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Home My WebLink About3009 BABB ST - 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 Vicinity: 3009 BABB ST HALLWAY CLOSET Parcel Number: 14113349 Applicant: RODRIGUEZ, ILDEFONSO Address: 7050 LAMPSON AV GARDEN GROVE, CA Owner: LETHER, IRENE TR Address: 3009 BABB ST COSTA MESA, CA Contrecror. EMPIRE PLUMBING Address: 7050 LAMPSON AV GARDEN GROVE, CA MECHANICAL PERMIT StaWs: ISSUED Applied: 02/23/2005 Issued: OZ23/2005 ISSUED BY: Phone: 714-530-7320 Zip: 9284'I Phone: Zip: 92626 Phone: 714-530-7320 Zip: 92641 ' License: 794154 SCOPE OF PERMIT CHANGE-OUT OF A FAU LOCATED IN THE CLOSET OF AN EXISTING SFD. 7 INST FAU < 100K 8TU NO OTHER WORK AUTHORIZED WITH THIS PERMIT. 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 Pireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers � t0000cfm AirHandlers> t0000cfm Floor Fumace Roor or Suspend Heater $23.50 Si4.8o $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 Quaniity FEESUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refrigeretion Unit Ventillation System Evaporative Cooler Commercial I n cinerator Domeslic Incinerator Compressors / Absorption Svstems Upto3hp/100kBTU 3Tot5hp/SOOkBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Up to 3 hp 3To15hp 15 l0 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspeclion 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 $0.00 $0.00 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, 12-27-92) 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 Inspections antl finel approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 244666 (6/00) WORKERS'COMPENSAnON DECLARAnON: — — 1 hereby ettirm under penelty ot perjury one of ihe following declaretions: ❑ I heve entl will maintaln a ceniticate ot consent to self-Insure tor workers' compensation, es provided tor 6y section 3700 of the Lebor Code, for the paAormance of ihe �work for which this permit is issued. "' I have and will meintain workers' compensation insurance, as requlred by section 3700 of ihe Lebor Code, for ihe pedortnance of the work for which ihis pertnii is issuetl. My workers' com ensatlon Insurance carrier and policy numbar ere: c�—KRM%Ja�a.n�Lan i'v,5i,,r��ren. c;n, Pa��`�a�: �3KRra;��l`,�'�� (This secHon neetl not be campleted i/ the permit is valuetl at one huntlred dallers ($100) or less.) ❑ I certity that in the pedortnance ot ihe work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation lews oi Celifomie, entl agree that it I should become 5ub�ect lo Ihe workers' compensation provisions ot Seclion 3700 oi the Labor Code, I shall forthwith compl with �hese rovisJ� s. a1 �/ �Sigoature: /�./i.��//L � oate: �. d .i' O �i WARNING FAILURE TO SECURE WORKERS' COMPENSATI ERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYEi�TO CR PENALTIES AND CIVIL FINES UP TOONE HIINDRED T/pUSAND DOLLARE (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED F-0R IN SECTION 3]O60f THE LABOR CODE, INTEREST, P.NO ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm that I em lic nsed under rovisic torce antl e%ecL Lic=� j'�1 S� CONSTRUCTION LENDING AGENCY: of C�apter 9(commancing with Section 7000) of Division 3 of the B Cle's"s�Yt end my license is in full ❑ I hereby aNirm that there is e consWction lending agency for ihe pedormance of ihe work for which ihis permit is issued. (Sec. 3097, Civil Code). Lentler's Neme: Lentler'S Atldress: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby affirtn Ihet under penaliy of perjury that I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW For ihe following reason (Sec. 7031.5, Business antl Protessions Code: Any ciry or counry which requires a permit to cons�ruct, alter, improve, tlemolish, or repair any strucNre, prior to its issuance, also requires the applicant for such permit to tile e slgneC statement that he or she is licensed pursuant to the provisions ot the Contrectors License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 