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Home My WebLink About223 FAIRWAY PL - Building PermitsJobAddress: 223 FAIRWAYPL � Status: ISSUED Suite No Applied: 03I082007 Vicinity: POOL AND SPA AT REAR SFD Issued: 03/08/2007 Parcel Nunmber: Appliwnt: Address: Owner. Address 43921210 MASKREY, BRIAN 223 FAIRWAY COSTA MESA, CA MASKREY, BRIAN 223 FAIRWAY � - COSTA MESA, CA . Contracror. O W N ER-BU I LDER Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool I Spa Lighting Fixis Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Molors to 1 hp Motors to tOhp Motors to 50hp Motors to 100hp Motors over t00hp � Communication drops Sub panel to 200a Pole Light Pkg Sign Circuit5 Temp Pwr Pole Intertned Pole Phone: 714-724-1133 Zip . 92627 _ Phone: Zip: 92627 Phone: Zip: License: 000000 ISSUED BY: SCOPE OF PERMIT CONSTRUCT 400SF IN-GROUND GUNITE POOVSPA AT THE REAR OF AN EXISTING SFD. , REF:607-00271 � � 1 SWIMMING/SPA 323.50 $0.00 50.00 50.00 50.00 549.50 50.00 $0.00 $0.00 50.00 50.00 $0.00 $0.00 50.00 50.00 50.00 50.00 $0:00 50.00 $0.00 $0.00 50.00 50.00 50.00 50.00 �uantiry FEE SUMMARY . Temp Dist System /�Ligh�ing � Busway/100ft Standing Seciion � Misc�Elecirical,Equipinent ' Trensformers�up l0 1 kva/kw ' ................up to 10 kva/kw .................up to 50 kva/kw ..........::.....up l0 100 kva/kw ..................over 100 kva/kw � .�Low Voltage Equipment Low Volt Wiring System / Ckt ' Misc. CoritluiL , Misc. Conduclor '= Circus ( gen or ride) �,� - Ciras (mech ride or lights) Chrisimas Tree Stand Fireworks Stand ' � ' Oiher Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantity $0.00 0 $0.00 0 so.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 50.00 0 50.00 . ' $0.00 50.00 50.00 � �TOTALCALCULATED FEES � 573.00 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by ihis permit shall compty wflh all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12•21-92) EXPIRATION: This permit shall eutomatically expire and become vold if work Is not commenced within 180 days, or If work is suspended or ebandoned for a period of 180 days. � INSPECTIONS: In ordei for the work authorized under this permit to be considered legal, such work must comply with ell applicable codes, and all requlred Inspectlone end final approvel must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 / 244&d8 (8�00) WORKERS' COMPENSATION DECLAiiA710N: I hereby aflirtn under penalry oi perjury one of Ihe Idlowing dedarations: ❑ I have end wlll meintain a cetlitipte of consent ta sell�lnsure tor workers' compensetian, es proNdetl for by section 3700 of the Labor Cotle, for Ihe peAortnance ol Ihe work for which this pertnit is issued. ❑ I have entl will meintain vrorkers' compensatbn insurarxe. as requiretl 6y sectlon 3700 of Na Lebor Cotle, for the peAortnance of ihe work for whkh this permit is issue0. My workers' compensation Insurance carner and policy number are: Carrier: permif /5 valued et one or less.) Policy Number. JI certity Ihat in Ihe perto ance of the work lar which this pertnit is issued, I shall not employ any parson in any manner so as to become suD�ect to Ihe workars' compensation lews f Iitomie, antl egree Ihat II I s�oultl bewma subject to the workers' compansation provisions of Section 3700 of ihe Lebor CoCe, I shall Iorihwilh comply wllh Ihese ions. �k�:�en—l'S^ipn`amro: �: ,3�� O WAP IN N0: FAILURE TO S CURE WORKERS' �APENSATION CpVERAGE IS UNLFWFUL AND SNALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTES AND GNIL FlNES UP TOONE HUNORED TVIOUSAND DOLLAHE (5100,0OO�.IN ADDITION TO TME COST OF COMPENSATION, DAMNGES AS PROVIDED FOR IN SECTIIXJ 3]O60F TME UBOR ODDE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirtn thal I am licensetl untler proNsions ot Chepter 9(commencing with Sectlan 7000) oi Divisian 3 af the Business and Prolessions Code, antl my license Is in full torce nnA eflecL LJc. a Class q CoNrnctofs SigneWre: Date: CONSTRUCTION LENDING AGENCY: ❑ I horeby aMirtn that there is e consVuctlon lending egency for �he peAormence ot t�e work for which Ihis permit is issuetl. (Sec. 3097, Civil Code). Lendels Namo: Lendors Address: Signeture: Dete: OWNER-BUILDER DECLARATIONS: I hereby aHirtn Ihet untler penalry ol per�ury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Busine5s and Professions Cotle: Any dry or counry which requires a pertnit to consWcL elter, impmve, demolish, or repair any sWcture, prior to its luuance, elso requlres the applicant for such pertnil to tile a signed stetement that ha or s�e is Iicensed pursuant to the provisions ot Ihe Cantrectors License Lew (Chapter 9(commendng with Seclion 7000) of DNision 3 ot ihe eusiness end Prolessions Cotle) or ihat �e or she I5 exempl theretrom and Ihe basis tor the alleged eaemption. Any violatlon ot Secllon 7037.5 by any applicant for e permit sublects the epPlicant to a civii penaly oi not more �hen iNe hundred tlollars ($500).j: �,q}' I, es owner ot the proper�y, o� my employaes vrith wages es their sole compensatlon, WILL DO THE WORK, entl the strucWre b not InterWed or oHeretl tor sale (Sec. J 70a4, Business entl Professions Cotle: The Contractors Licanse Law Ooes not apply lo en owner of proDerry who builds or improves ihereon, end who does such work himself or herselt or thmugh his or her own employees, providetl that such improvemems ere not intended or ottered far sele. It, however, ihe building or improvement is sold within one year at completion, the owner-builder will have the �urtlen of proNng that he or she did not build or improve for purpose oi saleJ. ' ❑ I, es ownar of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTAACTORS to consiruct the project (Sec. 7044, Business and Professions Cotle: The comraciors License Law tloes not apply to an owner of propeny w�o bullds or Impmves Ihereon, end who comracts tor such prolect wlih a comractor(s) licensa pursue to the Contrectors License lewsJ. ❑ I am eaemp Br 58t. BuSiness end Prol855ions Code for thi5 r085on: �� ''� ��. —��07 0 OwtlBr1D vedlied Dy ddvefs license. ❑ Ves ❑ No Dr�vef5 cense o. E:pl�es; . Verilicelion of Ownership by (rype at documen�, i.e. - properry tex bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certity ihat no excevetion tiva (5) or more leet in Oepth Into which e persan Is required to tlescend, will be matle In connection with work authorizetl by this permil, entl ihat no builtling structura, scaHolding, lalsework, or demoli�ion or tlismantling iheraof, will be mora than �hirry-six (38) teet high. (Chap. 3.2, Grp 2, Ar12, Sec. 341, Tilla 8, Celitomia Atlminisire�ive Catlej. ❑ As owner-bulltler, I will not employ enyane to do work w�ich would requlre e permit trom the Division of Industrial Setery, es notetl ebove, unless such person �as e permit to do such work from the tlivision. SignaWro: Date: Divislon oi Intlustrial Sefery Permit Number: CERTFICATE OF COMPLIANCE AND AUTHORIZA710N Of EMRV: I ceNty under penalty of perjury that I have read this epplication end state that the inlortnation given Is cortect. I egree to com ith atl siate laws enC dry ortlinances relatlng to builtling constructlon, and authonze representetives of Ihe Ciry ol Costa Mesa m enier upon NB ebove-described pro r inspeciwn purposes. I agree nat to accupy or allow accupency of any building authorized by ihis pe it until finel inspecUon. � �-e7 SignaWreO(_pdL ner(s) ,�� i AnNOr Authodzotl AppliceN Date COOE 1. INSPECTIONTYPE 1616 Fized System Finel Flre Prevention 1266 Pool Spe Final 200 Final Re-Roof 201 FIneI8locWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Flnel Demolilion PAIE It�ldl§ 40DE� INSPECTIONTYPE 206 Finel Mechanical 20B Finel Plumbing 210 Finel Elecincel 212 Finel Fire Prevention 220 Finel Planning Approval 222 Finel Site 250 Finel BuildinglOccupancy Qdg V�LS IZSEs7 ,,sb— (714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Jobnddress: 223 FAIRWAY PL Suite No Vicinity: POOL AND SPA AT REAR SFD Parcel Number: 43921270 Applicant: MASKREY, BRIAN Address: 223 FAIRWAY . � Owner: Address: �-_: COSTA MESA, CA' � � MASKREY, BRIAN 223 FAIRVJAY � COSTA MESA, CA Contractor. O W N E R-B U I L D E R Address: . - � Phone: ` � Zip: . � . License: 000000 SCOPE OF PERMIT CONSTRUCT 400SF IN-GROUND GUNITE POOUSPA AT THE REAR OF AN EXISTING SFD. REF:807-00271 ' - � ' MECHANICAL PERMIT Phone: 714-724-1133 Zip: 92627 Phone: Zip: 92627 Stalus: ISSUED Applied: 03/08/2007 Issued: 03/08l2007 ISSUED BV: 1 INSTA FAU < 100K BTU FOR POOUSPA ISSUE FEE Inst FAU <100 k BTU Insl FAU >100 k BTU RepairlAlt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <700 k BTU Refrig Sys >700 k BTU Gas Piping Fadory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan I Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers � 10000cfm � AirHandlers> t0000cfm Floor Fumace � � Floor or Suspend Heater �, ' Quantiry $23.50 $0.00 0 51820 1 $0.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 30.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 50.00 � 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 �-. 50.00 .� 0. � FEE SUMMARY � Repair/AltAbsobtionUnit , Repair/AltRefrigerationUnit , Yenlillalion Syslem - -� � _ , ,� EvaporativeCooler - Commercial Incinerator Domestic Incinerator � Comoressors I Absorotion Svstems Upto3hp/t00kBTU 3 To 15 hp / 500 k BTU 15 To 30 hp / 1,000 k BTU -. �• �,30 To 50 hp / 1,750 k BTU � Over 50 hp / Over 1,750 BTU � � Boilers� � . - - " Up to 3 hp , '_ � - , � � 3To15hp ' � ' ' � -. - . ,15 to 30 hp , . - ' , � , 30 to 50 hp . - Over 50 hp � - , � . . Other Mechanical Fee � ' - - '�_ Investigation Fee �� " � , . � Plan Check Fee . � � . , Reinspection Fee - Quantity $0.00 0 so.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 30.00 0 $0.00 0 50.00 0 30.00 0 50.00 . 0 $0.00 0 50.00 0 $0.00 0 i. i� $0.00 $0.00 $0.00 � - ' TOTAL CALCULATED FEES E41.70 COMMENTS / SPECIAL CONDITIONS NO710E: The work authorized by ihis permit shall comply with all applirable handicap access requiremenis under California statutes and related regulalions. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspendad or abandoned for a period of 180 days. INSPECTIONS: In order for the work euthorized under this permit to be considered legal, such work must comply with all epplicable codes, and all requlred Inepeetions and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiratlon of this permit. FOR INSPECTIONS CALL: (714) 7545626 � 244646(W00) WORKERS' COMPENSATION DECLARA710N: � _ I hereby aHirm under penelry of perjury one of ihe following daclara�ions: ❑ I have antl will maintain a cenificate of conseN to setl-Insure for workers' compensation, es provided for by section 3700 of the Lebor Code, for ihe peAormence of Ihe wark for whlch this permit is issuetl. ❑ I have antl will meinrein workers' compensation Insurance, as requlred by section 3700 of tha Labor Code, for the pedormance of the work for which this permit is issued. My workers' compensation Insurance carrier en0 policy number are: Cerner: need nof one or less.) Policy Number: LY�I certily �hat in ihe peAortnance of the work tor which this permit is issued, I shall not employ any parson in eny manner so as to become subject to the workere' ✓ wmpensation laws of Celitomia, and agrea t�at Ii I should become sub�ect lo the woBers' wmpensation provislons ot Section 3700 oi the Labor Code, I shell forthwith wmpty wi�h these pr 'sions. C�J �:p �t.