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Home My WebLink About919 CEDAR PL - Building Permits(774) 754-5273 • Fax (714) 754-4856 • www.ci.wsta-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 919 CEDAR PL Suite: Vicinity: Parcel Number: 42252304 Applicant: MANANGAN, ERNIE Address: 3865 OWENS RIVER LN ONTARIp, CA Owner: ZEMTSEV, NIKOLAI Address 3854 VALLEYBRINK RD LOS ANGELES, CA Contraclor: Address: Zip: Arch : Address: Phone: Zoning: Phone: 909-947-6448 ' Zip: 91761 Phone: Zip: 90039 Phone: License: Eng: Address: Status: ISSUED Applied: 12/20/2001 Issued: 03/19/2002 ISSUED BY: Phone: Zip: license: License: SCOPE OF pERMIT ADD 139 SQ. Ff. IIVING ROOM AREA W/FIREPIACE AND SKYLIGHT, EXTEND AND CONVERT EXISTING BEDROOM TO MASTER BEDROOM BY CONVERTING AN EXISTING 218 SQ. FT. ONE CAR GARAGE. ADD A BATHROOM AND SKYLIGHT IN MASTER BEDROOM AREA. ADD 436 SQ. FT. ATTACHED GARAGE. 2,174 SQ.FT. -- OR 30%-- COVERAGE PROPOSED; LEAVING 5,026 SQ.FT. OR 70% OPEN SPACE Plan Check: Permit SMIP Res: SMIP Com: Other: Inspection: Total: $320.29 $492.75 $3.43 $0.00 $0.00 $O.OD $816.47 SETBACKS MAINSTRUCTURE Front 23-0 ACCESSORY Front 0-0 PARKING Existin ; 2 NOTES: Rear 0- 0 Rear 0- 0 Reauired: 4 FEESUMMARY Calc Valuation: Ssa,zea.5o Claim Valuation: 50.00 PLANNING & ZONING Left 0- 0 Right Lett 0- 0 Right Pr000sed: 4 so 0- 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-g2) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a penod 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 requ(red inepectlona end flnel approval must be obtained. Failure fo obtain inspections and final approval will result in the expiration of this permit. � FOR INSPECTIONS CALL: (714) 75q-5628 � �V� WORK�RS' COMPENSATION DECLAqATION: - I �ereby effirm under penalry oi perjury one of the following declarations: ❑ I heve end will meintain a ceniticate of consent to self-Insure tor workers' compansation, es provided tor by section 3700 of the Labor Code, For the peAormence of tha �°'�rk for whic� this pertnit is issuetl. Q� have anC wiil maintain workers' compensatlon Insurance, as requiretl �y section 3700 ot the Labor Cotle, tor Ihe peAortnance ol t�e work for which Ihis permlt Is Issuetl. ntir worke��°°� n-s7a��i� Insu� e'c1ar��a1r�a�}tl polity number are: y /�(�f �j/�� Cerrier: \ 1 li\ 1!�. ' IW NY/ Policy Number. I 2'--f v I`�I. �� (This section n n 1 p/efed i he permit is valued ef one hondred dollars (5f 00J oNess.) -�� ❑ I certiy that in the pedorm��ot ih work tor w�ic is Oermy is issued, I shall not employ any person in eny manner so es to become su6ject to ihe workers' compensation laws of C i(fomia, a agree Ihal i shoultl % � e� to 1he workers' compensation provisions of Section 700 of Ih Labor Code, I shell lonhwit� ywi pro sions. _� �L A neture: Dat�_ WARNINO: FAILURE TO SEC WORKERS' COMPENS!�71G CAVERAGE IS UNLAWFUL ANO SHALL SU6)ECT Ml EMPLOYER TO CRIMINAL PEN LT ES ND IVIL FINES UP TOONE HUNDFED T/qUSANDDOLIARE($100,000),INADDITIONTOTIIE'FAuTOFC/JMPENSATION,DAMAGESASPROVIDEDf-0RINSECTION3/O60FTHELABOR 6DE,INTEREST,ANDATTORNEV'SFEES. Lic. a Cantrectors DECLARATION: with Seclion 7000) oi )t �he B Class a CONSTRUCTION LENDING AGENCVt_� / ❑ I hareby aftirm Ihat there is a construction lentling agency for the pertormance oi lhe work for which Ihis permit is issued. (Sec. 3097, Civil Code). Lentlefs Name: Lendefs Adtlress: Signature: Date: my licensa is in full I hereby attirm iheCuntler penelry,ot:perjury ihat I em EXEMPT FROM TME CONTRACTORS UCENSE LAW tor the following reason (SecJ031.5, Buslness antl Pmfessions Cotle: Any ciry or counry whicti,requires e parmi[to construct, alter, improve, demolish, or repair any strucNre, pdor to its issuance, also requires the applicant tor such pertnil m lile e signeA�.statement that he or�she'�! liceresed pureuant to the pmvisions ot the Comrecrore License Law (Chepter 9(wmmencing with Section 7000) of Dlvlsion 3 ot the Business entl Professions Code) or Ihet he(oushe is ezempt thereimm end the basis for the allegetl exemption. Any violetion of Section 7031.5 by eny epplicent for a pertnit subjects Ihe applicant to e civil penalry.of not more ihan fiva hundred dollars ($500).): a"r � ❑ I, as owner ot Ihe property, or my employees with wages as their sWe compensation, WILL DO THE WORK, antl ihe sWcture is not intended or oHered for sale (Sec. 7044, Business and Professions Code: The Contractors Licensa Lew does noi apply to an owner of property who Guilds or improves thereon, and who does such work himself or herself or ihrough his or �er own employees, pmvided thet such improvemems ere nat intended or offered for sale. If, however, ihe building or improvement is sold within one year of completioq Ihe owner-builder will have the Durden of proving that he or she tlid not build or improve tor purpose of sale.). ❑ I, as owner oF the properry, am ESCWSIVELV CONTRACTING WI7M LICENSED CONTRACTORS to consirua Ihe project (Sec. 7044, Business antl Professions Catle: The contractors License Law tloes not apply to en owner ot proparty who builds or improves thereon, and who contracts far such project wlih e contrectar(5) licensa pursuant to ihe Coniractors License Lews.). ❑ I am exempt untler sec. 8usiness end Pmfessions Cotla tor this reason: SignaWre: Da�e: Owner ID veritietl by driver's license. ❑ Ves ❑ No Driver's License No. Expires: Venfication of Ownership by (type of daument, i.e. - properry tax 6ill or tleed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby certify Ihat no exwvation fiva (5) or more feet in tlep�h into which a person is required to descend, will be made in conneciion with work authonzed by Ihis pertnit, end that no builtling slrucWre, scaXolding, talsework, or tlemolition or tlismantling thereoi, will 6e more than thirry-six (36) teet hiqh. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle B, Califomia Atlminisiralive Code). ❑ As owner-builder, I will not employ enyone to do wark which would require e permit tram the Division ot Indusirial Sefety, es notetl above, unless such person hes a pertnit to do such work from �he division. Signeture: Date: Division of Indusirial Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I certiry under penalry ol perjury that 1 �ave reaG this epplication and state that the information given is correct I egree to compty with ell s;ate lews end ciry ordinances relating to builtling construction, and authorize representetives of tne Ciry of Costa Mesa to enter upon the ebove-descnbed pro�erty for inspection purposes, I egree not to occupy or allow occupancy ol eny building authonzed by this permi� until final inspection. PA7E 1616 Fixetl System Final Fire Prevention 1266 Paol Spa Finel 200 Finel Re-Roof 201 Final Block/Retaining Well 202 203 Final Factory Fire Place Finel Sign 204 Finel Demolition 1NIID969 O COOEI INSPECTIONTYPE ' 206 Final Mechenical 200 Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy Date PA7E It�L$ (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: 919 CEDAR PL 42252304 MANANGAN,ERNESTO 3865 OWENS RIVER W , ONTARIO, CA ZEMTSEV, NIKOLAI TR Address 2315 MAURICE AVE LA CRESCENTA, CA Contractor: ALJOHN BUILDERS Address: 3865 OWENS RIVER LN ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1hp Motors to 70hp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole ONTARIO, CA ELECTRICAL PERMIT Phone: 323-663-9705 Zip: 91761 Phone: Zip: 91214-1536 Phone: Zip: 91761 License: 616383 ► Status: ISSUED Applied: 03/19/2002 Issued: 03/19/2002 ISSUED BY: ��- SCOPE OF PERMIT REF 801-01980. 6 LIGHTS, 6 OUTLETS , 6 SWITCHES AND UPGRADE METER TO 100AMP. $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $6.60 $8.80 $6.60 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $D.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 6 8 6 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lightin9 Busway /100 ft Standing Seclion 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 Misa Conductor Circus ( gen or ride) Circus (mech ride or lights) Chnstmas Tree Stand Fireworks Stand Other ElecMcal Fee Investigation Fee Plan Check Fee Reinspection Fee Quantity $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 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 $76.00 COMMENTS / SPECIAL CONDITIONS V� NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and related regulations. (Ord. No. 