The URL can be used to link to this page

Home My WebLink About2184 BOSQUE SPRINGS - Building PermitsCITY OF COSTA MESA � BlIILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: BX11-00035 PERMIT TYPE B MISC STATUS: ISSUED APN: 93786017 DATE ISSUED: 02/08/2011- Zoning: , ISSUED BY: RMD JOB ADDRESS: 2984 BOSQUE.SP_RINGS CM Suite/Unit: Vicinity: PATIO AND DINING AREA Primary Occ: _ .. Const Type :?? SQ. FT: 0 . � Valuation: E4,000.00 . , SCOPE OF WORK: REPLACE (2) EX1S7lNG PATIO SLIDING GlASS DOORS AND ENTRY DOOR WITH SIDELIGHT, L1KE FOR LIKE DUE TO SMOKE DAMAGE. OWNER: KOLpINGER, MARJORIE STOVALL TR Address:: %CHANG, SP,RAH L Unit COSTA MESA, CA City/State: 2184 BOSQUE SPRINGS ,� Zip Code: 95819-4146 . Phone: APPLICANT: VALLEJOS, TOM City/State: Phone: 714-727.7322 CONTRACTOR: BARTWOOD.CONSTRUCTION�INC Address: 10840 TALBERT AV City/State: FOUNTAIN VALLEY, CA Zip Code: 92708 . ARCHITECT: Phone ENGINEER: Phone FEE SUMMARY Building Plan Check: Building Permit: '" Electrical Permit: � SMIP Residential SMIP Commercial Bldg Std Admin Fund Address: Zip Code: License No. 592661 �� Phone 714-965-7900 ' $0.00 $97.25 $0.00 $0.50 $0.00 $1.00 License No. License No. Cell: Unit: Unit: Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays -9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal Holidays: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and relatetl regulations. (Ord. No. g2-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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 fnal approval will result in the expiration of this permit. CO�Et. INSPELPONTYPE DRTE INiIilALS CODEO INSPEGPONTYPE pqTE INIIPALS 1616 Fixed System Final Fire Prevention ' 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final BIocWRelaining Wall 212 Final Fire Prevenlion 202 Final Faclory Fire place 220 Final Planning Approval 203 FinalSign 222 Final Site �/ �, n 204 FinalDemolition 250 FinalBuilding/Occupancy /� 3—g�� Il[,(�c� WORKERSfCOMPEaSATION OECLqltniiON: I hereby aKrm untler penalty oi perj�ry one of the following tleclarations: ❑ I have and will maintain a certifcate of consent to sel(-Insure for workers' compensation, as provided for by section 3700 of the la6or Code, for the peAormance of Ihe work for which Mis permit is issued. I have and will mainlain v.�rkers' compensation insurance, as requiretl by s lion 3700 of the Labor Cotle, for the perfortnance of the vrork for which this permil is issued. My vrorkers' compensation Insurance carrier and policy numherare: �. �� u��- �O/ Carrier ,%/ " (This secnbn neetl e mmdetetl eme permrt is valued at rne nunmed dalars (SIDO) or less.) Policy Number: 3.�/O O O,SZJ ��'( — O(� ❑ I certify that in [he peAormance of [he vrork for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia, antl agree that if I shoultl become subject to the workers' compensation pmvisions of Section 3700 of the Labor C rthwith compl �ttrt�e provisioi s. Z g // cenPs SignaNre r e l.r"�� } WARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU9JECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP Tp ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed under provisions ot Chapter 9(commencing with Section 7000) ot Division 3 0/ the Business and Protessions Code, antl my license is in full force and eHect. � LiG#� � Class � V p Uaclor's Signalure oal� J CONSTRUCTION LENDING AGENCY: ❑ I hereby affrm that there is a construction lending agency for the perfortnance o( the work for which this pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: SlgnaWre Da�e OWNER-BUILDER DECLARATIONS: I hereby aKrm lhat under penalty of perjury thal I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for [he follovnng reason (Sec. 703t5, Business and Professions Code: Aqy cily or county which requires a permil to cons[ruct, aller, improve, tlemolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to fle a signetl statement thal 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 lherefrom and the basis tor ihe 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 ot the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the struclure is not intended or offeretl for sale (Sec. 7044, Businegs 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 ovm employees, provided that such improvements are not intentled or oRered for sale. If, however, the building or improvement is sold within one year o( completion, lhe owner-builder will have the burden of proving lhal he or she did not build or improve for purpose of sale.). ' ❑ I, as ovmer of ihe property, am EXCLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professbns Code: The contractas License Law dces not appty to an owner o� property who builds or impmves Iherpon, and wfio contracts for such project with a contracta(s) license pursuant to