�pnature: �'—O WARNING: FAILUFE TO SECURE WORKERS' COMPENSATION COVERAOE IS UNL4WFOL ANO $HP1L SUBJECT AN EMPL�TO CRIMINAL PENALTIES AND GVIL FlNES UP TO IXJE HUNDPED TFqUSAND DOl1ARE (5100.000), IN ADDRION TO THE CQST OF COMPENSATION, OAMAGES 0.S PFiOVIDED FOR IN SEGTON 3]OB OF TME LABOfi CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS UECLAHATION: I hereby aNirm Ihat I em licensed under proNsions ot Chapter 9(commencing with Section 7000) ot Division 3 of the 8usiness antl Professions Code, end my license Is in tull force end eflect Lic. a Class a Comracbr's Signeture: Date: CONSTRUCTON LENDING AGENCY: ❑ I hereby aNirm ihat there is a consiruction lending egency for the performance ot the work for which ihis permit is issued. (Sec. 3097, Civil Coda). Lendefs Name: Lenders Adtlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirtn that untler penelry ot perjury thel I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business and Professions Code: My ciry or wunry which requires a pertnit to construct, aller, impmve, tlemolish, or repair any sWCNre, prior to its issuance, also requires the applicant for such pertnit to file a signed atetement that he or she is licensed pursuant to the provislons of the Conirectors License Law (Chapter B(commencing with Sactlon J000) of Division 3 01 the Business enC Pmtessions Coda) or that �e or she is e:empt therefrom and I�e basis for the alle9ed exemption. Any Ndetion oi SeMion 7031.5 by any applicant for e pertnit �uhj s the epplicant to a civil penalry W not more Ihan live huntlretl dollars ($500).): I, as owner oi Ihe propeny, or my employees wit� wages as thelr sole compensetion, WILL DO THE WORK, and the strucWre Is not intended or otteretl for sale (Sac. 7044, Business and Pmfessions Code: The Conirectors License Law does no� epply to an owner ot propeny who �uilds or improves thereon, and who does such work himsalt or herself or Ihroug� his or her own employees, provided lhet such improvements ere not imendetl or oNeretl for sele. If, however, the building or impmvement is sold within one year of comple�ioq the owner-builder will heve ihe burden of provinq that he or she did not build or improve for purpose of sale.). ' ❑ I, as owner ot tha propeny, am EXCLUSNELY CONTRACTING WITH LICENSED CON7FiACTORS to consiruct t�e project (Sec. 7044, Business and Protesslons Code: The coniractors Ucense Lew does not apply to en owner ot pmperty who builtls or Impmves ihereon, end who coniracts for such projact wlth a contrector(s) license pursuant to Iha Contractors License Wws.). ❑ I em exempt 0 sec. Business end Professions Code for this reason: `S�Gre �' � E'pt�r s: 3 i d � Venfication ot Ownership by (rype of dacument, i.e. - property �av bill or deed): DIVISION OF INDUSTNIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity ihat no excavation five (5) or more feet in depth Into which a person is required to tlescentl, wlll be made in connection with work euthoAzetl by ihis pormit, and thai no builtling sWqure, sca%olding, �alsework, or demoli�ion or dismantling thereoi, wlll be more than thirty-six (36) feet hiqh. (Chap. 32, Gry 2, Art 2, Sec. 341, Title B, California AOminisirative Code). ❑ As owner-builder, I will not employ anyone to do work which woultl require a permit trom the Division oi Industrial Selery, es noted above, unless such person has e pormlt to do such wark irom the division. Signature: Date: Division of Indusirial Sefety Permit Number: CERTFlCATE OF COMPLIANCE AND AllfHORVA710N OF ENTRY: I cenity untler penalry oi perjury that I have reaC this eppliwtion and state that the infortnetlon given is correcL I agree to comply with all s e laws end city ordinances relating to Dullding construction, and authodze representaiives ot �he Ciry ot Casta Mesa m enter upon Ihe ebove-descnbed property for insp ti puryases. I egree not to occupy or allow occupancy of eny building authonzed by Ihis p it until final inspection. n � f'4 7 e .�_a��s� ��> AnNOr Authonzed Applicant Date COOE I, INSPECTIONTVPE �676 Flxed System Final Fire Prevention 1266 Pool SDe Final 200 Flnel Re-Raot 201 FIneI BIxWRetaining Wall 202 Finel Factory Fire Place 203 Finel Sign 204 Final Demolition QdjE I�LS , �,Qf�a INSVECTIONTYPE 206 Finel Mechanical 20B Finel Plumbing 210 Finel Electncal 212 Final Fire Prevention 220 Final Planning Approvel 222 Finel Site 250 Finel Building/Otcupancy PAIE Iti�LS t2 S o7 � JobAddress: 223 FAIRWAYPL � Suite No Vicinity: POOL AND SPA AT REAR SFD Parcel Nunmber: 43921210 npplicant: MASKREY, BRIAN Address: 223 FAIRWAY COSTA MESA, CA ,, Owner: MA9KREY, BRIAN Address �223 FAIRWAY - COSTA MESA, CA . � . Contractor: OW NER-BUI LDER Address: Phone: 714-724-1133 Zip: 92627 Phone: Zip: 92627 Phone: Zip: LiCenset 000000 . ISSUED BY: V _ . .\ � Status: ISSUED Applied: 03/08/2007 Issued: 03/08/2007 SCOPE OF PERMIT CONSTRUCT 400SF IN-GROUND GUNITE POOLISPA AT THE REAR OF AN EXISTING SfD. REF: BW-00271 � 1 GAS OUTLET (1-4), 1 SPA, 1 SWIMMING POOL . . - , � - . :. - AMT ISSUE FEE 523.50 Backflow irrigalion 50.00 Backflow Preventer 50.00 Bathtub . 50.00 Clarifier System $0.00 Connect pce,Soda,etc) 30.00 Dental Units $0.00 Dishwasher 50.00 Drain, Floor $0.00 Drain, Rainwater 50.00 Drain, Roof S0.00 Drinking Fountain 50.00 Expansion Tank S0.00 Gas Earthquake Valve $0.00 Gas (7-4 outlels) . -$6.15 Gas (Over4 outlets).� � , $0.00 Gas Repipe ' S0.00 Gas Service ` $0.00 Interceptors (Grease, Oil) �. $0.00 Interceptors (Sand Auto ) . $D.00 QTY 0 0 0 0 0 0" 0 0 0 0 0 0 . 0 1 0 0 0" 0 0 FEE SUMMARY ' AMT LaundryTub/Washer 50.00 Landscape Irrigation � 50.00' . _ P-Trap --- - . � -- �$0.00 i PressureRegularor- � 50.00� Process Piping (per 10 ft) $0.00 Receptors - 50.00 SepticTank � 50.00 SewerCaptorDemo � $0.00 SewerConnect - . 30.00 Sewer Private Line � � - $0.00 Shower, � 50.00 Sink, bar ' $0.00 � Sink, commercial , � $0.00 Sink, Floor . $0.00 Sink, kitchen' � '- 50.00 .� Sink, senice/mop $0.00 Spa (private) 530.25 Spa (public) ', 50.00 Qn 0 0 0� ' 0 0 0 0 0 0 0 0 •0 0 .' 0 0 0 1 0 SumpPump ,. SwimmingPool , Trap Primer Urinal � Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin � Wash Basin Set Waste and Vent System Water Closet (foileq Water Heater / veN Water Piping (Insl or Rep.) Water Re-pipe - WaterService - Water SoRener - - OTHER � - , ' ' VIOLATION , ' PLAN CHECK ' �" REINSPECTION.' AMT 50.00 560.75 $0.00 50.00 $0.00 50.00 50.00 $0.00 50.00 $0.00 3o.oa $0.00 30.00 $0.00 50.00 $0.00 $0.00 30.00 so.00 . � � � ' ' � - - TOTAL CALCULATED FEES: E120.65 COMMENTS / SPECIAL CONDITIONS Qn 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21•92) EXPIRATION: This permlt shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for tha work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeetions end final epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 /� 2C6&6818/00) WORKERS' COMPENSA710N DECLN7A710N: � � I hereby eflirm under penalry oi per�Vry one of Ihe tollowing daclarations: ❑ I heve entl wlll melntain e certit�cate of consent to self-Insure lor workers' compensetion, as providad for by section 3700 of Ihe Lebor Code, tor the perfortnance of the wark for which ihis permit is is5ued. � 1 have entl wlll meintain worker5' compensatlm insurance, as requiretl by section 3700 of Ne Lehor Cotle, For ihe peAortnance ot Ihe work for which Nis pertnit is issued. My workars' compensetlon Insurance cerrier and policy number ere: Carrier: Policy Number: :�(Trii secfion need nof be cbmp/eted �� fhe permit is valued et one hundred dollers ($ IOOJ or less.) I certify that in the pertormanc9 of the work for which ihis pertnit is IssueQ I shell nol employ any person in eny manner so as to become subjec� to ihe workers' � compensetlon laws ot Californla, and agree Ihat If I should become sub�ect to tha workars' wmpensetion provislons ot Sectlon 3700 oi Ihe Lebor Code, I shall forthwlth comply with thesa ovisions. APlIWn(S �ire: �Da1B: S— o '�7 WARNING: FAILURE TO SECURE WORKEAS' COMPENSATION CqVERAGE I$ UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES lIP TOONE HUNDRED TFKKISAN� OOLLARE (5100,000),IN AODIT�01�1 TO THE WST OF COMPENSATION, OAMAGES AS PROVIDEO FOR IN SECTION 31080F THE IABOR CO�E, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLAHATION: I hereby aHirm Ihat I am licensed under provisions of Chepter 9(commennng wiih Section 7000) ot Division 3 of the Business and Professions Code, and my license is in full force and eHect Lia k Class a Contractors SlgnaNre: Date: CONS7PUCTION LENDING AGENCY: ❑ I hereby eNirm that ihere is e construction lending agency for the peAormance of the work lor which Ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lendefs Nama: Lenders Address: Signawre: Date: OWNER-BUILDER DECLAAA7lONS: I hereby aHirm that under penalty of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business antl Professlons Cotle: Any ciry or county whic� requires e permit to construct, elter, Improve, demolish, or repeir any siructure, pnor �o its issuance, elso requires the applicant for such pertnit �o file e Slgned statement thet he or she Is licensed pursuent to Ihe provislons of Ihe Contractors LJcense Law (Chapter 9(commencing wlth Sectlon 7000) of Division 3 oi the Businoss entl Professlons Code) or thet ha or she is exempt therelrom end the hesis for the elleged esemption. Any violation oi Sectlon 7031.5 by eny epplicant for a permtl �suh' Is Ihe epplicant to e civll penelry of not more than five hundred dollers ($500)J: I, es owner ot the property, or my employees with wages es t�eir sole compensation, WILL DO THE WORK, ana ihe sWcture �s not imentleC or ottered tor sale (Sec. 7044, Business and Professions Cotle: The Coniractors License Lew does not apply to an owner of properry who huilds or Improves thereon, and who does such work himsell or herself or through hi9 or her own employees, provi0etl ihat such improvements are not intended or oHeretl tor sale. II, however, ihe building or impmvement is sold within one year ot completion, the ownervbuilder will have Ihe burden of proving that he or she did not builtl or improve for purpose of sale.). ' ❑ 1, as owner of the properry, em E%CLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS to construa ihe project (Sec. 7044, Business and Professions Code: The wntractors License L.ew does nm apply to an owner ol property who Dulltls or Improves thereon, antl who contracis lar such proled wl�h a coniractor(s) license pyrsuant to the ConlraAors License Lews.). ❑ I em e�mpl untler sec. ID ventietl by dnvers license. ❑ Ves ❑ No Business end Professions Code for this reason: a� > ? "d Driv ,s `� e� Expyes� �0 Verification of Ownership by (type of dacument, i.e. - property tev bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATON: ❑ I hereby certlfy thet no excavatlon tive (5) or more teet in tleplh Into which a person Is required to descend, will ba mede in connactlon wilh work authorized by ihls permit, antl that no building siructure, scaffolding, talsework, or tlemolition or dismantling thereof, will be more Ihen thir�y-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Ti�le B, Califomle Administrative Cade). ❑ As owner-builder, I will no� employ anyone to do work which would require e permit irom ihe Division of Intlustriel Sefety, es noted above, unless such person has e portnit to tlo such work from the division. Signamre: Date: Division ot Industrial Safety Partnit Number: CERTFICATE OF COMPLIANCE AND AUTHORIZA710N OF EHTAY: I certity untler penelry of perjury that I have reed ihis applicetion and state ihat the information given is correct. I egree Io c ply wilh all sta�e laws entl ciry ortlinances rele�ing to building cons�ruction, antl authodze represen�atives ot ihe Clry of Casta Mesa to enter upon the ebove-descnbed pr rty for' ection purposes. I egrea not to occupy or ellow occupancy oi eny building authorized by this permit until finel insDection. `� Sign 'OFLqtute �9J3(DPmer(s) (7.Date�' �<< AnNOr Authorizad Applicant Date CODE II, INSPEGTION`'fPE I 1676 Fi:etl System Final Fire Pre�ention 1266 Pool Spe Final 200 final Re-Root 201 Finel Block/Retaining Well 202 Final Fectory Fire Place 203 Finel Sign 204 Finel Demolition t{djg � j�� INSPEC110NTYPE 206 Finel Mechanical 20B Finel Plumbing 210 Finel Elecincal 212 Final Fire Prevention 220 Final Planning Approval 222 FinalSite 250 FinalBulltling/Occupency 4ATf, lti�El� 2� � t '1 � � � Job Address: 223 FAIRWAY PL ' Suite: Vicinity: POOL AND SPA AT REAR SFD Primary Occ: Type of Construction: Parce� Number: 43921210 Zoning: Applicant: MASKREY, BRIAN Address: 223 FAIRWAY COSTA MESA, CA Owner: MASKREY, BRIAN� Address 223 FAIRWAY � , � COSTA MESA, CA' " � "�' � " Comracror: O W N ER-B U I LD E R Address Arch : Address: Zip: Zip: � � „ Phone: , � License: � Status: ISSUED Applied: 03/OS/2007 Issued: 03/OS/2007 Phone: 714-724-1133 Zip: 92627 ISSUED BY: Phone: . � � �� Zip:- 92627 � , � � Phone: • " � - License: 000000 `� ��, Eng: TODD L LACHER ' Address: 1201 N TUSTIN AV � , � � � �Phone: 714-630-6{14 - � ANAHEIM,CA • 92807 SCOPE OF PERMIT . CONSTRUCT 400SF IN-GROUND GUNITE POOUSPA AT THE REAR OF AN EXISTING SFD. �� FEE SUMMARY Plan Check: $320.29 i ' ' _ , " • " Calc Valuation: Permit: $492.75 - � - —' � - Claim Valuation: SMIP Res: $3.50 . , SMIP Com: $0.00 License: C67656 $35,000.00 835,000.00 Other: $0.00 -, . Inspection: $0.00 ; � - - - � � i .