HomeMy WebLinkAbout416 ENCLAVE CIR - Building PermitsCITY OF COSTA MESA '
.
BI/ILDING DIVISION
F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754•4856 • w�vw.ci.wsta-mesa.ca.us
�, FOR INSPECTIONS CALL: (714) 754-5626
��,. F07-00212
FIRE SUPRESSION PERMIT
Job Address: 416 ENCLAVE CI - � — � • � � �
Suite: -, �, � -
Viciniry: - . --, . ' ' '
Parce�Nunmbec TPN007040''-',--`. � - ,Zoning: . ,
App�icane DOUG BROZOVICH- :, � �
Address: 1202 EAST HUNTER AVE� . � '
� � - Phone: 714-237-0739 �
SANTA ANA, CA - � Zip: 92705 ' .
Owner THE IRVINE COMPANY'
Address 110 INNOVATION I � � � �
� � ' � � � Phone: 949-720-5536
IRVINE.CA . ..,... .Zip: 92612. . . . ` . ,
Contrecror BAKER COMPANY CONSTRUCTORS INC
Address: 1202 EAST HUNTER AVE , � �- . ' ,
� , � Phone: �714-835-8572
SANTA ANA; CA;, �-' Zip: 92705'� _'
' , License: 822444 �
SCOPE OF'PERMIT
PHASE 3, INSTALL 240 OVERHEAD SPRINK4.ERS FOR NEW 17;030
"ENCLAVE�APARTMENT HOMES" ._ � � , , " �
� :,�,
. ; � =; " FEE SUMMARY
$0.00 ,. ..,
_. ,,
50.00
$0.00
Plan Check:
Permit:
Other:
Total: $0.00
Status: ISSUED
Applied: O6/27/2007
Issued: 07IO2I2007
, �, i,
S.F.,MFD, TYPE 1A, 20 UNITS,
Calc Valuation: So.00
' Claimed Valuation: so.00
FFP-cw- bl��lo$
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulatlons. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 780 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permil to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
CQUE/. INSPECTIONTYPE ORT� IN71ML5 �e INSPECTONTYVE 04T IN L
7816 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final � 208 Final Plumbing
200 Final Re-Roof 210 Final Electncal
201 Final Blotk/Retaining Wall 212 Final Fire Preven�i0n "� QGY
202 Final Factory Fire Place 220 Final Planning Appraval
203 Final Sign 222 Final Site
204 Final Demolition ZC�O Final Building�Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby aKrm untler penalty of perjury one of the�tu��.,wing declarations:
❑ I have and will maintain a ceAi(cate of consent to sel(-Insure (or workers'
Compensalion, a5 provided for by seCtion 3700 of (he Labor Code, for the
peRormance o( the work for which Ihis permit is issued.
��I'have and will main[ain v.orkers' compensation insurance, as required by
ctbn-3700 of the Labor Code, for the performance of ihe work for which this
pertnit is issued. My vrorkers' pompensation Insurance carrier and policy
❑ I certify that in the pertormance of [he work for which this permit is
issued, I shall not employ any person in any manner so as to become subjecl
ro the workers' compensation laws o( Califomia, and agree that if I should
become subject to the vrorkers' compensation provisions of Section 3700 of
the La6 F ia forth 'tq-c mply with these provisi s
�ApP���nPSSiqnawre � L Da�e ��.�
WARNING FAIL O SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATfORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm thal I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license js.j �tull foSce �n� eftect. n I 1
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrm that there is a construction lending agency for the
peAortnance of the work fa which this pertni� is issuetl. (Sec. 3097, Civil Cotle).
Lender's Name:
Lender's Address:
SignaWre �ale
OWNER-BUILDER DECLARATIONS:
I hereby aKrm lhat under penally of perjury thal I am EXEMPT FROM THE
CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Professions Code: Any city or counry which requires a permit to
construct, alter, improve, tlemolish, or repair any shucNre, prior to its
issuance, also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Comractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe
Business and Professions Code) or that he or she is exempt iherefrom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
fve hundred dollars ($500).):
❑ I, as owner of the property, or my employees with vuages as their sole
compensation, WILL DO THE WORK, and lhe structure is not intended or
otfered for sale (Sec. 7044, Business and Professions Cotle: The Contracmrs
License Law does not apply to an owner of property who builds or improves
thereon, and who tloes such vrork himself or herself or [hrough his or her ovm
employees, provided Ihat such improvements are not intendetl or oRered for
sale. If, however, the building or improvement is sold within one year of
completion, the ovmer-builder will have the burden of proving.that he or she
did not build or improve for purpose of sale.).
❑ I, as o,wner of the property, am EXCLUSIVEIY CONTRACTING WITH.
LICENSED CONTRACTORS to construct the pmject (Sec. 7044, Business and
Pm/essions Code: The contraclas License Law dces not apply to an ovmer o(
property who builds or improves thereon, antl who contracts for such project with
a contractor(s) license pursuant to Ihe Contractors License Laws.).
❑ I am exempt�under sec.
Business and Pmfessions Cotle for this reason:
Ovmer ID venfied by driv� nse. ❑ Yes ❑ No
Driver's License No. Expires:
Verifca�ion o( Ownership by (rype of dowment, i.e. - property tax bill or deed):
�DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
� I hereby ceAify that no excavation (ne (5) or more feet in depth into which a
person is required to descend, will be made in connection with work authonzed
by this permit, antl lhat no building structure, scaffdding, (alsework, a tlemolition
or dismantling ihereof, will be more ihan thirty-six (36) (eet high. (Chap. 32, Grp
2, Ari 2, Sec. 341, TiUe 8, Califomia Administrative Cotle).
❑ As owner-builtler, I will not employ anyone to do work which would
require a permit from the Division of Industrial Safety, as noted above, unless
such person has a permit to do such vrork from the tlivision.
Applicanfs $ignaWre
Division of Industrial Safety Permit Number _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the appliwnt or present or future building occupant neetl to fle and
certify a Business Plan for emergency response to release or Ihreatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Satety Code requires, with some
exceptions, that a Business Plan be filetl with the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantity of hazardous matenals equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperaWre and pressure).
2. Does or will the applicanl or present or (uNre building occupant need [o fle
a regis[ralion form for acutety hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health antl Safety Code, with some
exceptions, requires registretion with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantiry o( acutely
hazardous materials equal to or greater than a weight of 500 pountls, or a
volume o( 55 gallons, or 200 cubic feet of compressed gas al standard
temperaWre and pressure).
3. Does or will the applicant or present or (uture building occupam need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Sec�ion 25534 of �he Califomia Health antl Sa(ety Code pmvitles Ihat the
Costa Mesa Fire Department may require the preparation, certifcation and
filing wi[h the Fire Oepanment of an RMPP by businesses which are required
to register acutely hazardous materials wi[h [he Fire Department.
4. If an RMPP is presently required, has Section 25534 of lhe Cali(omia
Health and Safety Code been fully complietl with? ❑ Yes ❑ No
5. Does or will the applicant or present or fWure builtling ocwpant require for
the vrork which is the subject of this applica[ion a permit for such construction
Or motlificalion from lhe Soulh Coast Air Quality Management Districl or from
any oiher air pollution control distnct or agency? ❑ Yes ❑ No
(Sectbn 658502 0( the Califomia Govemment Code requires that the requested
infortnation be fumished on applications for nomresitlential building pertnits).
6. Will any part of the (aciliry to be constructed under this permit be within
1000 feet from the outer boundanes of a school? ❑ Ves ❑ No
Qf'yes", �he facility must meet the requirement of Sections 25534 and 42303
of the Califomia Health and Safety Code).
7. If a permit from the South Coast Air Quality Management Dislnc[ or ol�er
air polWtion control distric[ or agency is required for Ihe work which is the
subject of this application, have all of the disclosures prescribed by Califomia
Health antl Safety Code Section 42303 been made? ❑ Yes ❑ No.
B. Qf "yes", attach certifwte of compliance from the appropriate air polWtion
control oKcer�. .
CERTIFICA7E OF COMPLIANCE: I certify that under penalry of perjury the
�information given above is correct I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions. �
Signature Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certi(y under penalty of perjury that I have read this application and state thal
the information given is correcL I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
the City of Costa Mesa to enter upon the above-described property (or
inspeclion purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit unlil fnal inspection.
