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Home My WebLink About341 FLOWER ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job nddress: 341 FLOWER ST Suite: Vicinity: REAR YARD Parcel Number: 11725314 Zoning: npp�icant: MUELLER, SCOTT _ Address: 415 W BORCHARD ST - - - � � ." � � ,. ` ' �Phone: 714-569-0556 SANTA ANA, CA.;; .- � , , Zip: 92707 / ,� owner: HARRINGTON; JAMES A AND JUDITY A � �. Address 341 FLOWER�ST �= ' � . i �,�, � � � � - � - .'� i � , _ . - - � Phone: � ' COSTA MESA, CA. . _ Zip: 92627 Contracror: ' MUELLER POOL�CO Address: 415 W BORCHARD ST � �. SANTA ANA,CA Zip:. 92707 ' Arch : Address: Phone:, -714-569-0556 License:' 402699 Status: ISSUED Applied: 01 /03/2002 Issued: O7/03/2002 ISSUED BY: � % � , � �'�� ; . �� . , � ��;�� , �,�� - �� . � .� �,, �� \ • ' �,_.. , . . , ; . Eng: ' - , . � �� . � Address: � � � - � . Phone: �� . Phone: ' ' " - . . �� ` _. �1 , Zip: � -'License: � � � License: �� - SCOPE OF PERMIT _ � IN-GROUND SWIMMING POOL ABANDONMENT_ WORK TO INCLUDE REMOVAL OF POOL EQUIPMENT, DISCONNECT GAS � PIPMG AND ELEC CONDUITS. � � Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection; � � \ , Total: "� :�� FEE SUMMARY ' . � , . $0.00 — - � ` Calc Valuation: � - ga;soo.00� $11t25 ' ClaimValuation: , ga,soo.00 $0.50 $0.00 $0.00 �$0.00 «.,: ;;..` . � �. - .. ��' ��' ,. ;511175� i:.:,,.-,-:', , ' SETBACKS � �� MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existina: o NOTES: Rear 0-0 Reai 0-0 Required: 0 ;'�,:;' , . � , � , a . , %' //� �� ' ��ji Left 0- 0 Left 0-'0 Proposed: 0 � � ��,_ . � ;� Right _ 0- 0 , Right 0- 0, . NOTICE: The work authorizetl by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and finel approval must be obtained. Failure to obtain inspections and final approval will result in tha expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 2446-4fi (N00) � WORKERS' COMPENSATION DECLARATON: � � . �� I hereby�ettirtn under penalry ot parjury one of ihe tollowing declarations: � � - ❑ I have end will mainiain a certificate ai wnsent to sell-Insure for workers' mmpensation, as provitletl tor by section 3700 ot the Labor Code, for the performance of the work tor which this permit is issued. ❑ I have and will malntain workers' compensation insurance, as required Cy section 3700 of the Lffiwr Code, tor the peAortnance ot ihe work for which Nis pertnit is issued My workers' compensution Insurence cardar and policy number are: Y Cerner: Policy Number: (fhis section need not be completed i/ the permit is va/uea et one hundred eollars ($100) or /ess.) � I cetlify that In Ihe pedormance of t�e work for which this pertnit is issued, I shell not employ any person in eny manner so as to become subject to the workers' compensation laws ot Califomia, en0 egree that N I should become sublecl to Ihe workers' compensetion provisions ol Sactlon 3700 ot ihe Wbor Code, I s�all forthwith comply with th s provisions. /� /�l' r�,.�.� ApPlicant Signature: b� l� �1� Date: ��((n/i .�'� C.FJ�' � WARNING: FAILUFE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CMh11NAL PENALTIES AND GVIL FlNES UP TOONE HUNDRE� THOUSMI� DOLLARE ($100,000), IN A�DfrION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 310fi OF THE LABOR WDE, ItJrERESi, AND ATTORNEY'S FEES. LICENSEU CONTRACTORS DECLARATION: I hereby a%irtn Ihat I am licensad unda provis' force end ettect. Lic. A_--C� Contreciofs SignaNre: (commencing with Section 7000) of Division 3 ot the Business and Pc ssions Coda, and my license is in lull ciass x L—S� � Date: ��ftN' .