oi the Business and Professions Code) or ihet he or she is ezempt theretrom end the basis tor the alleged e:emption. Any violation of Section 7031.5 by eny applicant tor a permit su6jects the applicant to e civil penalry of nm more than five hundred dollars ($500).): ❑ I, as owner of t�e properry, or my employees with wages es their sole compensation, WILL DO 7HE WORK, an0 ihe s�ruclure I5 not intendeC or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law tloes not apply to an owner of properry who builds or improves ihereon, and who dces such work himself or herself or ihrough his or her own employees, provided ihat such improvemenis are not intended or oNered for sale. It, however, ihe builtling or improvement is sold within one year of completion, the owner-builder will heve the burden ot O�o�ing ihat he or she did not build or improve for purpose of sale.). � ❑ I, as owner of ihe properry, am EXLLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (SecJ044, Business and Pmfessions Code: The contractors Llcense Law does not apply to an owner of property who builds or impmves ihereon, and who contrects br such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I em e:empt untler sec. Business and Professions Code for ihis reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verificetian of Ownership by (type of document, i.e. - propeny taz bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMI7 CER7IFICA710N: ❑ I hereby certih/ thet no ezcavetion tive (5) or more fee� in depih into which e person Is required to descend, will 6e made in connection with work authonzed by ihis permit, antl that no building siructure, scaHolding, falsework, or tlemolition or tlismantling thereof, will be more ihan ihirry-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Calitornia AdminislraUve Code). ❑ As owner-builtler, I will not employ anyone to tlo work w�ich woultl require e pertnit irom the Division of Indusirial Safety, es notetl ebove, unless such person has e permit to do such work irom the divisian. Signature: Date: Division of Industrial Safery Permit Num6er: CER7IFICA7E OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I cehify untler penalty of perjury that I have read this epplication end state that the intormation given is corred. I egree to compty wlth ell state laws antl city ordinences rela�ing to building construction, and authorize representetives ot ihe City of Coste Mesa to enter upon the above-descnbed propetly tor inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until tinal inspection. 40pE �, INSPECTIONTYYE I616 Fixetl System Final Fire Prevention 1266 Pool Spa Final � 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Finel Factory Fire Place 203 Flnal Sign 204 Finel Demolition �[F� IMRIRLS 40DEt INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Preventian 220 Finai Planning Approval 222 Final Site 250 Final Building/Occupancy W �•1 � � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3009 BABB ST Suite No Vicinity: Parcel Nunmber: 14113349 Applicant: Address: Owner: RODRIGUEZ, ILDEFONSO LETHER, IRENE TR Address 3009 BABB ST COSTA MESA, CA Contractor: EMPIRE PLUMBING Address: 7050 LAMPSON AV GARDEN GROVE, CA PLUMBING PERMIT Phone: 714 530-7320 Zip: Phone: Zip: 92626 Phone: 714-530-7320 Zip: 92641 License: 794154 SCOPE OF PERMIT REPLACEMENT OF 40 GALLON WATER HEATER LOCATED IN GARAGE. ISSUE FEE BackFlow irrigation BackFlow Preventer Bathtub Clarifier System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outle4s) Gas (Over 4 outleLs) Gas Repipe Gas Service Interceptors (Grease, Oiq Interceptors (Sand Auto ) AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 30.00 $0.00 $0.00 $0.00 $0.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 'FEESUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulalor $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 SewerCapforDemo $0.00 Sewer Connect 50.00 Sewer Private Line $0.00 Shower 30.