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Home My WebLink About1065 CATAMARAN CT - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.cg uECTRICAL PERMIT 77 FAIH UHIVt, UUS I A MhbA, UA 92b2b Job Address: 1065 CATAMARAN CT Suite No Vicinity: REAR YARD Parcel Nunmber: 42451126 Applicant: SCHNIERER, STEVEN Address: Owner: DJADALI FAMILY TR Address 1065 CATAMARAN CT COSTA MESA, CA Contractor: Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Receipt Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1hp Motors to 10hp Motors to 50hp Motors to 1 00h Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole ADD AIR INC 957 N ELM ST ORANGE, CA Phone: 714-719-1689 Zip Phone: Zip: 92627-4584 Phone: 714-997-2969 Zip: 92867 License: 747643 Status: ISSUED Applied: 10/13/2006 Issued: 10/13/2006 ISSUED BY: 'elL SCOPE OF PERMIT INSTALL A NEW A/C UNIT IN AN EXISTING SFD. CONDENSER AT REAR OF PROPERTY. 1 A/C RES PKG NO OTHER WORK AUTHORIZED WITH THIS PERMIT. FEE SUMMARY Quantity $23.50 $0.00 $54.50 $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 -' $0.00 0 $0.00 0 $0.00 - 0 $0.00 -0 $0.00 _ 0 Temp Dist System / Lighting Busway /100 It Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw .:................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misc. Conduit - Misc. Conductor Circus ( gen or ride) Circus (meth ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection 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 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $78.00 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, 12-21-92) 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 244646 (6/00) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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. !have and will maintain workers' compensation insurance, as requiretl by section 3700 of the Labor Coda, for the performance of the work for which this permit is Issued. My workers' compensa n Insurance career antl policy number ere: Carder Policy.Number: I7L4106%-2)C*(o (rib section need not be completed if the permit is valued at one hundred dollars ($100) or less.) L_- ` ❑ 1 certify that in the performance of the 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 laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with thesesions. _ Applicant Signature: �C��—�� rDate: /O'13IOie WARNING FAILURE T SECUREQ WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, 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 rovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect. U -#- 7 3 I Class # C_ 7.0 Contractors Signature: s Date: /e)) 13 1rL.. CONSTRUCTION LENDING AGENCY: ❑ 1 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). Lenders Name: Lenders 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. It, 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - properly 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, 1 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? ❑ Yes ❑ 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? ❑Ves ❑ No (Section 25533 of the California 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 Depanment 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? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a,pplication a 9rmit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ as LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ............................................................................................................................................................................................................................................................................................................................................................................................ 6 WIII any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ 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 Oualiry Management District or other air pollution control district or, egency 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 ............................................................................................................................................................................................................................................................................................................................................................................................ 