thc Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Owner ID verifed by drive� ., ecense. ❑ Yes ❑ No ` Driver's License No. Expires: Verifcation of Ownership by (rype ot tlocument, i.e. - property tax bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation (rve (5) or more feet in deplh into wfiich a person is required [o descend, will be made in connection with wnrk aNhonzed by ihis pertnit, and that no building slruc[ure, scaffdding, (alsewurk, a tlemolition or dismantling lhereof, will be more Ihan thirty-sik (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle 8, Califomia Administ2�ive Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Oivision o! Industrial Sa(ety, as noted above, unless such person has a permit to do such work from the division. Applicanl's Signalure Division of Induslrial Safety Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to fle and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Satery Code requires, with some exceptions, Ihat a Business Plan be 61ed with the Costa Mesa Fire Depanment by every business which has at any one time during a reportetl year a quantity of hazardous marerials equal to or grea[er [han a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at s[antlard temperature and pressure). Z. Does or will the applicant or present or tulure building occupant need to (le a regisiration fortn for awtely hazardous materials7 ❑ Yes ❑ No (Sec[ion 25533 of the Califomia 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 ro or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperaNre and pressure). 3. Does or will Ihe applicant or present or fuWre building occupant neetl to prepare an RMPP (Risk Management and Prevention Pro9ram tor acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Heal[h and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and fling with the Fire Departmenl of an RMPP by businesses which are required to register awtely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of [he Cali(omia Health and Safety Code been fully complied with? ❑ Ves ❑ No 5. Does or vnll the applicant or presenl or fu[ure building occupant require for the work which is the subject of lhis application a pertnit (or such constmction or motlifcation fmm the South Coast Air �uality Management District or from any other air polWtion con[rol tlis[rict or agency? ❑ Ves ❑ No (Sectbn 658502 0( lhe Califomia Govemmenl Code requires that Ihe requesletl infortna[ion be fumished on applications (or non-residential building pertnits). 6. Will any part of the facility to be constructetl untler ihis permit be within 1000 feet from the ouler boun0aries of a school? ❑ Yes ❑ No Qf "yes", [he facility must meet the requirement of Sections 25534 antl 42303 of the California Health and Safety Code). 7. If a permit from [he South Coasl Air Quality Management DisUict or other air pollution contml tlisVict or agency is requiretl for the work vmich is the subject of Ihis application, have ail of the disdosures prescribed by Califomia Health and Safety Cotle Section 42303 been made? ❑ Yes ❑ No 8. Qf "yes", attach certi�cate of compliance from the appropriate air pollulion control offcer). CEft71FICA7E OF COMPLIANCE: I certify that under penalty o( peryury the information given above is correcl I agree to comply with all state laws antl city ordinances regarding Hazardous Matenals antl Emissions. Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certity under penalty of perjury that I have read this application antl state that the information given is correcL I agree to comply with all slate laws and city ordinances relating to building consiruction, and authonze representatives of Ihe City o� Costa Mesa to enter upon the above-described propeny for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by Ihis permit until fnal inspection. Signawre f Legal Owneqs� Da�e SignaWre Date �' ___-__��F 9 � 305]A6 (3/0]) � �_��i� qpplirant Oal • `• B12IGHTON SPI2INGS HOMEOWNERS ASSOCIATION � � • c/o Seabreeze Management Company, Inc. 39 Argonaut, Suite 1(10 � 9liso Viejo, CA 92656 (949)555-1800 (949)S��-6678 Fax February 7, 2011 R�: Bri;hton Sprin�s Homeowners Association Deck and Windo�n� Rebuild City of Costa Mesa, This letter is to inform you dia[ Bartwood Construction is �he approved contractor for The Briehton Spruigs HOA. Shoidd you have any questions or if I can be of any assistance. please do not hesitate to contact me at (949) 855-1800, Ext. 9029 or via emai] at dleathers@seabreeszememt.co�n Sincerely, Debbie Leathers Account Executive �. �'�— " - Fire Inbident r# /n -/ Z 7 I � ,. Police Incident # � % 1� RELEASE OF PROPERTY AFTER ENIERGENCY INCIDENT . . CO. MESA FIItE DEPARTMENT P.O. BOX ]200 COSTA MESA, CA 92628-1200 (714) 549-1113 The Costa Mesa Fire Department, in the interes[ of the safety and welfare of the community at ZZ �% (time) ��'�s�o(date), assumed conVol of the property located at �/�2 •/ Z3 o s p„�c S��c � r, C,4 The necessity for assuming control of Ihe property was because of ` 5`-'fFt u c-� �.r �c F7,e E . Pursuant to the'condi6ons contained herein�as of (time) / �/s /io (date), [he subject property is released to, and is to be under_the control and the responsibility of �l.