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop 50.00 Spa (pnvate) 50.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Status: ISSUED Applied: 03/25/2005 Issued: 03/25/2005 ISSUED BY AMT Sump Pump $0.00 Swimming Pool $0.00 Trap Primer $0.00 Unnal $0.00 Vacuum Brkr Bkflow(1-4) $0.00 Vacuum Brkr BkFlow(5+) $0.00 Wash Basin $0.00 Wash Basin Set $0.00 Waste and Vent System $0.00 Water Closel (Toilet) $0.00 Water Healer / vent � 1'a.�jp $0.89- Water Piping (Inst or Rep.) $0.00 Water Re-pipe $0.00 Water Service $0.00 Water Soflener $0.00 OTHER $0.00 VIOLATION $0.00 PLAN CHECK $0.00 REINSPECTION $0.00 TOTAL CALCUTATED FEES: E23.50 QTY 0 0 0 0 0 0 0 0 0 0 -eC�l �. 0 0 0 0 NOTICE: The work authonzed by ihis 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 tor 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 Inspectlons and final approval must be obtained. Failure to obtain inspactions and final approval will result in ihe expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 eaeo-na �aw� WORKERS'COMPENSATON DECLARAnON: I hereby eNirm under penelty of perjury one of Ihe following declerations: ❑ I heve and will meintein e certificete of consent ro selt-Insure for workers' compensatlon, as provided br by section 3700 of the Labor Code, for the pertormance oi the work for which ihis pertnit is issued. ❑7 I heve end will meintein workers' compensetion insurance, as required by section 3700 ot the Labor Code, br the pedormance of the work for which this pertnit is issuea. F, My workers' co/m pensetion Insurence carner and policy number ere: e�p-/ 'Cartier: ��M/['il�A�encl� Zhs�'�/ Po�Number. i.^,3KR0��%sp(� (This secNon n�at be crompleted il the partnit is velued et one hundred dollars ($100) ar less.) �I certify that in Ihe peAormence of the work For which ihis permit is issueQ I shell not employ any person in eny manner so as to become sublect to ihe worknrs' crompensation laws ol Celifomia, entl egree thet it I should become subject to tha workers' compensation provisions of Section 3700,,poof the Labor Code, I shell lorihwith �ompy with these Provi i s. � �/ / Applican� SigneNre: .i ate: �:� �C7�O 5 WARNING: FAIWRE TO CURE W6 KERS' COMPENSATION CO RAG IS UN UL ANO SHALL SUBIECT AN EMPLOVEF TO C IINAL PEPlALTIES AND CIVIL FlNES UP iOIXJE HUNDRED TiqUSANDDOLL4FE(510p,0p0),INADDITIONTOTHECOSTOFC SATION,DAMAGESASPROVIDEDFORINSECrION3/060FTHELABOFCODE,IMEREST,ANDATTORNEI"SFEES. IICENSED CONTRACTORS DECLARATION: I hereby aHirtn thaf I am licensgd under pmvisi< � rc�end effecL Lic. a_ C�ontrador's Signature: CONSTRUCTION LENDING AGENCY: of Chapter 9(commencing with Section 7000) of Division 3 of Code, aryf my license is in full . ❑ I hereby attirm that there is a constmction lending agency for the pedormance oi ihe work for which this permit is issuetl. (Sec. 3097, Civil Code). lender'S Name: Lender's Addra55: Signalure: OWNER-BUILDER DECLARATONS: Date: I hereby alfirm that under penalry of pe�ury that I am E%EMPT FROM 7HE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business anG Professions Code: Any Ci�y or coun�y which reQuires e partnit to construc�, alter, impmve, demolish, or repeir eny stmcture, prior �o its issuante, also requires the aODlicant for such permit to file a signed statement thet he or she is licensed pursuant to Ihe pwvisions of the Contractors License Lew (ChaO�er 9(cammencing with Section 7000) of Division 3 ot the Business entl Pmtessions Code) or that he or she is e:empt Iherefrom and Ihe besls for the elleged e:em0�ion. Any violation of Section 7031.5 by any appliwnt for a permit subjects ihe epplicant to e civil penalry of not more than fiva huntlred tlollers ($500).): ❑ I, es owner oi the property, or my employees with wages as iheir sole compensatlon. WILL DO TME WORK, and Ihe siructure is not intentletl or oNered for sale (Sec. 704d, Business antl Protessions Code: The Contractors License Law does noI aOPly lo en owner ot