8 (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certily 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. al Owners)Date 101 13 )0(e Ir And/Or Authonzed Applicant /Date. }, CODE 0. INSPECTIONTYPE g6IE INITTALS CODE# INSPECTION TYPE 2AH jam$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical�(- i 201 Final Block/Retaining Well 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 (714) 754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR UHIVL, UUb I A MtbA, UA 92040 Job Address: 1065 CATAMARAN CT Suite No Vicinity: CONDENSER AT REAR SFD Parcel Number: 42451126 - Applicant: SCHNIERER, STEVEN Address: Owner: DJADALI FAMILYTR Address: 1065 CATAMARAN CT COSTA MESA, CA Contractor: ADD AIR INC Address: 957 N ELM ST ORANGE, CA MECHANICAL PERMIT ISSUED BY: Phone: 714-719-1689 Zip: Status: ISSUED Applied: 10/132006 Issued: 10/13/2006 Phone: 1p Zip: 92627-4584 Phone: 714-997-2969 R Zip: 92867 License: 747643 SCOPE OF PERMIT INSTALL A NEW A/C UNIT IN AN EXISTING SFD. CONDENSER AT REAR OF PROPERTY. 1 INST FAU < 100K BTU, 1 COMPRESSOR 3-15 HP1500K BTU NO OTHER WORK AUTHORIZED WITH THIS PERMIT. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Repair / Alt Absorbtion Unit S0.00 0 Inst FAU <100 k BTU $14.80 1 Repair / Alt Refrigeration Unit $0.00 0 Inst FAU >100 k BTU $0.00 0 Ventilation System $0.00 0 Repair/ Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst / Rep. Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys <100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys >100 k BTU $0.00 0 Compressors / Absorption Systems Gas Piping $0.00 0 Up to 3 hp / 100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500k BTU $27.15 1 Hood w/Meth Exhaust $0.00 0 - 15 To 30 hp / 1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp / 1,750 k BTU $0.00 0 Vent Fan / Single Duct $0.00 0 Over 50 hp / Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers < 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers > 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $65.45 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or If work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2a6 -4e (6=) DECLARAn, 0146 WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. }pa 1 have and Will maintain workers' compensation insurance, as required by sectlon 3700 of the labor Code, for the performance of the work for which this permit is issued. My worke� ponsatlo V u� carrier and policy number are: 1Certier.- a G priNumber: 1-/410(0% aObCo (This section need not be completed N the permit Is valued at we hundred dollars ($ f00) or less.) ❑ 1 certify that in the performance of the 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 laws of California, and agree that It I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shelf forthwith comply With Nese r s. Applicant Signature: t, � Delo:' 1013, OCo WARNING: FAILURE TOES CURE WORI9RS' COMPENSATION COVERAGE IS UNLAWFUL AND SHAI I SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOUARE (St 00,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed unde�rprovislons of Chapter 9 (commencing With Section 7000) Of OMslon 3 of the Business and Professions Code, and my license is in full force and effect. 1.1c.4, 747/643 Class's,: C_2ZD Contractors Signature: (Date 7o�r9kte 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). Lenders Name: Lenders 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 ne 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 Cole) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant to a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1, 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 (Sac. 7044, Business and Professions Cade: 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 Ucense Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ 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: ❑ 1 hereby certify that no excavation live (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, Tltie B, 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 WIII the applicant or prose t or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes jfNo (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 Daes or will the applicant or present Or future building Occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time hes 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 appplicant 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 0l the California Health and Salary Code been fully complied with? ❑ Yes ❑�No 5 Does or will the applicant u present or future building occupant yrequireother for the work ontch Is the subject c this a plication aPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agent)? � Yes LJ 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 Io be constructed under this permit be within 1000 feet from the outer bountlanes of a school? [I Yes ❑ No (1f yes-, the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .............._._....................._.._................. _....._....