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Home My WebLink About265 ALBERT PL - Building PermitsCITY OF COSTA MESA BI/ILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-5273 • Fax (714) 754-4856 Job Address: 265 ALBERT PL Suite No Vicinity: Parcel Nunmber: 42608305 Applicant: LORIE GLOVER Address: 2737 S CRODDY SANTA ANA, CA Owner: STOCKMAN, JOHN F Address 4875 SURREY DR CORONA DEL MAR, CA PLUMBING PERMIT Phone: (714)241-1414 Zip: 92704 Phone: Zip: 92625 Contractor: COAST ROOTER PLUMING HEATING 8 AIR CONDITIONING Address: 2737 S CRODDY Arch / Eng : Address: SANTA ANA, CA WATER HEATER CHANGE OUT. ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Connect Qce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oip Interceptors (Sand Auto ) 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 $0.00 $0.00 $0.00 so.00 $0.00 so.00 $0.00 Qn Phone: (714)241-1414 Zip: 92704 License: 529127 Phone: Zip: License: SCOPE OF PERMIT FEE SUMMARY AMT Laundry Tub I Washer $0.00 Landscape Irrigation $0.00 P-Trap � $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Seplic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Conned $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink,kitchen $0.00� Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS PERMIT NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 06/30/2000 Issued: O6/30/2000 ISSUED BY: �" I , � U SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr BkFlow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $72.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: E35.80 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. 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 Inepectione and final approvel must be obtained. Failure to obtain inspections and final approval will rasult in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATON: `� I hereby aHirtn untlar penalry of perjury one of the tollowing tleclarations: ❑ I have and will maintain a certificate ot consent m self-Insure tor workers' compensation, as provitletl for by section 3700 of the Labor Cotle, for ihe pertormance of ihe work for which this permit is issued. FY%I have and will maintain workers' compensation insurance, as requiretl by section 3700 ot Ihe Labor Code, for ihe pedormance of Ihe work tor which this permlt is issued. T My wo r' com^p�nsation Insurance carner and policy number are: �I O 8 gR U� Carcier. /Ll ' ��'1 PolicyNumber: (This secfion ed not be complefed Af e permi( is alued et one hundred dollers ($100) oNess.) ❑ I certify that in ihe pedormance of the work for whic� this permit is issued, I shall not employ eny person in eny manner so as to become subject to Ihe workere' compensation laws of Calitomia, antl agrea ihat it I should become subject to the workers' compensation pmvisions of Section 3700 of the La6or Code, I shall tonhwith comply with Ihese provisions. . / Applicant Signature:��— Date: (� �3 Z%� WARNINGFAILURETOSECUREWO RS'CAMPENSATIONCOVERAGEISUNLAWFULANDSHALLSUBIECTANEMPLOVERTOCRIMINALPENALTIESANOCIVILFINESUPTOONEHUNDRED THOUSAND DOLLARE ($100,000), IN AODITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]W OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn that I am torce antl effect Lic. x_ Contractor's Signeture: ot Chapter 9(commencing with Section 7000) of Division 3 of ihe Busine�n�P�otessions Code, and my license is in full � Class a ,(�/..,�` Date: �r�().—v (/ CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirm that there is a constmction lending agency for ihe pertormance of ihe work for which Ihis permit is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lender's Atltlress: SignaWre: Date: OWNER-BUILDER DECLARATIONS: �`� 4^Z I hereby effirm iha� Undef pe�alry of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Professions Coda: Any ciry or counry"',whiCh�requires a'permit�to consiruct, alter, improve, tlemolish, or repair any s�ructure, pnor to its issuance, also requires the applicant for such pertnit to tile a signed stetement thzt�he�or�sha is licensetl'pursuam to the provisions of the Comractors License Law (Chapter 9(commencing wilh Section 7000) ot Division 3 of ihe Business and Professions Cotle) or thafhebrsAe9s exempt theretrom and the basis for ihe alleged exemption. Any violetion of Section 7031.5 by any epplicant for e permii sublecis iha applicent to a civil penelty of not more ihan tive huntlretl tlollars ($500).): ❑ I, as