properry who builds or improves ihereon, and who does such work himseli or hersetl or Ihrough his or �er own employees, provitletl that such improvemenis are not intended or offeretl for sale. Ii, however, the huilding or improvement is sold within one year ot completion, the owner-builder will have the Ourden ol proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner Of Ihe property, am E%CWSIVELV CONTRACTING WITM LICENSED CONTRALTORS to consimct ihe project (Sec. 704d, 8usines5 an0 Professions Code: The contrector5 License Lew does not apply to an owner of pro0erty who bullds or Improves I�ereon, and who coniracts br such project with a conlractoQs) license pursuent to t�e Contrectore License Laws.). ❑ I em eaempt under sac. Business and Pmfessions Coda for this reason: Signature: Date: Owner ID venfiad by drivers license. ❑ Ves ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property ta: bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICA710N: ❑ I hereby certify ihet no exwvetion five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized hy t�is permi�, and Ihat no building siructure, sraflolding, falsework, or demolition or tlismentling thereot, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title B, Calitomia Atlministretive Code). ❑ As owner-builder, I will not employ enyone to do work which would require e permit irom t�e Division of Indusinal Safery, as noted above, unless such pereon has a permit to do such work from the division. Signature: Date: Division of Industrial Satary Pertnil Number: CEHTIFlCATE OP COMPLIANCE AND AUfHORVATION OF ENfRV: I cenify under penelty of pequry ihat I heve reatl ihis application and state ihat lhe information given is correci. I agree to wmply with all staie laws antl ciry ordinances rela�ing Io Duilding conslmction, entl authorize representatives of the City ol Cas�a Mesa to enter upon ihe above�described property for inspection purposes. I agree not to occupy or ellow xcupancy ol any 6uilding euthorized by this permil umil final inspection. COOE �, INSPEC710N TYPE 1616 Fixed System Final Fire Preven�ion 1266 Pool Spa Finel 200 Final Re�Rool 201 Final Block/Retaining Well 202 Final Factory Fire Place 203 Finel Sign 204 Final Damolition D1TE �NTITIALS COUEN INSPECTIONTYPE 20fi Final Mechanical 20B Finel Plum6ing 210 Finel Electrical 212 Finel Flre Prevention 220 Finel Planning Approval 222 Finel Site 250 FinalBuilding/Occupency Qsj� INTRIAL9 �»a> �sa-sz�s • Fa,c (�ia� �sa-aess CITY OF COSTA MESA BUILDING p1VISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT Job Address: 3009 BABB ST Suite: Vicinity: RESIDENCE & ATTACHED GARAGE. ParcelNunmber: 14113349 Applicant: DAVIS, WES Address: 238 GARFIELD AVE POMONA,CA Owner: LETHER, IRENE TR Address 3009 BABB ST COSTA MESA, CA Contracror GREEN DIAMOND ROOFING Address: 238 GARFIELD AVE POMONA,CA Zip: 91767 Arch : Address: Zoning: Phone: 909-623-7911 Zip: 91767 Phone: Zip: 92626 Phone: 909-623-7911 License: 742607 Eng: Address: Phone: � .: . NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Slatus: ISSUED Applied: 05/07/1999 Issued: OS/07/1999 ISSUED BY: '�� Phone: Zip License: Zip: License: SCOPE OF PERMIT REROOF: T/O 8 LEAVE EXISTING SHEATHING; APPLY 1 LAYER OF 30# FELT UNDERLAYMENT; REROOF WITH 25 YR CLASS A DIMENSIONAL COMP. SHINGLES. 2700 S� Ff. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $87.25 $0.50 $0.00 $0.00 $0.00 587.75 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Ezistinq: 0 NOTES: Rear 0- 0 Rear 0-0 Required: 0 FEE SUMMARY , PLANNING & ZONING Lek 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $3,800.00 $3,800.00 NOTICE: The work authorized by ihis 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 1 BO 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 end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5826 � WORKERS' COMPENSATION DECLAHATION: I hereby aNirm untler penalry ot perjury one ot the follawing declaratlons: ❑ I have end wlll melntaln a certificeta of consent ta self-Insure for workers' campensetion, as provided for by sectlon 3700 of ihe Labor Cade, for �he performenca of the / work fOr which this pertnit i9 155uetl. `� I have anC wlll maintaln workers' compgnsation Insurence, as required by section 3700 of ihe Labor Code, for ihe peAortnence of tha work for which NIs pertnit is issued. My workers' comDensatlon Insurance cartier antl policy number ere: Carrier ST�T�F F«.