 CENTRAL AVE ISSUE FEE BackFlow irrig8tion BackFlow Preventer Bathtub Clarifier System Connect pce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-0 ouUets) GARDEN GROVE; CA 0 Phone: 714-231-9773 Zip: 92844 � License: 850222 ISSUED BY: Status: ISSUED SCOPE OF PERMIT ADD 69 SF TO THE FRONT OF THE SFD TO CREATE A WALK IN CLOSET. REPLACE SLIDING GLASS DOOR IN LIVING ROOM WITH FRENCH DOORS, REPLACE DINING ROOM'S WINDOW WITH FRENCH DOOR, CHANGE OUT 3 WINDOWS IN THE LIVING ROOM, KITCHEN AND BATHROOM. REMODEL EXISTING BATHROOM AND KITCHEN. REF.: BOS-00796 PLUMBING TO INCLUDE: 1 BACKFLOW PREVENTER, 1 BATHTUB, 1 LAUNDRY TUB/VJASHER, 1 P-TRAP, 1 SHOWER, 1 KITCHEN SINK, 1 WASH BASIN SET, AND 1 WATER CLOSET. AMT $23.50 $0.00 $9.80 $9.80 . �$0.00 �". � � $0.00 _ � � �$0.00 �-$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY . i- 1, 0 1 0 � 0 Q 0 0 0 0 0 0 0 0 -FEE SUMMARY AMT Laundry Tub / Washer $9.80 Landscape Irrigation� $0.00 P-Trap � $9.80 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 Cine . $0.00 Showef . $9.80 Sink, bar $0.00 Sink, commercial . . . $0.00 Sink, Floor $0.00 Sink, kitchen $9.80 QTY 1 0 1 0 0 0- 0 0 0 0 1 0 0 0 1 � --SumpPump Swimming Pool ,Trap Primer � V rinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) ` Wash Basin N/ash Basin Set Waste and Vent System Water Closet (Toileq � Water Heater / vent Wa[er Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $9.80 $0.00 $9.80 50.00 $0.00 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Califomia statules and related regulations. (Ortl. No. 92-28, § 1, 12-21-92) EXPIRATION: 7his permit shall automatically expire and become void if work is not commencad within 780 days, or if work is suspended or abandor)e-tr for a period of 180 days. 0 INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable c s, and all required InspeCtions and final approval must be obtained. Failure to obtain inspections antl final approval will result in the expiration of s permit. FOR INSPECTIONS CALL: (714) 7545626 zaaws (r✓oo� WORKERS'COMPENSAnON DECLARAnON: I hereby ettirm under penelty of perjury one oi the following Aecleretions: ❑ I heve end wlll malntain a cenificate oF consent to self-Insure for workere' compensation, es provided for by sectlon 3700 oi ihe Lebor Cotle, for the performence of the wark for which ihis pertnit Is Issued. �ave antl will melntain workers' compensatlon Insurence, es reqWred by section 3700 of the Labor Coae, for the pertortnance of the woAc for which Nis permit is issuetl. ` My workers' compensatlon Insurance carrier and policy number ere: / / / � ST�T� �v^'� ; PolicyNumtier::'-� I 6 Z�I V Q'-d b (lhis secNon need not be complefed i/ the permtt is va/ued ef one hun0ied dollars ($100) oi less.) ❑ I certify that in the peAortnance of Ihe work tor which ��is permit is issueQ I shall not employ any person in eny mannar so es to become subject to iha workers' compensation lews of Celitomia agree that if I shoultl became subJect ta the workers' compensation proNslons of Saction 3700 of Ihe Lebor Gode, I shall forthwith comply with these provis ons A cantSignelurer_-.. Dete �/��� �,�. ,,,;.:_ �;. WqFtAMCi:1PAICURE TO SECURE WORKERS' COMPENSATION COVEMGE I$ UNLAWFU� AND SHALL SU8IECT AN EMPLOVEti TO CRIMIWIL PENALTIES PND CIVIL FlNES UP TO ONE HUNORED THOUSAND DOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION �OB OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I �ereby aHirm that I em licensetl untler provislons of Chapter 9(commencing with Section 7000) of Division 3 of the Business end Professions Cade, and my license Is in full n� nnA wffari I'in a':`--�StS�� 2 Z Z '�/I CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn tha� �here is a consiruction lending agency for Ihe perfortnance oi ihe work for which ihis permit is issued. (Sec. 3097, Civil Cotle). Lendefs Neme: Lendefs Atltlreu: Signeture: OWNER-BUILDER DECLARATIONS: Date: I hereby eftirtn thet under penalry ot perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business end Professions Cotle: Any ciry or counry which requires a pertnit to consiruct, alter, improva, tlemolish, or repair any siructure, pnor lo its issuance, elso requires the appliwnt tor such permit to file a signetl stetement that he or she is licensed pursuant ro t�e provisions of ihe Contradors License Lew (Chepter 9(commenGng with Section 7000) of Division 3 of ihe Business end Professions Cade) or that he or she is exempt thereiram entl the 6asis for Ihe elleged exemptlon. Any violatlon oi Section 7031.5 by any applicent tor e permit su6jads the appllcant to e civil penalry of not more than five huntlretl tlollars ($500).): ❑ I, as owner of ihe properry, or my employees with wages as Iheir sole compensation, WILL DO TME WORK, ena Ihe sirucNra is not intenaea or oRered tor sele (Sec. 7044, Business and Protessions Code: The Contrectors License Law does not apply to an owner of property who builds or improves Ihereon, and who does such work himself or herself or through his or her own employees, providetl ihet such improvements are not Intended or oNerad for sale. It, however, tha buildinq or Improvement Is sold within one year oi completion, ihe owner-builde� will heve the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I, as owner of t�e property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business and Professlons Code: The contrec�ors Llcense Ww does not apply to en owner ot property who builds or impraves Iheraon, antl who contracts tor such projact with a contrector(s) license pursuent to the Conirectors License Laws.). ❑ I am esempt untler sec. Business antl Protessions Coda for this reason: Signature: Date: Owner ID verifietl Dy tlriveYs license. ❑ Ves ❑ No Dnvefs License No. Veriticetion of Owners�ip by (rype of document, i.e. - properry tex bill ar tleea): Etpires: DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFlCATION: ❑ I hareby cenify t�et no excavation five (5) or more feet In depth Into which a pereon is required to descend, will ba made In wnnedion with work authorized by Ihis pertni�, and ihat no building sirucNre, scaHolding, falsework, or demolition or dismantling thereoi, will be more Ihen �hirly-siz (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Celifornia Administrative Code). ❑ As owner-builder, I will not employ enyone to do work which would raquire e permit from Ihe Division of Industrial Sefery, es noled above, unless such person hea a permit lo do such work from the division. Signature: Date: Division of Industrial Safety Pertnit Number: CERTiFlCATE OF COMPLIANCE IWD AUTNORVJITION OF EMRY: I certily under panalry ot perjury thet I have read this epplication antl state that the informatlon given Is correc�. I agree to comply with all state lews and ciry ortlinences relating to building construdion, entl euthonze representetives of the Ciry ot Costa Mesa to enter upon �he above-described propeRy for inspection purposes. I agree not lo occupy or allow accupancy ot any building euthonzed by this permit until finel�nspecyon. CQOE t. INSPECTIONTYPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spe Finel 200 Final Re-Raot 201 Final Black/Fletaining Well 202 Final Fedory Fire Plece 203 FInelSign 204 Finel Demolition Q�¢ INTRIRLS CODE• INSPECTIONTYPE 206 Final Mechenicel 208 Final Plumbing 210 Final ElecMcal 212 Final Fire Praventlon 220 Finel Plenning Approval 222 Finel Slle 250 Finel Buildinp/Octupancy PeIF 1HI�L$ (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ce.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT Jobnddress: 2897 ELLESMEREAV Suite No Vicinity: Parcel Numher: 13926112 Appliwnt: KEITH DAIGNAEAULT Addr�ss: 8182CENTRALAVE . GARDEN GROVE, CA Owner: BUDDE, LOU Add�pss: 2897 EILESMERE AVE COSTA MESA, CA Contrector: KEIMA CONSTRUCTION INC Address: 8182 CENTRAL AVE GARDEN GROVE, CA Phone: 714-23�-9773 Zip: -92844 Phone: Zip: ,92626-3650 Phone: 714-231-9773 Zip: 92844 License: 850222 Status: ISSUED Applied: 07/11/2005 Issued� 07111/20 ISSUED BY: SCOPE OF PERMIT ADD 69 SF TO THE FRONT OF THE SFD TO CREATE A WALK IN CLOSET. REPLACE SLIDING GLASS DOOR IN LIVING ROOM WITH FRENCH DOORS, F2EPLACE DINING ROOM'S WINDOW WITH FRENCH DOOR, CHANGE OUT 3 WINDOWS IN THE LIVING ROOM, KITCHEN AND BATHROOM. REMODEL EXISTING BATHROOM AND KITCHEN. REF.: B05-00796 MECHANICAL TO INCLUDE: 1 REPAIR/ALT COOLING/HEAT AND 1 HOOD WIMECH EXHAUST. ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Rec�ss Wall Htr Refng Sys <100 k BTU Refng Sys >100 k BTU Gas Piping Factory FireplaCe Hood w/Mech Exhausl VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Hantllers < 10000cfm Air Handlers > 90000cfm Floor Furnace 523.50 50.00 $0.00 $13.70 $0.00 50.00 So.00 50.00 $0.00 $10.65 $0.00 50.00 $0.00 $0.00 50.00 50.00 $0.00 $0.0p $0.00 Quantity 0 0 1 0 0 0 0 0 1 0 0 0 0 0, 0 0 0 0 FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt ReFngeration Unit Ventillation System Evaporative Cooler Commercial Incinerator Dameslic Incineretor Compressors / Absorption Svstems Upto3hp/100kBTU 3 To 15 hp I 500 k BTU 15 To 30 hp /1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Upto3hp 3To15hp 15 to 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Quanlity $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 So.