__.________._................___._....................._.....................................____.___._._........................... 7 If a permit Iron the Soutn 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 B (Ii 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 cerect. 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. 1 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 slow Occupancy of any building authorized by this permit until final inspection. lure Of Legal Owner(s) Date /OI131� T ApNOr Authorized Applicant Data y CODE.. INSPECTION TYPE PARE RTITIA CODE INSPECTION TYPEgm MWIflo, 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 Block(Retaining Wag 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Bullding/Occupancy APPROVED CITY OF COSTA MESA PLANNING DIVISION SUBJECT TO BLDG. DEPT. REG. NOTE: ADDITIONS, DELETIONS, OR CORRECTIONS SHALL BE APPROOr ED BY THE PLANNING DIV. BY:DATE: 0 H Ouse. Pik I0(oS WsAcz, c---,-,CjfL qZ(oZ7 I PROJECT AOeRRE s -1065 CATAMARAN CT UNIT: 85 owNERSNp:KAUFMANN 6 BROAD FIRE SMIP/RES ADDRESS160 N. RIVERVIEW DR PERMIT SUITE 300 39.50 69.86 32.75 ANAHEIM, CA 92808 ARCNIENGINEER: MIKE WOODLEY RE0.1110.:CI_11pa ADDRESS: 180 N. RIVERVIEW DR 300 PERMMEE: ANAHEIM CA 92808 KAUFMANN F BROAD (714)921-0500 ADDRESS: 180 N. RIVERVIEW DR, 30.0 ANAHEIM CA 92808 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section CITY UC.: 8 STATE LIC.:3344� Cuss: B - Date: Signature' W_471XX K� WORKER - COMP NSATION DECLARATION: hereby affirm thhave a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3 , Lab. C). ' JCYNO.:4189-1090 EKP.DATE: 03/07/90 JIM PANY:T ANS. INS}-, L� Certified c y is here y furnished. 1(l Certifiedy is filed with a city Build 0 Divisi -. Date: Applicant EKEMpT10 ROM W KERS'COMPENSATION DECLARATION:' (Thisneed not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the 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 Laws of California.- Date: Signdture: x NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith 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 d the work for which this permit is issued (Section 3097, CIv. C).' • .j ti LENDER: r ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt tram the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prier to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed 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. 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 (5500). 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 (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. It, 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 for the purpose of sale). - I, as owner of the property, am exclusive )y contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor($) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. 8 P. C. for this reason: Date: _._ Owner Ido hereby certify that l am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 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 Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby candy that I have read this application and statf ordinances and st to laws relating to building construcgdn property for ins ctipn urposes. Date: / eel Signature: Driver's dense or Social Security ,: -Applicant; Pink -Revenue; Goldenrod -Assessor CITY OF COSTA MESA - BUILDING PERMIT PERMIT RO: G 044974 PLAN CHECK NO: N GOVT: N SUPP: N. CONSTRUCTION TYPE: V -N PERMIT TYPE: ELE NEC PLU STR PURPOSE: NEW JOB DESCRIPTION SFD SQ FT: 21537 CLAIM VALUE: 144063.00 CALC-VALUE: 144063.24 GROUP DCC: R-3 /M -1 - COMMENTS: PC4234-89A PD 129.51 Z O N I N G R E Q U I R E M E N T S S E T B A C K S MAIN BUILDING FRNT: 18 FT 6 IN REAR: 12,FT IN LEFT: 5 FT IN RGHT: 5 FT IN PARKING REQUIRED: 2 PARKING PROVI PLANNING NOTES> SINGLE FAMILY RESIDENC > PARKING SPACE•PER UNIT D E V E•:L 0 P, M• E_N T S..E;R V ZONING APPROVED BY ,, .BUILDING APPROVED BY, APPLICATION ISSUED Bx;• s. LEGALIZATION:N F E E' ACCESSO LEFT: FT I W. LDING FTA- IN 33/-FaFT IN i9 -ZONE: PDRMiO L C E S &:E Q U I R E M E N T•'S �Ll3C� DATE: DATE: C2-.