92-28, §'1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 180 days. INSPECTIONS: In order for the work authorized undet this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis pertnit. FOR INSPECTIONS CALL: (714) 754-5826 ewo-aa �vw� WORKERS' COMPENSATION DECLARATION: . I hereby aHirm under penalry of perjury one of the following tleclarations: . . ❑ I have antl will maintain a certificate of consent to seli-Insure for workers' compensation, as providetl for by section 3700 ot the Lebor Code, for Ihe pertormance of the work tor which this permit is issuatl. �I have antl wi intain workers' compensation insurance, as required by section 3700 of ihe Labor Cotle, for ihe performance of Ihe wod w which this pertnit is i ued. M workers' 1�I urance c r antl o1li� number are: � �! � Carner:Y ��C� � N Y/ Policy Number: � (This section neetl no be complefed i! the if is valued et one hundred dallers ($ f 00) or /essJ ❑ I certify iha� in Ihe compensatlon lew � � ant Sign . _ AR G: FAILURE TO SE THOUSANDDOLLARE(� LICENSED CON�T� I hereby tlrat I am torce an , ic. # Co ctofs Signature CONSTRUC710N LENI ❑ I hereby aHirm ltfa Lentler's Name: Signature: 1 the wotic for which end ap(pe that if I s IN ADDITION is issued, I shall not employ eny person in any manner so as to becoma subject to lhe workers' �n sublect to Ihe workers' compensation provislons of Sec'on 3700 the Labor Gode, I shall fotlhwith 7 I� � �✓ AW FUL AND SHALL SU�ECT AN EMPCBYFAip CFIMINAL pENALTIES �AND CIVIL FlNES UP TO ONE HUNDRED DAMAGES AS PROVIDED FOR IN SECTIQY 3106 OF THE 1A60R CODE, INTEREST, AND ATTORNEY'S FEES. Section 7000) of Division 3 of the�usiness antl Professions Cotle, and my license is in tull is a const �ctio ding agency for Ihe pedormance of the work for which Ihis permit is issued. (Sec. 3097, Civil Code). Lentler's Address: Date: OWNER•BUILDER DECIARATIONS: I hereby aflirm thel under penalry ot perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or couny which requires a permit to consimct, alter, improve, demolish, or repair any simcture, prior to its issuance, also requires the applicant tor such permit b file a signetl statement that he or sha is licensed pursuant to ihe provisions of the Coniractors License Ww (Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Code) or ihet he or she is exempt therefrom and the basis tor the allegetl enemption. Any violation of Section 7031.5 Dy any applicant tor a permit subjects Ihe appliwnt to a civil penalty of not more than tive hundred dollars ($500).): ❑ I, as owner oi the pmperry, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and ihe structure is not intended or oHered for sale (Sec. 7044, Business and Protessions Code: The Contractors License Law does not apply to an owner ot property who builds or improves ihereon, and who tloes such work himself or hersetl or t�rough his or her own empioyees, provided that such improvemenis ere not intended or oHered for sale. If, however, the building or improvement is sold wi`hin'ooe�year,oi.comple�ion, the owner-builder will have the burden of proving that he or she did not builtl or improve for purpose of saie.). ❑ I, as owneqof the property; am,E%CWSIVELY CONTRACTING WITH LICENSED WNTRACT08S to construct Ihe pwiect (Sec. 7046, Business antl Professions Code: The conirectors Licensa Caw does not apply to an awnar of propetly who huilds or Improves thereon, end who contracts tor such project with a contractoQs) ' license pursuant to the Goniractors.Cicense Laws.). ❑ I am ezempt under sec. ��S Business antl Professions Cotle for ihis reason: Signature: �y � T � Date: Ownar ID verified by drivers license. ❑ Yes ❑ No Driver's License No. E:pires: Verification oi Ownership by (type of document, i.e. - pmpeny tax 6ill or deed): DIVISION OF INDUSTRIAL SAFETY oERM1T CERTIFICATION: ❑ I hereby certify that no exwve�ion five (5) or more feet in depih into which e person is required to descend, will be made in connecilon with work authonzetl by this permit, and tha� no builtlinq sWcture, scattolding, falsework, or demolition or dismantling ihereot, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Ar12, Sec. 341, Title 8, California