' iglidl e o ega mer �aqte �,,��/
SignaWre �a�e �_� �� L, � �
305]-0fi (3/Ol) � ��..,(�
�Ana/or A'ul�oriiaG Applicant,,,�,_,_,� �--�- Daia��v�--�1
r,y„ ...
CITY OF COSTA MESA
o "'F, BUILDING D/VISION
F`�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • �wvw.ci.costa-mesa.ca.us
��oFOR INSPECTIONS CALL: {714) 754-5626 F07-00212
'� FIRE SUPRESSION PERMIT
JobAddress: 416 ENCLAVE CI
Suife:
Vicinity:
Parcel Nunmber: TPN007040
Applicant: KIRK HEMANS
Address:
Owner: THE IRVINE COMPANY
Adtlress 1101NNOVATION
IRVINE, CA
Zoning:
Phone: 714-666-8450
Zip:
Phone: 949-720-5536
Zip: 92612
Contr�qor: RESIDENTIAL FIRE SYSTEMS INC
Address: 2871 E VIA MATRENS
ANAHEIM, CA
Phone: 714-666-8450
Zip: 92806
License: 786965
Stalus: ISSUED
Applied: 0627l2007
Issued: 07/02/2007
SCOPE OF PERMIT
PHASE 3, INSTALL 240 OVERHEAD SPRINKLERS FOR NEW 17,030 S.F. MFD, NPE 7A, 20 UNITS,
"ENCLAVE APARTMENT HOMES"
FEE SUMMARY
Plan Check: $0.00
Permit: 50.00
Other: $0.00
Tatal: $0.00
�' «' C w- �o � 1'1 � ��
Calc Valuation: so.00
Claimed Valuation: so.00
NOTICE: The work authorized by this pertnit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 7, 72-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for lhe work authorized under this permit lo be considered legal, such work musl comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
L� INSiECTIOMTYPE QRjF� NTI AL CODEI INSPECTIONTVVE D� N iUL
1616 fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 20B Finai Plumbing
200 final Re-Roof 2t0 Final Electrical
201 Final Block/Retaining Wall 2t2 Final Fire Prevention �'� 7�� '�'�'-''
202 Final Factory Fire Place 220 Final Planning Approval
203 FinalSign 222 FinalSite
204 Final Demolition ' 250 Final BuildinglOccupancy
WORKERS' COMPENSATION DECLARATION:
I hereby aKrm under penal�y of perjury one of Ihe tollowing declarations:
❑ I have antl will mainUin a certificate o( consent to sel(-Insure (or workers'
compensalion, as provitletl for by section 3700 of the Labor Code. for the
pertormance Of the wOrk for which this pertnit is issued.
+' -`Phave and will maintain eorkers' compensatbn insurance, as required by
".e - io`n 3700 of the Labor Code, for the perfortnance of ine work for which this
pertnit is issuetl. My workers' wmpensation Insurance carrier and policy
�Cmber, are: �
arrier.�'`��"T�'�%� �N�
(inisscaibnnaednoteecanp/N ��tn,e-p�emm�7svadxdarwren�mdretlddarsfSta0lpbssJ
Polit�y�'Num_`,ber;� .'Y'.-1 �Yi / -�Y� �� 7P�� �
❑ I certify that in the peAormance of the work for which this permit is
issued, I shall not employ any person in any manner so as to bewme subject
lo the workers' wmpensation laws of Califomia, and agree thal if I should
become subject lo the workers' compensation provisions o( Sectio 3700 0l
the Labor Code. I 1(forthwith comply with Nese provision .
� ^—_ b�i,,.
� r
Wl'e`:4' �.MWieu�'s���ure.'_.--• • �/:u.voa „__^e�.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT AN EMPIOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE CAST OF CAMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hareby affrtn that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 0( the Business and Professions Code, and
my license_is in full force and eHect.
CONSTRUCTION LENDING AGENCY:
❑ I hereby affmm that there is a consimcl'an lentling agency for the
peAortnance of the v.ork fa �Mich tNs pertnit is issued. (Sec. 3097, Civil Code).
Lentler's Name:
Lentler's Address:
OW NER-BUILDER DECLARATIONS:
I hereby affirm Ihat under penalry ol perjury that I am EXEMPT FROM THE
CON7RACTORS LICENSE LAW tor the following reason (Sec. 703t.5,
BUsiness and Profe55ions COtle: Any ciry or wunry which requires a partnit to
consWct, alter, improve, tlemalish, or repair any strucNre, prior to ils
issuanca, also requires Ne applicant for such pertnit to file a signed statement
Ihal he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or ihat he or she is exempt therefrom antl
the basis lor Ihe alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects lhe aDPliwnt ro a civil penalty o( no[ more than
fve huntlred dollars (5500).):
❑ I, as owner ol the property, or my employees with vrages as I�eir sole
compensation, WILL DO THE WORK, antl the structure is not intended or
offered lor sale (Sec. 7044, Business and Professions Code: The Contractore
License Law Oces not apply to an owner o( property who builds or impmves
thereon. and who dces such vrork himsel( or �erself or throu9h his or her own
employees, provided ihat such improvemenls are not intended or oftered for
sale. If, hovrever, ihe building or improvement is sold vrithin one year of
wmpletion, the owner•builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to croslrucl Ihe project (SecJ044, Business antl
Professbns Code: The contrectors License Law tices not appty to an ovmer of
property who builtls or improves tliereon, and who cont2cls (or suth project with
a cmtracta(s) ticense pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
$ignaWre ' Da�e
309�46 (3/0))
Owner ID venfieC by Oriver's li. .a. ❑ Yes ❑ No
Driver's License No. Expires:
Venficalion of Ownership by (rype of document, i.e. - property �ax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certily that no excavation frve (5) w more feet m deplh into wAich a
persm is required to tlescentl, v.ill be made in connection vrith work autlarized
by Ihis permit, antl that rro buildifg struclure, scaF(dding, false�wrk, a Cemditbn
or tlismantling lhereof, will be more than thirty-siz (36) (eet high. (Chap. 32, Grp
2, M 2, Set. 341, Title 8, Cali(wnia Administ2tive Code).
❑ As ovmer-builder. I will no� employ anyone to do work which would
require a permit from lhe Division ol Industrial Sa(ety, as noteA above, unless
such person has a permil to do such wark from lhe tlivision.
AppliWnYS SipnaWrc Wte
Division of Industrial Safety Permil Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or luture building occupant neetl to file and
certify a Business Plan for emergency response to release or threatened
release o( a hazartlous matenall ❑ Yes ❑ No
(Section 25505 0( the Cali(omia Health and Salety Coda requires, with some
exceptions, that a Business Plan be filetl with Ihe Costa Mesa Fire
Depanment by every business which has at any one time dunng a reported
year a quanlity of hazardous materials equal to or greater t�an a weight of
500 pountls, or a volume of 55 qallons, or 200 cubic teet of compressetl gas
at slandard temperaWre and pressure�.
2. Does or will the applicant or present or future builtling occupant need to file
a registration form lor acutely hazardous materials? ❑ Yes ❑ No
(Sec�ion 25533 of the Calilomia Health and Safery Code, vrith some
exceptions, requires registration with the Cosla Mesa Fire Department by
each business which at any one lime has on hand a quantity of acutely
hazardous materials equal to or greater than a weight ol 500 pountls, or a
volume of 55 gallons, or 200 cubic leel of compressed gas at standard
temperature and pressure�.
3. Does or will Ihe applicant or present or luture Duiltling occupant neetl to
prepare an RMPP (Risk Management antl Prevention Program for awtely
hazardous matenals)? ❑ Yes ❑ No
(Seclion 25534 of [he California Health and Safety Code provides that l�e
Cosla Mesa Fire DepaAment may require the preparation, certification and
filinq with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with Ihe Fire Depariment.
4. If an RMPP is presently required, has Section 25534 of Ne Califomia
Health antl Safety Cotle Deen lully complied vrilh7 � Yes ❑ No
5. Does or will the appliwnt or present or luture building occupant require for
Ihe work which is Iha subjacl ol lhis application a pertnit (or such conSWcHon
or modification from the Soulh Coast Air Ouality Management District or Imm
any olher air pollulion control distncl or agency7 ❑ Ves ❑ No
(Seclion 65850.2 of the Califomia Govemment Cotle repuires that the requested
infama�ion be fumished on applications for non-residential builCing pertni[5�.