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 NOTICE: The Work authorized by ihis parmit shall comply wlth all applicable handicap access requirements under California statutas and related regulations. (Ord, No. 92-28, § 1, 12-21-92) EXPIRATION: This pertnit 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 ihe work aulhorized under ihis permlt to be considered legal, suc1� work must comply with all applicable calesr�nd all requlred inapectlona and final approval must be obtained. Failure to obtain inspections and final approval will resufl in the ezpiralion of this rtnit. FOR INSPECTIONS CALL: (714) 754-5626 zaae-ae �6roo) WORKERS'COMPENSAnONDECLARArON: I hereby aflirm under penalry ot perjury one o� �he tollowinq declaretions: ❑ I heve end will meintein e certificete ol consent lo self-Insure for workers' compensetion, es provlded for by sactlon 3700 oi the Lebar Cotle, for the pertormence of the work far wNch this permit Is Issued. �-Mave and wlll melnteln workers' compe�set�on insurance, as reqWretl Dy section 3700 oi the Lshor Cotle, for the perfortnence of the work tor w�ich ihis pertnit lv issuetl. �1� workers' compensatlon Insurance rAmer end policy number are: �Policy_N mbec^_lb% %��O ��� ef one hundretl tlollars ($100) or/ess.l ❑ I certify Ihet in Ihe peAormance of Ihe Wo�k tor w�ich Ihis permit is Issued, I s�all not employ any person In eny manner so es to become suDject to the workers' compensetlon lews of Califomie, end egree Ihel II I should become su��ect to the workers' compensetion provislons ol Sectlon 3700 of the Lebor Code, I shell forihwlth comply wilh these.prov' / �IppNeenfSipnat�ure�. '..---� � � � te:---,-%! .���� r ..,� fi� �� WA1iNIN�FILURE TO SECURE WORKERS' COMPENSATIIXJ COVERAOE IS UNLAW FUL MlU SHALL SUB1ECr AN EMPl.OYER TO'CRIMINAL'PENALTIES AND GVIL FlNES UP TO ONE HUNDRED TqUSAND DOLIARE (E/00,000), IN ADDITION TO'TME COST OF COMPENS4TION, DMUGES A$ PROVIDED FOR IN SECf10N 3�OB OF THE UBOR CODE, INTEqEST, AN� ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: under provisions of Chepter B(commencing with Sectlon 7000) of Divislon 3 ot the Business and Professions Code, end my license is In full � 2 'L ida� �/ CDa, le ��ii � .— i EONSTRUCTION LENDING AGENCY: ❑ I hereby eHirtn that there is a consiruction lending egency lor ihe peAormance ot Ihe work for which Ihis permi� is issuetl. (Sec. 3097, Civll Code). LenGefs Name: Lende/s Atltlress: SignaNre: Dete: OWNER•BUILDER DECLARA710NS: I hereby atlirtn ihet untler penelry of perjury Ihat I am E7(EMPT FROM THE CONTRACTOHS LICENSE LAW for Ihe following reamn (Sec. 7031.5, Business antl Professlons Code: Any Gry or counry which requires e pe�it to wnstruct alter, improve, demolish, or repair any structure, pdor to its issuance, elso requires Ne applicant for such partnit to file e signed stetement that he or she is Iloensed pursuant to Ue proNsions of Iha Contraqors License Law (Chepter B(commendng with Sectlon 7000) of Dlvision 3 of tha Buslness end Professions Code) or Nat he 0� she is eaempt therefrom antl the besis tor tha elle9etl exemptian. Any vidation oi Sectlon 7037.5 by eny epplicant for a pertnit sub�ects t�e epplicent to e civil penalry of nat more then tive hundred tlallers ($500).): ❑ I, as owner ot lhe propaity, or my ampfOYees with wages es thelr sole compensation, W{LL DO 7HE W ORK, entl the structure Is not intandetl or ottered for sale (Sec. 7044, Business and Professions Coda: The Conirectors License Lew does not apply to en owner ot properry who builds or improves thereoq antl who does such work himsell or herself or Ihrough his or her own emplayees, proNded ihet such improvements ere not Intentletl or oXered tor sale. If, however, the building or Improvement is sold within one yea� of completion, ihe owne�-buildar will heve t�e burden ol proving that he or she did not 6uiltl or ImD�ove for purpose of saie.). • ❑ I, es owner of the proDerry, am E%CLUSIVELV CONTRAC7ING WITH LICENSED CON7RACTORS to construct the project (Sac. 7044, Business and Professions Code: The contrectors License Law do�s not apPly lo en owner ol property who builds or Improves thereon, entl who con�wcis lor such pro�ed wit� a wmredor(a) license pursuant to the Contractors Lice�se Laws.). ❑ I em exempt untler sec. Businass end Protessions Cade for this reason: SlgneWre: Dete: Owner ID verified by driver's licanse. ❑ �es ❑ No DriveYs License No. Vedlicatian oi Ownership by (type oi tlocument, i.e. - properry �ax blll or AeeO): E�ires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTFICATION: ❑ 1 hereby cenify that no exwvation flve (5) or mora teet In depth into which a person is required to descend, wlll be mede in connectlon with work euthorizeO by Ihis pertnit, and that no building structure, sceHdtling, falsework, or demolition or tlismantling Ihereoi, will be more than Ihirty-six (38) feat high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ti11e 8, Calllomla Administrativa Code). ❑ As owner-builder, I will not employ anyone to tlo work w�lch would require e pertnit trom the Division oi Intlustnel Satety, es noted ehove, unless such person has e permil to do such work from ihe division� Signatura: Date: Division o1 Intlustrial Sefery Pertnit Number: CERTIFlCATE OF COMPLIANCE IW� AlITT10R¢ATION OF ENfAY: I certify under penalry ot perjury that I have read this epplication antl stete that the intortnetion given is wrrect. I egree ro wmpy with all state laws end ciry ordinances relating to building consWction, end euthodze representetives ot tne City ot Cosla Mesa to enter upon the abova-described property tor inspedion purposes. I egree not to occupy or ellow occupancy of any building autharized by this permit until final ins0ection. COUE �. INSPECfIONTYPE 1616 Fizetl System Final Fire Prevention 1268 200 201 202 203 204 Pool Spa Final Finel RaRoo1 Flnai BIocWReteining well Flnal Fectory Fira Placa Final Slpn Finel Damolition Qejf, ��$� f�QQE,( INSPECTIONTYPE 206 Final Mechenlcal 208 Final Plumbing 210 Final Eleciricel 212 Finel Fire Prevention 220 Finel Plenning Approval 222 Flnel Slte � 250 Flnel BulltlinglOccupancy ,, ,., , � �_. � . �,. ,. ,,, , � ____ ......._..___._ ...___ -- -- Job Address: Suite No Viciniry: Parcel Nunmber: Applicant Addres5: Owner: Address 2897 ELLESMERE AV 13926112 KEITH DAIGNAEAULT 8182 CENTRAL AVE GARDEN GROVE, CA BUDDE,LOU 2897 ELLESMERE AVE COSTA MESA, CA ELECTRICAL PERMIT Convacmr. KEIMA CONSTRUCTION INC Address: 8182 CEN7RAL AVE ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 7000a Motors to 1 hp MotoB to 10hp Motors to SOhp Motors to 100hp Molors over 100hp GARDEN GROVE, CA Phone: 714-231-9773 Zip 92844 Phone: Zip: 926263650 Phone: 714-231-9773 Zip: 92844 License: 850222 Status: ISSUED Applied: 07/11/2005 Issued: 07/11/2005 ISSUED BY: SCOPE OF PERMIT ADD 69 SF TO THE FRONT OF THE SFD TO CREATE A WALK IN CLOSET. REPLACE SLIDING GLASS DOOR IN LIVING ROOM WITH FRENCH DOORS, REPLACE DINING ROOM'S WINDOW WITH FRENCH DOOR, CHANGE OUT 3 WINDOWS IN THE LIVING ROOM, KITCHEN AND BATHROOM. REMODEL EXISTING BATHROOM AND KITCHEN. REF.: BOS-00796 ELECTRICAL TO INCLUDE: 10 LIGHT FIXTURES, 20 OUTLETS, AND 10 SWITCHES. $23.50 $0.00 $0.00 so.00 50.00 50.00 $11.00 $22.00 $11.00 $0.00 50.00 50.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 10 20 10 0 0 0 0 0 0 0 0 0 0 FEESUMMARY Temp Dist Syslem / Lighling Buswayl700ft Standing Section �Misc ElecUical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up l0 100 kva/kw ..................over 100 kva/kw Low Voltage EQuipment Low Valt Winng Syslem / Ckt Misc. Conduit �Misc. Conductor Cirws ( gen or nde) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Quantity 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 $0.00 0 $0.00 NOTICE: The work authorized by lhis permit shall comply with all applicable handicap access requiremenis under Calilomia statutes and releted regulations. (Ord. N0. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspende abandoned tor a period of 180 days. INSPECTIONS: In order for tha work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all raquired Inspeetlons end final epprovel must be obtained. Failure to obtain inspections and final approval will result in the expiralion of this permit. FOR INSPECTION$ CALL: (714) 754-5626 , ri..�y.,:rs+;.:n� WORKERS'COMPENSATON DECLARATON: I hereby aHirtn under penelry of perjury one of ihe following tlecleretlons: ❑ I heve end wlll melntaln e certiflcate at consent to setl-Insure tor workers' compensatlon, es provitled lor by section 3700 ot the Lebor Code, for Ihe peAormence af ihe work for w�ich Ihis permit is Issuad. .�t�.�d J�eve end will maintain woAcere' compensation Insurence, es requlre0 by sectlon 3700 of the LaDor Cotle, for Ihe pertormence of Ihe work tw whiU this peimit Is issuetl. �,--� y,WOAcers' compensation Insurence carrier entl policy number are: .c�a� .�s"S'T.rr.s- ' f�....=. e�.r�,;�;o��--./ 6Z 7/a 6-u 6 }:Th�ection need not be campletetl i! Ne pemut is valuetl er one nundred dWlars ($t00) or less.) �;.�—' ❑ I certity ihat in t�e peAormance of tha work for w�ich Ihis pertnit is issued, I shall not employ eny person in any manner so as to become subject ro the workers' compensatlon laws of CalHomle, en ree ihat ii I shoulC become suE�ect to the workers' compensetion provislons of Sectlon 3700 oi tha Labor Cotle, I shall lonhwilh comply with Ihese provisio . ��pyp'gIlc�ent�,Sipneture:" ..