The URL can be used to link to this page

Home My WebLink About1820 CAPETOWN CIR - Building Permits 4`el 'tCITY OF COSTA MESA Oe ke BUILDING DIVISION F sl S DEVELOPMENT SERVICES DEPARTMENT PEE IT NUMBER 1 y ' PERMIT I / P07-00153. (714)754-5273 • Fax(714)754-4856 w.ci.costa-mesa4 L&JMBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 r' Job Address: ' 1820 CAPETOWN CIR . `•` Status: ISSUED Suite No Applied: 03/13/2007 t• Issued: 03/13/2007 Vicinity: GARAGE \ ., Parcel Nunmber: 42451138 - • °, - - _ / , Applicant: ELLIS, JOE Address: 3801 LENAWEE AVE ISSUED BY: A . Phone: 310-253-5229 / / CULVER CITY,CA Zip: 90232 Owner: BLAIR, LEO Address 1820 CAPETOWN CIR Phone: COSTA MESA,CA Zip: 92627-6302 Contractor ORANGE COUNTY SERVICES INC DBA GEORGE BRAZIL PLU Address: 3801 LENAWEE AVE - Phone: 310-253-5229 CULVER CITY,CA Zip: 90232 License: 679898 • SCOPE OF PERMIT • CHANGE-OUT OF AN EXISTING WATER HEATER IN THE GARAGE OF A DWELLING. 1 WATER HEATERNENT • NO OTHER WORK AUTHORIZED WITH THIS PERMIT: -. FEE SUMMARY AMT QTY AMT QTY . AMT QTY ISSUE.FEE $23.50 Laundry Tub/Washer $0.00 0 _ Sump Pump $0.00 0 Backflow irrigation $0.00 0 - Landscape Irrigation ' $0.00 ' 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub • $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) . $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set . $0.00 0 Drain,Floor $0.00 0 Sewer Connect - $0.00 0 Waste and Vent Sstem $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 , 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 . _ Sink,bar $0.00 0 • - Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0' . TOTAL CALCULATED FEES: $35.80 COMMENTS/SPECIAL CONDITIONS • 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 the work authorized 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 of this permit. FOR INSPECTIONS CALL: (714)754.5626 2446-46(6/00) DECLARATIONS I r, •-• I .. - I . ( 1 WORKERS'COMPENSATION DECLARATION: - - , I hereby affirm under penalty of perjury one of the following declarations: • • 0 I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the mow�/// work for which this permit is issued. ' ' '' ' . ,›I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ,i My workers'cam ensat/ia�n In��mnce yacrier n/d licy number are: J-1(;0(4 /�fi' / �/'Y�1 ttarrfer:'�"'O TA ! �+ POItcy.Number: �O {f,�l`1 �o"�ll� (This section need no be completed it the permit is valued at one hundred dollars($100)or less.) • ❑ I certify that in the perfo e oftor . is p:rmit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of t-. I should•ecome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro ' • �ip 3:-_-/ /'{� /�q7 ,.(`} /� Appllcani Slgnatdre:a r /l/J ' 9aie:9 v- �V WARNING:FAILURE TO SECURE WOR RS'COMPENSATION••'ERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED ' THOUSAND DOLLARE($100,000),IN Ar 0ITION TO THE COST OF••• PENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: ' I hereby affirm that I am licensed under pr sops— pter 9(commencing with Section 7000)of Division 3 of the Business aye Projr36i9ms Code,and my license is in full force and effect.tic-75-3, / 7J[J9w/� - Class, (i�-(J ro Contractor:s.Signflturs: �'V- LirC Date.• q ✓�`''1 CONSTRUCTION LENDING AGENCY: �/"�� • . ❑ . I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). • Lender's Name: . Lender's Address: . • Signature: Date: OWNER-BUILDER DECLARATIONS: . I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the 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,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): • ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • . ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of properly who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: - ' ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp,2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: ' 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes„ 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the Califomla Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention.Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No - 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes ' U No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). . 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No 6 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). ' CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: • CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. , ke er(a) 2 _/3 -D . i A &Hied•Applica, Date,..•yy 1` . CODE 0 JNSPECTION TYPE ail 1NTITIAL$ .. CODE. INSPECTION TYPE . • . 1NTITUU 1616 Fixed System,Final Fire Prevention ..: _ . r 206 Final Mechanical 1266 Pool Spa Final - 208 Final Plumbing - - AI'7'9^Q7• : =, • 200 Final Re-Roof • •, . 210 •Final Electrical • - • 201 Final Block/Retaining Wall 212 Final Fire Prevention 202,, Final Factory Fire Place - - 220• Final Planning Approval 203 Final Sign - ' - '" 222 ' Final Site '.I . ' 204 Final Demolition 250 Final Building/Occupancy ' . .. I PROJECT ADDRESS: 1820 CAPETOWN CIR uNIT: 62 CITY OF COSTA MESA - BUILDING PERMIT PERM NO: G 046974 OWNER'S NAME:4KAUFMANN 6 BROAD ADDRESS: X80 N. RIVERVIEW DR PERMIT NO: G 046974 PLAN CHECK NO: N GOVT: N SUPP: N ' UITE 300 • ANAHEIM, CA 92808 CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE MEC PLU STR PURPOSE: NEW ARCH/ENGINEER: MIKE WOODLEY REO.NO.:C15730 JOB DESCRIPTION : NEW SFD SQ FT: 2, 910 ADDRESS: 180 N. RIVERVIEW DR 300 • ANAHEIM CA 92808 CLAIM VALUE: 169, 417 . 00 CALC-VALUE: 172, 657. 70 GROUP OCC: R-3 /M-1 PERMmEE: KAUFMANN 6 BROAD (714 ) 921-0500 ' ADDRESS: 180 N. RIVERVIEW DR 300 COMMENTS: PC#234-89A PD • ANAHEIM CA 92808 **********************EE*eEe ******eE****x•***eE**SF**********+ *******1E***+E*+r****r**** UCENSED CONTRACTOR DECLARATION: I hereby a ' - . . 'd under provisions of Chapter 9(commen ' • with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions .ode,and my license • full force and effect. SETBACKS CITY LIC.: 0 4 8 4 STATE LIC.:3344 • ., CLASS B-1 � i " Dater// r9 Signature: ./ 114 �k s' F If MAIN BUILDING ACCESSORY BUILDING • WORKERS'COMPENSATION DECLARATION: I hereby affirm that lhay.. a ncate of consent to self-insure or a ertiticate of Workers' FRNT: 19 FT IN REAR: 10 FT IN FRNT: FT IN REAR: FT IN. Compensation Insurance,or a certified copy thereof(Section 3800, ). LEFT: 5 FT ,IN RGHT: 5 FT IN LEFT: FT IN RGHT: FT IN • POLJCYNO.: 4189-1090 •• 03/07/91 PANY: TRANS, INS , , PARKING REQ• 2 PROV: 2 PARCEL: 42433101 ZNE: PDRM REF NO: PA8840 enified copy is hereby furnished. ® Certified a: is tiled with the Building Divi ion. / PLANNING NOTES> SINGLE FAMILY RESIDENCE WITH ATTACHED TWO CAR GARAGE AND. _� 7 �� ,/ > HALF OPEN PARKING SPACE. ON STREET_ FOR GUEST � 6iQ , e: - Applicant: . ../ / *************************************,********** *********** 'fE******* EXEMPTION FROM WORKERS'COMPENSATION DECEARATION:4(This sect/ 4 not be completed it the permit is for one hundred(5700)or less). DEVELOPMENT ' S E ,R V I C ES R E Q U I R E' M E N T S I certity that in the perloimance of the work for which.this permit is is-r�shall