� ,� � ��. n, r� (name), who is the owner O, owner's representative (j�)', tenant O. ' YOU ARE HEREBY PLACED ON NOT[CE OF TAE FOLLOWING CONDITIONS (Check applicable condi[ions): (� A rekindle or an addiuonal fire from a hot spot is possible. The Fire Department recommends that a fire watch, with a means to extinguish hot spots, should be posted for 24 hours. O The following utili[ies: elec[riciry O, gas O, water O, serving [he proper[y have been shu[ off. I[ is advisable [o contac[ Ihe appropria[e utiliry company before restoring the service. O The s[ruchue may have been weakened by the incident. Until a structural su�vey can be made, it is advisable to keep all unnecessary people out of and away from the building. .` ( jQ Buildings tha[ cannot be locked or sewred by normal means must be secured by a([ernative means. Barricades and/or fencing are required to prevent unauthorized entry. It may be necessary to provide a security guard. O Rebuilding and/or repairing the damage will require permits (e.g., building, elecVical, etcJ from the Ciry of Costa Mesa's Development Services Departmen[, Building Safery Divisioa They may be contacted Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. by calling (714) 754-5273. ' . � The Costa Mesa Fire Department and the Costa Mesa Police Depar[ment retain the right to re-enter the property at reasonable hours, should [heir imes[igation of this incident require such re-entry. () Otherprecautions/conditions(specify): �-�'�Ze,�� C�L«�rr a7 �'ia.anT 71ooi2 F�e.+. �D T>ne,r[�+v <>eAer � SG-i�E.1 F2on. G,itr� � The conditions listed above are not all inclusive. They are intended as guidelines for [he City's Fire Departmen[ in exercising their discre[ion in providing'emergency assistance advice. ..� Infortnadon concerning a copy of [he report for this incident can be obtained by calling the Fire Department Business Office a[ (714)' 754-5106, Monday through Friday, between the hours of 8:00 a.m. and 5:00 p.m. You may be entitled to a reassessmen[ and subsequen[ reduction of your property tax as a result of this incident. For further information contact the Orange County Assessor's Office at (714) 834-2727!flvionday through Friday, between the hours of 8:00 a.m. and 4:45 p.m. The OWNER, OWNER'S REPRESENTATIVE, and/or TENANT shall protect, defend, indemnify and hold harmless CI1'1' and its elected and appointed boards, ofTcers, and employees from any and aIl claims, liabilities, expenses, or damages of any nature, including attorney fees, for injury to or death of any person, and for injury to any property, including wnsequential damages of any na[ure resulting therefrom, arising out of or in any way connected with the negligent pedormance of this Release by act or omissioq by or on behalf of OWNER, OWNER'S REPRESENTATIVE, and/or TENANT, or resulting from any violation by OWNER, OWNER'S REPRESENTAT[VE, and/or TENANT of any statute, law, regula[ion, or other legal requiremen[. Signed: �/ � �' � ��u-Q- Date � �%f / / � Time � a ' � Owner ( ) Owner's Representative ( ) Tenant ( ) � � 5 g�� ,�� Costa Mesa Fire Deparfinent Signed: /-G-rf ��+--yu-._._._ Assignment %i�s�•t �I` Officer in Chafge Wffl7'E-FIIiEADMIMSTRATTON YELIAW-OWNER/OR'IJER'SREPRESENTATTVE/fENANT PIIVK-DEVELOPAfEIYTSERVICESBUILD4�'GSAFETY , . _ _ • R. _—__� Fire Incident # /O . j o% Police Incident # COS' 1ESA FIRE DEPARTMENT P.O. BuX 1200 COSTA MESA, C.4 92628-1200 (714)754-5106 RELEASE OF PROPERTY AFTER EMERGENCY INCIDENT , The Costa Masa Fire Deparhnent, in [he interest of [he safety and welfare of the community at (i9/`'� (time) �� /'� (date), assumed control of the property located at �`7 `i / ��. L The necessity for assuming conhol of [he property was because of Pursuant to the conditions contained hereiq as of /�� and is to be under the control and the �esponsibility of Yb1 a rt' is the ormer (�), owner's represedtative ( ), tenant ( ). (date), the subjec[ property is released to, (name), who YOU ARE HEREBY PLACED ON NOTICE OF THE FOLLOWING CONDITIONS (Check applicable conditions): (�) A rekindle or an addi[ional fiie ftom a hot spot is possible. The Fi�e Department recommends [ha[ a fire watch, wi[h a means to extinguish hot spots, should be posted for 24 hours. (IX ) The following utilities: elect�icity (x), gas ( �Q, water ( 0O, serving the property have been shut off It is advisable to contact [he