�__ . . �---Dete:=���/1— N'(� 11J0`��ALLURETO'SECURE WORKER$' COMPENSATIIXJ COVERAOE IS UNUW FUL AND SMALL SUBJECT AN EMPL�OVEq TO CFIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED THOUSPfJD OOLLFRE (E100,000J, IN ADDITIIXJ TO THE �ST OF COMPENSATION, DMMGES PS PROVIDED FOR IN SECTION 3]OB OF THE LABOR CODE, INiEPEST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I �ereby effirtn ihat I em licensed under provisions of Chapter e(commencing with Section 7000) af Dlvision 3 of ihe.Business end Pmtessians Code, and my Ilcense Is in full �en e�Lk. a � z 2 L Class M. "� � '.' .: . . C�jOWrectoY&�S�gneNre: � � "p re--'7 _/i �Q �� � CONSTRUCTION LENDING AGENCY: ❑ I hereby aXirm that ihere Is a constmction lending egency for ihe peAormance oi lhe work for which ihis permit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lender's Address: Signeture: OWNER-BUILDEH DECLA(iATONS: Date: I hereby aflirm that untler penalry ol perjury Ihel I am EXEMPT FROM THE CONTRACTORS LICENSE LAW far the following reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or wunry whic� requlros e permit to construct, eller, impmve, tlemolish, or repeir eny strucWre, pnor lo its issuance, elso requires the applicant lor such pertnit lo flle a signed stetement that he ar she Is Ilcensed pursuent to �he pravisions oi Ne Contreclors Llcanse Law (Chepter 8(commenUng wlth Section 7000) of DlWsion 3 of the Buslness antl Professions Gode) or that he or she is axempt theieirom end the basis far the elleged exemption. Any Nolatlon of Sectlon 7031.5 by eny epplicent for a pertnit suD�ecis iha applicant to e civil penalry af not more than live huntlred tlollars ($500).): ❑ I, as owner oi ��e D�aPerty, or my employees with wages as their sole compensa�lon, WILL DO 7ME WORK, and the structure Is not Intended or oHered tor sele (Sec. 7044, Business antl Professions Code: The Contrectors lJcense Law tloes not apply to an owner of property who builds or improves thereon, and who tloes such work himselt or herselt or through hls or har own emplayees, praWded Ihet such improvements ere noI Intentletl or oflered tor sale. N, howevar, the building or Improvemem is soltl within one year of completion, �he owner-builder will heve the burtlen of Droving Ihet he or she ditl not build or imDrove for purpose ot sale.). • ❑ I, as owner ot t�e pmperty, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sac. 7044, Business and Professions Cotle: The contreMors License Law tloes not appy to en owner o1 property who builtls or Improves lhereon, antl who wntracls lor such prqect with e coniractor(s) license pursuant to tne Contractors License Laws.). ❑ 1 em exempt under 5ec. Busineu and Profession5 Code tor this reason: SlgnaNre: Da�6: Owner ID verifiad by dAvefs Ilcense. ❑ Yas ❑ No Drivefs License No. Eapires: Veriticetion of Ownershlp by (type ol document, i.e. - property tex blll ar aeetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby ceriify that no escavetlon five (5) or more teet in depth into which e person is required to descend, will be meCe in connection wiih work euthoAzed by this pertnit, end that no building structure, scattolding, telsework, or demolition or tlismantling thereol, will be more then Ihirty-six (38) leet high. (Chep. 3.2, Grp 2, Art 2, Sec. 341, Ttle 8, Celifomla Atlminlslra0ve Code). ❑ As awner-builder, I will not employ enyone to do work which would require e pertnit irom I�e Divislon oF Industnel Sefery, es noted ebove, unless such pereon hes a pertnit to do such work from Ihe tliWsion. SigneWre: Date: Divisian at Industnel Safery Pertnil Number: CER7IFlCATE OF COMPLIANCE ANO AUTHORIZATON OF EHTAY: I certify under penelry of perJury ihet I heve read thls epplication end stele that the Infortnation given is correct. I egree to comply wii� ell stete lews end ciry ortlinances releting to buil0ing constructlon, end authorize represenletives of Ihe Ciry of Casta Mese to enter upon the ebove-tlescribed properry for inspection purpases. I agree not to occuDY a� allow occupency of any building euthorized by this permit until finel inspection. COUE I. INSPECTIONTYPE 1616 Fixed System Finel Fire Prevention 126fi Pool Spe Finel 200 Final Re-Roof 201 Finel BIocWReteining Well 202 Final Fedory Fire Plece 203 Finel Sign 206 Finel Demolition Qdj[ ��$ CO�E! INSPECTIONME 208 Final Mechanical 208 Finel Plumbing 210 Final Electrical 212 Finel Fire Preventlan 220 Final Planning Approval 222 Finel Site 250 Flnel BuildlnyOccupency QAiE It�ELi z.' 1 'Qi �i m (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92826 BUILDING PERMIT Job Address: 2897 ELLESMERE AV Suite: Vicinity: FRONT OF SFD, KITCHEN AND BATH Primary Occ: R3 Dwellings/ Cong Res <10 Type of Construction: V-N Parcel Number: 13926112 Zoning: R1 Applicant: RUDY JUREACK Address: 2035� IRVINE AV STE 5 NEWPORTBEACH,CA Owner: BUDDE, LOU Address 2897 ELLESMERE AVE COSTA MESA, CA Contracror. KEIMA CONS7RUCTION WC Address: 8182 CENTRAL AVE Arch : Address: Zip: GARDEN GROVE, CA Zip: 92844 Phone: � - License: 0 Phone: 714-545-2263 Zip: 92707 Phane: Zip: 926263650 „ Pbone: 714-231-9773 �License: 850222 Eng: Address: Status: ISSUED Applied: 05/18/2005 Issued: 07/11/2005 ISSUED BY: Phone: License: . SCOPE OF PERMIT ADD 69 SF TO THE FRONT OF THE SFD TO CREATE A WALK IN CLOSET. REPLACE SLIDING GLASS DOOR IN LIVING ROOM WITH FRENCH DOORS, REPLACE DINING ROOM'S WINDOW WITH FRENCH DOOR, CHANGE OUT 3 WINDOWS IN THE LIVING ROOM, KITCHEN AND BATHROOM. REMODEL EXISTING � BATHROOM AND KITCHEN. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspeotion: Total: $353.11 $543.25 $4.00 $0.00 $0.00 $0.00 $900.36 SETBACKS �� � , MAINSTRUCTURE Front� 0-0 . ACCESSORY Front 0- 0 � PARKING Existinq: o Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING-& ZONWG Left 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right � . � 0- 0 $ao,000.00 sao,000.00 NOTICE: The work authorized by this p6rmit shall comply with all applicable handicap access requiremenis 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. INSPEC710NS: In order for the work authorized under this permit fo be considered legal, such work must comply with all applicable code d all requlred inspectlons and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot th' rmit. FOR INSPECTIONS CALL: (714) 7545626 2aasas (r✓oo) WORKERS'COMPENSATON DECLARAnON: - I heraby aNirm untler penelty oi perjury one of the tollowing tleclarations: ❑ I have end will malnteln e certificete of consent to self-Insure for workers' compensetion, as provldetl for by sectlon 3700 of the Labor Coda, for the pertortnence of Ihe work lor which this pertnit is issued. ❑ I have antl will maintain woAcers' compensetion Insurance, as requiretl by secUon 3700 of the Labor Code, for the peAortnance of the work for whlch Ihis pertnit Is Issuetl. ��'�.M1y workers' crompansation Insurence carner and policy number ere: �,a�;�_ Sr� m– �—� Po icy: Ni" mbei �sY,. �( Z�i o G- 0 6 �;Rry's.sectlon need nof be canplered i/ the permit is valued et one hundred dollers ($100) ar /essJ �` '�'—� � ❑ 1 certity t�at in Ihe pertortnance oi the work for which this pertnit Is issued, I shell not employ any parson in any manner so es to become subiect to the workers' compensetion laws of Cfllifomie, d'�grS that it I s�ou10 become subjed to the workers' compensation proNsions of Sectlon 3700 ot t�e LeDor Code, I shell to�hwith compl� hege proyision AuditafilqSipnelurei.�.• -;�' �'' � �� �..-,[3ele:� ?/ � S WA�INGi FA RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMGIOYER TOORIMINAL PENALTIES AND GVIL FINES UP TO qJE HUNDRED TFKKISAND DOLURE (5100,000�. IN ADOrtION TO THE COST OF COMPENSNTION, �AMAGES AS PiIOVIDED FOR IN SECTION 3]O6 OF THE LABOR CODE, INTEREST, ANO ATiORNE'fS FEES. LICENSED CONTFiACTORS DECLARATION: provisions ot Chapter 9(commencing with Sectlon 7000) ot Division 3 of the Business and Pmfessions Code, and my license Is In full z z . ,;�_ � ,.� R / CONSTRUCTION LENDING AGENCV: ❑ I hereby affirtn Ihet ihere is a conslruction lending egency for the pertortnance ot Ihe work tor which �his permit is iuued. (Sec. 3097, Civil Code). Lenders Name: Signature: _ OWNER-BUILDER DECLARATONS: Lendefs Adtlress: Date: I hereby ettlrtn ihat under penalry of perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or counry whic� requires e permit to consWct, alter, improve, demolish, or repair any strucNre, prior to its issuance, also requires Ihe applicant for such pertnit to Ole e slgneA stetement ihet ha or she is Ilcensed pursuant to the proNsions of the Contreclors License Law (Chepter 9(commencing with Section 7000) of Dlvislon 3 of t�e Business end Professions Code) or that he or sha is exempt tharefrom end the besls for the alleged eaemption. Any violation of Sedion 7031.5 by eny applicant for a pertnit subjecis ihe epplicant to a civll penalry of not more ihan five hundred dollars ($500).): ❑ I, as owner of ihe properry, ar my emplayees with weges as their sole compensatlon, WILL DO 7ME WORK, end Ihe structure Is not intended or oflered lar sale (Sec. 7044, Business and Professions Code: The Contractors License Lew dces not epply to an owner of property who builtls or improves thereon, end who tloes such work himselt or herselt or ihrough his or her own employees, provided that such improvemenls ere not intendetl or oNered for sale. N, however, the builtling or improvement is sold within one year oi completion, the owner-builder will have ihe 6urtlen of proving Ihet he or she did not build or improve for purpose of sele.). � ❑ I, es owner of the properry, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the proJect (Sec. 7044, Busineu antl Professions Cotle: The contractors Licensa Lew does not epply to en owner of pmperry who builds or improves thereon, entl who contracis for such project with a contractor(s) licanse pursuant to the Conirectors License LewsJ. ❑ I am exampt under sec. Business end Professions Code for this reason: Signature: Data: Owner ID verifietl by tlnver's license. ❑ Yes ❑ No Dnvals License Na. Expires: Venfication ot Owners�ip by (type ot Uocument, i.a. - property tac bill ar deed): DIVISION OF INDUSTRIAI SAFETV PERMIT CERTIFICATION: ❑ I hereby certity ihat no excavation five (5) or more feet in depth imo which e person is requiretl to tlescend, wlll be made in connection with work euthonzed by ihis permit, antl ihat no building siructure, scaftolding, falsework, or demolition or dismantling thereof, will ba more than thirty-siz (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, 71tle 8, Califomla Adminisiretive Code). ❑ As owner-builder, I will not employ enyone to do work which would require e permit from the Dlvision ot Industrial Safery, es notetl aDova, unless such pereon has e permi� lo do such work irom the division. Signature: Date: Division of IndusMal Satery Permit Number. CERTIFlCATE OF COMVLUWCE AND AUfNORVATION OF EMRY: I certiry under penalty ot perjury that I have rea0 this application antl siate that ihe informetion given is conect. I agree to comply with all state laws end ciry ortlinences relating to builtling construction, antl authonze representatives ot �he Ciry oi Coste Mesa to enter upon Ihe above-tlescnbed property for inspection purposes. I agree not to occupy or eilow occupency of any building authorized by this pertnit until final inspection. COOE �. INSPEC770NTYPE 1676 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 FInaI8locWRetaining Well 202 Flnal Fectory Fire Plece 203 Flnel Slpn 204 Flnel Demolltion ,. .uuI.1F. LOOE� INSPECTIONTYPE 206 Final Mechenical 208 Final Plumbing 210 Final Eleclrical 212 Final Fire Preventlon 220 Flnal Planninp Approval 222 Flnel Slte 260 Flnel BulldlnplOccupancy Pdlf. 1.Sc=L� 1t�L@ (714) 754-5273 • Fan (774) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 2897 ELLESMERE AV Suite No Vicinity: , Parcel Nunmber: 13926112 � Applicant CANDY NOCK Address: 11612 KNOTT ST SUITE 217 GARDEN GROVE, CA Owner. BUDDE, LOU Address 2897 ELLESMERE AVE COSTA MESA, CA Contractor. NOCK PLUMBING Address: 11612 KNOTT ST SUITE 217 GARDEN GROVE, CA Arch / Eng : Address: CHANGE OUT WATER HEATER ISSUE FEE Backflow irtigation Backflow Preventer Bathtub Clarifier System , Connect (Ice,Soda,etc) , Dental UniLs � Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Foun�ain Expansion Tank Gas Earthquake Valve AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 30.00 $0.00 $0.00 $0.00 $0.00 Qn PLUMBING PERMIT Phone: (714) 8951246 Zip: 92841 Phone: Zip: "926263650 Phone: (714)895-1246 Zip: 92841 License: 707775 Phone: Zip: License: SCOPE OF PERMIT FEE SUMMARY, , " AMT Laundry Tub / Washer $0.00 Landscape Irtigalion $0.00 P-Trap $0.00 Pressure Regulalor � $0.00 Process Piping (per 70 ft) $0.00 Receplors , $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, Floor "" " �$0.00 Qn 0 0 0 0 0. 