6. win any part ot the lacility lo be consWcted under Ihis permil be within
t0001ee1 from the outer boundaries o( a schoo1l ❑ Yes ❑ No
(If "yes", lhe lacility must meet the requiremenl of Seclions 25534 antl 42303
of the Calilomia Healt� and Safety CoEe).
7. I( a Dertnil Irom Ihe South Coast Air Ouality Manaqement Dis[ricl or other
air pollution control district or agency is required for the work which is the
subject of this applicalion, have all ol the disclosures prescribed by Califomia
Health and Safety Code Section 42303 been maCe? ❑ Yes � No
8. (If'yes", attach certificate of compliance from Ihe appropriate air pollutlon
coNrol oKceq.
CERTIFICATE OF COMPLIANCE: I certity lhat untler penalry of perjury [he
infortnation given above is correcl I agree to wmply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
SignaWre Da�e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury thal I have rea0 this application and state that
ihe infortnation given is cortect. I agree to comply with all state laws and city
ordinances relating to builtling wnstruction, antl authorize representatives of
the Ciry of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not lo occupy or allow occupancy of any buildin9
authorized by Ihis permit until final inspeclion. -
, Signa� � 01 LeBal Ovmer(s) �e
/c ,�•9.
.n%""'�A ttAul�o�iiedA`p'pllam;:•. - �.v e• ��_ ... _
�1 �:.
CITY OF COSTA MESA
BYILDING DIVISION
F` . � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • www.ci.costa-mesa.ca.us
�. FOR INSPECTIONS CALL: (714) 754-5626 F07-00311
�'"'°'°"°� FIRE SUPRESSION PERMIT
JobAddress: 4�6 ENCLAVECI ` � . - � - .-. � . . _ � Staws: ISSUED
Suite: . � . .. ... ' Applied: 10/31/2007
Vicinity: � - � - . � Issued: 11/OB/2007
Parce� Nunmber TPN007040, '.,' - __ Zoning: �
/r.-:�. �'� �' . - � � � � , .
Applicant: VICTOR+BACANCIO :'
�:,
Address: 17992 COWAN -
' Phone: 949-474-0555 �. - �
• IRVINE;^�CA ��� _ - Zip: 92614 � - � " � �
i
. .�'., . � ._ . � .
owner THE IRVINE COMPANY.
Address 1101NNOVATION ,� � � �� � ��� ", " .
� - . ' � Phone: 949-720-5536 � � �� �
IRVINE, CA � , . Zip: 92612 � � ' � -
Contracror: THE GREATER ALARM CO INC
Address: 17992 COWAN . - � -
� . , Phone: 949-474-0555 .. .. ' �
IRVINE,�CA �� , : Zip: 92614 � - ' , .. . �,
,,, , �� � ' License: 469046 ��
SCOPE OF PERMIT
FIRE ALARM SYSTEM FOR PHASE III: NEW� 17,030 S.F. MFD, TYPE tA, 20 UNITS W/3,233 S.F.
ATTACHED GARAGES FOR "ENCLAVE APARTMENT HOMES". REF#: BC07-00054
FEE SUMMARY
Plan Check: $0.00 , Calc Valuation: So.00
Permit: � _ Claimed Valuation: $o.00
Othec $0.00
Total:
«1�'CW - � I 1� 10�
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) �
EXPIRATION: PERMIT EXPIRES 180 DAYS 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
required inspections and final approval must be obtained. FaiWre to obtain inspections and fnal approval will result in the expiration of this permit.
OE . INSPECl10NTYPE DRTE INTI71AL5 LOOE;1 'INSPECTIONTYPE DRTE INTITIpL
1616 � Fized System Final Fire Prevention 206 Final Mechinical
1266 Pool Spa Final ' ' 208 Final Plumbing
200 Final Re-Roof 210 Final Electncal
201 Final Block/Retaining Wall � 212 Final Fire Prevention � -•� .", �
202 Final Factory Fire Place 220 Final Planning Appmval
203 Final Sign 222 Final Site
204 Final Demolition ' 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby aKrtn untler penalry of perjury one of the following declarations:
❑ I have and will mainlain a certificate of wnsent to self-Insure for workers'
compensation, as provided for by seclion 3700 of the Labor Code. for the
perfoimance of the work for which this permit is issuetl.
I have and vnll maintain wo`kers' compensation insurance, as requiretl by
s tbn 3700 of lhe Labor Code, for the pedormance of the work foi which this
pertnit is issued. My vrorkers' compensation Insurance carrier and policy
number are: ' '/
Cartier:- � ����J T �T�� � N�, • �
(7Ais se[Abn neetl rrof mmdetetl il e permd is valued at one ho1ntlietl tldlars (5/00) orless )
Policy Number: r� d� �O,'% /
❑ I certiFy Ihat in [he pertortnance of the vrork for which Ihis permit is
issued, I shall not employ any person in any manner so as to become subject
to the workers' co pe sation laws o( California, antl agree that if I should
become subject ,[he rkers' compensation provisions of Section 3700 of
the Labor Code e�( orthvnth comply with lhese pmvisions.
A = fs Signal LDate ��
i
WARNING: FAILU O SEC WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHAIL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOILARS
($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) o( Division 3 of the Business antl Professions Code, and
my license is in full force and eflect.
���.-�- > � �� s� c�a -�►
�� �_u•9•0�
Conl ' 9gnaWre (�_Date_TT
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrtn tha[ there is a construc[ion lentling agency for Ihe
pedortnance of the v.ork fa wfiich this permit is issued. (Sec. 3097, Civil Code�.
Lender's Name:
Lender's Address:
OWNER-BUILDER DECLARATIONS:
I hereby aKrm that under penalty of perjury [hat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Professions Code: Any ciry or county which requires a permit to
construct, alter, improve, demolish, or repair any sirucNre, pnor ro its
issuance, also requires the applican� tor such permit to fle a signed statement
that he or she is licensed pursuant [o the provisions of the Contrectors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or thal he or she is exempt therefrom and
the hasis for the alleged ezemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
fve huntlretl dollars ($500).): .
❑ I, as ovmer of the property, or my employees wi[h wages as iheir sole
compensation, WILL DO THE WORK, and the structure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
Ihereon, and who does such vrork himself or herself or through his or her own
employees, provided that such improvements are not intended or oHered for
sale. If, however, the building or imprOvement is sold within one year of
completion, the owner-builder will have ihe burden of proving that he or she
did not build or impmve for purpose of sale.).
❑ I, as ovmer of Ihe property, am EXCLUSIVELY CON7RACTING WITH
LICENSED CONTRAC70RS to construct the projecl (Sec. 7044, Business and
Pm(essions Code: The con[ractas License Law dces not appty lo an owner o(
property who builds or improves thereon, and who contracts for such project vnth
a contracta(s) license pursuant tothe Contractors License Laws.). �
� I am exempt under sec.
Business and Professions Code for this reason:
Slgnature �a�e
305�-66(3/0])
Owner ID verified by driver's . .ee. ❑ Yes ❑ No
Dnver's License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cert'rfy �hat no excavation frve (5) or more feet in tlepth into which a
person is required to descend, vnll be made in connection with work authonzed
by this pertnit, and Ihat no building s[ructure, scaffdding, lalsework, or demolition
or disman[ling thereof, will be more [han thirty-six (36) fee[ high. (Chap. 32, Grp
2, Art 2, Sec. 341, Title 8, Califomia Administrative Code).
❑ As owner-builtler, I will not employ anyone to do vrork which would
require a permi[ from the Division of Indus[nal Safety, as noted above, unless
such person has a permit to do such vrork from the division.
ApPli[anl's Signalure
Division of Indusirial Sa(ety Permi[ Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
i. Will the applicant or present or future building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release o( a hazardous material? ❑ Yes ❑ No
(Section 25505 of lhe California Heal[h and Safety Code requires, wi[h some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
Department by every business which has at any one time during a reportetl
year a quantity of hazardous matenals equal to or greater than a weight o(
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas
at standard temperawre and pressure).