appropriaie utility company before restoring the service. (D�) The structure may have been weakened by the incident Until a structural survey can be made, it is advisable to keep all unnecessary people out of and away from the building. (� Buildings that cannot be locked or secured by normal means must be secured by altemative means. Barricades and/or fencing are required to prevant unauthorized entry. ][ may be necessary to provide a security guard. (� ) Rebuilding and/or repairing the damage will require pernu[s (e.g., building, elecMcal, etc.) from [he City of Cos[a Mesa's Development Services Department, Building Safety Division. They may be contacted Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. by calling (714) 754-5273. (�) The Costa Mesa Fire Department and the Costa Mesa Police Departmen[ retain [he right to re-enter [he property at ' reasonable hours, should their investigation of this incident require such re-entry. (�) Other precautions/conditions (specify): f�/Jo �,fN G/� /��.i ti1��GE-rV S• N bc c.., o A��v �y � ft-lt+�os0.(.�+r� _ . The conditions listed above are not all inclusive. They are in[ended as guidelines for the City's Fire Department in exercising their discretion in providing emergency assistance advice. '� Informa[ion concerni�g a copy of [he report for Ihis inciden[ ca� be obtained by calling the Fire Department Business Office at (714) 754-5106, Monday through Friday, between the hours of 8:00 a.m. and 5:00 p.m. You may be entitled to a reassessment and subsequent reduction of your property tax as a result of this incident. Foc fur[her information contact the Orange Counry Assessor's Office at (714) 834-2727, Monday through Friday, between [he hours of 8:00 a.m. and 4:45 p.m. The OWNER, OWNER'S REPRESENTATIVE, and/or TENANT shall prorect, defend, indemnify and hold harmless CITY and its elected and appointed boards, officers, and employees from any an all claims, liabilities, expenses, or damages of any nature, including attomey fees, for injury to or death of any person, and for injury [o any property, including consequential damages of any nature resulting therehom, arising out of or in any way connected with the negligent performance of this Release by act or omission, by or on behalf of OWNER, OWNER'S REPRESENTATNE, and/or TENANT, or resulting from any violation by OWNER, OWNER'S REPRE�SEN�T CI E,.andlor TENANT of any stam[e, law, regulation, or other legal requiremen[. Owner ( ) Costa Mesa Fire Department Signed: s Representative ( ) Tenant ( ) Charge 2923-a4 wnM1e - Fire Aammslralion, Veibw - �xnedOwnei s ReoresenW�ve/renanl, Pink - Development Servicesieuiltling Sa�e�y Date: � v/'� / o Time: � Z 7 c� Assignment: (� f�K �'`l f} ��c- f�3 ��00�82��?�.l� /��5� �6 �627L� �16.84 TL. /! COSTA MESA BUILDINGSAFETY DEPARTMENT APPLICATION F��TRIf�'��1�, PERMI'� � 6� / P.O.BOX1200 COSTAMESA,CALIFORNIA92626 �� RECEIVEDBV PERMIT For Applicant to Fill in Comple[ely — Use Ink Onty BUILDING q.p, NO./�� ADDRE55 OWNER OR A�IDRE55� TENANT Iv1.D. Janes CO. � TI1C. UNIT OR ADDREss 2950 AiY'Way Ave., D-9 SPACENO. TR.NO. LOT BLK. c�Tv Costa biesa 92626 No`979-337 � /s � a� CONSTRUCTION NEW, ADD ALTER REPAIR MOVING DEMOLISH LENDEA N/A BRANCH y+ /J� OWNE .�[J. ADDRESS ARCNITECT TEL US WE5��7 ORENGINEER Sam ieri I1 N,549-252 ADDRES51%92`Z �,cj�C Park, Irvine 92714 ZONE � TVPE GROUP APPROVED CONTRACTOR �Jj]eT BY DATE ADDRESS TEL. CITV NO. F STATE CITV APPROVEDSETBAGKS � � LIC. NO. LIC. NO. (y SIZE NO.OFBLDGS. (� (FFOMC/LSTREET) �. OFLOT IrTeg. NOWONLOT Y' ROM FT. Q USE Of (� � EXISTING BLDG. Y� � FT, N FSepara[e permits are required for L. SIDE FT. 0 electric, plurtibing and hea[ing work. REAR � FT. �.W., USE OF BUIIDING AND WORK TO BE PERFORMED PLANNING acTloN Q � minium & �G�!l�-/5�7 °vrAoveo �/-/3-7 a � , r Attached Garages. "��i � O ;�''79 � HOLD FOR SPECIAL REQUIFcEh1ENTJ v� �a I hereby ecknoWletlga that I hava reatl this application antl steie that the abova I�formetion is correct antl aB�ee io comply with d all laws regulaiing builtling construction, antl I ehell not employ ,'Z any parson In v�p�ation ot the workman's compen3etion laws of � W ffie State of Califoroia. 3 I hereby cenify that I am properly licensetl as a contractor under SQ. FT. tha State of California Business antl Professions Cotle, Division 3, THE AMOUNT SHOWN UNOER VALUATION IS FOR Chaptar 9, and that such licenses are in full farce antl etfact, ar I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: am exemot from e provisions of the5tate ot California Business VALUATION ' PERMIT FEE S � and Profassions C' e, Divisjpn 3, Chapter 9. Signature of V/ � �7 �l PLAN CHECK S�� O Permiaee " $ u // / QV TAX ' " 5 /S or � � �/ �7 Authorizetl Ag Da� �� TOTAL PAI D S'j 34 T�' PFlOJECTAOOHESS: Z1B4 B�SQ ❑E SPRINGS owxensxame:STWALL, CLYDE E aoosess: $SESMA NICHOLAS J 2184 B65QUE SPRINGS COSTA MESA CA 92627 AflCH/ENGINEEN: � 7 S 9% S 9 S— S J G y qEG.NO.: A�ONESS: UNIT: uxir: PEPMITTEE: CRANK HROTHERS ROOFING ( 714 ) 548-5569 aoosEss: 126 COMMERCIAL WAY COSTA MESA CA 92627 UCENSEO CONTpACTOP DECLABAtION: I here�y aihrm I�al licensetl untler provisions o� Ch ammen ' wi�h Section 7000) ol �ivision 9 0l Ihe Business antl Pmlessians CoOe, an m license is in �ull �orce and e cirruc p g3 sT euc.