0 0 0 0 0 0 0 0 0 Status: ISSUED Applied: 08/04/2004 Issued: OB/05/2004 ISSUED BY: AMT Sump Pump $0.00 Swimming Pool $0.00 Trap Primer � $0.00 . Urinal- i "- � / $0.00 Vaaium Brkr Bkflow(1'-4)� 50.00 Vacuum Brkr BkFlow(5+) $0.00 �. . Wash Basin " $0.00 � Wasti Basin Set� $0.00 Waste and Vent System $0.00 Water Closet (Toileq $0.00 Water Heater / vent $12.30 ,.- Water Piping (Inst or Rep.) $0.00 Water Re-pipe $0.00 Water Service $0.00 on 0 0 0 0 0 0 0 0 0 0 1 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 ezpire and become void if work Is not commenced vnthin 180 days, or il work is suspended or abandoned for a period of 1 BO days. INSPEC710NS: In order for iha work authorized under this permit to be considered legal, such work must comply with all applicable cotles, and all requlred inapectlona 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 2448d8 (N00) WORKERS' COMPENSATION DECLAHA770N: - I hereby aflirtn under penalty ai perjury one ot t�e tollowing declarations: ❑ I entl wlll mainteln e certiticata ol consent to self-Insure tor workers' compensatlon, es proddetl tor by section 3700 0l the Lebor Cotle, tor the pedarmance of the ork tor which this permit Is issuetl. I have antl wlll melntaln workers' Compensation insurance, as required hy section 3700 of Ihe lebor Code, tor Ihe peAortnence of ihe work for which this pertnit Is Issued. My workere' compansatlon Insuranca carner enC policy number are: Carrier. Policy Number. (Th/s sectlon need nof be comp/eted i/ the peimit is ve/uetl at one huntlred dollars ($100) or /ess.) ❑ I cenity Ihat In the pertortnance oi the work for which this pertnit is issued, I shall not employ eny Derson in any menner so s to become sublect to the workers' compensalion lews ol Celifomia, and agree that If 1 should become sub�ect ro the workers' compensetion provlsions ol Se ion 3T 0 of the Labor Cotle, I shall forthwlth comply with Ihese provlslons. �1 Applicent Signeture: ��J� Dere: v WARNINO: FAILURE TO SECURE WORKERS' OOfdPEN5AT10N COVERAGE IS UNLAWRIL AND SHFLL SUBJECT Ml EMPLOVER TO CFIMINAL PENALTIES N D CNIL FlNES UP TOONE HUNDRED THOUSAND DOLLARE (5100,000�, IN ADDITION TO THE WST OF WMPENSATION, DAMAGES AS PROVI�ED FIXi IN SECTION 37060F THE UBOR WOE, IMEPEST, PND ATTORNEI"S fEES. LICENSED CONTRACTORS DECLARATION: I hareby aHirtn that I em licensed under provisions of Chapter 9(commencing with Section 7000) ot Division 3 of the Business and Pmfessjpns Code, and my license is in full fome and eHect. Lic. N Class A .-// Contractor's Signature: �T• Date: . �O CONSTRUCTION LENDING AGENCY: ❑ I hareby attirm thet there is a conslruction lending egency for the pedormance of ihe work for w�ich Ihis permit is issued. (Sec. 3097, Civil Code). Lendar's Neme: Lentler's Address: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereDy aHirm thet untler penalry ot per�ury t�et I am E%EMGT FROM THE CONTRAC70RS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business antl Professions Code: Any ciry or counry w�ic� requires e permit to construct, alter, improve, demolish, or repair any structure, pdor to its issuance, elso requires ihe epplicant for such pertnil b flle e signetl stetement t�et he or she is Ilcensed pursuent to Ihe provisions of the Contrectors License Lew (Chepter 9(commencing with Sectlon 7000) of Divislon 3 of Ihe Business end Prolessions Code) or thet he or she is esempt therefrom and the besis tor tha ellegetl exemption. Any violatlon of Section 7031.5 by any epplicenl for e permit sublects the applicent to e civil penalry ot nat more then fiva hundred tlollars ($500).): ❑ I, es owner ol the property, or my employees with wages as their sole compensation, WILL 00 THE WORK, enC ihe siructure is noi intended or oHered for sele (Sec. 7044, Busineu enC Professions CoOe: The Coniractors License Law does not apply to en owner of property who builds or Improves thereon, and who does such work himselF or hereelf or thmuph his or her own employaes, provided that such Improvements are not Intended or oHered for sale. tl, however, Iha builtling or improvament Is sold wiihin one year of completion, ihe owner-builtler will have ihe burden ol proving that he or she did not huild or improve for purpose of sale.). � ❑ I, e5 owner ot the proDerry, Bm E%CWSNELY CON7RACTING WITH LICENSED CONTRACTORS ro con5�rutt ihe project (Sec. 704a, Business and Proleuion5 Code: The wntrectors Llcense Lew tloes not appy to an owner of pmpeny who builtls or Improves thereon, and who contwcts br such pmjem with a contractor(s) licanse pursuem to the Contractors License Lawa�. ❑ I em exempt under 5et. Business end Professions Code for t�15 ree5on: SigneNre: Date: Owner ID venfie0 by tlriver's Ilcense. ❑ Yes ❑ No Dnvefs License No. Venficatian oi Ownership by (type of document, i.e. - proparty tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTFICA710N: Expires: ❑ I hereby certiy ihet no excevatlon Ove (5) or more fest in depth into which e person is required to tlescend, will be made in connection with work euthorized by this permit, end ihat no building structure, scaflolding, talsework, or tlemolitlon or tlismantling ihereot, will be more ihan thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle B, Cellfomia Atlministrativa Code). ❑ As owner-bullder, I wiil not employ enyone to do work which would require a parmlt trom the Division of Indusirial Seley, as nored above, unless such person hes e permit to do such work from the division. Signature: Date: Division oi Indusiriel Setety Permit Number: CER7IFICA7E OF COMPLIANCE AND AUTHORIZA710N OF ENTAV: I cehify under penatty of perjury thet I heve read ihis epplication antl state Met ihe intormation givan is correct. I egree to wmply with ell state laws end ciry ordinances relating to 6ullding consWctlon, end authodze representatives ot the Ciry ot Costa Mesa to enter upon the above-descnbetl property for inspection puryoses. I egree not to occupy or ellow occupancy of any building euthonzed by ihis permit until final inspection. ��� ture gal Owner(s) ' � AnNOr Auihonze Applicent COOEI, MSPECTIONTYFE 1616 Fixed System Finel Fire Praventlon 1266 Pool Spa Finel 200 Flnel RB-Root 201 Final BIocWRetaining Wall 202 Final Fectory Fire Plece 203 Finel Sign 204 Finel Demolition o"re 1NiIDSLff CO�E 1 INSPECTION TYPE 206 Finel Mechanical 20B Finel Plumhing 210 Finel Electdcal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency P� ItRIDlLS • •• L. I Pfl0.1ECTRODHE53: ZB9'� ELLESMF.RE AV OWNEN'8 NRME: TI'IOMAS CRANDALL RDOHESS: 14(j'� �LLESMERE �HCMIENOINEEfl: RUGHESS: flE0.N0.: uxir: uxrt: � PENMITTEE: BOB 'MORALE$ ' i 71�i ) 548-4%Si �ooeess: 2526 UNIVERSZTY N.fl. CA 92'660 11LENSEU fANTMLTOB DELIAMTION: I �eaEy aifirm that I am IicenSeG unGer pmvisions of CAapter 9(wmmenrinp witn Sectwn 70� ol Olvislon J OI llle BuSiness anU Pm�e55ion5 CoGC, anU my liCenSe is in lull �orCO an0 efleCi. CITY Ut.: � S711tE uC.: C1A58: Oate: SipnaWm: WONKEflB' COMPENSATION OECUMTION: I Aereby atlirm roat I Aave a certificate of consent m selbinsure or a cetlificate oi Workers' ComDensation Insurance, or a certilie0 copy t�ereoi (Sectlon 3800, Lab. C). Pol1CY ND.: E%P. ORTE: � � COMPRXY: ' ' . � CerlifieE copy is here�y fumis�ed. ❑ Certifie0 copy is IiteO with ihe ciry BuIlEinp Oidsion. Oate: AOVlicani: IXEMPfION FBOM VlOBNEPS' COMPENSITION OECUMTION: (This secnon neetl not be co pletM il Ne permit is lor ona AunG�eG (5100) or lew�. I certity that in the petlormance of the wark Por w�ich this permit Is issue . I stull not ploy any parson in anY anner so as ro bacome suEject ro Ihe WOAcers' Compenution Laws ol Califomia. . Date: � — Siqnatum: NUTICE: If, aRer maNinO tha tleGaraii n. you stwul0 become suhjeci ta ihe Workers' Compenution Drovisions ol Ihe LaEor Cotle, you must PortRxit� cromDN �i� such pmWvons or tNs Dermit stwll Oe GeemeE revokeU. , . CONSTXUC710N 1FN01N0 �GENCY: I here0y aifirm ihat (here is a con5tructiau lentlinq apenry for ihe Derfarmance al [�e work for wAic� I�is pemtit R i55uM (Seciion 3097. Civ. C�. . , lENOEH: aooeess: . .. '. OWNEB BUIIDEB OECIAMTION: I �ereEy atlirm t�all am exem0�immthe Canlraclors' Slate License Law fortAe I011owin0 �eason (Section 7031.5 Business aM Professional Cotla: My ciry nf counry whic� repuiru a permit to construct, alter, im0�ove, GemoLLS�, or repair any structure. pdor to Its iwua�e, aLso reQuires t�e appOrant far such De��� �a ���e a sipneE statement tta� he/she ¢ Ocense0 pursuam io tAe pmvisions of the Contractors State Licenu Law (Chapter 9(commencing with Section 7000) of Division 3 0l tha Busineu antl Pmlusions COEe� or Nat tie/s�e is exempt thereirom anE I�e 6asis for the allepe0 evemp6on. My yiolatlon oi Sectlon 7031.5 Gy any applicani tar a permit wCl� ��e applkant ro a dvil penalry of not more than five �untlretl Oollars (f500): I, as axner of Ihe OroOerty or my employees with wages as thelr sole� compensailon, will ao ihe work, and ihe � StmcNre is not intendeE or offeatl for sale (Sectlon 70Aa, Business anG Professional Coae: The Contractors' State Liansa Law Ooes not apDN ro an ovmer ol a O�oDerty whu UuilUs or Impmves tAereon, an0 who Eoes such woM �imsel8�erself ar IAroup� �is or her awn employees, OwvideE that such improvements are not intenaetl or oifereA for sale. II, however the huil4in0 ar improvement I5 sold within one year oi camDletion, t�e owner will have the burtlen oi pmvin0 he/s�e Uid not �uild or ImD�ove lo� Ine Durpose of satel. . � � I, as owner oi ihe O�operty. am erclusively canirac[inp with Iicense0 coniractors to consimct Ihe pmlecl (Section 7044, Business ❑ an0 Pmle53ian5 CaUe: The Canlraciors' State License Law dces not apDly to an owner oi.pmperry who 6mltls or Impmves Nereon anU who contracts lor such D�ojecls wit� a coniractor(s) license Dursuant to the Contractors' State L¢ense Law). I am aware tAat proof ol t�eir Worker's Campensation insurance s�oultl ba DmnOeU to me. ' � 1 am e�em0� untler Seplon: B. 8 P. C. lor lhis reasan: % \F�'tl J�J W.X.