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Home My WebLink About2181 AMERICAN AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No 2181 AMERICAN AV A PLUMBING PERMIT Vicinity: UNIT A GARAGE (RIGHT SIDE FACING BLDG) Parcel Nunmber: 42208115 Applicant: CHUNGEHRLICH, PAM Address: 2�81 AMERICAN AVE COSTA MESA, CA Owner: EHRLICH, DANIEL NORMAN Address 2181 AMERICAN AVE COSTA MESA, CA Contractor: O W N ER-BU I LDE R Address: Arch / Eng : Address: ISSUE FEE Backflow irrigation BackFlow Preventer 8athtub Clarifier System Connect (Ice,Soda,etc) Dental UniLs Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank ISSUED BV: Phone: 949-722-1207 Zip: 926273922 Phane: Zip: 92627-3922 Phone: Zip: License: 000000 Phone: Zip: License: SCOPE OF PERMIT REPLACE A WATER HEATER IN THE GARAGE FOR UNIT A IN AN EXISTING DUPLEX. NO OTHER WORK AUTHORI2ED WITH THIS PERMIT. AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 FEE SUMMARY QTY AMT Laundry Tub / Washer $0.00 0 Landscape Irrigation $0.00 0 P-Trep $0.00 0 Pressure Regulator $0.00 0 Process Piping (per 10 ft) $0.00 0 Receptors $0.00 0 Septic Tank $0.00 0 Sewer Cap for Demo $0.00 0 Sewer Connect $0.00 0 Sewer Private Line $0.00 0 Shower $0.00 0 Sink, bar $0.00 0 Sink, commercial $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 Status: ISSUED Applied: 11/20/2002 Issued: 11/20/2002 SumpPump Swimming Pool Trap Primer , Unnal Vacuum Brkr Bkflow(7-4) Vacuum BrkrBkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Waler Heater / vent Water Piping (Inst or Rep.) Water Re-pipe AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.30 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. � INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 2446d8 (N00) WORKERS' COMPENSA7��N DECLARA710N: � � I hereby aftirm under penalry ot perjury one ot the following tleclerations: ❑ I have and will maintain e certificate ot consent to self-Insure tor workers' compensation, es provided for by section 3700 of the Labor Code, tor the pertormance of the wark tor which Ihis p��it is Issued. � I have and will mainlain workers' compensation insurance, as requiretl by section 3700 of the Labor Code, Por the performance ot ihe work for w�ich this permit is issuetl. My workers' compenSation Insuranca carrier and policy number are: Cerrier: Policy Number. (This section need not be G�p�etetl i/ the permit is valued at ane huntlretl tlollers ($100) or less.) ❑ I cerlity that in ihe perfo�ance of the work for which Ihis partnit is issued, I shall not employ any person in eny manner so as to becoma su6ject to lhe workers' compensation lews o� Califomia, end agree that if I should become subject to ihe workars' crompensation provisions ot Saction 3700 oi the Lebor Code, I shell forthwit� comply with ihese prOvisions. Applicant Signature: Dete: WARNING FAILURE TO SECUPE WOFKEFS' COMPENSATION COVEfiAGE IS UN�AWFUL AND SHAIL SU8IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARE (5100,00�). IN ADDITION TO THE COST OF COMPENSATIIXJ, DAMAGES AS PROVIDED WR IN SECTION �OB OF THE UBOR CODE, INTEREST, AND ATTORNEI^5 FEES. LICENSED CONTRACTOHS DECLARATION: � I hereby aNirtn ihat I em lic�nsad under provisions of Chapter 9(commencing wlth Section 7000) oi Division 3 of the Business antl Professions Code, and my license is in full force and eHect Lla p Cless N ContractoYs Signeture: Daie: CONSTFUCTION LENDING AGENCY: ❑ I hereby aHirm that there Is e constmction lending agency for the pedormance of ihe work for which this permit is issued. (Sea 3097, Civil Code). Lentlefs Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLMATIONS: I hareby aftirtn Ihat under penalty of perjury thet I am E%EMVT FROM THE CONTRACTORS �ICENSE LAW for Ihe tollawing reason (Sec. 7031.5, 8usiness entl Professlons Code: Any ciry or counry which requires a pertnit ro construct, elter, improve, tlemolish, or repair eny siructure, pnor to its issuance, also requires the applicant for such permil to file a signed stetement tM1at he or she is licensed pursuant to ihe provisions of ihe Contrectors Llcense Law (Chapter 9(commencing with Sectlon 7000) oi Division 3 of ihe Business and Prolessions Gode) or ihat he or she is exempt therefrom end the besis for the alleged ezemption. Any violation of Section 7031.5 by eny applicant for e permit subj s the applicant to a Givil penalty of not more then five hundretl tlollars ($500).): I, es ownar of the property, or my employees with wages es their sole compensation, WILL DO THE WORK, end Iha structure is not intended or ottered for sale (Sec. 7044, Business and P�o�essions Code: The Contractors License Law tloes not apply �o an owner oi property who builds or improves thereon, and who does such work himseN or herselt or tn�wyh his or her own employees, providetl that such improvemants are not intended or oHered for sele. lf, however, lhe building or impmvemem is soltl within one year o� completion, the owner-builder will heve the burden of proving ihat he or she did not Duild or improve for purpase of sale.). - ❑ I, as owner of the property, am EXCWSIVELV CONTRACTING WI7M LICENSED CONTRAC70RS to consimct the project (Sec. 7044, eusiness antl Professions Cotle: T�e contrectors Licensa Law tloes not apply m an owner of propeny who builds or Improves thereon, end who contrecis for such project with e comracroqs) license pursuant to Ihd Coniractors License Laws.). ❑ I am exempt der sec.��i� Signature: �/Y/TI-'� ['ti� Owner ID verifiatl by tlriver9license. ❑ Ves VetlNcation of Owne�ship by (�ype oi documem, I.a. - propeny taz bill or tleatl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: Professions Cotle for Ihis reason: � Date: % /• 1 O � � �- Drwers License No. Expires: /- 2 4-05/ ❑ I hereby cenity that no ezceveNon five (5) or more feet in depth imo which e person is requlred to descend, will be made in connemion with work authonzad by this permit, and Ihat no 6uilding stmcNre, scettoltling, falsework, or demolition or disma�tli�g thereot, will be more than thirty-slx (3fi) teat high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle B, Calitomia AdmlNsiretive Gode). ❑ As owner-builder, I will not employ anyane to do work which would require a permit from the Division of Indusinal Sefary, as notetl ebove, unless such person hes e pertnit to do such worR ��om the division. Signature: Date: Division ot Industriel Satery Permit Number: CERTIFICATE OP COMPLIANCE AND AUTHORIZATION OF ENTRY: I cetlity under penalty of perjury that I heve read this epplication antl state thet the information given is correct. I egree to comply wlth ell state laws and ciry ordinances relating to building constmction, antl authorize representatives of ine City of Costa Mesa to enter upon t�e ebove-de i d propetly fo� inspe tion purposes. I �ag.ree�Jnot t�oJoccupy or ellow occupancy ol eny building authonzed by this permit until final inspection. �/%'%% �/�YI.C4 '� �-�/�?i� �/' o��'�oZ Signature Ot al Owner(s) Date And/Or Authorized Applicant COOE t. INSVECTIONTYVE 1616 Fixed System Final Fire Preven�ion 126fi Pool Spa Finel 200 Final Re-Root 201 Final BIocWRetaining Wall 202 203 204 Final Factory Fire Place Final Sign Final Demoli�ion �:� � _ j�QQF,( INSPECTIONTYPE 206 Final Mechanical 20B Finel Plumbing 210 Finel Elecirical 212 Final Flre Prevention 220 Final Planninq Approval 222 Flaffi Site 250 Final BuiltlinryOccupancy IA INfIfIALB i�-a�-oa � .