- '� i Total: $816.54 PLANNING & ZONING SETBACKS MAINSTRUCTURE Front 0-0 Rear '0=0 Lefl 0-0'�� RigM 0-.0 '" , �, ACCESSORY Front 0- 0 � � Rear 0- 0 " Left 0. 0 ��'� Right 0- 0 ' - � PARKING Existina: 0 _,Reauired: 0 , � Pr000sed: 0 - �'�� "�i , � � ; / . ; '- _ , . . � . � .� � , � � . -,� , . , � . , 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, § 7, 12-21-92) EXPIRATION: This permit shall automatically ezpire and become void if work Is not commenced within 1 BO days, or if work is suspended or abandoned tor a period of 1 BO 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 requlred Inspectlona 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 / ( 2aeaae (e�oo� � WORKERS'COMPENSAnONDECLARATON: I hereby ettirm untler penalry of Derjury one ot t�e following declarations: ❑ I heve antl will malntain a certificete of wnsent to selbinsura tor workers' compensation, as provided lor by section 3700 oi the Lebor Cotla, for the pertormance of the work tor which Ihis permlt is Issuad. ❑ I have antl will melntain workers' compensa6on Insurance, as requiretl �y section 3700 ot the Lebor Cotle, tor Ihe pedortnance of the work lor which Ihis pertnit is iuued. My workers' compensetlon Insurence carrier antl policy number ere: Cerri Policy Number: (Th" section need not be complefed i! fhe permit is veluetl af one hundred dollars ($100) or Iess.J � I certity ihat in the edormence of Ihe work tor which this permil is issued, I shall not employ any person in eny menner so as to become sublecl lo iha workers' compensation la 5 1 Celitornle, entl egree that If I should become suDjact to the workers' compensation provislons of Sectlon 3700 0l the Labor Code, I shall torthwith comply with the isions. G APWI!;.eM�SlgtYgNre: _ � � ^ p � Q % WAFlNNG!FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWR/L AND SW1LL SU&IECT AN EMPLOYER TO CRIM1UNPL PENA�TIES rWD QVIL FINES UP TOONE HUNDRED TTIOUSAND OOLL4RE (5100,000), IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE LABOR COOE, INTEREST, AND ATTOPNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirtn that I am licensetl untler provlslons ot Chapter 9(commencing with Section 7000) of Division 3 0l the Business antl Professions Code, antl my license is in full force entl ettecL Lic. a Cless a Contractors SignaNre: Date: CONSTRUCTION LENDING AGENCY: ❑ I �ereby aXirm ihat there is e consiruction lending agency for the pertormance of Ihe work tor which ihis pertnit is issued. (Sec. 3097, Civil Code). Lendefs Name: Lendefs AOtlress: Signature: Date: OWNER•BUILDER DECLARATONS: I here6y eNirtn that untler penalry of perjury thet I am EXEMPT FROM 7HE CONTFiACTORS LICENSE LAW lor ihe following reason (Sec. 7031.5, Business entl Protessions Code: Any ciry or counry whic� requires e permit to construc6 alter, improve, demolish, or repair eny sirucWre, pnor to Its issuance, also requires the flpplicant for such permit to file a signed scetement ihet he or she Is Ilcensed pursuem to ihe provisions of Ihe ConlraIXors Licensa Lew (C�epter 9(commencing wit� Sectlon 7000) of Division 3 ot ihe Businass end Protessions Code) or t�at ha or sha is exempt therelrom antl the basis for Ihe elleged exemption. Any violetion of Sactlan 7031.5 6y eny epplicant for e parmit sub'gcts the applicant to a civil penalry of noI more than frve hundred dollars (5500).): I I, es owner of the property, or my employees wllh wages as t�eir sole compensation, WILL DO THE WORK, end the slructure Is not intentletl or oHered tor sele (Sec. 7044, Business antl Prolessions Coda: The Contractors License Law tices not apDly to an owner of property who builtls or Improves thereon, and who tloes such work himself or �ereelf or ihrough hls or her own employees, providetl that such improvements are not iNendetl or oNered for sale. If, however, iha builtlinq or impmvemem is sold within one year of completion, ihe owner-builder will have lhe burden ot proving thal he or she did not build or improve lor purpose of sale.). ' ❑ I, as owner ot the propeny, am E%CWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct tha prolect (Sec. 7044, Business anC Proteuions Code: The contrecbrs License Lew tloes not epply to an owner of pmperty who builtls or Improves iheraon, end who contracts tor such project wlth a contractor(s) license pursy@nt to ihe Conirectors License Laws.). ❑ I em exe�t�intler sec. Business end Professions Coda lor this reason: ignaturet �, e�.�� Owner ID venlletl hy tlrivers licensa. ❑ Yes ❑ No Dnv� icre-L se (�Eirylres: �-$'� � Verificutlon oi Ownership by (type of documenl, i.a. - propeny tax blll or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hareby cenify that no excavatlon five (5) or more feet in depih into which a person is requiretl to tlescend, wlll be mede In connection with work euthorizetl by Ihis permit, and ihat no building s�ructure, scalloltling, falsework, or tlemolition or dismantling Ihereof, will be more ihan thirty-slx (38) leet high. (Chep. 32, Gip 2, Ar12, Sec. 341, Title 8, Cellfomia Adminiscrative Code). ❑ As owner�builder, I will not employ enyone to tlo work which would require e permil from the Divislon al Industriel Safery, es no�etl above, unless such person hes e permit to tlo such work Irom the tliNsion. Signature: Date: Division ot Intlustrial Safery Permit Number: CERTFICATE OF COMPLJANCE AND AUfHORIZA710N OF ENtRY: I ceniry under penelry oi perjury thet I heve reatl this epplicetion antl stete that the information given is conecl I egree b comply ell steta laws entl ciry ortlinances relating to building construction, antl euthorize reD�esentaiives ot Ihe Ciry ot Casta Mesa to enter upon the ebove-doscribed propert or i pection purpases. I egree not to occupy or ellow occupancy of eny building authonzed by lhis permit until finel inspection. /�� - ��--0% Sigr�etoraOf�al Owuer7LT Def.. �� And/OrAuthonzatl Applicant Date �QOE 1. INSPECTONttVE 1616 Fixetl System Final Fire Prevention 1266 Pool Spe Final 200 Final Re-Roat 201 Flnal Block/Retaining Wall 202 Final Factory Fire Placa 203 Finel Sign 204 Final Demolition GLIE IN(ffIALS 2' ' � V+�a� cooe� ixsvecnoxTrve 206 Finel Mechaniwl 20B Final Plumbing 210 Finel Elecincal 212 Finel Fire Prevention 220 Final Planning Approval 222 Finel Site � 250 Final Bullding/OccuDancy PAIE �4 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.�i }LDING PERMIT 77 FAIF DRIVE, COSTA MESA, CA 92626 .lob Address: 223 FAIRWAY PL Suite: Vicinity: Primary0cc: R3N1 ' � Parcel Number: 4392121 � Applicant: MASKREY, BRIAN Address: 223 FAIRWAY COSTA MESA, CA Owner: MASKREY, BRIAN Address 223 FAIRWAY COSTA MESA, CA Type of Constmction: V-N Zoning: - � . .�� F �`r �� . Th Contractor; OWNER-BUILDER Address: Zip: Arch : SHIV TALWAR Atldress: 3262 FOREST MEADOW DR Phone: 909-393-8655 CHINO HILLS,CA Zip: 91709 License: C23477 Phone: License: 000000 Status: ISSUED Applied: 7122/2005 Issued: 12/28/2005 �� '� / � /��• Eng: HAI HONG, P.E. Address: 15658 COUNTRY CLUB DRIVE Phone: 909-606-8540 CHINO HILLS, CA 91709 License: C68610 SCOPE OF PERMIT 773 SF ADDITION AND 604 SF ATTACHED GARAGE TO SFD. WORK TO INCLUDE: ADD 178 SF TO 1ST FLOOR, DEMOLISH EXISTING ATTACHED GARAGE, CONSTRUCT A NEW 604 SF ATTACHED GARAGE, ADD 595 SF AND A 90SF DECK ON SECOND FLOOR. EXISTING 3 BEDROOM, 2 BATHROOM SFD TO BE CONVERTED INTO A 2 BEDROOM AND 3 BATHROOM SFD. PLANNING: LOT SIZE = 7,200 Sa. FT. RESIDENCE = 2,228 SQ. FT. GARAGE = 604 SQ. FT. DRIVEWAY = 352 SQ. FT. lOT COVERAGE = 3,184 S�. FT. (44%) OPEN SPACE = 4,016 SQ. FT. (56%) Plan Check: $591.34 Permit: $909.75 SMIP Res: $8.76 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Totai: $1,509.85 SETBACKS MAIN STRUCTURE Fronl 25- 0 ACCESSORY Front 0-0 Rear 5-0 Rear 0-0 PARKING Existina: o Reauired: 0 FEE SUMMARY PLANNING 8 ZONING Left 5- 0 Lefl 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 7- 0 Right 0- 0 $87,64320 545,010.00 NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period ot 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all; requlred Inapeetlona end finel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaa�ae �a�oo� WORKERS' COMPENSATION DECLARA7ION: — � I hereby affirm under penalry of perjury one oi the following declaretions: ❑ I have entl will maintain a certificata of consent to self-Insure tor workers' compensetion, as piovidetl for by section 3700 of ihe Labor Code, tor ihe pedortnance ot the work for which this permlt is issued. ❑ I have and will maintain workers' compensation insurance, as requiretl by section 3700 of the Lebor Cotle, foi Ihe pedormance of the work for which ihis pertnit is issued. My workars' compensation Insuranca carrier and policy number are: Carrier. Policy Number: (This section need not be completed i! the Oermit is valued af one hundred dollars ($ f00) or /essJ ��. I certify �hat In Ihe p&rtormanca of the work for which this pertnit is issueQ I shall not employ any person in any manner so as to become subject to the workers' �"compensation la o� Celifornia, and agree that it I should become subject to ihe workers' compensation provisions of Section 3700 of Ihe Labor Code, I shall torthwtlh comply with the � ions. Y' ��—O � 'Applice Sgneture:; �, ` Date: WARNIF7G: PAI� LURE TO SECURE WORKERS' COMPENSAiION COVERAGE IS UNIAWFUT AND SMALL SUBJECT� E PM�1LpYFASO CRIMINAL PENALTIES AND pVIL FINES UP TOIXJE HUNDRED iFiOU$AND DOLLARE (5100,000). IN ADDITION TO THE COST OF CAMPENSATION, pAMAGES AS PROVIDED Fpq INSECTION 3]W OF THE IABOR OppE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm ihat I am liGensed under provisions of Chapter 9(commencing with Sedion 7000) of Division 3 of the Business and Protessions Cotle, and my license is in full torce end eHecL Lic. a Class a Contrador'S Slgnawre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that tpere is a construction lending agency for the peAormance of ihe work lor which ihis permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARAnONS: I hereby attirm that under penelty of perjury ihat I am EXEMPT FROM TME CONTRAC70RS LICENSE LAW for tha following reason (Sec. 7031.5, Business antl Professions Code: Any ciry or county which requires a permit to constmct, alter, improve, demolish, or repair any strucWre, prior to its issuance, also requires t�a applicant for such pertni[ to file a signed statemant ihat he or she is licensed pursuant to ihe provisions ot the Contrectors License Law (Chapter 9(commencing with Section 7000) oi Division 3 of Ihe Business and Professions Code) or ihat he or she is e:empt therehom and the basis for the alleged exemption. Any violetion of Section 7031.5 by any appiicant for a permi� su6jec�s the.eppliwnt to a civil penalty of not more than fiva huntlred dollars ($500).): �(1 I, as owner ot Ihe property, or my employees with wages as Iheir sola compensaGon, WILL DO THE WQRK, aad the strucWre is oot imentled or otteretl tor sale (Sec. +�""'-7044, Business and Professions Cotle: 7he Contractors License Law tloes not apply to an owner ol property who builds or improves ihereoq and who does such work himself or herseN or Ihmugh his or her own employees, provitled ihat such impmvemenis ere not imendetl or oflered tor sele. I(, however, t�e building or impmvement is sold within one year of completion, the owner-builder will have ihe burtlen of proving ihat he or she did not build or improve for purpose of sale.J. � ❑ I, as owner of t�e praperry. am EXCLUSIVELY CONTRACTING WITH LICENSED CONTBACTORS to construct the project (Sec. 7044, Business antl Professions Cotle: The coniractofs License law tloes not apply to en owner of pmpetly who builds or improves thereon, antl who contracis for such projact with a contractor(s) ,.