� Z� CONSTRUC710N LENDING AGENCV: ❑ I hereby aflirtn that Ihere is e consWction lending agency for the peAortnance ot the work lor which this permit is issuetl. (Sec. 3097, Civil Cotle). Lentlefs Name: Lendefs Address: SignaNre: Date: OWNER-BUILDER DECLARATIONS: I hereby attirtn thet untler penalry ol perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Profeuions Code: Any ciry or counry which requires a pertnit to construct, elter, improve, demolish, or repair any structure, prior to its issuance, elso requires ihe apDlicant for such permlt to file e signad statement that he ar she is licensed pursuent to the provisions of the Conirectors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Code) or that he or she is eaempt thereirom antl the hasis for Ihe ellegetl exemption. Any violation of Section 7031.5 by any applicent for e pam+. subjecis ihe epplicam to a civil penalry M not more ihan five hunared tlollare (5500).): ❑ I, as ov.•ner of ihe properry, or my employees with wages as thelr sole compenution, WILL DO THE WORK, end the swcture Is not intended or otteretl for sele (Sec. 7044, Business and Professions Code: The CONraciors License Law tloes noi apply to an owner of property who builds or impmves thereon, end who does such work himself or herseN or ihrough his or her own employees, providad thet such impravements are not iniended or ofleretl tor sale. tl, however, Ihe building or improvement Is sold within one year of completion, ihe owner-builder will have the burden of proving that �e or she tlitl not build or improve for purpose ot sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business and Professions Code: The contrecbrs License Lew does not epply to an owner of property who �uiltls or Improvas thereon, and who comracts for such project with a contraaor(s) license pursuant to ihe Contractors License Laws.). ❑ I em enempt under sec. Business and Professions Code tor this reason: Signature: Date: Owner ID verified 6y tlnver's license. ❑ Y85 ❑ NO Driver's License No. Veritication of Ov+nership 6y (type of aocument, i.e. - properry tax bill or deed): E:pires: DIVISION OF INDUSTRIAL SAFE7Y PERMI7 CERTFICATION: ❑ I hereby certity that no excevation five (5) or more feet in depth into which e person Is requiretl Io tlescend, will be made in connection with work authonzed by this permit, and that no building structure, scallolding, falsework, or demolition or dismantling ihereoi, will be mora than thirty-six (36) teet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Tiile 8, Califomia Administrative Cotle). ❑ As owner-builder, I will not employ enyone to do work which would require e permit from the Division ot Intlustnal Safery, es notad ebova, unless such person hes e permit to tlo such work tram Ihe division. Signature: Date: Division oi Industnal Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AllTHORQA710N OF EMRY: I cenify under penalry ot perjury ihat I hava read this application and state Ihat the infortnation given is correct. I egree to comply wit� all stete laws end ciry ortlinances relating to building consiruction, end euthotlze representatives of the Ciry of Costa Mesa to enter upon ihe ebove-d i e operty for inspection purposes. I eqree not to occupy or allow occupanty oi any building authonzed by Ihis pertnit until final inspection. ' naWr LegalO �� _ �}e.� � �J✓V Antl/Or A Ihonzed Applicant � Date COpE �, INSVECTIONTYPE QejE INTRIALS 1616 Fixetl Sysiem Final Fire Pravention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Well 202 Final Facfory Fira Place 203 Final Sign 204 Final Demolition CODE� INSPECTIONTYPE 206 Final Mechanical 208 Final Plum6ing 210 Pinal ElecMcal 212 Final Fire Prevention 220 Final Planning Approval 222 FinalSite 250 Final Building/Occupancy Q� Itl�L$ � ►. F � ,� n � ! �� "D' C?o�ta 7?%a,2 �u�E�co�y ?