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Home My WebLink About251 BRENTWOOD PL - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 251 BRENTWOOD PL Suite No Vicinity: Parcel Nunmber: 43933231 Applicant: NOCK, RON Address: 17612 KNOTT ST SUITE 17' GARDEN GROVE, CA Owner: TUBBS, DANIEL O SR TR Address 251 BRENiWOOD ST COSTA MESA, CA Contractor: NOCK PLUMBING Address: 11612 KNOTT ST Arch / Eng : Address: GARDEN GROVE, CA r PLUMBING PERMIT Phone: 714-895-1246 Zip: 92841 Phone: Zip: 92627 Phone: (714)895-1246 Zip: 92841 License: 707775 Phone: Zip: License: SCOPE OF PERMIT INSTALL NEW DISHWASHER. THIS IS NOT A CHANGE-OUT. 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 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $9.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY O .. . . 0 0 0 0 0 1 0 0 0 0 0 0 0 0 � 0 0 0 FEE SUMMARY , AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Private line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $�.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: 01/03/2002 Issued: 01/03/2002 ISSUED BY: v �-- SumpPump Swimming Pool Trep Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0 00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $33.30 an 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 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 tnspections erW finel epproval must be obtairtad. Failure to obtain inspactions and final approval will result in the ezpiration of ihis pertnit. FOR INSPECTIONS CALL: (714) 754-5626 2446d6 (fi/00) WORKERS'COMPENSAnON DECLARATION: ' I hereby aifirm under penalty of perjury one of the following declarations: � , ❑ I have end will maimain a certificate of consent b self�lnsure for workers' compensation, as provided tor by section 3700 of the Labor Code, for the pertormance of ihe work For which this permit is issued. ave and will maintain workers' compensation ins�rance, as required by section 3700 of the Labor Code, for the performance ot Ihe work for which this pe r�i �is is5ued. My workers' mpensation Insure/nce carrier and oalicy num6er are: �, Y>� l/y7 r> l/��u ) Cerrier: �� / Q—��%- A l Policy Numberl�C/LJ �/ Su �U (This section need not be completed i/ Ne permif is valued at ane hundred dollars ($100) or less.J ❑ I certify that in the pedormance ot ihe work for which this permit is issued, I shall not employ any pereon in any manner so as to 6ecome suble� �o �he workers' PP compa9nsation laws of Califo�� ree ihat it I pacttll e�iie s� ubject to tha workers' compensation provisions of Section 3J 700 of the Labor Code, I shall forthwith comply with these provisio% C A licant Si nature: I Date: J� J � � WARNING FAILURE TO SECURE WO 5' CAMPENSATION CAVERAGE IS UNLAWFUL AND S ECT AN EMPLOVER TO CRIMINAL PENALTIES AND QVIL FINES UP TOONE HUNORED THOUSAND DOLLARE (8100,000), IN ADDITIQV TO THE COST OFCAMPENSATIqV, DAMAGES AS PROVIDED FOR IN SE 7C�f`i 6FTHE L4BOF CODE, IMEPEST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm that I am licensed und rovisio of Chapt ( mmencing with Section 7000) of Division 3 of the Business and�o�s�QOde, and my license is in full force and eHact. Lic. W Class # L� _�-� Comractor's Signature: Date: — CONSTRUCTION CENDMG AGENCV: ❑ I hereby afiirm that there is a consVuction lending agency for the peAormance of tha work for which ihis permit is issued. (Sec. 3097, Civii Cotle). Lender's Name: Signature: _ OWNER-BUILDER DECLARATIONS: Lender's Address: Date: I hereby aHirm that under penalty of perjury Ihat I am EXEMPT PROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, 8usiness and Professions Code: Any city or county which requires a permit to construci, alter, improve, demolish, or repair any stmcture, prior to its issuance, also requires the applicant for such permit to tile a signed statement that he or she is licensetl pursuant to the provisions of �he Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 ot the Business and Protessions Cotla) or that he or she is exempt theretrom and the basis for ihe allegad exemption. Any violalion ot Section 7031.5 by any applicant for a pertnit subjects Ihe applicant to a