�08677 ciass:C39 �ate: � Z Sgna�ure: _ WONREBS' COMPENSATION DECLABATION: I hereb irm at I have a ceailicate of consent to sel4insur r a cenificate oi Workers' Compensation Insurance. or a cenilie0 copy �herea ecti 3800, Lab. C). eoucreo.:z85-93UNIT00 4 E%P.DFTE:OSIOSI94 cornrnNr:STATE FUND ❑ Ce ' ietl copy is hereDy fumishetl. � Cenified covY is f h ine ci�y uiltling oivision. . ��—_`�� ate: _ � Applican� �,��` E%EMPTION FBOM WOXNEflS' fAMPENSATION �ECIABATION: (This sec�ion nee0 noi be complele0 ii Ue permit is �or one �unered ($100) or less�. I ceNty Ihal in Ihe petlormance oi ��e work tor which Ihis Dermii is i55ue0. I shall not employ any persan in any manner so as Io become suble�� o I�e Workers' Compensaiion Laws of Califomia. �aie: SignaWre: NOTICE: II, ailer making Ihis tleclaraiion, you 5hou10 become SUDject lo ihe Workers' Compensaiion pmvisions oi Ihe La6or Cotle, you mus� fotlhwil� compty wilh such pmvisions or Ihis permi� shall be deemed revokea. CONSTNUCTION LENOING RGENCY: I hereby allirm Ihai Ihere is a con5imc�ion lending agency for Ihe pedormance of �he work for which ��is oermit is i=.suetl (Semion 3097. Civ. C�. LENDEfl: A�ONESS: OwNEB BUILOEX oECIAPRiION: I nereby altirm inat I am exempt imm ine Conimctors' State License Law for the following reason (Section 7031.5 Business and Professional Cotle- �Pny ciry ol counry which reQuires a permit Ia con5tmci, al�er, impwve, Oemolis�, or repair any slmcWre, prior Io iis issuance, also repuires Ihe aOPlican� for such p¢�mit �o file a signed statement ��a� he/she is licen5etl Dursuani �o I�e pwvisions ol ihe ConVac�ors' S�ale Llcense Law (Chap�er 9(cammencing with Section 7000) ot Division 3 of the Business ana Pmlessions Code) or thai he/she is evempl Ihereirom anU �he basis br ihe aliegetl exemp�ion. Fny violaiion ot Seciion 7031.5 by any applicanl for a permi� Subleci5 �he apDlicanl to a civil penal�y o� no� more �han five �untlretl tlollars (4500). I. as owner af �he pmperty or my employees with wages as their sole compensation, will tlo Ihe work, an0 the ❑ simcture is noi intentled or ofieretl for sale (Section 7044, Business and Professional Code: The Contractors' S�ate LicenSe Law Ooes not apPty Io an owner at a pmperly wha builOs or impmves thereon, an0 who tloes such work himself/�ersel� or ihmugh his or her own employees, pmvided Iha� suc� imDrovemenis are noi inlen0ed or offere0 for sale. II, �oweuer ��e �uilaing or imOrovemenl is soltl within one year oi completion. �he owner will have �he burtlen ot O�oving �e/she ditl not builtl or impwve for I�e purpose af sale). I. as owner ol Ihe properry. am excNsively conirac�ing wiih licensetl conVaciors �o cons�mcl lhe D�oleci (Section 70A4, Business ❑ ane Prolessions Cotle: The Comracmrs' Sia�e License Law does no� appry m an owner al Dmperty who builAs or improves �hereon and who caniratls lar such pmlecis wi�h a contrac�or(5)license pursuan� to t�e ConVacrors' Slaie License Law�.l am aware �hat Dmol ol Neir Worker'S Compensa�ion insurance should Ge pwvitlea to me. ' � i am exemD� under Section: B. 8 P. C. lor Ihis reason. Daie: Owne[ I do �ere�Vi cenily thai I am aware oi an0 underslantl �he requiremems oi Calilomia Heallh antl Sa�ery Cotle Sections 25505, 25533, and 2553G ane �hai I or any �uture building occupant willlwill nol (cirde one) neetl �o comply with 5ai0 state co0e5 and �he reQuiremen�s for a permi� for cons�mction ar motltlicalion Irom the Fir Ouabty Managemen� �islricl Residenlial conslmciion aDPlica�ions are exempi Imm ��ese Omvisions. Dale: Applicanl: I hereby cerii�ythal I �ave read Iltis aDP�icaiion and stale7 ordinancesa O51alelawsrelaling�obuiltlmgcanSlmciiona; property I inspectmn Durp05e5 �ate: '� � � Signalu ._ �rivefs License or Social Secwily x: a�ove inlormation is correcl gree to comply wilh all ciry and coun�y y auihorize represenla)jue��s cily �o en�er u0on �he above-men�ionetl 1641�46 WM1ne—Butltlinq; Green—Cotle Eniomemen�; Canary—Applicant: Pink—Revenue: Galdenmtl—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 062687 PERMIT NO: B 062687 PLAN CHECI( NO: N GOVT; N SUPP; N CONSTRUCTION TYPE; 5—N PERMIT TYPE; STR PURPOSE; ALT JOB DESCRIPTION ; T/O S INSTALL 'HOT SYSTEM' &'GRAVEL' SQ FT; 1,793 CLAIM VALUE; 1,743,00 CALC—VALUE: 1,793,00 GROUP OCC: R-1 / COMMENTS• SMOKE DETECTORS RE�UIRED PER THE 1991 EDITION OF E E Cr p x+�*�r*�r**i�x****�r*�r��rxx*�***�* ***�r+r�r*�r�r�t�r�r*��r�t�t�r�t�t�t*�r�*�r�*�*��I��iE�EY��fl Z O N I N GS ERTEB�AUCIKRSE M E N T S REQUIRED ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR; FT IN FRNT; FT IiJ REAR; FT IN LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN PARICING RE • PROV; PARCEL; 93786017 ZNE; REF NO; PLANNING N T'ES> �' l. , if if ihlE �f 1! iF k iE iF iF itlk ik if iF iE k 1E i!!! iF iF 1E if k 1F 3f iF ik iF if k if if it iF if if iE iE iF 1F 1FlF iF 1f iFiF 1F1E �Flt if iE i!