2. Does or will the applicant or present or future building occupant neetl to fle
a registration (orm for acutely hazartlous materials? ❑ Yes ❑ No
(Section 25533 of lhe Califomia Health and Sa(e[y Code, wi[h some
excep[ions, requires registretion wi[h the Costa Mesa Fire Depariment by
each business which at any one time has on hand a quanlity of acutely
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
temperature and pressure).
3. Does or will the applicant or presen[ or fuNre building occupant need to
prepare an RMPP (Risk Managemen� and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the Cali(omia Heal[h and Safety Code provides that the
Costa Mesa Fire �epartment may require the preparation, certification and
filing wi[h Ihe Fire Departmen[ of an RMPP by businesses which are required
to regisler acutely hazardous materials with Ihe Fire DepartmeN.
4. I! an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been (ully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future builtling occupant require for
lhe vrork which is lhe subjec� of [his application a permit for such constmction
or modification from lhe South Coast Air Quality Management Districl or (rom
any other air polWtion control disMct or agency? ❑ Ves ❑ No
(Sec[bn 658502 oF the Califomia Govemment Code requires that Ihe requested
infwmation be fumished on applications for non-residential building permits).
6. Will any part of the (acility to be constructed under Ihis permit be within
7000 feet from the outer boundaries of a school? ❑ Yes ❑ No
Qf'yes", the faciliry must meet the requirement of Sections 25534 and 42303
ot ihe California Heallh antl Sa(ety Code).
7. If a permil from the South Coast Air Quality Management District or o[her
air pollution wntrol district or agency is required for the work which is the
subject of this application, have all of the discbsures prescribed by Califomia
Health and Satety Cotle Section 42303 been made? ❑ Yes ❑ No
8. (If'yes", anach certificate of compliance from the appropriate air pollution
control officeq.
CERTIFICATE OF COMPLIANCE: I ceAify that under penalty of perjury the
information given above is correcL I agree to comply with all state laws and
city ordinances regarding Hazardous Materials antl Emissions.
Signawre
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION�OF ENTRY: I
certify under penalry of perjury that I have read this application and state that
the in(ormation given is correct I agree ro comply with all state lavus antl ciry
ordinances relating to building conslruction, and authorize representatives of
me City ot Costa Mesa to enter upon the above-described pmperty tor
inspec[ion purposes. I agree not to occupy or allow occupancy of any building
authorizetl by this permit until final inspection.
SiqnaW meqs) Dale _
_ j�,C� •D7
A�tl) u n je0 App i � ! Dale" -
_ — _ � )
[ �: . , . � � .. , • � '
CITY OF COSTA MESA
evao�N� o�v►s�oN
�
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • vnvw.ci.costa-mesa.ca.us
� � FOR INSPECTIONS CAIL: (714) 754-5626
PERMIT NUMBER: BC07-00054
a
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: MFD_NEW ,. DATE ISSUED: 06I2512007
- - ISSUED BY: SOK
JOe nooReSs: 416 ENCLAVE CI CM` ; „ Suite/Unit:
Viciniry: : Primary Occ
ConstType: V-1H , :'., �� ''.SQ.�FT, �µ����17030 �-�� Valuetion:_1,,940,1,85.00 .
SCOPE OF WORK: PHASE III: NEW 17,030 S.F. MFD, TYPE tA, 20 UNITS. W/3,233��S._F. �ATTACHED GARAGES FOR "ENCLAVE
APARTMENT HOMES" � < " ��
,:a;
OWNER: THE IRVWE;COMPANY !' , �- �-Address: 1101NNOVATION � Unit: ,
PHONE: 949-720-5536 , > ; .r � ,. , ��� . CitylStatA/Zip: IRVINE, CA . .. .
APPLICANT: PEGGY BLOCK --� '- Address: 8 EXECUTIVE CIRCLE Unit:
PHONE: 714-557-0244 � . - - City/State/zZip:
:- ... . . . . .. ,._... _
CONTRACTOR: WESTERN NATI�ONAL CONTRACTORS _ - ,. � �
Address: 8 EXECUTIVE CIRCLEUnit - . �
City/State� IRVINE,CA . ZipCode: 92614 . - --� - �„
ARCHITECT: � .. � - License No. �
ENGINEER: - - License No. . -. �
COMBINTATION PERMIT.FEE SUMMARY -_
Buildin Plan Check - -� $1 469�55 � -
IRVINE, CA �
. - .. .. ' � . �..
License No: 840973 � -
PHON E: 714-557-0244 .-
CELL: "
� � ' PHONE: �
. _ � �:-PHONE:
g
Building Fees: ,�,��, $9;043 40 .-' ��>��., .., �� - �
Electrical Fees: � . ' - ����$875.00' . - � : ,
Mechanical Fees: � - � �, $1,04720 _. �'.:-�� ',.- .- . . �,
.�,_ . . . � .., ,
Plumbing Fees: ?,, $1.,91330��;��... � -- ' �
SMIP Residential: � �����::$194 02 ``.... , �� r'��' � . ' �
SMIP Commercial: - �$0:00. . . . _ • . •
TOTAL FEES: $13,072:92 : ,: _ -
"Re(er [o fee receip[s for all (ees paid for project " �"- � � � � - �
:'
NO710E: The work au[horized by this permit shall comply vrith all applicable handicap access requirements under California statutes and related
regulalions. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be wnsidered legal, such work must comply with all applirable wdes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permil.
CODE �. INSPECTION TYPE
1616 Fixed System Final Fire Prevention
1288 Pool Spa Final � �
200 Final Re-Roof
201 Final Block/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
OATE INTITIA SODEh INSPECTIONME
206 Final Mechanical
208 Finai Plumbing
210 FinalElectriWl
212 Final Fire Prevenlion
220 Final Planning Approval
222 Final Site
250 Final Building/OccuOancy �/�.
�E� INTITIpLS
WORKERS' COMPENSATION DECLARA710N: �
I hereby aKrtn under penalry o/ perjury one of Ihe fo��....�ng declarations:
❑ I have antl vrill maintain a certificate o( consent to self-Insure for workers
compensation, as provideG for by section 3700 of the Labor Code, (or the
per(ormance of the work for whic� Nis Dermit is issuetl. . �
� I �ave and will maintain workers' compensation insurance, as required by
tion 3700 of the Labor Code. for Ihe pedormance of the wvrk fa which this
pertnit is issued. My vrorkers' compensation Insurance carner and policy
numbera�: � �`�c�-�1�, � "���
Carrier: �.{ 1 Y�� � w
�—(rnissevenne�ea���/�ce�c'1omd �AMLepem�9fkvaWeOGa1 m�e'7nuntlretl/c;bqars(5i100)aiess)
Policy Number: wl.i O� �l�[ ]��Y7�J L. � U��O
l___
❑ I certify that in ihe peAormance of the vrork for which this permit is
issued, I shall not employ any person in any manner so as to become subjecl
to ihe workers' compensation laws of California, and agree that if I should
become subject to the workers' compensation provisions o! Section 3700 of
ihe Labor Code,yWi811 forthwith comply with these pmvi5ion5.
`Y ( J i[i
GA pli n sSiBnaWre L,Data
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNIAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOILARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affrm that I am licensed under provisions o( Chapter 9(Gommencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license i in full for/ce} -a�nd Zeffect.
C.Lic. # - � m�l._ L ) ( Class #
�1/Y1 `
Comr to naWre Dat
� -' _
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrm that there is a constructqn lentling aqency for Ihe
peAormance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Adtlress:
SignaWre
�
. Owner ID vedfietl by Orive. ;e. ❑ Yes ❑ No
�� Driver's License No. Expires:
� Verification of Ownership by (rype of document, i.e. - property tax bill or deed):
OWNER-BUILDER DECLARA110NS:
I hereby affirm that under penalty ol perjury that I am EXEMP7 FROM THE
CONTRACTORS LICENSE U1W tor the following reason (Sec. 7031.5,
eusiness antl Professions Cotle: Any city or counry which requires a permit to
construct, aNer, improve, demolish, or repair any strucNre. prior to its
issuance, also requires the applicant for such permit to flle a signed statement
lhat he or she is licensetl pursuant to the provisions of the Conlractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or thal he or she is ezempl Iherefrom antl
the basis for the alleged exemption. Any violation of Section 7031.5 Dy any
applicant for a permit subjects Ihe applicanl to a civil penally of nol more Ihan
fve hundred dollars ($500�.):
❑ I, as owner of the property, or my employees with wdges as their sole
compensation, WILL DO THE WORK, and ihe strvcture is not intentled or
offered for sale (Sec. 7044, Business and Protessions Code: The Contractors
License Law does not apply lo an ovmer of property who builds or improves
[hereon, and who does such vrork himself or herself or Ihrough his or her ovm
employees, provided that such improvements are not intended or oHered for �
sale. If, however, �he building or improvement is sold within one year o(
completion, the owner-builtler will have Ihe burtlen of•proving tha[ he or she
did not build or improve for purpose of sale.). .