civil penalry ot not more ihan tive hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, and ihe simcture is not intentletl or oNered tor sale (Sec. 7044, Business and Professions Code: The Coniractors 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 ihat such improvemenis are not intended o� oHered for sale. If, however, ihe building or improvement is sold within one year of completion, the owner-builde� will have the burden ot proving ihat he or she did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Protessions Cotle: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who coniracts for such project with a contractor(s) license pursuant to ihe Contractors License Laws.). ❑ I am exempt under sec. SignaWra: Owner ID venfied by tlriver's license. ❑ Yes ❑ No Business and Professions Code for this reason: Verification of Ownership by (type of document, i.e. - pmperty tax bill or deed): DIVISION OF INDUSTRIAL SAFE7Y PEHMIT CERTIFICA710N: Driver's License No. Date: Expires: ❑ I hereby certity ihat no excavation tive (5) or more teet in depth into which a person is required to descend, will be made in connadion with work au�honzed by Ihis permit, and that no building structure, scaHolding, talsework, or tlemolition or tlismantling thereoi, will be more than thirry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Administrative Cotle). ❑ As owner-builder, I will not employ anyone to do work which would require a permi� from Ihe Division of Industriel Sefety, as noted above, unless such person has e permit to do such work from ihe dlvision. Signature: Date: Division of Industrial Safety Permit Number: CER7IFlCATE OF COMPLIANCE AND AUh10R1711710N OF ENTHY: I cetlity under penalty of perjury that I have read this application and state ihat the information given is correct. I agree b comply with all siate laws and city ortlinances relating to building construc�ion, and authorize representatives of the City of Costa Mesa to enter upon Ihe above-described property for inspedion puryoses. 1 agree not to occupy or allow occupancy ot any building authorized by this permit until tinal inspection. 6g eture O epa pwne j „��e^ �� AnNOr Authorized Applicant Date COpE t. INSPECTIONTYPE 1676 Fixed System Final Fire Prevention 1266 200 201 202 203 Pool Spa Final Final Re-Roof Final Block/Retaining Well Final Factory Fire Place Finel Sign 204 Final Demolition . . D�TE INTRIRLS CODEt INSGECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Sita 250 . Final Building/Occupancy D�TE I�EL$ i �• � � � i�2si COSTA MESA BUILDING-SAFETY DEPARTMENT p, O. BOX 9f7 C06TA MEBA. CALIFORNIA For Appllcant fo Fill In Completely TYPE OR PRINT BUILDING � 3 l �� _ ADDRE88 COSTA MESA. CALIFORNIA IAD RFS� �� TNo.i'L �/ / O �� -��: :� �.� - � � �; k(�/� �� dUN 1 41962 r �-ji11; �� '= �1'_i��. CII7 n� �� )�,, ::i::SA APPLICATION FOR PERMIT BUILDING For Office Use Only �RHCHIPT NO. P69I�11_T fl�/ /ld�' HIVfD eY I DAg._NE�612VEPi D 199UED /f' S 1. �% �� 1 if ,!1E ? FIRE ZONE APPROVED COSTA MESA. ADDRES6 _ �v%�%Z-� ZONING ZON NO. OP I UeE OP NEW Si+9 m Rtli CIiY — I 'PlANB � 9UILOING w LIC.TNO. ^�� Q - // NO. -- tacw� ��C ,�a- ��7 T/C 3 � . OBSCRIPTION / � BIZE J/l ��7� //n� �3 I xOW oN oos.� OF LOT / A. P. NO. USE OF YARDS EVES � EX18TING BLDG APPROVEO ALLOWED 96TBACN UN6 PPOM /� �� ICENieH lIN[ 6T.1// CHNTER OP �ReHT �L' REAR VARD �G FRONT -/ � FT. IN. l7 / y SIDE VARP LEFT �,�� RIGHT / R.SIDE ! FT. IN. DESCRIPTION OF WORK �, SIDE '✓ FT. �I/ �N. NEW IIALTERATION I IIIIADDITION I REAR � ( FT. ` IN. ' ' REPAIR I IIMOVING � IIDEMOLISH I e�PROVED ),��_ AATF `�/%t�GL . u,•� �BZILDING � �Dfy�O ROOMS STORIES � EXTERIOR WALL IROOF GOVERING COVERING �if%��- USE OF BU�LDING AND WORK TO BE PERFORMED � �{gpggy ACKNOWLEDO�AT� READ TH�9 APPLIGTION AND BTATL THAT TH6 ABOVE Ie CORP6CT ANO AGReB TO COM- PLY WITN ALL CITY 0101NANCEB AND 8TAT8 I.�WB lI80YLAi1N0 BUILDINa GON9TIIURI . / %/ /J / f� // SIGNATIINH OF /7IiHl/L �1 �/�iUn � AGENT �`.,.2 /SS°.� �/S� a THH AMOUM BHOWN UNDEH V�LUA N 19 IOP TH[ PUPP08H OP EBTABLIBMINO A PHHMIT PHH ONLY. VALUATION �// ///I/ PERM17 FEE $ � $ /� / �� pLAN CHECK $ � / � TOTAL FEE S �/