�afcdca� REQUIREMENTS TO ABANDON IN-GROUND SWIMMING POOLS 1. Obtain a demolition permit from the Building Divisioa The fee is based on the valuation of demolition and fill. 2. Obtain construction access permit from Engineering Division, 4th floor, Costa Mesa City Hall. 3. Break out and remove a three foot square section of the bottom at each end of the pool. 4. Remove the coping and the bond beam around the perimeter of the pool to 12" below grade. 5. Provide a soil compaction report, certifying a compaction of 90/95% at the time of final inspection. 6. Remove aud cap electrical to main service. 7. Remove and cap gas line to main service. 8. Remove and cap water line to main service. 9. Re-establish proper drainage: 2% from Building 1% to an approved disposal area Please contact the Building Division at (714) 754-5273 if you have any quesUons. 2501-46 (REV.990) (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: Suite No Vicinity: 341 FLOWER ST REAR YARD Parcel Nunmber: 11725314 � ::��.. " .,i -. Applicant MUELLER, SCOTT'' �, . Address: 475 W BOF2CHARD ST � , . . - Phone: 71 SANTA�ANA; CA � � Zip: 9 /�'�� `� � - - / ,`l�; � , / i �J � / :. / � � � � ." , ' - _ " Owner.l�HARRINGTON'rJAMES A AND JUDITH A , . .� _ � . �. - Address �341 FCOWER-ST"� , . , i � . � Pha�e: , . � � .. � COSTA MESA, CA =Contractor. , �MUELLER POOL CO Address: �415 Nl BORCHARD ST ' � � - F , i, - �==SANTA ANA;CA , � , � � Arch / En � ' ' � B:'�� Address: � 4 �� t 4-569- 2707 Zip: 92627 Phone: 714-569 Zip: 92707 License: 402699 Phone: Zip: Llcense: Status: ISSUED Applied�. Otl03l2002 Issued: 01/03/2002 ISSUED BY: � 1�, . � �� -� . 0556 � ! _ �'� � ' .� � ` �� ' � ._�,'�' L < �1'`� \ ��\ � '.. i� .�`��` ^ ` � .'% ' ��'�A�A � . �'�� / .`�_a� � j `i � \ ,A � � �' , 1 � �'�V •. .-' . - `� i.. . . _ ' �� . � �A � �� i � � �) � � . .. '�.'�.� \ i.�} ' �� , .- � . � � �,.i�, •. v -0556 .. , , �_i � . . ' � �',, " `\ �, \ .,��,.:i �,�,_�,�� _ '��, _ A -, � , -, . , � ,i ` - � . , : - ' '. t ,, .� �. .-__._..._' � , ,:�. - �� V l _ , �� I . .. ;i�.�, � , , ,. ._ ' - - � _ . , �.'/� I � � SCOPE OF PERMIT'', =� � �'"! '� '"� ' � . �, IN-GROUND SWIMMING POOL ABANDONMENT. WORK TO INCLUDE REMOVAL OF POOL EQUIPMENT,�,. � �'` ; , � DISCONNECT GAS PIPING AND ELEC QONDUITS. 1,MISC TO CAP GAS FOR POOL ;�r' �/� <�, �..'% i � , � _ . --i�' � � i � �� ': FEESUMMARY�' i;%j - �� , -' ,,. , , ��' � i � AMT� �� - - � - AMT� G QTY - � %% ' � � � � AMT , �_ ISSUE FEE� ,` `` $23 50 � �, �` � Laundry Tub / Washer � $0.00 0 ~� Sump Pump. \ % � �$OAO Backflow irdgation '- ,� $OAO � 0 -, Landscape Irrigation $0.00 0 .� Swiimming Pool % �1 ; � $0.00 Backflow Preventer� � .$0.00 �' 0 ` � V P-Trap � • $0.00 � 0 �: '�Trap`Prinier'1 f % / $0.00 Bathtub �� $0.00 � 0 - Pressure Regulator $0.00 - ,0 ; � � .Urinal� ;� � �� % i $OAO Clarifer System V`�� $0.00 0 Process Piping (per 70 ft) $0.00 -� 0" � Vacuum-Brkr Bkflow(1-4) $0.00 Connect (Ice,Soda,etc)' .,' �$0;00 � � 0' Receptors $0.00 0 ' �' Vacuum Brkr Bkflow(5+) $0.00 Dental Units � $0.00 � 0 . � � Septic Tank $0.00 .�0 . �'� ', ; Wash.Basin; r $OAO Dishwasher $0.00 � 0 � � Sewer Cap for Demo $0.00 �- 0• Wasti Basin Set $0.00 Drain, Floor $0.00 - 0 � Sewer Connect $0.00 -'0 � ��Wsste end Vent System $0.00 Drain, Rainwater $0.00 � 0 - Sewer Private Line $0.00 0 ��'� �. Water CloSel (Toilet) $0.00 Drain, Roof $0.00 0 � - � 'Shower $0.00 -� 0 ' '.' � Water Heater / vent $0.00 Drinking Fountain $0.00 0 Sink, bar �$O.00�f - 0` Water Piping Qnst or Rep.) $0.00 Expansion Tank $0.00 0 Sink, commercial $0.00 0 Water Re-pipe $0.00 Gas Earthquake Valve $0.00 0 Sink, Flooi $0.00 0 Water Service $0.00 Gas (1-4 outlets) $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 Gas (Over 4 outlets) $0.00 0 Sink, service/mop $0.00 0 OTHER $9.80 Gas Repipe $0.00 0 Spa (private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa (public) $0.00 0 PLAN CHECK $0.00 Interceptors (Grease, Oil) $0.00 0 REINSPECTION $0.00 Interceptors (Sand Auto ) $0.00 0 TOTAL CALCULATED FEES: E33.30 aTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 L NOTICE: The work authorized by lhis parmit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) �, EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. �.. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapectlons and ffnal app�oval musl be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this pertnit. FOR INSPECTIONS CALL: (714) 754-5626 2616i6 (8�00) WORKEqS'COMPENSAnON DECLARAnON: • — . I hereby affirm under penalry ot perjury one oi the following daclarations: � . � � ❑ I have and will maintain e certiticate ot consent to self-Insure for workers' compensation, as pmvitled for by section 3700 of the Labor Code, for the pedormance ot ihe work for which ihis permit is issued. ❑ I have and will maintain workers' compensation insurence, as required by section 3700 of ihe Labor Code, for the peAormance of Ihe work tor w�ich �his pertnit is issued. My workers' compe�satlon Insurance carrier end policy number ere: Carrier. Policy Number: p(T�his section need no( be comple(ed i/ the permit is valued at one huntlred dollars ($100) or less.) pj I cenify that in tha pertortnance of ihe work for which this pertnit is issued, I shall not employ any person in any manner so as to hecome subject to the workers' compensation laws oi Calitomia, and agree that it I should become subject to Ihe workers' compensation pmvisions of Section 3700 of ihe Lebar Code, I shall forthwlth comptywithUie rovision. ��/ � � � ^� Appliwnt Signeture: �� !'�LLLo Date: r� �"—z-�7 / WAqNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNL4WFUL AND SHALL SUBJECT AN EMPLOVER TO C�PENALTIES NND GVIL FINES UP TOONE HUNDPED TFIOUSAND DOLLAFE (5100,000). IN AO�ITION TO THE COST OF COMPENSATION, DAAMGES AS PROVIDED FOR IN SECiION 3lOfi OF THE LABOR COOE, IMEREST, AND ATTOfiNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm ihai I am licensetl un er�L } torce and eNecL Lic. » �� Contractors Signamre:� CONSTRUC710N LENDING AGENCV: Chapter 9(commencing with Section 7000) of Division 3 of the Business and�rp(essions Code, end my license is in full Class» ��> .� � G L C ✓!` Date: '7 f-h�� — Z' 2zm'� ❑ I hereby aNirm that there is e consimction lending agency for ihe pedormance of ihe work to� which this pertnit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lendefs Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby attirtn ihet under penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Protessions Cotle: Any city or county which requires a permit to consWcL alter, improve, demolish, or repair any strucWre, pnor to its issuance, also requires t�e epplicaN tor such permit to lile a signed statement that he or she Is licensed pursuant to Ihe provisions of lhe Contractors Licensa Lew (Chapter 9(commencing with Section 7000) of Divislon 3 of ihe Business antl Protessions Code) or that he or she is exempt t�erefrom and the Dasis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a pertnit subjects tha applicam to a civil penalry of not more ihan tive hundred dollars (5500).): ❑ I, es owner ot the property, or my employees with wages as their sole compensation, WILL DO 7HE WORK, antl ihe strucwre is not in�ended or oflered for sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law does not apply to an owner of property who builds or improves Ihereon, and who does such work himselt or �ersetl or ihrough his or her own employees, provitlad that such improvemenis are not intended or oHered for sale. If, however, Ihe building or improvement is sold within one year ot completion, ihe owner-builder will have the burden of proving ihat he or she did no� build or improve for purpose of sale.). ❑ I, es owner of