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to conslruct the project (Sec. 7044, Business and
Professbns Code: The cont2ctors License Law dces not appty to�an owner of �
property who builds or improves thereon, and who contracts for such project vrith
a contractor(s) license pursuant to the Contractors Ucense Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
SignaWre Dale
305]i6 (3I01)
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: .
❑ I hereby ceAify that no excavation (rve (5) or more feet in tlepth into which a
person is required to descentl, will be made in connection with wvrk auttwrizetl
by Ihis permit, antl that no building strucWre. scaFfGding, falsewark, or demolition
or dismantling Ihereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp
2, M 2, Sec. 341, Title 8, Califomia Administrative Code).
❑ As owner-builtler, I will not employ anyone to do work which vrould
require a permit from Ihe Division of Industrial Safety, as noted above, unless
such person has a permit to do such work from Ihe tlivision.
ApPlicanl's SiB�aWre Dale
Division of Industrial Safery Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future builtling occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous matenal? ❑ Yes ❑ No
(Section 25505 0( Ihe Califomia Health and Safery Cotle requires, with some
exceplions, ihal a Business Plan be filed with Ihe Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressetl gas
al standard temperature antl pressure).
2. Does or will the applicant or present or future building occupanl need to file
a registration lorm tor acutely hazartlous materials? ❑ Yes ❑ No
(Section 25533 ot the California Health and Salely Cotle, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazardous matedals equal to or greater than a weighl of 500 pountls, or a
volume of 55 gallons, or 200 cubic feet ot compressed gas at standard
temperature and pressure�.
3. Does or vnll the applicant or preseM or fuNre builtling occupant need to
prepare an RMPP (Risk Managemeni and Prevention Program for acutely
hazardous materials)7 ❑ Yes ❑ No
(Section 25534 of the Cali(omia Health antl Safety Cotle provides [hat the
Costa Mesa Fire Department may requira the preparation, certification and
fling with the Fire Department of an RMPP Dy businesses v+hich are required
ro register aately hazardous matedals vrith the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the Califomia
Health an0 Safety Cotle �een fully complied with? ❑ Ves ❑ No
5. Does or vrill the applicant or present or luture building occupant require for
the work which is the subject of Ihis application a pertnit for such consWction
or modification from the South Coast Air Qualiry Management District or trom
any other air pollution control tlistnct or agency? ❑ Yes ❑ No
(Sectbn 658502 of the Califomia Govemmen� Code requires that tt�e requested
infortnation be fumished on applications for noo-residential building permits).
6. Will any part of the facility to 6e constructed under lhis permit 6e within
1000 feet (rom the outer boundaries o( a school? ❑ Yes ❑ No
(If yes", the faciliry must meet the requirement of Sections 25534 and 42303
of Ihe California Health and Safery Code).
7. If a permit from the South Coast Air Quality M1fana9ement District or other
air pollution wntrol district or agency is required for the work which is the
subject o/ this application, have all of the discbsures prescnbed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No _
8. Qf'yes"�,�attach cenifiwte of compliance from the appropriate air pollution
control officer). , .
CERTIFICATE OF COMPLIANCE;.I certify that under penalry of perjury the
information given above �is cortecL I agree to comply with all state lav+s and
ciry ordinances regarding Hazardous Matenals and Emissions:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify untler penalty of perjury that I have read this application and state that
the information given is correct. I agree to comply with all state lavrs and city
ordinances relating to building construction, and authorize representatives of
the Ciry of Costa Mesa ro enter upon the ahove-describetl property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until fnal inspeclion.
Sig LegalOwneqs) /�Da � Oc'�
_ �� (
i An or AUl�onzeE ApP�'��nl - � Date �
l_
To:
Applicant:
Address:
Telephone Number. � � �C"l
Tract/Parcel and Lo!
Location of Project:
Number of Square Feet of:
Residential Space
Commercial and
Industrial Space
Commercia�lndustrial Projed is: (Check One)
. �.
NEWPORT-MESA UNIFIED SCHOOL DISTRICT
CERTIFICATE OF COMPUANCE OF DEVELOPMENT FEES
PURSUANT TO AB 1600 ANO A8 181
oF,-z�-zam�.._;.-= ���,.�
�Gr :i_P. . .
DDj.-'�%�l��i�"'v' v �
�° 6647
(� City of Costa Mesa Distrid Receipt No.
( ) Ciry of NewpoA Beach
( ) Counly of Orange Plan Check No. � '�
Warehouse
R8D
Movie Theater
Mini-storage
Heavy Industrial
Regional Shops
Light Industrial
This projed is exempt because
(�1 O✓O x 51.84
x S .30
_ Motel
_ Bank
_ Neighborhood Shops
_ RacqueVHealth
_ Hotel
_ MediealOffice
_ Office Park
To�, �31► 2�j 20
Total
Preschooi
Auto Repair
Hospital
Large Ofice
Office Bldg.
Restaurant
Fest Food
This certifies that the abaye-named Developer/AppGcant has paid school faaqry (ees in comp6ance with Govemment Code sections
53080 and 65995. The Building Pemiifs for this square footage in fhis proposed development may now be issued by your jurisdic6on.
Checks are to be made payable to Newport�ulesa Unified School
ANMtlied
The above representa5on as to square (ootage is We. App�cant agrees that if it is later detemtined that such representadons are not
true, then this certificate shall automaticaly temtinate and the appro ' te Cily/County shall be notified.
oa�e � ��-�l I.� 1 �� �
�
:
ARNET EPTGINEERING, INC.
1577 North Main Street, Suite A
Orange, CA 92867
(714)379-3789 Fax:(714)379-8024
FAX'I'RANSMITTAL COVER SHEET
FAX TO: Western National " FAX NO: Hand-Delivered
ATTN: Bob Hemandez DATE: 8/16/07
FROM: Beat Arnet TIlVEC:
PROJECT: Enclave / The Irvine Company
416 Enclave �/ Building Permit No. BC07-00054-�
Total number of pages is I, including this cover sheet
(Please call if you do not receive all pages, or if transmission is illegible).
MESSAGES/COMMENTS:
The "Structural Observation" per UBC 1702 regazding suand and rebaz layout was performed by me on
August 16, 2007 on the following portions of the Post-Tensioned Slab-on-Grade of the above referenced
project:
Building #29 (1 A)
The installations are in general conformance to the plans.
Feel free to call me, if you should have any question.
Sincerely,
ARNE FiINEERING, INC.
Beat Arnet, P.E. �,,,
cc: Roberto Ortiz Fax 997-3857
v Ci Qi�40U �, r-`r
Exp.3/32;�; �.,;,;
r .,
Name: �-AC
ro.Ck I()�t
—Z Date: � � - v�
Pro'ect No. �)��- �
Permit No. Il� U7" l/�
��
The footing excavations listed above were observed and probed and found to bottom on firm competent
bearing material. � �
�The above listed slab subgrades were observed and testetl and found to have satisfactory moisture
penetration to the recommended depth, and were found to be firm and dense. "' �
(� The above listed interior trenches were observed and found to be backfilled with clean sand which were
u densified by jetting and flooding with water.
❑The curb and gutter / street subgrade listed above was observed, probed and tested and found to be firm
and unyielding with a minimum of 90% relative compaction.
❑The aggregate base listed above was observed and tested and found to be firm and unyielding with a
minimum of 95% relative compaction.
❑The retaining wall backdrain listed above was observed and found to be installed in compliance with our
recommendatiqns.
❑The subgrade listed above was observed, probed and tested, and found to
be of firm bearing soils, adequately presaturated per our recommendations.
Remarks:
N es:
he observations reported above do not constitute an approval o( foundation location, footing size or depth,
reinforcement or foundation design.