� .;u, ¢��p M� q o, � , _ r J '�� ,,; (714) 754-5273 • Fax (714) 754-4856 Job Address: Suite No Vicinity: CITY OF COSTA MESA BUILD/NG DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 2181 AMERICAN AV HALLWAY CLOSET Parcel Number: 42208115 App�icant: RYAN, GRANT Address: 431 W. ALTON #H SANTA ANA, CA owner. CHUNG, PAMELA K Address: 2305 LA LINDA NEWPORT6EACH,CA Contrecror. CAIIFORNIA AIR CARE Address: 431 W. ALTON #H Arch / Eng : Address: SANTA ANA, CA MECHANICAL PERMIT Phone: (714) 641-7580 Zip: 92707 Phone: Zip: 92660 Phone: (714)641-7580 Zip: 92707 License: 705852 Phone: Zip: License: SCOPE OF PERMIT REMOVE & REPLACE EXISTING FAU WITH NEW 60K BTU UNIT. ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm AirHandlers> 70000cfm FloorFurnace Floor or Suspend Heater $23.50 $14.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY PERMIT NUMBER M00-00069 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 02/10/2000 Issued: 02/10/2000 ISSUED BY: Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Com mercia l I nci ne rator Domestic Incinerator Compressors / Absorption Systems Upto3hp/100kBTU 3Toi5hp/500kBTU 15To30hp/1,OOOkBTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Up to 3 hp 3Tot5hp 15 to 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or i( 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 requlred Inapeetlona and final approval must be obtained. Failure to obtain inspections and final approval will resuN in the expiration o( this permit. FOR INSPECTIONS CALL: (714) 754-5626 WORKERS' COMPENSATION DECLARATION: � I hereby aNirm untler penalty of perjury one of the following tleclarations: ❑ I have and will maintain a certificate of consent ro self-Insure tor workers' compensation, as provitletl tor by section 3700 oi the Labor Code, for ihe pertormance oF the work tor which this permit is issued. ❑ I hava and will maintain workers' compensation insurance, as required by section 3700 of ihe Lebor Code, tor the peAortnance of the work for which ihis permit is issuetl. My workers' compensation Insurance carner and policy number are: Carrier: Policy Number: (Triis section neetl no( be completetl il the permif is valued at one hundred dollers ($100) or less.) !��- 1 ceRify that in the pedormance ol the work for which Ihis permit is issuetl. I shall not employ any person in any manner so as lo become subject to the workers' �canpensation laws of Calif ia, antl agree that if)J$y��' tl 6ecoma suDjeci to ihe workers' compensation provisions of Section 3700 of the Labor Code, I shall fonhwith comply_�i[hthesep=oyisy . „�/( / � ��pp�I�icanCSignaWre: / ��I bl��— Date: : Iz� � U` i��G7cic; rVJRHIVING'FAIWRE TO SE E W R�ATION ERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE �$100,000�, IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 31W OF THE LABOR fADE, INTEFEST, ANO ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: 1 hereby aHirm t am licensed untler provisions of Chapter 9(commencing with Section 7000) of Division 3 o e.8usiness and Professions Code, antl my license is in full torce and eRect Lic..�'. .. .'� d S f1 5��—� _.. ass u_J C� — yLJ CONSTRUCTION LENDING AGENCY: J ❑ I hereby attirm ihat there is a constmction lending agency tor the pedormance ot t�e work tor which this permit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lenders Address: Signature: Data: OWNER-BUILDER DECLARATIONS: I hereby aHirm that under penalty ot perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business antl Protessions Code: Any ciry or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicaM for such permit to file a signed siatement that he or she is licensed pursuant to the provisions ot