not employ any person in any manner so as to become - subject to the workers'Compensation Laws of California.. ZONING APPROVED' BY : 0../\j 1n- Tv=iffrcr - DATE: p¢• Lis 0 Date: _ Signature: • � � ) -\ - - px NOTICE:it,after making this decimation.you sholld'tiecome subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : w 1. L_ -N DATE: 6/ 4- ' i6 ' )1t Code,you must.!animal comply with'such provisions or this permit shall be deemed revoked. , CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: • - DATE: O 4 'C)v which this permit is issued(Section 30W,.Civ.C): '1 *********************** * ** * *** * -I-4* *****4F***********iF********** LENDER: ************************************** **** *************************** ADDRESS: LEGALIZATION:N F E E _S U MARY • STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTtRIC ECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 895 .00 41 , 50 82:599 32 .75 12 , 09 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed2 5 2 150 S .25% SMIP/NON-RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business • - and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by .PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 00). ISSUE FEE 3 , 00 1 5"`0 (55 0 15 . 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ tructure Ls not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTAL S----> 1064 . 33 33 .00 .' 0 . 00 1097 . 33 1097. 33 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herseff or through 'r his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> - LOLL ECT ED: 1097. 33 OVER/SHORT: 00 for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Bus 895 . 00 44 .$0 97. 99 4�7 . 75 12 . 0 9 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves they j and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ***********************************************************************.**.*.****.* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL :,; F E .E BR EAKDOWN ❑ I am exempt under Section: B.8 P.C. _ . for this reason: TYPE QTY DESCRIPTIO Nt. UNIT COST TOTAL COST • • Date: Owner: SFR 2371 DWE-TYPE V-WOOD FRAME -GOOD 69 .00 163, 599 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 76 RES-BALCONY, EXTERIOR STAIRWAY 1 3 . 80 1 , 048 . 80 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from SFR 463 RES-GARAGES TYPE V • 17 . 30 8, 009 . 90 these provisions. ELE 2371 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT .03 • ' 82 . 99 MEC 1 INST FORC-AIR/GRAV FURN <= 100 K BTU 9 .00 9 . 00 Date: Applicant MEC 1 REFRIGERATION SYSTEM <= 100 K BTU/H 9 .00 9 . 00 I hereby certify that I have read this application• d state that t • .•we information is correct.I agree to comply with ity and county MEC 5 GAS PIPING SYS 5+ OUTLETS PER OUTLET .75 3 .75 ordinances and state laws relating to building const•.on and hereby au '•rize representative of this:, to ente .. e-mentioned MEC 1 FACTORY FIREPLACE 6 , 50 6 , 50 property lorinspection purposes. '1 i MEC 1 VENTILATION FAN CONN TO SINGLE DUCT 4 . 50 4 . 50 Date: y'17..94) Signature: ; : CONSTRUCTION AND PLANNING AP ' PO#PA ' A?PROVALIS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Servke or Poles, 52. Pool & Equipment Location IT.PipStUng.rQrnde-C ` c S YJ ' cel) 53. Steel Reinforcement ti�a a f.... x;9.c61esiiicat'.6ontfYtit�lfiility-Undrgrnd� 54. Forms `"Eltctr i call6Ilidtit=Uind rgrnd. c S 55. Electrical Bonding G. tl>t.»G N r .cStaeLRelDforcement •xf$Lf0 (c4' 56. Rough Plumbing& Pressure Test 1�1 Erci 6. lec• ,^•trica tWER Grnd. a S-elo� &wee 57. APPROVAL TO COVER-GUNITE -) ��Fot' .1 "' xP1 c... ¶g.J ' 44.,14458. Electrical Conduit-Undrgrnd. i Qtings p, '8.