�n PollcyNumDer (This section need not be completed il the p9rmit is velued af one hundred dollars ($100) or /ess.) ❑ I certity ihat In the pertormance of th� work tor which this pertnit is issued, I shall not employ eny person in eny manner so as to become subject to the workere' compensation laws of Celifomie, an gre that it I should becoma subject to ihe workero' crompensetion provisions of Section 3700 of the Labor Cotle, I shall fonhwith comply with ihese D�a�sions/ � � ApplicantSignature: � t .9+� r'� Dete: �-7 - s WARNING: FAILURE TO SECURE WORKERS' COM1�pENSATION COVERAGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND pVIL FlNES UP TOONE MUNDRED THOUSAND DOILARE (5100,000�, IN ADDRION TOl}�E COST OF COA9PENSATION, DAh41GES AS PROVIDED FOH IN SECTION 3]W OF THE LABOR CO�E. IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby effirm ihat I em Iicensetl und�f �rovisions ot Chapter 9(wmmencing with Section 7000) of Division 3 of the Business antl Protessions Cotle, and my Ilcense is in full force and eHect. Llc. #—T � C —\ Class k Conireaofs Signature: l 1--i�s-x_�. q 2_ Da�6: •S' 7- CONSTRUCTION LENDING AGENCV: ❑ 1 hereby ettirm ihat there is e conslrucqon lending agency tor the pertarmence of the work for which this permit Is Issued. (Sec. 3097, Civil Code). Lentlers Name: Lenders Atldress: OWNER-BUILDER DECLARATIONS: I here6y ettirm that under penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business antl Professions Code: Any city or counry which requires a pertnit to consimct, alter, improve, demolish, or repair any sirucNre, pnor to its issuance, also requires the applicant for such pertnit to file e signed stetement thet he or she is licensed pursuent to Ihe provisions oi tha Coniractors Licensa Law (Chapter 9(commencing with Section 7000) of Divlsion 3 ot the Businass and Professions Code) o� ihat he or she is exempt �hereiram end the basis tor the alleged exemption. Any violation ot Section 7031.5 by eny applicent for e permit subjecls the applicent to e civll penalty of not more than five hundred dollars ($500).): ❑ I, as owner of Ihe propeny, or my employees with weges es thelr sole compensation, WILL DO THE WORK, end Ihe structure is not intendetl or oHered for sala (Sec. 7044, Business and Professions Code; The Coniractors License Lew does not apply to an owner ot propeny who builtls or improves thereon, end who does such work himselt or herself or through his or her own employees, provided Ihat such Improvaments are not intended or offered tor sale. If, however, the builtling or Improvement is sold within one year of completion, Ihe owner-builder will have ihe burden of proving that he or she did not build or improve for purpose ot sale.). ❑ 1, as owner oi the properry, am EXClUSIVELV CONTRAC7ING WI7H LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Protessions Code: 7he contrectors License Lew does not appry ro en owner of pmperty who builtls or improves t�ereon, an0 who contracis for such project with a contractor(s) license pursuanl to the Contractors License Laws.). ❑ I am exempt under sec. Business and Protessions Code for Ihis reason: SignaNre: Date: Owner ID venfietl by drivefs liCenSe. ❑ Yes ❑ No Drivers License No. Veritication of Ownership by (rype of docum4nt, i.e. - property ta�c bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Expires: ❑ I hereby certlty Ihet no excavation tive (5) or more teet in depih into which e person is requiretl to descentl, wlll be made in connection with work