the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Protessions Coae) or that he or she is ezempt iherefrom and Ihe basis tor the alleged exemption. Any violation of Section 7031.5 by eny epplicant for a permit subjects ihe applicani to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of ihe propetly, or my employees with wages as their sole compensation, WILL DO TME WOfiK, antl the stmcture is not intentletl or oHered for sale (Sec. 7044, Business and Protessions Cotle: The Contractors License Law does not eppry to an owner of propeny who huilds or improves ihereon, and who does such work himself or herself or through his or her own employees, provided that such improvemenis are not intended or oHeretl for sale. Ii, however, the builtling or improvement is sold within ona year of completion, ihe owner-builder will have ihe 6urden oi proving that he or she did not build or improve tor purpose of sale.). ❑ I, as owner ot the property, em EXCLUSIVELY CONTRAC7ING WITM LICENSED CONTRACTORS to constmct the pwject (Sec. 7044, Business antl Professions Code: The contractors License Law does not apply ro an owner of pmperty who builds or improves lhereon, and who contracis for such project with a contrector(s) license pursuant to the Gontraciors License Laws.). ❑ I am exempt under sec. SignaWre: Owner ID verifietl by driver's license. ❑ Yes ❑ No Business and Professions Cotle for t�is reason: Venfication ot Ownership by (type of document, i.e. - property taa bill or deed): Driver's License No. Date: Expires: DIVISION OF INDUSTRIAI, SAFE7V PERMIT CERTIFICATION: ❑ I hereby certity �ha� no excavation five (5) or more fee� in tlepth into which a person is required �o descend, will be made in connection with work authorized by this permit, antl that no building simcture, scafloltling, falsework, or demo�ition or dismantling Nereof, will be more than ihirty-siz (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Calitornia Atlminisirative Code). ❑ As owner-builde�, I will not employ anyone to do work which would require a permit irom ihe Division of Industrial Safery, as no�ed above, unless such person has a permit to do such work from ihe division. SignaWre: Date: Division of Indusirial Safety Permit Number: CER7IFICA7E OF COMPLIANCE AND AUTHORIZATON OF ENTRY: I certify under penalty of perjury that I have read ihis applica�ion and state that ihe information given is wrrect. I agree to comply with all state laws antl city ordinances relating to building constmction, and authorize represen�atives of ihe City of Costa Mesa to enter upon ihe above-tlascribed propehy for inspection purposes. I egree not to occupy o� allow occupancy ol any building authorizetl by ihis permit until final inspection. CO�E M. INSPECTIONTYPE 7616 Fixed Sysrem Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition 244636 OATE INTITIALS CODE� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Pire Prevention 220 Final Planning Approval 222 Final Site ' 250 Final Building/Occupancy (714) 754-5273 • Fax (714) 754-4856 Job Address: Suite No Vicinity: CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 2181 AMERICAN AV B IN CLOSET - UNIT B Parcel Number: 422081'15 Applicant: RYAN, GRANT Address: 431 W ALTON #H SANTA ANA, CA owner: CHUNG, PAMELA K Address: 2305 LA LINDA NEWPORT BEACH, CA Contrector: CALIFORNIAAIRCARE Address: 431 W ALTON #H ArchlEng: Address: SANTA ANA, CA MECHANICAL PERMIT Phone: (714)641-7580 Zip: 92707 Phone: 2ip: 92660 Phone: (714)641-7580 Zip: 92707 License: 705852 Phone: Zip: License: SCOPE OF PERMIT REMOVE & REPLACE FORCED AIR UNIT FOR EXISTING DUPLEX (UNIT B). ISSUE FEE Inst FAU <700 k BTU Inst FAU >700 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < t0000cfm Air Handlers > 10000cfm Floor Furnace Floor or Suspentl Heater $23.50 $14.