� 1f 1flE iE iF iE iF1klE iF iEiE i! iFiElFlk if if iE iE iE 1E D E V•E�I, O P M E N T S E R V I C E S R E Q U I R E M E N T S 20NING APPROVED�BY DATE; BUILDING APPROVED BY ; APPLICATION ISSUED HY; iF i! if iF 1E iF f! i! iE it iE if iF ik iE ik if 1F iF �f i! iF if iF iE �t if if iE iE iE iE ilik iE i! if k iE 1t if iF if iE it if iE ik iE ik it it iFiF iF if if it if iE it �f ft iF iF LEGALZ2ATION;N F E E S U M M BLDG PMT PERMIT 91.00 DATE; �� DATE; �i��iF#�' iFii� iF3Fi�iFi�iFiFiF iF i! it �f if if iF iE ik i!� if iF kiF if iF �FlF �7k 1E iFlE if !F 1! iF 1E 3F �f iF iE �F iFlE �F *!E it �f 3f �lk iFlE iF !F iF A R Y STRUCTURAL SEGMENT;Y' PLUMBING ELECTRIC MECHANIC PLAN ` ' � • ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PliAN�CHECK TOTALS----> 41.50 0,00 i.;: 0,00 REVENUE DIVISION TOTALS--> COLI:ECTED; BLDG PMT PLUMBING ELECTRIC MECHANIC 41.00 _. FIRE SMIP/R50 GRADING SMIP/NON—RES TOTAL PAID DUE 41,50 41.50 ,00 41,50 OVER/SHURT: ,00 FIRE SMIP/TO�T GRADING PLAN—CHECK iF iF i! iE iE iE if it 1k iFiF ff iE if iF iF if iF �F it if iF if k aE if iF 3E �If 3E iFiE ik 1k kiF 3EiE iF iE iE i!il�F 1E if iE iF iE iF if iF iE�F it it it iFlf iE IE it �E iE 3t �F 3t if iE jFif 3F 3E iF �k 1ElE iF if I N D I V I D U A L�' F E E B R E A K D O W N � �, TYPE QTY D E S C R I P T I O'N UNIT COST TUTAL COST �'-� SFR�;7 1793 REROOF BY VA'UE RESIDENTIAL NOZONE 1,00 1,743,00 .-END OF FEES EXPIRED ` ` � p,lete Inspectians �0i� �� \ � � 9 �1 ��: ni Q0241403—pp1414�4 TiG T 4i.5t1 DATE: 05{?2/93 TI11E: 11:06 , � CONSTRUCTION AND PLANNING POOL _ �PA � APPROVALS Permit # _ Daie Inspector APPROVRLS Permit # Date Inspector � i. Temporary Electrical Service,or Pote,. 52. Pool & Equipment �ocation r 2, Soil Pipe-Undrgrnd. � � � - 53. Steel Reinforcement "� 3. Eiectricaf Conduit U2ilitY�Undrgrnd. 54. Forms . 4. "Electricai Conduit-Undrgmd. - _� . . ' 55. Electrical Bonding � � 5�. Steel Reinforcemene ' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVALTO COVER�GUNITE ^ 'i 7. Footings r 58. Electrical Conduit-Undrgrnd. 8. Foundation �_ � , 59. Gas Pipe, � Undrgmd., Test � . ., 9. Water Pipe�Und�grnd. �; . 60. Backwash �ines, P-Trap, L�1 U�drgmd. � �-10. Structural Floor SYstem �.. • 61. APPROVAL TO DECK �- 11. Property Sewer Line & House Connection . g2, Backwash & ReceptorPinai � 12. Sewer Cap , . 63. Heater & Vent-Final �/' i 13. Roof Drains , ` � � 64. Ptumbing System � F1nal . 14. Rougii Plumbing ' ' 65. Electrical�Final 15. Rough Electrical-Conduit _ . 66. Solar SYstem-Finai � 16. Rough Electric Wiring `� 67. Fencing & Access ApProval . � 17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING 18. Rough Electrical-7 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Conditioni�g _ FIRE DEPT. REQUIREMENT �r _ 20.:Rou�h Factopy F�ireplace ' ' ' � .. . ' APPROVALS ' Permit # � � , 27. Ducts, in St�ucture � _ -'� `-70. Underground Hydro �..Y i 22. Oucis, Ventitating ., , - . � - _ _. ,�71, Producx:Pfping CGas ❑.Oil 23 ��Gas Pipe-Rough & Test � _ 72 Underground Flush � � � � - 24: floof Framing : � r; ` ' �' ' � _ ' '73. Undergrnd: Srorage Tank Q 6as ❑ 0+1 �� 25. Roof Sheathing - �/� _ l�l, ,/1� 74;:Overhead Hydro � � � 26. T�Bar Ceilin {Sttucturall &�Monocoat `e �/�]mQ 75.. Dr Chemical Y ' ' 9 Y 27. Frameand Rlashing A: �._ - - � 76. DryStandpipe . _ - 28. L2thing & Siding .� ' ' - �; ' - i _ 77. FIXED SYSTEM FINAL � 29. Insulation � . - • �- i � _ 78.=FIRE PREV. FINAL - - I � � " ` - HEALTH DEPT: REQ'UIREMENT 30. Orywall.Nailing " - �_ . � 31. Plaster Bro��m Coat ��, _ :;� ..79,�FINAL WSPECTION � 32. Electrical Power Meter-Final� , � -�- � •�80. FOOD CERT�FICATE �SSUE�, , J; / • `,� �n � (f 33. �Final Electria . � � 1 = ` i �� Notes: r„/30��:_1' ^ _ �J, ,_``�_f1 �4",� � �Kyid` Wri� i�7JV 34.'�Final Heating:& AirConditioning> , � � � (i � i i 35. Final GAs Pipe�Test � . ' - '36. Hood or Canopy �- �' � "� i - ' ' 37. Final.Factory Fi[eP�ace � , _� �, , -�-.,_ � _. � 38. Final Plumbing � ` '•' � i - , - �--�-- 39. 4Vater Service-Fina1` , "' � � - ' � � 40. Gas Service-Final _ • � � � � i � - - �41. Solarpomestic-Final _ - - � j� ' . , , 42. Backtlow Preventer. - � i - • � � - 43. Backflow Irrigation . ' , ' 44. �andscape Irripation System= ' � � � � � � '' � • r� 45. �Sound Attenuati0n -.