authorized by ihis permit, and ihat no builtling strucNre, gcaHolding, talsework, or demolition or dismantling t�ereof, will Oe more than ihlrry-siz (36) feet high. (Chep. 3.2, Grp 2, Art 2, Sec. 341, Tltle 8, CelHornie AdministraGve Cotle). ❑ As owner-6uilder, I will not employ anyone to do work which woultl require a pertnit from Ihe Divlsion oi Industrial Sefery, as notetl ebove, unless such person has a permit to tlo such work irom ihe tlivision. Signature: Date: Division ot Indusirial Setery Pertnit Number: CERTIFICATE OF COMPLIANCE AND AUT1{ORVATION OF ENTRV: I certify under penelty ot perjury thet I heve reetl this epplication and stete that ihe informetion given is correct. I egree to comply with state ws and ciry ordinances relating to building construction, and authorize representatives of ihe Ciry of Caste Mese to enter upon the above-tlescribed property tor ins eclion pu oses. I agree not to occuOY or ellow occupancy of any building authorized by Ihis pertnit until finel inspectlon. Signatu ,Ot Leg Owner(s) Date Q s-7 - 9 , AndOr Au o i Applicant Date CODE �. INSVECTIONTYPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Finel 200 Final Ra-Roof 201 Finel BIocWRe�aining Wall 202 Final Fectory Fire Place 203 204 2b66d6 Final Sign Final Demolition BAIE 1tII�4� �IL"i � �� COOE� INSPELTIONflFE 206 Final Mechenicel 208 Final Plumbing 210 Finel Electrical 212 Flnel Fire Prevention 220 Finel Planning Approval ... 222 Finel Site 250 Finel Builtling/Occupancy pdg iNrmn�s ; �- �� COSTA MESA BUILDING-SAFEfY DEPARTMENT P. O. BOX 9H C08TA M69A� CALiFORN1A For Applicant to Fill In Completely TYPE OR PRINT BUILDIN(d AOORE53 � COSTA MESA, CALIFORNIA w MA�� carv o� ��;3 iA �ESA SEP 22 196�"" �eo�� DEBCRIPfi _ A. P. NO. NOTE: N +u U �y .`.� K / NO. ni' ,[Vi.=c�G �v / x � �---o � "�w°.",W �o.. LINE FROM DESCRIPTION OF WORK 'BUILDIN6 NO.OF SIZE ROOMS EXTERIOR WALL I ROOI WORK TO BE � -i �! � HEFEBY ACKNOWLEO06 THAT 1 XAVH RPAD TH18 APPLIGTION AND bTATE THAT THE ABOVE IB COqpECT AND AOREB TO COM- PLY WITX �LL cITY OFOINANCBB AND 8TAT6 LAWB RHOULATINO BUILDINO CON6TRUCTIO r �^yJ SIGNATUREOF �� PERMITTEF � AUTHORIZED A6ENT RHC[IPT NO. �� — ZONING NO.O� UBEOFN6W ' PLANB � BIIILOINO ^ �� oN ` 3 e� . �—� <-133- O EAV E OV ERHAN6 8HALL BE LESS THAN YARDS APPROVED MAIN BUILDIN6 VAR. �C YARDSAPPROVED ACCESSORY BUILDIN6 BET. MAIN ACCESS.B OATE H $Q. �. � TME AMOUNT 9XOWN UNOER VALUATION 19 FOR THE F PURPOSE OF 68TABLI6NIN0 A PEqMIT F86 ONLY. 0 LUATION f , ( ,� OG m � , JOB ADDR�SS GENERAL A^ LH1G -GG� V � PF.i;.MIT NO. Date GROUP I TYPE V ZONE PERMIT: SUBCONTRACTOR I n��,. i nr.,., LOT _� TRACT %L2 Z 1. �_,c�� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX H17 COBTA MEBA. CALIFORNIA Fo� Applicanf fo Fill In Complefely TYPE OR PRINT COSTA MESh CALIFORNIA t555 FPLACENTIA AVENUE NONE K W KOLL p�Ty NEWPORT BEACH STATE TEL. LIC. NO. NO. $'ZE 6i � x ioo.26� OF LOT USE OF NONE EXISTING BLOG. 8E'lO�CK LINH PROM 1. i CENTeR OF 9TMCeT �� C�nv veon I � CCTri 17�1 I� OF FEE RECEIUE� ,�SEP2713S1 FINANCE DEPT. APPLICATIOI��Y�fP��ItR�F1� MESA BUILDING For Offiee Use Only BV BUILDING ADDRESS COSTA MESA. CALIFORNIA FIRE ENUE ZONING ZONE NO.OF U6E OP N¢W S�' �ch.� 2�I I PLANe � I BUILUINO��. W/�' K� � DEBCH�PTION `OL � / /\ �/ � 3 Z NO. OF BLD�9. O NOW ON LOT w e .... YARDS APPROVED R� FRONT LINe Bi.) �� 1 I� S_ R. 51 DE K L. SIDE s oN ( o�,0 3 0 E%TBRIORWAL �ROOF(,OMPO SHINGLE COVERING C[O COVERING USE OF BUILDING AND WORK TO BE PERFORMED SINGLE FAM{LY RESIDNECE AND $fi2�'GdE ��[ �� APPROVED AGE L/ � � i HEREBY ACKNOWLEO6E THAT 1 HAVE READ TX18 APPLICATION THE AMOUNT BXOWN 11ND¢P VALUAT�ON IB POR TH¢ AND BTAT¢ TNAT THE /�BOVE �8 CORREGT AND AGPEB TO COM- pUliP09E OF 88TABL�9HING A PERMIT FEE ONLY. PLY WITN AL1. CITY OPOINANCEB AND BTAT6 LAWB PHOULATINO BUILDINa cONBTRUCiION. VALUATION SIGNATURE OF � �� JJ � /y /— PERMIT FEE $ ,�S PERMI7TE � 7/ �] S PLAN CHECK A I /. -�i D 'AUTNORIZED AGENT ' � ITOTAL FEE $ ; l ��OI