the property, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The wntrectors License Law does not apply to an owner ot pmperty who builds or impmves Ihereon, antl who contrects for such project with a contractor(s) license pursuant to ihe Con�radors License Laws.). ❑ I am eaempt under SeC. Business and Professions Code tor ihis reason: Signature: Date: Owner ID venfied by tlnvers license. ❑ Yes ❑ No Drivefs License No. Eapires: Verification oi Ownarship by (type oi tlocument, i.e. - property tax bill or daetl): DIVISION OF INDUSTRIAL SAFETY VERMR CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be matle in wnnectlon with work aufhorizetl by Ihis permit, and ihat no builtling siructure, scalloltling, falsework, or tlemolition or dismantling ihereof, will be more than thirry-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Ttle 8, Califomia Adminisirative CoOe). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of IntlusMal Satery, as noted ebove, unless suc� person hes e permit to tlo such work trom �he division. Signawre: Date: Division of Intlusirial Safery Permit Number: CERTIFlCATE OF GOMPLIANCE AND AUTFfORVJ1710N OF ENTRV: I cenify under penalry of perjury ihat I have reatl this application and state ihat the inlortnetion given is wrrect. I egree to comply with all state laws and ci�y ortlinances relating to building consimction, and authorize representatives of the Ciry of Cos�a Mese to enter upon Ihe above-descnbed property for inspaction puryoses. I egree not to occupy or allow occupancy of any building euthorized by this permit until finel inspection. CODE �. 1616 F/i ed System Final Fire Prevention 1266 �Pool Spa Final 200 Final Re-Foot 201 Final Block/Retaining Well 202 Final Factory Fira Place 203 Finel Sign 204 Final Demolition PIS€ IMRIALS COpEY INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 272 Final Fire Prevention 220 222 250 Final Planning Approval Final Site Final Builtling/Occupancy ��1\1�1111.��] (714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 341 FLOWER ST REAR YARD 11725314 Applicant: MUELLER, SCOTT Address: 415 W BORCHARD ST ' � � , . , �� .Phone: 714-569-0556 SANTA ANA,. CA� �� . � , Zip: 92707 i� � � � Owner: � HARRINGTON, JAMES A AND JUDITH A� Address� -341�FLOWERSP - � . " , � . � � ,�.- - Phone: ` COSTA MESA, CA 2ip: 92627 Contractor. Address: MUELLER POOL CO 415 W BORCHARD ST SANTA ANA, CA, Status: ISSUED Applied: 01/03/2002 Issued: 01/03I2002 .� i - . ISSUED BY: � -Phone: 714-569-0556 - Zip: 92707 . . License: 402699 , . . _ . . _ SCOPE OF PERMIT ; . _ i IN-GROUND SWIMMING POOL ABANDONMENT. WORK�,TO INCLUDE REMOVAL OF POOL EQUIPMENT, � DISCONNECT GAS PIPING AND ECEC CONDUITS. t MISC ECEC TO�CAP ELEC � � ' � � �_ FEE�SUMMARY �, � _ � � � � Quantity _ - � , _ Quantity ' ' � ISSUE FEE , ' Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) , Pool / Spa Lighting Fixts Recept Outlets � Switches � � Non Res Appl , � Res Appl Service to 200a Service to 1000a ' Service over 1000a � Motors to 1hp Motors to 10hp Motors to SOhp Motors to t00hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole $23.50 $0.00 $0.00 $0.00 0 $0.00 0 $0.00 0 $0.00 0 . .� � $0.00 0 . $0.00�; � � - 0 . $0.00 0 $0.00 � � 0 $0.00 � � 0 � " $0.00 � � 0� � $0.00 0 $0.00 0 $0.00 � , 0 - - - $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 Temp Dist System / Lighting Busway /100 ft Standing Section� Misc Electrical Equipment . Transformers up to 1 kva/kw �� ...........:....up to 10 kva/kw .............:�...up to 50 kva/kw .._ .............up to 100 kva/kw � ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit � , Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand , Other Electrical Fee Investigation Fee � � _ Plan Check Fee Reinspection Fee $0.00 0 ; $0.00 0 $0.00 