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 Quantity 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY PERMIT NUMBER M99-00527 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Repair / All Absorbtion Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Com me rcia l I nci nerato r Domestic Incinerator Compressors /Absorption Systems Upto3hp/100kBTU 3To15hp/500kBTU 15To30hp/1,OOOkBTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Up to 3 hp 3To15hp 15 to 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: 11/19/1999 Issued: 11/19/1999 Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 538.30 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28. § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a penod of 1 BO days. INSPECTIONS: In order for the work authorized under Ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapeetlons and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby aflirm under penalry of perjury one ot t�e following declarations: ❑ I have antl will maintain e certiticate ot consent to seif-Insure for workers' compensation, as providetl tor by section 3700 of Ihe Labor Coda. for ihe peAormance of the work for which Ihis permi� is i55ued. ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for ihe perfortnance oi the work kr which this permit is issuetl. My workers' compensation Insurance carrier and policy num6er are: Carrier. Policy Number: (This section neetl no( be crompleted il the pertnif is valued at ane hundred dollars ($100) ar less.) ,� I cenify that in the peAormance ot Ihe work for which this permit is issued, I shall no� employ any person in any manner so as to become subject ro the workers' compensation laws of CaVfomia, antl agre fY�should 6ecome su6ject to the workero' compensation provisions of Section 3700 of tha Labor Code, I shall fonhwith comply with Ihese pr i�6ns. / App�icam signawre: Date: / f — 1 9 —9 i WARNWG FAILURE TO CURE WORKERS' CAMPENSATION JOVERAGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSANDDOLL4RE(510�,000),INADOITIONTOTHECOSTO fAMPENSATIIXJ,DAMAGESASPROVIDEDFORINSECTION3]O60FTHEL4BORCqDE.IMEREST,ANDATTORNEV'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm Ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of tha 8usiness antl Professions Code, and my licensa is in tull torce and eRect. Lic. p Class # G ��—<-'+ Contractofs Signawre: _ _ _ Date: � � — I °1 — � 4 CONSTRUC710N LENDING AGENCV: ' � ❑ I hereby aHirm that there is a construction lending agency for ihe peAormance of the work for which ihis permit is issued. (Sec. 3097, Civil Code). Lendets Name: Signature: _ OWNER-BUILDER DECLARATIONS: Lentler'S Addre55: Date: I hereby aHirm that under penalty of perjury lhat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for t�e following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires tha applicant for such permit to file a signed statemeN ihat he or she is licensed pursuant to the provisions of ihe Coniractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of tha Business antl Proiessions Code) or thet he or she is eaempt iheretrom and the basis for the atleged exemption. Any violation ot Section 7031.5 by any applicent tor a permit su6jecis ihe applicant to e civil penal�y of no� more ihan five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sola compensation, WILL DO THE WORK, antl the structure is not intended or oNered for sale (Sec. 7044, Business and Protessions Code: T�e Contractors License Law does not apply to an owner of propetly who builds or improves ihereon, and who does such work himself or