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Home My WebLink About3333 ALABAMA CIR - Building Permits(714) 754-5273 • Fax (714) 754•4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 lob Address: 3333 ALABAMA CI Suite No Vicinity: Parcel Nunmber: 13958123 Applicant: ELLIS, E J, JR. Address: 84301779 Owner: KEARNS, PAUL S TR Address 3333 ALABAMA CIR COSTA MESA, CA PLUMBING PERMIT Phone: Zip: Phone: Zip: 92626 Contractor: ORANGE COUNTY SERVICES INC DBA GEORGE BRAZIL PLU Address: 380'I LENAWEE AVE Arch / Eng : Address: ISSUE FEE BackFlow irrigation BackFlow Preventer Bathtub Clarifier System Connect Qce,Soda,elc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earlhquake Valve CULVER CITY. CA Phone: (310)253-5229 Zip: 90232 License: 679898 Phone: Zip: License: SCOPE OF PERMIT REPLACE 30 GALLON WATER HEATER. 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 FEE SUMMARY QTY AMT Laundry Tub / Washer $0.00 0 Landscape Irngation $0.00 0 , P-Trap , $0.00 0 Pressure Regulator $0.00 0 .� Process Piping (per 10 ft) 50.00 0 � Receptors $0.00 0 Septic Tank $0.00 0 � Sewer Cap (or 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 0 Sink, Floor $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ISSUED Status: ISSUED Applied: 10/29/2004 Issued: 10/29/2004 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 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 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 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 end become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectlons and final epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5828 26a6<6 (N00) WORKERS' COMPENSATION DECLARATION: � , — I hereby aHirm under penelty oF perjury one af the fai wing declaretions: - � ❑ I heve end will meintain a cenificate of consent b self-Insure tor workers' compensetion, as provitletl tor 6y section 3700 of the Labor Code, for ihe pertormance oi ihe work for which ihis permit is issuetl. � I have entl will maimain workers' compensation insurence, as requiratl by section 3700 of the Labor Code, for the pedortnance of ihe work tor which this pertnit is issued. j M�ryworkers' ccom� pen/s�ation I ranc arri/e�r a� policy number are: '"7 �q c/�' Carrier:� iJT[�7� �Ul �4J Policy_ umber /�/�� L�V / -(This section need nat 6e completetl il the permit is velued at one hundred dollers ($100) or /ess.J ❑ I certity ihat in Ihe pertormanca oi the workje i ihis�mi it is issued, I shall not employ any person in any manner so es to become subject to the workers' compensetion laws oi Califomi . r 6 i o Id be ome subject to Ihe workers' compensation provisions ot Section 3700 0l ihe Labor C de, I shall forthwith comply with these provisions /� �,(/,� /% 'yAppl1~�cant�SignaNre: _ Date. �!/�� / '7JARNING FNILURE TO SECURE WORNERS' �MPENSATION COVE GE IS UNLAWFUL ANO SHALL SUBJECT AN EMPCOYER TO CRIMINAL PENALTIES AND QVIL FINES UP TOONE HUN�RED THOUSANDDOLLARE($100,000),INA�OITI TOTHECOSTOF ENSATION,�AMhGESASPROVIDEDFORINSECTION3]O60FTHELABORCODE,IMEPEST,ANDATTORNEY'SFEES. LICENSED CONTRACTORS DECLARATON: I hereby aflirmi�hat I am licensed yn plpvisjc b�rc.e�a � cL Lic. a 6��E ConVactofs SignaWre: 9(commencing with Section 7000) of Division 3 of ihe Code, and my license is in full CONSTRUCTION LENDING AGENCV: �' ❑ I hereby aNirm that ihere is a construction lentling agency tor ihe performance oi ihe work for which ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARA710N5: I hereby aHirm Ihat under penalry oi perjury that I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for ihe toliowing reason (Sec. 7031.5, Business antl Pmtessions Code: Any city or county which requires a permit to constmct, elter, improva, demolish, or repair any stmcture, prior to its issuance, also requires ihe applicant for such permit to tile a signed statemem that he or she Is licensed pursuant to the provisions of ihe Contrectors License Law (Chapter 9(commencing wlth Sedion 7000) of Divislon 3 of the Business and Professions Cotle) or thet he or she is exempt thereirom and tha basis for the allegetl exemption. Any violetion oi Section 7031.5 by eny epplicant for e pertnit su6jacis ihe applicant to a civil penalry of not more ihen five huntlretl tlollars ($500).): ❑ I, as owner of Ihe propeny, or my employees with wages as their sole compensation, WILL DO THE WORK, antl �he structure is not intendetl or oNeretl tor sale (Sec. 7044, Business and