�,IL j Dare: I I' Z( ' e� � l owner. ^' V`v. �..., I Go �emGy certiry that I am awam of antl untlarstan0 ihe requiremenis of Califomia Health an0 Safery CaOe Sections 255Q5, 25533. anE 25531 ana tlat I or any futura euileinq acupant wiluwill not (circle one) neeU ta comply witn Saia slate m0es an0 the reQuirements for a pemnl for wnsiructbn or maOiliwtion Imm t�e Nr Oualiry Manaqement Oistrice FevOentul constmctbn apDlia6ons are exempt Irom tAeu pmvisions. Date: Apptiwnt: 1 �ere0y certity t�at I �ave rea0 tAis a071iwtion an0 state tAat tAe above information is wrrect. I aprea ro comDly vnt� all ciry an0 counry Ofdinances an0 State lavrs relaWp IO CuilEinq wnslNctian an0 here6y aNhona r presenUuve50t tl� ary Io enl¢r u0 the aUwe�mEntion pmperty lor inipection purpoSAeS.c� Oate: � � — � � —O 1 (qnaNre: � Dnver's �icense or Sociai Secunry 18abC6 Wl�i�e—Buikirq: Green—CaEa Enlorcemem: Cenerv—Molicant: Pink—Ravenue; GdEenraC—Assesaor � CITY. OF COSTA MESA — BUILDING PERMIT PERM NO: E 045095 PERMIT NO: E 045095 PLAN CFIECK NO: , N GOVT: N SUPP: N CONSTRUCTION TY.PE: PERMT.T TYPE: ELE PURPOSE: REP JOB DESCRIPTION : ELECT WIRING SQ FT: ' CLAIM VALUE: CALC—VALOE: • GROUP OCCe R-3 / COMMENTS: REFER TO BUILDING PERMIT #H94627 ***********�***+�*�e****+�**�**+r�*x��r*�*x **�**���**���*�**�*�+�'+r*+��**********+��*����� Z O N I N G R E Q O 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; FT IN REAR: FT IN LEFT: FT IN RGHT: FT , IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 13926112 ZNE: . `REF NO: � PLANNING NOTES> � > * iE iE it �E iE iE iE �k if iE iE 3E iE 1E iE af if IE iF 1E iE iE �E ik IE It ik 1F ik ih it ik it iE if if if iF iE k k 1E iE iF iE iF 3E if if if if !f iE it ik if iFdE iE it if iF 3E iE �1E 3E iE iE iE �E iF iE ik if iE iE iE iE 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 iLONING APPROVED BY . BUIliDING APPROVED BY : � DATE: nATE': APPLICATION ISuUED BY: �J}} DATEe �1'—�-1'—P5� *it�x�x�**�*it*�x�it�*iEatatit*it*3F'iFTF'SFiFTFiF3F7F3F�FiF'3F�F3F3F aF7FlF3F'iFiF3FiF"iF'3F'iF'�F3F3F'R"ifif3Fx�*itat****iE*iF�F3F�FiFiFiF3F7Nit�iE iE �! i6 ik 1k fk iE 1f it )F iE if iE iE 3t iE iE iF iE iE IE IE 3E iE iE iE �E iI� iE aE iE iF if ik if iF iE it if iE iE iE iE iE it ik if 1t iF IF ik it 1t k iF iE iE iE if iF 3E iE iE iE iE iE fE iE jE aE iE 1E iF iE 1E iE iFif dE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N DLDG PMT FLUMBING ELECTRIC. MECHANIC FIRE SMIP/RES GRADING PERMIT 15 . 0,0 . 503 SMIP/NON—RES eLan� � ISSUE FE� 15.00 'BUII,DIidG—DIV—> PERMIT TSSUE 'PLAN—CHECK TOTAL PAID DUE ,TOTALS----> 15.U0 15.00 . 0.00 30.00 J0.00 ,00 REPENUE DIVISIODI TOTAI�S--> COLLECTED: 90.00 OVEA/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANZC FIRE SMIP/TOT GRADING PLAN—CHECH 30.00. �, iE iE iE if �lE iE iE iE if # if if if 3E IE jF 3E it iE iE if iE iE iE i(� )E i(-1E fF iE �)E iE iE iP �E iE �E 3E iE 3E iF iE 3E if K fElE iE jEiE iE k if iE df 1E iE iE iE ff iE �)E IE # 3E iE 1E iE �E M �E i6 3E fE iE 3F * iE iE I N D I V I D U A L: F E E H R E A K D O W N TYPE (�TY D E S C R I P T I O N�-' UNIT COST TOTAL COST � ELE 1,7 RECEPT/OUTLET 1-:ST 20 EA. .75 ELE 9 RECEPT/SWITCH �� 1`ST 20 EA. .75 ELE 1 RES APPLIANCE NOT OVER�' 1.0 HP 3.00 END 'OF FEES .� " `J 9.75 2.25 3.00 0 � CONSTRUCTION AND PLANNING . POO. .iPA '. APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd.- ' 53. Steel Reinforcement � - ,_3. Electrical Conduit Utility-Undrgrnd. 54. Forms . � "4._Electrical Conduit=Undrqrnd. ; ' 55. Electrical Bonding , "� '..5: Steel Reinforcement ' 56. Rough Plumbing & Pressure Test � ���6. ElectricalUFEFi'Grnd. 57. APPROVALTOCOVER-GUNITE _ =� 7. Footings � 58. Electrical Conduit�Undrgrnd. "�8. Foundation -- 59. Gas Pipe, O Undrgrnd., Test � '� 9. Water Pipe�Undrgrnd. _ 60. Backwash Lines. P�Trap, D Undrgrnd. ,, 10. Structural Floor System 61. APPROVAL TO DECK � 11. Property Sewer Line & House Connection ,__ 62. Backwash & Receptor-F�inal' �,. � -�, 12. Sewer Cap � , 63. Heater & Vent-Final • 73. Roof Drains -' . 64. Plumbing System - Final �'� 74. Rough Plumbing ' 65. Electrical-Final � -� '� � a 15. Rough Electrical-Conduit ',� 66. Solar System-Final . 16. Rough ElettrirWiring � 7. Fencing & Access Approval " 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ' 19. Rough Heating & Air Conditioning _ „ .FIRE.DEPT. FiEQUIREMENT 20.-Rough Factory Fi�eplace : , APPROVALS�. Permit# 21: Dutjs, in Structuce ' :- - ` ���70. Underground Hydro � - 22.Oucts,Ventilating-� � _� ♦. �71, Product'�PipingOGas ❑Oil ' 23. Gas-Pipe-.Rough &.Test _ _ � :_ _ _ ' '7y, Undeiground Flush " 24. �Roof Framing . � ' � 73: Undergrnd. StorageTank � Gas ❑ Oii 25. Roof Sheathing ' "� � ' 74. Overhead Hydro .. 26:�T•Bar Cei��ng (Structural) &'Monocoat .. �� 75. Dry Chemical - � - - - 27. Frame and Flashing � - ' .: g 76. Dry Standpipe ��� _ � '28. Lathing & Siding_ , ' _ " � � 77. FIXED SYSTEM FINAL _ 29. Insulation _ - ' . ' - 78.; FIRE PREV. FINAL . ' ,: ' 30. Drywall Nailing �� . a... � ;. � � HEALTH OEPL. REQUIREMENT 31. Plaster B�own Coat� ' " �: � 79. FINAL INSPECTION � 32._Electrical Power�M'eter-Final 60. FOOD CER FICATE ISSUED 33. Final Electric ' - �� otes: " , � � -•r 34'. Final He3ting & Ai� Conditioning ' ,; ' � � 35. Final Gas Pipe-Test �� � -� ` r, '• �� ' _'36._ Hood or Canopy ' "' �' , ' ; _. 37. •Final Fattory Fireplace-' � � � r 38. Final Plumbing ' �J � , . 39. Water Service�Final. - � � `. +� � � � , i "40. Gas Service�Final . • � , �' , ' 47. Solar pomesticFinal - , �� r �. � - . � � - 42. Backflow Prevente( � ' � - � i' 43. Backflow Irrigation. � . + �• � 44.. Landsca0e Irripation System:t�: _� � �� - � f : � � ' � .�� 45.�.Sound Attenuation - • � � . . � � �- �� ' � • 46.' Hartdicap Regulations - - • _ - . � �47. FINAL 5TRUCTURE & BU�LDING _ � , � . 48. FINAL PLANNING " ' -, ' 49:, Electric Release to:Edison � � , �- � ' S0: �Gas Release to Southem Cafifornia Gas Co , : '• ; , ' 51. CERTIFICATE OF OCCUPANCY ' No. Date Pfl0.1ECTRODNES3: z8(j7 ELLESMERE AV OWNEfl'S NAME: THOMAS CRANDALL �DOflFSS: z89'� ELLBSMERE pqCN/ENCINEEfl: FDOflE53: uHn: NEO.NO.: � uxrt: PEHMRTEE: HOFi MORALES ( 714 ) 548--4752 aooness: 2526 UNIVERSITY N.H. CA 92660 IItENSEO fAN7MCTOB OECUM710N: I hereEy atlirm that I am Iicense0 unGer provisio�5 of Chapter 9(commencin0 ��� �tion 7000� of DNision 3 otihe Bu4ness antl Pmfessions CaOe, ana rtry Ikensa 'a in Iltorca and effect. ciTr uc.: sr�re uc.: cuss � n.� Oate: � Sipnature: 1��^���e � WOHNENS' LOMPFNSRTION OECIAMTION: I �ereby affirm that I have a cMificate of mnunt to ult�insure or a certi(icate oi Workers Compensation Insurance, or a certifieE coDY thereof (Saction 3800, Lab. C). PoLIC�NO.: EXP. ORTE: COMPRNY: • � Certified copy Is hereby furniSAeE. ❑ CertmeA caOY M«ed wi[h Me cHy BNltlinq DiNston. Date:r PpPlicant: IXEMPfION FliOM WORNEHS' COMPENSIITION UECUMTION: (Ihis sec�iun n,e0 no� wmpletN if ihe permit is for oire AuiMrM (5100� a Iess1. re I certiry that in the perlarmance of tAe wod lor w�ich t�is Oermit is isgued stull i employ any perm in any manner so az to 6ecome sublect ro the Wohers' Compensation Laws�alifomia. � /I . Oate: ��— � ` �� Sipnawm: �'`'�' - � � r NOTICE: II, atler maknB this EecWratio , you s�ould became sppj� to t�e Warkeri Compensation O�avisbns ol t�e La�or CoEe, you mustiotlhvnih comply vnih suc� provislons arthis permit shall he Eeemed revokeC. � fANSTNUCTION lFNOING AGENCY: I �er¢Ey affirm ttwl there is a construction IenGinp apency for t0e peAormance ol the vroM lor which this Dermii is issue0 (Sec�ion 3W7, Civ. C�. , , LENDEN: ' 11DONE33: � ' ' � OWNEB BUIlDEB �ECUMTION: I here�y affirm thai I am exemDt irom the Contractors' State License Law lor the lallowinp reason (Sectian 7031.5 Business ana Professianal COGa: My dry of counry �c� repuires a permit to consWct, atter. imprwe, EemoliU�, or repair any slmcWre, D�ar to As issuance, atm reQuires I�e applican� tor such permit lo file a signeG statemem that �e/s�e ¢ IicenSeG pureuant to Itre Drovisions ol tAe Contrzctors' State License Law (Chapt¢r 9(wmmenciny wiih Section 7000) af Oivision 3 0l the Busineu and Pmhssions CaUe) ar ttwt he/sAe a eeemD� I�erefmm and the Cays lor I�e alleOeU exemptlan. My WOWtion of Section 7031.5 Ey any aDPlicant tor a Oe�mit su�lecls I�e apDlicanl ta a civil penalry ol not mom than iNe hunEreO Eollars (5500). I, az owner of Ihe property ar my employees wit� wapes az t�eir sole compensatlon, will Oo t�e wor�, ane me � stmcture is not imenaee or ottere0lor sale (5¢CUan 7044, Bu5ine55 antl Pml¢SsiOnal Co0¢: Th¢ Con�2tlor5' $Iaie LiCense Law Cces noi appy to an owner oi a pmpeM �o huiWs ar Improves thereon, anE wlro does such woM himSeliPoerull ar t�rou0h his or �er own employees, DmviOed tAat such improvemems are not intenAeO or oBer¢d for sale. It, hawever Ne 6uil4in0 or improvement is solA within one year of com0letlon, iha owner will have ihe Ourden of pmving �e/she tli0 not OuiIE or impmve far Ihe puryase of sale�. • I, ad owner ol ihe DropeM. am excluslvely coniractinp with IitenseU coniractors to constmct the D�olect {Saction 704A, Business ❑ an0 Professions COAe: T�e Coniractors' State License Law Op¢5 not apDN �a an avmer of DropeM � buAAs or improves Nereon � an0 wha cantracis for such pmlacis vnih a contractoqs)lic¢nse Dursuant to the Contrzctars' Staro License Law�.l am awara IAat prooi ol their Worker'S Campenution insuance shoul0 pe DroviEed�ro me. � I am exempt unGer Sectlon: 8. 