�
Debris and slough should be removed prior to placemenl of reinfo/rce�ment or co ete
' . / l �J �"�j
.�r.� ..�.,, NMG
FIELD MEMORANDUM RP.CP.IVP.CJ bVf ��I i�.�.
-, � , .- , �
_ , , �.
� :; �
..� _. ���.. .`�'-'i
fd E F R 1 t7 G
August 16, 2007
Inspection Division
City of Costa Mesa
Building & Safety
77 Fair Drive
Costa Mesa, CA 92628
Attention:
Subject:
City Grading Inspector
Civil Engineer's Certification of Compliance for Top of Forms
Project: Grading Permit No
Building Site:
Buildings:
Job Address:
Owner:
Work Completed:
G06-00029
Enclave
29, 46, Pool Equipment Bldg & G13
450 Mton Blvd.
IAC
August 15, 2007
5�.� nu y �
Infon�i Fn,pi, �-
ot��.•', ,at:
In accordance with the City of Costa Mesa Grading and Excavation Code and the
requireme�ts of the Building Code, I certify approval of this project as outlined above, to
top of bldg forms. Top of Forms has been completed substantially in conformance with
the approved grading plan for this project and in full compliance with said Codes.
Certification includes horizontal and vertical control and positive building pad drainage.
This certification does not include approval of the placeme�t and compaction of
earthwork within the purview of others.
Sincerely,
FUSCOE ENGINEERING, INC.
�
Trevor Scott Dodson, P.E.
RCE 42029
Exp. 03/31 /O8
��Q�,oQscorroo�
s
� � o
W No.42029 z
2
\* /
CIVi� ��Q'
�F C Al.\F�/
16795 Von Karman, Suite 700, irvine, Californio 92606 � tel 949.474J960 '� fox 9d9.474,5315 ^ www.fuscoe.com
DALE CHRISTIAN/
STRIK7URAL EtVG1NEER, ING
C0t�6UL7TNG 8 DFSIGN
1 �s8 Wat KateDa Ax�ue
�Qange, U. 92867
774997I145 7749973857FAX
<dalechrislian.com>
DCSE,'Inc. Job Name: The Enclave Phase III
DCSE,Inc. Job #: 06060
FIELD OBSERVATlON LOG
�BEE NOTEB BELOII�
t31dg. Type & Lot #: __> ��d �q �}
Artival at DcpaAun from � IM�aU ol Supe�inte�arrt
� Dato Engineer � Items Observed end I.ocetions . Stems
Job Site l06 Site � �
O.ok
�'iSrO �D . �..3p y :3o Pre-Slab: Fp� ec.oro _ �,Ar1�5 �,�5 ✓
o, r�m mm�.
W� '
O,ok
2nd Floor Framing
o. r�a., mm�.
wonc
O, ok
3rd Floor Framing
o, n�oea. me�.
won�
o. oR
Roof Framing
o. wae. man.
wa�c
NOMs:
1- A mmimum of 3-Irz Ne. will be c0e�gcA [m eecU end cvmy visi� tn Nc�oD s�te.
2-This fwm is onty for edmini�tlntive pu(pose md does mt i�irau atruciumi npprove� of eny buildiuB. If building confo�mmm lettu is
iequirtd, supaintendent aMuld contect ILe wginw af `cmd m Dale Chriztian�s af6ce.
I•
Project Name: ' Project No: Date: Report No.
3r�C � Ti�lG GJ`�GL4V� APrS G 5�93 - c Z �G/o�
Location: Author: / Day:
�I� C^����V� S� A!X IJ M T W T S S
CliendContraf tor: / nrz r,,,1E -L SupUForeman: �Qn/ rur+� o Weather:
'Tac / GvES7Exa N.cL � i uni�..✓
Field Supervisor. Geologisc � I Engineer: �
Obsmation/I'esting oC Txh '
pR6 P�vR ��SP�cn�•� ' TyPc /A2 .Sri I
Hours � � I
[3L.�t, �� ERr�, r u - ovoS
Equipment Working:
Summary of Operations:
A�t�vE r�,.� s�rc P �x .�r, �� � Ev�ri/ rJSP��ro� o� .a. �v=
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Page i of !
Received by:
FIELD REPORT _ MG
NMG GEOTECHNICAL, INC.
White - File Copy Yellow - Client Copy Pink - CliendAgency Copy Gold - Field Copy
WESTERN NATIONAL CONTRAC' S
8 EXECU7fVE CIRCLE �
IRVINE, CA 92614-6746
Ph:(949)862-6200
Letter of Transmittal
To: HENRY MARTINEZ
CITY OF COSTA MESA
77 FAIR DRIVE
COSTA MESA, CA 92628
Ph:(714)754-5652 Fax:714 754-4856
Subject: ENCLAVE BUILDING CERTIFICATIONS
WE ARE SENDING YOU
�" Shop drawings
C" Copy of letter
Letter of CeRification
Letter of Certification
Lefter of Certification
Letter of Certification
Letter of Certification
Letter of Certification
Letter of CeRification
Letter of Certification
Letter of Certification
Letter of Certification
p Attached
C Pnnts
t� Change order
L
C
C
C
C
0
C
C
C
�
�
Date
THESE ARE TRANSMITTED as checked below:
Transmittal #: 293
Date: 6/19/2008
Job: 10-193 THE ENCLAVE
t"' Under separate cover via None the following items:
C Plans t" Samples
fy Specifications C'� Other
No. Descri tion
1 Fuscoe Engineering - c
� Arnet Engineering -
� Dale Christian -
� NMG Geotechnical -
1 CitY of Costa Mesa -
1
DRI - Roofng
Gateway Insulation
AMPAM Parks - Pli
Residential Electric
LDI Mechanical
� For approval t- Approved as submitted t"' Resubmit _ copies for,approval
r For your use C" Approved as noted C." Submit _ copies for distribution
� As requested � Returned for corrections � Return _ corrected prints
C` For review and comment C" Ofher
[W FOR BIDS DUE i" PRINTS RETURNED AFTER LOAN TO US
Remarks: BUILDING 29
Copy To:
Received:
/
Henry Martinez Date
If enctosures are not es noted, kindly natily us at ance.
Page 1 of 2
� ���°�Q
��DOoo o � � �J �O LS
E N G 1 N E E R I N G
June 9, 2008
Inspection Division
CITY OF COSTA MESA
Building & Safety
77 Fair Drive
Costa Mesa, CA 92628
Attention
Subject
City Grading Inspector
Civil Engineer's Certification of Compliance for Precise Grading
Project: Grading Permit No
Building Site:
Building:
Job Address:
Owner:
Work Completed:
GOb-00029
Enclave
29
450 Anton Blvd.
IAC
June 6, 2008
San Diego
Inland Empire
Palm Springs
In accordance with the City of Costa Mesa Grading Excavation Code and the
requirements of the Building Code, I certify approval of this project as outlined above,
for Precise Grading. Precise Grading for building 29 has been completed substantially
in conformance with the approved grading plan for this project and in full compliance
with said Codes, pending any revisions that may come later. Certification includes
horizontal and verticol control.
Sincerely,
FUSCOE ENGINEERING, INC.
���
Trevor Scott Dodson, P.E.
RCE42029
Exp. 03/31 / 10
/ u 1 I c i r< I e f h i n k i n g
16795 Von Karman, Suife 100, Irvine, California 92606 � tel 949.474.1960 � fax 949.474.5315 � www.fuscoe.com
AI2NET ENGINEERING, INC.
1577 North Main Street, Suite A
Orange, CA 92867
(714)379-3789 Fax:(714)379-8024
FAX TRANSMITTAL COVER SHEET
F'AX TO: Western National FAX NO: Hand-Delivered
ATTN: Bob Hernandez DATE: 8/16/07
FROM: Beat Arnet T[ME:
PROJECT: Enclave / The Irvine Company
416 Enclave / Building Permit No. BC07-00054
Total number of pages is 1, including this cover sheet
(Please call if you do not receive all pages, or if transmission is iliegible}.
MESSAGES/COMMENTS:
Dear Bob:
The "Structural Observation" per UBC 1702 regarding strand and rebar layout was performed by me on
August 16, 2007 on the following portions of the Post-Tensioned Slab-on-Grade of the above referenced
project:
Building #29 (1 A)
The installations are in general conformance to the plans.
Feel free to call me, if you should have any question.