^Fotlndatioi' <C> 59. Gas Pipe, 0 Undrgrnd., Test nU3 0 H CH I.- w 9.`Wat Pipe Jndrend. • • 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. StructuralrFloor System o ..' 61. APPROVAL TO DECK 11. Property Sewer Lini2& Hduse'Conrtection 62. Backwash & Receptor-Final 12. Sewer Cap c.-‘, co o., 63. Heater & Vent-Final ,N •A 13. Roof Drains,!;',_, 0 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical-Final 15. Rough Eljectri all-Conduit �, /� 66. Solar System-Final 16. Rough E(,_ectric`_1Niring. , i*i9 �/ // -67. Fencing & Access Approval :'47. Rough Wiring Snron / 4 GKIG`•" 68. APPROVED FOR PLASTERING 18. Rough Electric i-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT r C, ,� n n* I m•: trcr+ ,r t� tb ,C* x y m t^i-I czTH F NN urntax;:Etr!r m r 1 'n 1* ' gym rC`7 * O + > OC * r mfr'*-.171Mmtitstri 20;�Rott�h Factory Fireplace I Str GCC * S „do >'* .r �APPR VALSjI..,IE.,Pel fit # �-1;i;ln;In;.70 21.1--Ou¢ts, iVStrtcturo* t •• •• 1-is is S d ?4* * ;70. Dhderg? itff Hydro * .•n tx en :* I 'SH * 0 H n* :ir ti ,-i1•.I .J * 22.�Du , V�nti aunE.* 'p,S * S �* * m 1 Z„ .JJ* I ,J * O et n , r Q71. Produch-,♦ping C��'es 6t,0i1 23.•Gas-Pipe-Rough & Test 1 mS * tr. 0' <C O* * -•172. Underground FIbQC' * `- 1'' aw n n• m Hi, , mrr• r4 '* rr r. c*' * -1 .-1 v •- IU * - t.i D> 24. 'Rocf FrEa�r1ing' * t HE. •' - * > • cC $ * 73r1UndergrneStoraerank )Gas D011ro'E.-4i+'"''-'t'14--i 25. RoofiSh6athing ...,r. 'cC v' 44 &(C. 7.e. * 74cgverhead Hydro? * ,. rn g ` , 74t-)t �rn 26.'r1-BiTt Ceiing,_iStrM..ural) &'t ...-.coat •.X* O ZI C m* * 75C' y Chemic2_ * H O a_.m� mS-'m' rI:amH W 01.* .# •., 4 # t-1,4 , •• .2- 4. > 0.1 .•.1.d-..,...m...• Cu '4.t-I'+ 27wFrarne a� Fdaushug* :...IMM -Jt * t^ >I IDn* * 76. Dry Stancpe Ka<, * nnl : IIrl^ rrHt,.-Irntr1cZ 128. Lathin & Siefin r'* '1 '7'Q= c: S ••* * o' y * +K4mtT'CJHC`7t7'Q H 9' g0X .7 t�F )111,1 -I .•I : f * 77..1 FIXED S.Y,$uTE!v5 15AL4, H n r.•y,:NOmtr.-1<WCU 29. Insulation * u S <L'.* :I \, * 78EF•IRE PREY. FIN' #1_ * > S O'Jtzn<Sr- m n n .� .✓ .ems T i• �- W -r * tiC -n 0-I , c.-,/-11.,4n n: 7730. Drywall Naill�rg " " '� * .� _I r� * H 'N 'fiE'A LTFEPT'e RQUIRF?NNN ''N �H SS 1 ov < H * S;�PJ o:u:J .a. x. ,� ,HN,•, I.'a X 1 T ✓ # Ip t..?+ rV • HI.- # V L 1/4•, ��'''+++ r_a Jll•1.• 031. Plaster BrowlhCoatr S I rrrr vino .. , A: -r79. FINAL INSPP.ECTIetN• * O:T:Etn ., Nr't< : t - i' =al.__ ,n, V, 'n H J'+• 0r-.n1 ,c"' a32 lectrical Povoer MvercF nal: "m * r. A0 I ` * TeOmFOOD CERTIFFGAfE IS`C ED E" ztc''PJ(' 1 w L� I N Y I ( •K * . t.I •r"u. '-i Rim cc t.) cc ti' I * 1 V H * to m 7y X KN `•�'t^ S -33*rinpt Electric', x m ; dFG'ci ' 4▪ 1 ( ,* No[es> •-+'-7 7m * 1-1 0 <I:' m0 S I v' ,-^ - n er c0 nen ._, c :ti 4(Fine7 Heatin 1& Airf'CoriditicMiTIF 0: k?4, CCp �:* �Q.„:6 , U�['".x MO i" Cr' H El * 0.1 "7 Il r, . ,w v. J7 'd.4 a- .^ •J ...>,.,.1 t] 35. final Gas Pi -Test .. LCI r✓ CF Pipe-Test* Os _ 6�{(.-�10', * :K :cc v:-+t� * : F nG36. Hood or Canopy * D mry <1--i.'* n t- k no....c>/:94esc. -. H S to * n I zm 4.- * 1 I . Ip*'*. 1�(`%.o d Orn S H `, rn r•+ F-H i ' -Ji 14 I .<,* .l . . * c r,-Ola _37..Final Factory Firepjzce,� IE.r, a {q� (,jd�,•' 4 Yu * c: No Q ', I M t ..• ,. , * -re'''. m .8. FinarPlumbing * ~N i -IF; iniq,,p ckjk :: S •1.4 • .-IH * m I r 0 y * viol OF+t:? I I 'X K n HL-'U 0 Ot * CNZCI0 O I'39. Waer ServiceYinal* •�� Y1 ' O * O mn -] n r40. Gas'3ervice-Final A: m *trim Sri 1 s w * m j I *t* Ct..- * F.