-. � , � � _ � �. 46. Handicap•Regulations . � -. � � ' � � � 47. FINAL STRUCTURE & BUILDING . � , ;' � t. 48.�FINA�PLANNING _ . , j ; , . , . r 49. Electric Release to Edison �-' -) � 50.. Gas Release to Southern Californie Gas C4 i � • � 51. CERTIFICATE OF OCCUPANCY No._ ' Date � � / / AOo��ant lo till in all spaces exeept tnose witnin neavY �ortler Ilnes antl sign all aoPropriate aeclarations. CiTY OF COS7A MESA CONSTRUCTION PERMIT ProjectAddress' '�i8y g0-:fC'x.lP s�%�Jtfi't Applicant's Mailin9 /A�d-drr-e�ss • �'�� -r Gi� J e�wner's Name t�G, •S T ��i2-'l�fcLL phone�o��—S�-i%' Address 3f8 � Arch/Eng. icense No. Address Contractor's Nam � � F �ti' Phone Address (mailing) STX m� City license No. - r LICE NTRACTOR DECLARATION I hereby a(fi�m t licensetl untler prOvi5lon5 ot (commencing �� section ]000) of Divisi t th antl Pwfessions Gotle, antl licerise is in full force ana . License Class e No. D Signature ' WORKERS'COMPENSATION DECLARATION I hereby affirm tnat I have a certificate ot consent to selt-insure or a certi(icate ot Workers' Compensation Insurance, or a certitietl copy thereof (Section '800, Lab. C.) ' •olicy No. Company - 8 Certifietl copy is hereby iurnishetl. Certifietl copy is tiletl with the city Builtling Division. Date Applicant � EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection neetl not be completetl if the permit'is for one huntlretl ($100) or Iess). I wrtify thaf in the performance ot th¢ work tor which this perm�t is issuetl, I shall not employ any person in any manner so as to become subject to'Ihe Workers' Compen5ation Laws of Califomia. Date Signature NOTICE: 1(, aiter making this tleUaration, you shoultl become subject co the Workers' Compensation provislons of the Labor Cotle, you must tortnwith cOmply with such provisions o� tM1is pe�mlt snall be tleemetl �evoked. GONSTRUCTION LENDING AGENCV 1 hereby aifirm that there Is a constructlon lentlin9 a9ency for the performance of the work for which tnis permit is issuetl (Section 3097 Civ. CJ LenGer's Name Lentler's Atltlress OWNER BUILDER DECLARATION ' I he�eby affirm Ihat I am exempt from the Contracto�'S License Law tor the following reason (Section �031.5 Business antl Protesslonal Cotle: Any city or . County which requires a permit to consfrutf, alt¢�, imp�ove, tlemoli5h or reOalr any structure, prior to its issuance, also requires the applicant (or such permit to file a signetl Statement that he/She is licensetl pur5udnt fo the O�ovisions of the Contractor'z License Law (Chapter 9(commencing with Section �000) of Division 3 of the Business antl Professions Cotle) or that he/she is exempt �=heretrom antl the basis for the allegetl exemption. Any violation of Section �',9�:;�1.5 by any applicant fOr a permit SubjeCtS tne applicant. to a civil %..:�alty ot not more than (ive huntlretl tlo11ar5 (E500j.. {'-fi,..-I, as owner of the property or my employees with wages as their sole �''ompensation, will tlo the work, antl the structure is not intentletl or.of(eretl 3 for sale (Se<[ion 7044, Business antl Professional Cotle: The Contractor's License LAw does not appty to an owner of a property who builtls or improves tnereon, antl who aoes such wOrk himself/herseli o� th�ough his o� he� own employees, provitletl that such improvements are not intentletl or olferetl for sale. If, howev¢r, Ihe builtling or improvement IS Soltl wlthin one year oi mm- pletioq the owner will have the burtlen of provin9 he/she tlid not builtl or im- �1rove torthe purpose of sale). U I, as owne� of the p�operty, am exGlusively cont�acting witlt licensetl con- [ractorsto construct the pro]ect (Section ]044, Business antl Professions Cotle: The Contractor's License Law tloes not appty to an owner of property who builtls 0 Imoroves thereon. ana who tonVacts for such oroiects with a ron- tractor(51 Lcense pursuant to cne Contractor�s License Law). I am aware that proof of their WOrkeYs COmpensatio i surance shoul�tl bfe provitletl to me. ❑ I am;eti�empt �ntler Section �b� B. p ryi�for ILis reason � if AA--WJJ / / Date , `�( �(� 1 hereby certify that I ha Information Is correct. I ac antl state IaWs relati to sentatives of Ihi [o Inspection 0 rp Signature Drivers' License or 55 � Con antl state thai the above all clev antl counN ortlinances 3�3543� .� �o�as � l I__. TVPE OF CONSTRUCTION NEW�� DD ALTERATION REPAI R ❑ CONVERSION ❑ DEMOLISH L_ OTHER + �5� CRIPT 4ON OF Wor� K/USE OF BLDG.� C E �Z O% e�t' �1 r¢a.T'c�.a S't2�ra.a —s�n—e�^Qp '"!��'1 VPEOFPEFMIT GR ING ❑F NOATION C�STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ,❑/N�CHANIC{jeLC ��C n sT� h a aaY'a.