6 P. C, lor IAis reawn: • � �ate: ' ' Owner: I Uo �ereGy cerliry that I am aware of and un0erstan0 t�a repuiremen�s af Calllomia Healt� an0 Safery COAe Sections 25505, 25533, anG 25534 anC t�at I or any future buit0inp occupant will/will not (circle one) neeA to comply wit� sai0 state cotles aritl the requiremenis for a permit lor constmction or modtlication from ihe ar Oualiry Management DislricL PesiOential consimction aDO����ions are exem0� fmm ihese pmvisions. , . Data: RpplicanC ' I here0y cetliry Ihal I luve read this aOPliwtion anE state that the a04ve information is correct. I a9�ee to comDM ��� all city an0 counry orainarkes ana state lavrs rela[i(p m Ouilainp construRion antl nere�y am rae aD� ����'� ol iNs ciry ta emer upon tAe aEove�mentrone0 property for inspectiorn Durposu. � /� �- , o � � Oate: �.� � Y' 81 Si9naWre: Y�b V�CI w�A�:i�.: oriver's �icense or socia� secur� t89L48 Whita—Building; Greon—CoCe Enlorcemant: C¢nary�qpp�icant; Pink—Revanue; GOWenratl—Assesaor � � CITY OF COSTA MESA —'BUILDING.PERMIT PERM NO: BP 044A48 PERMIT NO: BP 044848 PLAN CHECK NO: 01362-89 S GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: PLU STR PURPOSE: REP JOB DESCRIPTION : REPLACE WALL SHEATHING SQ FT: 500 CLAIM VALUE: 500.00 CALC—VALUE: 500.00 GROUP OCC: R'-3 / COMMENTS: �*�r**�r*��r�r+r*��r�**x x **�r�r+r**,�+��r�**�**�r*�**�r�******�e*��r*+��r*�*�*��t��*���r*�r�*�r��*** � 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: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN PARKING REQUIRED; PARKING PROVIDED: PARCEL: 13926].12 ZONE; PLANNING N15TE5> � if it ik �1E if 1E k IF iE iE i! 3k iE 1k �E 1E IF iE iP if iE ik if if ik if iE iE iE ik iF ik if i! iE IF if iE if iE if iE ik ik if it iF i6 iE 1F ik 1E if ik if iE If iElE iE 1E If iF ik iE # ik iF jk if If 1F iE ik i! �k ik ik 1E D E V E I. 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 JZONING APPROVED BY IJO PiffNfJlf�iL� F�PPtZ.aV/l't N�l�ji DATE: _ HUILDING,APPROVED BY : DATE: APPLICATION ISSUED BY: 25q- DATE: I�D��`�, fliEiEikiFitiElflfffiElEiElEiFiEiElFitiEiEit i�F� 1E3kiliEliikiEififik ifl! IE iE iF if ik ft �t ft iE if iF if k if 1E k iF it M 1E iE 1E iE 1E iE iE if 3E iE iE iF 1E i! if iE M M iE it IE iE 1F iF i! if ik ik 3f if 1k 1E 1F if iE k iE iF If iF iF if it iF 3F if iE if if iE 1E iE 1F if iF iF ik ik iF it LEGALIZATION:N F E E S U M M A R Y STRUCTURP:L'SEGMENT:Y 1 . HLDG PMT PLUMBLNG_ ELECTRIC MECHANIC FIRE SMIP/RES� GRADING PERMIT 15.00. 6.00 50 25Y � SMIP/NON—RES PLAN 9.75 ISSUE FEE 3.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK T`OTAL PAID DUE TOTALS----> 21.50 3:00 9,75 J4.25 34.25 .00 REVENUF DIVISION TOTALS--> COLLECTED: 39.25 OVER/5HORT: .00 . HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 15.00 9.00 ,50 9.75 iE iE it !t iE ik 1E iF 1F iF ik iE IE IE IE If 3E 3f iF 3E iE ff k iE iE if iF iF IF if iE it k iF 1k if if !f iE if if ik if if if iE if iE if k if M k iE iE iF 1F IE iE M iE 1E k iF if k iF 1F �f If fE i! iE iE 3t �f 1E 1E 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 COST TOTAL COST SFR S00 ALTER BY VALOE RESIDENTIAL NOZONE 1.00 500.00 PLU ; ]. SINK, KITCIiEN 2.00 2.00 PLU 9 WATER CLOSET (TOILET) 2.00 2.00 PLU 1, WATER IiEATER AND/OR VENT 2.00 2.00 END OF FEES � . • � . .�_ _t._ i..' _ " " , �' . "' '` ' _ ,.. n CONSTRUCTION AND PLANNING . POO. SRA APPROVALS Permit # (_ �ate Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Seivice,or Pole 52. Pool & Equipment Location � -2 ,.Soil Pipe-Undrgrnd� ' 53. Steel Reinforcement : � ;3-Electrical Conduit��Uiility-U�drgmd. - 54. Forms � 4:-E�ectrical Conduit-Undrgrnd. L� � 55. Electrical Bonding �- '=�5."Sreel Reinforcement • 56. Rough Plumbing & Pressure Test ;.;•6�-ElectricalUFERiG�nd. 57. APPROVALTOCOVER�GUNITE - -iJ,�Footings '� 58. Electrical Conduit-Undrgrnd. ^� -• � ..- �'�8. Foundation j; �t �� 59. Gas Pipe, O Undrgrnd., Test �- ,� 9. Water Pipe-Und�gmd., - � 60. Backwash Lines, P�Trap, � Undrgrnd. -�j � 10. Structurel Floor System 61. APPROVAL TO DECK 11. Property Sewer Line�& House Connection 62. Backwash & Receptor-Final ' 12. Sewer Cap -� _ 63. Heater & Vent�Final �_ 13. Roof Drains � �^. _ y 64. -Plumbing System-� Final � 14. Rough Plumbing 't�� ,:� 65. Electrical-Final � 15. fiough Electric`al-Conduit , 66. Solar SYstem-Final '- : 16. Rough ElectriaWiring 67. Fencing & Access ApProval 17. Rough Wiring Si9n 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19._Rough Heating &.Air Conditioning _,,," ,�- � , � � TFIRE_DEPT. REQUIREMENT .�_. - , 20i-��Rou h Factor Fi're lace " �' . - � ~ �` ^� � =� �� '^ y y P ;r. �;,� ; u : :APPR�QVALS;..iE`-Permit # ^'+� �,,. - 21 �Ducts, in St uct�[e� " ' ; � " �" � : r �70. Undergiound Hydro � �. . 22_Ducts, Ventilating��;: ' t: n �„; x p c77. ProducrP pin9 O�Gas d0il 23.'Gas=Pipe�Rough & Yest _�_ �?.� `' � � - � nF x �7z, Underground Flush'_, '"" _ ♦: . ' .. c ���- .:.:n r: _ r xu _ '� ._. �-�� , v - 24-Roof Framing >. �.�1 ;: -� « + ••73.^,Undergrnd. Storage_T:ank O Gas ❑ Oily 25. Roof Sh`eathing �"', '�� "�" ' k„ � ; � �y y x f.74 �Overhead Hydro- _ '" 26,�T�Bar Ceilin IStructural) &"'Monocoat �,� � ���-� �� - • � - ` 9 .. '_i r. , 75 _Dry Chemical � � � 27-FrameandFlashin- D="": �'.�"' y�:•�" � -_ a' � c"s-c- �^ 9 --�--,.. � �. , 76. Dry StandpiPe � .r : c� c- -^ � J. �W` ' ^ • ' '�� � 77�+FIXED SYSTEM�FINAL- - 28. Lathing'& Sidin9 . -7t, _• ,�� � ' .- - 29. Insulation � ` � _ � : � 78�FIRE PREV. FINA�L � "� " ��,' T ` �' t � �� : "� � HEALTH�DEPTt REQUIREMENT= 30. Drywall-Nai�ling ; r-. r -� r �� a; �c:v _ ^31. Plaster Biown Coat�_ �� n"G' � �- ' �'� a• '79, FINAL INSPECTION �� "'�� r� c.� �� a: x mr. t- �- -'32,Electrical Power Metei-Final � ��' .i �r i, �80:=FOOD CERTIFfCATE ISSUED.~ " -33'Final Electric '� r -� � ^ * � � - � - ' � Notes: � .�y- M m �.r 'i y' r� �e J � ��'1 (. I �:34.`..Final Heating& AiyCon'�itioning' '' � : y' yX. - � � -' {�, . _� 35. �Final Gas Pipe�Testi. "v n+ * i �^ � ' =' ' _ " -- - .-, r_ .1. �,. �36 �Hooii or Canopy �� '~ ,:��, .. `� l'� ' .s s _ :: f.�- � ~ Y -. . �• CC t•l i' � �,: ., f i `.: rJ x- r• . !'- ^37.�Final Factory Fireplace^. ��- '• • "� * '-: �� i� -� �1 r� e� r a' ' -38 _Final Plumbing '� f�.R'(� Lf.`% �`. •,', � �Y'� �� � `�39�Nlater Service:Final:: � . � I - :. � . �� �-- �, r �� .r c-.. , � ri A40.._Gas:Service-Final F h Q�"F � �� � ' �:.,��,. cG �� "',� �� `47: Solar pomestic-Final' ny -j .� ` i i a - , , � - , - c� r-,' - 42.� Backflow Preventer: �' " '� ^ � Y' ✓ -u^ � r r � .J � fi l.,Hty +ti w r M i�.vl. „Y � ._. 43. Backflow Irqgation- � `�`� •i, t' c =� -. � H' - � . -' �. «, - - -^ - o- ;r'C �1 i:�: _ �f '�_X:v: � ^; :i� 'K' ^; -C - �44.. Landscape Irriqation System- �;.: � ` �* t � � � ,_ � - � _ � � a�. =. . . -• .. ,_, ,- , - '= _ ' - '45r?Sound �Attenuation ti~ •• � r . [:.�• +� - ^ - <"� -' , 46.' Handicap Regulatiohs ^' �� .� " i` T� x � �°� �- � �. 'J !' 1] ��47'�FINAL STRUCTURE & BUI'LDING� �' � ` �� � �� . .-� ti �� y48�FINAL PLANNING �'E" •• '� �" ' '' r. ,; r:� a; f :• L �. i: : r . 1 f� . �;,49.: Eleciric_Release to,Edison ' r � � �- �x ,j 4; w � . - r - -50�Gas'TRelease to 5outhem California GasCo '•" n� ^ • �n ' -` r � •� � • ..i n -. � a: .4: ^ 5 ��'t.� '� iJ c� O G? '�51. CERTIFICATEOF'OCCUPANCY •' � " � ' "' ` No. Date Pfl0.1ECT�ODflESS: z(�(�'� tiLL£SMERE AV OWNEX'SNRME: 1HOMAS CRANDALL ROOHESS: zO9% F.LLESMERE �ptXIFNGINEEN: A9DNE33: flE0.N0.: UNIT: uxrt: PEflMITTEE: BOH MORAL�S ( 714 ) 548-4752 pDDflE33: zSZG UNIVERSITY • ' N.B. CA,92660 ULENSED CONTMCTOP OFCIAlUT10N: I hereby affirm ihat I am IicenSeE under pmvtsions al COaDter 9(cammencln0 ��h Sectlon 7000) ol Divisbn 7 al Ille Bu51neS5 ana ProleiUWiS CpOe, anG my IICenSe LS in lull lortt an0 etleci. cm uc.: srnn uc.: cuu: Date: SiOnaNre: WOBNERS' COMPENSRTION OEClAN1TI0N: I �¢reCy attirm that I have a ceniticate of consent ro selbinsure or a certilicate af Workers' CamOensation Insurance, or a certifietl copy ihereal (Section 3800; Lab. C�. , PoLICY NO.: E%P. ORTE: COMPRNY: '�7 cen�rree coPY �s nereay mm�snee. ❑ cen�eee coor is riea �m me c�n suiiaino o��sion. oate: COMPENS�TION pD011cant need not be complNeG if the permit is for ane hunOreO (1100) or less�. I. I shall no[emo�oy any oefson in anXmanner so as to �ecome Oate: 1� i%^ `''/V / SipnaNre: �nA i..