herself or Ihrough his or her own employees, provided ihat such improvemanis are not intended or oflered for sale. If, however, the building or improvement is sold within one yeer of completion, ihe owner-builder will have ihe burden of proving ihat he or she tlitl not huild or improve tor purpose of sale.). ❑ I, as owner ot lhe property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construd the project (Sec. 7044, Business end Professions Code: The contrectors License Law does not apply to an owner of propeny who 6uiltls or improves ihereon, and who contrects for such project with a contrador(s) license pursuam ro the Coniractors License Laws.). ❑ I am exempt under sec. Signature: Owner ID venfied by drivers license. ❑ Ves ❑ No Business and Professions Code tor this reason: Venfication of Ownership by (rype of document, i.e. - property tat bill or tleetl): DIVISION OF INDUS7RIAL SAFETV PERMIT CER7IFICA710N: Drivers License No. Date: Expires: ❑ I hereby certity �hat no azcevation five (5) or more feet in tlepth into which a person Is required to descend, will be made in connection with work authorized by this permit, and ihat no builtling sWc�ure, scaHolding, falsework, or demolition or tlismantling thereot, will be more than thirty-siz (36) teet high. (Chap. 32, Grp 2, Atl 2, Sec. 341, Title B, Galitomia Atlminisirative Code). ❑ As ownervbuiltler, I will nol employ anyone to tlo work which would require a permit imm the Division of Intlustrial Safery, as notetl above, unless such person has a permit to do such work from ihe division. Signature: Date: Division of Indusirial Safery Permit Number: ICER7IFICATE OF COMPLIANCE AND AUTHORIZATON OF ENiFiY: I certity under penalty of perjury ihat I have read this application and state iha� the information given is I correct I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Ihe City of Costa Mesa to enter upon the above-descnbed propeny for inspection puryoses. I agree not ro occupy or allow occupancy of any building authorized by Ihis pertnit until tinal inspection. COpEM, INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition 2646-<6 OATE I INTTIALS l �- i 9 -9 g Date COpE♦ INSPECTIONTYPE P�Tg INTI IAL 206 Final Mechanical / a- r-9 �� 208 210 212 Final Plumbing Final Electrical Final Fire Prevention 220 Final Planning Approval 222 FinalSite 250 Final Building/Occupancy �3�5�� COSTA MESA BUILDING•SAFETY DEPARTMENT P. O.HOX 917 C08TA MEBA. GALIFORNIA For Applieanf fo Fill In Complefely TYPE OR PRINT BUILDING 2181 American Avenue ADDRE6S COSTA MESA CALIFORNIA „u,tiF„ PRINCETON, INC. Costa Mesa 91151 CONTRAGTOR Dike & Colegrove� InC. AD�RE55 1533 Balcer �Jt.• � �„� Gosta Mesa, Calif. �?� No. 167293 No: KI 9-1151 s�ze 76 x 1li9 � u°w°�u .`�asnone nv � nr USE OF EXISTING BLDG. BETBACK LINE PROM CENTER oF BTStEET O� REAR YARD � SIDE YARO I LEPT 7� I RIGHT J� DESCRIPTION OF WORK urw I i� II e� rcwennra I II enmm�v I �C. EXTERIOR WALL ROOF COVBRING Sti11CC0 COVERING COIfID• rock USE OF BUILDING ANO WORK TO BE PERFORMED M t' attached garage (two livin units. Plan AR 1 HEq6BY ACKNOWL¢DGE TXAT 1 HAVE RP.�O THIB APPLIGTION ANO BTATE TXAT TXC ABOVE 16 CORRECT AND AGRC¢ TO COM- PLV WITX ALL CIiY ORDINANCE9 AND BTATE LAWB ReGULATINO BUIlDINO CONBTRUGTyON////,� BIGNATURE OF ✓J/ /°� j� w A/J�--'� 'AUTHORIZED AGENT Dike RC CO.