Protessions Code: The Contractors License Law does not apply to an owner of property who builds or improves ihereon, and who does such work himself or herself or Ihrough his or her own employees, provided ihat such improvements are not Intended or oHared for sele. If, however, the building or improvement is sold within one year ot completion, tha owner-Ouilder will heve Ihe burden oi proving that he or she did not build or improve for purpose of sale.). • ❑ I, as owner ot the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Profassions Code: The contractors License Lew tloes not apply to an owner of propeny w�o builtls or improves ihereon, end who comreds tor such project with e coniracta(s) licensa pursuant to tha Contrac�ors License Lews.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verifietl by tlriver's license. ❑ Yes ❑ No Driver's License No. Verification of Ownership by (type oi document, i.e. - property taa bill or tleetl): DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIFICATION: Expires: ❑ I hereby certify ihat no excavetion five (5) or more feet in depth into which a person is required to descend, will be matle in connection with work authonzed by ihis pertnit, entl that no building simcture, scaHolding, falsework, or demolition or dismantling thereof, will be more than ihirty-siz (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, 7lle 8, Calitomla Adminisiretive Code). ❑ As owner-builder, I will not employ enyone to tlo work which would require e permit irom ihe Division of Industrial Satary, es noted above, unless such person hes a permit to tlo such work from the division. Signature: Date: Division of Industrial Se�ety Permit Numher: CEFTIFlCATE OF COMPLIANCE AND AUTHORIZA110N OF ENTRY: I cenify under penalty oF perjury ihat I have reaG ihis application and stete ihat ihe intormation given is correct. I agree to comply with ell state laws and city ordinances relating to building constmction, end authorize representatives of the Ciry of Costa Mesa to enter upon the ebove-described property for inspection purposes. I egree not to acupy or allow occupancy of any buiiding authorized by this permit un�il tinal inspection. COOE 1. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root 201 Final Block/Reteining Wall 202 Final Factory Fire Place 203 Final Sign 204 Finel Demolition ' INTRIRLS ✓ CODE� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Sita 250 � Finel Building/Occupancy f'1-�I�ItIiuL1F� OWNER CITY � C06T JOB ADDRESS zzm ei GAS `+ WATEP j / RO H PWMBING. I � PRO . 5 LINE NOUSE C .� �C' SPRI KLING VSTE \J MISC LLA1 �OUS , ROUG ATING ANO AIR CONDITIONING TEMPO ARV SERVICE OR POLE . UN�ERGROUND I-I POWER I-I SHEATHING FRAME ANO FL LATHING - IN PLASTER.BRO1 r DATE BUILDI RIPTION of WORK glp� ZONE VALUE PE G OUf SUBCONjRAC OR :11: � 1 �I COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For APP��cant to Fill in Completely BUILDING />�OO A, - ADDRESS 3 f��It �WNER G( T 1 -i�/ ��S jk V TiS�' MAIL CITV BRANCH ARCHITECT OR ENGINEEF ADDRESS � ADDR S� � � CITV STATE /C�� IC. NO. ( V SIZE OF LOT USE OF EXISfING BLDG. 512E OF NEW BLOG. EXTERIOR WA�L TEL. ti� NO. R OWNER yy�y S FIFE ZONE APPROVE ( O BV T E L.� �� NO. CITV LIC. NO. NO. OF BLDGS. NOW ON LOT NO.OF ROOMS STOf ROOF COVERING AND WORK TO BE PERFORMED - -I' : �: . /� � :� �lyd � �II�� U �..i l.Jc�.1L'd �C�� CATION FOR BUILDING PERMIT � v J U LE FIECEI�,f; i DATE I SUI �� I—r�� PE fyl NO �� Q � i ,�,(�43 P°t6f a�o� )D vi7y 0 �Si �- K- �U glL �A��s� TYPE 1• GRO�U/P � . DATE / �� ZO�� INO.OF� PLAfS � VARDS APPflOV ED OISfANCE BET MAIN BLDCv. V AR. # I hereby acknowledpe that I have reatl this application antl rtate thet the above InfOrmation is corract antl egree to comply with all laws reg�lating builtling consvuction, and I shall not employ any person in violation ot the workmen's compensation laws of tha State of CalifoY�ia. I hareby ceriify that I am O�operly licensetl as a coniracior untler SQ. FT the State ot CalifoYnia Businass antl Professions Cotla, Divisicn 3, THE AMOUNT S Chapter 9, entl that s�ch licenses are i full t e a ffact, or 1 TNE PURPOSE OF am exampt from t e provisions o ta of al' ia Businass VALUATION antl Professions o, Division 3 t, Si8^ature o / � Permitte - $_�� Autho zetl A nt USE OF NE1ME BUILDING � VARDS API ACCESSOflV BET. MAIN ACCESS. BL DATE APPROVED TOTAL FEE ING �/ � � W 0 VALUATION IS FOR � A PERMIT FEE ONLY: m ¢ � m =s n � � m K$ E `o //'l� � LL