0 $18.20 1 � $0.00 0 $0.00 ' ' 0 $0.00� � �' 0 $0.00 0 $0.00 0 $0.00 0 $0.00 , 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 � � $0.00 " ' 0 $0.00 " 0 $0.00 so.00 $0.00 $0.00 TOTAL CALCULATED FEES $41.70 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be consideretl legal, such work must comply with all applicable cotles, antl all required Inspectlona 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 zaas-as �doo� WORKERS'COMPENSAnON DECLARArON: � � — I hereby atlirm under penalty oi perjury one oi ihe tollowing tleclarations: ❑ I have antl will maintein e certificate ot consent to self-Insure lor workers' compensation, es provided for by section 3700 ot t�e Lebor Code, For the pertormence of Ihe work tor which t�is pertnit is issuetl. ❑ 1 have and vrill maintain workers' compensatlon insurence, as requiretl by section 3700 of the Lebor Code, tor ihe performance ot Iha work for which ihis permlt Is issued. My workers' compansation Insurance carrier end policy numher are: y Cerrier. Policy Numbec (Thi�ction need nof be comp/efed /l the permit is veluetl et one hundretl dollars ($100) or less.) .0 I certity that in t�e peAormanca of ihe work for which [his permit is issued, I shall not employ eny person in any manner so as to become subjec� to ihe workers' compensetion Califomia, and egrae thet if I s�oultl bewme suDject to the workers' compensation provisions of Sectlon 3700 of the Lebor Code, I shell forthwlth comDly with ih e Pr, si ^/,� ^ ^� i7 /% A � i ��, � Appliwnt Signature: .u3(}� � �� i . .� � ��; r� 0 �� Date: T/7� O�ya WARNING: FAILURE TO SE RE WOFKERS' CIXAPENSATION COVERAGE IS UNIAWFl1L AND SHAl1 SUBJECT AN EMPLOVER TO CBYLIINAL PENALTIES AND CIVIL FlNES UP TO IXJE MUNORED hKK15AND OOLLARE (5100.000). IN ADDRION TO THE WST OF COMPENSAiION, DAAMGES AS PqOVIDED FOR M SECiION 3lOfi OF THE LABOR WDE, IMEREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm that I em licensetl under provisions of Chapter 9(commencing with Section 7000) of Division 3 ot the Business and Professions Cotle, end my license Is in tull torca and eHect. Lic. a �- �c � Class q L— �� Contractors Signeture: oate: )A� 3' 2� 2 CONS7RUCTION LENDING AGENCY: , ❑ I hereby aHirtn that Ihere is a construction lending agency for the pertormance ot Ihe work tor which this permit is issuetl. (Sec. 3097, Civil Code). ' Lendels Neme: Lentlers Address: Signature: Dete: OWNER-BUILDER DECLARATIONS: I hereby ettirtn thai under penalry ol perjury that I em E%EMPT FROM THE CONTHACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business end Professlons Code: My ciry or wunry which requires e pertnit to consirucL alter, improve, tlemolish, or repair eny siructure, prior to its issuance, elso requires the epplicant tor suc� pertnil m file a signed statement that he ar she Is licensed Dursuflnt b Ihe D�aWsions oi ihe ContraIXors License Lew (Chapter 9(commendng with Sectlon 7000) of Division 3 of the Business antl Professions Code) or that he or she Is exempt t�ereirom and Ihe besis for t�e alleged exemption. Any violatlon oi Section 7031.5 by eny epplicant for e pertr+' subjects the epplicem ro a civil penelry oi not more than tive hundred dollars ($500).): ❑ I, as owner ot the property, or my employees with weges as Iheir sole compensation, WILL DO THE WORK, antl ihe structure Is not intentletl or ofla�ed tor sale (Sec. 7044, Business antl Protessions Cotle: The Coniractors License Lew dces noi apply lo an owner of property who builds or improves Ihereon, and who does such work himsetl or hersetl or through his or her own employees, provided that such improvements are not Intentled or o%ered tor sele. If, however, the building or improvement is sold within one year ot completion, ihe owner-builder will have ihe burden of