{�C�MIVE� IIIC� FEE RECEIVED � FEB 201�;if �J�j Fl�NpANCrE� DEPT. APPUCATION `PCM P�R1N1�A MESA BUILDING For Oifice Use Only R¢CEIPT NO. �PERMR Np._ BY cosTa rnEsa FIRE ZONING ZONE I NO. OF I U6E OP � R�I. PLAN9' BUILDINO µ �ea�� _ . _ _ ..., EVES (C¢NTER LING BTJ APPROVED Gar, 1�1.t1 sq, ft. 189UED att gar. TME AMOIINT BNOWN UNOER VALIIATION 19 POR THE PIIRP08E OF EBTABLIBHIN6 R P6RMIT FEE ONLY. VALUATION PERMIT PEE $ 37�00 s 17,979D0 PLAN CHECK $ 1V�"O C 0 t TY O F ANGE September 25, 1970 JOHN R. PHIIP, M.D. NEALTH OFFICER SANTA ANF OFFICE 605 NORTH RO55 STREET SANTA RNA, CALIFORNIA 92]02 TELEPHONE: B3l-313� MoUlnp Add�.sai P. D. 8n: 355 Sanra 4no, Coll/ornlo 92702 ANANEIM OFFICE 1011 SOUTM EAST STREET ANNHEIM,CALIFORNIA 7ELEPHONE: ]76�5551 HEALTH DEPARTMENT MolllnpAddr.+a: P.O.Boi355 Son�o Ana� Colllorn/a 92702 Costa Mesa Department of Building and Safety 77 Fair Drive Costa Mesa, CaLi£ornia Attention: Frank Hruza, Assistant Director Re: Water Problem at 2181 Apartment A, American Avenue, Costa Mesa Gentlemen: Enclosed is a chz�onological record of this Department's action and activities regarding this episode. Although the problem is essentially resolved from the "health aspect", it is our opinion that the conditions created by the owner of the property and his worlmien were serious. To date, there is no evidence that they are aware of that seriousness. If flirther assistance is desired, please feel free to ask. Very truly yours� ��. �lr%-� John R. Waples, R.S. Supervising Sanitarian Division of Environmental Health JRW:bw cc: Costa Mesa County Water District Costa Mesa City Attorney's 0£fice Orange County Sheriff� Attention Mr, Ragle Enclosure -� � V � d . f' � � � l3UILDING SAFETY DEPT. Jf-i� ,,,� J IJ�� r�r� U�l�irjr�<� ��. i.�.��.ti4i.�r5f�� REPORT ON C�LAINT ABOUE POSSIBLE CONTAFffNATED WATER BY: JOHN R. WAPLSS � 9-3-7o at 9:00 A.M., Juanita McSwain, 2181(A) American Aae., Costa Mesa, 633-9393 �• 661, called relative to a chemical taste and odor of the water at the premises. She stated that a man had placed a material in the hat `rater line to stop a leak'. Also� that she had made tea with the Water after the material had been injected, and detected taste and odor� but did not indicate any adverse efYects from the water. Wayne Shurts. District Sanitarian, was asaigned to the investigation. He verified the odor in the xater and took samples of the vater. Trro bottles of water were submitted to the Orange County Health Department Lsboratory for bacteriolqgical ana�ysis and one was submitted to Mf'. Ragle, chetnist with the Orange County SheriYf's Laboratory. The bacteriological results were negative for coliform organisms. Mr. Ragle determined that the material in the water xas volatile. At 9:30� 9-3-70, Mr. Waples inYormed F'rank Hruza� Assistant Director of Building and Safety, Costa Mesa, of the problem. He had a plumbing inspector investigate to determine xho did the xork. On 9-4-70 at 11:�5 Frank Aruza and John Waples agreed to further investigate. He xas to check with the city attorney's office for possible compla.int and with the Costa Mesa County Water District. I was to contact Mr. McKay� 642-5466� owner oP the apartment. On 9-4-70 at 1:25 P•M. Waples called Mr. McKay. He informed me that a plastic material was placed in the hot xater line oi Apastment A. The material plugged the line� so gasoline Was put in the line to dissolve the plastic. He xas inYormed that thia rras an 311ega1 act and also� a potential health �?a�• He appeared not to be impressed. He further eaid that a representative of the water campany had just been at the epartment and stated a Plushing of the line would be suFficient. I told him that Juanita Mcswain reported she had flushed the line Yor over two hours and the odor still persisted. on 9-4-7o at 1:45 a four w�y telephone conversation betxeen Frank HXu2a; Ray Wallace, Mana�er, Costa Mesa County Water District; A1 Cerrano� Costa Mesa County Water District; and Waples relative to further action. The Water Compai�y was_to determine if the hot water line could be shut off and Frank and I xere to proceed as indicated at 1':25 P.M. on 9-8-70 �'• Chambers� Costa Mesa County Water District� reported he had checked the apartment in the A.M. and the alor vas still coming irom the hot vater line. 9-10-70 Frank gruza reported he had conferred r+ith Mr. Roy June� Costa Mesa City pttorney. 