^..TH n i nFH mt7'.X i * * • 1,,E * < 541. Solar,Domestic-Final I: •• * 0 �{pr * •$w � . iT1 c•-.;1* : I 1 x rr '-JU) y '� * 7t :. f iv _ t. C--. . w 42.+Backflow Preventers' N t'O 1* = I I E* * cc ?H • * V 1-1 n * n, 1-'1,4-4 M .3* i•-, * * m TIOO K H rr.),-1'-i 43. Bac4s`flow Irrigation SSS a<'.-▪ M * * J -HCr. *. J n lid w� .,+... 11..).....41.4• • r44.^Landscapi If igatloh Systenm rr r - g ti C' G v* K 0 .^_.0 * N COOL/OOP-10000 - -^ mn a: C <* X _ N N a E X o. 0 * S , 2- C n 4. '-•iccH cr'<" .T_ H H H* K '1 H H rt.-- o.:< * Sound Attenuation y ., •• m RI m* * H Cr'•�t"' ' • HC * C46. -Handicap-Regulations '-i O5 :-* * * - tc •S Ow S * r r 041 y: c I I 1: d moo (J * (.47.`PINAL STRUCTURE & BUILDING 0'K T 03 I .. 'K -1 Na,S * bqo, P W - * H " 48...F.tN-A'LPtANNINGpz C:-- ou-Cl..r fit ..I .1"�* n n-i 'C * rn rn ,1, = ."2* *O CJ N S r 'C •. . . 149.'Ele?Mic&eledse to Edison 1 4. I *. `I .-1-k; ' * * ,<_- ,• -1 .c.„.... 50.::Gas:Release to ttl Souern California Gas •Z* ---I „f Ix * L 1'-' d • om fi c0 ^' r ' -v 1< "+ '-•:t * •• S 00 n * N 09a/a-ooiru Joo 451. CERTIFICATE OFiOCCUPANCY i-* • * * )- ,? mo z M OC.,JwVOv J� No. Date E, • DECLARATIONS ` WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 7I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'corn•enation Insurance cattier n �°licy number are: /,/ /J�j/ �5/C' �/�}��) (��t It 1._ P`tcy.Number: `�O — W`1U - '�0 ✓/ "(7Ms section need no-be completed li the permit is valued at one hundred dollars/5100)or less.) ❑ I certify that in the perform. :oft or . is•:rmit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of t'. I should••ecome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro •. ' a-7 ?_—/ J`�� App cent SfgnStute:a_ / r 9 U 'Ll WARNING:FAILURE TO SECURE WOR. RS'COMPENSATION••IERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN •• ON TO THE COST OF•• PENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under p s s pter 9(commencing with Section 7000)of Division 3 of the Business ay.Pr Igns Code,and my license Is in full force and effect. / (^ ClIgint (�� to/�� CODuactads Signeare,---�--� . Deter .iJ �! 1 f CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is Issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: . I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to contract,alter,improve,demolish,or repair any structure,prior to Its Issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than foe hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or Improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I.as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Dale: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 I•o (Section 25533 of the California Health and Safely Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP H presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application akemit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given Is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of arty building authorized by this permit until final inspection. tom; , ,� ar(a) 2 —13 O7 w-1 �7M • a e r A`oilzed'ApplIca I - ate— CODE F INSPECTION TYI,E 2AX INTIDaLS Ms INSPECTION TYPE PAIL MAL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical �� 1266 Pool Spa Final 208 Final Plumbing I `L1-o7 ( ,t 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy OP'` CONSTRUCTION•AND'PLANNING ?O A ' - • _ -.1. ` ' Date. Inspector - ' -Date - I,nspector� 7 r APPROVALS Permit# - - - APPROVALS .Permit # 1`'Temporary Electrical Service oriole . - L.. '•52,.'Pool.