proving �hat he or she did not build or improve for Ourpose of sale.). ❑ I, as owner ot the properry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business and Professions Cotle: The comractors License Lew does not epply to en owner ot proparty who builds or Improves thereon, antl who contracis for such project with a contrecbr(s) licen5e pursuam to the ConirectOrS License Laws.). ❑ I em exempt undar sec. Business antl Professions Cotle for this reason: Signatura: Date: Owner ID veritied by dnvefs license. ❑ Ves ❑ No Drivers License No. Vedfication of Ownership by (type of tlaument, i.e. - properry tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IPICA710N: Expir85: ❑ I hereby certify thai no excavetion fiva (5) or more teei in tlepih into which e person is required to descend, will be matle in connection with work euthonzed by this pertnit, antl that no building siructure, scaffolding, falsework, or tlemolition or dismantling thereof, will 6e more than thirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Administretive Code). ❑ As owner-builder, I will not employ anyone to do work which would require e permit from ihe Division of Indusinal Sefery, es noted above, unless such person hes e pertnit ta do such work from the division. Signature: Date: Division ot Indusirial Sefery Permit Number. CERTIFICATE OF COMPLJANCE AND AUTHORIZATON OF ENTRV: I certify untler penalry of perjury ihat I have read this application end state ihet ihe infortnetion given is correct. I agree to comply with all state laws antl ciry ordinances relating to building cons�ructlon, and authodze representatives of Ihe Ciry of Costa Mesa to enter upon the ebove-described pmperty for inspection purpases. I agree not to acupy or ellow occupancy of eny building euthorized by this pertnit until final inspection. re O_f LAe al Owner( /� �� '� Dat /YU/A ?iI [�_ ��G � Aut�orizatl Applicant " (/ �Date COUE �. INSPECTIONTVPE 1616 Fixed Sysiem Final Fire Preven�ion 1266 Pool Spa Final 200 Finel RB-Rooi 201 Finel8lock/Retaining Well 202 Final Faciory Fire Place 203 Final Sign 204 FinalOemolition Q� INiITIALS COpE� INSPECTONTYPE 206 Final Mechanical 208 Finel Plumhinq 270 Final ElecMcal 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy �_ 1 .1111_ �� 1� � �` `f� � � �i � .. �2� ZA� _�2=� 102 ?wininq Laboratories af �sou�£Z�z c�a�'�fo=n�, �,�. � 3370 Anport Way / �qaibng Atln�ess P 0 Bo� 47 / Lo��g eeach. Ca 90801 / �213� a26J355 / 1213) 636�2388 /(714) 828-643: TES7ING aA<ne� o�Fiee �si»�o n,,,�� ia,�� s:�e�� i s�� A��, e< s�ioa i ir�a! s3i-2oas August 26, 1980 Examination: SC80-4636 COMPRESSION TESTS ON GUNITE CYLINDERS Mr. Errol F. Heesch 12921 Aspenwood Lane Cardee Grove, California 9?640 PROJECT ALBERT SPENCER RESIDENCE ADDRESS 341 Flower St., Costa Mesa SAMPLE FROM Gunit= Swimming Pool & Spa ♦ACM1IECT kM01NEE11 Mix DATE CAST DATE TE51ED SPECIMEN NO. 4; - 1 8-15-80 8-22-80 1 COMPRFSSION '7-➢ay TOTA1 IOAD, LBS. jl8,000 POUNDS PER 50. IN. 2,21'j Cyls. 4,5,6 "HELD Itv FIF.LD" COMPIIANCE SPEC�MENS CONT��CtOR Blue Haven Pools SU�COHi��CTOA Ver:: Anthony G,an:.te, Inc. SPECIfIED � STRENGTH 2,000 psi SWMP SIZE 5�" x 12° e-zz-ao a-z?-ao 2 7-Day 4 �l , 000 2,o3z 7-Day tests comoly with specifications. •uoE sr Jr. oisnuurioN: E. F. Heeseti - 2 Vern Anthony Gunite, Inc. Costa hiesa B.D./ChuckConner DFIIVE�EO �1' Heesch 3 7-Day 58,000 2,679 lFCEIVFO OM 8-19-80 RECEIV�D SFQ 0 31980 m Neale Zuidema . .iPo=.s .oc sae�i.reo •z *�c <onsmvrtu� vAOP[r+rr or e��eHrs. ..�o.ia.*ior. �ow r�nuuriow o� ovn eeroa*s. eove�usror+s. on �a. LA�CIS �NOu O> w(G�ROIIaG iN[� i5 P[SEMV[O nFMOiryG OVR wPIiTEM �YP90V�1 �S � MVTII�L VROiECTION TO C�IEMT�, TNE VV�IIL 1MD OV1��ELV[S. 33U �2 e _- �,-v;n _�. - `F"""""�unr°nyrl�� """`+"' �, � ��//—Lszu.