�i.e /a so �� PROJECT DES o�or�n �i SQ. F. OCCUPANCV —3 CONSTRUCTIONTVPE VALUATION$ �OO�� • ZONE GRAOINGCU.YDS. ACRES Remarks: Bar Sink Backflow Preventer eackflow Irrigation eathtubs Clarifiers Dishwasher Drinking Fountains - Floor Dreins Floor Sinks . Gas Servic.e Outlets Kitchen Sink Lavatories P—Trep Roof Drains Reinspection Fee � ' $15 Boiler ' Duct-Under Ground Duct - Strucaral Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. iCBO # Heating System & Ducting ❑ ai oa,000 sTu O i oo,000 Reinspection Fee I $15 0865-46, rev. 5/8B � White - Bulltling; Canary - qpplicant; Pink - Accounting; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Water Closet Water Heater Water Service Auto-Wash Issue Fee Hoodor Typel � Canopy Typell ❑ �eretion System ]aioo,000sru ❑ioo,000 'ystem RepaidAlteration � ire Dampers F X P 1 f Registers lnrqmnlete li Oate — laue Fae FEES A.P. # � —� S Main Buiiding: E T Front A Rear C Right K Left S' Ping. Ref. # Planning Notes: r Automatic Washer Construction Pole Sub. :• � �� , � ��' _ ��.�� - � �� _�/.l �/��_.�i[�i 1 6IL_.�l L . [��a1 �[I�T�=� C_ /_ ' .Id . ELECTRICAL . , Transformer ❑ 75-50 KW ❑ 50+KW Cooking Unit Meter ❑up to 100 amps ' Dishwasher Meter ❑over100amps Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0-5 KW �5-15 KW ' � Heinspection Fee � $15 $ 3 DEVELOPMENTSERVICESREQI Zonin9 APProved By FEES Building Approved B� $ 3 Suh Panel Motors OO-1 HP � 1'/: - B Inc.Solar �9-15 HP 016-75+ Microwave Pole light Range Sign Standing Sections Trash Compactor . i luue FEES � 3 �� SUMMARV OF F�S ! W BUILDING PERMIT $ j0 • �� SMIP � $ • �fl PLAN CHECK $ � • �S pERM1T PLUMBING $ .. ISSUANCE �•�;'$' 't' PLAN CHECK 25% $ ENERGV P.C. $� �+ELECTRICAL $ �-I. O� GRADING $ PLAN CHECK 50� $ MICROFILM $ MECHANICAL $ . TOTALFEE $ � � PLAN CHECK 25% $ . {: O10013240S-JOD3240� 'Ef_J�` 61.25 �fiTE: OS/Q5/$S TII7t: 1_S:£,b . . � � �� (i/ . ..`,`.: , _ .�'f o. _t. f ,. . , .�, CONS`TRUCTION AND PLANNING FOOL A • APPROVALS � Permit # � •'Date � Inspector qppROVALS Permit # Date Inspector , � i 1.r:Temporary Electrical Ser ice or Pole � 52. Pool & Equipment Location '�i"�" � v � 2. Soil Pipe-Undrgrnd. .��• � , 53. Steel Reinforcement � :�) .�. `_.3: Elect,�ical Conduit Utility-Undrgrnd. � - 54. Forms »" %,"i T �4b Electiical Conduit-Undrgrnd. � . 55. �Electrical Bonding J.. ✓ � 5.�Steel,Reinforcemerit , �� f " 56. Rough Plumbing & Pressure Test � = 6, Electrical UFER�Gmd. r� . 57. APPROVALTO COVER-GUNITE � .,i ,1 J 7.'�Fooiing3� '�". r� - 58. Electrical Conduit-Undrgrnd. �l,Y�j' 7; , �. I :r' !. 8r.Foundation � � �� 59. Gas Pipe, O Undrgmd., Test ��. ��7 n' . r- I t i, . 9. Water P,ipe-Undrgrnii.�� . �� 60. Backwash Lines, P-Trap, O Undrgrnd. ��'� � 10�Structural Floor System � �� 61. APPROVAL TO DECK �� "�" 11�� Property Sewer Line'& House Connection 62. Backwash & Receptor-Final �` ;� 12.' Sewei Cap �%� � 63. Heater & Vent-Final �" f;� =' r 13. RoofzDrains � 64. Plumbing System - Final ,!� i . 14. Rough'Plumbing ` . 65. Electrical-Final . �f 15. Rough Electrical-Conduit � - 66. Solar SYstem-Final '��6. Rough F�Jectric Wiring � , - 67. Fencing & Access Approval 17. RougK'Wiring Sign ' ' -68. APPROVED FOR PLASTERING t� � �1$; Rough Electrical�T 8ar Ceiling . 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating`& Air Condit�oning FIRE DEPT. REQUIREMENT � 20. Rough Factory fireplace `' APPROVALS Permit # r,� , _ 21. Ducts, in�Strucit.'_6re J; _ 70. Underground Hydro 22. Ducts, Ventilat`g 1�;� l 71. Product Piping O Gas ❑ Oil � 23. Gas'Pip�RougFi'& Test � - � 72. Underground Flush ;� 24. Roof.F�aming �' � ,.:.73. Undergrnd.StorageTank OGas OOiI� "z '+ �25.�Roof Sheathing, . _ � �« � . , _ , , . 74..Ove�head Hydro � . � . . . . � _ � 26. T-Bar;C,`eiling (Structural� &.1Vlonocoat 75. Dry Chemical � 27� rame a'nd Flashing � � 76. Dry Sta�dpipe � r. i � 28. Lath'�g,&�Siding .�,� 77. FIXED SYSTEM FINAL �• ri 29. Insula�tion ,� �� 78. FIRE PREV. FINAL � 30. Dryw,all{Nailingi _ �'.' � � HEALTH DEPT. REQUIREMENT 31. Plas{ei Biown Coat �� `� 79. FINAL INSPECTION 32. Elec�ical Po e;�Mefer-Final:.._. 80. FOOD CERTIFICATE ISSUED _�.�,� ., - 33. Final�Electric�� ir� Notes: .., 34. Final Heating &'Air Gonditioning ' �, � i�. . L� 35. Final Gas Pipe-Test � _ � . • � �� / 1 36. Hood or Canopy -- " � � 37. Final Factory Fireplace � 38. Final Plumbing � . • 39. Water Service-Final � ? . - � i-� 40. Gas Service-Final �'' _ ,1? 41. Solar pomesticFinal � � � -��'�� i!:/ � 42. Backflow Preventer • , • :_ % r �y = 43. Backflow Irrigation' ' ' .' J;'' �' l.n'/. .h..i 44. .Landscape Irrigation SYstem � If7C m,Ir+ ;lin� n V�� V, , y� '. 45. Sound Attenuation ' - �' P�'� ' 46. Handicap Regulations � - . �g � _�- � r ,{, 47. FINALSTRUCTURE&;BUILDING � ' . 48. Special Requirement's Completed � � � �� 49. Electric Release to Edison �. �1 �� F;j �50. Gas Release to.Southem California Gas Co � „ .,;,, ��-.;�,', ,� . : i 51. CERTIFICATE OF OCCUPANCY N 1�\ ;,, r' + jN� re /�1 No. Date tV � ;J a ?��/y � � ' , 7�1 n Y� /n