-1 14`P") 9 - DATE: S Ufir M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 797.00 39.50 69.86 32.75 10.08 25% 50% 25% SMIP/NON-RES PLAN ISSUE FEE 3.00 15.60 15.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS-=--> 949.19 3.3.00 0.00 982.19 982.19 .00 REVENUE DIVISION TOTALS—> COLLECTED: 982.19 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 797.00 42.50 84.86 47.75 10.08 ############################################################################### I N D I V I D U A L 'F E E B R E A K 0 0 W N TYPE' QTY D E S C R I P T I O N-='. UNIT COST TOTAL COST SFR 1996 OWE -TYPE V -WOOD FRAME:: -GOOD 67.70 135,129.20 SFR 76 RES -BALCONY, EXTERIORiSTAIRWAY 13.54 1,029.04 SFR 465 RES -GARAGES TYPE V 17.00 79905.00 ELE 1996 NEW RES BLDG FOR I OR 2 UNITS/ SQ FT .03 69.86 NEC 1 INSTALL FORC/AIR FURN <-- 100 K BTU/H 9.00 9.00 MEC 1 REFRIGERATION SYSTEM <= IOn K BTU/H 9.00 9.00 NEC 5 GAS PIPING SYS 5+ OUTLETS PER OUTLET .75 3.75 NEC 1 FACTORY FIREPLACE 6.50 6.50 NEC 1 VENTILATION FAN CONN TO SINGLE DUCT 4.50 4.50 PLU 2 BATHTUB 2.00 4.00 PLU 1 DISHWASHER 2.00._.`; ..,)y 2.00 U. ' CONSTRUCTION AND PLANNING- _ & SPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole' - 52. Pool & Equipment Location ' 2.. Soil.Pipe-Undrgrnd: t t 53. Steel Reinforcement 3.,Erectrical Conduit Utility-Undrgrnd. ' - 54. Forms 4. Electrical Conduit Undrgrnd. , 55. Electrical Bonding ' • 5.'Steel•Reinf6rcemeht " 56. Rough Plumbing &Pressure Test t.t Electrical UFER,Grnd. u, (2 (� 57. TO COVER-GUNITE _APPROVAL u ' 7.:.Footings 1.. Cy..JsW %(4 58. Electrical Conduit-Undrgrnd. 1 8.. Foundation - Grj•1 9 4•Ll 59. Gas Pipe, 0 Undrgrnd., Test 9..Water Pipe-Undrgrnd. ji 3o'n LW 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural !Floor §ystem 61. APPROVAL TO DECK 11. Property Sevver Line & Hoylse Connection 62. Backwash & Receptor -Final 12. Sewer Cap " - 63. Heater & Vent -Final 13. Roof Drains, -. 64. Plumbing System - Final ' 14. Rough Plumbing 241SQ ( j0 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final • 16. Rough Electric -Wiring Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVEDFORPLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning Clow FIRE DEPT. REQUIREMENT Permit 20. -Rough FactoryFireplace Qpl r xI (APPROVALSPI 21.''Du&s, in_StructureC I '''° a, it - �.;• t - ` Underground Hydro r w, ; *, ,..70. J 22. Ducts, Ventilating.' j . "; r., ` I •:71. Product -Piping O Gas OOiI 23.•Gas,Pipe=Rough & Test I 72, Underground Flu`sh'Z v 'r L 24.' Roof Framing ,.r- - I - r,• : c 5. i '-x - .. - Undergrndj. Storage Tank �O Gas 0 Oil n - • 2 • -.• - .73: :.7 25. Roof Sheathing `• �•" �•''}. <� 6(,v W -Overhead Hydro: ; 26.' T-B@r Cgiling,IStrueturall & Monocoat... 75Dry Chemical t t: ,• 27t -Frame and Flashing:." 76. Dry Standpipe �;'r• I r28•Lathing`&Siding "� �Q I Lir*: 77=.FIXED S.YSTEM:FINAL„,.- v,`h t.y' C y-•-�f�^I,f. 29. Insulation r CJs/ (Q GI <Y<TT 78 -FIRE P�REV. FI AL c r r .: .. 30. Drywall Nailing 1 c r RP I �'' Y O r •l _ r..- n n _'P-tALTH DEPT;.I EQUIR�MENT ' 31. Plaster Brown Coat,• ` I ' "- (..� ' r 9. FINAL INSPECTION• �lr' ' ' - -' ` Electrical Power MeterFinall..:FOOD CERTIFItCATE ISSUED,.; ,',32.* ,n f r,r• r- �33.: Final Electric. r I I.: • I " t otes:. ' I .,.:..� ':' �• ••. r I .. 4 c• r X 34.'. Final Heatirib & Air.^Conditioning c-;. ' 17y0 35; Final Gas Pipe -Test;` Hood or Canopy 1 r" - • •' - I '' ;;t ;:. U : ,. _36. ,37.�Final Factory Fireplace; I • A134 6"'11. r , -• <: 11, `38. Final Plumbing t, 1 1 I LW, " i" '-1, r 1lI'"` i. < IQ C. r, _ 39. Water ServiceTFinal;` 40. Gas_Service-Final --rr f. <- ,. 1 I H; i. ,. • '_-�r 41. Solar Domestic -Final i ••G. 42. Backflow Preventers. '> �" I I li• •:. i • ' l.. Y nl t .k .. i, i. r. i,' 2 ti4. r i • 43. Backflow Irrigation,. - c •. C ;i,, it i' F .t V :b t+ V ; . t • : -. •'• 44. Landscape Irrigation System_'__ 45. Sound Attenuation •, o'- u 46., Handicap Regulations ' ` •'• ^ - °I 47.FIN'ALSTRUCTURE & BUILDING r 48.. FINAL PLANNING r ' *z /. 