Sincerely,
ARNE INEERING, INC.
Beat Arnet, P.E.
cc: Roberto Ortiz FaY 997-3857
� C 0404&G r
� Exp.3/31/09 �
.�
DALE CHRISTL4N/
STRUCNRAL ENGINEER, INC.
CONSULTING � DFSIGN
1744 West Katella �venue
Suite 107
Orange U 92867
PH 714 997 1 I45
FX 714 997 3857
March 26, 2008
Mr. Jerry Crosby
Western National Construction
8 Executive Cirde
Irvine, CA 92614
Re: T'he Enclave — Phase III —(Building 29 - concrete and framing)
Irviue Apartment Communities (Our Job No. 06060)
Deaz Ivlr. Crosby:
Pursuant to yoiu request, ihis office hac made several site visits to the above descnbed project The p�upose of Ihe
visit on August 2, 2007 was to observe the placemeni of the various holddown 6ardware prior to the concrete pour.
Buildiag 29 was observed dwing this visit Deficient items, some quite minor, wete brougUt to the attention of tLe
concrete foreman and were corrected during the pre-slab visit and Building 29 appeared to be in substanrial
conformance with structuial drawings.
This office made a site visit on January 2, 2008, to observe rough fiaming for the above mentioned building for
substautial confo�ance to the shuctival plans. Deficient items, some were quite minor, were discussed with either
Tony Ramos with Westem National Construction or TWR's Framing Foreman. Observed deficient items were
coirected and the rough framing appeared to be in substantial confomnance with the structunl drawings by the time
ow� visits were complete.
These observations are intended only to azsist the framing contractor in conformance with the shucttual plaos as they
relaze to U�is residential aparhneat project and are not to be construed as "Special Inspections”. The responsibility
for such plan conformance, of course, remains with the contractor. Please do not hesitate to contact me at my office
should you have any fiuther quesbons regazding the site observatioq or with information included in this report.
Sincerely,
� V
Dale A. Christian, S.E. 2705
President
cc: Tom Hilton
JoLn Hyde
G:\WORD_poc106�06060�Phase Mf0 LetterslBuilding 29.doc
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NMG
rt�a;,»w,'y?.�'W;'Fi',uT<�i�'g
Geotechnical, Inc.
May 16, 2008
Project No. 04093-01
Precise Permit No.: G06-00029
"I�o: In�ine Apartment Communities
I 10 Innovation Drive
Irvine, California 92617
Attention: Mr. Tom Hilton
Subject: Summary of Geotechnical Observation and Testing during Precise and Post
Grading Operations, and Special [nspection Services for Buildings 22 through 36
and Garages G-I, G-10 through G-12 and G-14 through G-16, The Enclave
Apartment Community, City of Costa Mesa, County of Orange, Califomia
As requested, NMG Geotechnical, Inc. WM6) has prepared this document to present the
results of our geotechnical observation and testing during the precise and post grading
operations, and our special inspection services at the subject site. Our services during gading
activities included observation and testing during utility line trench backfill, footing excavations,
and hardscape subgrade preparations. In addition, NMG has performed special inspection
services, including structural concrete reinforcement; structural concrete placement; stressing of
post-tension cables; welding; hardware epoxy fix; and concrete compressive strength testing.
Based on our observation and testing, the above improvements were performed in substantial
compliance with our recommendation, project specification, and the requirements of the City of
Costa Mesa. Details of our observation and testing, including field density test results and
locations will be provided in separate reports.
If you have any ques[ions regarding this repoR, please contact our office. We appreciate the
opportunity to provide our services.
Respectfully submitted,
NMG GEOTECHNICAL, INC.
"�/`��
Sha rooz "Bob" Karimi, RCE 54250
Principal Engineer
SBK/jC
No.0054250 �
EXP. 12/09
*
's'T,q� CIVIL 0���/
� OFr.e�lf
Distribution: (2) Addressee
(23) Mr. Bob Hemandez, Western National Contractors (includes copies for
submittal to the City of Costa Mesa)
17991 Fiech • Irvine, California 92614 • PHONE (949) 442-2442 • FAX (949) 476-8322
/3nar�/ of Di�ectors
Arl Pcrrv
�rlrnc Sr.hnJirr
Bab Onr<�r�
.lumc.c Ferr�vnqn
Cinrl' Mrrnn6nn
Stqlr'
Rohiu (i. ilarner,r
Mana,ger
Di.�yrict Gn,ginerr
f949) 631-173 /
77��mms A. Fntnh
A.�tcistrtnl Mnnager
Joru� Rcvak
liom�d Secrelurv
i'rogrnr» Mann,�er
Cler'k o/'�hr. Di.rlrict
Alart R. Burrts
Legal Cn,insef
� � Mttrcua' D. Dovia�
Tr��ru�pm�/Uiret7nr nf.
Finmir,e
Plione
�949) (45-5400
Fas
(9d9) 650-22s3
Addreatc
628 W. l9rh Srrerr
Co.rra Mc.cn. CA
92(27-27/6
Oa
dm a r� r��«-�r „��
Rr�)�rlyd Vaprr
��� .����. ��.����.�� ��������
. . . an In)epen�ent Specia[ District
SEWER INSPECTION LOG
FINAL SIGN-OFF
ENCLAVE
1'RACT # 10950
BUILllING 27 418 (20 units)
20 ki[chen sinks
201aundry wbs/washers
28 bathmbs
28 wash basins
20 water closels
BUILDING 28 417 (20 units)
20 kitchen sinl:s
201aundry tubs/washers
28 bathtubs
28 wash basins
20 water closets
BUILDING 29 416 (20 units)
20 kitchen sinks
20 laundry wbs/washers
28 bathwbs
28 wash basins
20 water closets
�
Joe
� �
s -a�-°�
Date Finaled
Protecting our communitv�s G�ea�tl� br� proviaing so[i� waste ana sewer co[(ection services.
www.crosaca.gov
Property Address
� CITY OF COS7'A MESA '
BUILDIPdG DIVISION
�0�� COV���9�ffl1C� C����9C���0�
Permit No. BC07-00054
The Enclave; B1dg.29,Type lA, 416 Enclave, Costa Mesa, CA 9262E
Owner The Irvine Company, LLC. A Delaware Limited Partnership
Contractor DRI Residential Corporation
State Contractor License Number $19960
Classification C3 9
1 hereby certity that I have installed, or caused to be installed. a minimum Class C roof covering at ihe
above atldress in conformance with Chapter 15, end Appendix 15 of the iatest adopted edition af the Uniform
Buiiding Code, and the tnstaltaqon instrucYions of the menufacturer.
❑ I turther certify that I am the owner of ihe property. (Owner-Builder permittee ony).
❑ I funher certiy that I am:
❑ Owner of sole proprfetorship company
❑ FWI partner of the company
❑ l imited partner ot the compa�y
❑ OHicer of the corporation
! certity thal as an authorized officer or agant ot ihe company or corpwation, I am empowered to make thls
certNicflUon, which ShaU be bintling on ap Successors or assigns of the company or corpordtion.
I shall deliver a copy of this Certification to the above Gsted owner, after submittal oi form to the Bullding
Division for acoeptern:e.
Reoeivetl by Building Division
By:
M9P�6 MW 690 NTb � Bu�M4 Ox. f:rw�Y � Camacv. v.w . qrrw
DRI Residential Corporation
cAmpa�r or cAmomre Hame
17182 Armstrong Avenue
nddreu
Irvine, CA 92614
� May 29, 2008
ture Date
Patrick Kay; Vice President Operations
P�mwC o� Typod Namp
� • ! _
- r
, ` J'j_ ;`•,
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN COMFORMANCE
WITH THE CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATNE
CODE, TITLE 24, STATE OF CALIFORNIA, IN THE BUILD[NG LOCATED AT:
SITE ADDRESS: a16 ENCLAVE, IRVINE CA.
EXTER[OR WALLS
MANUFACTURER-CERTAINTEED THICKNESS/CYPE-3.5^FBERGLASS
RNALUE - R 13
EXPOSED FLOOR
MANUFACTURER - CERTAINTEED THICKNESS/TYPE - 615" FIBERGLASS
RNALUE - R19
CEILINGS
BLOW:MANUFACTURER-CERTAINTEED THICKNESS/TYPE-12"FIBERGLASS
RNALUE - R30
GENERAL CONTRACTOR: WNC
LICENSE #
INSULATION CONTRACTOR: GATEWAY INSULATION, INC. L[CENSE # 797001
BY: � TITLE: OPERATIONS MGR. DATE: 5/9/2008
BUTCH INGRAM OPERATIONS MANAGER.
