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Home My WebLink About202 ALBERT PL - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa{��MBING PERMIT 77 FAIR �RIVE, COSTA MESA, CA 92626 Job Address: 202 ALBERT PL Suite No Vicinity: Parcel Nunmber: 42607401 Applicant: JOHNSTON, GINA MARIE Address: 2278 ORANGE AVE Phone: (949) 515-9211 COSTA MESA, CA . - � - ,Zip: --92627 - Owner: JOHNSTON, GINA MARIE , Address 2278 ORANGE AVE �. � . , � . Phone: (949) 515-9211 . COSTA MESA, CA . � Zip: 92627 �" � Comractor. OW NER-BUILDER Address: ISSUED BY: Status: ISSUED Applied: OS/30/2005 Issued: 08/302005 � Phone: " , � Zip: : � , . . .. , ' , License: � 000000 _' - � _ ; SCOPE OF PERMIT ' 1 WATER SERVICE. � � - - ' � : AMT ISSUE FEE ,'. � $23.50 Backflow irrigation $0.00 � Backflow Preventer $0�.00. ` Bathtub , $0.00 Clarifie� Syslem $0.00 Connect Qce,Soda,etc) $0.00 � Dental Units $0:00 Dishwasher $0.00 Drain, Floor $0.00 Drein, Rainwater �'50.00 Drain, Roof . , $0.00 Drinking Fountain $0.00 Expansion Tank $0.00 Gas Earthquake Valve ; ° $0.00 � Gas (1-4 outlets) . $0.00 ' Gas (Over 4 outlets) , , $0.00 Gas Repipe , $0:00 Gas Service $D�.00 Interceptors (Grease, Oip� � � $0.00 ' Interceptors (Sand Auto j --$0.00 ` FEE SUMMARY � `-" � QTv , - _. � ' Qrv = � � -� Laundry Tub / Washer „ ��,. `. $0.00 � 0 . � �Sump Pump, . • . 0 -- .- Landscapelrrigation ,: _ $0.00 0 � � � SwimmingPool,".'� - 0 P-Trap $0.00 -0�� Trap Primer -. .0 Pressure Regulator $0.00 -0 Urinal - � - 0 F,,-, � Process Piping (per 10 ft)" �., $0.00 0. Vacuum Brkr�Bkflow(1-4) , 0 � � - = Receptors . � -$0.00 -0 ' - .� Vacuum Brkr Bkflow(5+) 0 � - SeplicTank � - � $0.00 �. 0 � Wash Basin - 0 Sewer Cap for Demo $0.00 0 Wash Basin Set ` � 0 Sewer Connect -$0.00 0 Waste and Vent System ; 0 Sewer Private Line ,-.$0.00 _ .0 �Water Closet (Toilet). _� 0 Shower $0.00 0 WaterHeater/vent - � 0: Sink, bar $0.00 0 Water P.iping pnst or RepJ 0 � Sink, commercial -�. �... $0.00 0 Water Re-pipe -•. -r0 Sink,,Fl,00i � �. �$0.00,,,_0 WaterService ,=' 0 � � ,Sink;�kiJchen. . $0.00�� "� 0 Water�Softener. - � 0;. ' ' -;'Sink, service/mop � , $0.00 � 0 � �� OTHER � - 0 � �.�� Spa (private) -r' ' $0.00 0 � -- VIOLATION . �� 0 �'�. Spa (public) , � ' , , $0.00 ,-.,.: 0 "' PLAN CHECK p�, - � �., . � ' , � REINSPECTION -.`�� ..^� 0 � . y ' " , . . .. . _, ' �TOTAL: CALCULATED FEES: "` COMMENTS I SPECIAC CONDITIONS AMT ',' QTY $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 $9.80 1 $0.00 0 $0.00 $0.00 $0.00 $0.00 0 $33.30 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 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 Inepectlona and final approval must be obtained. Failure to obtain inspections and tinal approval will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 <ano�no �ww� WORKERS' COMPENSAnON DECLAHAnON: • � '�'T• I hereby aftirm untler penalry ot perjury one of the tollowing tleclaretions: ❑ I hava ana will maintain a certiticate of consent b salf-Insure tor workers' compensatlon, es provitled for by section 3700 0l iha La�or Code, for the pertortnence of the work tor which this Dermit is issued. ❑ I have and wiil maintain workers' compensatlon insurance, as requireU by sectlon 3700 of ihe Lehor CoOe, for the peAortnance ot the work for which Ihis pertnit is Issued. My workers' compensation Insuranca cerriar and policy number are: Carriar: Policy Number: (This section need not be completed il Me pe�mit is velued ef one hundred dollars ($100) or Iess.J ❑ I certify that in the pertortnance oi the work for which this pertnit is issuad, I shell not employ any person in any manner so as lo become sublect to Ihe workers' compensation laws of Califomia, end e9ree that it I should become sub�ect lo the workers' compensetlon provisions of Section 3700 of tha LeDor Coda, I shell forthwith compty wit� t�ese pmvisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATIIXJ COVEMGE IS UNUWFUL AND SHALL SUflIECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVI� FlNES UP TO ONE HUNDRED Tl-IOUSANO Dd1ARE ($100,000�, IN ADDITION TO TNE CQST OF COMPENSATIqJ, DAAUGES AS PROVIDED WR IN SEGTION 3106OF THE LABOR CODE, INTEREST, AND ATTOfiNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aXirtn ihat I am licensed under provisions of C�apter 9(commencing with Sectlon 7000) of Division 3 of the Business and Professlons Code, entl my license Is in full force and effect. Lic. » Class a Contrador's Signatura: . Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aNirtn that there is a consiruction lending agency for ihe peAormence of the work for which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lentlers Address: Signature: Date: OWNER-BUILDER DECLARA710N5: I hereby ettirtn ihat untler penalry ot perjury that 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business entl Professions Code: Any ciry or counry w�ich raquires a pertnit to consimct, elter, improva, demolish, or repair any slrucNre, prior to its issuance, elso requires Ihe applicant for such pertnit to file a signed statement that he or she is licensed pursuent to the provisions of the Contrectors License Lew (Chapter 9(commencing with Sectlon 7000) oi Division 3 ot ihe Business end ProFessions Code) or ihat he ar she is exempt iherefrom end the besis lor the elleged exemptlon. Any violetion of Section 7031.5 by eny applicent for a pertnit subjects the eppliwnt to a civil penalry of not more then tive hundred dollers ($500).): . ❑ I, as owner of the properry, or my employees with weges es their sola compensation, WILL DO THE WORK, end the structure Is not Intended or offeretl for sele (Sec. 7044, Business and Protessions Code: The Contractore Licensa Law does not apply to an owner of property who builtls or improves Ihereon, end who does such work himselt or herseN or ihrough his or her own employees, provided that such improvemenis are not Intended or otteretl for sele. It, however, ihe building or improvement is sold within one year oi completioq Ihe owner-builtler will have the �urtlen of proving ihat he or she did not builA or improve for purpose of sale.�. • � P'as owner oi ihe properry, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTOHS to construct the project (Sec. 7044, Business antl Profassions P `� ode: The contractors License Law does not apply to an owner of propehy who bullds or Improves Ihereon, antl w�o contracts for such project with a contractor(s) license pursuani to ihe Contractors License Laws.). ❑ I am exempt !Owiie� ID veritied 6y vers license. Verification of Owners ip by (type of Business end Professions Code for this reason: ❑ No property tea bill or DIVISION OF INDUSTRIAL SAFE7Y PERMIT CEYiTIFICATION: ❑ I hareby certify thet no excavation fiva (5) or more feet in depih into which e person is required to tlescentl, will be made In connection with work euthonzetl by ihis permit, and Ihat no builtling s�rucWre, scaHolding, falsework, or demolition or dismantling thereoi, will be more than t�irty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Calitornia Administrative Gode). ❑ As owner-builder, I will not employ anyone to do work which would require e permit irom the Division ot Industnal Safety, es natetl aDove, unless such person hes e permit �o do such work irom Ihe division. SignaNre: Date: Division of Industrial Safery Permit Number: CERTIFlCATE Of COMPLJANCE AND AUTNORIZATON OF ENTRV: I certify under penalty of perjury that I have read this epplication and sta�e �hat the infortnation given is cortect I egree to c mply with ell stete la s and ciry ordinances relating to building construction, end authotlze representetives of the Ci�y of Cos�a Mesa to enter upon the above-descnbetl pro rry for ins`pection p os . I ag not py-oaallow occupancy of any 6uilding euthorized by}ais permi� til finel inspeoction. SV J �1J S SSlgn`atiiie}Ofl e,g_alOwner(s),�� -tis_ ,� :D'ate, : And/(lr Authn znA Aoolicant . D2IB COpE �. INSPECTION TYPE 1616 Fized System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition PAIE 1ti�19L5 CO�E� INSPECTIONTYPE 206 Final Mechanicel 208 Finel Plumbing 210 Final Electricel 212 Final Fire Preveniion 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupency P9g I[�ELfl