Atlministrative Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require e permit from the Division of Industriel Safery, as notetl above, unless such person hes a permit to do such work fram the division. SignaWre: Date: Division of Indusirial Satety Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF EN7RY: I cenity under penalty ot perjury ihat I have read ihis application and state that ihe infortnation given is corred. I agree to comply with all state laws and city ordinances relating to buiiding consiruction, and authorize representatives of the Clty of Costa Mesa to enter upon the above-descnbed property for jepHcfiqn puryoses. I a�ree not to occupy or allow occupancy of eny building au�honzed by ihis permi� until final inspection. COUE E INSPECTIqNTYPE 1616 �Fi�ce System Final Fire P� 1266 Pool Spe Final 200 Finel Re-Roof 201 Final Blak/Retaining Wail 202 Final Factory Fire Place 203 Final Sign 204 Final �emolition j�if, INTRIALS CO�E♦ INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 22o Final Planning Approval 222 Final Site 250 FinalBuiltling/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 919 CEDAR PL Suite No Vicinity: Parcel Nunmber: 42252304 Applicant: MANANGAN,ERNESTO Address: 3865 OWENS RIVER lN ONTARIO,CA Owner: ZEMTSEV, NIKOLAI TR Address 2315 MAURICE AVE LA CRESCENTA, CA Contractor: ALJOHN BUILDERS Address: 3865 OWENS RIVER LN� Arch / Eng : Address: ONTARIO, CA PLUMBING PERMIT Phone: 323-663-9705 Zip: 91761 Phone: Zip: 91214-1536 Phone: Zip: 91761 License: 616383 i Phone: Zip: License: SCOPE OF PERMIT 1 BATHTUB, 7 WASHER, 1 WASHBASIN AND 1 WATER CLOSET. ISSUE FEE BackFlow irrigalion BackFlow Preventer Bathtub Clarifer System Connect Qce,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 $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 $0.00 $0.00 $0.00 $0.00 aTY • FEE SUMMARY AMT Laundry Tub / Washer $9.80 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 R) $0.00 Receptors $0.00 Septic Tank $0.00 SewerCapforDemo $0.00 Sewer Connect $0.00 Sewer Pnvate Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kilchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Status: ISSUED Applied: 03/19/2002 Issued: 03/19/2002 ISSUED BY: � SumpPump Swimming Pool Trap Primer " Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Venl System Water Closet (Toilet) Water Heater / vent Water Piping Qnst or Rep.) Water Re-pipe Water Service Water Sokener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $9.80 $0.00 $0.00 $9.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: 562.70 QTY 0 0 0 0 0 0 t 0 0 1 0 0 0 0 0 7 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements undar Califomia 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 tor 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 Inspectlons and 11na1 approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 iZE!:�1r:7(+'i�ll WORKERS'COMPENSAnON UECLARAnON: ., � I heraby aflirm under penalty of perjury one of ihe tollowing declaretions: ❑� I have and will maintain a cetlificate of consent to self-Insure tor workers' compensation, as provided for hy section 3700 of ihe Labor Code, tor the pedormance of ihe work for which this permit is issued. b I have and will mainWin workers' compensation insurance, as required by section 3700 of ihe Labor Code, tor tha pertortnance of the work for which this permit Is issued. � My workers' ensatlon Insuran g,ra[`i911alntl ppliry number are: �� /" �-�-4 � Carner: ' r �'n !/J PolicyNumber. � 1 � (This secfion need� b d nplefed il the permit is valuetl at one hundred dollars ($100) or less.) ❑ I certify that in the performance he wo k for com ion laws of Calitomi , and a ee th provisions. plice na re: � RNING: FAILUPE TO SECIIRE W ERS' COMPENSAT THOUS� /fSt00,00p�ttJADDITIONTryFHECQB '_ / L/ LICENSED CONTRACTORS DE�ATION: I hereby afl"�aN�m licenpeead under%provisions of which this rmit i issued, I shall not employ any person in any manner so as to et ii I sh tl bec e�su6jeci to Ihe workers' compansation provisions of Section : 71G7FUL AND SHALL SUBJECT AN EMPIOT�RiO CRIMINAL PE DAMAGES AS PROVIDED FOR IN SECTIqJ 37060F THE LABOF with Section 7000) of Division 3 �me subjectto the workers' oi ih Labor