49 ;; PROJECT ABARESS: UNIT: r OWNEWS NAME: ADDRESS: ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: ADDRESS: LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full forte and effect. Cm LIC.: STATE LIC.: CUSS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' mpensation Insurance, ora certified copy thereof (Section 3900, Lab. Q. JCY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. i Date: Applicant: EXEMPTION FROM YORKERS' COMPENSATION DECLARATION: (Tia section need not be completed B the permit is for one hundred ($100) or less). I certity that in the performance of the work tar 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 California. Date: Signature: ' NOTICE: If, after malking this declaration, You should become subject to the Workers' Compensation provisions at the Labor Code, you must forthwith 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 which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant lot such permit to file a signed statement that he/she is licensed 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. 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 (5500). I, as owner of the property at my em loyees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/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 will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the propeM, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Cade: The Contraccors' Sate License Law does col apply to an owner of property who builds or improves thereon and who contracts lar such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof at their Wotkef's Compensation insurance Should be provided to me. ❑ I am exempt under Section: B. 3 P. C. for this reason: Date: Owner: I do hereby certity that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I of any future building occupant wiNwin not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Nr uality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that 1 have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state Laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. Date: Signature: Driver's License or Social Security 0: 164146 White—Building: Green—Code Entomemem: Canary—Applicant: Pink—Revenue: Goldenrod—Aeeeasor PERMIT NO: G 044974 PLAN CHECK NO: N PAGE: 2 TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU I LAUNDRY TUB OR WASHER 2.00 2.00 PLU I SHOWER 2.00 2.00 PLU I SINK, KITCHEN 2.00 2.00 PLU 4 MASH BASIN 2.00 8.00 PLU 3 WATER CLOSET (TOILET) 2.00 6.00 PLU I WATER HEATER AND/OR VENT 2.00 2.00 PLU I WATER SERVICE 2.00 2.00 PLU 5 GAS PIPING SYS 5+ OUTL-PER OUTLET .50 2.50. PLU I CONNECTION TO BUILDING SEWER, EA 5.00 5.00 PLU I GAS SERVICE 2.00 2.00 END OF FEES CONSTRUCTION AND PLANNIN` ' APPROVALS Permit # Date Inspector )L & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd.I t+MAI$4. C. >W 6(1 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 & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning L. r . FIRE DEPT. REQUIREMENT APPROVALS Permitif# - 20. RougFFaioryFireplace'.- 21. Ducts}in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24: Roof'Framing `' '"'` 73. Undergrnd. Storage Tank OGas OOil 25. Roof Sheathing 74. Overhead Hydro 26. T18aqCeiling (Stiu£turall'&Monocoat ;. .,L .v a:a .Moh 75. Dr Chemical y 27. Frame and Flashin- L., I. %. ``� 76. Dry Standpipe 28. Lathing &,Sidiig• „�.F 77. FIXED SYSTEM FINAL 29. Insulation. H F Z•. 78. FIRE PREY. FINAL 30. Drywall rJailing r'r�e HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat -• r 79. FINAL INSPECTION 32. ElectPicalPower Meter -Final 80. FOOD CERTIFICATE ISSUED 33. F.inal;Electric n r, Notes: 34. Final -,Heating & Air Conditioning_ 4 35. Final.'Gas Pipe -Test 36. Hoodror Canopy r 37. Final{Factory Fireplace . .v 38. FinaliPlumbing 39. Water. Service -Final r, 40. Gas Service -Final 41. Solar�Domestic-Final 42. Backf,Iow Preventer . 43. Backflow.lrrigajic'Ln' 44. Landscape Irrigation System - - 45. Souna Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern,Ca(4mia Gas Co 51. CERTIFICATE OF.00CUPANCY, No. iDate f IWA ENGINEERS i 17390 Brookhurst Street, Suite 100 Fountain Valley, Califomia 92708 (714)968-1221 0FAX (714)968-9286 May 18, 1990 J.N. 207-03 City of Costa Mesa Building Department 77 Fair Drive Costa Mesa, Ca. 92628 Attn: Mr. Victor Clift Subject: Fine Grade Certificate I hereby certify that the fine grading for lots 21, 59 through 61 and 78 through 87 of Tract 13224 were graded as shown on the approved precise grading plans for said project. eaLs ------ Lc;`65 Llewellyn D. Incledon RCE 17593 Oi;j7- FNAB