�E-z5T n�iiainF Address _ Cf3E�L'TJPE�`-�G-?lhaner ��,�� ,fjl-�.��_,v C�ntr;ict:or L�fNtp[�._ `�Y�Arldres:; Pennl[ Uate �C'�fS</Num6er ��s/�%fJ Issue� .- crrY ot r,osT,� rt�<sa, nr:��na� �•tr:trr n� 14UII.UIicG tiAl�li'CY P.eglsLereJ I�epu�y Ruitdin,n, inspectoc CertlflcaCr_ oi CompLiance Unte ut thls i;er[iLlcu[e 'Ib [he Direct.c�i of iSutJdinb S;iiet.p: --_'__—'______ __�� . I het'r.l�y r.rrilfy I:haf. thc :nllnu�ln}; P�rtlniu: oi wurlc un Ihu biiSld(n{;:t ;�e che :ibove addrus, which required contLnuous tnr:p.:cclon ,md �:hich I wa:; empluycd [u 1n:;pccC, wcrr. insper.tr�i h:r mc ❑n�l �:u:iiplp wi[h Lhr pruvlSl.uns oI [hc 1iu11dtng Code apyllcablc tLcretu. � 1) Ccncr�.tc �i) Wcldlnf: 5) SpeciaL Cases 2) Nasonry I / �') Helntnrrrd f:��,�u:o Swimmin� Pooi Siz•� �S ��_ C+�iilce ✓_Hnnd '�'nck Sacks Cemca[ �le 1-- 1'ons uf Sand ��' ApproxSm:itc % nf �ua[er in :�ggrr�;ntc S d 1'h!s report covers kork completrd durtn�; w�rc� endln�;y _ 8�1a`� At�c�[L99_ ��17QC�+U ��7J�._ I.�boratorY ' i�vi�%�_ 7'clephone 2�/_z�� - Fo xm DU 6 ( U�'�,17 ^iC� E(�� 1�'� � .:EfY�:�1 'F�,;:i`i:i:c�; :i;:i::E':;f t�:;ys�a's,ea%�:.'�?�e!��'s�. I -:!::' S[;Eis'g,i,::i.:::;�.; ' . •. <:�zSiF'e ::>i' �:: : + : _.::::� :��:-::�::_;::;: ::::,,:: >::`;:� : ::::::: ::::::;:::: � :a�e:'`•',-SY-.':�!`i��'� =? �•q•e-�:5'�:-."��, �"j�'T'] :`:��:C f,Rly:-F::tQi:::ZNr� + ::..::: �..:::::�:��:� �: .:.: :... ...... . . . . . .`�� . �.��F;s�� ''Si�??�:'-iv?�: ^:.c,k � `t�::;Ei._._._.., ......... : �;��i�, i" �y-A� _ :}••: : =E.:...��• �ly�:g ��_� .:�� COSTA MESA BUILDINGSAFi��"�.`'�bEPARTMENT � APPLICATION FO�. .,fRI��.QQ PERMIT 78� 70 T�: .. ................ ............�.,.......�..................... R I BV PERMIT 1V� 50454 For Applicant to Fill in Completely — Use Ink Only ADIDRESS p1 � St ' A'P' N�' Z1ZS� BUILDING � OWNER OR , �ilp��.,^? A�DRE55 � TENANT _��L ��e�v UNIT OR MAILING Q �� SPACENO. ADDRE55 � V`� �� NO.lP1��J/V T� I V LOT ? C� BLK. CIT �_ ' . NEW ADD ALTER REPAIR MOVING DEMOLISH CANSTRUCTION L ) � �� LENDER r1 (/1 IJ� BRANCH Q �,,( OWNER /� `nC�` ADDflESS � VSE UULtSPJ1 VAIUE ARCNITECT /^� TE �Jv� a IO/Q�O Ofl ENGINEER' ' 1 N J� ADDRES S riJ�+`J ZONE � TVPE GROUP APPROVED CONTRACT '��Q�O BV DATE ADDRES '�'— j–C(.l.��11�/v TEL l CITV � NO.�S� / STATE CITV APPROVEDSETBACKS IIC. NO. � LIC. NO. 5¢E NO.OF BLDGS. (FROM GLSTFi�ET) OF LOT NOW ON LOT RONT FT. USE OF � ON EXI5TING BLDG. F . Separate permits are required for L. SIDE FT.B� electric, plumbing and heating work. � � REAR ZI FT. O USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION -+ }�n � DATE . �/�_ AP7ROVED APPROVE� /Ld � O W�. I hereby eeknowletlpe that I have read this application and state that the ebove intormetion is correct and agree to comply with all laws ragulatin8 building consvuction, antl I shell not employ any pe�son In violation of the workman's compensation laws of the State ot California. , a I hereby certify that I em p�ope�ly licensetl as a contractor untlar SQ. FT. the State of California Business antl Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and thai such licenses a�e In full force antl affect, or I THE PUflPOSE OF ESTABLISHING A PERMIT FEE ONLY: am axampt from the provlSiT of t�e Stafe ot Celitornia eusiness VALUATION PERMIT FEE $ entl P�otessions C rvision , Chapter 9. . �� PLAN CHECK $ ,� Signatura o� ' `'� �O Permlttae � $ ' U iJV TAX $ or Authorizetl ABent Date O TOTAL PAID $ D OWNER �E�, JOB ADDRESS GENERAL CONTR No. 117-25 .PECTIONS Pool Location _ Forms Main Drain Steel Reinfarce _ Elec. Bond _ Approval to Cove� Underground Electric _ Gas Piping Test Filtering System Lines � � Backwash Lines and Recep. ' � Electrical �Final � F' ��r and Vent Final � y. Syst2m Final � Backwash and Recep. Final �`+ Fencing Final DATE BUILDING PERMIT N SUBCONTR4CTOR �