& Equipment Location • ' e ' 1. Soil Pipe•Undrgrnd: - - ;j• , 53- Steel Reinforcernent - - - 3. Electrical Conduit Utility-Undrgrnd- - 54 Forms' s. - • • : i f ., 4. Electrical Conduit-Undrgrnd. 4 55'. Electrical Bonding. 5. Steel Reinforcement - I - - 56, Rough Plumbing & Pressure Test - - 6. Electrical UFER Grnd:' - _ 57,_APPROVALTO COVER:G.UNITE 7. Footings . . 58. •Electrical Conduit-Undrgrnd. ' y `. 8: Foundation 59.1Gas Pipe, 0 Undrgrnd:,Test 9. Water Pipe-Undrgrnd. . . - , f - : ' • 60,`.Backwash Lines, P,Trap, 0 Undrgrnd.. `' 10. Structural Floor System - - . - 61. APPROVAL TO DECK ' • • 11. Property Sewer Line & House Connection ' • , 62...Backwash & Receptor-Final { 12. Sewer Cap " _ .' 63,,Heater& Ven%Final . .. 7 ' 13, Roof Drains . ' - - - 64,.-Plumbing System- Final . - , 1 • 14. Rough Plumbing _ _ - - 65.;Electrica Electrical-Final - • 15. Rough Electrical Conduit 66. Solar System;Final - .. - "' 16: Rough Electric Wiring- . • 67r_Fencing & Access Approval ' ' 17. Rough Wiring Sign 7 _ 't ,: - 68,-APPROVEDFOR PLASTERING _ . } 18. Rough Electrical-T Bar Ceiling . i ' - 69.9P00127SPA'SYSTEMS FINAL 19.Rough Heatiag & Air Conditioning - FIRE DEPT REQUIREMENT r a. a,t-$$O'7rr an.:r, +' ^7 ac x"7'7:- 20. Roygh F:actor�-�f�elace,�� - APPROVALS Permit.# 21 ',Ducts, in Structure • . 70: Underground Hydro • - - . 22..Duc4s, Ventilating ' • •\\ '`.< �•"' \r-\ . 71. Product Piping 0 Gas ;0 Oil - . -. -, - • r 23. scPie- "GaRou h.& Test _ I P7 9 _ - 72. Underground Flush•` 24.rFloc.1 Framing 73. Undergrnd.Storage;Tank 0 Gas 0Oil 4, - ,:_ ,-"$ 25.•Roaif,Sheathing 1.. _ .2„--... > • -.. .. 4' ' _ - - ;74.•Overhead•Hydro = - ' F • 4. 2.6.4-Bier.CPingSi'riL�1'. at )" q,NFoat 75. Dry Chemica li -- . • 27.LFrame,and Eta i•irTIT4Mt*nr1 r:, - 76. Dry Standpipe r ' - • et '* .1,1 T rt'itrt'rnnh2' . . . 28. Latjingt& S 1i gy� nxNl Q 7 77. FIXED SYSTEM FINAL • s. ,-,:J .1,,:.-:,--.✓'-. 29. Insulation, 4 :�NOroC%:St-in • 78. FIRE PREV. FINAL - - :}•." 30. Drywall Nailg "rtC1Nm0 _ . -HEALTH DEPT. REQUIREMENT • 31. PlasterBrow¢PCoat rC N S 79. FINAL'INSPECTION, L. - Hr 0 - ' .32.t.Elec}tricAPo er MeteQ alr, - 80. •FOOD CERTIFICATE ISSUED ;$ , ,- " Ti 133.4inad.Eleatric t• aNotes: • S t 4 TC - _34.tr inti Heatin• g Co Air, r iti€inC , - : j . ,. 35. incl Gas Pipe-Test H .71-1 'Far' , 36: 1odi or Canopy ' • r ~•e, ' • . • . . T1 7 37.ainal Factory Fireplace - ^ N , . • .. • t .:38.UFin4l Plumbing sy39: /at4r Service-Final i .n ,- . . 1 _ _ y • t S' ' 47 .. - 40.t -Final ' • ( - i * - .. . . . . . .. . 1 , 41.rSol4 Domestic Final.,• k _ . . _ . .. , •. BackfloPrevente 42 = w{ r - - 'x H .. c rirl�:ncnc :nn VM I 43. Baclsflowtlrn-gation . . , . - . r -- sac , - 44. LanlriscaP1e IfratibPS"Wem°O0 • . . 45. ,Sougd 'Attenuation • 46.tHandicap'Regulations, • . . • 47: INft&L STRUCTURE & BUILDING - 48.CFIN14L PLANNING -- • - -. . - • ' 49. Electric Release to Edison - - . - - • • ' .' .50.cGasARelease to Southern California-Gas Co - r ru 000000OrVOO - . ' . 51.'CERTIPICATE-bF' CCWFANCYP , . No. •.. Date - - . . - 1 r IWA ENGINEER'S. ,,.. a ^\ 17390 6rookhurst Street,Suite 100 Fouetcln Valley.Co tomia 9270e a (714)968-1221 •FAX(714)968-9286-1 November 26, 1990 J .N. 207-03 City of Costa Mesa BuiFairg rivartmentti5T-4462 �S eli 77 Fait Drive l0 Costa Mesa, Ca. 92628 Attn: Mr. Victor Clift $1411111 Subject: Fine Grade Certificate I hereby certify that the fine grading for lotsc 62 ,_j63 and 74 through 77 of Tract 13224 were graded as shown on the approved precise grading plans for said project. �' !'„�� Q ?f �L� Llewellyn D. Incledon RCE 17593