���
��
INSTALLATION C� _TIFICATE
Site Addr s
1 of
Permit Number
C��
M installation certificate is required to be posted at the building si[e or made available for all appropriate inspections. (The
information pmvided on this form is required; however, use of this form to pcovide the information is optionaL) After
completion of final inspectioq a copy must be provided to the building department (upon request) and the building owncr at
occupaocy, per Sectiou ] 0-1 D3(b).
HVAC SYSTEMS:
Heating Equipment
Equip. ' M of E�cirney Duct Duc[ or Hra[ing Hea[ing
Type (pkg. CEC Certified Mfr Name Ideutical (A£UE, etc.)� Lncation Piping Load Capacity
h to 1 nd M delN mb Svst ms f2CF-lRvalu 1 (etti t 1 R- nl fHtu/hr) lBtu/h 1
Coo[irtg Equipment
Equip. CEC Certfied Comprrssor k of Effwirnry Duct Coaling Caoling
Type (pkg. Unit Mfr Nazne end Idrntical (SEER, cm.)� Loca�on Duct Load Capacity
hcet oumol Modcl Numbcr Svstems f2CF-IR �aluel (attic, ctc.l R-value fHeu/hd lBtu/hrl
1. > reads greater than or equal to. '
I, the undasigoed, verify that equipment iisted above is: 1) is the actual equipment installed, 2) equivalent to or more
efficieut than that specified io the certificate of compliance (Fortn CF-1R) submitted for compliance with the Energy
E�cienry Srondards for residen[ial buildings, and 3) equipment Iha[ meets or exceeds the appropriate requirements for
manufactured devices (from the Appliance Ejficieney Regulotions or Part 6), where applicable.
Date
WATER HEATING SYSTEMS:
siR�pi�=DRv ik!!!/YL
Hrater CEC Ccrtified Mfr
Twe Name & Model Numl
Dishibution IfRccir-
Type (Std, cuiatiou,
'oiaraf-Usel Coutrol Tv
Installing Subconhactor (Co. Name) �
OA General Contractor (Co. Name) OR Owner
N of Rffied� Tauk
identical laput(kW Voiume
S stcros or BtWhr allons`
���_. �-
Effi- Extcmal
irnc� Staudh� Insulation
2 For smali gas t[orage (aicd iuput oflas than or equal Io 75,000 Bnilhr), dectrie rcsistance avd hent pump water hea[en, lis[ Hncrgy Factor.
For large gu [tonge waur hnters (mted input of g[eater than 75,U00 BhJhr), list Rewvery Efficirncy, $taodby Loss end Rated Input.
For instan[aneous gaz water heater5, list Recovery Efficienry and Rn[ed loput.
3. R-I2 eztemal insularian is mandzWry' for seonge watec heatets with ea rnergy faclor of less Ihan 0.58.
Faucets & Shower Heads:
All faucets and showerheads iosta(led are certified to the Gommission, pursuant to Title 24, Part 6, Section 1] 1.
I, the undeisigned, verify thai equipment Listed above my signature is: 1) the actual equipment ins[alled; 2) equivalent to
or more effici t ar� at specified in Ihe certificate of compliance (Form CF-1R) submitted for compliance with the
Ett dards for residential buildings; and 3) equipmen[ that meeLs or exceeds the appropriate
re �rem r acNred devices (from the Applianee E�ciency Regulations or Pari 6), where applicable.
� 9 D8 �M�e.k-s �'l���q j_.
Si amre, D t Instal3ing Subcontractor (Co. Name) OR
Geoeral Contractor (Co. Name) OR Owner .
COPY . � ding Depamnent
HERS Provider (if applicable)
Building Owner at Occupancy
Compliance Forms
August2001
A-23
//��� RESIDEf ,AL ELECTRIC ASSOCI, cS, INC.
REA� 0 19—�Q' Contractor License #610435
L� www.reselectric.com
May 9, 2Q08
City of Costa Mesa
77 Fair Dr.
Costa Mesa, CA 92626
Attn: Randy Buck
RE: Contractor: Western ;Vational
Project: The Enclave
450 Anton Blvd.
Costa Mesa, CA
Building #29 Address 416
Dear Randy,
The electrical work on these buildings complies with the Califomia Title 24
Requirements.
Sincerely,
.� G����� �
/
Bob Tripp
General Manager
Corporafe Address Sania Ana Division
123 Rose Drive, Fullerton, CA 92833 3240 S. Standard Ave., Santa Ana, CA 9270.5
Phone (714) 278-0400 Fax pl4) 278-0600 Phone pl4) 556-3813 Fax pl4) 556-3929
INSTALLATION
Enclave Building #29
Site Address: Irvine, Ca
� CF-6R
Permit #
M instalfadon certificate is required to be posted at the building sife or made availabie for all appropnate inspections. (The infom�apon provided on this fwm is
required; howeveq use of this fortn to provide the information is optionl.) Af[er wmpletion of final inspection, a copy must 6e pmvided to the building
deparlment (upon tequcst) end the buildi¢g owner af occupancy, per secfion 70-] 03(b).
HVAC SYSTEMS:
Heating Equiprnent
Equip. Type
(pkg. heat CEC Catified Mfr, Make &
pump, etc.} Model Number
Hydronic First Company 18CDXQ-F-C
Hydronic First Company 25C➢XQ-F-C
# of Efficiency Duct Duct or Heating Heating
Identical (AFUE,etc.)' Locaaon Piping Load Capaciry
S�Stems [2CF-iR value] (attic, etcJ R-valuc (Btu/hr1 (B7U/EIr)
10 soft"it R-4.2 18,000
10 soffit R-0? 25,000
Coolirtg Equiprxent
Equip. Type . # of Effecirncy
(pkg. heat CEC Cerafied Compressor Unit Identical (SEER, ac)
PumP, �c.) MG. Name and Model Number Systems [>CF-7 R vah
DX-Cooling Yark GCGD78S21SI 10 t3.00
DX-Cooling York GCGD24S21S1 10 13.00
1>_ reads geatcr than or equal to.
Duct
Lowrion Duct
attic, eteJ R-vslue
soffit R-4.2
Cooling Cooling
Load Capaciry
24,000
I, the undersigned, vertfy thst the equipmrnt listed abovo is: I) is the actual equipmrnt installed, (2) equivelrnt m or more efficient than that specified in die
ccrtificate of wmpliance (Form CF-1R) submitied for compliance with the Energy Efficicncy Standards for residrntial buildings, and (3) equipmrnt that meets
or ezceeds the appropriate requirements for manufactured devices (from the Applianee Efficiency Regulations or Part 6), where applicable.
t �--- LDIMechenicel
Lorrafne Bernendez HVAC Subcontractor (Co. Name)
OR Grneral Coutractor OR Owner
WATER AEATING SYSTEMS:
l;Water CEC Certified Distribution If Recir- Rated Input Tank Efficimcy Standby Extemal
Heater Mfr Name & Type (Std, culatioM # of Idrntical (kW or Volume (EF, RE) Loss (%) Insulation R-
Typd# Model Numba Poin4of•Use) Control Type Systems Btu/hr) (gallons) velue
FAUCETS & SHOWER HEADS:
All faucets and showerheads instailed are Iisted in the Commisions Directory of Cerrified Faucets and Showerheads,
pucsuant to Titl�24, part 6, Subchapter 2, Sxtion I 11.
I, the undersigned, vefify tLat t6c equipment listed in the category above my signatu}e is the actual equipment installed end that the equipment meets w o:cuds
the requirements of tt�e Applienec Efficimcy Standards. ]n addirion, I have verifi�d that the equipment is equivalrnt to or morc ef£cient than the equipmmt
specified on the Certificate of Compliance submitted W demonstrste compliance with the Energy EfHcirncy Standards for residential buildings.
Signatiue, Date
COPY TO:
@uildiug Departrnent
$8RS Provida (if applicable)
$uildin� Owntt at Occupancy
Plumbing Subwotractor (Co. Name)
OR Grneral Contracror OR Owner