9-21-70 Dean Dorris� Costa Mesa Building Inspector and I checked out the vater condition at the apartment and observed the folloving: 1. A neW copper line had been installed from the hot xater tenk to the lavatory� kitchen sink and bath tub. 2. There vas a chemical odor in the hot water coming Yrom the kitchen sink. 3• There was uo odor detected in the xater at the bath tub or bathroom lavatpry. Summery of findings: l. An unknoxn (to us) substance had been put into the hot vater line. 2. The vork was done at the request of the property ovner� by an unlicensed person. 3• No permits to do the vork (prior to the episode� xere secured from the Costa Mesa Building Department. 4. A potential health hazard vas created. Conclusion: 1. Mrs. Mc Swain rras instructed to continue flushing the line and not use the hot water for cooking purposes until the odor is gone. 2. The persons causing the problem should have action brought egsinst them. The episode to this date has caused the taxpayers over $200.00. expense. CITY O F COSiA fi/i ESA IIVTER-OFFICE f!/iEIVIORAfVDUfl�I ^ September 10 , �g 70 TO Roy June, City Attorney FROM Frexrilc Hruza, BuildinG :afetv SuDervisor S(P3JECT: possible contami.nated wai.er at 2181, Apartment A, American Avenue I received a call from John �laples, Orange County Health Depart:nent,at c:35 Ata on Septe�nber 3, 1970 in re�;ar6. to contarr:ina'Ced •��rzter a't the �bove adiaress. 22±e Health DepArt- ment picked_ up a sample of the r�ater at this adcress and advised DSrs. Juanita McSwain (the tenant) that this water Was not to be useu for hwr�an consw;:ption. HowArd Caffrey, Plwnbin� 7nspector taith the Buildin�; Saiety Departu�ent� investigated this complaint. Ne repos�ted that a plastic of some forr,i was u�ed or pu¢:ped i.nto the hot water line al.ong with a gasoline to try and stop a water leal.. The line Nas then flushed iii son�e manner �ri.th s�ater for aoproxir.�ately two hours. The odor end taste oP petroleum pro- duc�t� is sti11 noticable in the tap water drawn from the hot wtzter taps. The owner� Cl,vde A. D1cFCay of 2tS32 llrake l,venue, had a Nu•. I•ti�rk Lee or 236�� santa Ana Aver_ue� Costa h;esa, try to r�ake the repairs. His telephone number is 642-2255. On Septe�Uer 4, 1970� at 11:1:5 Ati, bIr. 'rlaples 1:elephoned r�e and stated it was his feelin� that the Co�ta 2-ie5a S7ater District be notified.; a].so, requested that I contact you regr�rd- ing this reet{;er. A1: 1:25 Pid on Septer�ber �t� 1970, t�x. �•Iaples called an� T had idr. ,Jallace� Manager oi tne Costa idesa Water Corupany� on ccnference call. He said he rrould send Nir. A. Serranto fron his office to checic the situatiou. Mr. Serranto chec�:ed the hot rrater and felt, b� shuttin� off the hot water tasu; (the inlet valve on top), they would be able to use the cold water over this holiday week end. The owner oi the property� Clyde A. IdcR�y� et al� 2532 Dra�e pvenue� Costa hiesa is in vio- lation of the followin� sections of the Uniform Plurnbin,r, Ca1e, 1907 Edition: Section 1.6 - Dangerous and Insanitary Construction Section 1.7 - Violations and Pen�tie� Section 321 - Health and Safety SecLion 1003 - Cross-connection Control Section 1004 - haterials FFI : zh cc: Orange County Health Department Howard Caffrey, Plumbin� Inspector Costa Mesa 47ater Compas�y Juanita McSwain, 2181 American Avenue, Apt. A, Costa hiesa