�>7 I I Y 1Li(G)'�L'CJ NOTICE: II, atler maian0 �his OecWratlon, yau s�oulG Gecome suUl�� �o t�e Workers' Campensation Drwisions ol t�e LaOor CaOe, you must IorthvnN comply wiN such pmNsions ar tNs Dermit shall Ee UremeO revoked. CONSTBUCTION lFN0�N6 �CEHLY: 1 �ereEy aryirm that ihere is a construction lendinq a0ency tor t�e pedormance ol l�e woM far wAich �his permic i5 iuuetl (Sec�ion 3W7, Civ, C), IFNOEfl: aooeess: OWNEP BUIlDEB DECLANITION: I hereEy atlirm Itwl I am exempt trom ihe Cantractors Stata Lkense Law lor the tWlovrinp reasan (Stttion 7031.5 Business anC Prolessional CoEe: My ciry oi wunry whic� repuires a permil ro conswct, alter, imDrwa, Eemolis�, ar rt0air any stmcturo, pdar ro its iuuance, alm reQuires t�e applicant for such permif to f1e a vqneE statement tAat �e/sAe is IicenseE pursuam to t�e D�ovisians ol t�e Conlracrors' State License Law (CMpter 9(commencinp wit� Section 7000) oi Oivivon 3 al ��e Busineu anA Pmfessions COCe) or t�at helshe is ewem0� ��eretrom antl ihe Casis lor the alleAed exemption. Any violation al Section 7031.5 hy any apDlicant for a permit suClects ma a001icant ro a pvil penalry al not mam tlun five hunEmO Collars (550�). I, as awner ol t�e DroDeM or my pmployees vnth waAes as t�eir mle compensatlon. will tln the work, and the � swcture is not inteMeG or attere0 far sala (Section 767d, Business anE Pmfessianal Code: TAe Contractors SWte License Law Goes nm apPh �o an owner of a properry wtro EutlEs or impmves ihereon, anE wha Uces sucA wod �imselt/�erutl or t�roup� �is or Aer ovm employees, DroviEeA tAat such impmvements are nat inten0e0 ar olferetl for ule. II, Ipwever t�e UuilOinq ar improvement is solU mi�m ona year ol completion, the awner will �ave t�e DurCen ol pmving �e/she tli0 noi EuilA or imprave 1or ihe purpose ol Sale). ' , � � ' I, as owner ot tAe D�aperty, am exclusively conVacting with Iicense0 contracmrs to consimct t�e prolect (Sectlon 7074, Business ❑ antl Vmtessions CoOe: The Contradors' $W�e License Law Aoes not a00h �o an owner of D�oDerty w�o buAAs or imOmves ihereon anU w�o conlracts for such prolects wliq a caniractaqs�license Dursuant to tha Contractors' State License Law�.l am aware (Ild� Df00� 01 IllEt! WOlkEf'S �OIIIpE013I100 IOSU2110E ShOUIG �E D�ONUCU [p RIP. � I am exempt unOar S¢ction: B. 8 P. C. � lor t�is reason: ,r^y/��_ Oale: �` �� �_� Owner: � I 1�c� ' 7 / i I Oo hereey cenity tAat I am aware of antl untlersland tAe repuiremenis al Catitomia Healih antl Satery CoOe Sections 25505. 25533, and 2553d antl that I or airy IuWre Euiltling acupant wilV_ will not (circle ane) nretl ta comply with uiJ state waes and t�e requimments for a permii far wnstruciion or moGiliWlion tmm t�e Nr OuaGry Manapement USViCL HeSiGenGal fAnSlNciion apD�iWtionS are exempt Imm I�ese prmisions. I hea�y certiry ttwt I luve reaC this aDP�ication anG state that the aUove inlormaGon ¢ mrrect. I apree to camDN ��� all ury anU counry ortlinances ana state Wws ala�inq �o OuilOinp consiw�ion anE IrereGy apyIAorize reD�e�nGiives ol Nis ciry �o eni upon ��e above�menuon pmDerty lor inspetli0n Purposes. • f1 y _ � yr�^�CJ I,CYwI'Y . � Date: 1^�' �O ��Onawre: \����n Driver's Licenu ar Saul Securiry ; AoplicanC Pink—Ravanue; GolOenrod—qAsaeswr CITY OP COSTA MESA — BUILDING PERMIT PERMIT NO: P 045645 PLAN CHECK NO: N CONSTRUCTION TYPE: PERMIT TYPE: PLU JOB DESCRIPTION : REPLACIi'GAS SERVICE CLAIM VALUE: CALC—VALUE: PGRM NO: P 045545 GOVT: N SUPP: N PURPOSE: REP SQ FT: GROUP OCC: R-3 / COMMENTS: *+r*��**�*+r*�+r*�**�r****�*x�**��+�*��c ��**���*�+r*����e���**�+�+r*x�*****�***��r�r*�����r�+�* 2 O N I N G R E(J U I R E M E N T S ' S E T B A C K S ---------- MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------- FRNT': FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT: rT IN RGHT; FT IN LEFT: FT IN RGHT: F1' IN PARKING REQ: PROV:• PARCEL: 1397.6112 ZNE: ' REF NO: PLANNING NOTES> > ***+t�r*�ti�i��t+��*�*+r*�t�e**f�+riti�x��tit��t�+t*�r***�r�x;**+t**+r*x�ir�r***�r***��****it�ti��titfr�tft�tft**�tit+t�r+tit 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 � %�ONING APPROVED BY ' DATE: (BUILDING APPROVED HY : ' DATE: � APPLICATION LSSUED BY: - DATE: j( a_� %1k 1F 1E iF iE 3k 1E �k !F if k k k iE k 1ElE 1E iflE iE iE 1E f! ff ik iEiE iE �k iE�FiFF�N'�iFiF iF iE Ik lE 1Flf iE iF iF IE 1k k fF if IE iElF �Flk 3F ik k 1E !E!E if k iE k!E iF 1F 1E �E iF iF ff j! 1! fk iF iE Ik ik 1k iE iE Ik iE If ik IF M�k %iE k ik fE �lk 1E iE 1f 4 fF iElF kiE ik 3k if ik M iE iE iE iF 1F #t iF LEGALIZATION:N F'E E S U M M A R Y ' STRUCTURAL SEGMENT;N BLDG FMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 2.00. 25t F,MIP/NUN—RES PLAN ISSUE FEF. 3.00 BUILDING—DIV—> PERMIT ISSUE. PLAN—CHECK TOTAL PAID DUE TOTALS ---> 2.00 3.00 0,00 5.00 5.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 5.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MEC1iANIC FIRG aMIP/TOT GRADING FLAN—CHECK ' , 5.�0 ' ' if iF 3E if iE iF iF if it if fk IE iF iE IE 1E iElt iE ik it ik k iE ik if k if iF iF iE iF fE if iE iE iE IE iE 1F �t iE IE if IE iF i! iE M if k k k!F �f iE iF it if it jt 1F iE iE if ik if if !E ik df iE iF iE iE if iE k If Z N D I V I D U A L F E E B R E A F( D O W N TYPE QTY D E S C R I P T I O N PLU 1 GA5 SERVICE END OF FEES UNIT COST TOTAL COS`f 2.00 � 2.00 0 �DUF'LICpYE RECEI�"T# . 01 00�51334-00041334 Ta] T� S.Q�• DATE: O1/08/90 TItIE: 14:`Z � CONSTRUCTION ANDPLANNING� PqOI ,PA APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector � 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . 2, ,Soil Pipe-Undrgrnd.- 53. Steei Reinforcement �•3:.EI'ectrical CohdOit�Utiliry-Undrgrnd. 54. Forms '� A..Electrical Conduii�Undrgrnd. 55. Electrical Bonding � �-� SrSteel Reintorcement 56. Rough Plumbing & Pressure Test .� `?'yC "Electrical UFER;J'..�rnd. 57. APPROVAL 70 COVER-GUNITE � `2 3� � .� _ � 7;�Footings i� . 58. Electrical Conduit�Undrgrnd. - ^'8. Founciation ' 59. Gas Pipe, O Undrgrnd., Test � i �' 9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P-Trap, O Undrgrnd. �� 10. Structural Floor System . 61. APPFOVAL•70 DECK , � 11. Property Sewer Lirte;& House Connection 62. Backwash & Receptor�Final ... i 72. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains � � 64. Plumbing System � Final 14. Rough Plumbing v 65. Electrical-Final _ � 15. Rough Electric�t-Conduit 66. Solar System-Final � 16. Rough ElectriaWiring 67. Fencing & Access Approval � 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical�T 8ar Ceiling 69. POOL/SPA SYSTEMS FINAL 79FRough Heati�g & Air Conditioning � � �A r � �FIRE DEPT. �REQUIREMENT �, .� -� : c- K - ; �. .: � � �-��r n. 20.�Rough EactofY F.i'teplace _ S�: � = �,-� � :AppROVALS:,_,Permrt# �� � _ 21 rDucts, in�Str.ucturea � •• •• " �� �� '-' �" �70. Undergr`nund Hy.dro ` �-: ^ x � �-; r. x z ,�, � 22�Ducts.Ventilatiri " "' :° ^ =: `:'�:'. ; �-"� �"' ,4,x �� w � a; q i-.x : a77. Product-Piping O6as O:OiI 23. Gas-Pipe-Rou9h & Test IT;S :� -' ^ '� x,72. Under round FfusFi• '� -.. ; 'r 9 x 24r�Roof F aming ` "-' ���� t' ^` r 73=,Undergrnd.StorageTank,OGas� ❑Oil 25. Roof Sheathing * - • � � _' " ' <' ��7q-' Overhead Hyd%�F 26�T�8ar Ceilin (Stru�tural� &-Morwcoat � ` _ _� '✓ ' = a �- � _ :: . : . . 9 _ j �, 75� Dry Chemical. r J �• . �, - �- - - � . _ � .. 27.�Frameal?d Flashing� jt-r <:� ?, pri :. 76. Dry Stand¢ipe ^�'� x :k :! -•.G: = "' * � .. . . ., c .n � i � n� ^28 Lathing?& Siding ,�, j� � * „ k 77,., FIXED SYSTEM�FINAL _ -,,; r29. Insulat o � s �• * �r :- 78=PIRE PREV. FINA-L - � �30. Drywall.Nailing :i � �� � ' a ."Y '`� .,'HEALTH.DEPT,�: REQOIREMENT ��31. Plaster 8iown CoatK _; . �. � , w r.7g FINAL INSf?ECTION - � �32?Electric�l Po�wer Meter-Flnal; W`"` � � `y �' '$0:_FOOD CERTIFICATE ISSUED;, x ' ' d, i I! .l. .• ' . L � g334Final Electric � , . 4` r � � �* �: ��Nates: � > �! •� �34:�Fin`al Heating�& Ai�r,�'Conditioning� � * , � � * l `� - 4'1 � - '� " -� � - '. � ,. . ... . _ .. _ 35i�Firial Gas Pi�pe-Test�, ��'� .. (, Q(� (�$0�:; �; _ � �, Cir= ;. . ='36. Hood or CanOPY ` � � - �� � � �r �n = f �� � h" c - Y i: - 'K �' '� + "'7 r �37.:Pinal Factory Fireplace� ;,-�- �-� � a� x iJ -38. Final Plumbing ' :� -' r � � : ii�iJ'x ,',� =� `� ` - x �' � ��c . � �• �' � ^ "39. Water Service�Final; � - " ' t ' " " ,, w � �: v .. v•. k •• :'40. Gas Service-Final N. m �;,-":- S �x ? i ' !u # J •: ^C; s: ~ i: ; i a.. ^- 7 ' G: x <- • C= K a. �41.SolarpomesticFinal' �� " �'� ; f '�#� `" - �' - , � ! �:': ^37 r, �%'r, D 42 Backflow Preventer � c' r i , '� a: '�r. J'r < � '�+ ' n�� �: a. �- �a: x m r.� :.� �. .-, s ° � � .^ .ti r. �: �h N �ti c,J . 43. Backflow tr�,igation „ ;� � �; , � � .� � . ' =�.44. Landscape triigation System;� � C � ^� '-' r ��� * � �� - �'�� ^ ,+ �� � ti. .-. c^ -� r.� x �c ? r' x.- ^ c.• :r. '�' r-. �'� r r; .^n E� n v: u '^ t-� F�: x i . .-• C; c, < j-45:-:Sound Attenuation _ , „ ]; m _ {.;x; ,�: , y�'. ._,� �: � 46�Handicap Regutations � �K � � x �« � .. _ S * <. � � n< r c,47�FINAL STRUCTU�tE & BUILDING � ; , �; * ' � � 'S * E., ` �' �.. 48:_FIN�AL PLANNING � r:-� � n � I ' �r d: . � :t� �. = 1 u: ic i i� :3 �' :,•, c -49`Electric Release to•Edison �`' � i`. �' ' '^ ;; � . ,. , W � . �. ;: - �; � n �50 _Gas.Release to $outhem California Gas Co = ' ' �' >� � � • ' �'' '' C • � �r �- c n 'c• ^ C • �l K [ti .�51. CERTIPICA7E OF�OCCUPANCY * ' � � �� '}� ^ �� � �- No. Date . � �_1.:� �`s COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 317 COSTA MESA. GALIFORNIA fOR APPL/CANT TO f/LL /N COMPLETfCY TYPE OR PRINT BUILDING 2a97 Ellesmere Avenue AODRE55 COSTA MESA, CALIFORNIA MAIL +JJJ riaucu�i� ADDRE55 �,r., Newport Beach K�Y1• 11011 LIC.NTO. 011 CONTRACTOR - acen � a ADDRE55 Newport Seach p LEGAL ILOT �]f1 I I l�2 OF LOT 68x97 irreg I NO.OF BLDGS. 0 NOW ON �OT USE OF None EXISTING BLOG. SETBTCK LINE FHOM 1 p c[N*eR oF s'rrse[i �� REAR YARD 1V t SIOE YARD ILEFT Jt IRIGHT �" DESCRIPTION OF WORK . NEW I X II ALTERATION I II ADDITION I 'REPAIR I IIMOVING I IIOEMOLISH I BUIL�ING 1800 b.f' ROOMS ( STORIES 1 SIZE L.,.t� EXTERIOR WA}.li___ __ I ROOF WOOd Sa�O.ne B u1i1�10—Pt1Wil,y RGD1(1BY1CPi and Attached Garage a s�c . 1 HEREBT ACHNOWLEOGE THAT 1 HAVE FEAD TH16 APPLICATION RND STATE THAT THE ABOVE IS CONRECT AND AGREE TO COM- PLY WITH RLL Cli OINPNCES � STATE LA\ S�FEGULATIN6 BUILDING CONS UCTI N. � � � SIGNATURE O � PERMITTEE AUTHORIZED AGENT �=EE �E����l�� �'Gt!/ a -.� � � FINAIICE DEPT. cirr o� cosTA� r�rs,a APPLICATION FOR� PERMIT BUILDING FOR OfF/CE USE ON[Y I HECEIPT NO. I Pe,Ei{M1T �A2�1 IV�EO+[g�/ OATE1 NEC IVE� [ DATE I5: /AA �l � �.��GQ) 1 L� � BUILDING COSTA MESA, CALIFORNIA TYPE ✓ GROIJP � APPROVED BY DAT ZONING ZONE n� INO.OF _ IUSE OF !K PLANS �i�'�UILDII 0 SF � F , : r'.R. No.�// U At'PROVED _�=� -/-� THE AMOUNT 6HOWN UNOER VALUATION IB FOR THE PURPOSE OF ESTA9LISHING A PENMIT FEE ONLY. VALUATION �%�/ PERMIT FEE $ ��� $ �-/ " �� PLAN CHECK $ �y� TOTAL FEE 5 � %'— �p0.1ECTpODflESS: 2(jJ'J ELLESMEitE AV OWNEWS NRME: THOMAS CRANDALL� ' RODNESS: Z(j9'] ELL65MERE � PBCH/ENCINEEfl: - nooness: �'� UNIT: � qEG.NO.: . uxiT: PEHMIREE: �jOB MORAL'ES . ! 