�Iicanse�pursuantdo.the.Contractors Licensa Laws.). Business antl Pmfessions Code for this reason: �Oivnei ID ver�ied by driver's license. Ves ❑ No Verification of Ownership by (type of doc en i.e. - property tax bill or DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICATION: ❑ I hereby cenify that no excavetion five (5) or more feet in depth in�o which a person is required to descentl, will be made in connection with work authorized by t�is permit, and ihat no builtling siruaure, scaHolding, talsework, or tlemolition or dismantling ihereof, will 6e more than ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, California Atlminisirative Cotle). ❑ As ownerbuiltler, 1 will not employ anyone to do work which would require a permil from ihe Division of IndusMal Safery, as noted above, unless such person has e permit to do such work from ihe division. Signature: Date: Division of Intlustriai Safery Permit Number: CERTIFICATE OF C IANCE AND AUTFIORIZATON OF ENTRV: I certity under penalry of perlury ihat I have read this application and state that ihe intormation given is wrrect. I agree to mpl With state laws and ciry ortlinances relating to building construciion, and authorize representatives ot ihe Ciry of Coste Mesa to enter upon the ebove-described p for i ection puryoses. I agree not to occupy or ellow occupancy of any building authorized by this permit until final inspectio �-,.� �Z 2�-o j�- SlgnatureOfLegal�Owner(s) � ._��'-'- { Dat�='Y'x-� AnrUOr Authonzed Applicant Date CODE �. INSPECTIONTYVE 1616 Fixed System Fina� Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Placa 203 Final Sign 204 �� Final Demolition p� IAL COpE 1 INSPECTION TYPE 206 Final Mechanical 20B Final Plumbing 210 Final Electrical 212 final Fire Prevention 220 Final Planning Approval 222 250 Final Site Final Buildin Occupancy � .m (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: 223 FAIRWAY PL 43921210 Applicant: MASKREY, BRIAN Address: 223 FAIRWAY COSTA MESA, CA Owner: MASKREY, BRIAN Address 223 FAIRWAY COSTA MESA, CA Contractor: OWNER-BUI LDER Address: ISSUE FEE Temp service tesl Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting FiMs Recept Oullets Switches Non Res Appl Res Appl Service to 200a Service to t000a Service over 1000a Motors to thp Motors to 10hp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Giraits Temp Pwr Pole Intermed Pole ,�� T� 9�� ad�. �:� � r�'s� ra „r. +�. . � �� '^:,; � :,• Phone: Zip: 92627 Phone: Zip: License: 000000 Status: ISSUED Applied: 12/28/2005 Issued: 12/28/2005 / ISSUED BV: SCOPE OF PERMIT 773 SF ADDITION AND 604 SF ATTACHED GARAGE TO SFD. WORK TO INCLUDE: ADD 178 SF TO 1ST FLOOR, DEMOLISH EXISTING ATTACHED GARAGE, CONSTRUCT A NEW 604 SF ATTACHED GARAGE, ADD 595 SF AND A 90SF DECK ON SECOND FLOOR. REF.: B05-02110 ELECTRICAL TO INCLUDE: 6 LIGHT FIXTURES, 10 OUTLETS, 8 SWITCHES, 1 SERVICE TO 200 AMPS AND 1 SUB PANEL TO 200 AMPS. $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $6.60 $11.00 $8.80 $0.00 so.00 $30.50 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 Quantiry 0 0 0 6 10 8 0 0 7 0 0 0 0 0 0 0 0 1 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway /100 ft Standing Section Misc Electrical Equipment Transformers up to t 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) Christmas Tree Stand Fireworks Sland Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee $0.00 so.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 $0.00 $0.00 so.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES E710.90 COMMENTS / SPECIAL CONDITIONS Quanlity 0 0 0 0 0 0 0 0 a 0 0 0 0 0 0 0 0 NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Calitornia 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 780 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 requlred Inapectlona and finel epproval must be obtainad. Failure to obtain inspections and final approval will resutl in the ezpirati�s-peimit. FOR INSPECTIONS CALL: (714) 7545626 2446d8(&00) WORKERS' COMPENSATION DECLARATION: I bereby aHirm under penalry ot pa�ury ooe of the tolbwing deGarations�. � I have and wlll meimain a cenificete of consent to self-Insure for workers' compensation, es provitled for by sec�ion 3700 of Ihe Labor Code, br ihe pedormance of the work tor which Ihis pertnit is issued. ❑ I have antl will meintain workers' compensation insurence, as requiretl by section 3700 0l Ihe Lebor Code, For the pedortnance of t�e work for which ihls permit is issued. My workers' compensation Insurance carrier and policy number are: Cdrrier. papcy Number: (This secfion neetl no( be completetl il rhe permit is valuetl a( one huntlred dollers (5700) or /ess.) �'] 1 certity thet in the pertortnance ot t�e work tor which �his permit is issuea, I shell not employ any person in eny manner so as to become subject b lhe workers' compensatlon laws ol Calilomia, end agree that if I should become subiec� to Iha workers' compensation provisions ot Section 3700 0l the Labor COCe, I shall tonhwith comply with ihasa pr io ApplicantSigneWre: Date: � Z-'�2�j—a'� WARNING: FAILURE TO $ECURE WORKERS' COMPENSAiION CpVERAGE IS UNIAWFUL M!D SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIE$ AND GVIL FlNES UP TOONE HUN�RED hKK1SrW D Dd1ARE (5100,000). IN ADORION TO THE COST OF COAIPENSATIIXJ, DAAWGES AS PROVIDED FOR IN SECTION 3�O60F THE LABOp CODE, IMEREST, pN0 ATTORNEY'S FEES. LIGENSED CONTRACTORS DECLARATION: I hi3re6y attirm that I am licensed under provisions of Chapter 9(commancing with Section 7000) of Division 3 ol the Business and Professions Code, antl my license is in full force antl ettecL Lic. M Class N Coniractor's Signature: Date: CtlNS7RUCTION LENDING AGENCV: ❑ I hereby attirm �hat ihere is e cons�mction lending agency for �he pedormence of Ihe work for which Ihis permit is issued. (Sec. 3097, Civil Code). LentleYs Nama: Lender's Address: Sig�ature: Date: OWNER-BUILDER DECLARAilONS: I hereby ettirm �hat under penalry of perjury that I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for the following reeson (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires e permit to consiruct, aller, improve, demoiis�, or wpair eny simcture, prior to its issuance, elso requires the applicaN for such pertnil to d�e e signed slatement Ihet he or she is licensed pursuam to the provisions of the Contrectore IJcensa Law (Chapter 9(commencing with Sec�ion 7000) of Division 3 of tne BuSiness end Pro�essions Code) or ihat he or she is exempt therafrom antl t�e besis br t�e alleged exemption. Any violetion of Sedion 7031.5 by eny epplicent for a permit suJIecis ihe epplicant to a civil penalry of not more than five hundred tlollars (5500).): `gt I, as owner ot the properry, or my employees with weges es their sole compensa�ion, WILL DO THE WORK, and the structure is not inten08tl or oHered tor sale (Sec. 70a4, Business and Professions Code: The Contractors License Law tloes not apply to an awne� at prope�ty wha builtls w impwves thereon, and wtw tloes such work himsell or herself or through his or her own employees, p�wided thal such improvemems are not intentled or oflered for sale. If, however, Ihe building or improvemeN is sold within one year of completbn, t�e owner-builtler will have the burden ol proving that he or she did not build or improve for purpose of sale.). � ❑ I, as owner ol ihe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 704d, Business end Prolessions Code: The contractors Llcense Lew does not apply to en ownar ol property w�o bullds or Improves ihereon, and who contracls tor such prolect with a contractor(s) license pursuent to ihe Contraclors License LawsJ. ��I am exam ntler ec. Business antl Professions Coda for this reason: ignaWre: i Date� / — �' Owner ID verilied by driver's license. Yes ❑ No Driver's License No. ,, Ezpires: �7^ �'Y� +KP Vedlication ol Ownership by (type of docy(ne`it, i.e. - property �az bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cehify ihat no excavaiion five (5) or mora faet in depth into which e person is required m descend, will be made in connection with work euthodzetl by Ihis permi6 antl Ihat no builtling structure, scaHolding, talsework, or demoli�ion or dismantling ihereof, will be more Ihan ihirty-six (36) taet high, (Chap. 32, Grp 2, Atl 2, SeC. 341, Trtle B, California Atlminisirative Cotle). ❑ As ownar-buildar, I will not employ anyone to tlo work which would require e permit from the �ivision of Intlustnal Sefary, as noted ebove, unless such person has e pertnit to do such wark from ihe divisian. Siqnature: Oate: Division ot Industnel Sefery Permii Number: CODE,�, INSPECTONTYVE � PAIE II�DELS 1616 Fized Sys�em Final Fire Prevention 7266 200 201 202 203 204 Pool Spe Finel Final Re-Rooi Final BIxWRetaining Well Final Factory Fire Place FinalSign Final Demolition p COOE 1 INSVECTION TYPE 206 F(nal Mechanical 208 Final Plumbing 2l0 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Sita 250 Final Building/Occupency P�IE Itl�EL3 ��04. �1 Address: 223 FAIRWAY COSTA MESA, CA Owner. MASKREY, BRIAN Address: 223 FAIRWAY COSTA MESA, CA Contractor: O W N ER-BU I LDE R Address: Phone: 949-642-9615 Zip: 92627 Phone: Zip: 92627 Phone: Zip: License: 000000 SCOPE OF PERMIT 773 SF ApDITION AND 604 SF ATTACHED GARAGE TO SFD. WORK TO INCLUDE: ADD 178 SF TO 1ST FLOOR, DEMOLISH EXISTING ATTACHED GARAGE, CONSTRUCT A NEW 604 SF ATTACHED GARAGE, ADD 595 SF AND A 90SF DECK ON SECOND FLOOR. REF.: BOS-02110 MECHANICAL TO INCLUDE: 7 REPAIR/ALT COOLING/HEAT AND 1 VENT FAN. ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt CoolingMeat Inst / Rep. Recess Wall Htr Re(rig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Faclory Fireplace Hood wlMech Exhaust VAV Box Vent Fan I Single Dud Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm AirHandlers> t0000cfm Floor Furnace Floor or Suspend Heater 523.50 $0.00 $0.00 $13.70 $0.