Code, I shall forthwith '1 � h �7/ i AND CIVIL FINES UP TOONE HUNDRED IN�EREST,ANDATTORNE`fSFEES. Code, and my license is in full forc d eflect. Lic. q Class k � Co ignaWre: �� < �— L'�IiSTF�CTION LENDING AGF�tiC�:/ ❑ I he by.attirt�n �ha� �here is a wnsiruction lending agency tor ihe peAormance ot the work for which this permit is issued. (Sec. 3097, Civil Code). Lendefs Name: Lentlers Address: Signature: _ OWNER-BUILDER OECLARATIONS: Date: I hereby ettirm that under penal�y of perjury Ihat I am EXEMP7 FROM 7HE CONTRACTOFiS LICENSE LAW for ihe following reason (Sec. 7031.5, 8usiness antl Professions Code: Any ciry or county which repuires a permit to construct, alter, improve, demolish, or repair any siructure, prior to its issuance, elso requires ihe applicant for such permit to tile a signed statement Ihet he or she is licensed pursuent to the provisions of ihe Coniractors License Lew (Chapter 9(commencing with Section 7000) oi Division 3 ot iha Business end Professions Code) or ihat he or she is exempt therafrom and Ihe besis for ihe allegad exemption. Any violation of Section 7031.5 by any applicant tor e pertnit subjecis ihe epPliwnt to a civil penalty of not mora than five hundred dollers ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the strucWre is not imentletl or oNered tor sale (Sec. 7044, Business and Professions Code: Tha Coniractors License Law does not apply to an owner of property who builds or improves ihereon, and who tloes such work himself or herself or ihrough his or her own employees, provided ihat such improvements are not intended or oNered for sale. If, however, the building or improvement is sold within one year of completion, the ownervbuiltler will have the burden of proving ihat he or she ditl not build or improve tor purpose of sale.). h^S ❑ I, as owner of ihe propartyyam EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTOflS to conslmct the project (Sec. 7044, Business entl Professions Code: The contractore Llcense Cew does not epply to an owner ot propeny who builtls or improves ihereon, antl who coniracts for such project with a contracror(s) license pursuant b �he Coniractors Cicensa Lews.). ❑ I em exempt under sec. �'-r � pOc... Business antl Professions Code for ihis reason: Signature: `' � r i! Date: Owner ID verified by drivefs license. ❑ Yes ❑ No Driver's Licensa No. Expires: Venfication of Ownerehi � �� r � p y(type of daument, I:e. - propeny tax bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMI7 CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more faet in depih into which a person is required to descend, will be made in connection with work euthonzetl by this permit, and that no building siructure, scaHoltling, talsework, or demolition or tlismantling ihereof, witl be more ihan thirty-six (36) feet high. (Chap. 32, Gry 2, Ar12, Sec. 341, Title e, Califomia Atlminisirative Cotle). ❑ As owner-builder, I will not employ anyone to do work which woultl require a permit irom the Division ot Intlustnal Safery, as noted ebove, unless such person has a permit to do such work from ihe division. Signature: Date: Division of Industrial Safety Permit Number. CERTIFlCATE OF COMPLJANCE AND AU7HORVA710N OF EMAV: I certify under penalty ot perjury that I have read this apDlication and state ihat ihe information given is correcL I agree to comply with all stata laws end city ordinances relating to building construction, and authonze representatives ol the Ciry of Costa Mesa to enter upon the above-described property for'�i ep2Ction poryoses. I egra� ocapy or allow occupancy ot any building authorized by ihis permif untif tinal inspection. cooe �. System Final 1266 Pool Spe Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Factory Fira Place 203 Final Sign 204 Final Demolition . I7AIE 1t�19LS CO�E� INSPECTIONTYPE 206 Final Mechanical 200 Finel Plumbing 210 Pinal Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Finel Site 250 Final euildinyOccupancy Z� I4H�ILmr1b7 � Z-?�h�7 "l � ORANGE COUNTY BUILDIMG DEPARTMENT APPLICATION FOR PERMIT � 636 North Broadway � p � � � � � � � ' SANTA ANA, CALIFORNIA - • � • . . 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