owner oi the propetly, or my employees with wages as iheir sole compensalion, WILL DO THE WORK, and Ihe stmcture is not intended or oHered for sale (Sec. 7044, Business antl Protessions Code: Tfie Contractors License Law does not apply to an owner of property who builtls or improves lhereon, and who does such work himseli or herself or through his or her own employees, provided that such impmvemems are not intended or oflered for sale. Ii, however, iha building or improvement is soltl within one year of completion, ihe owner-builtler will have �he burden of provinq ihat he or she ditl not builtl or improve tor purpose of sale.). ❑ I, as owner of �he property, am EXCLUSIVELY CON7RACTING WITH LICENSED CONTRACTORS to constmct Ihe project (Sec. 7044, Business antl Professions Cotle: The contracbrs Liconse Law does not appty to en owner of propetly who builds or improves thereon, antl who coniracis tor such prolect with a comrector(s) license pursuam to the Conirectors License Lews.). ❑ I am exempt unaer sac Business and Pmfessions Cotle for Ihis reason: SignaWre: Date: Owner ID verifietl by tlriver's license. ❑ Yes ❑ No Drivers License No. Verification of Ownership 6y (type of document, i.e. - propetly tex bill or deed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: Eapires: ❑ I hereby certity ihat no excavation tive (5) or more feet in depih inm which a person Is requirad to descentl, will be mada in connection with work authorized by ihis permit, antl ihat no building slmcNre, sceHolding, falsework, or tlemolition or dismantling ihereof, will be more ihan thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Gelitornia Adminisirative Code). ❑ As owner-builder, I will not employ anyone to do work which would requira a permit irom the Division of Indusirial Safery, as notetl above, unless such person has a permit to tlo such work irom �he tlivision. Signature: Dete: Division of Industnal Safery Permit Num6er: CERTIFlCATE OF COMPLIANCE AN� AU7HORIZATION OF ENTRV: I cetlity under penalry of perjury that I have read ihis application and state that ihe infortnation given is correct. I agree to comply with all state laws antl city ordinances relating to building construction, and authorize representatives of ihe Ciry of Cwta Mesa to enter upon the above-tlescribed property for inspection purposes. I agree not to occupy or allow occupancy of eny building euthorized by ihis permit until final inspection. S' re Of Legal Owner(s) i Date � lZ . /��D�U And/OrAuihorizetlApplicant E� Date COUE M. INSPECTIONTYPE 1616 Fixetl System Final Fire Prevention 1266 200 201 202 203 Pool Spa Final Final Re-Roof Final BIocWRetaining Wall Final Factory Fire Place Final Sign 204 Final Damolition 2dd&46 D� INTITIALS COOE 11 INSGECTION TVPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approvel 222 Final Site 250 Final Building/Occupancy QAjf, INTITIALS v� �► , .� a�ai;�, i COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f7 C08TA MEBA. CALIFORNIA For Applicanf to Fill In Complefely � � TYPE OR PRINT _____� BUILDING � � 6 � ��6 y' / (d C�, ADDRE58 eY L 0 T C05TA MESA. CALIFORNIA oWp1ER 2OTH CENTURY �ON£S� {NC• ADDRE65 2 `� NEWPORT �OU�EYARD C�7yCOS7A MESA No��8938 RCENGINEER MEl Loae NO.L�893S ADDRE55 2L� 2 NE@lPORi a�ULEVARD CONTRAC70R 2OTH f'EN TURY HOME S I NC AODREss 2L�. 2 NEWPORT BOULEVARD. CITYCOSTA MESA� CALIFORNIA LIC.TNO. 2Oi}—�C�1 No: �� 8 9388 OF LOT � 3 rJ. 53 44* I�o, oF e�.oae. O 2OX • NOW ON LOT USE OF N 0 N E �� EXIBTING BLDG. BHTBACK LINC PROM DESCRIPTION OF WORK on�nuc 6 �T„o,« 1 srEa Ic i AND WORK 1 NER68Y ACKNOWI-CDGH THAT 1 HAVE AND BTALE THAT YXE ABOVE IS CORAf PLV WITX ALL CIN OROINANCE9 AND/ BUILDINO CONB�TRjU'\�/�O�N. I SIGNATURE OF' V Y.�. O�. M1 / ■ AUTHORIZED FEE RE�t�vtv �� NOV 3 �� w FINANCE OEPT. CIT`� OF COSTA �E� APPLICATION FOR PERMIT BuauiN� For Offiee Use Only NELEIPT NO. PpjtNl�l10., �.. `.'.i d :'�1 rr BY I DATE RECEIVEDi I OATE IB6LIEO a� COSTA MESA. CALIFORNIA FIRE ZONING ZONE NO.OF J IISE OF NEW 1 � � I PLANB [� 9UILDIN� �/� LEGAL dN �� 3� / DESCRIPTION �P��4� /��5�' e o ran ��/! �-• % G O —• b V ICENTeR L�NC 9TJ � � 'RONT 2. SIDE � _. SIDE "�' iEAR SO. � 4PPROVEO � o� 3Y �� HOLD FOR SPE� IN. DATE ��/7 ��D / REQUIRFMENTS � , t . s�o4 �� c3 �� --s�a� b �O iXIB APpLIWTION THG AMOUNT BHOWN UNOER VALWTION 1 FOR THE AND A6AEE TO COM- pURPOBE OF EBTABLIBHING A PERMIT FEE ONLY. LAwB REpULATiN6 . VALUATION I _ ,.V $/`T/ (� �% � � �