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 $7.25 $0,00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Commercial I nci ne ralor Domestic Incinerator Compressors / Absorotion Svstems Upto3hplt00kBTU 3 To 15 hp / 500 k BTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k 8TU Over 50 hp I Over 1,750 BTU Boilers Up l0 3 hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechaniwl Fee Investigalion fee Plan Check Fee Reinspection Fee TOTALCALCULATEDFEES COMMENTS I SPECIAL CONDITIONS Quantity 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 30.00 $0.00 E44.45 NOTICE: The work authorized by this permit shall comply with all applicable handicap access raquiremenis under California statutes antl related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permlt to be considered legal, such work must comply with all applicable codes, an requlred Inspeetlona and Iinel epprovel must be obtained. Failure to oblain inspectlons and tinal app�oval will result in tne axpiration of this pe FOR INSPECTIONS CALL: (714) 7545626 zaas�ae ��oa� WORKERS'COMPENSA�ON OECLARAnON: 1 hereby affirtn untler penalty oi perjury ona of tTe foilowinq dedarallons: p I have entl wlll meintain e certilicate ol consent to setl-Insure lor workers' compensation, as pmvitled tor by section 3700 ot the Labor Cotle, for [he pertortnance of the work for which ihis pennit i5 issued. ❑ I have and will mainWin workers' compensation insurence, as requlred by section 3700 of Ne Le�or CoAe, for the peAortnance of Ihe work for which this pertnit is issued. My workers' compensation Insurence cartier and policy num�er are: Carner: Policy Number: (This section need nat be cromplefed i/ the permit is valued ef one huntlred dallars ($ f 00) or /ess.) Q I cenify that in tha peAormence of the work tor which this permit is issued, I shall not employ eny person in any manner so es to become subjett to Ihe workers' compensation laws of ellfornia, end egree thet II I should become subject to ihe workers' compensation provisions oi Section 3700 oi Ihe Lebor Cotle, I shall forthwith comply witti these pro i 1 p ApplicentSlgnature: y �ate: �,Z`2 p �O� WARNING FAILURE TO SECUPE WORNEFS' CAMPENSATION CAVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOVER i0 CRIMINAL PENALTIES AND QVIL fINES UP TOONE HUNDRE� THOUSAN� DOLIARE ($100,000), IN ADDITION TO THE COST OF COA/PENSATION, �AMAGES AS PROVIDEO WR IN SECTIIXJ 3]Ofi OF THE IABOR CODE, INiEREST, AND ATTOHNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I nereby aflirm ihat I em licensed under provisions of Chapter 9(commencinq with Section 7000) of Division 3 of the Business end Professions Code, antl my licensa is in full forca and efleci. Lic. N Class k IConiracrors Signewre: �ate: � CONSTRUCTION LENDING AGENCV: d I hereby aNirm thet ihere is e consiruction lending egency for the peAortnance of the work for which thi5 Oermit is issued. (Sec. 3097. Civil Cotle). Lentlefs Name: Lender's Atltlress: Signawre: Date: ON'NER•BUILDER DECLARATONS: I I peroby affirm thet under penelry of perjury that I em EXEMPT FROM THE CONTRAC70RS LICENSE LAW br ihe following reason (Sec. 7031.5, Busineu end Professions ' Code: Any ciry or counry which requires a permit to construct, elter, impmve, tlemolish, or repair any structure, prior to its issuance, elso requires t�e ap0licant for such permit b file a signetl stetemem that he or s�e is Iicense0 pursuam to Ihe provisions of the Cantrecbrs License Lew (Chepter 9(commencing with Sectlon 7000) at Divislon 3 o1lhe BVsiness antl Prolessions Code) or t�at he ar she Is exempt therefrom and Iha �asis for the alleged exemption. Any violation of Section 7031.5 by eny applicent for a permit �. so lacts the applicant to a civit panalry of not more Ihan five hundred doitars (SSOD)J: I, es ownar ot t�e properry. or my employees wit� wages es their sole compensation, WILL DO THE WORK, anC Ihe sWcture Is not intendetl or ofleretl for sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law tloes no� apply to an owner of property who builds or imOroves Ihereon, antl who Aoes such work himself or hersell or through his ar her own employees, provided ihat such improvemenis are not intended or oNered lor sale. If, however, ihe builtling or improvement is sold within one yeer of completion, the owner-builder will hava the burden oi proving ihat he or she tlid not build or improve for purpose ol sale.). ' I❑ I, as owner of tha property em EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct lh0 pmject (Sec. 7044, Business and Protessions Cotla: T�e comractors Llcense Lew does no� apply to en owner of propeny who builds or Improves thareon, antl who comracts tor such project with a contrecmqs) license pursuent lo the Contracbrs License Laws.). � I am ezempt yqder sec. Signature�. � Owner ID vorilied y dnver's licanse. Verification of Ownership by (type of Business and Professions Code for this reeson: Date: - 0 Yes � No Driver's License No. ` � Expires: - �(, i.e. - property tax bill or tleed): DI��SION OF INDUSTRIAL SAFETY PERMI7 CERTIFICATION: ❑ I hereby cenity that no e:cevation five (5) or more �eat in depN into which a person is required to descend, will be made in connection with work authorized by Ihis permi4 antl ihat no builtling siruc�ure, scaHolding, lalsawork, or demolition or dismamling thereof, will 68 more Ihan tnirry-six (36) leet high. (Chap. 32, Grp 2, A� 2, Sec. 341, Tilla 8, Californie Atlministrelive Code). � As awner-builder, I will not employ enyone ta tlo work which would require a permit irom the Division of Industriel Sefety, es noted ebove, unless such pereon hes e permit to do such work irom the division. Signature: Date: Division of Induslrial Safety Permit Number: CEFnFICATE OF COMPLIANCE AND AUTHORIZATION OF EMRV: I certify under penal�y of perjury that I nave reatl thi5 application antl state that the information given is corfect. I agr�mply with all stete laws and ciry ordinances relating to builtling construction, and authorize representatives of ihe Ciry ol Costa Mesa to enter upon the abo�e-tlescri mperty t r nspecf purposes. I egrea not to occupy or allow occupancy of any huilding authorizetl by this Dermit until tinal inspedion. /L�- /��Z�-G�� Signeture Ot Legal Owner(s) Date A�NOr Authorizetl Applica�t �11 � INSVECTIONT'PE QJ�IE INTRIRLS 1616 Fixatl SyStem Final F�re Prevenlion 1266 Pool Spa flnal 2p0 Final Ra-Roof 201 Finel Block/Retaining Well 202 Final Faclory Fira Ptace 203 204 Final Sign Final Demolition 400E� MSPECf10NTYFE 206 Finel Mechanicel 208 Fina1 Plumbing 210 Final Electncal 212 Final Fire Prevention 220 FinatPlanning Approval 222 final Site 250 Final Builtling/Otcupency p9� JL�A'44 �_ � 1 l (714) 754-5273 • Fex (714) 754-4856 • Www.Ci.Cos�a-meSa.Ca.us 77 FAIR DFIVE, COSTA MESA, GA 92626 JobAddress: 223 FAIRWAY PL Suile No vicinity: Parcel Nunmber: 43921210 Applicant: MASKREY, BRIAN Addrpss: 223 FAIRWAY COSTA MESA, CA Owner: MASKREY, BRIAN Address 223 FAIRWAY COSTA MESA, CA Contractor: O WNER-8UI LDER Address: PLUMBING PERMIT �� `� p � �� ,YW," � �s,� Phone: 949-642-9615 Zip: 92627 Phone: Zip: 92627 Phone: Zip: License: 000000 ISSUED BY: Status: ISSUED Applied: 12/28/2005 Issued: 1228/2005 773 SF ADDITION AND 604 SF ATTACHED GARAGE 70 SFD. WORK TO INCLUDE: ADD 178 SF TO 1ST FLOOR, DEMOLISH EXISTING ATTACHED GARAGE, CONSTRUCT A NEW 604 SF ATTACHED GARAGE, ADD 595 SF AND A 90SF DECK ON SECOND FLOOR. REF.: BOS-02110 PLUMBING TO INCLUDE: 1 BATHTUB, 1 GAS (1-4 OUTLETS), 1 LAUNDRY TUBNVASHER, 1 P-TRAP, 1 WASH BASIN, 1 WATER CLOSET, 1 WATER HEATER AND 1 WATER PIPING. ISSUE FEE Backflow irrigati0n Backflow Preventer Bathtub Clarifer Syslem Connect (Ice,Soda,etc) Dental Units Dishwasher Drein, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank - Gas Earthquake Valve Gas (1-0 outlets) Gas (Over 4 oudets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $23.50 $0.00 $0.00 $9.80 so.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $6.15 50.00 $0.00 $0.00 $0.00 $0.00 FEE SUMMARY AMT Laundry Tub / Washer $9.80 Landscape Irrigation $0.00 P-Trap 59.80 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 SepticTank $0.00 Sewer Cap for Demo $0.00 Sewer Connecl $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial 50.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, servicelmop 30.00 Spa (private) $0.00 Spa (public) $0.00 �N 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilel) Water Heater I vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Soflener OTHER VIOLATION PLAN CHECK REINSPECTION AMT 50.00 $0.00 $0.00 $0.00 so.00 $0.00 $9.80 $0.00 $0.00 $9.80 $12.30 $9.80 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: 5100.75 � 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord, No. 9248, § 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 1 BO days. INSPECTIONS: In order tor ihe work authorized under this permit to be constdered legal, such work must comply with all applirable codes, antl all required Inapeetlone and 11ne1 approvel must be obtalned. Failure to obtein Inspections and final approval will result in ihe expi� f�this permit. FOR INSPECTIONS CALL: (714) 7545626 � eaae-aa �vw7 WORKERS'COMPENSATON DECLAqArON: I nere�y eHirm under penelty ot perjury one ot Ne tollowing declaretiw�s: ❑ I heve and wlll maintain a certilicate ot consent to selFlnsure for workers' compensatlon, es pmvidad for by section 3700 of Ihe Labor Code, for the pertormanca of the work for which this permit is issued. ❑ I have antl wlll maintain workers' compensation insurance, as required by sectlon 3700 of Ne Labor Code, Por the pertortnance of ihe work for which this pertnit is issued. My workers' compensatlon Insurance carrier antl policy numbei are: Ca�der. Policy Number: (yhis secf/on need nat be completed il the permif is valued et one hundretl tlollars ($100J or less.) 'GT) I certity �hat in Ihe pertormance oi Ihe work for which this pertnit Is issued, I shall not employ eny person in eny manner so as to become subject to the workers' �C compensatlon laws Celifomia, and agrae Iha� i( I should become subject b t�e workere' compensetion pmvisions of Sectlon 3700 ot Iha Labo� Coda, I s�all fort�with complywithihesa o isi qpplicant Signeture: _� Date: �2'2-Q- 0 �� WMNING: FAILURE TO SECURE WORNERS' WMPENSATION COVERAGE IS UNLAWFVI qND SHALI SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CNIL FlNES UP TOONE HUNpRED THOUSANO DOLLARE ($100,000�, IN ADDITION TO TME COST OF CJJMPENSATIQV, UMIAGES AS PROVI�ED FOii IN SECTION 3�O60F iHE IABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED COMRACTORS DECLARATON: I hereby aHirtn lhat I em Iicensetl under provisions ot Chapter 9(commencing with Section 7000) ot Division 3 oi the Busineu and Prolessions Code, and my license is in full Iorce end eflacL Lic. N Class N Coniractors Signature: Date: CtlNSTRUCTION LENDING AGENCY: ❑ I hare6y affirm ihat Mere is a constmction lending agency for ihe pedormance of ihe work for which ihis permit is issuetl. (Sec. 3097, Civil Gode). Lentlofs Name: Lentler's Atltlress: Signature: Date: OWNER•BUILDER DECLARATIONS: I hbreby eflirtn Ihat untler penalry ot perjury that I em EXEMPT FNOM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions Code: Any cily or county which requires e permit to constmcL alter, impro�a, Demollsh, or repair any siructure, pdor to Its issuance, also requires the applicant ior such permit lo fila a signad statement Ihat he or she Is licensed pursuant b the prodsions of the Contrectors License Law (Chepter 9(commencing with SecOon 7000) ot Divislon 3 of tha Businoss end Pmfessions Code) or that he or she is exempt therefrom and the besis for ihe alleged exemption. Any violation of Sectlon 7031.5 Dy any aOPlicent for a permit subjects the epplicant to e civil penalry of not more than tive huntlred dollare (5500)J: �I, as owner ot the property, or my employees with wages as Iheir sole compensetion, WILL DO TME WORK, and Iha structure is not Intentled or ottered tor sale (Sec. 7044, Business ana Professions Code: The Contractors License Law tloes not apply to an ownar of property who builtls or improves thereon, and wRo tloes such work himself or herselt or through his or her own employae5, pmvidetl �ha� such impmvemenis ere not imentletl or ofleretl tor sale. If, however, the building