714 ) 548-4752 � nooeess: 2526 UNTVERSITY � N,D. , CA 92660 UCENSEO CONTMCTOH DECIAMTION: I hereby aiilrm ihat I am licensed unAer pmvisions oi C�apter 9(commencing with Section 7000) af Division 3 al t�e Business antl Professions CoUe, anA my license is in full lorce an0 etlect. CITY LIC.: STATE LIC.: , CUSS: Date: Signature: WOBNEBS' COMPENSRTION OECLAMTION: 1 Aereby aflirm ihat I �ave a certificate of consent to seli-insure or a cenifiwte of Workers' Compensation Insurance, or a cenifieA copy t�ereoi �Section 3800, Lab. C�. POLICY NO.: E%P. DRTE: — COMP�XY: ❑� Certi(ietl copy is herehy fumisAetl. ❑ Certifiea coDY is filed vnth the ciry BuilAinA Oivision. � Da�e: APPliuni: ' ' . , ' E%EMPTION FI10M WOPI(ENS' COMPEN&1TION OECUIIRTION ,(This settlon neeA not be Complefetl i� �he p¢rmii i5 �Or One hunAfeO (5100) of IeSS). i ceniry Nat in the pedormance ol ihe work lor which ihis permit is issue I shan not empioy any p�manner so as ro become 5uble« �o the Wofrcers' Compensation Laws ol California. Uate: �Q — ��"Z � $� �gnaWre: � NOTICE: If, afler making ihis Oeclaratian, you s�oulA hecome suhlect to [he Workers' Campensation Dravisions of Ihe Labor CoOe, you must fonhvrith cBmDly with such provisions.or this permit s�all Ge deeme0 rerokeU. � • CONSTBUCTION LENOING �GFNCW. f hereUy aflirm tliat there is a constmc[ion lentling aAency tor the De�armance o( Ne work for which �his De�mii is i5sue0 (Sectian 3097, Civ. C). . , , ' ' LFNOEH: RUOflES3: - " - . ' ,. . . .• . OWNEq BUILDEN OECLANITION: 1 here0y aflirm Ilwt I am exemD� ��om t�e Coniractors' Sute License Law for iha lollowinp reazon (Section 7031.5 Business antl Pmfessional Coae: � Fny ciry of caunry which reQuires a permR to cons[mct, alter, imD�ove, Uemolish, or reDair any stmtlure, prior ro its issuance, also requires Ihe applicant (or such permit to file a sipneU statement tha[ he/she is IicenseU pursuant to tAe proHsions ol Ne Contracrors' State license Law (Chapter 9(cammencing with Section 7000) of �ivision 3 of ihe Business anE Professions Coae) or that Ae/s�e is exempt therelmm ana Ne Gasis for the alleqeE exemption. Any dolatlon af Section 7031.5 �y any apD�icanlfor a Oermit su6iects the applicant to a civil panalry oi not more tnan hva hunAretl Aollars (55001. � I, as owner of the pmperty or my employees with wages as their sole compensation, vnll Eo the work, anU the swc[urais notintende0 oroHereG/orsale(Section 7044, Business anE PmfessionalCaUe: The Contracrors'�State License Law ' tloes notappry m an owner ofa pmperty who bwl0s orimprovest�ereon, anA wAo tloes suc� work himself/Aerselt ortArough his or Aer own.emDloyees, pmvitled that such impmvemenis are not intende0 or oifere0 for sale. If, �awaver Ne �uil0ing or impmvement is sold vnihin one year ot wmpletioq the awner will have the Eurden of pmving �els�e tlid not builU or impmve for Ih¢ purpose 0� Sale�. � . , . I, az owner ot the pmperry, am exclusively coniractinA wit� licensed contractors ro constmc[ the pmle�� (Sectlon 7044, Business ❑ and Pmieuions CaUe: ihe Can[rzcrors' State license Law Ooes not apPy ro an owner of D�operty who bwitls or improves thereon antl wAo contracts far suc� D�ojecis vnth a contracror�s) license Dursuant to [�e Cantracmrs',State License Law). I am awara Ihat prooi ol their Worker's ComDensation insurance shaula be O�ovitletl to me. • � I am exempt un0er Section: B. 8 P. C. : . tor t�is reason: p Date: W �2��-' 8 1 ' . . /Owner: �� ' ' """""' F I Oo �ere�y certity that I am aware ot and untlerstanE tAe requirements oi California Health antl Safery Code Sections 25505, 25533, antl 25534 an0 that I or any fuNre builtling occupant wilUwill not (circle one) neea to comply with saitl state co0es antl t�e requiremenis for a permit for constmction or mo0ification from t�e Air Oualiry Manapement Uisirict. BesiAential cousiructian apDlications are exempt fmm these Drovisions. � ' � Da�e: � Applican�: _ I �ere6y c¢nity t�at I �ave rea0 ihis appliwtion anC state ihat ordinances antl stale laws relatinq Io buil0inp conslmc�ion and hi pm0erry �or inspection purposes. Date: �'2'Z"_�� iAnature:_ oriver's �icense or Sociai secunty information is carrect I a0ree to comply witA all ciry an0 counry mze rep�esentaliues of this ciry,�o enter upon t�e above-menuoned 166136 W�ite—Builtlin¢ Grean—CaOe Enfomement: Canerv—AOPlicant: Pink—Revenue: GOltlenroE—Assessor • CITY 07' Cc�STi;. MESA —.BUILDING PERMIT PERMIT�NO; B 044627 PLAN CHECK NO: 01102-89 S CONSTRUCTION TYPE: PERMIT TYPE: 5TR JOD DESCRSPTION e POOTING REPAIR &�DRYWALL PATCH3NG CLAIM VALUE: 7,000.00 CALC—VALUE: 7,000.00 PERM Nb: B• 049627 GOVT; N SUPP; N PURPOSE: REP SQ FT:. 7;000 GROUP OCC: R-3 / �, COMMEN'TS: ' � � �� �***;�*x***�r****+t*+r�+t*x�r***�*���r����*�*���***�+�**+rx�**�-+�*�r*�*�*+�*+����**�+t�*rt**� � 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 IIUILDING ------------ ---------- ACCESSORY BUILDING --------- FRNT: FT Irl REARi FT IN FRD1T: FT IN REAR: FT IN, LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQUIRED: PARKING PROVIDED: PARCEL: 139,26112 ZONE: R1 PLANNING NOTES> PLANNING APPROVAL FOR SLAH AND FOUNDATION REPAIR ' .' , . 7 . ' . . _ . , �If iE it iE iE if it it iE iE iEiE 3t iE �E if iE iE iF iE it if iF k it it it it it it i(� it it iP iF it jF IF it iE it it it iE jE it iF it �E �lE 3t iE It if iF �IE �lE iP iE 3E 3E dE aE it iE if 3E it iF iF iE iE 3(-iE iF iP iP it i(� D fi V F. L O. P.M E N T 'F, E jt V I'C E S R E Q U I R E M E N T S i. (� � r ZONING APPROVED F3Y % ?fk },� C�, f= _ , DATE: <<3—_��� DUILDING APPROVED DY;: DAT'fi: ` � APPliICATION IS'SUED '�Y: DATE:� (�-2,��� atit***ititititieitiEit*it*atieae"itiF� iEk�ritiEiEificitiE#F�FiFiF' ��i�� iE k iE iE it ik iE ik if iE if �iE iE iF iE if fF ik iF iF 1f dE i! iE iE �F jE� jE if iE iE if �)E iE iE 1E iE iE iE iE iF * if 3E iE 3f if �E 3f it �E'f(-�! ik fE iE iE iE if iF iE iF iF iE iF ih iE ik iE jE it iE ik iE �k� iF jF iE if LEGALIZATION:h1�. � F E E S U M M A R Y STRUCTURAL SEGMENT:Y �: . � BLllC PMT PLUMBING ELECTRiC �'MECHANIC PIRE SMIPIRCS GRADING PERMIT 90'.00 -, '' � "50 PLAN " 58. 50 . , ' � �L; ' SMIP/NON' RES ISSUE FEE • � � HOILDING—DIV-> PERMIT ISSUE PLt1N—CHECK�` 1 TOTAL PAID. ` DUE TOTALS----? 90.50 0.00 ` 50.50 � 149.00 149.00� ,00 REVENUE'DIVISIOtd TOTALS--> COLliECTED•; %r'`''� '149.00' OVER/SHORT: 'a' . .00 BLDG PMT PLUMDING ELECTRIC MECHANIC.�.; F,IRE SMIP/TOT GRADING P'I,AN—CHECK �o.00 . � ,so .sa.so t. ..�. �:- :' _� ;, , {.s( iE iF iE �E iE iE iE 3f iE iE iE �F iE �E iE j' 3E k iE iE iE if iE iF iE iE iF?E �E �E # iElE fE �E iF K jE�if iE jE iE iF 3F iF iE 1E �E 1E ik if iE iE It iE �E �E fF if 3E iE iE �E �E it �)l-iE iF �F'iE dF iE it iE �4 iE ff i(-if �ry ' 1: N D I,V I D U A L ;I E`E ,D R E A K D O W N • ' � • ' r'' . :? . : TYPC QTY D E S C.A I. P T I O. N �;_ �?; •% UNIT COST ': TOTAL COST � '. J Yi ' ' :.. '' ..{� i SFR 7000 STRUCTURAL DY VALUE PHR'$.Y.Q,O 1.00 ;', ' 7,000.00 END OP=�FEE,�`i . (� . , . � 1, � r' ` {�'� � ' /' . `, . ' rF. , .'.- , 4X� (� � .� . r � • ,r_' �,` 1 .' .. . � ... �f' ' � ` . ' � '. :F f.., � , . ��� 0 � pGD=,: :"i—�'Q�74; is-: 7�? �''" . . ,.' , . , . �, e , L�:TF: L�i�jiv� -T`I�; +I;.ri ' . _ ;� . . . . . . - . . -� _.,_ ... � CONSTRUCTION AND PLANNING � : PO( � SPA - Date Inspector � Date Inspector APPROVALS Permit # - � APPROVALS Permit # , 1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location � �� ,2. .Soil Pipe-Undrgrnd.� 53. Steel Reinforcement • y,' �� �- :3.��Electrical Conduit Utiliry-Undrgrnd. a' 54. Forms � � �;1 %L � `4.. Electrical Condui[=Undrgrnd. 55. Electrical Bonding � , " �- 5:'Steel Reinforcement - 56. Rough Plumbing & Pressure Test � ,�.6. �Electrical UFER:Grnd. 57. APPROVALTO COVER�GUNITE -� �,�.7r..Footings . '�I� !� 58. Electrical Conduit�Undrgmd. . ' ' 8. Foundation -. • 59. Gas Pipe, O Undrgmd�., Test � /;' -�� 9. Water Pipe�Undrgrnd. . 60. Backwash Cines,P�Trap, O Undrgmd. �'1 � 10. Structural Floor System �; 61. APPROVAL TO DECK `-;� __r S 17. Property Sewer Line & House Connection 62. Backwash & ReceptorFinal �`-� a : � -'72. Sewer Cap ' , =�:. 63. Heater & Vent�Final -�-� %j 13. Roof Drains � - � C, 64. Plumbing SYstem � Final _ 14. Rough Plumbing . �� 65. Electrical�Final � •`-� �. 15. Rough EleMrical-Conduit � � 66.�'Solar SYstem-Final � <"� _� 16. Rough Electric.Wiring 67. Fencin & Access A . g pproval :��` 17. Rough Wiring Sign � . 68.�APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SP.4 SYSTEMS FINAL � - � 19._Rough Heating & Air Conditioning __. 4: _ . PIRE,DEPT. REQUIREMENT, ., 20._ Rough Pactory Fireplace . - _ . APPROVALS. -.Peimit # - 21: Oucts, in Structuje' � - - -� �. 70. Underground Hydro , 22.-Ducts, Ventilating ��� � _� -� . i 77. product Piping O Gas ❑ Oil `� 23. Gas'Pipe,Rough & Test __ -- ., `� ` ' ��72. Underground Flush - - _ 24. Roof Fiaming .- • -. - .� � 73.� Undergmd. Storage_Tank�� Gas ❑ Oil 25. Roof Sheathing ' " -' -� 74, Overhead Hydro_ .. ^ 26.=T-Bar Ceiling IStructural) &"Monocoat - - 75�.� Dry Chemical ' - - 27. Frame and Flashing� - � " = � "� 76. Dry Standpipe _ . - _28. Lathing�.& Siding . - _ _ � . � . 77-. FIXED SYSTEM�FINAL - � ' ' 29. Insulation _' ` .. • ' 78` FIRE PREV. PINAL . �� � � 30. Drywall-Nailing �. - � F- � = HEALTH DEPT. REQUIREMENT 31. Plaster Biown CoaY = '-- _- i "79. FINAL INSPECTION i. _ 32.�-Electrical Power MeterFinal - . ' }� "80: FOOD CERTIFICATiE ISSUED. ' - 33:� Final Electric ' - � i � � - Noter. -- ' � � �,r.- �. 34'.. Final Heating & Aii Conifiti0ning� ', � ; ._ • ; ' j - 35; Final Gas Pipe-Test "+`� - T-�p_- o. Q�.. e1-�. _ 36._Hood or�Canopy ' - � _ � ,. - _ / ' 37. �Final Factory Fireplace"' "�- : �' ' �- ,,, v l -38.. Final Plum6ing .., � �� x; � � � - , ' 39.lWater Service�Final �' " � ''�� _�' " ' - :=40.� Gas Service-Final ' � �� � - - � � ,' ' ' �, � -41. Solar pomestioFinal � � . - ^ • -' � -� ' . ;;� 42. Backflow Preventer� , � _ _ '� , - . - �' � 43. Backflow Irrigation - � � � " .'.:44.. Landscape lirigation System, . � � � . ' , „ -_ ._ � . - 45r Sound Attenuation � - '" � - • �� ' - 46: Handicap Regulations .. . . ,' r � , � j� � 47: FINAL STRUCTURE & BUI�LDING:� ,. , 5' .��e ; te,,A_ �J�-- 48. FINAL PLANNING � �' " - , ' 49. Electric�Releaseto.Edison � � � � 50r Gas Release to Southem Califoinia Gas Cn �� � ,- � . - _ ' 51. CERTIFICATE OF OCCUPANCY " ' - No. Dace