or impmvemeM is sold within o�e year of completion, the owner-builder will have the burden of proving Ihat �e or she ditl not build or improve for purpose ot sele.). � � I, as owner ol the property, am EXCLUSIVELV LONTRACTING WITH LICENSED CONTRACTORS ro consiruct the project (Sec. 704d, Business antl Pmfessions Code: The coniractors License Law tloes not apply to an owner ol pmpeny who builds or Improves Ihereon, and who contracts for such project wlth a contraqor(s) � license pursuant to the Contwctors Ucense Laws.). I am exemo�ynder sec. ID veritiatl�tlrivers license. tian of Ownership 6y (type af ❑ No Business and Pmlessions Code br ihis reason: Daie: � -� Oriver's Licensa No. Expires: 7y`�-O ( i.e. - propedy tax bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cert��y ihat no excava�ion five (5) or more feet in tlepth into which a person is required to descend, will he made in connec�ion with work authonze0 by this permi�, antl Ihat no builtling stmcture, scalloltling, falsewo�k, or demolition or dismantling ihereot, will he more than ihirty-sia (36) feet high. (Chap. 32, Grp 2. Art 2, Sec. 341, Tnla 8, Calilornia Atlministrative Cotla). ❑ As owner-builtler, I will not employ anyone ro tlo work which would require a permil irom ihe �ivision of Indusidel Sefery, as noted above, unless such pereon hes a pertnit to tlo such work from �he division. Signature: Date: Division of IndusMal Safery Permit Number: CEH7IFICATE OF COMPLIANCE AND AUTHORVA710N OF ENTtiV: I certity untler penalry of perjury ihat I have reatl ihis epplication entl state Ihat ihe information given is corract I agree to comply with all state laws and ciry ordinances releling lo builtling consimction, end amhorize representatives of Ihe City oi Coste Mese to enter upon �he eboVa-described prop br ins ection puryoses. I agree not to occupy or allow occupancy of eny building authorized by Ihis permit unlil final inspection. ( 2- 28- 6 Y � Signature Of Legal Owner(s) Date �1 y INSPECTIONTYPE 1616 Fined System Final Fira Prevention 1266 200 201 202 203 204 Pool Spe Finel Finel Re-Roof Final Block/Retaining Wall Final Factory Fire Place Final Sign Finel Demolition Applicant II�Lfi COpE I INSPECTION TYPE 206 Final Mechanical 20B Final Plumbing 210 Final ElecVicet 212 Final Fire Prevenlion 220 F(nal Planning Approval 222 Final Site 250 Final Building/Occupency PdI€ IIff�Lfl V . � (714) 754-5273 • Faz (714) 754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT ELECTRICAL PERMIT dobAddress: 223 FAIRWAYPL Suite No Vicinity: MASTER BEOROOM 8 BATHROOM Parcel Nunmber: 43921210 , � Appliwnt: MASKREY, BRIAN � Address: 223 FAIRWAY CA COSTA MESA � Owner: MASKREY, BRIAN . Address • 223 FAIRWAY � ' ' � �CA � COSTA MESA-"� ; Contracror: Address: ISSUE FEE Temp service test Res. alc 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 1 hp Motors to 10hp Motors to SOhp Motors to t00hp Motors over t00hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole 'Phone: (949)642-9615 Zip: 92627 ; � Phone: (949)642-9615 � Zip: 92627 , Phone: �.. ' Zip: - � /License: ,' . NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 0912211999 Issued: 09122/1999 SCOPE OF PERMIT ELECTRICAL PERMIT FOR ADDITION TO SINGLE FAMILY RESIDENCE. INSTALL 25-LIGHTING FIXTURES, 25-RECEPTACLE OUTLETS, 15-SWITCHES, & 1-60 AMP SUB-PANEL. REF: B99A7008 Quantity $23.50 50.00 50.00 $0.00 $0.00 50.00 $23.65 $23.65 $16.50 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0:00 $0.00 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 0 0 0 25 25 15 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 FEE SUMMARY , , Temp Dis� Syslem / �ighting Busway I700 ft Standing Section Misc Electrical Equipment Transformers up to 7 kva/kw ................up l0 10 kva/kw .................up to 50 kvalkw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System I Ckt Misc Conduit � Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Chnstmas Tree Stand Fireworks Stand Other Eledrical Fee Investigation Fee Plan Check Fee Reinspection Fee Quanlity $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 80.00 0 $0.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 $0.00 $0.00 50.00 TOTAL CALCULATED FEES 5117.80 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall compiy with all applicable handicap access requirements under Calitomia statutes and retated regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work aulhorized under this pertnit to be considered legal, such work must comply with all applicable cotles, and all requlred Inepectlona and final epprovel must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSAnON DEGLARAnON: I hareby attlrtn untler penalry oi per�ury one at the lollawing tleUarations: � ❑ I �ave end wlll maintain a cedificate of consent lo sel4lnsure lor workers' compensetlan, as pmvidetl tor by sectlon 3700 ot Ihe Labor Cotla, br the DeAortnance oi the work tor which this pertnit is issuetl. ❑ I have entl vnll mainiain wwkers' compensatlm insurance, as required by secilon 3700 ol ihe Lebor Code, for Ihe pertormance of ihe vrork for which Nts pertnit is issued. My workers' compensation Inburance carner end polity number ere: Cerrier: Policy Number: (Thls secfion nsed not be comp/etea I! fhe perml( Is valued et one hundred dollers (S100J or less.) ❑ I certity ihat in lhe pedormen�e ol �he work for which this pertnit is Issued, I shell not employ any person in any mennar so es ro become subject to the workers' componsa�ion laws of Celifom�a, entl agree that II I shoultl become subject to the workers' compensetlon provislons of Section 3700 ot the Lebor Cotle, I shall forihwith comply wlih ihese provisions. Applicant Signawre: Date�. WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNL4WFUL AND SHALL SU&IECT AN EMP�OVER TO CRIMINAL PENALTIES AND GVIL FlNE$ UP TO ONE HUN�REO THOUSANO DOILARE (5100.000). IN AWI710N TO THE WST OF COMPENSATqN, DPMAGES AS PqOVIOED FOR IN SECfION 3�00OF THE UBOR CODE, IMEREST, AND FTTORNEI"S FEES. LICENSED CON7RACTORS DECI.N�AnON: I heraby aHirm lhet I em Iicense0 under praWsions oi Chepter 9(commencing wilh Sectlan 7000) of Divislon 3 of ihe Buslness antl Professions Cotle, end my Iicense is In full force entl eNect. Lic. k Class a Contractofs Signeture: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirm that Ihere is e W�struction lending agenty for iha peAormanca of the work tor w�ich ihis permlt Is luuod. (Sec. 3097, CINI Code). Lentler's Name: Lenders Atltlress: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirtn t�at untler penalry of perjury thai I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business antl Prolessions Cotle: Any ciry or counry which requfres a pertnit to consWci, alter, improve, demolish, or repair eny strucWre, pnor to its issuance, also requires the applicent for such permit to file a slgned statement that he or she is licansetl pursuant �o the pmvisions ot ihe Contractors License Law (Chepter 9(commencing with Section 7000) of Division 3 of Ihe Business and Pmfeuions Code) or thet he or she is exempt therelrom enA the Dasls tor the ellegetl exemptlon. Any violeHon of Section 7031.5 by eny appliwnt tor a pertnit 5�1�@cis ihe epplicant to e civil panalry oi not more lhen fiva hundred dollere ($500).): �'�"�I, es owner ot Ihe ro e ployees with wages as their sole compensatlon, WILL DO THE WORK, entl the stmcture is not intentletl or oHeretl for sale (Sec. �� p p rty, or my em ��/ 7044, Business and Professions Code: The Coniractors License Law does not apply to an owner of property who builtls or improves Ihereon, entl who dces such work himself or herself or through his or her own employees, provided that such Improvamenis are not intendetl o� ottered lor sala. If, however, ihe builtling or improvement is sold within one year of completion, the owner-builtler vrill �ave Ihe burden of proving that he or she did not bui10 or imD�o�e for purpose of sale.). ❑ I, as owner of the pmperty, am EXCLUSIVELY CON7RACTNG WI7H LICENSED CONTRACTORS to mnstruct the project (Sec. 7044, Business ana Pmfessions Code: The contractors License Law does noi appty to an owner of property who builtls or impmves ihereon, entl who coNraIXs for such projec� with a comractor(s) Ilcense pursuant to the ContraC�ors License Laws.). ❑ I em e pt under sec. Business end Protessions Catle for this reeson: SignaWre: ��(.� Data: � ZZ Owner ID ve ed by dnvefs licen . ❑ Yes ❑ No Drivefs License No. �� Expires: �� Verification ot Ownership by (type ot tlocvment, i.e. - property tax bill or tleed): �IVISION OF INDUSTRIAL SAFET' PERMIT CERTIFICATION: ❑ I hereby cenity that no excava��on flva (5) ar more tee� in Cepth INo whlch a person Is requiretl to tlescentl, wlll be mede In connectlon with work authonzed by this permit, end that no building strucwre, scaHoltling, falsework, or demolilion or tlismantlinp thereoi, wlll be more Ihan thirty-six (36) feet high. (Chep. 32, Grp 2, An 2, Sec. 341, Title 8, Celifomia ACminis�retive Cotle). ❑ As owner-builtler, i will not employ enyone to do work w�ich woul0 require a pertnit trom iha Division ot Intlusiriel Salery, as no�etl above, unless such person has a parmit to do such work trom the tlivLsion. Signature: Date: Divislon ot Industrial Salery Pertnit Number. CERTIFICATE OF COMPLIANCE AND AUTHORIZATON OF ENTAV: I certity under penalty of parjury tha� I have reatl this epplication and stata that the information given is correct. I agree m comply with all sld�e laws and dry ordinances relaling to bullding construc�ion, and authodze representetives of Ihe Ciry of Caste Mesa ro enrer upon the aDove-�25cdpetl prop rty t r inspecilon purya5es. I agree not to occupy or ellow accupancy ol any bulltling au�hodzed by this permit until tinel inspectlon. u, i�:.��- � 22-�'� Tv�,.�, SigneWre Ot Legal Owner(s) Date And/Or Authorinetl Applicant COOE 1. INSPECTIONTYPE 1616 Fizotl System Finel Fire Pre�enilon 1268 Pool Spa Final 200 Final Re-Roof 201 Final BIocWReteining Well 202 Final Fectory Fira Place 203 Final Sign 204 Final Demolition 2d4&46 B9IE I[�d15 COUE� INSPECTIONTYFE 206 Final MBchBniCel 208 Finel Plumbing 210 Finel Electticel 212 Final Fire Prevemion 220 Finel Plenning Approval 222 Final Slte 250 Finel Bulltling/Occupanry Q�IF. IHililAlS . •r � 1 (774) 754-5273 • Fex (714) 754-4856 Job Address: 223 FAIRWAY PL Suite No CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT MECHANICAL PERMIT Vicinity: ADDITION @ SIDE/REAR OF PROPERTY Parcel Number: 4392'1210 � .i Applicant: MASKREY, BRIAN Address: 223 FAIRWAY � - i ' CA � -� COSTA MESA � ; �. � . Owner: MASKREY, BRIAN Address:�,223FAIRWAY'. � . " . , : i 'i �qi ':� i ,�� COSTA MESA % _ ,.: � '� �i/�i-=� % Contractor: �j�� - Address: � ' ' i , ,: i , . � � ' r Arch)Eng: r ^ � Address: � -� � .� � " �� . � '" : � , . . • � . Phone: (949)642-9675 � Zip: 92627 Phone: (949)642-9615 , Zip: 92627 Phone: . . . Z�R . . . , � � � License: , Phone: Zip: License: NUMBER M99-00368 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: OB/04/7999 Issued: OS/04/1999 ISSUED BY: ,�-� < . � � `� � SCOPE OF PERMIT INSTALL NEW FAU IN ATTIC - LESS THAN t00K BTU, f-GAS PIPING, 1-FACTORY � FIREPLACE (ICBO #NER-492), 2-VENT FANS, 1-KITCHEN HOOD�FOR � ADDITION/REMODEL. , . . � � . - � - f b' . � . _ . �, REF: B99-01008 . � _ - - � % r ISSUE FEE , � � � � , Inst FAU <700 k BTU . � Inst FAU>100 k BTU � � Repair/�AIt�Cooling/Heat � � Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU � RefrigSys>100�k8TU , Gas Piping . Factory Fireplace � � � Hood w/Mech EzhausC � VAV Box � : ��, Vent Fan / Single Duct � Appliance � Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm AirHandlers> t0000cfrn Floor Furnace Floor or Suspend Heater quantity $22.00 $1325 1 $0.00 0 so.00 0 ' $0.00 0 $0.00 ' 0 $0.00 0' $5:50 1. $9.50 7 $9.50 1 $0.00 0 $13.00 2 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 FEE SUMMARY � � _ - � ; �' Repair/AltAbsorbtionUnit � � . - � Repair / Alt Refrigeration Unit - , - - Ventillation System , � � �Evaporative Cooler , ` Commercial Incinerator . ' � � Domestic Incinerator - - " � Compressors/AbsorptionSvstems, , Upto3hp/100kBTU " � 3 To 15 hp / 500 k BTU �. 15 To 30 hp / 1,000 k BTU � � 30 To 50 hp / 7,750 k BTU Over 50 hp / Over 7,750 BTU � Boilers Up to 3 hp . � 3Tot5hp � i5to30hp 30 �to 50 hp " ' Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS I SPECIAL CONDITIONS � a � � 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 $0.00 $0.00 b72.75 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, 12-21-92) 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 period of 1 BO days. , INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapectiona 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 WORKERS' COMPENSATION DEC�NTION: � I hi3reby aHirm under penalry of perjury one ot the lollowing tleclarations: ❑ 1 heve end will maintain a cetlificate of wnsent to seli-Insure for workers' compensation, as provitlea for by section 3700 of the Labor Cotle, for ihe performance of the work for which this parmit is issued. ❑ I have and will maintain workers' compensatlon insurance, as requiretl by section 3700 of the Labor Code, for the performance of tha work for which this pertnit is issued. My workers' compensetion Ins�rance carrier end policy number are: Cerner. Policy Number: (This section need not be crompletetl �� the permit Is valued at one huntlred dollers ($100J or less.) ❑ I cenify that In ihe pertortnance of the work Por which ihis permit is issued, I shall not employ eny person in any menner so as to become subjem to the workers' compensation laws of California, antl agree ihat it I should become subject to the workers' compensation provisions of Section 3700 of Ihe Lebor Cotle, I shall forthwith comply with ihese pmvisians. Applicant SiqnaNre: Date: WAHNINO: FAILURE TO SECURE WORKEAS' CAMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJEGT AN EMPIOVER TO CRIMINAL PENALTIES AND CIVIL fINES UP TO ONE HUNDRED THOUSAND DOLLARE �bi00,OW), IN AODITIOtJ TO THE COST OF CqMPENSATION, DFMAGES AS PROVIDED FOF W SECTION 3106 OF THE LABOR CO�E, IMEREST, ANO ATTORNEY'S FEES. LICENSED CON7RAC70RS DECLARATION: I hereby affirtn Ihat I am licensed under provisions oi Chapter 9(commencing with Section 7000) of Oivision 3 of Ihe Business and Protessions Code, antl my license is in fu�l forco and eHect Lic. # Class k Contrector's Signeture: Date: CONSTRUCTION LEN�ING AGENC�: ❑ I hereby aHirtn that there is a cansiruction lending agency for Ihe pedormance of the work tor which �his permit is issuad. (Sec. 3097, Civil Code). Lenders Name: Lenders Atltlress: SignaWre: Date: OWNER-BUIIOER DECLAHATIONS: I hereby ettirm ihat untler penalry oi perjury that I am EXEMP7 FROM THE CON7RACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requiles a permit to constmct, altar, improve, tlemoiish, or repair any siructure, prior to its issuance, also requires the applicant for such permit to file a signed statement ihat he or she is licensed pursuant to ihe provislons of the CoNrectors License law (Chapter 9(commencing with Section 7000) of Division 3 ot Ihe Business and Professions Code) or that he or she Is exempt iherefrom antl �he basis for ihe allegetl exemption. Any violation of Section 7031.5 by eny applicant for a permit subjecis iha epplicant to e civll penelty of not more than five hundred tlollars ($500).): ❑ I, as owner of the property, or my employaes with wages as iheir sole compensation, WILL DO THE WORK, antl the structwe is not intended or otteretl for sale (Sec. 7044, Business antl Pmfessions Code: The Coniractors License Law does not apply to en owner of property who builds or improves Ihereon, and who does such work himself or herself or ihrough his or her own employees, provided that such improvements are not intended or oHeretl for sale. If, however, the builtling or improvement is sold within one year of completion, ihe owner-buiider will have the burden of proving ihat he or she tlid not build or improve for purpose o� sale.). � I, es owner of the property, en� EXCLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions Code: The contrectors License Lew tloes not appry to en owner of property who 6uiltls or improves ihereon, and who conirects for such prolect with e contractor(s) license pursuant to the Contracbrs License Lews.). p lam Signalure: Owner ID by drivers license. ❑ Yes ❑ No Businass and Professions Code for this reason: �ate: — f f Driver's License No. % Expires: — �00 Verification of Ownership by (type of document, i.e. - propetly tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenity ihat no excavation five (5) or more feet in depth into which a person is requlred to descend, will be made in connedion with work authorized by Ihis permit, and that no builtling siruc�ure, scafloltling, taisework, or demolition or dismantling ihereof, wili be more ihan thirry-six (36) taet high. (Chep. 32, Grp 2, Ah 2, Sec. 341, Title 8, Calitornia Administfative Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a permit irom ihe Division of Industriel Safery, as noied above, unless such person has a permit to do such work from the division. Signature: Date: Division oi Industnal Safety Permit Nomher: CERTFICATE OF COMPLIANCE AND AUfHORVJRION OF EN7RY: I certify under penalty of perjury that I have read Ihis application and state Ihat the intormation given is correct. I egree to compty with all state laws end ciry ordinances relating m buildinq consiructlon, end amhorize representatives of the Ciry of Costa Mesa to enter upon the a6ove-descnbetl propen o specf n pi oses. I agree not to occupy or allow occupancy of any building au�honzed by Ihis pertnit until final ins ection. �--_ � y- s� Signature Of Legal Owner(s) Date And/Or Authorized Applicant LODE II. MSPECTIONTVPE PAIE INTfilALS i6i6 Fixetl System Final Fire PreVention ,26y 200 207 Pool Spa Final Final Re-Roof Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition CO�EfI INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Pinel Electrical 212 Final Fire Preventlon 220 Finel Planning Approval 222 Finai 5ite 250 Final BuildingiOccupency 0 (714) 754-5273 • Fax (�ia) �sa-aess JobAddress: 223 FAIRWAYPL Suite No CITY OF COSTA MESA BUILD/NG DIVIS/ON DEVELOPMENT SERVICES DEPARTMENT PERMIT PLUMBING PERMIT Vicinity: ADDITION @ SIDE & REAR OF PROPERTY Parcel Nunmber: 43921210 App�icant: MASKREY, BRIAN Address: 223 FAIRWAY � ' � CA COSTA MESA ' . . . „��/�' -�� owner ';MASKREY„ BRIAN. �, . , , Addrsss- � 223 FAIRWAY-��. - - - � . � ;i�� . r� '� ,-, , , _ %�,ti7 . CA\.�' �i,j" ;' � - � bOSTA'MESA % , i � �-i./ i,�'/ ,� Coniractor: � N£� Phone: (949)642-9615 ,� Zip: 92627 "�. Phone: (949)642-9615 Zip: 92627 i � Address: � ,, . : :. ' . . - . � � � � � ' -Phone� , � -• ( ' .ArchlEng:; � j�Address, � � � - ' Zip: License: , , , Phone'. Zip: License: PER IT NUMBER P99-00445 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 08/04/1999 Issued: 08/04/1999 ISSUED BY: � �. �A- : � �� _� . _, , i � _ ' SCOPE OF PERMIT � - PLUMBING PERMIT FOR ADDITION/REMODEL OF SINGLE FAMILY-RESIDENCE. INSTALL t-BATHTUB, . 1�-DISHWASHER, 2-GAS OUTLETS, 1-SHOWER, 1-KITCHEN SINK, 1-WASH BASIN SET, & 1-WATER � ,�HEATER. - � . � � �REF:899-01008 y �� - AMT� QTY ISSUE FEE �� ; '- $22.00, �- � Backflow irrigation, $0.00 0 � BackflowPreJenter� �$0.00 �0 Bathtub � ' . $875 1 Clarifier System � ' . $0.00 . 0 Connect(Ice,Soda,etc)� ��$0.00 0 DentalUnits � ��$0.00 0 Dishwasher ' $8:75 7 Drein, Floor $0.00 _ 0 Drain, Rainwater $0.00 _ 0 Drain, Roof $0.00 0 Drinking Fountain $0.00 0 Expansion Tank $0.00 0 Gas Earthquake Valve $0.00 0 Gas (1� oullets) $5.50 1 Gas (Over 4 outlets) $D.00 0 Gas Repipe $0.00 0 Gas Service $0.00 0 Interceptors (Grease, Oil) $0.00 0 Interceptors (Sand Auto ) $0.00 0 FEE SUMMARY AMT' �, .a . ,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 SewerCapforDemo $0.00 � Sewer Connect $0.00 Sewer Private Line $0.00 Shower .,, $875 Sink, bar $0.00 Sink, commercial , .$0.00' Sink, Floor � $0.00 Sink, kitchen $8.75 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 0 0 0 0 0 D 0 0 0 0 1 0 0 0 1 0 0 0 COMMENTS / SPECIAL CONDITIONS , -.Sump Pump . � Swimming Pool Trap 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 Soflener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 ' $0.00 $0.00 $0.00 $0.00 $0.00 $8.75 $0.00 $8.75 $71.00 ) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $91.00 QTY 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 L 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 1 BO days, or if work is suspended or abandoned for a period of 1 BO days. . INSPECTIONS: In order for Ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapeetlona end flnal approval must ba ohtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTION5 CALL: (714) 754-5626 WORKERS'COMPENSAnON DECLARAnON: I hereby aHirtn under penalry at perjury one o� the following tleclaretions: ❑ I have antl will maintein e certificate oi consent to self-Insure for workers' compensetion, as providetl for by section 3700 of the Labor Cotle, for,iha pertortnance of ihe work for which this permit is Issued. ❑ I have antl will maintain workers' componsation insurance, as requiretl by section 3700 of the Labor Code, for ihe pedormance of Ihe work tor which inis permit is issued. My workars' compensation Insurance carner and policy number ere: Carrier. Policy Number: (This secfion neetl not be completed il the pe�it Is valueO et one hundred dollers ($700) or /essJ ❑ 1 certify that in Iha pertormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to ihe workers' compensation lews of Celifornia, entl e9�ee ihet if I should become subject m the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with Ihese pmvisians. Applicant Signa�ure: Da�e: WARNWG PAILURE TO SECURE WORKERS' CAM7ENSATION COVERAGE IS UNLAWPUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED TMOUSAND DOLLARE �$100,000), IN A�DRION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3/W OF iHE LABOR COOE, IMEREST, AND ATiORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn Ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Code, and my license is in full force end eflect. Lic. N_ _ Class # Contracbrs Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm that there is a coretruction lending egency for the peAormance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lenders Address: Signature: _ _ Date: OWNER•BUILDEfi DECLARA710NS: � I hereby affirm Ihat under penalry of perjury tdet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW toi ihe following reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or county which requires a peR�it to consWct, alter, improva, demolish, or repair any strudure, pnor to its issuance, also requires �he applicant for such permit to file e signed stetement that he or she is lica�sed pursuent to the provisions of ihe Coniractors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Cotle) or that he o� sha Is exempt ihereirom antl 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 mora than five huntlretl tlollars ($500).): I1] I, as owner ol iha propeny, or my employees wilh weges as their sole compensatlon, W1LL UO THE WORK, entl the strudure is not intentled or oReretl for sale (Sec. . 7044, Business and Professions Coda: The Contrectors License Law does not epply to an owner of property who huilds or improves Nereon, and who tloas such work '��. himsetl or herselt or through his or her Own employaes, provided that such improvemenis are not intended or offeretl For sale. If, however, the buildinq or improvement is �soltl within one year ot completion, Ne Jwnervbuilder will have ihe burtlen ot proving Ihat he or she tlitl not build or improve for purpose ot sale.). I, as owner ot ihe properry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRAC70R5 to consiruct ihe project (Sac. 7044, Businass and Protessions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracis fa such prqect with a con�ractor(s) Ilcense pursuant to ihe Con�rectors License laws.). � ❑ lam SignaNre: Owner ID • sec. by tlnver5liCense. ❑ Ves ❑ No eusiness and Professions Code tor ihis reason: ,/ % Expires: 3— �� Venfication of Ownership by (type of tlaumer��. i.e. - pmperty tau bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIGICATION: ❑ I hereby cartity ihat no excavation five (5) or more feet in depth into which a person is required to descentl, will be made in connection with work authorizetl by this permit, and Ihat no building siructure, sCaftolding, talsework, or demolition or tlismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Administretive Code). ❑ As owner-builder, I will not employ anyone to do work which woultl require a permit irom ihe Division of Industrial Safery, as notetl above, unless such person has a permit to do such wark from the division. Signature: Date: Division of Induslrial Safe�y Permit Number: CER7IFICATE OF COMPLIANCE AND AUTHORIZA710N OF EMAV: I certify under penalry of perjury that I have read this application and state that the information given is correct. I agree to compl with all state laws and ciry ordinances relating to building consiruction, end authorize represantatives of the City of Costa Mesa to eNer upon the above-descnbed prope o inspect, ion purposes. � agree not to occupy or allow occupancy oi eny builtling authorized by Ihis permit urtil final inlpec�ry, �G✓L� 0 Y � Signawre Ot Legal Owner(s) Date And/Or Authonzed Applicant CODE 1, INSPECTIONTY7E i6�6 Fixetl System Finel Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWFetaining Wall 202 Final Feclory Fire Place 203 Final Sign 204 Final Demolition 2446 46 j1�TE INTIfIALS �Qp� INSPECTIONTYVE 206 Final Mechanical 208 Final Plumbing 210 Final ElecMcal 212 Final Fire Prevention 220 Finel Planning Approval 222 Final Site 250 Final Builtling�Occupancy PATE INTRIALS /�F�:� O .� r (714) 754-5273 • Fax (714) 754-4856 CITY OF COSTA MESA BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT JobAddress: 223 FAIRWAYPL Suite: Vicinity: SIDE/REAR OF HOUSE Parcel Nunmber: 43921210 Applicant: MASKREY, BRIAN Address: 223 FAIRWAY CA COSTA MESA �;.' � owner: MASKREY, BRIAN � Address 223.FAIRWAY � !;CA . � �.��COSTA MESA � � _ . � . � ' � i. � . � Contractor: �� i � �� ,�Address: � ,-_� ,, � Zip: BUILDING PERMIT Zoning: Phone: (949)642-9615 " Zip: 92627 : . NUMBER ' I 699-01008 77 FAIR DRIVE, COSTA MESA, CA 92626 Phone: (949) 64&9615 � � � Zip: 92627 \ .`.. .. . Phone: License: Status: ISSUED Applied: O6I30/7999 Issued: 08/04/1999 ISSUED BY: � � Arch : CAC� � ' ' o' , ' Eng: � . " Address: , ' . � , ' , , � Address: � . - � - Phone: " . Phone: I �- `, Zip ` �' _� � � � , License: Zip: �� License: ` SCOPE OF PERMIT � ,�� ADD 845 SF SINGLE STORY ADDITION (MASTER BEDROOM, FAMILY ROOM & DINING ROOM) TO EXISTING SINGLE � FAMILY RESIDENCE. � � � ' � � " , � ., ` Plan Check � $458.90 ` • Permit: � ' $706.00 � � SMIP Res: � $7.05 `SMIP Com: $0.00 � �. Other. $0.00 �� Inspection:�� $0.00 . �� -Total: � $1,171.95 SETBACKS- � MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: o NOTES: Rear 0-0 Rear 0. 0 Reauired: 0 FEE SUMMARY , - . Calc Valuation: Claim Valuation: PLANNING & ZONING Left 0• 0 Lefl 0- 0 Proposed: 0 Righl 0- 0- Right 0-0 $�o,as�.so $65,000.00 � 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 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 requlred inepaetlons and final approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 � WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of p��jury one of the totlowing declarations: ❑ I have end will maintaln a certiflcete of consent to selFlnsure tor workers' compensation, es provitled for by secllon 3700 of ihe Lebor Cotle, for the pertormance of Ihe work lor which IhiS permit is issuea. ❑ I have and will maintain workers' compensation insurance, as requiretl by section 3700 of (he LeDor Code, for the pedormance of Ihe work lor which this permit is issued. My workers' compensation I�surance cerner and policy number ere: Carrier: pollcy Number: (This section need nat be campleted ll fhe Oermit is velued et one huntlred dollers ($100) or less.) ❑ I certily that in ihe peAormance of the work for which this permit is issuetl, I shell not employ any person in any menner so es to become subject to Ihe workers' compensetion laws ot Califomia, and egree Ihat It I shoultl become subject to the workers' compensation provisions of Section 3700 of ihe LaDor Code, I shell toRhwith comply with ihese Drovision5. Applicant Signeture: Date: WnRNING: FAILURE TO SECIIRE WOflKERS' COMPENSATION CAVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOIXJE HUNDRED T}IOUSAND DOLLARE (3100,000), IN ADDRION TO THE COST OF ODtdPENSATION, DPh41GES AS PROVIDED FOR IN SECiION 3]OB OF THE LABOR COOE, IMEREST, AND AiTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm that I am licensetl under provisions of Chepter 9(commencing with Sec�ion 7000) of Dlvlslon 3 of iha Business and Professions Code, antl my license is In full force and eMecL Lic. # Class q Contractors Signature: Dete: CONS7RUC710N LENDING AGENCV: ❑ I hereby attirtn ihat there is a construction lentlinq agency for the peAortnance ot the work tor which this pertnit Is luued. (Sec. 3097, Clvil Code). Lenders Name: Lentler's Address: Signature: Date: OWNER-BUILDER �ECLARA710NS: I hereby affirtn Ihat under penalry Of perjury thai I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business antl Professions Code: Any ciy or counry which requires e permit to construct, alter, impmva, demolish, or repair any sWCNre, prior to its issuence, elso requires iha epplicant Por such permit to fiie a signetl statement ihet he o� she is licensetl pursuant to ihe provislons of the Contrectors License Law (Chepter 9(commencing with Sectlon 7000) of Dlvislon 3 oi Ihe Business and Profeuions Code) Or Nat he ar she is e:empt iherefrom entl the 6asi5 for ihe allegeA exemption. Any vlolation ot Section 7031.5 by eny epplicant for a permit sub�ecis Ihe epplicant to e civil penalry of not more Ihan five �untlred dollars (5500).): ❑ I, as owner of the O�operty, or my employees with weges as their sola compensetion, WILL DO THE WORK, antl the structure is not intended ar oHerea lor sale (Sec. 7044, Business antl Pmfessions Code: The Contractors License Lew does not appty to an owner of property who builtls or improves Ihereon, antl who does such work himself or herselt or through his or her own employees, provitled that such improvements are not Intended or oMeretl ior sale. If, howaver, ihe building or ImpmvemeN is sold within ona year of comple�ion, �he owner-builde� will have the burden of proving that he or she did not builtl or improve tor purpose of sele.). �I, as owner of the pmperry, am E%CLUSIVELV CONTRAC7ING WITH LICENSED CON7RACTORS to constmct the project (Sec. 7044, Business end Professions Coda: The contractors License Lew does not epply to en owner of pmperry who builds or improves thereon, and who conireas for such pro)ect with a contractor(s) license pursuant to the CONfactors License Laws.). ❑ I am eze pt un r s c. � Signature: _� Owner ID venfietl by tlnver's license. ❑ Yes ❑ No Business end Prolessions Cotle lor this reason: Verifcation oi Ownership by (rype of dwument, i.e. - pmperty tax bill or deed): DIVISION OF INDUSTHIAL SAFETY PERMIT CERTIFICATION: Dnvers Licanse No. Date: �- � — Ezpires: � 3—Y �� ❑ I hereby ceriity �hat no exca�a6on five (5) or more feet in tlepih Into which e pereon is requlred to descend, will be matle In connection with work authonzetl by this pertnit, end that no building sWCWre, scaffoltling, falsework, or demolition or tlismentling ihereof, will be more ihen ihirry-six (36) feet high. (Chep. 32, Gry 2, An 2, Sec. 341, Title 8, Califomia Atlmin�strative Code). ❑ As ownerbuilder, I will not employ anyone to tlo work w�ich would require a permit Irom the �ivision of Industnal Safery, as noted above, unless such pereon has a permit to tlo such work irom ihe tlivision. Signature: Date: Division of Induslrial Sately Pertnit Number: CERTIFICATE OF COMPLIANCE AND AUTHORVATION OF EMRY: I certity under penalry of perjury tha� I hava read this application antl state thet Ihe intortnation given is correct. I agree ro comply wilh all state lews and ciry ordinences relating to 6uiltlinq construction, and euthorize representatives of the Ciry of Costa Mesa to enter upon Ihe above-describetl pr rty inspe � n pyrposes. � agree fwt b xcupy or allow occupanry ot any bulWing aui�odzeU by this permit until final inspec; n. Y1�-- X �y s � Signature Ot Legal Owner(s) Date And/Pr Authorized Applicent CO�E M. INSVECTIONTYPE 1616 Fi:etl System Finel Fire P�eventian 1266 Poal Spa Finel 200 Finel Re-Rooi 201 Finel BIocWRataining Wall 202 Finel Fettory Flre Plece 203 Finel Sign 204 Finel Demolition QB¢, 7�$ �d INSPECiIONTYPE 206 Final Mec�anical 20B Flnel Plumbing 210 Final Electncal 212 Final Fire Preventlon 220 Finel Plenning Appro�el 222 Final Site 250 Finel Building/Occupancy PAg � 1tffII1B45 "" Y-JV-/V SUILDING PERMIT N0. e SUBCONTRAGTOR ROUGH PLUMBING PROP. SWR. LINE � SPRINKLING SVSTEM MISCELLnNE0U5 NOUSE ROOGH MEATING ANO AIR CONDITIONING TEMPORaRY SERVICE OR POLE UN�ERGFOUNO � POWER ❑ ROUGH WIRING TRENCHES [ FOfiMS STEEL REINF. FLOOF SVSTEM 90N� BEPM � STEEL REINFORCE ❑ SMEATHING �� _ FRAME AND FLASHING I GTXINf. — IN n PLASTER ST^^cTU H G SPECIPL REOU�AEMENTS F C Lcl a a y � .'L' F G w F r.i ..1 Q 7 r .� � m a � � a z LL7 T 3 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING /) /1 n �T . _ . . . _ '77/�. OWNER �R / �/� S MAIL 0�� ADDRESS L.� ,�A cirv �/iS�.O /v/E BRANCM ADDRESS AflCHITECT ADDRESS CONTRACTOR �� ADDFESS �� T�s�.� � STATE LIC. NO��OZ � SIZE OF LOT USE OF TEL. ' V r . TEL. ' � � NO. CITV LIC. NO. INO.OF LB�DGS. NOW ON LOT Separate permits are required for electric, plumbing and heating work. OF BUILDING AND WORK TO BE PERFORA rQ/z,¢G; �' � 4 x ' S I hereby acknowletlBe that i have read this apPlication antl stete that the above informetlon is corraci and agree to comply wit� all laws re0��eting builtling construction, antl I sholl not employ any De�son in violation of Mo workman's compensailon laws ot the Stntt of Californle. I haraby cartify that 1 em proparly licensatl az a contrecior untlar the SWte of Callfornle Busineu antl Professions Code, Divlelon 3, Chaptar 9, antl thnt such Ilconms are in 4�II forca nntl atfoct, or i am exampt frOm tha provlalOns Of the Sie[e of CalitOrnia Bu61nBEs entl Professlons Cotlo, Givislon 3, ha r 9. SlBneture � • PermlttBe Auffiori Ageni `?R 30-7F�wc�fl01761'> --*':':48.SC CA 'ION FOR STRUCI'URAL PERMIT ED V TE ECE D T I UED � ' � ^'17�� O P RMITNO. O. L— E 5 (r(,�� W � . TRACT � J LOT BLOCK ADD A GU �' 2�1 / „ _ _ _ . � VALUE / . �a � APPROV OATE%� � ' ZO NO.OF USE OF NEW'�� • � PIAN$ 2 BUILDING VAROSAPPROVED VARDSAPPROVED MAIN BUIIDING ACCESSORV BUILDII (FROMGLSTREET) . � _ � DISfANCE BET. BET. MAIN & / / MAIN BLDGS. ACCESS. BLDGS. lD VAfi.sW OATE 30- n m i m i SQ.FT. w THE AMOUNTSHOWN UNDER VALUATION �S FOR m THE PURP06E OF ESiABLISHING A PERMIT FEE ONLV: e VALUATION PERMIT FEE S. d � N m ' / ^� / PLAN CHECK $ ^� LL'�C � o g / d TAx E � .� u TOTALPAID y